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Patient safety in nursing

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https://www.readbyqxmd.com/read/28735437/prospective-and-retrospective-study-of-videoconference-telemedicine-follow-up-after-elective-neurosurgery-results-of-a-pilot-program
#1
Melissa Reider-Demer, Pushpa Raja, Neil Martin, Mariel Schwinger, Diana Babayan
Existing literature suggests that use of telemedicine during postoperative appointments can increase access to care and is valued by patients and providers alike. While research examining the clinical equivalency of telemedicine visits for postoperative care has been growing, few studies have reported on telemedicine follow-up after neurosurgery. This study examined if a videoconferencing visit could substitute for an in-person clinic visit for elective neurosurgical cases in the USA. This was a single-center prospective study of patients who underwent elective neurosurgical procedures (aneurysm clipping, resection of cavernous angiomas, resection of arterial venous malformation, microvascular decompression for trigeminal neuralgia and hemifacial spasm, and certain benign brain tumors) and were offered telemedicine follow-up care by an allied health professional during the first 90 days after neurosurgery...
July 22, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28734486/nurse-practitioner-malpractice-data-informing-nursing-education
#2
Casey Fryer Sweeney, Anna LeMahieu, George E Fryer
BACKGROUND: Nurse practitioners (NPs) are often identified in medical malpractice claims. However, the use of malpractice data to inform the development of nursing curriculum is limited. The purpose of this study is to examine medical errors committed by NPs. METHODS: Using National Practitioner Data Bank public use data, years 1990 to 2014, NP malpractice claims were classified by event type, patient outcome, setting, and number of practitioners involved. RESULTS: The greatest proportion of malpractice claims involving nurse practitioners were diagnosis related (41...
July 2017: Journal of Professional Nursing: Official Journal of the American Association of Colleges of Nursing
https://www.readbyqxmd.com/read/28734004/comparison-of-preferences-of-healthcare-professionals-and-ms-patients-for-attributes-of-disease-modifying-drugs-a-best-worst-scaling
#3
Ingrid E H Kremer, Silvia M A A Evers, Peter J Jongen, Mickaël Hiligsmann
BACKGROUND: The choice between disease-modifying drugs (DMDs) for the treatment of multiple sclerosis (MS) becomes more often a shared decision between the patient and the neurologist and MS nurse. This study aimed to assess which DMD attributes are most important for the healthcare professionals in selecting a DMD for a patient. Subsequently, within this perspective, the neurologists' and nurses' perspectives were compared. Lastly, the healthcare professionals' perspective was compared with the patients' perspective to detect any differences that may need attention in the communication about DMDs...
July 21, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28733142/deprescribing-for-frail-older-people-learning-from-the-case-of-mrs-hansen
#4
Anne Gerd Granas, Marit Stendal Bakken, Sabine Ruths, Katja Taxis
Drug treatment is often an essential part in treatment and prevention of diseases in older people, but there is much concern about inappropriate medication use. This paper aims to describe the complexity of medication safety issues and clinical judgments when optimizing prescribing in older individuals. It uses the case of Mrs. Hansen, an aged nursing home resident, to illustrate the facilitators and barriers of this process. With decreasing life expectancy, medication use should shift from cure to care, focusing on symptomatic treatment to increase the patient's well-being...
July 13, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28728199/-polypharmacy-solutions-for-enhanced-drug-safety
#5
Olaf Krause, Gesine Picksak, Ulrike Junius-Walker
Polypharmacy (≥ 5 drugs) is common among older people and may lead to falls, ADEs and delirium. Adherence is an important part in the medication management. Simple questions (i. e. for OTC, handling and omission of drugs) are effective. As most old people are treated by general practitioners (GP), they play a key role for drug safety and reducing polypharmacy. The involvement of pharmacists in analyzing one patient's drugs can enhance solutions for drug problems ("two-man rule"). An IT-based medication plan acts as an important communication tool for an enhanced team work between doctors, pharmacists and nursing care...
July 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28727629/an-automated-inpatient-split-dose-bowel-preparation-system-improves-colonoscopy-quality-and-reduces-repeat-procedures
#6
Rena Yadlapati, Elyse R Johnston, Adam B Gluskin, Dyanna L Gregory, Rachel Cyrus, Lindsay Werth, Jody D Ciolino, David P Grande, Rajesh N Keswani
BACKGROUND/GOALS: Inpatient colonoscopy preparations are often inadequate, compromising patient safety and procedure quality, while resulting in greater hospital costs. The aims of this study were to: (1) design and implement an electronic inpatient split-dose bowel preparation order set; (2) assess the intervention's impact upon preparation adequacy, repeated colonoscopies, hospital days, and costs. STUDY: We conducted a single center prospective pragmatic quasiexperimental study of hospitalized adults undergoing colonoscopy...
July 19, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28727475/guidance-for-supplemental-enteral-nutrition-across-patient-populations
#7
Douglas L Nguyen
Enteral nutrition is preferred over parenteral nutrition as a result of the greater safety of enteral nutrition therapy and comparative convenience. A wide variety of enteral nutrition products have been developed, including disease-specific products to help manage the nutritional needs of patients with kidney failure, liver failure, lung disease, diabetes, and other conditions. An assessment of each patient's nutritional needs and digestive function should be conducted prior to initiation of enteral nutrition therapy...
