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Journal of Nursing Care Quality

Kara Misto, Cynthia Padula, Elizabeth Bryand, Kate Nadeau
BACKGROUND: While there are many benefits of electronic medical record documentation, the presence of a computer may adversely affect provider-patient interaction. PURPOSE: The purpose of this project was to examine staff nurses' perception of the impact of electronic documentation in the presence of the patient on the nurse-patient relationship. METHODS: A survey was administered to 276 staff nurses, and open-ended interviews were conducted with 11 novice and 20 expert nurses...
July 2, 2018: Journal of Nursing Care Quality
Staci Sue Reynolds, Chris Sova, Bridget McNalty, Suzanne Lambert, Bradi Granger
BACKGROUND: Evidence supports daily bathing using chlorhexidine gluconate (CHG) cloths to decrease preventable hospital-acquired central line-associated bloodstream infections (CLABSIs). However, implementation of this practice is inconsistent. Using multifaceted strategies to promote implementation is supported in the literature, yet there is a gap in knowing which strategies are most successful. PURPOSE: Using the Grol and Wensing Model of Implementation as a guide, the purpose of this study was to determine whether using tailored, multifaceted strategies would improve implementation of daily CHG bathing and decrease CLABSIs in a large neuro ICU...
July 2, 2018: Journal of Nursing Care Quality
Katja Janhunen, Päivi Kankkunen, Tarja Kvist
BACKGROUND: Pediatric patients comprise a large user group for emergency services. However, few studies have concerned the views of children and parents on emergency care. PURPOSE: To describe and compare assessments of the quality of pediatric emergency care by children and their parents. METHODS: Ninety-eight children and their parents from 4 emergency departments participated in the survey. Data were analyzed using descriptive methods and logistic regression analysis...
July 2, 2018: Journal of Nursing Care Quality
Ibrahim Salami, Maha Subih, Rima Darwish, Muntaha Al-Jbarat, Zyad Saleh, Mahmoud Maharmeh, Jafar Alasad, Rasmieh Al-Amer
BACKGROUND: Medication administration errors (MAEs) have short- and long-term implications on patients' health as well as on hospitals' accreditation and financial status. PURPOSE: The purpose was to explore Jordanian nurses' perceptions about MAEs. METHODS: A cross-sectional design was used with a convenience sample of 470 nurses. RESULTS: The most common types of MAEs were wrong time (32.6%) and wrong patient (30.5%)...
July 2, 2018: Journal of Nursing Care Quality
Amy J Spooner, Wendy Chaboyer, Leanne M Aitken
BACKGROUND: Interruptions during handover may compromise continuity of care and patient safety. LOCAL PROBLEM: Interruptions occur frequently during handovers in the intensive care unit. METHODS: A quality improvement study was undertaken to improve nursing team leader handover processes. The frequency, source, and reason interruptions occurred were recorded before and after a handover intervention. INTERVENTIONS: The intervention involved relocating handover from the desk to bedside and using a printed version of an evidence-based electronic minimum data set...
June 18, 2018: Journal of Nursing Care Quality
Jennifer R Hunt, Kelli Jo Ouellette, Michelle Reece
BACKGROUND: Heart failure (HF) is the leading cause of hospitalization among older adults in the United States. Health systems target readmission rates for quality improvement and cost reduction. LOCAL PROBLEM: Heart failure core measure (CM) scores at our medical center were lower than the national average, and methods for capturing the appropriate documentation on HF patients to ensure CM compliance were not clear. METHODS: An interdisciplinary team determined barriers to increasing CM scores, gathered baseline data, and identified gaps in the existing process...
June 14, 2018: Journal of Nursing Care Quality
Denise Cooper, Marilyn McFarland, Francesca Petrilli, Cherrell Shells
BACKGROUND: Nursing home providers face challenges in urinary tract infection assessment and treatment, often prescribing unnecessary antibiotics for asymptomatic bacteriuria, a practice that can result in adverse drug reactions, drug resistance, and an increase in antibiotic-associated diarrhea. PURPOSE: The purpose of this project was to replicate the Cooper Urinary Tract Infection Program in another facility and measure its effectiveness. METHODS: Using a pre-post design, this project was implemented at a 120-bed, long-term care and rehabilitation facility located in the Midwest United States...
June 14, 2018: Journal of Nursing Care Quality
Yingyan Chen, Frances Lin, Andrea Marshall
BACKGROUND: The safety and effectiveness of same day discharge (SDD) following percutaneous coronary intervention are well demonstrated; however, the uptake of this model of care is low. PURPOSE: The aim was to examine the effectiveness of implementing SDD using a process evaluation methodology. METHODS: This study was undertaken in a cardiac services department of a tertiary teaching hospital in southeast Queensland, Australia. It was anticipated before the implementation that 120 patients could be discharged the same day in a 6 months' time period...
June 14, 2018: Journal of Nursing Care Quality
J Margo Brooks Carthon, Linda Hatfield, Colin Plover, Andrew Dierkes, Lawrence Davis, Taylor Hedgeland, Anne Marie Sanders, Frank Visco, Sara Holland, Jim Ballinghoff, Mary Del Guidice, Linda H Aiken
BACKGROUND: Nurse engagement is a modifiable element of the work environment and has shown promise as a potential safety intervention. PURPOSE: Our study examined the relationship between the level of engagement, staffing, and assessments of patient safety among nurses working in hospital settings. METHODS: A secondary analysis of linked cross-sectional data was conducted using survey data of 26 960 nurses across 599 hospitals in 4 states...
