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Perceptions of Nurses Who Are Second Victims in a Hospital Setting

Video Author: Draus, Catherine DNP, RN, ACNS-BC, CCRN, MSNBC; Mianecki, Therese B. PhD, RN; Musgrove, Hannah MSN, APRN, AGCNS-BC, PMGT-BC; Bastien, Danielle J. DNP, APRN, FNP-BC; Greggs, Dana MSN, RN, ACNS-BC; Halash, Christine BSN, RN, CCRN; (Larry-Osman) Bellamy, Che
Published on: 03.10.2022
Associated with: Journal of Nursing Care Quality. 37(2):110-116, April/June 2022

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.

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CLABSI Rounding Team: A Collaborative Approach to Prevention

Creator: Pate, Kimberly DNP, RN, ACCNS-AG, PCCN-K; Brelewski, Kiersten MSN, RN, AGCNS-BC, OCN; Rutledge, Sarah R. MSN, RN, ACCNS-AG, CCRN, OCN; Rankin, Veronica DNP, RN-BC, NP-C, CNL, NE-BC; Layell, Jessica BSN, RN, CIC

Duration: 4:43

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.

Play Video |

Improving Lung Cancer Screening Rates Through an Evidence-based Electronic Health Record Smoking History

Creator: Russell, Cynthia K. DNP, RN-BC; McNeill, Margaret PhD, RN, APRN-CNS, CCRN-K, TCRN, CPAN, NE-BC, NHDP-BC, FCNS, FAAN

Duration: 3:53

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.

Play Video |

Perceptions of Nurses Who Are Second Victims in a Hospital Setting

Creator: Draus, Catherine DNP, RN, ACNS-BC, CCRN, MSNBC; Mianecki, Therese B. PhD, RN; Musgrove, Hannah MSN, APRN, AGCNS-BC, PMGT-BC; Bastien, Danielle J. DNP, APRN, FNP-BC; Greggs, Dana MSN, RN, ACNS-BC; Halash, Christine BSN, RN, CCRN; (Larry-Osman) Bellamy, Che

Duration: 4:34

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.

Play Video |

Fall Prevention and Injury Reduction Utilizing Continuous Video Monitoring in Hospitalized Patients: A Quality Improvement Initiative

Creator: Hogan Quigley, Beth DNP, MSN, RN, CRNP; Renz, Susan M. PhD, DNP, RN, GNP-BC; Bradway, Christine PhD, CRNP, FAAN, AGSF

Duration: 3:25

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. This article is offered for CE (see link at the end of the article).

Play Video |

Workplace Predictors of Quality and Safe Patient Care Delivery Among Nurses Using Machine Learning Techniques

Creator: Havaei, Farinaz PhD, RN, MERM; Ji, Xuejun Ryan PhD, MEd; Boamah, Sheila A. PhD, RN

Duration: 3:05

Working in unhealthy environments is associated with negative nurse and patient outcomes. The purpose of this study was to identify the most important workplace factors predicting nurses’ provision of quality and safe patient care. A cross-sectional correlational survey involving 4029 direct care nurses in British Columbia was conducted using random forest data analytics methods. Nurses’ reports of healthier workplaces, particularly workload management, psychological protection, physical safety and engagement, were associated with higher ratings of quality and safe patient care. After watching the video. read the article – it is Open Access

Play Video |

Modeling Patient Risk for Hospital Acquired Pressure Injuries During COVID-19: A Retrospective Study

Creator: Montgomery, Aoyjai P. PhD, BSN; Patrician, Patricia A. PhD, RN; Hall, Allyson PhD, MBA, MHS; Miltner, Rebecca S. PhD, RN, CNL, NEA-BC; Enogela, Ene M. MPH; Polancich, Shea PhD, RN

Duration: 2:36

COVID-19 negatively impacts many organ systems including the skin. The aim of this study was to determine risk factors that would place hospitalized patients at a higher risk for hospital-acquired pressure injuries (HAPIs) during the COVID-19 pandemic. There were 247 out of 23,093 patients who had pressure injuries and 1053 patients who had a positive COVID-19 diagnosis. Diagnosis of COVID-19, age, male gender, risk of mortality, severity of illness, and length of stay were statistically significant factors associated with the development of HAPIs. Learn more about this study in the video and article.

