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Medical Surgical Nursing

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https://www.readbyqxmd.com/read/28107301/implementation-of-a-pediatric-orthopaedic-bundle-to-reduce-surgical-site-infections
#1
Jan Schriefer, James Sanders, Julie Michels, Kori Wolcott, Connor Ruddy, Jenna Hanson
Surgical site infections (SSIs) cost an estimated $27,288 per case. An analysis of the National Surgical Quality Improvement Program data at the University of Rochester Medical Center suggested that rates of SSIs could be lowered in comparison with both peers and baseline. The aim of this study was to reduce the number of SSIs to zero through the implementation of a "bundle" or a combination of practices. Meetings were held with the multidisciplinary care team that includes surgeons and staff from pediatric pharmacy, pediatric infectious diseases, anesthesia, and nursing to create a care bundle for all pediatric orthopaedic surgery patients...
January 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28105882/quality-improvement-in-hospitals-barriers-and-facilitators
#2
Dick E Zoutman, B Douglas Ford
Purpose The purpose of this paper is to examine quality improvement (QI) initiatives in acute care hospitals, the factors associated with success, and the impacts on patient care and safety. Design/methodology/approach An extensive online survey was completed by senior managers responsible for QI. The survey assessed QI project types, QI methods, staff engagement, and barriers and factors in the success of QI initiatives. Findings The response rate was 37 percent, 46 surveys were completed from 125 acute care hospitals...
February 13, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28103397/the-economic-burden-of-nurse-sensitive-adverse-events-in-22-medical-surgical-units-retrospective-and-matching-analysis
#3
Eric Tchouaket, Carl-Ardy Dubois, Danielle D'Amour
AIMS: To assess the economic burden of nurse-sensitive adverse events (NSAEs) in 22 acute care units in Quebec by estimating excess hospital-related costs and calculating resulting additional hospital days. BACKGROUND: Recent changes in the worldwide economic and financial contexts have made the cost of patient safety a topical issue. Yet our knowledge about the economic burden of safety of nursing care is quite limited in Canada in general and Quebec in particular...
January 19, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28101983/working-to-define-professionalism-in-pediatric-anesthesiology-a-qualitative-study-of-domains-of-the-expert-pediatric-anesthesiologist-as-valued-by-interdisciplinary-stakeholders
#4
Justin L Lockman, Alan Jay Schwartz, Peter F Cronholm
BACKGROUND: Unprofessional behavior is a significant problem throughout graduate medical education programs and medical centers. Some authors have suggested that professionalism curricula should be focused toward faculty, not trainees, to interrupt the modeling of unprofessionalism. Developing such curricula requires a needs assessment and is challenging given data indicating that the definition of professionalism varies based on medical specialty. Thus, a specialty-specific definition of professionalism is needed as a first step in any curriculum development...
February 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28100958/routine-dyspnea-assessment-and-documentation-nurses-experience-yields-wide-acceptance
#5
Kathy M Baker, Susan DeSanto-Madeya, Robert B Banzett
BACKGROUND: Dyspnea (breathing discomfort) is a common and distressing symptom. Routine assessment and documentation can improve management and relieve suffering. A major barrier to routine dyspnea documentation is the concern that it will have a deleterious effect on nursing workflow and that it will not be readily accepted by nurses. Nurses at our institution recently began to assess and document dyspnea on all medical-surgical patients upon admission and once per shift throughout their hospitalization...
2017: BMC Nursing
https://www.readbyqxmd.com/read/28096015/association-of-medication-errors-with-drug-classifications-clinical-units-and-consequence-of-errors-are-they-related
#6
Maki Muroi, Jay J Shen, Alona Angosta
Registered nurses (RNs) play an important role in safe medication administration and patient safety. This study examined a total of 1276 medication error (ME) incident reports made by RNs in hospital inpatient settings in the southwestern region of the United States. The most common drug class associated with MEs was cardiovascular drugs (24.7%). Among this class, anticoagulants had the most errors (11.3%). The antimicrobials was the second most common drug class associated with errors (19.1%) and vancomycin was the most common antimicrobial that caused errors in this category (6...
February 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28093837/effects-of-simulation-education-on-oral-care-practices%C3%A2-%C3%A2-a-randomized-controlled-trial
#7
Miia M Jansson, Hannu P Syrjälä, Pasi P Ohtonen, Merja H Meriläinen, Helvi A Kyngäs, Tero I Ala-Kokko
BACKGROUND: Implementation of evidence-based oral care protocols, nurse education programmes and assessment tools may reduce the risk of developing ventilator-associated pneumonia by increasing critical care nurses' knowledge and skills in adhering to current oral care recommendations. AIMS: To evaluate the longitudinal effects of single-dose simulation education with structured debriefing and verbal feedback on critical care nurses' knowledge and skills in adhering to current oral care recommendations...
