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Journal of nursing care quality
Lippincott Williams & Wilkins
Journal of nursing care quality

Lippincott Williams & Wilkins

1057-3631

Journal of nursing care quality/Journal Journal of nursing care qualitySSCIISSHPSCI
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    Correlation of the US News and World Report–Calculated Nurse Staffing Index With Actual Hospital-Reported Nurse Staffing

    Ryan P.,MerkowJeanette W.,ChungJennifer M.,SlotaCynthia,Barnard...
    4页
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Designing and Implementing a Zero Harm Falls Prevention Program: A Quality Improvement Study

    Mary-Agnes,WilsonMatthew,Hacker TeperMaya,SinnoKim,Kohlberger...
    7页
    查看更多>>摘要：Inpatient falls with harm have severe implications on patients and the health care system. We implemented a zero harm approach to falls prevention, which aimed to reduce falls with injury by 25% within 1 year. We implemented a multifaceted and multidisciplinary quality improvement falls prevention strategy that included facilitating organization-wide education, adopting the Morse Fall Risk Assessment tool, displaying real-time unit-specific falls rates, and implementing a transparent root-cause analysis process after falls. Our outcome measure was falls with injury per 1000 patient-days. We observed a decrease in the rate of patient falls with injury from 2.03 (baseline period) to 1.12 (1 year later) per 1000 patient-days. We also observed increases in awareness around falls prevention and patient safety incident reporting. Our zero harm approach reduced falls with injury while improving our patient safety culture.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    A Multidisciplinary Approach to Improving the Pediatric Discharge Process

    Emily,DickCarrie,MoelberKayla,Jubic
    7页
    查看更多>>摘要：A collaborative and multidisciplinary shared responsibility with providing discharge information to pediatric patients/families can support successful reassimilation to life posthospitalization. An analysis of the current discharge process at an urban pediatric hospital identified variations in discharge practices and instructions. A multidisciplinary taskforce used the Plan-Do-Study-Act methodology to standardize the discharge process including creating a discharge template, adopting a new education platform, enhancing the electronic health record, and implementing strategies to improve discharge. There was a reduction in 7-day readmission rate from preintervention 4.58 to postintervention for 4 consecutive quarters of 3.92, 4.20, 3.44, and 3.41, respectively. Percentile ranking and top box scores of the patient satisfaction measure of discharge preparation increased from 12th-62nd to 65th-95th percentile postimplementation and 81% to 88%, respectively. A local improvement initiative related to standardization of the discharge process resulted in a reduction in 7-day readmission rate and improved patient satisfaction scores.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Reducing Opioid-Induced Constipation Post-Cardiac Surgery: An Improvement Project in a Pediatric Cardiac Intensive Care Unit

    Miranda A.,RodriguesTochie,LoftonSebastian C.,TumeKatherine I.,Lemming...
    5页
    查看更多>>摘要：Pain management with opioids and underutilization of prophylaxis for constipation can prolong a patient's hospital length of stay and impede pain management efforts. In pediatric postoperative cardiac patients, opioid therapy is a common approach to pain management but often places them at greater risk for constipation due to anatomy and age. A retrospective review of 50 patients' medical records for baseline data was conducted, and a survey evaluated providers' current knowledge and practice. The intervention was an electronic order set that provided decision support. Additionally, prophylactic measures were supported by a validated assessment tool that created a common language to report constipation risk. Although not statistically significant, postintervention data demonstrated a 21.5% decrease in postoperative constipation and a 57% increase in ordered bowel regimens. More focus is needed toward prophylactic bowel regimens to reduce the risk in this already high-risk population.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Bridging the Acute-to-Outpatient Care Gap in Mental Health: Developing and Implementing a Mental Health Transition Process

    Jia,FanFilda,NavarroPatrick,SonzaScott,Fears...
    7页
    查看更多>>摘要：A national Department of Veterans Affairs (VA) mental health (MH) quality metric tracks engagement in outpatient MH care after discharge from residential and inpatient settings, with recommendations for 2 or more visits 30 days postdischarge. A gap in transitioning patients from residential to outpatient MH care was identified at this site. A transition management process was developed and piloted, including a new MH Discharge Consult and an RN Transition Care Managers team. Transition Care Managers triaged Discharge Consults, communicated with schedulers and patients pre- and postdischarge, and tracked MH engagement for 30 days postdischarge. Process, outcome, and balancing measures were developed and iteratively adjusted using Plan-Do-Study-Act (PDSA) cycles. Over 55 weeks, 443 Discharge Consults were placed. There was an average 89% success rate in connecting patients with 2 or more MH visits versus 53% preintervention. This pilot showed promising results in improving postdischarge MH engagement with the use of PDSA cycles to collect data and refine processes.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Continuous Video Monitoring: Readiness for Growth