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Nurse Burnout Syndrome and Work Environment Impact Patient Safety Grade

Creator: Montgomery, Aoyjai P. PhD, BSN; Patrician, Patricia A. PhD, RN, FAAN; Azuero, Andres PhD, MBA

Duration: 2:02

This study examined nurse-reported patient safety grade and its relationship to both burnout and the nursing work environment. A cross-sectional electronic survey was conducted among 928 nurses in acute care Alabama hospitals. All burnout dimensions of the Copenhagen Burnout Inventory and work environment were related to patient safety grade after controlling for nurse characteristics. Health care organizations can reduce negative patient safety ratings by reducing nurse burnout and improving the work environment at the organization level. Learn more about this study in the video and article.

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Reducing Cardiac Telemetry Nuisance Alarms Through Evidence-based Interventions

Creator: Karapas, Eleftheria T. DNP, RN; Bobay, Kathleen PhD, RN, NEA-BC, FAAN

Duration: 02:29

Interventions were directed at reducing nuisance alarms on a 32-bed, non–intensive care - a cardiac telemetry unit. A nursing staff education module with evidence-based practices for reducing nuisance alarms, a daily care protocol for patients on cardiac telemetry monitoring, and daily audits of protocol adherence were implemented. Staff knowledge increased, and daily audits for 7 weeks demonstrated an average of 58.46% staff adherence. Telemetry technician call volume reduction was 16% postimplementation, but nuisance alarms were not reduced significantly.

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Universal Depression Screen of Ambulatory Heart Transplant Recipients with Referral for Mental Health Intervention: A Quality Improvement Project

Creator: Peters, Laura L. DNP, RN, FNP; Ambardekar, Amrut V. MD; Rosenthal, Laura D. DNP, RN, ACNP, FAANP; McIlvennan, Colleen K. DNP, RN, ANP

Duration: 06:28

Patients with a heart transplant and depression have higher rates of graft failure and noncompliance. The heart transplant clinic implemented routine use of the Patient Health Questionnaire (PHQ). From July 2018 to February 2019, there were 834 visits; PHQ2 screens were completed during 779 (93%) of those visits with 40 (5%) positive screens. All 40 patients had PHQ9 assessment, with 33 patients (4%) exhibiting moderate or severe depressive symptoms. All 33 patients were provided with mental health resources and received follow-up. Implementation of universal depression screening in a heart transplant clinic is feasible, identifies patients with depression, and does not add significant clinical burden.

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Keeping Patients under the Damage Threshold for Pressure Injury: Addressing Microclimate Through Allostasis

Creator: Tanner, Laurel MA; Rappl, Laurie DPM, CWS; Oberg, Craig PhD; Call, Evan MS, CSM-NRM

Duration: 02:25

Patient microclimate is a contributing risk factor for pressure injuries (PI). However, the acceptable range for microclimate is unknown, in part because the body adapts to changing conditions. Addressing microclimate, when coupled with an increasing awareness of the cumulative effect of individual patient risk factors, can help resolve the risk of PI by lowering the cumulative inputs to keep patients under the threshold for tissue damage. Learn more about this in the video and article.

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Universal Depression Screen of Ambulatory Heart Transplant Recipients with Referral for Mental Health Intervention: A Quality Improvement Project

Creator: Peters, Laura L. DNP, RN, FNP; Ambardekar, Amrut V. MD; Rosenthal, Laura D. DNP, RN, ACNP, FAANP; McIlvennan, Colleen K. DNP, RN, ANP

Duration: 6:28

Patients with a heart transplant and depression have higher rates of graft failure and noncompliance. The heart transplant clinic implemented routine use of the Patient Health Questionnaire (PHQ). From July 2018 to February 2019, there were 834 visits; PHQ2 screens were completed during 779 (93%) of those visits with 40 (5%) positive screens. All 40 patients had PHQ9 assessment, with 33 patients (4%) exhibiting moderate or severe depressive symptoms. All 33 patients were provided with mental health resources and received follow-up. Implementation of universal depression screening in a heart transplant clinic is feasible, identifies patients with depression, and does not add significant clinical burden.

