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Christine A DeForest, Virginia Blackman, John E Alex, Lauren Reeves, Alejandra Mora, Crystal Perez, Joseph Maddry, Domenique Selby, Benjamin Walrath
Introduction: Military prehospital and en route care (ERC) directly impacts patient morbidity and mortality. Provider knowledge and skills are critical variables in the effectiveness of ERC. No Navy doctrine defines provider choice for patient transport or requires standardized provider training. Frequently, Search and Rescue Medical Technicians (SMTs) and Navy Nurses (ERC RNs) are tasked with this mission though physicians have also been used. Navy ERC provider training varies greatly by professional role...
March 14, 2018: Military Medicine
Laura J Olivieri, David Zurakowski, Karthik Ramakrishnan, Lillian Su, Fahad A Alfares, Matthew R Irwin, Jenna Heichel, Axel Krieger, Dilip S Nath
BACKGROUND: Postoperative care delivered in the pediatric cardiac intensive care unit (CICU) relies on providers' understanding of patients' congenital heart defects (CHDs) and procedure performed. Novel, bedside use of virtual, three-dimensional (3D) heart models creates access to patients' CHD to improve understanding. This study evaluates the impact of patient-specific virtual 3D heart models on CICU provider attitudes and care delivery. METHODS: Virtual 3D heart models were created from standard preoperative cardiac imaging of ten patients with CHD undergoing repair and displayed on a bedside tablet in the CICU...
March 2018: World Journal for Pediatric & Congenital Heart Surgery
Chetan P Huded, Michael Johnson, Kathleen Kravitz, Venu Menon, Mouin Abdallah, Travis C Gullett, Scott Hantz, Stephen G Ellis, Seth R Podolsky, Stephen W Meldon, Damon M Kralovic, Deborah Brosovich, Elizabeth Smith, Samir R Kapadia, Umesh N Khot
BACKGROUND: Women with STEMI receive suboptimal care and have worse outcomes than men. Whether strategies to reduce STEMI care variability impact disparities in the care and outcomes of women with STEMI is unknown. OBJECTIVES: We assessed the care and outcomes of men vs. women with STEMI before and after implementation of a comprehensive STEMI protocol. METHODS: On 7/15/14 we implemented: (1) emergency department catheterization lab activation, (2) STEMI Safe Handoff Checklist, (3) immediate transfer to an immediately available catheterization lab, and (4) radial first approach to percutaneous coronary intervention (PCI)...
March 7, 2018: Journal of the American College of Cardiology
Donna K Bigani, Andrea M Correia
PURPOSE: The purpose of this study was to explore nurse, patient, and family perceptions about change-of-shift bedside report in the pediatric setting and to describe specific safety concerns that were identified during change-of-shift handoff. DESIGN AND METHODS: An exploratory-descriptive qualitative study designed to elicit nurse, patient, and family experience with change-of-shift bedside report was utilized for this study. Interviews were conducted and reviewed to identify common themes...
March 5, 2018: Journal of Pediatric Nursing
Jennifer O'Rourke, Joanna Abraham, Lee Ann Riesenberg, Jeff Matson, Karen Dunn Lopez
AIM: To identify the core components of nurse-nurse handoffs. BACKGROUND: Patient handoffs involve a process of passing information, responsibility and control from one caregiver to the next during care transitions. Around the globe, ineffective handoffs have serious consequences resulting in wrong treatments, delays in diagnosis, longer stays, medication errors, patient falls and patient deaths. To date, the core components of nurse-nurse handoff have not been identified...
March 8, 2018: Journal of Advanced Nursing
Jennifer M Singleton, Leon D Sanchez, Barbara A Masser, Betzalel Reich
Admission handoff is a high-risk component of patient care. Previous studies have shown that a standardized physician electronic signout ("eSignout") may improve ED-to-inpatient handoff safety and efficiency in teaching hospitals. This model has not yet been studied in non-teaching hospitals. The objectives of the study were to determine the efficiency of an eSignout platform at a community affiliate hospital by comparing ED length of stay (LOS) for a 5-month period before and after implementation and to compare the quality assurance (QA) events among admitted patients for the same time period...
