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April/June 2021 - Volume 36 - Issue 2

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

Proning intubated ICU patients for the management of acute respiratory distress syndrome is an accepted standard of practice. Authors 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. 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. Other articles describe how a multidisciplinary team planned for a surge of COVID-19 patients, the use of continuous video monitoring to replace sitters, an implementation framework for a clinically indicated removal policy for peripheral intravenous catheters, and implementation of an automated sepsis screening tool in a community hospital. Don’t miss these articles and others in this issue.

Marilyn H. Oermann, Editor-in-Chief

Implementing Prone Positioning for COVID-19 Patients Outside the Intensive Care Unit

Francisco, Mary Ann; Pierce, Nicole L.; Ely, Elizabeth; More

Journal of Nursing Care Quality. 36(2):105-111, April/June 2021.

Implementing Prone Positioning for COVID-19 Patients Outside the Intensive Care Unit

Rallying All Resources: A Multidisciplinary Innovation to Plan for the Projected COVID-19 Inpatient Surge

O'Glasser, Avital Y.; Stroup, Scott; Merkel, Matthias J.; More

Journal of Nursing Care Quality. 36(2):112-116, April/June 2021.

Rallying all Resources: A Multidisciplinary Innovation to Plan for the Projected COVID-19 Inpatient Surge

An Implementation Framework for the Clinically Indicated Removal Policy for Peripheral Intravenous Catheters

Takashima, Mari; Cooke, Marie; DeVries, Michelle; More

Journal of Nursing Care Quality. 36(2):117-124, April/June 2021.

An Implementation Framework for the Clinically Indicated Removal Policy for Peripheral Intravenous Catheters

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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.
​​The purpose of this study was to determine the incidence of nonventilator hospital–acquired pneumonia NV-HAP in our community hospital and to identify patient and nursing care factors associated with its development. A retrospective study identified possible NV-HAP cases and then validated cases using CDC criteria. The incidence of NV-HAP was 0.64 cases per 1000 patient-days. Patient factors most strongly associated with NV-HAP were age  and the presence of underlying disease. Head-of-bed elevation reduced by 26% the odds of developing NV-HAP. Dr. Patty explains the study in the video - learn more in the article​.
​​​On inpatient units, patients experience lack of sleep due to noise and multiple interruptions at night. A pilot intervention to support the initiative, “Don't wake the patient for routine care unless the patient's condition or care specifically requires it,” was implemented on 3 units in 3 hospitals. Nurses implemented the project using a purposeful strategy of sleep masks, earplugs, noise detectors, and bundling care. The experiences across the 3 hospital units were positive for providers, patients, and patients' families. ​Watch the video and read the article ​to learn more.
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Person-centered care has become a widely used philosophical framework and yet has varying definitions and characteristics. Learn about the new Patient Empowerment, Engagement, and Activation Survey that can be used to evaluate patients' perspectives of care quality (empowerment and engagement) and readiness for discharge (activation). Learn more by watching the video and be sure to read 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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