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Preventing Catheter-Associated Urinary Tract Infection: A Multi-Pronged Collaborative Approach

Video Author: Mundle, William RN, MN, CMSN(C); Howell-Belle, Carnett RN, MN; Jeffs, Lianne PhD, RN, FAAN
Published on: 12.21.2019
Associated with: Journal of Nursing Care Quality. 35(1):83-87, January/March 2020

Catheter-associated urinary tract infections (CAUTIs) rates in our unit were higher when compared with the overall hospital rates. An interprofessional working group developed and implemented a QI bundled approach to reduce CAUTIs. There was a 79% reduction in average CAUTI rates following the bundle implementation along with reduced variability in rates.

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Preventing Catheter-Associated Urinary Tract Infection: A Multi-Pronged Collaborative Approach

Creator: Mundle, William RN, MN, CMSN(C); Howell-Belle, Carnett RN, MN; Jeffs, Lianne PhD, RN, FAAN

Duration: 4:10

Catheter-associated urinary tract infections (CAUTIs) rates in our unit were higher when compared with the overall hospital rates. An interprofessional working group developed and implemented a QI bundled approach to reduce CAUTIs. There was a 79% reduction in average CAUTI rates following the bundle implementation along with reduced variability in rates.

Play Video | + Favorites

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.

Play Video | + Favorites

Rapid Response Team-Quality Champion Registered Nurse: Observations and Perceptions

Creator: McNeill, Margaret M. PhD, RN, APRN-CNS, CCRN-K, CCNS, TCRN, CPAN, NE-BC, NHDP-BC, FAAN; Archer, Susan DNP, RN, APRN-CNS, CCRN; Remsburg, Dana MSN, RN, CCRN; Storer, Jill BSN, RN; Rudman, Heather BSN, RN

Duration: 5:07

Using a rapid response team (RRT) and quality champion (QC) nurses at a community hospital provides benefits not entirely captured by analysis of mortality data. The purpose of this study was to determine the perceived benefits of the RRT at our facility and behaviors and activities observed during actual RRT responses. This was a mixed-method study including qualitative (interviews, focus groups, and surveys) and quantitative (retrospective chart reviews) data collection. Benefits of the RRT-QC registered nurse were extensive. Observations showed support, education, and teamwork in an effort to improve outcomes and support clinicians.

Play Video | + Favorites

Interdisciplinary Rounds on a Hospitalist Service: Impact on Palliative Care Measures, Quality and Utilization Outcomes

Creator: Smith, Catherine V. DNP, RN, CCNS, CCRN; Maduro, Ralitsa S. PhD; Morgan, Merri K. DNP, RN, CCRN; Ver Schneider, Patricia; Rutledge, Carolyn M. PhD, FNP-BC; Zimbro, Kathie S. PhD, RN

Duration: 5:53

Palliative care (PC) referrals are often underutilized or delayed. To improve referrals, interdisciplinary rounds (IDRs) were implemented on the hospitalist service in a nonintensive care setting. Following implementation, median time to PC referral decreased by 2 days. Length of stay, direct cost, and 30-day mortality also decreased. Postintervention patients were more likely to transition home compared with another facility. Learn about the project in this video and then read the article: You can get CE credits for this article!

Play Video | + Favorites

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).

Play Video | + Favorites

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.

Play Video | + Favorites

Nursing Documentation of Postoperative Pain Management: A Documentary Analysis

Creator: Shoqirat, Noordeen, PhD; Mahasneh, Deema, PhD, MSc, RGN; Dardas, Latefa, PhD, PMHN; Singh, Charleen, PhD, MSc, RGN, Neuro-SN; Khresheh, Reham, PhD

Duration: 1:25

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.

Play Video | + Favorites

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

Creator: Siegel, Sharon, RD, LD; Fan, Linlin, PhD; Goldman, Amanda, MS, RD, LD, FAND; Higgins, Joseph, MS, RD, LD; Goates, Scott, PhD, MBA; Partridge, Jamie, PhD, MBA

Duration: 6:07

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.