March 7, 2018: Internal and Emergency Medicine
Bridgette L Kram, Jennifer M Schultheis, Shawn J Kram, Christopher E Cox
PURPOSE: To evaluate whether a pharmacist-initiated electronic handoff tool can reduce the overall, and potentially inappropriate, hospital discharge prescribing rate of atypical antipsychotics (AAP) initiated in AAP-naive critically ill adults. METHODS: This pre-post quality improvement study was initiated in 5 intensive care units (ICUs) at a large academic medical center. An electronic handoff tool (iVent) was utilized in the post-intervention period to enhance pharmacist communication at inpatient transitions of care...
January 1, 2018: Journal of Pharmacy Practice
Meredith Merz Lind, Marco Corridore, Cameron Sheehan, Melissa Moore-Clingenpeel, Tensing Maa
Objective To design and assess an advanced pediatric airway management course, through simulation-based team training and with multiple disciplines, to emphasize communication and cooperation across subspecialties and to provide a common skill set and knowledge base. Methods Trainees from anesthesiology, emergency medicine, critical care, pediatric surgery, and otolaryngology at a tertiary children's hospital participated in a 1-day workshop emphasizing airway skills and complex airway simulations. Small groups were multidisciplinary to promote teamwork...
February 1, 2018: Otolaryngology—Head and Neck Surgery
Julia Geynisman-Tan, Oluwateniola Brown, Margaret Mueller, Katarzyna Bochenska, Sarah Collins, Christina Lewicky-Gaupp, Kimberly Kenton
OBJECTIVES: This study aimed to determine if personnel handoffs or number of learners in the operating room (OR) are associated with longer OR times in women having pelvic organ prolapse surgery. METHODS: A retrospective review of women undergoing prolapse surgery in 2016 was conducted. Demographics; procedure; OR, anesthetic, and surgical time; number of handoffs between anesthesia members, circulators, and surgical technologies; and number of learners were abstracted...
March 2018: Female Pelvic Medicine & Reconstructive Surgery
Moon Sung Park
We often overlook the importance of several safety issues such as identification of patients, timeout procedure, hand hygiene, handoff communication, and many others. This ignorance, along with many other issues, leads to medical error being ranked as a third leading cause of death in the U.S. Consequently, quality improvement (QI) has become one of the major subjects in healthcare despite a relatively short history. Improving quality is about making healthcare safe, effective, patient-centered, timely, efficient, and equitable...
January 2018: Korean Journal of Pediatrics
Marianne Storm, Jörn Schulz, Karina Aase
OBJECTIVE: The study objective was to assess the effects of an interorganisational educational intervention called the 'Meeting Point' on patient safety culture among staff in hospital and nursing home wards. DESIGN: The study employs a quasi-experimental, non-randomised design with a hospital and nursing home intervention group and a hospital and nursing home control group. The study uses one preintervention and two postintervention survey measurements. The intervention group participated in an educational programme 'The Meeting Point' including interorganisational staff meetings combining educational sessions with a discussion platform focusing on quality and safety in transitional care of the elderly...
January 31, 2018: BMJ Open
Andrew P Reimer, Celeste M Alfes, Amanda S Rowe, Bianca M Rodriguez-Fox
BACKGROUND: Patient handoffs between care teams have been recognized as a major patient safety risk due to inadequate exchange or loss of critical information, especially during emergent patient transfers. The purpose of this literature review was to identify the essential elements of effective patient handoffs in emergency situations to develop a standardized tool to support a structured patient handoff procedure capable of guiding education and training. METHOD: A literature search of handoff procedures and patient transfers was conducted using the Cumulative Index to Nursing and Allied Health Literature and PubMed between 2008 and 2015...