July 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28726067/lifestyle-advice-provision-to-teenage-and-young-adult-cancer-patients-the-perspective-of-health-professionals-in-the-uk
#8
Gemma Pugh, Rachael Hough, Helen Gravestock, Kate Williams, Abigail Fisher
PURPOSE: Health professionals are an important source of information for teenage and young adult (TYA) cancer patients. However, little is known about health professionals' provision of lifestyle advice to young people with cancer who are in their care. METHODS: An online survey was distributed to health professionals within the UK who identified themselves as working with TYA cancer patients. Health professional awareness of lifestyle guidance, provision of lifestyle advice to young people and views on lifestyle information format and delivery were explored...
July 19, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28725160/significance-of-quality-of-care-for-quality-of-life-in-persons-with-dementia-at-risk-of-nursing-home-admission-a-cross-sectional-study
#9
Christina Bökberg, Gerd Ahlström, Staffan Karlsson
BACKGROUND: Quality of life in persons with dementia is, in large part, dependent on the quality of care they receive. Investigating both subjective and objective aspects of quality of care may reveal areas for improvement regarding their care, which information may ultimately enable persons with dementia to remain living in their own homes while maintaining quality of life. The aim of this study was to 1) describe self-reported quality of life in persons with dementia at risk of nursing home admission...
2017: BMC Nursing
https://www.readbyqxmd.com/read/28722809/measuring-the-outcomes-of-nursing-practice-a-delphi-study
#10
Jenny Sim, Patrick Crookes, Kenneth Walsh, Elizabeth Halcomb
AIM: To develop nursing-sensitive patient indicators to measure the outcomes of nursing practice. BACKGROUND: Nurses play an important role in the health care system yet there is no consensus on how the impact of nursing work should be evaluated. Limited research has previously examined the views of clinical nurses on the important concepts for measuring nursing practice. DESIGN: A four-round modified Delphi survey sought opinions from patients and nurses about the relevant concepts and their relative priority as indicators of quality nursing practice...
July 19, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28720612/translating-staff-experience-into-organisational-improvement-the-heads-up-stepped-wedge-cluster-controlled-non-randomised-trial
#11
Samuel Pannick, Thanos Athanasiou, Susannah J Long, Iain Beveridge, Nick Sevdalis
OBJECTIVES: Frontline insights into care delivery correlate with patients' clinical outcomes. These outcomes might be improved through near-real time identification and mitigation of staff concerns. We evaluated the effects of a prospective frontline surveillance system on patient and team outcomes. DESIGN: Prospective, stepped wedge, non-randomised, cluster controlled trial; prespecified per protocol analysis for high-fidelity intervention delivery. PARTICIPANTS: Seven interdisciplinary medical ward teams from two hospitals in the UK...
July 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28719479/a-simulation-based-quality-improvement-initiative-improves-pediatric-readiness-in-community-hospitals
#12
Travis Whitfill, Marcie Gawel, Marc Auerbach
BACKGROUND: The National Pediatric Readiness Project Pediatric Readiness Survey (PRS) measured pediatric readiness in 4149 US emergency departments (EDs) and noted an average score of 69 on a 100-point scale. This readiness score consists of 6 domains: coordination of pediatric patient care (19/100), physician/nurse staffing and training (10/100), quality improvement activities (7/100), patient safety initiatives (14/100), policies and procedures (17/100), and availability of pediatric equipment (33/100)...
July 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28716313/telemedicine-for-management-of-inflammatory-bowel-disease-myibdcoach-a-pragmatic-multicentre-randomised-controlled-trial
#13
Marin J de Jong, Andrea E van der Meulen-de Jong, Mariëlle J Romberg-Camps, Marco C Becx, Jeroen P Maljaars, Mia Cilissen, Ad A van Bodegraven, Nofel Mahmmod, Tineke Markus, Wim M Hameeteman, Gerard Dijkstra, Ad A Masclee, Annelies Boonen, Bjorn Winkens, Astrid van Tubergen, Daisy M Jonkers, Marie J Pierik
BACKGROUND: Tight and personalised control of inflammatory bowel disease in a traditional setting is challenging because of the disease complexity, high pressure on outpatient clinics, and rising incidence. We compared the effects of self-management with a telemedicine system, which was developed for all subtypes of inflammatory bowel disease, on health-care utilisation and patient-reported quality of care versus standard care. METHODS: We did this pragmatic, randomised trial in two academic and two non-academic hospitals in the Netherlands...