Play Video |

Keeping Patients under the Damage Threshold for Pressure Injury: Addressing Microclimate Through Allostasis

Creator: Tanner, Laurel MA; Rappl, Laurie DPM, CWS; Oberg, Craig PhD; Call, Evan MS, CSM-NRM

Duration: 2:25

Patient microclimate is a contributing risk factor for pressure injuries (PI). However, the acceptable range for microclimate is unknown, in part because the body adapts to changing conditions. Addressing microclimate, when coupled with an increasing awareness of the cumulative effect of individual patient risk factors, can help resolve the risk of PI by lowering the cumulative inputs to keep patients under the threshold for tissue damage. Learn more about this in the video and article.

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Patients’ and Nurses’ Perceptions of the Quality of Nursing Care in Surgical Clinics: A Multicenter Study in Turkey

Creator: Mert, Selda PhD; Kersu, Özlem MSc; Aydin Sayilan, Aylin PhD; Baydemir, Canan PhD; Ilter, Gonca MSc

Duration: 4:49

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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Implementing and Sustaining Bedside Shift Report for Quality Patient Centered Care

Creator: Becker, Sherry MSN-Ed, RN-BC, CWOCN; Hagle, Mary PhD, RN-BC, FAAN; Amrhein, Andra BSN, RN; Bispo, Jeffrey MSN, RN, CNL; Hopkins, Sarah MSN, RN, CNL; Kogelmann, Mary BSN, RN; Porras, Elizabeth BSN, RN; Smith, Melissa M. BSN, RN

Duration: 4:15

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.

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

Creator: Francisco, Mary Ann MSN, APN, AGCNS-BC, CCRN-K; Pierce, Nicole L. PhD, RN; Ely, Elizabeth PhD, RN; Cerasale, Matthew T. MD, MPH; Anderson, Daniela MD; Pavkovich, David MD, FACP, FAAP; Puello, Frances MD; Tummala, Sandeep MD; Tyker, Albina MD; D'Souza, Fel

Duration: 4:22

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.

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Reducing Delirium in Hospitalized Adults Through a Structured Sleep Promotion Program

Creator: Gode, Autumn MS, APRN-CNS; Kozub, Elizabeth MS, APRN-CNS, CCNS, CNRN, CCRN; Joerger, Kyla BSN, RN-BC; Lynch, Cassandra BSN, NE-BC, OCN; Roche, Maren BSN, RN; Kirven, Justin MD

Duration: 2:15

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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Impact of a Real-Time, Pharmacist-Led, Intensive Care Unit-based Feedback Intervention on Analgesia and Sedation Quality Among Mechanically Ventilated Patients

Creator: Mancheril, Benjamin PharmD, BCPS, BCCCP; Kram, Bridgette PharmD, BCPS, BCCCP; Schultheis, Jennifer PharmD, BCPS, BCCCP; Kram, Shawn PharmD, BCPS, BCCCP; Trammel, Morgan PharmD, BCCCP; Liu, Beiyu PhD, MS; Jordan, Weston MS; Cox, Christopher E. MD, MPH

Duration: 4:00

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..

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Incidence and Predictors of Nonventilator Hospital-Acquired Pneumonia in a Community Hospital

Creator: Patty, Christopher M. DNP, RN, CPPS; Sandidge-Renteria, Alisha MSN, FNP-C, RN-CMSRN; Orique, Sabrina PhD, RN, AOCNS; Dixon, Craig MSN, FNP-C, RN; Camarena, Emma DNP, CNS, RN, ACCNS-AG; Newsom, Rose MSN, RN, NE-BC; Schneider, Alicia MSN, AGCNS-BC, RN-BC, C

Duration: 3:49

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.

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Challenges of Implementing the Choosing Wisely® Guideline to Promote Sleep and Rest at Night for Hospitalized Patients

Creator: Graham, Kimberly DNP, APRN, ACNS-BC; Ogbuji, Grace BSN, RN; Williams, Zainab BSN, RN; Crain, Maria BSN, RN, BMTCN; Rolin, Barbara MSN, RN-BC; Juala, Jeremy BSN, RN, CMSRN; Larbi, Ida BSN, RN, OCN; Bernard, Noreen EdD, RN, NEA-BC, FAAN; Oster, Cynthia A. P

Duration: 2:40

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.

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Psychometric Testing of a Patient Empowerment, Engagement, and Activation Survey

Creator: Stichler, Jaynelle F. DNSc, RN, NEA-BC, FACHE, FAAN; Pelletier, Luc R. MSN, APRN, PMHCNS-BC, FAAN

Duration: 2:17

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).

