The need for interprofessional, team-based care is well established but not easy to implement in health care settings. An article in this issue presents evidence on Clinical Nurse Leader integrated care delivery, a model that promotes interprofessional, team-based care.
Interdisciplinary rounds provide a valuable venue for delivering patient-centered care but are difficult to implement due to time constraints and coordination challenges. Nurses and physicians developed a unique model for promoting bedside interdisciplinary rounds by adjusting the morning medication administration time and auditing physician communication with nurses. Our CE article presents a project that all readers can adapt for their own settings. Anecdotal evidence collected from nurses indicated inconsistent practice of intermittent irrigation of indwelling urinary catheters. To address this, they developed a standardized practice, supported by an order in the EMR. Nurses have reported spending a lot of time charting in the EMR, keeping them away from direct care of patients. An important study by Higgins et al examined hospital nurses' work activity through observations, nurses' perceptions of time spent on tasks, and EMR time stamps. Activities most frequently observed included documenting in and reviewing the EMR. Nurses' perceptions of time differed significantly from observations of their work. In another article, Armstrong et al report on their study to assess bedside nurses' perceived skills and attitudes about patient safety concepts and their impact on medication administration errors and adherence to safe medication administration practices. Findings support that medication administration errors result from an interplay among system-, unit-, and nurse-level factors. Other articles in this issue present innovative QI projects, studies on falls and prevention, the APRN role in improving quality in nursing homes, and more.
Marilyn H. Oermann, Editor-in-Chief