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January/March 2019 - Volume 34 - Issue 1

  • Marilyn H. Oermann, PhD, RN, FAAN
  • 1057-3631
  • 1550-5065
  • 4 issues / year
  • 58/118
  • 1.191

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This issue includes articles on a wide range of initiatives and studies. Lehr et al describe how they used Lean principles and partnerships to transition to new smart pumps: this article is OPEN so share widely with colleagues. Lean also was used to change processes for identifying patients with heart failure and increasing core measure scores (read this article for CE). Are you thinking about doing nurse peer review? An article explains how nursing leaders and staff nurses from rural and critical access hospitals collaborated to establish peer review. Other articles report research on the effects of nurse engagement and nurse staffing on patient safety, alarm fatigue among labor nurses, and much more.

Marilyn H. Oermann, Editor-in-Chief

Achieving Outcomes With Innovative Smart Pump Technology: Partnership, Planning, and Quality Improvement

Lehr, Jennifer; Vitoux, Rachel R.; Evanovich Zavotsky, Kathleen; More

Journal of Nursing Care Quality. 34(1):9-15, January/March 2019.

Achieving Outcomes with Innovative Smart Pump Technology: Partnership, Planning, and Quality Improvement

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

Cooper, Denise; McFarland, Marilyn; Petrilli, Francesca; More

Journal of Nursing Care Quality. 34(1):16-21, January/March 2019.

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

Using Lean to Enhance Heart Failure Patient Identification Processes and Increase Core Measure Scores

Hunt, Jennifer R.; Ouellette, Kelli Jo; Reece, Michelle

Journal of Nursing Care Quality. 34(1):28-33, January/March 2019.

Using Lean to Enhance Heart Failure Patient Identification Processes and Increase Core Measure Scores

Association of Nurse Engagement and Nurse Staffing on Patient Safety

Brooks Carthon, J. Margo; Hatfield, Linda; Plover, Colin; More

Journal of Nursing Care Quality. 34(1):40-46, January/March 2019.

Association of Nurse Engagement and Nurse Staffing with Patient Safety

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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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Learn about this interesting study that used a process evaluation methodology. The aim was to examine the effectiveness of implementing same day discharge (SDD) following percutaneous coronary intervention. During implementation, 22 patients were discharged home the same day. It was found, however, that staff did not follow the guideline consistently, with an overall adherence of 77.3%. The study is important as it provides direction for future improvement both in the criteria and implementation process. After watching this video, be sure to read the article. 
​​A goal in many health systems is to improve heart failure (HF) core measure (CM) scores. Learn how an interdisciplinary team analyzed the processes in their setting, implemented an accurate reporting system, redesigned the process for identifying patients with HF, and changed the EHR. There was a decrease in readmissions from 12% to 8%, and HF CM compliance score increased from 88% to 100%. increased from 88% to 98%. Watch the video and then be sure to read the full article (for CE).
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​​​Incomplete or inaccurate triage examination in an emergency department can result in delays, which could compromise patient outcomes. Dr. Johnson discusses the outcomes of her study on triage interruptions and how they affect the triage process. A significant difference was seen in triage duration between interrupted and uninterrupted interviews. Understanding the impact of interruptions on patient outcomes allows nurses and other health care providers to develop interventions to mitigate the impact. After watching this video, be sure to read the article.
​​​Achieving optimal compliance for bar code medication administration (BCMA) in mature medication use systems is challenging due to the iterative system refinements over time. The author describes a nursing leadership initiative to increase BCMA compliance, measured as a composite across all hospital units. Compliance increased from 95% to 98%, but most importantly, through this initiative, leadership discovered unanticipated benefits and unintended consequences. The methodology used provides valuable insight into effective strategies for BCMA optimization with applicability for other QI initiatives. After watching the video, learn more about the initiative in the article.