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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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Implementation Strategies to Improve Evidence-based Bathing Practices in a Neuro ICU

Creator: Reynolds, Staci Sue, PhD, RN, ACNS-BC, CCRN, CNRN, SCRN

Duration: 3:56

Evidence supports daily bathing using chlorhexidine gluconate (CHG) cloths to decrease preventable hospital-acquired central line–associated bloodstream infections (CLABSIs). Using the Grol and Wensing Model of Implementation as a guide, this study examined whether using tailored, multifaceted strategies would improve implementation of daily CHG bathing and decrease CLABSIs in a large neuro ICU. Following implementation, infection rates decreased, and improvements were seen across all process measures. After watching the video, read this article to learn more about strategies to implement evidence, which you can use in your own setting.

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Perspectives on Patient and Family Engagement with Reduction in Harm: The Forgotten Voice And Developing an Intervention to Reduce Harm in Hospitalized Patients: Patients and Families in Research

Creator:

Duration: 6:29

Strategies have been identified to establish patient-centered care and improve patient engagement with care. However, the relationship of patient/ family engagement to reduction of harm is not well understood. Dr Schenk, in her first study, identified an opportunity for reducing risk and harm by more actively engaging patients and families in the effort. In another study her team convened a Patient Safety Advisory Panel to explore potential interventions to increase patient/family engagement with safety. The preferred intervention was Speak Up-My Advocate for Patient Safety. Learn about these studies in the video and implications for engaging patients and families in your own settings of care. Be sure to read both articles.

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Mealtime Assistance...from Chaos to Calm: A Collaborative Best Practice Implementation Project

Creator:

Duration: 3:34

Providing appropriate and timely mealtime assistance to hospitalized patients should be part of a multifaceted and multidisciplinary approach to optimizing the patient's nutritional care plan. The combined interventions of staff engagement, redesigning the model of care to reprioritize activities at mealtimes, clarifying nutritional care roles and responsibilities, introducing a protected mealtime and a novel 2-tiered colored tray system, and implementing an awareness and education program have resulted in significant improvements in mealtime assistance. Learn more about this project from the authors in the video and their article.

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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.

Play Video | + Favorites

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

Creator: Marilyn Oermann

Duration:

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

Duration:

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

Creator:

Duration:

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.

Play Video | + Favorites

Implementing Same Day Discharge Following Percutaneous Coronary Intervention: A Process Evaluation

Creator:

Duration:

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.

Play Video | + Favorites

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

Creator:

Duration:

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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Effects of Interruptions on Triage Process in Emergency Department: A Prospective, Observational Study

Creator:

Duration:

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.

Play Video | + Favorites

Preventing Catheter-Associated Urinary Tract Infection: A Multi-Pronged Collaborative Approach

Creator: Mundle, William RN, MN, CMSN(C); Howell-Belle, Carnett RN, MN; Jeffs, Lianne PhD, RN, FAAN

Duration: 4:10

Catheter-associated urinary tract infections (CAUTIs) rates in our unit were higher when compared with the overall hospital rates. An interprofessional working group developed and implemented a QI bundled approach to reduce CAUTIs. There was a 79% reduction in average CAUTI rates following the bundle implementation along with reduced variability in rates.

Play Video | + Favorites

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.

Play Video | + Favorites

Rapid Response Team-Quality Champion Registered Nurse: Observations and Perceptions

Creator: McNeill, Margaret M. PhD, RN, APRN-CNS, CCRN-K, CCNS, TCRN, CPAN, NE-BC, NHDP-BC, FAAN; Archer, Susan DNP, RN, APRN-CNS, CCRN; Remsburg, Dana MSN, RN, CCRN; Storer, Jill BSN, RN; Rudman, Heather BSN, RN

Duration: 5:07

Using a rapid response team (RRT) and quality champion (QC) nurses at a community hospital provides benefits not entirely captured by analysis of mortality data. The purpose of this study was to determine the perceived benefits of the RRT at our facility and behaviors and activities observed during actual RRT responses. This was a mixed-method study including qualitative (interviews, focus groups, and surveys) and quantitative (retrospective chart reviews) data collection. Benefits of the RRT-QC registered nurse were extensive. Observations showed support, education, and teamwork in an effort to improve outcomes and support clinicians.

