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January/March 2019 - Volume 34 - Issue 1
pp: 1-90,E1-E23
Table of Contents Outline
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AHRQ Commentary

Innovations in Quality Improvement in Long-term Care

Association of Nurse Engagement and Nurse Staffing on Patient Safety

Brooks Carthon, J. Margo; Hatfield, Linda; Plover, Colin; More

Journal of Nursing Care Quality. 34(1):40-46, January/March 2019.

Using Lean to Enhance Heart Failure Patient Identification Processes and Increase Core Measure Scores
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Journal: Journal of Nursing Care Quality January/March 2019, Volume 34, Issue 1;
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A goal in many health systems is to improve heart failure (HF) core measure (CM) scores. Learn how an interdisciplinary team analyzed the processes in their setting, implemented an accurate reporting system, redesigned the process for identifying patients with HF, and changed the EHR. There was a decrease in readmissions from 12% to 8%, and HF CM compliance score increased from 88% to 100%. increased from 88% to 98%. Watch the video and then be sure to read the full article (for CE)
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Implementing Same Day Discharge Following Percutaneous Coronary Intervention: A Process Evaluation
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Journal: Journal of Nursing Care Quality January/March 2019, Volume 34, Issue 1;
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Learn about this interesting study that used a process evaluation methodology. The aim was to examine the effectiveness of implementing same day discharge (SDD) following percutaneous coronary intervention. During implementation, 22 patients were discharged home the same day. It was found, however, that staff did not follow the guideline consistently, with an overall adherence of 77.3%. The study is important as it provides direction for future improvement both in the criteria and implementation process. After watching this video, be sure to read the article.
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Reducing Inappropriate Antibiotics for Urinary Tract Infections in Long-Term Care: A Replication Study
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Journal: Journal of Nursing Care Quality January/March 2019, Volume 34, Issue 1;
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Nursing home providers face challenges in urinary tract infection assessment and treatment, often prescribing unnecessary antibiotics for asymptomatic bacteriuria. The project tested the effectiveness of the multifaceted Cooper Urinary Tract Infection Program that includes the Cooper tool algorithm, didactic education for providers, and change champions. This Program led to significant improvements in nurse knowledge and reduced rates of urinary tract infections, inappropriate antibiotic treatments, and urinalyses. Learn about this important Program: Dr Cooper presents her Program in this video and describes the study in her article.
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Mealtime Assistance...from Chaos to Calm: A Collaborative Best Practice Implementation Project
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Duration: 3:34
Journal: Journal of Nursing Care Quality January/March 2019, Volume 34, Issue 1;
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Providing appropriate and timely mealtime assistance to hospitalized patients should be part of a multifaceted and multidisciplinary approach to optimizing the patient's nutritional care plan. The combined interventions of staff engagement, redesigning the model of care to reprioritize activities at mealtimes, clarifying nutritional care roles and responsibilities, introducing a protected mealtime and a novel 2-tiered colored tray system, and implementing an awareness and education program have resulted in significant improvements in mealtime assistance. Learn more about this project from the authors in the video and their article.
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Perspectives on Patient and Family Engagement with Reduction in Harm: The Forgotten Voice And Developing an Intervention to Reduce Harm in Hospitalized Patients: Patients and Families in Research
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Duration: 6:29
Journal: Journal of Nursing Care Quality January/March 2019, Volume 34, Issue 1;
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Strategies have been identified to establish patient-centered care and improve patient engagement with care. However, the relationship of patient/ family engagement to reduction of harm is not well understood. Dr Schenk, in her first study, identified an opportunity for reducing risk and harm by more actively engaging patients and families in the effort. In another study her team convened a Patient Safety Advisory Panel to explore potential interventions to increase patient/family engagement with safety. The preferred intervention was Speak Up-My Advocate for Patient Safety. Learn about these studies in the video and implications for engaging patients and families in your own settings of care. Be sure to read both articles.
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