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CLABSI Rounding Team: A Collaborative Approach to Prevention

Creator: Pate, Kimberly DNP, RN, ACCNS-AG, PCCN-K; Brelewski, Kiersten MSN, RN, AGCNS-BC, OCN; Rutledge, Sarah R. MSN, RN, ACCNS-AG, CCRN, OCN; Rankin, Veronica DNP, RN-BC, NP-C, CNL, NE-BC; Layell, Jessica BSN, RN, CIC

Duration: 4:43

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.

Play Video |

Improving Lung Cancer Screening Rates Through an Evidence-based Electronic Health Record Smoking History

Creator: Russell, Cynthia K. DNP, RN-BC; McNeill, Margaret PhD, RN, APRN-CNS, CCRN-K, TCRN, CPAN, NE-BC, NHDP-BC, FCNS, FAAN

Duration: 3:53

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.

Play Video |

Perceptions of Nurses Who Are Second Victims in a Hospital Setting

Creator: Draus, Catherine DNP, RN, ACNS-BC, CCRN, MSNBC; Mianecki, Therese B. PhD, RN; Musgrove, Hannah MSN, APRN, AGCNS-BC, PMGT-BC; Bastien, Danielle J. DNP, APRN, FNP-BC; Greggs, Dana MSN, RN, ACNS-BC; Halash, Christine BSN, RN, CCRN; (Larry-Osman) Bellamy, Che

Duration: 4:34

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.

Play Video |

Fall Prevention and Injury Reduction Utilizing Continuous Video Monitoring in Hospitalized Patients: A Quality Improvement Initiative

Creator: Hogan Quigley, Beth DNP, MSN, RN, CRNP; Renz, Susan M. PhD, DNP, RN, GNP-BC; Bradway, Christine PhD, CRNP, FAAN, AGSF

Duration: 3:25

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. This article is offered for CE (see link at the end of the article).

Play Video |

Workplace Predictors of Quality and Safe Patient Care Delivery Among Nurses Using Machine Learning Techniques

Creator: Havaei, Farinaz PhD, RN, MERM; Ji, Xuejun Ryan PhD, MEd; Boamah, Sheila A. PhD, RN

Duration: 3:05

Working in unhealthy environments is associated with negative nurse and patient outcomes. The purpose of this study was to identify the most important workplace factors predicting nurses’ provision of quality and safe patient care. A cross-sectional correlational survey involving 4029 direct care nurses in British Columbia was conducted using random forest data analytics methods. Nurses’ reports of healthier workplaces, particularly workload management, psychological protection, physical safety and engagement, were associated with higher ratings of quality and safe patient care. After watching the video. read the article – it is Open Access

Play Video |

Modeling Patient Risk for Hospital Acquired Pressure Injuries During COVID-19: A Retrospective Study

Creator: Montgomery, Aoyjai P. PhD, BSN; Patrician, Patricia A. PhD, RN; Hall, Allyson PhD, MBA, MHS; Miltner, Rebecca S. PhD, RN, CNL, NEA-BC; Enogela, Ene M. MPH; Polancich, Shea PhD, RN

Duration: 2:36

COVID-19 negatively impacts many organ systems including the skin. The aim of this study was to determine risk factors that would place hospitalized patients at a higher risk for hospital-acquired pressure injuries (HAPIs) during the COVID-19 pandemic. There were 247 out of 23,093 patients who had pressure injuries and 1053 patients who had a positive COVID-19 diagnosis. Diagnosis of COVID-19, age, male gender, risk of mortality, severity of illness, and length of stay were statistically significant factors associated with the development of HAPIs. Learn more about this study in the video and article.

Play Video |

Nurse Burnout Syndrome and Work Environment Impact Patient Safety Grade

Creator: Montgomery, Aoyjai P. PhD, BSN; Patrician, Patricia A. PhD, RN, FAAN; Azuero, Andres PhD, MBA

Duration: 2:02

This study examined nurse-reported patient safety grade and its relationship to both burnout and the nursing work environment. A cross-sectional electronic survey was conducted among 928 nurses in acute care Alabama hospitals. All burnout dimensions of the Copenhagen Burnout Inventory and work environment were related to patient safety grade after controlling for nurse characteristics. Health care organizations can reduce negative patient safety ratings by reducing nurse burnout and improving the work environment at the organization level. Learn more about this study in the video and article.

