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Medical Surgical Nursing

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https://www.readbyqxmd.com/read/27925447/rehospitalization-of-preterm-infants-according-to-the-discharge-risk-level
#1
Burcu Aykanat Girgin, Güler Cimete
PURPOSE: The rehospitalization rate of preterm infants is between 22 and 52% within the first year after discharge. The purpose of this study was to investigate the rehospitalization of preterm infants within 2 months following discharge, considering the level of risks originating from the infant, parents, and the social factors. DESIGN AND METHODS: The sample was composed of 238 preterm infants and their parents. The data were collected with a Descriptive Information Form, the Post-Discharge Infant Follow-up Form, and the Neonatal Discharge Assessment Tool (N-DAT)...
December 7, 2016: Journal for Specialists in Pediatric Nursing: JSPN
https://www.readbyqxmd.com/read/27924674/work-load-and-management-in-the-delivery-room-changing-the-direction-of-healthcare-policy
#2
Gianfranco Sfregola, Antonio Simone Laganà, Roberta Granese, Pamela Sfregola, Angela Lopinto, Onofrio Triolo
Nurse staffing, increased workload and unstable nursing unit environments are linked to negative patient outcomes including falls and medication errors on medical/surgical units. Considering this evidence, the aim of our study was to overview midwives' workload and work setting. We created a questionnaire and performed an online survey. We obtained information about the type and level of hospital, workload, the use of standardised procedures, reporting of sentinel and 'near-miss' events. We reported a severe understaffing in midwives' work settings and important underuse of standard protocols according to the international guidelines, especially in the South of Italy...
December 7, 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27908955/measuring-family-satisfaction-with-care-delivered-in-the-intensive-care-unit
#3
Kathleen Clark, Kerry A Milner, Marlene Beck, Virginia Mason
BACKGROUND: In our competitive health care environment, measuring the experience of family members of patients in the intensive care unit to ensure that health care providers are meeting families' needs is critical. Surveys from Press Ganey and the Centers for Medicare and Medicaid Services are unable to capture families' satisfaction with care in this setting. OBJECTIVE: To implement a sustainable measure for family satisfaction in a 12-bed medical and surgical intensive care unit...
December 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27908945/norwood-procedure-for-palliation-of-hypoplastic-left-heart-syndrome-right-ventricle-to-pulmonary-artery-conduit-vs-modified-blalock-taussig-shunt
#4
Dorothy M Beke
Patients with hypoplastic left heart syndrome undergo a series of operations to separate the pulmonary and systemic circulations. The first of at least 3 operations occurs in the newborn period, with a stage I palliation. The goal of stage I palliation is to provide pulmonary blood flow and create an unobstructed systemic outflow tract. Advances in surgical techniques and intraoperative and postoperative care have helped decrease morbidity and mortality for patients with hypoplastic left heart syndrome who have the stage I Norwood operation, but the patients continue to be at increased risk for hemodynamic collapse and adverse outcomes...
December 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27906769/measuring-harm-in-health-care-optimizing-adverse-event-review
#5
Kathleen E Walsh, Polina Harik, Kathleen M Mazor, Deborah Perfetto, Milena Anatchkova, Colleen Biggins, Joann Wagner, Pamela J Schoettker, Cassandra Firneno, Robert Klugman, Jennifer Tjia
OBJECTIVE: The objective of this study was to identify modifiable factors that improve the reliability of ratings of severity of health care-associated harm in clinical practice improvement and research. METHODS: A diverse group of clinicians rated 8 types of adverse events: blood product, device or medical/surgical supply, fall, health care-associated infection, medication, perinatal, pressure ulcer, surgery. We used a generalizability theory framework to estimate the impact of number of raters, rater experience, and rater provider type on reliability...
November 30, 2016: Medical Care
https://www.readbyqxmd.com/read/27906736/an-exploratory-descriptive-study-of-registered-nurse-innovation-implications-for-levels-of-adoption
#6
Debra Polster, Dana Villines
PURPOSE: The aims of this study were to describe registered nurses' levels of personal innovativeness and registered nurses' perceived organizational innovativeness and determine the relationship between these 2 variables. BACKGROUND: There is limited research to describe the levels of innovation of nurses within a hospital. The levels of innovation can determine the likelihood of adoption of evidence-based practices at the bedside. As change agents, clinical nurse specialists can determine successful implementation strategies tailored to nurse levels of innovation...