January 16, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/28076685/diffusion-of-evidence-based-intensive-care-unit-organizational-practices-a-state-wide-analysis
#8
Rachel Kohn, Vanessa Madden, Jeremy M Kahn, David A Asch, Amber E Barnato, Scott D Halpern, Meeta Prasad Kerlin
RATIONALE: Several intensive care unit (ICU) organizational practices have been associated with improved patient outcomes. However, the uptake of these evidence-based practices is unknown. OBJECTIVE: To assess diffusion of ICU organizational practices across the state of Pennsylvania. METHODS: We conducted two web-based, cross-sectional surveys of ICU organizational practices in Pennsylvania acute care hospitals, in 2005 (chief nursing officer respondents) and 2014 (ICU nurse manager respondents)...
January 11, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28073733/antibiotic-therapy-and-staphylococcal-skin-infections-in-a-tropical-malarial-zone-guyana-practices-in-conventional-and-exceptional-situations
#9
S-P Corcostegui, H Lefort, A Dia, V Pommier de Santi, C Carfantan, J Galant, E Lightburne, P Guénot, X Deparis, R Migliani, J-J Morand
A problem of community-acquired Staphylococcus aureus skin infections emerged in the French armed forces in 2004, in a malaria-endemic areas. The high incidence rate led us to evaluate military staff practices. This was a cross-sectional survey of doctors and nurses deployed as officers in French Guyana since 2006. The definition of skin and soft-tissue infection came from the criteria for epidemiological surveillance of the armed forces. We studied the management of antibiotic therapy and its related difficulties...
November 1, 2016: Médecine et Santé Tropicales
https://www.readbyqxmd.com/read/28068158/follow-up-after-rectal-cancer-developing-and-testing-a-novel-patient-led-follow-up-program-study-protocol
#10
Ida Hovdenak Jakobsen, Therese Juul, Inge Bernstein, Peter Christensen, Frank Svendsen Jensen, Christoffer Johansen, Susie Lindhardt Larsen, Søren Laurberg, Mogens Rørbæk Madsen, Ole Thorlacius-Ussing, Henriette Vind Thaysen
BACKGROUND: The main treatment for non-metastatic rectal cancer (RC) is surgical resection. Late adverse effects that are highly prevalent and negatively impact patients' symptom burden and quality of life are: bowel-, urological and sexual dysfunctions; psychological distress; fear of recurrence. Patients and clinicians have requested a more patient-centred follow-up, balancing the focus on detection of recurrence, and physiological and psychological late adverse effects. The current follow-up program primarily focuses on detection of recurrence, with less attention on late adverse effects...
January 9, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28063274/morbidity-and-functional-outcomes-with-head-and-neck-free-flap-reconstruction-in-patients-aged-90%C3%A2-years-or-older
#11
Adam P Fagin, Savannah Gelesko, Mark K Wax, Daniel Petrisor
PURPOSE: Morbidity of free tissue transfer in the extremes of age is controversial and not well studied in patients aged 90 years or older because of the rarity of these patients and many clinicians' natural hesitancy to perform such a large operation in patients of this group. The purpose of this study was to answer the following clinical question: Do patients aged 90 years or older who undergo free flap reconstruction have worse functional outcomes than their younger counterparts? MATERIALS AND METHODS: We performed a retrospective chart review of patients aged 90 years or older who underwent free flap reconstruction at Oregon Health and Science University Hospital from 2000 to 2015...
December 18, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28062329/managing-symptoms-enhancing-patients-self-management-knowledge-and-skills-for-surgical-recovery
#12
REVIEW
Jan Odom-Forren, Susan Wesmiller
OBJECTIVES: To review postoperative symptoms experienced by patients following surgery for cancer and discuss focused, evidenced-based methods to teach the patient acute pain and symptom management to include both pharmacological and non-pharmacological strategies. DATA SOURCES: Peer reviewed articles and national guidelines. CONCLUSION: Although significant advances have been made in providing effective acute pain control, pain remains a serious consequence after cancer surgery...
January 3, 2017: Seminars in Oncology Nursing
https://www.readbyqxmd.com/read/28056819/quality-of-care-assessment-and-improvement-in-aortic-stenosis-rationale-and-design-of-a-multicentre-registry-impulse
#13
Norbert Frey, Richard P Steeds, Antonio Serra, Eberhard Schulz, Stephan Baldus, Matthias Lutz, Christiane Pohlmann, Jana Kurucova, Peter Bramlage, David Messika-Zeitoun
BACKGROUND: Severe aortic stenosis (AS) is a common, serious valve disease in which no effective medical therapy is available and, if not treated by intervention, has a 5-year survival of only 40-60%. Despite the availability of guidelines supporting the effective use of surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI) to treat the majority of these patients, adherence to these guidelines in clinical practice is still unsatisfactory. Several recent studies have emphasised the necessity for improved communication between multidisciplinary teams, with the aim to ensure that severe AS patients receive appropriate treatment...
