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July/September 2022 - Volume 37 - Issue 3

  • Marilyn H. Oermann, PhD, RN, FAAN
  • 1057-3631
  • 1550-5065
  • 4 issues / year
  • 1.728

Inpatient falls with harm have severe implications for patients and the health care system. Authors implemented a zero harm approach to falls prevention with multiple strategies including the display of real-time unit-specific falls rates and a root-cause analysis process after falls. The fall rate decreased from 2.03 (baseline period) to 1.12 (1 year later) per 1000 patient-days, and there was an increase in patient safety incident reporting. In a new process to improve the transition of patients from inpatient settings to outpatient mental health (MH) care, RN Transition Care Managers triaged discharge consults, communicated with schedulers and patients pre- and postdischarge, and tracked MH engagement for 30 days postdischarge. Over 55 weeks, 443 consults were placed, with an average 89% success rate. Other articles share innovative QI studies with implications for your own settings.​
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Marilyn H. Oermann, Editor

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

Wilson, Mary-Agnes; Hacker Teper, Matthew; Sinno, Maya; More

Journal of Nursing Care Quality. 37(3):199-205, July/September 2022.

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

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

Rodrigues, Miranda A.; Lofton, Tochie; Tume, Sebastian C.; More

Journal of Nursing Care Quality. 37(3):213-217, July/September 2022.

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

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

Kantaria, Tina; Talag, Germiniano; Fan, Jia; More

Journal of Nursing Care Quality. 37(3):218-224, July/September 2022.

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

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The management of healthcare-acquired infections (HAIs) challenges acute care facilities due to variability in practices.  The purpose of this QI project was to decrease central line-associated bloodstream infection, catheter-associated urinary tract infection, and Clostridioides difficile using a visual management (VM) tool, called the Safety Tracker, to address practice variations. In 12 months, HAIs decreased from 9 events to 1 with a corresponding reduction of indwelling urinary catheter utilization and central line utilization. More than $160,000 were avoided in health care costs.​ Learn more by watching the video and reading the article.
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Central line–associated bloodstream infections (CLABSIs) are an ongoing concern in health care. This was a QI project including a collaborative rounding approach supported by specialty nursing roles. In addition to implementing a variety of evidence-based interventions, the rounding team performed audits to assess performance and created focused education tools to address the identified opportunities within each individual unit. High levels of engagement as evidenced by increased audit completion resulted in CLABSI reductions. However, 2 peaks in CLABSI rates were associated with higher volumes of coronavirus disease (COVID-19) hospitalizations and decreased audits. Watch the video and read the article ​for more.
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Lung cancer is prevalent worldwide, with 2.1 million new cases and 1.8 million deaths in 2020.  Our community residents were more likely to be diagnosed with lung cancer in later stages (62%) compared with 56% nationally, resulting in an increased community mortality rate. Evidence-based changes in an electronic health record system supported identification and referral of high-risk patients for low-dose computer tomography to improve early lung cancer detection rates. Early-stage lung cancer detection increased 24%. Learn more in this video and article ​about how the authors improved early-stage lung cancer detection.
​​​Second victims (SVs) are health care workers traumatized by unanticipated, adverse patient events. These experiences can have personal and professional effects on SVs. The purpose of the study was to determine the prevalence of nurses who identified as SVs. Of 359 participants, 159 (44.3%) identified as SVs. There was a significant relationship between work tenure and SVs (P = .009). A relationship was found between SVs and awareness and use of support resources, with debriefing being the preferred method after an event.​ Be sure to watch the video and read the article​.
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Reduction of falls in hospital patients remains a priority. Although fall rates were in the acceptable national safety standard guidelines, interventions were explored to further decrease falls using continuous video monitoring (CVM). Two-way cameras and a virtual sitter were used to observe fall risk patients. CVM with virtual sitters depicted a 14% decline in fall rates and a 6% decrease in fall-related injury rates with positive budget implications. Learn more about this QI project in the video and article. ​













Watch our Videos on Writing Journal Articles on QI

This is the first video in our writing for publication series. The purpose of the manuscript and intended readers guide your selection of a journal for submission. Learn about directories of nursing and other journals and sending a query email.
This is the second video in our writing for publication series. Learn about the journal’s Information for Authors and why important, formats for writing different types of manuscripts, and reporting guidelines. The video will prepare you for writing papers about quality improvement and using the SQUIRE guidelines. References and tables/figures also are discussed.
​This is the final video in our writing for publication series. In this video you will get some additional tips on writing your manuscript and will learn about peer review and responding to reviewers’ comments. Other topics include authorship criteria, copyright, open access, and avoiding “predatory journals.”
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