January 2017: Clinical Nurse Specialist CNS
https://www.readbyqxmd.com/read/27904743/frontline-worker-perceptions-of-medication-safety-in-india
#7
Sangeeta Sharma, Fauzia Tabassum, Sarbjeet Khurana, Kaveri Kapoor
BACKGROUND: To explore interprofessionals' perceptions about patient safety, particularly medication safety and associated factors and barriers. METHODS: A total of 389 respondents were recruited using convenience sample in the cross sectional survey. RESULTS: Medication safety was perceived as somewhat safe (60%). One-third of respondents witnessed 3-4 or more medication errors (MEs) within the past 1 year. Out of that, one quarter were reportedly, sentinel events...
December 2016: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/27903757/beyond-hand-hygiene-a-qualitative-study-of-the-everyday-work-of-preventing-cross-contamination-on-hospital-wards
#8
Su-Yin Hor, Claire Hooker, Rick Iedema, Mary Wyer, Gwendolyn L Gilbert, Christine Jorm, Matthew Vincent Neil O'Sullivan
BACKGROUND: Hospital-acquired infections are the most common adverse event for inpatients worldwide. Efforts to prevent microbial cross-contamination currently focus on hand hygiene and use of personal protective equipment (PPE), with variable success. Better understanding is needed of infection prevention and control (IPC) in routine clinical practice. METHODS: We report on an interventionist video-reflexive ethnography study that explored how healthcare workers performed IPC in three wards in two hospitals in New South Wales, Australia: an intensive care unit and two general surgical wards...
November 30, 2016: BMJ Quality & Safety
https://www.readbyqxmd.com/read/27899248/unexplained-increases-in-serum-vancomycin-concentration-in-a-morbidly-obese-patient
#9
REVIEW
Sean P Kane, Scott D Hanes
INTRODUCTION: To report a case of increases in vancomycin concentrations without additional vancomycin doses being given. CASE STUDY: A 64 year-old morbidly obese female received three total doses of vancomycin for surgical prophylaxis and for ventilator-associated pneumonia. Subsequent vancomycin concentrations from the patient's central venous catheter (CVC) demonstrated increasing drug levels from 27.1 to 45.9mcg/mL despite no additional vancomycin being given and proper line flushing prior to sample collection...
November 26, 2016: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/27898697/risk-of-death-influences-regional-variation-in-intensive-care-unit-admission-rates-among-the-elderly-in-the-united-states
#10
Colin R Cooke
RATIONALE: The extent to which geographic variability in ICU admission across the United States is driven by patients with lower risk of death is unknown. OBJECTIVES: To determine whether patients at low to moderate risk of death contribute to geographic variation in ICU admission. METHODS: Retrospective cohort of hospitalizations among Medicare beneficiaries (age > 64 years) admitted for ten common medical and surgical diagnoses (2004 to 2009)...
2016: PloS One
https://www.readbyqxmd.com/read/27895940/real-time-reporting-of-small-operational-failures-in-nursing-care
#11
Kathleen R Stevens, Robert L Ferrer
Addressing microsystem problems from the frontline holds promise for quality enhancement. Frontline providers are urged to apply quality improvement; yet no systematic approach to problem detection has been tested. This study investigated a self-report approach to detecting operational failures encountered during patient care. Methods. Data were collected from 5 medical-surgical units over 4 weeks. Unit staff documented operational failures on a small distinctive Pocket Card. Frequency distributions for the operational failures in each category were calculated for each hospital overall and disaggregated by shift...
2016: Nursing Research and Practice
https://www.readbyqxmd.com/read/27894030/fatigue-in-hospital-nurses-supernurse-culture-is-a-barrier-to-addressing-problems-a-qualitative-interview-study
#12
Linsey M Steege, Jessica G Rainbow
BACKGROUND: Fatigue in hospital nurses is associated with decreased nurse satisfaction, increased turnover and negative patient outcomes. Addressing fatigue in nurses has been identified as a priority by many organizations worldwide in an effort to promote both a culture of patient safety and a healthy nursing workforce. OBJECTIVES: The overall aim of this study was to explore barriers and facilitators within the hospital nurse work system to nurse coping and fatigue...
November 21, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/27893510/preparing-critical-care-and-medical-surgical-nurses-to-open-a-new-hospital
#13
Odette Y Comeau, Josette Armendariz-Batiste, Jennifer Grant Baer
Building a new hospital is an exciting time. However significant planning is required to prepare staff to assume care of patients in an environment with new workflow changes and new equipment. The challenges of this advanced preparation are compounded when the opening of the new hospital includes the planned move of the inpatient census of patients from an existing hospital to the new hospital. Goals and objectives on the move day include patient and staff safety, with a seamless transition to the new environment...
January 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27892247/family-satisfaction-with-patient-care-in-critical-care-units-in-pakistan-a-descriptive-cross-sectional-study
#14
Younas Ahtisham, Parveen Subia, Victor Gideon
AIM: To assess family satisfaction with care provided to patients in critical care units in Islamabad. METHOD: A descriptive cross-sectional study was conducted in 11 medical and surgical critical care units at two private hospitals in Islamabad, Pakistan. The purposive sample consisted of 323 immediate family members and other relatives and friends (referred to as family members in this article) of 323 patients admitted to the critical care units for at least 24 hours...