January 1, 2018: Journal of Continuing Education in Nursing
Christopher R Leon Guerrero, Tracy Anderson, Allyson R Zazulia
OBJECTIVE: To determine the relationship between neurology inpatient satisfaction and (1) number of physicians involved in the patient's care and (2) patients' ability to identify their physicians. METHODS: A 10-item questionnaire addressing patient satisfaction and identification of physicians on the care team was administered to patients admitted to an academic, tertiary care, inpatient neurology service from May 1 to October 31, 2012. We hypothesized higher satisfaction among patients having fewer physicians on the care team and among patients able to identify their physicians...
January 19, 2018: Neurology
Brittany Ransom, Karen Winters
What is the effectiveness of the I-PASS mnemonic in reducing handoff related errors during inter- or intrahospital transfers for hospitalized patients?The objective of this systematic review is to identify the impact of the I-PASS mnemonic during hospitalized patient inter- or intrahospital transfers on medication errors, transfer delays, treatment delays and mortality.More specifically, the objective is to identify the effect that the I-PASS mnemonic has on handoff related errors during inter or intrahospital patient transfers by comparing rates pre and post I-PASS implementation...
January 2018: JBI Database of Systematic Reviews and Implementation Reports
Mi Yu, Hyang Yuol Lee, Gwen Sherwood, Eun Man Kim
AIM AND OBJECTIVES: This study aimed to examine nursing handoff, identify causes of handoff errors, evaluate current methods of handoff, and determine the factors associated with handoff evaluation in delivery rooms and neonatal units of hospitals in South Korea. BACKGROUND: Handoff is a critical communication process in clinical settings. Less attention has been paid to the handoff practice to assure safe perinatal care in hospitals. DESIGN: This is a cross-sectional descriptive study...
January 3, 2018: Journal of Clinical Nursing
Katherine M Ernst, Sara A McComb, Cathaleen Ley
AIMS AND OBJECTIVES: To qualitatively investigate the medical-surgical nurse shift handoff as a process within the workflow of the exchanging nurses. Specifically, this study sought to identify the ideal handoff, ways the handoff deviated from ideal, and subsequent effect on nursing care. BACKGROUND: The functions as well as information content of the handoff have been studied. However, typical studies look at the handoff as an isolated activity utilising nurse perceptions as the primary measure of quality...
January 4, 2018: Journal of Clinical Nursing
Anne Ray Streeter, Nancy Grant Harrington
No abstract text is available yet for this article.
January 5, 2018: Seminars in Oncology Nursing
Brodie Parent, Lacey N LaGrone, Mohamed T Albirair, Peter T Serina, Jonathan M Keller, Joseph Cuschieri, Erin J Addison, Lapio Choe, Genecelle B Delossantos, Cameron E Gaskill, Sarah D Moon, Jestine T MacDonald, Matthew J Stolzberg, Erik G Van Eaton, Jennifer M Zech, Patricia A Kritek
Importance: Clinician miscommunication contributes to an estimated 250 000 deaths in US hospitals per year. Efforts to standardize handoff communication may reduce errors and improve patient safety. Objective: To determine the effect of a standardized handoff curriculum, UW-IPASS, on interclinician communication and patient outcomes. Design, Setting, and Participants: This cluster randomized stepped-wedge randomized clinical trial was conducted from October 2015 to May 2016 at 8 medical and surgical intensive care units at 2 hospital systems within an academic tertiary referral center...
January 3, 2018: JAMA Surgery
Amalia Cochran
No abstract text is available yet for this article.
January 3, 2018: JAMA Surgery
Vaughn A Starnes, Maura E Sullivan
Introduction Recent changes in surgical education have had an impact on our congenital training programmes. The mandate of the 8-hour workweek, a rapidly expanding knowledge base, and a host of other mandates has had an impact on the readiness of the fellows who are entering congenital programmes. To understand these issues completely, we interviewed the top congenital experts in the United States of America. The purpose of this paper is to share their insight and offer suggestions to address these challenges...
December 2017: Cardiology in the Young
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