January 5, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28032558/early-learners-as-health-coaches-for-older-adults-preparing-for-surgery
#14
Jennifer A Kaplan, Zabecca Brinson, Rebecca Hofer, Patricia O'Sullivan, Anna Chang, Helen Horvath, George J Chang, Emily Finlayson
BACKGROUND: Few opportunities exist for early learners to engage in authentic roles on health care teams. In a geriatric optimization clinic for frail high-risk surgical patients, first-year medical and nurse practitioner students were integrated into an interprofessional team as health coaches. MATERIALS AND METHODS: Frail surgical patients with planned operations were referred to a new preoperative optimization clinic to see a geriatrician, occupational, and physical therapists and a nutritionist...
October 20, 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/28032071/exploring-nurse-s-communicative-role-in-nurse-patient-relations-a-qualitative-study
#15
Ali Fakhr-Movahedi, Zahra Rahnavard, Mahvash Salsali, Reza Negarandeh
Introduction: Recognition the nurses' communicative roles can influence quality of patient's care. Therefore, this study was aimed to explore nurse's role in nurse-patient relations. Methods: This study was a qualitative research in which collected data was analyzed by content analysis method. The participants were 23 nurses, patients and their families in medical and surgical wards of a referral hospital in Tehran, Iran. Data were collected by semi-structured interview and observation. Results: Data analysis was led to the emergence of a main conceptual category: The patient's need-based communication...
December 2016: Journal of Caring Sciences
https://www.readbyqxmd.com/read/28025061/understanding-resident-performance-mindfulness-and-communication-in-critical-care-rotations
#16
Kevin Real, Katelyn Fields-Elswick, Andrew C Bernard
OBJECTIVE: Evidence from the medical literature suggests that surgical trainees can benefit from mindful practices. Surgical educators are challenged with the need to address resident core competencies, some of which may be facilitated by higher levels of mindfulness. This study explores whether mindful residents perform better than their peers as members of the health care team. DESIGN: This study employed a multiphase, multimethod design to assess resident mindfulness, communication, and clinical performance...
December 23, 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/28013104/the-impact-of-nursing-delirium-preventive-innterventions-in-the-intensive-care-unit-underpin-icu-a-study-protocol-for-a-multi-centre-stepped-wedge-randomized-controlled-trial
#17
Annelies Wassenaar, Paul Rood, Lisette Schoonhoven, Steven Teerenstra, Marieke Zegers, Peter Pickkers, Mark van den Boogaard
BACKGROUND: Delirium is a common disorder in Intensive Care Unit (ICU) patients and is associated with serious short- and long-term consequences, including re-intubations, ICU readmissions, prolonged ICU and hospital stay, persistent cognitive problems, and higher mortality rates. Considering the high incidence of delirium and its consequences, prevention of delirium is imperative. This study focuses on a program of standardized nursing and physical therapy interventions to prevent delirium in the ICU, called UNDERPIN-ICU (nUrsiNg DEliRium Preventive INterventions in the ICU)...
December 8, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28009735/mock-pages-are-a-valid-construct-for-assessment-of-clinical-decision-making-and-interprofessional-communication
#18
Margaret L Boehler, Cathy J Schwind, Stephen J Markwell, Rebecca M Minter
IMPORTANCE: Answering pages from nurses about patients in need of immediate attention is one of the most difficult challenges a resident faces during their first days as a physician. A Mock Page program has been developed and adopted into a national surgical resident preparatory curriculum to prepare senior medical students for this important skill. OBJECTIVE: The purpose of this study is to assess standardized mock page cases as a valid construct to assess clinical decision making and interprofessional communication skills...
January 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28005564/usability-evaluation-and-implementation-of-a-health-information-technology-dashboard-of-evidence-based-quality-indicators
#19
Mark Christopher Schall, Laura Cullen, Priyadarshini Pennathur, Howard Chen, Keith Burrell, Grace Matthews
Health information technology dashboards that integrate evidence-based quality indicators can efficiently and accurately display patient risk information to promote early intervention and improve overall quality of patient care. We describe the process of developing, evaluating, and implementing a dashboard designed to promote quality care through display of evidence-based quality indicators within an electronic health record. Clinician feedback was sought throughout the process. Usability evaluations were provided by three nurse pairs and one physician from medical-surgical areas...
December 21, 2016: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/27993407/evaluation-of-the-effect-of-an-intervention-on-the-nutritional-status-of-hospitalized-patients
#20
Isabel Miguel Montoya, Rafael Ortí Lucas, Esperanza Ferrer Ferrándiz, David Martín Baena, Raimunda Montejano Lozoya
BACKGROUND AND OBJECTIVES: To compare the nutritional status of a population of hospitalized patients, divided into 2 different groups, both at admission and hospital discharge, and to assess the influence of nutritional alteration during the hospital stay. MATERIAL AND METHODS: Quasi-experimental study comprising 2 groups of patients (N=581); an intervention group (n=303), in which nurses received specific training on managing care methodology, and a control group (n=278), in which nurses continued their usual dynamics...
December 16, 2016: Medicina Clínica
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