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July/September 2021 - Volume 36 - Issue 3

  • Marilyn H. Oermann, PhD, RN, FAAN
  • 1057-3631
  • 1550-5065
  • 4 issues / year
  • 1.425

Many sepsis cases originate in the home and community. To prevent hospital readmissions due to sepsis, a home health care provider implemented a sepsis-screening protocol and QI initiative. To analyze the impact of the protocol, they conducted a chart review of 33264 sepsis screens of 7242 patients. The majority (69.2%) of positive sepsis screens resulted in patients receiving early medical intervention and avoiding hospitalization. There is limited evidence on best practices to sustain outpatient-to-inpatient handoff processes. Using a Lean Six Sigma approach to improve patient transfer, the team documented a steady decrease in patient transfer time including reduced variability over 36 months. Longitudinal monitoring provides the opportunity to identify beneficial outcomes. Don't miss these articles and others in this issue.
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Marilyn H. Oermann, Editor-in-Chief

Building a Reliable Health Care System: A Lean Six Sigma Quality Improvement Initiative on Patient Handoff

Alexander, Catherine; Rovinski-Wagner, Christine; Wagner, Sandra; More

Journal of Nursing Care Quality. 36(3):195-201, July/September 2021.

Building a Reliable Healthcare System: A Lean Six Sigma Quality Improvement Initiative on Patient Handoff

Do Falls and Other Safety Issues Occur More Often During Handovers When Nurses Are Away From Patients? Findings From a Retrospective Study Design

Demaria, Jessica; Valent, Francesca; Danielis, Matteo; More

Journal of Nursing Care Quality. 36(3):202-209, July/September 2021.

Do Falls and Other Safety Issues Occur More Often During Handovers When Nurses are Away from Patients? Findings from a Retrospective Study Design

Building Capacity in Health Professionals to Conduct Quality Improvement: Evaluation From a Collaborative Interorganizational Program

Plummer, Carolyn; Ruco, Arlinda; Smith, Kerry-Ann; More

Journal of Nursing Care Quality. 36(3):229-235, July/September 2021.

Building Capacity in Health Professionals to Conduct Quality Improvement: Evaluation from a Collaborative Interorganizational Program

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The aim of this study was to determine patients' (n=503) and nurses' (n=308) perceptions of the quality of nursing care in surgical clinics and influencing factors. Characteristics of patients such as age, gender, complications, and nursing care scores, and characteristics of the nurses such as being satisfied with the current clinic and work affected perceptions of care quality. Patients' perceptions were lower than those of nurses, and some factors belonging to the patients and nurses negatively influenced the quality of care. Dr. Mert shares her study in this video and the article​.
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Two evidence-based practice projects and an innovative model provided best evidence and a framework for the implementation and sustainment of a bedside shift report (BSR) quality improvement project. Facilitators and barriers were identified and addressed during planning. Key elements of BSR were incorporated. Implementation was completed in 4 months for 11 units. After 15 months, there was consistent BSR on 82% of the units and improved patient satisfaction with nurses taking time to listen.  This is an excellent example of sustainability of a practice change: watch the video and be sure to read the article.
​​Proning intubated ICU patients for the management of acute respiratory distress syndrome is an accepted standard of practice. We examined the nursing climate in 4 units and its impact on implementing a novel self-proning protocol to treat COVID-19 patients outside the ICU. Nurses from 4 nursing units were surveyed about the implementation process on the self-proning protocol. Their perception of unit implementation was assessed via the Implementation Climate Scale. Consistent education on the protocol, belief in the effectiveness of the intervention, and a strong unit-based climate of evidence-based practice contributed to greater implementation of the protocol. Learn more by watching this video and reading the article​.
​​​Delirium affects approximately 1 in 4 patients during their hospitalization and is associated with numerous complications. An evidence-based practice project was implemented to reduce the development of delirium through sleep promotion on 2 inpatient units. A dedicated time was selected, and key strategies were identified to promote sleep with minimal interruptions. Delirium decreased by 33% and 45% on the 2 units over 1 year. Overall, patient satisfaction for quietness at night survey responses also increased (P = .0005; CI, 0.05 to 0.67) with ongoing sustainment. Learn about this project in this video and article​.
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Consensus guidelines for pain, agitation, and delirium (PAD) in mechanically ventilated patients recommend maintaining a light level of sedation. Consistent attainment of target PAD assessments in these patients is often challenging. This was a single-center, prospective study. In the intervention group, a pharmacist provided weekly feedback to nurses on their success in achieving target PAD assessments compared with a historical cohort without feedback. Overall, 478 patients and 205 nurses were included. Weekly feedback to nurses on PAD assessments did not impact the achievement of PAD goals.​ Learn more by watching the video ​and reading the 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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