July 14, 2017: Lancet
https://www.readbyqxmd.com/read/28715535/improving-adherence-to-long-term-opioid-therapy-guidelines-to-reduce-opioid-misuse-in-primary-care-a-cluster-randomized-clinical-trial
#14
Jane M Liebschutz, Ziming Xuan, Christopher W Shanahan, Marc LaRochelle, Julia Keosaian, Donna Beers, George Guara, Kristen O'Connor, Daniel P Alford, Victoria Parker, Roger D Weiss, Jeffrey H Samet, Julie Crosson, Phoebe A Cushman, Karen E Lasser
Importance: Prescription opioid misuse is a national crisis. Few interventions have improved adherence to opioid-prescribing guidelines. Objective: To determine whether a multicomponent intervention, Transforming Opioid Prescribing in Primary Care (TOPCARE; http://mytopcare.org/), improves guideline adherence while decreasing opioid misuse risk. Design, Setting, and Participants: Cluster-randomized clinical trial among 53 primary care clinicians (PCCs) and their 985 patients receiving long-term opioid therapy for pain...
July 17, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28709455/barriers-and-facilitators-to-reducing-frequent-laboratory-testing-for-patients-who-are-stable-on-warfarin-a-mixed-methods-study-of-de-implementation-in-five-anticoagulation-clinics
#15
Geoffrey D Barnes, Sevan Misirliyan, Scott Kaatz, Elizabeth A Jackson, Brian Haymart, Eva Kline-Rogers, Jay Kozlowski, Gregory Krol, James B Froehlich, Anne Sales
BACKGROUND: Patients on chronic warfarin therapy require regular laboratory monitoring to safely manage warfarin. Recent studies have challenged the need for routine monthly blood draws in the most stable warfarin-treated patients, suggesting the safety of less frequent laboratory testing (up to every 12 weeks). De-implementation efforts aim to reduce the use of low-value clinical practices. To explore barriers and facilitators of a de-implementation effort to reduce the use of frequent laboratory tests for patients with stable warfarin management in nurse/pharmacist-run anticoagulation clinics, we performed a mixed-methods study conducted within a state-wide collaborative quality improvement collaborative...
July 14, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28709013/association-of-nurse-work-environment-and-safety-climate-on-patient-mortality-a-cross-sectional-study
#16
Danielle M Olds, Linda H Aiken, Jeannie P Cimiotti, Eileen T Lake
BACKGROUND: There are two largely distinct research literatures on the association of the nurse work environment and the safety climate on patient outcomes. OBJECTIVE: To determine whether hospital safety climate and work environment make comparable or distinct contributions to patient mortality. DESIGN: Cross-sectional secondary analysis of linked datasets of Registered Nurse survey responses, adult acute care discharge records, and hospital characteristics...
June 24, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28709012/de-escalation-of-aggressive-behaviour-in-healthcare-settings-concept-analysis
#17
REVIEW
Nutmeg Hallett, Geoffrey L Dickens
BACKGROUND: De-escalation is the recommended first-line response to potential violence and aggression in healthcare settings. Related scholarly activity has increased exponentially since the 1980s, but there is scant research about its efficacy and no guidance on what constitutes the gold standard for practice. OBJECTIVES: To clarify the concept of de-escalation of violence and aggression as described within the healthcare literature. DESIGN: Concept analysis guided by Rodgers' evolutionary approach...
July 4, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28708798/the-nursing-performance-instrument-exploratory-and-confirmatory-factor-analyses-in-registered-nurses
#18
Knar Sagherian, Linsey M Steege, Jeanne Geiger-Brown, Donna Harrington
BACKGROUND: The optimal performance of nurses in healthcare settings plays a critical role in care quality and patient safety. Despite this importance, few measures are provided in the literature that evaluate nursing performance as an independent construct from competencies. The nine-item Nursing Performance Instrument (NPI) was developed to fill this gap. PURPOSE: The aim of this study was to examine and confirm the underlying factor structure of the NPI in registered nurses...
July 13, 2017: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/28707992/transitional-care-services-a-quality-and-safety-process-improvement-program-in-neurosurgery
#19
Faith C Robertson, Jessica L Logsdon, Hormuzdiyar H Dasenbrock, Sandra C Yan, Siobhan M Raftery, Timothy R Smith, William B Gormley
OBJECTIVE Readmissions increasingly serve as a metric of hospital performance, inviting quality improvement initiatives in both medicine and surgery. However, few readmission reduction programs have targeted surgical patient populations. The objective of this study was to establish a transitional care program (TCP) with the goal of decreasing length of stay (LOS), improving discharge efficiency, and reducing readmissions of neurosurgical patients by optimizing patient education and postdischarge surveillance...
July 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28707273/team-communication-patterns-in-emergency-resuscitation-a-mixed-methods-qualitative-analysis
#20
Lisa Anne Calder, George Mastoras, Mitra Rahimpour, Benjamin Sohmer, Brian Weitzman, A Adam Cwinn, Tara Hobin, Avi Parush
BACKGROUND: In order to enhance patient safety during resuscitation of critically ill patients, we need to optimize team communication and enhance team situational awareness but little is known about resuscitation team communication patterns. The objective of this study is to understand how teams communicate during resuscitation; specifically to assess for a shared mental model (organized understanding of a team's relationships) and information needs. METHODS: We triangulated 3 methods to evaluate resuscitation team communication at a tertiary care academic trauma center: (1) interviews; (2) simulated resuscitation observations; (3) live resuscitation observations...
December 2017: International Journal of Emergency Medicine
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