June 8, 2018: Journal of Nursing Care Quality
Bernadette Bumpers, Valorie Dearmon, Paula Dycus
BACKGROUND: The aim of this quality improvement project was to determine whether a communication bundle would impact parents' ratings of nurse-child communication in relation to (a) how often the nurse listened carefully to the child and (b) how often the nurse explained things in a way easy for the child to understand. LOCAL PROBLEM: The Child Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores on the unit lagged behind the hospital's 75th percentile external benchmark established by the National Research Corporation...
June 8, 2018: Journal of Nursing Care Quality
Kathleen Rice Simpson, Audrey Lyndon
BACKGROUND: Nurses can be exposed to hundreds of alarms during their shift, contributing to alarm fatigue. PURPOSE: The purposes were to explore similarities and differences in perceptions of clinical alarms by labor nurses caring for generally healthy women compared with perceptions of adult intensive care unit (ICU) and neonatal ICU nurses caring for critically ill patients and to seek nurses' suggestions for potential improvements. METHODS: Nurses were asked via focus groups about the utility of clinical alarms from medical devices...
June 8, 2018: Journal of Nursing Care Quality
Elizabeth C Schenk, Ruth A Bryant, Catherine R Van Son, Tamara Odom-Maryon
BACKGROUND: Despite continued efforts to improve safety in hospitals, hospital-acquired harm persists. Strategies have been identified to establish patient-centered care and improve patient engagement with care. However, the relationship of patient and family engagement to reduction of harm is not well understood, with limited findings available in current literature. PURPOSE: This qualitative study explored the perceptions and attitudes of patients and family members and several clinical disciplines toward patient engagement in reducing preventable harm in hospitalized patients...
June 8, 2018: Journal of Nursing Care Quality
Mary Godley, Jeanne B Jenkins
BACKGROUND: Patient satisfaction scores in the vascular interventional radiology department were low, especially related to wait times in registration and for tests/treatments, with low scores for intentions to recommend. PURPOSE: The purpose of our quality improvement project was to decrease wait times and improve patient satisfaction using Lean Six Sigma's define, measure, analyze, improve, and control (DMAIC) framework with a pre-/postintervention design. RESULTS: There was a statistically significant decrease in wait times (P < ...
June 8, 2018: Journal of Nursing Care Quality
Stephanie D Drobny, Amy Snell, Lisa Morris, Cathy Harshbarger, Pat Village, Shelly A Fischer
BACKGROUND: Peer review is an essential element of professional nursing practice. LOCAL PROBLEM: Implementing nursing practice peer review is a challenge in any organization; some characteristics of small and rural hospitals can make the task especially daunting. METHODS: A team of nursing leaders and staff nurses from rural and critical access hospitals within 1 health care system was formed to make recommendations about implementing nursing practice peer review in the small rural facilities...
June 8, 2018: Journal of Nursing Care Quality
Rebecca Culver Clark, Kimberly Ferren Carter, Julie Jackson, Deborah Hodges
The purpose of this quality improvement study was to explore the impact of audit and feedback on the pneumococcal immunization rate for at-risk adults in ambulatory settings. Study findings support the hypothesis that timely, individualized audit and feedback can have a positive impact on immunization rate; generalized feedback that did not provide actionable information did not have the same impact. The difference between the interventions was significant, χ (1, N = 1993) = 124.7, P <.001.
July 2018: Journal of Nursing Care Quality
Ivana Dehorney, Pamela F Ashcraft
Two major cost concerns related to joint replacement surgery are patient length of stay (LOS) and 30-day hospital readmission rates. A quality improvement project was implemented to evaluate the impact of a joint replacement program on patient readmissions and hospital LOS. A total of 1425 patients older than 50 years participated. At the end of the project period, readmission rates decreased from 6.19% to 2.8% and average LOS decreased from 5.87 days to 2.7 days.
July 2018: Journal of Nursing Care Quality
Jenny Spahr, Jennifer Coddington, Nancy Edwards, Sara McComb
The Patient-Centered Medical Home care model emphasizes efficient, coordinated care distributed among interdisciplinary team members. One key function to care coordination is referral/test tracking. This study evaluated the referral practices in a nurse-managed Patient-Centered Medical Home primary care clinic. The major findings corroborate the need for a well-organized referral-tracking system that is centralized and contains safety nets to reduce the number of delayed or missed referrals.
July 2018: Journal of Nursing Care Quality
Gregory L Alexander, Richard Madsen
No abstract text is available yet for this article.
July 2018: Journal of Nursing Care Quality
Richard Ricciardi, Marjorie Shofer
No abstract text is available yet for this article.
July 2018: Journal of Nursing Care Quality
Yina Han, Jung Eun Choi, Yin Ji Jin, Tai Xian Jin, Sun-Mi Lee
Nurses working in intensive care units have expressed concern that some categories of the Braden scale such as activity and nutrition are not suitable for intensive care unit patients. Upon examining the validity of the Braden scale using the electronic health data, we found relatively low predictability of the tool. Risk factors from the sensory perception and activity categories were not associated with risk of pressure ulcers.
July 2018: Journal of Nursing Care Quality
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