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A Successful Prevention Effort for Catheter-Associated Urinary Tract Infection

Video Author: Sue Rees, RN, VP for Development, Nursing & Patient Care Services at University of Wisconsin Hospital & Clinics
Published on: 03.04.2014
Associated with: Journal of Nursing Care Quality. 29(2):141-148, April/June 2014

This interdisciplinary team reduced the number of catheter-associated urinary tract infections in their health system. Learn more about the 4 strategies they used and how they implemented the project system wide.

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Duration: 3:11
Patient safety checklists are ubiquitous in health care. Nurses bear significant responsibility for ensuring checklist adherence. To report nonadherence to a checklist and stop an unsafe procedure, a workplace climate of psychological safety is needed. The author analyzed organizational data to examine the relationship between psychological safety and reports of nonadherence to the central line bundle checklist. Results showed varied perceptions of psychological safety but no relationship with nonadherence. You will enjoy watching this innovative video and will learn a lot from it (and be sure to also read the article).
Duration: 4:31
The Consolidated Framework for Implementation Research guided the formative evaluation of the implementation of a redesigned interprofessional team rounding process. The redesigned process was intended to improve health team communication about hospital discharge. Themes emerging from interviews of patients, nurses, and providers revealed the inherent value and positive characteristics of the new process, but also workflow, team hierarchy, and process challenges to successful implementation. The evaluation identified actionable recommendations for modifying the implementation process. Ms. Bahr summarizes the study in this video but be sure to read the full article in JNCQ.
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.
Duration: 3:53
Approximately a quarter of medication errors in the hospital occur at the administration phase, which is solely under the purview of the bedside nurse. Dr. Gail Armstrong reports on her study that assessed bedside nurses' perceived skills and attitudes about updated safety concepts and examined their impact on medication administration errors and adherence to safe medication administration practices. Findings supported the premise that medication administration errors result from an interplay among system-, unit-, and nurse-level factors. Watch this video and then read Dr. Armstrong’s articles about the study and tool development.
Duration: 4:40
The QSEN RN-BSN Task Force developed recommendation for a systems-based practice competency. Recommendations are to integrate systems-based practice into both education and practice settings. Watch the video and read the article to learn more about this proposed QSEN competency.
Duration: 4:11
Learn more about this study to test an intervention to reduce medication omissions without documentation. The authors are using nurse-initiated recall cards and medication chart checking at handover. Watch the video and then read the full article.
Duration: 2:10
Most health care quality improvement (QI) studies focus on the engagement of executive leadership and frontline staff as key factors for success. Little work has been done on understanding how mid-level unit/program managers perceive their role in QI and how capacity could be built at this level to increase success. In this video and article, the authors present an ethnographic study on the experience of hospital middle managers to consider how the expectations and capacity of their current position might influence QI progress organizationally.
Duration: 5:57
Telemetry monitoring is a limited resource. This quality improvement project describes a nurse managed telemetry discontinuation protocol to stop telemetry monitoring when it is no longer indicated. After implementing the protocol, data were collected for 6 months and compared to preintervention. There was a mean decrease in telemetry monitor usage and likelihood of remaining on a telemetry monitor until discharge. Learn about this nurse-managed telemetry discontinuation protocol – watch the video and then read the article.
Duration: 3:41
Learn about this project to develop and implement a nurse-driven protocol to remove urinary catheters using evidence-based criteria. The specific aim was to decrease average catheter dwell time with the use of a nurse-driven protocol in MICU patients. In this video the author explains the need for the practice change and how she improved care on the unit. After watching the video, be sure to read the article.
Duration: 7:53
Assessing high risk for falling among psychiatric inpatients is particularly challenging in that assessments with strong sensitivity and specificity are not available. The author explains their study to validate use of the Baptist Health High Risk Falls Assessment (BHHRFA), a medical-surgical fall risk assessment, with a psychiatric inpatient population. Data collected on 5910 psychiatric inpatients using the BHHRFA showed acceptable sensitivity, specificity, and diagnostic odds ratio. After you watch the video, take time to read the article.
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.
Duration: 3:15
Many readers are interested in transitional care. This video and article provide the information you need. The authors describe their project to reduce readmissions through the establishment of a pilot program using the C-TraC program, which is a phone-based, protocol-driven, low-cost, nurse-led, transitional care model. The goal was to connect with the patients telephonically up to 30 days postdischarge to mitigate current confusion regarding the discharge plan and identify potential medication discrepancies. Learn about this effective transitional care model.
Duration: 2:41
Medication errors are a source of serious patient harm. A unique approach, Socio-Technical Probabilistic Risk Assessment, was used to analyze medication errors in this pediatric setting. Three steps were identified that should be taken with every intravenous medication or fluid administration. Nurses check for the 3Cs: Connections, Clamps, and Confirming pump settings. Preliminary analysis revealed a 22% reduction in errors. This video is prepared with a pediatric theme!
Duration: 4:04
Learn more about this study that examined the implementation of handoff as part of TeamSTEPPS initiatives for improving shift-change communication. The authors conducted on-site interviews and made observations in 8 critical access hospitals. Facilitators and barriers were different between high and low performing hospitals. Staff involvement and being part of the “big picture” were important facilitators to change management and buy-in. After viewing this video, read the article to learn more about this important study.
Duration: 2:58
Rapid response team (RRT) adoption and implementation are associated with improved quality of care of patients who experience an unanticipated medical emergency. The sustainability of RRTs is vital to achieve long-term benefits of these teams for patients, staff, and hospitals. The author describes a study that examined the relationship between sustainability elements and RRT sustainability in hospitals with RRTs. Watch the video and be sure to read the article.
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.
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.
Duration: 3:07
The purpose of this QI project was to determine the feasibility of using provider-led participatory visual methods to scrutinize 4 hospital units' infection prevention and control practices. Methods included provider-led photo walkabouts, photo elicitation sessions, and postimprovement photo walkabouts. Nurses readily engaged in using the methods to examine and improve their units' practices and reorganize their work environment.
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.
Duration: 16:32
A multicomponent intervention was attempted in a pediatric emergency department to increase reporting of workplace aggression committed by patients and visitors. Overall reporting decreased from 53% to 47% (p = .06). Reasons for reporting were severity of incident and being asked to report. However, many incidents were not reported. Watch the video and be sure to read the article.