Play Video |

Implementing and Sustaining Bedside Shift Report for Quality Patient Centered Care

Creator: Becker, Sherry MSN-Ed, RN-BC, CWOCN; Hagle, Mary PhD, RN-BC, FAAN; Amrhein, Andra BSN, RN; Bispo, Jeffrey MSN, RN, CNL; Hopkins, Sarah MSN, RN, CNL; Kogelmann, Mary BSN, RN; Porras, Elizabeth BSN, RN; Smith, Melissa M. BSN, RN

Duration: 4:15

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.

Play Video |

Development of the Nursing Quality Improvement in Practice Tool: Advancing Frontline Nursing Practice

Creator: Tschannen, Dana PhD, RN; Alexander, Catherine DNP, MPH, RN; Tovar, Elizabeth G. PhD, APRN; Ghosh, Bidisha MS; Zellefrow, Cindy DNP, MSEd, RN, LSN, PHNA-BC, EBP-C; Milner, Kerry A. DNSc, RN

Duration: 4:35

Frontline nurse engagement in quality improvement (QI) improves nurse-sensitive outcomes. The purpose of this study was to develop and psychometrically evaluate the Nursing Quality Improvement in Practice (N-QuIP) tool to measure nurses' competency, engagement, and barriers/facilitators to QI engagement. Item development was guided by an expert panel and literature review. Factor analysis and reliability indices were assessed through 681 surveys completed by nurses at one medical center. Preliminary data suggest that the N-QuIP is a valid and reliable tool for assessing nurse QI competence and engagement. Watch the video and read the article.

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Restorative Quality Improvement: Novel Application of Six Sigma in a Skilled Nursing Facility

Creator: Johnson, Hannah DPT, PT, GCS

Duration: 3:02

Six Sigma was used in a nursing home to improve the functional maintenance program charting/auditing. With the existing staff, capability was increased by 17 residents ($200 000 revenue) and 90% to 100% charting congruence was achieved. Learn more about implementing QI in nursing homes in this video and article.

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Recommendations for Fall Related Injury Prevention: A 1-Year Review of Fall Related Root Cause Analyses in the Veterans Health Administration

Creator: Soncrant, Christina MPH; Neily, Julia RN, MS, MPH; Bulat, Tatjana MD, CMD; Mills, Peter D. PhD, MS

Duration: 8:08

Injurious falls continue to challenge health care. Learn about this study that analyzed root cause analysis reports on falls and coded injury type, fall type, location, and root causes. There were 154 reported fall RCAs during the study period. Most (83%, n = 128) falls resulted in major injury: hip fractures (43%, n = 66), other fractures (25%, n = 38), and head injury (16%, n = 24). Most falls were unwitnessed (75%, n = 116). Patients who fell were not wearing hip or head protection. These interventions may help prevent future injurious falls. After you watch this informative video, read the full article.

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Development and Implementation of a Model for Research, Evidence-based Practice, Quality Improvement, and Innovation

Creator: Hagle, Mary PhD, RN-BC, FAAN; Dwyer, Darcy DNP, RN, ACNS-BC; Gettrust, Lynn DNP, RN, ACNS-BC; Lusk, Dana DNP, RN, CHPN, AHN-BC; Peterson, Kristen BSN, RN; Tennies, Sherry MSN-Ed, RN-BC, CWOCN

Duration: 2:57

The I3 (Inquiry, Improvement, and Innovation) Model was developed to guide EBP and QI projects, research studies, and innovation. The model provides an algorithm with steps and decision points for nurses to follow based on a question from a clinical issue or problem. The model is used for guiding projects in the health care system.

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Augmenting Atrial Fibrillation Care after an Emergency Department Visit: Implementing Telephone Practice

Creator: Hart, Danielle RN (EC); Hopman, Wilma M. MA; Hammond, Sharlene BN, RN; Redfearn, Damian P.

Duration: 3:12

Atrial fibrillation (AF) care can be episodic and heavily reliant on hospital resources, particularly the emergency department (ED). A nurse practitioner developed a new program to improve AF care after an ED visit, which included contacting patients by telephone. Telephone contact was highly effective: 37 of 90 patients with AF presented to the ED prior to telephone contact and 7 of 90 patients did so post–telephone contact (P < .001). Telephone practice led by an NP provides an opportunity to improve assessment and management of patient care. Learn more about this intervention in this video and read the full article.

