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Journal of Nursing Care Quality

Lisa Zubkoff, Julia Neily, Beth King, Storm Morgan, Yinong Young-Xu, Shoshana Boar, Peter Mills
The Veterans Health Administration implemented a Virtual Breakthrough Series to prevent pressure ulcers. The pressure ulcer rate decreased from 1.2 to 0.9 per 1000 bed days of care (P = .017). The most common interventions were education (N = 26; 68%), improved documentation (N = 23; 61%), and the use of equipment and supplies (N = 21; 55%). In summary, this project helped improve pressure ulcer rates in the Veterans Health Administration and presents a promising model for implementing a virtual model for improvement...
November 29, 2016: Journal of Nursing Care Quality
Carman Turkelson, Michelle Aebersold, Richard Redman, Dana Tschannen
Effective interprofessional communication is critical to patient safety. This pre-/postimplementation project used a multifaceted educational strategy with high-fidelity simulation to introduce evidence-based communication tools, adapted from Nursing Crew Resource Management, to intensive care unit nurses. Results indicated that participants were satisfied with the education, and their perceptions of interprofessional communication and knowledge improved. Teams (n = 16) that used the communication tools during simulation were more likely to identify the problem, initiate key interventions, and have positive outcomes...
November 21, 2016: Journal of Nursing Care Quality
Hui-Ying Chiang, Ya-Chu Hsiao, Huan-Fang Lee
Nurses' safety practices of medication administration, prevention of falls and unplanned extubations, and handover are essentials to patient safety. This study explored the prediction between such safety practices and work environment factors, workload, job satisfaction, and error-reporting culture of 1429 Taiwanese nurses. Nurses' job satisfaction, error-reporting culture, and one environmental factor of nursing quality were found to be major predictors of safety practices. The other environment factors related to professional development and participation in hospital affairs and nurses' workload had limited predictive effects on the safety practices...
November 21, 2016: Journal of Nursing Care Quality
Suzanne Purvis, Gregory D Kennedy, Mary Jo Knobloch, Amy Marver, John Marx, Susan Rees, Nasia Safdar, Daniel Shirley
Leadership engagement is an important aspect of integrating best practices at the bedside. The catheter-associated urinary tract infection (CAUTI) prevention workgroup at our academic medical center implemented leadership rounding in partnership with clinical staff to increase participation in CAUTI prevention initiatives on inpatient units. There was an associated decrease in urinary catheter utilization and CAUTI rates. Implementation of leadership rounds should be considered as a part of comprehensive CAUTI prevention efforts in health care settings...
November 21, 2016: Journal of Nursing Care Quality
Haesun Seol, Mark Thompson, Kathryn Evans Kreider, Allison Vorderstrasse
The burden of diabetes is greater for minorities and medically underserved populations in the United States. An evidence-based provider-delivered diabetes self-management education intervention was implemented in a federally qualified health center for medically underserved adult patients with type 2 diabetes. The findings provide support for the efficacy of the intervention on improvement in self-management behaviors and glycemic control among underserved patients with diabetes, while not substantially changing provider visit time or workload...
November 21, 2016: Journal of Nursing Care Quality
Eun Young Hur, Yinji Jin, Taixian Jin, Sun-Mi Lee
The Johns Hopkins Fall Risk Assessment Tool (JHFRAT) is relatively new in Korea, and it has not been fully evaluated. This study revealed that the JHFRAT had good predictive validity throughout the hospitalization period. However, 2 items (fall history and elimination patterns) on the tool were not determinants of falls in this population. Interestingly, the nurses indicated those 2 items were the most difficult items to assess and needed further training to develop the assessment skills.
November 10, 2016: Journal of Nursing Care Quality
Xin Zhang, Shih-Yu Lee, Jingli Chen, Huaping Liu
This study analyzed risk factors for medication/near-miss errors in the neonatal intensive care unit by using Grey Relational Analysis based on self-incident reports from staff nurses. The ASSESS-ERR Medication System Worksheet was used. A total of 156 medication/near-miss errors were found across 5 stages of the medication use process. The order prescribing stage had the most errors. The highest systemic risk factors were critical drug information missing; environmental, staffing, and workflow problems; and lack of staff education...
November 8, 2016: Journal of Nursing Care Quality
Sarah J Bahr, Danielle M Siclovan, Kristi Opper, Joseph Beiler, Kathleen L Bobay, Marianne E Weiss
The Consolidated Framework for Implementation Research guided formative evaluation of the implementation of a redesigned interprofessional team rounding process. The purpose of the redesigned process was to improve health team communication about hospital discharge. Themes emerging from interviews of patients, nurses, and providers revealed the inherent value and positive characteristics of the new process, but also workflow, team hierarchy, and process challenges to successful implementation. The evaluation identified actionable recommendations for modifying the implementation process...
