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July/September 2019 - Volume 34 - Issue 3

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

A quiet environment promotes rest and healing but is often challenging to provide in a busy acute care setting. Nurses and other stakeholders developed a quiet time (QT) protocol that included nighttime and afternoon QT supported by rounding and scripting, dimming lights, lowering staff voices, offering a sleep menu at night, and replacing noisy wheels on carts. The QT protocol led to measurable improvements in quiet scores. Despite its high prevalence, malnutrition in hospitalized patients often goes unrecognized and undertreated. A hospital system improved nutrition care through a QI initiative: nurses screened patients on admission using the Malnutrition Screening Tool and initiated oral nutrition supplements for patients at risk. A review of the records of 20 697 adult patients documented benefits of this early initiation of nutrition therapy. The average time from admission to oral nutrition supplements was reduced by 20 hours (20.8%) and patients’ length of stay decreased. This is an open-access article: share with your colleagues in your agency and beyond.

Marilyn H. Oermann, Editor-in-Chief

Impact of a Nutrition-Focused Quality Improvement Intervention on Hospital Length of Stay

Siegel, Sharon; Fan, Linlin; Goldman, Amanda; More

Journal of Nursing Care Quality. 34(3):203-209, July/September 2019.

Improving Patient and Caregiver New Medication Education Using an Innovative Teach-back Toolkit

Blended Facilitation as an Effective Implementation Strategy for Quality Improvement and Research in Nursing Homes

Pimentel, Camilla B.; Mills, Whitney L.; Palmer, Jennifer A.; More

Journal of Nursing Care Quality. 34(3):210-216, July/September 2019.

Using Continuous Vital Sign Monitoring to Detect Early Deterioration in Adult Postoperative Inpatients

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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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The purpose of this study was to qualitatively analyze nursing documentation of pain management among postoperative patients in Jordan. A documentary analysis method was used. A purposive sample of 80 medical records were reviewed, and a total of 720 nursing records were analyzed. The analysis revealed that nurses' documentation of pain management was limited, vague, incomplete, and largely dependent on their subjective evaluation. There also was little documented evidence of efforts to evaluate the effectiveness of pain management interventions. Dr Shoqirat explains the study in this video, and you can learn more about the study in his article.
​​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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​​​Despite its high prevalence, malnutrition in hospitalized patients often goes unrecognized and undertreated. In this initiative nurses screened patients on admission using the Malnutrition Screening Tool and initiated oral nutrition supplements for patients at risk. A review of the medical records of 20 697 adult patients revealed that the average time from hospital admission to oral nutrition supplement initiation was reduced by 20 hours (20.8%), and length of stay also decreased for patients at nutritional risk. Watch this outstanding video to learn about this project and share the article with colleagues: it is open-access. 
​​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. 













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.”