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Quiet Time Improves the Patient Experience

Creator: Hedges, Christine, PhD, RN, NE-BC; Hunt, Candice, MHA; Ball, Pamela, BSN, RN, NE-BC

Duration: 2:44

A quiet environment promotes rest and healing but is often challenging to provide in a busy acute care setting. A multidisciplinary team used Lean methods and the Model for Improvement to test interventions for Quiet Time (QT) and used HCAHPS “always quiet” scores as the primary outcome measure. The team instituted nighttime and afternoon QT supported by rounding and scripting, dimming lights, lowering staff voices, offering a sleep menu at night, and replacing noisy wheels. Quiet scores improved on both units after 11 months. You will appreciate the level of noise patients experience in hospitals (watch this video for a demonstration) and learn more about QT intervention – you can implement QT in your settings. Don’t miss this video and article (and get your Continuing Education).

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Quality Improvement Project to Manage Workplace Violence in Hospitals: Lessons Learned

Creator: Schwartz, Franklin, DNP, APRN, PMHNP-BC; Bjorklund, Pamela, PhD, APRN, PMHNP-BC, CNS-BC

Duration: 3:58

In this video, the author describes a violence management program that she and her coauthor piloted on a general medical unit following staff requests for measures to protect them from patient and visitor violence. An independent pre/posttest design measured changes in participant knowledge. The Staff Observation Assessment Scale Revised (SOAS-R) was used for data collection on aggression pre- and postimplementation. The violence management training program included in situ simulation training in de-escalation techniques. Knowledge of de-escalation techniques to reduce violence risk increased. In the article the authors share important lessons for ongoing program implementation.

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Nurses' Perception of the Impact of Electronic Documentation on the Nurse-Patient Relationship

Creator: Misto, Kara, PhD, RN; Padula, Cynthia, PhD, RN; Bryand, Elizabeth, BSN, RN-BC; Nadeau, Kate, MPH, RN

Duration: 5:16

While there are many benefits of EMR documentation, the presence of a computer may adversely affect provider-patient interaction. The purpose of this project was to examine staff nurses' perception of the impact of electronic documentation in the presence of the patient on the nurse-patient relationship. A survey was administered to 276 staff nurses, and open-ended interviews were conducted with 11 novice and 20 expert nurses. Nurses identified benefits and challenges to EMR documentation and strategies to maintain therapeutic relationships and communication. Dr Misto explains the study in this video and article.

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Individualized Fall Prevention Program in an Acute Care Setting: An Evidence-Based Practice Improvement

Creator: Spano-Szekely, Lauraine, DNP, RN; Winkler, Anne, MA, RN, CCRN; Waters, Cathy, MSN, RN, OCN, NEA-BC; Dealmeida, Susana, MHA, RN-C; Brandt, Kathy, RPh; Williamson, Marsha, MSN, RN-BC, ANP-BC, CCRN-K; Blum, Christina, BSN, RN; Gasper, Lori, BSN, RN; Wright,

Duration: 1:09

Learn how this team evaluated their hospital's fall prevention program and decreased their fall rate – watch the video and be sure to read their article. The team used a clinical practice guideline with 7 key practices to develop an individualized fall prevention program with multiple interventions (nurse-driven mobility assessment, purposeful hourly rounding, video monitoring for confused and impulsive fall-risk patients, and others). The fall rate decreased to 1.14, with a 72% expense reduction based on decreased sitter usage.

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Writing Journal Articles: Tips for your Success Series Video 1: Getting Started: Purpose, Readers, Selecting a Journal

Creator: Marilyn Oermann

Duration:

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.

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Writing Journal Articles: Tips for your Success Series Video 2: Next Steps: Manuscript Format and Content

Creator: Marilyn Oermann

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This is the 2nd 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.

