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Nursing safety

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https://www.readbyqxmd.com/read/28724193/saline-irrigation-for-the-management-of-skin-extravasation-injury-in-neonates
#1
REVIEW
P N Gopalakrishnan, Nitin Goel, Sujoy Banerjee
BACKGROUND: Extravasation injury, a complication commonly seen in the neonatal intensive care unit, can result in scarring with cosmetic and functional sequelae. A wide variety of treatments are available, including subcutaneous irrigation with saline (with or without hyaluronidase), liposuction, use of specific antidotes, topical applications, and normal wound care with dry or wet dressings. All such treatments aim to prevent or reduce the severity of complications. OBJECTIVES: Primary objective To compare the efficacy and safety of saline irrigation or saline irrigation with prior hyaluronidase infiltration versus no intervention or normal wound care for tissue healing in neonates with extravasation injury...
July 19, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28722809/measuring-the-outcomes-of-nursing-practice-a-delphi-study
#2
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/28722167/assisted-autogenic-drainage-in-infants-and-young-children-hospitalized-with-uncomplicated-pneumonia-a-pilot-study
#3
Lieselotte Corten, Jennifer Jelsma, Anri Human, Sameer Rahim, Brenda M Morrow
BACKGROUND AND PURPOSE: Pneumonia is the most important respiratory problem in low-to-middle income countries. Airway clearance therapy continues to be used in children with pneumonia and secretion retention; however, there is lack of evidence to support or reject this treatment. This study aimed to investigate the feasibility of a randomized controlled trial (RCT) on the efficacy and safety of assisted autogenic drainage (AAD) compared to standard nursing care in children hospitalized with uncomplicated pneumonia...
July 19, 2017: Physiotherapy Research International: the Journal for Researchers and Clinicians in Physical Therapy
https://www.readbyqxmd.com/read/28721693/towards-relational-recovery-nurses-practices-with-consumers-and-families-with-dependent-children-in-mental-health-inpatient-units
#4
Kim Foster, Sophie Isobel
Facilitating parent-child and family connections during parental hospitalization provides important opportunities for mental health services to support individual and family recovery. Nurses are often the primary point of contact for families in the inpatient context. They play an integral role in the care provision of consumers and families and in supporting consumers' recovery. The aim of the present qualitative study was to explore nurses' practice with families in inpatient mental health settings in the context of designated family rooms...
July 18, 2017: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/28720612/translating-staff-experience-into-organisational-improvement-the-heads-up-stepped-wedge-cluster-controlled-non-randomised-trial
#5
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
#6
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
#7
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
#8
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/28712478/comparison-of-effects-of-local-anesthesia-and-two-point-acupressure-on-the-severity-of-venipuncture-pain-among-hospitalized-6-12-year-old-children
#9
Parisa Shahmohammadi Pour, Golnaz Foroogh Ameri, Majid Kazemi, Yones Jahani
The aim of the present study was to compare the effects of topical anesthesia and acupressure at the Yintang (Extra 1) and the Laogong (P-8) points on the severity of venipuncture pain among hospitalized 6-12-year-old children. A sample (n = 120) of 6-12-year-old hospitalized children was recruited from two teaching hospitals located in Rafsanjan, Iran. The children were allocated to the topical anesthesia, acupressure, and control groups. For children in the topical anesthesia and the acupressure groups, eutectic mixture of local anesthetic (EMLA) cream and two-point acupressure were used, respectively, prior to performing venipuncture, whereas children in the control group only received routine prevenipuncture care...
June 2017: Journal of Acupuncture and Meridian Studies
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
https://www.readbyqxmd.com/read/28707258/-connecting-the-dots-a-qualitative-study-of-home-health-nurse-perspectives-on-coordinating-care-for-recently-discharged-patients
#16
Christine D Jones, Jacqueline Jones, Angela Richard, Kathryn Bowles, Dana Lahoff, Rebecca S Boxer, Frederick A Masoudi, Eric A Coleman, Heidi L Wald
BACKGROUND: In 2012, nearly one-third of adults 65 years or older with Medicare discharged to home after hospitalization were referred for home health care (HHC) services. Care coordination between the hospital and HHC is frequently inadequate and may contribute to medication errors and readmissions. Insights from HHC nurses could inform improvements to care coordination. OBJECTIVE: To describe HHC nurse perspectives about challenges and solutions to coordinating care for recently discharged patients...
July 13, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28704079/paediatric-inter-hospital-transportation-a-clinical-governance-project
#17
Maria Breathnach, Paula Lane
This article discusses a quality improvement project in the context of paediatric inter-hospital transportation. The project was set in a large university teaching hospital in Ireland. Risk assessment on the clinical site revealed a gap in the application of best national and international standards in inter-hospital transportation practice. A project was undertaken to explore current paediatric transport services and respond to a clinical service deficit. Consequently, the proposed quality improvement initiative proposes a universal Paediatric Advanced Life Support Programme (PALS) to upskill and enhance the required clinical standards and competencies of neonatal nurses...
July 13, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28701459/staff-perceptions-of-community-health-centre-team-function-in-ontario
#18
Jennifer Rayner, Laura Muldoon
OBJECTIVE: To examine perceptions of different staff groups about team functioning in mature, community-governed, interprofessional primary health care practices. DESIGN: Cross-sectional online survey. SETTING: The 75 community health centres (CHCs) in Ontario at the time of the study, which have cared for people with barriers to access to traditional health services in community-governed, interprofessional settings, providing medical, social, and community services since the 1970s...
July 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28700030/risk-for-adverse-reaction-to-iodinated-contrast-media-a-validation-study
#19
Beatriz Cavalcanti Juchem, Miriam de Abreu Almeida
Objectives: To validate the content of the nursing diagnosis, Risk for adverse reaction to iodinated contrast media, and its nursing interventions and outcomes according to standardized terminologies. Method: Fehring's (1987) model of diagnosis content validation was used, with the participation of experts including registered nurses and physicians. Results: Seventy-four experts validated the title and the definition of the diagnosis, and assessed 28 risk factors, five of which were validated as primary, 22 as secondary, and one was discarded...
July 6, 2017: Revista Gaúcha de Enfermagem
https://www.readbyqxmd.com/read/28699994/safe-surgery-validation-of-pre-and-postoperative-checklists
#20
Francine Taporosky Alpendre, Elaine Drehmer de Almeida Cruz, Ana Maria Dyniewicz, Maria de Fátima Mantovani, Ana Elisa Bauer de Camargo E Silva, Gabriela de Souza Dos Santos
Objective: to develop, evaluate and validate a surgical safety checklist for patients in the pre and postoperative periods in surgical hospitalization units. Method: methodological research carried out in a large public teaching hospital in the South of Brazil, with application of the principles of the Safe Surgery Saves Lives Programme of the World Health Organization. The checklist was applied to 16 nurses of 8 surgical units and submitted for validation by a group of eight experts using the Delphi method online...
July 10, 2017: Revista Latino-americana de Enfermagem
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