    JacQualine Renee,AbbeChristian,O'Keeffe
    6页
    查看更多>>摘要：A large academic medical center in the Pacific Northwest successfully introduced continuous video monitoring (CVM) as an adjunct measure to replace sitter use when appropriate. Adoption of the technology was influenced by nurse enculturation, standard work, data tracking management, and patient/family engagement. The purpose of this article is to identify critical data metrics to inform expansion of CVM programs when determining readiness for growth. There is a lack of literature to advise organizations on needed data and metrics to inform growth readiness of CVM programs. Specific indicators can support initiatives to achieve financial support for program expansion. CVM readiness for expansion is evident when metrics such as utilization rates, wait-list expansion, frontline staff perception, and sitter patient population outgrow current camera capacity. Successful metric analysis can inform initiatives to grow CVM programs, which, in turn, support a culture of safety at large academic medical centers for at-risk populations.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Preventing Health Care–Associated Infections Through Implementation of an Interprofessional Visual Management Safety Tracker

    Patricia,Frist AvilaK. Renee,TwibellHeather,Demaree
    7页
    查看更多>>摘要：The management of health care associated infections (HAIs) challenges acute care facilities due to variability in practices. The purpose of this quality improvement project was to decrease central line–associated bloodstream infection, catheter-associated urinary tract infection, and Clostridioides difficile infection in a high acuity care environment using a visual management (VM) tool to address practice variations. An acute care unit experienced increasing HAIs. An interprofessional team used Lean methodology to implement a VM tool reflective of evidence-based HAI prevention practices that staff had frequently omitted. A VM tool called the Safety Tracker was created. In 12 months, HAIs decreased from 9 events to 1, with a corresponding reduction in indwelling urinary catheter utilization and central line utilization. More than $160 000 were avoided in health care costs. Creating an interprofessional VM Safety Tracker could significantly reduce HAIs.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Adaptation of a Lean Tool Across Surgical Units to Improve Patient Experience

    Brianna,Salinas
    7页
    查看更多>>摘要：High reliability organizations (HROs) sustain consistently excellent outcomes over time. Health care systems need to eliminate major quality failures to become reliable. Practice variations, unstructured leader rounds, and unfavorable patient experience outcomes with Responsiveness of Hospital Staff prompted leaders to adopt Kamishibai cards (K-cards). Evidence-based practices (EBPs) such as timeliness of answering call lights, purposeful rounding, communication, and engaging patients were used to develop Responsiveness K-cards. Responsiveness K-cards established standard work for staff responsiveness and audited process compliance. Findings determined what areas needed improvement, and leaders engaged frontline staff in practice changes. Percentile rank for Responsiveness of Hospital Staff had a sustained increase. Four of 6 hospital units using Responsiveness K-cards achieved 80% rank or better in every patient experience domain for the entire fiscal year. K-cards use HRO principles to standardize practice and improve outcomes. They encourage continuous improvement, which supports the sustainability of EBPs.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Memes and Poetry: A Descriptive Analysis on Creative Arts Therapy to Reduce Health Care Worker Burnout

    Staci S.,ReynoldsChristopher,Sova
    4页
    查看更多>>摘要：Health care workers (HCWs) face high levels of burnout, which can lead to workforce turnover and poor patient outcomes. Health care leaders should identify strategies to improve staff resilience. The purpose of this study was to describe HCWs' perspective on using creative arts therapy to reduce burnout and improve resiliency. During Infection Prevention week, staff were encouraged to submit and vote on educational memes and haikus. Staff were asked their perspectives on how this activity could be used to reduce burnout and improve resiliency using a 4-point Likert scale. Twenty-two staff members submitted 26 memes and 27 haikus. Staff felt this activity could be an effective strategy to help reduce burnout and improve resiliency. Further research is warranted to better understand the correlation between this form of art therapy and burnout and resiliency; however, health care leaders may consider using this as a tool for staff well-being.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins

    Nurses' Perceptions of Recommended Fall Prevention Strategies: A Rapid Review

    Amanda,GarciaRagnhildur (Raga) I.,BjarnadottirGail M.,KeenanTamara G. R.,Macieira...
    8页
    查看更多>>摘要：Limited studies have synthesized evidence on nurses' perceptions of recommended fall prevention strategies and potential differences between those and the practiced strategies. To synthesize evidence about nurses' perceptions of recommended fall prevention strategies for hospitalized adults. Using PubMed, 50 records underwent abstract and full-text screening, and 10 studies were retained. Narrative synthesis was conducted to identify common themes across studies. Quality assessment was not performed. Nurses are aware of effective fall prevention strategies but identified unit-level barriers and facilitators to implementing these in their practice. Unit culture and policies, educational offerings, nursing interventions, and style of communication and collaboration were seen to influence fall prevention. Nurses recognize falls as a multifactorial issue suggesting that prevention efforts be tailored to the unit and involve all employees. We recommend that future research emphasize identifying and understanding the combination of factors that produce successful unit-level fall prevention strategies.
      原文链接:
    • NSTL
    • Lippincott Williams & Wilkins