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Writing Journal Articles: Tips for your Success Series Video 3: Submission, Responding to Reviews, and Other Tips

Creator: Marilyn Oermann

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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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Reducing Inappropriate Antibiotics for Urinary Tract Infections in Long-Term Care: A Replication Study

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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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Applying the PDSA Framework to Examine Use of the Clinical Nurse Leader to Evaluate Pressure Ulcer Reporting

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Duration: 4:08

Clinical nurse leaders (CNLs) improve care at the microsystem level. Learn about the use of the CNL role in an academic medical center for evaluating pressure ulcer reporting – watch this video and be sure to read the article. The authors used the Plan-Do-Study-Act cycle as the methodology for the study. The CNL assessment of pressure ulcers resulted in a 21% to 50% decrease in the number of hospital-acquired pressure ulcers reported in a 3-month time period. The CNL role has potential for improving the validity and reliability of pressure ulcer reporting.

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Nurses' Perceptions of Quality Care

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Duration: 4:03

Limited research has been conducted on how nurses perceive “quality nursing care.” The authors conducted focus groups to identify nurses' perceptions of quality care at a Midwestern academic medical center. Transcripts of the focus group sessions were analyzed using thematic analysis techniques, and 11 themes emerged: Leadership, Staffing, Resources, Timeliness, Effective Communication/Collaboration, Professionalism, Relationship-Based Care, Environment/Culture, Simplicity, Outcomes, and Patient Experience. Learn how nurses define quality care: watch the video and read the article.

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Alarm Fatigue: Use of an Evidence-based Alarm Management Strategy

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Duration: 4:43

The authors developed an evidence-based alarm management strategy and describe their project in this video. The alarm management program reduced alarms up to 30%. Evaluation of patients on continuous cardiac monitoring showed a 3.5% decrease in census. This alarm management strategy has the potential to save $136 500 and 841 hours of registered nurses' time per year. Make sure you read their article too.

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Examining IV Insulin Practice Guidelines in the Cardiac Surgery Patient: Nurses Evaluating Quality Outcomes

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Duration: 7:26

Recent changes in the Surgical Care Improvement Project guideline require blood glucose values be less than 180 mg/dL 18 to 24 hours after anesthesia end time after cardiac surgery. The authors studied 2 groups of patients: the first group of patients was transitioned off IV insulin on postoperative day 1, 24 hours after anesthesia end time, whereas the second group was transitioned off IV insulin on the second day, 48 hours after anesthesia end time. The results showed no statistical differences in outcomes between groups. Watch this video and read the article to learn about the study and evidence they gathered from it.

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Health System Quality Improvement: Impact of Prompt Nutritional Care on Patient Outcomes and Health Care Costs

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Duration: 6:12

Among hospitalized patients, malnutrition is prevalent yet often overlooked and undertreated. The author implemented a QI program that integrated early nutritional care into the nursing workflow. Nurses screened for malnutrition risk at patient admission and then immediately ordered oral nutritional supplements for those at risk. Supplements were given as regular medications. Pressure ulcer incidence, length of stay, 30-day readmissions, and costs of care were reduced. Watch this video and read the entire article for free: the article is open access so readers can learn about this important QI initiative.

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Nursing Staff Develop a Video to Prevent Falls: A Quality Improvement Project

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Duration: 5:48

Many fall prevention strategies exist with some degree of effectiveness. Watch this video and read the article to learn about a staff-driven QI initiative to develop a video in partnership with patients and families to prevent falls when hospitalized. Since the video's release, the fall rate has decreased by 29.4%.

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Missed Nursing Care and Unit-Level Nurse Workload in the Acute and Post-Acute Setting

Creator: Sabrina Orique and Christopher Patty

Duration: 5:08

Watch this video and read the article to learn more about the nature and causes of missed nursing care and how it relates to unit-level nurse workload. This study was conducted in California, which legally mandates nurse staffing ratios. There were no significant relationships between patient turnover and missed nursing care.

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Innovations to Increase Timely Defibrillation Rates

Creator: Meredith Borak

Duration: 5:35

Early defibrillation is critical for patients with in-hospital cardiac arrest. This video and article describe how a team at The University of Chicago Medicine increased the rate of early defibrillation by nurse first responders in noncritical care areas.

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Predictors of Travel Nurse Job Performance

Creator: Carol Tuttas

Duration: 2:38

Travel nurses fulfill temporary full-time contracts in hospitals across the US, but little is known about their job performance and factors that influence their adjustment to the work setting. This mixed-methods study by Carol A. Tuttas identified the unique needs and characteristics of travel nurses.

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