Journal of Nursing Care Quality

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April/June 2023 - Volume 38 - Issue 2

  • Staci Reynolds, PhD, RN, ACNS-BC, CPHQ
  • 1057-3631
  • 1550-5065
  • 4 issues / year
  • 1.728

In this issue: Patient mobility has been linked to improved patient outcomes.  Despite the benefits of mobility, issues related to bed rest and immobility exist among health care systems.  Authors provide a framework for implementing a mobility program, known as the Johns Hopkins Activity and Mobility Promotion (JH-AMP) program.  Recommendations are provided for each component of the program to facilitate implementation at other institutions.

Clinicians implemented a multifaceted hypoglycemia prevention bundle, including patient and staff education, coordination between meal delivery and insulin coverage, and a hypoglycemia protocol.  Hypoglycemia events significantly decreased from 26.78 to 10.27 per 1000 patient days, p<.001.  Their results showed that a bundled approach can improve management of hypoglycemia.

Staci S. Reynolds, Editor​

The Johns Hopkins Activity and Mobility Promotion Program: A Framework to Increase Activity and Mobility Among Hospitalized Patients

McLaughlin, Kevin H.; Friedman, Michael; Hoyer, Erik H.; More

Journal of Nursing Care Quality. 38(2):164-170, April/June 2023.

The Johns Hopkins Activity and Mobility Promotion Program: A Framework to Increase Activity and Mobility Among Hospitalized Patients

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High quality nurse-physician communication during family-centered rounds (FCR) can increase patient safety. Using quality improvement methodology, we measured nurses’ perceived awareness of components of the shared mental model, nurses’ attendance during FCR, compliance with completing FCR summaries, and average time spent per FCR encounter. A structured resident huddle took place prior to FCR. Residents used a tool to send individualized alerts to bedside nurses to prepare them for FCR, and sent a summary text to nurses who were unable to attend FCR.  Over 16 weeks, nurses’ perceived awareness increased from 70% to 87%. Nurse attendance increased from 53% to 75%.  We successfully piloted multiple interventions to improve nurse perceived awareness after FCR.  Read the full article​ after watching this video.​
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Falls are the leading cause of injury-related death and disability in community-dwelling older adults. Evidence-based fall prevention activities in primary care, including nurse-facilitated wellness visits, have been limited. Barriers including patient engagement and adherence exist. A quality improvement project integrating components of the Centers for Disease Control’s Stopping Elder Accidents, Deaths and Injury was introduced by registered nurses during older adult annual wellness visits. A total of 522 patients were screened, with 21% (n=111) having increased fall risk. Of these, 78% (n=87) engaged in home safety, gait, strength, and balance assessments and the majority (95%, n=83) participated in fall prevention plans of care. At 2-week follow-up, patients’ self-reported adherence was 74% for gait/strength/balance and 67% for home safety. An expanded primary care team model shows promise for promoting fall prevention behaviors. Read the full article​ after watching this video.
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Licensed Practical Nurses (LPNs) working in nursing homes are the primary licensed nurses providing care and ensuring patient safety in New Jersey (NJ). As such it is important to understand LPN’s perception of patient safety culture (PSC) and job satisfaction, which may impact resident safety.  A cross-sectional study was used to describe the relationship between LPNs’ perception of PSC in nursing homes and job satisfaction. LPNs working in nursing homes were less satisfied compared with LPNs working in other settings, and their perception of PSC was lower than 2019 national data. Now is an opportune time to implement initiatives to foster a culture of safety in nursing homes.  Read the full article ​after watching this video.
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Literature shows that interdisciplinary huddles help promote clear communication and proactive reporting of potential errors. High Reliability Organization (HRO) and just culture models were implemented, yet fragmented team communication about patient safety remained. Daily interdisciplinary huddles were implemented to improve communication, reduce errors, and improve patient and employee satisfaction.  Near miss reporting; patient satisfaction with how the staff worked together to provide care; and employee satisfaction and perception of workgroup communication, collaboration, and psychological safety scores improved. Read the full article ​after watching this video.
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Up to 40% of delirium cases are preventable and early identification is key to improve patient outcomes. A delirium intervention program targeted patients at high-risk for delirium and included patient and nurse education, risk stratification, multi-disciplinary rounds, a non-pharmacological intervention bundle, and a treatment order set. After implementation, there was a reduction in length of stay of 6.3 days (p = .01), a 24% decrease in disposition to a skilled nursing facility (p= .05), and increased detection of delirium by nurses. Positive patient outcomes were achieved by employing a multifactorial approach for delirium identification, prevention, and management. Read the full article​ after watching this video.













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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