November 23, 2016: Nursing Standard
https://www.readbyqxmd.com/read/27888716/family-participation-in-intensive-care-unit-rounds-comparing-family-and-provider-perspectives
#15
Selena S Au, Amanda Roze des Ordons, Andrea Soo, Simon Guienguere, Henry T Stelfox
PURPOSE: To describe and compare intensive care unit (ICU) patient family member and provider experiences, preferences, and perceptions of family participation in ICU rounds. METHODS: Cross-sectional survey of ICU family members and providers of patients admitted to 4 medical-surgical ICUs from September 2014 to March 2015. MEASUREMENTS AND MAIN RESULTS: Surveys were completed by 63 (62%) family members and 258 (43%) providers. Provider respondents included physicians (9%), nurses (56%), respiratory therapists (24%), and other ICU team members (11%)...
November 4, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27884219/the-role-of-the-perioperative-nurse-in-improving-surgical-patients-clinical-outcomes-and-satisfaction-beyond-medication
#16
Patricia Bruckenthal, Melanie H Simpson
For the perioperative nurse, the management of postsurgical pain includes various responsibilities, such as performing postsurgical pain assessments as an essential first step, facilitating recovery from surgery, and maximizing patient satisfaction during the postsurgical period. In addition, nurses are responsible for providing patient education regarding pain management, the quality of which may strongly influence patient satisfaction. External and internal challenges exist in perioperative care processes, however, and addressing these challenges will promote the overall goal of providing high-quality care...
December 2016: AORN Journal
https://www.readbyqxmd.com/read/27884218/the-current-state-of-perioperative-pain-management-challenges-and-potential-opportunities-for-nurses
#17
Melanie H Simpson, Patricia Bruckenthal
Achievement of adequate postoperative pain management is a critical challenge in health care, with an estimated three out of four adult surgical patients reporting moderate to extreme pain after surgery. Overreliance on opioids in acute care settings has persisted, despite well-known adverse side effects frequently associated with this class of drugs. Furthermore, patients with a history of chronic opioid use present additional challenges in terms of postsurgical pain management. Advances in the development of newer analgesic agents and anesthetic techniques may be useful in surgical patients with a history of chronic opioid use and in the overall surgical patient population...
December 2016: AORN Journal
https://www.readbyqxmd.com/read/27880987/assessing-surgical-research-at-the-teaching-hospital-level
#18
Kate E McBride, Jane M Young, Paul G Bannon, Michael J Solomon
BACKGROUND: To undertake a comprehensive needs assessment to determine the baseline of surgical research activity at a tertiary referral hospital in Sydney, Australia. METHOD: The comprehensive needs assessment comprised three components: a retrospective audit of the hospital ethics committee records to identify surgical research activity; a survey of all 17 surgical departments about the availability of 10 potential research resources and a survey of surgical staff to ascertain perceptions of research culture at the organizational, team and individual levels...
November 23, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27878785/lesions-requiring-wound-management-in-a-central-tertiary-neonatal-intensive-care-unit
#19
Angéla Meszes, Gyula Tálosi, Krisztina Máder, Hajnalka Orvos, Lajos Kemény, Zsanett Renáta Csoma
BACKGROUND: Most of the skin disorders that occur in neonatal intensive care units are due in part to the immaturity and vulnerability of the neonatal skin. Various iatrogenic diagnostic and therapeutic procedures are also conducive to iatrogenic damage. This study was to review the neonates admitted to our neonatal intensive care unit who needed wound management, and to assess the most common skin injuries and wounds, and their aetiology. METHODS: Data were extracted from medical records of neonates who needed wound management in our Neonatal Intensive Care Unit between January 31, 2012 and January 31, 2013...
November 23, 2016: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/27878350/home-return-after-surgery-in-patients-aged-over-85%C3%A2-years-is-associated-with-preoperative-albumin-levels-the-type-of-surgery-and-apache-ii-score
#20
Bora Lee, Sungwon Na, Miran Park, Sungyeon Ham, Jeongmin Kim
BACKGROUND: Owing to an aging society, both the number of operations for patients aged >85 years and the average age of patients admitted to the intensive care unit (ICU) are rapidly increasing. However, mortality is not an appropriate outcome measurement in patients aged >85 years; a more important outcome is home return (HR), because quality of life is valuable to these patients. We identified predictors for HR of patients aged >85 years admitted to the ICU after surgery...
November 22, 2016: World Journal of Surgery
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