November 1, 2016: Journal of Nursing Care Quality
Cynthia Holt, Valorie Dearmon, Sherry M Lawrence, Chrystal L Lewis, Christine E Skotzko
This quality improvement project evaluates the effectiveness of implementing an evidence-based alcohol withdrawal protocol in an acute care setting. Patient outcomes, length of stay, and nurses' knowledge and satisfaction with care are compared pre- and postimplementation. Implementation resulted in significant reduction of restraint use, transfers to critical care, 1:1 observation, and length of stay, whereas no reduction was seen in rapid response calls. Nurses' knowledge post-alcohol withdrawal protocol education increased and satisfaction with patient care improved...
October 26, 2016: Journal of Nursing Care Quality
(no author information available yet)
No abstract text is available yet for this article.
January 2017: Journal of Nursing Care Quality
Kermit G Davis, Susan E Kotowski, Matthew T Coombs
Patient migration, or the amount of movement toward the foot of the bed, has been shown to significantly vary because of the mechanical design differences in hospital beds. Previously, the amount of migration was measured immediately following head-of-bed articulation in healthy subjects. This study not only evaluates how much migration occurs immediately after head-of-bed articulation but also measures additional migration during a standard 2-hour repositioning period in subjects with limited mobility.
January 2017: Journal of Nursing Care Quality
Jacob W Turmell, Lola Coke, Rachel Catinella, Tracy Hosford, Amy Majeski
The purpose of this article is to describe the impact of an evidence-based alarm management strategy on patient safety. An alarm management program reduced alarms up to 30%. Evaluation of patients on continuous cardiac monitoring showed a 3.5% decrease in census. This alarm management strategy has the potential to save $136 500 and 841 hours of registered nurses' time per year. No patient harm occurred during the 2-year project.
January 2017: Journal of Nursing Care Quality
Milisa Manojlovich, David Ratz, Melissa A Miller, Sarah L Krein
Although the Awakening and Breathing Coordination, Delirium assessment, and Early exercise/mobility (ABCDE) bundle may be effective, individual components of ABCDE may not be implemented as intended. We examined the use of daily interruption of sedation (DIS) and early mobility, looking for an association between these bundle elements. Despite the growing use of DIS and early mobility, the two do not seem to be adopted together, with serious implications for the effectiveness of the ABCDE bundle.
January 2017: Journal of Nursing Care Quality
Kelley H Pattison, Anita Heyman, Jennifer Barlow, Kali Barrow
No abstract text is available yet for this article.
January 2017: Journal of Nursing Care Quality
Sarah Xiao, Kimberley Widger, Ann Tourangeau, Whitney Berta
Identifying how nursing care directly affects patients is essential to improving care quality, reducing costs, and determining nursing's contribution to overall organizational performance. This scoping review examined methods used for developing nursing process health care indicators. Key concepts and sources of evidence were identified to lay a foundation for future development and identification of valid and reliable nursing process health care indicators.
January 2017: Journal of Nursing Care Quality
Jessie Reich, Kathryn Farrell, Courtney Maloney, Deborah Drayton, Tonya Johnson
Falls with injury are a persistent patient safety challenge in the acute care setting. This article describes the creation and implementation of a Certified Falls Prevention Advocate (CFPA) program on a medical-surgical unit. The program created standardization of nursing support staff involvement in falls prevention and engaged them as members of the interdisciplinary team. The CFPA program was an important element in the unit's improvement in falls with injury rates. The mean falls with injury rate decreased from 1...
January 2017: Journal of Nursing Care Quality
Nahla Tayyib, Fiona Coyer
This article reports on the development and implementation process used to integrate a care bundle approach (a pressure ulcer [PU] prevention bundle to improve patients' skin integrity in intensive care) and the Ottawa Model of Research Use (OMRU). The PU prevention care bundle demonstrated significant reduction in PU incidence, with the OMRU model providing a consolidated framework for the implementation of bundled evidence in an effective and consistent manner into daily clinical nursing practice.
January 2017: Journal of Nursing Care Quality
Vanessa Ervin Lyons, Lori L Popejoy
Surgical safety checklists were introduced to improve patient safety. Urban and rural hospitals are influenced by differing factors, but how these factors affect patient care is unknown. This study examined time-out and checklist processes in rural and urban operating rooms and found that although checklist use has been adopted in many organizations, use is inconsistent across both settings. An understanding of these variations is needed to improve utilization.
January 2017: Journal of Nursing Care Quality
Yvonne Ford, Anita Heyman
Patients' perceptions of satisfaction, understanding, participation, and feelings of safety were significantly correlated with the frequency of bedside handoff. Mean responses to survey items in these areas were significantly higher for patients who "always" experienced bedside handoff than for those who experienced it sporadically. Quality improvement strategies were effective in increasing the frequency of bedside handoff.
January 2017: Journal of Nursing Care Quality
Sung-Heui Bae
This integrative review synthesized evidence on the consequences of the Centers for Medicare & Medicaid Services (CMS) nonpayment policy on quality improvement initiatives and hospital-acquired conditions. Fourteen articles were included. This review presents strong evidence that the CMS policy has spurred quality improvement initiatives; however, the relationships between the CMS policy and hospital-acquired conditions are inconclusive. In future research, a comprehensive model of implementation of the CMS nonpayment policy would help us understand the effectiveness of this policy...
January 2017: Journal of Nursing Care Quality
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