Play Video | + Favorites

Interdisciplinary Rounds on a Hospitalist Service: Impact on Palliative Care Measures, Quality and Utilization Outcomes

Creator: Smith, Catherine V. DNP, RN, CCNS, CCRN; Maduro, Ralitsa S. PhD; Morgan, Merri K. DNP, RN, CCRN; Ver Schneider, Patricia; Rutledge, Carolyn M. PhD, FNP-BC; Zimbro, Kathie S. PhD, RN

Duration: 5:53

Palliative care (PC) referrals are often underutilized or delayed. To improve referrals, interdisciplinary rounds (IDRs) were implemented on the hospitalist service in a nonintensive care setting. Following implementation, median time to PC referral decreased by 2 days. Length of stay, direct cost, and 30-day mortality also decreased. Postintervention patients were more likely to transition home compared with another facility. Learn about the project in this video and then read the article: You can get CE credits for this article!

Play Video | + Favorites

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).

Play Video | + Favorites

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.

Play Video | + Favorites

Nursing Documentation of Postoperative Pain Management: A Documentary Analysis

Creator: Shoqirat, Noordeen, PhD; Mahasneh, Deema, PhD, MSc, RGN; Dardas, Latefa, PhD, PMHN; Singh, Charleen, PhD, MSc, RGN, Neuro-SN; Khresheh, Reham, PhD

Duration: 1:25

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.

Play Video | + Favorites

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.

Play Video | + Favorites

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.

Play Video | + Favorites

Perspectives on Patient and Family Engagement with Reduction in Harm: The Forgotten Voice And Developing an Intervention to Reduce Harm in Hospitalized Patients: Patients and Families in Research

Creator:

Duration: 6:29

Strategies have been identified to establish patient-centered care and improve patient engagement with care. However, the relationship of patient/ family engagement to reduction of harm is not well understood. Dr Schenk, in her first study, identified an opportunity for reducing risk and harm by more actively engaging patients and families in the effort. In another study her team convened a Patient Safety Advisory Panel to explore potential interventions to increase patient/family engagement with safety. The preferred intervention was Speak Up-My Advocate for Patient Safety. Learn about these studies in the video and implications for engaging patients and families in your own settings of care. Be sure to read both articles.

Play Video | + Favorites

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.

Play Video | + Favorites

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

Creator: Marilyn Oermann

Duration:

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.

Play Video | + Favorites

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

Creator:

Duration:

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.

Play Video | + Favorites

Implementing Same Day Discharge Following Percutaneous Coronary Intervention: A Process Evaluation

Creator:

Duration:

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.

Play Video | + Favorites

Effects of Interruptions on Triage Process in Emergency Department: A Prospective, Observational Study

Creator:

Duration:

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.

Play Video | + Favorites

Nurses' Decisional Involvement: Differences in Perceptions Related to Nurse Characteristics, Role, and Shared Leadership Participation

Creator:

Duration:

Learn more about this study of 1933 RNs in 24 hospitals with shared leadership and the nurses’ perceptions of their decisional involvement. The author explains the study and its implications for nurses. Be sure to read the article for details about this important study and how you can use the findings in your own health care setting.

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Relationship Between Psychological Safety and Reporting Non-adherence to a Safety Checklist

Creator:

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).

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The Baptist Health High Risk Falls Assessment: One Assessment Fits All

Creator:

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.

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Reduction of Medication Errors: A Unique Approach

Creator:

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!

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Chart it to Stop it: A Quality Improvement Study to Increase the Reporting of Workplace Aggression

Creator:

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.

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Transformational Teamwork: Exploring the Impact of Nursing Teamwork on Nurse-Sensitive Quality Indicators

Creator:

Duration: 3:18

Dr. Rahn examined the relationships between nursing teamwork and NDNQI outcomes including pressure ulcers, falls, and catheter-associated urinary tract infections, and she found some significant relationships. Improving teamwork in medical-surgical acute care units can transform care and impact the occurrence of preventable adverse outcomes. Watch this video and read the article to understand the importance of teamwork on your unit.

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The Race: Quality Assurance Performance Improvement Project Aimed at Achieving Superior Patient Outcomes

Creator:

Duration: 7:21

The Race is led by Clinical Nurse Specialists in partnership with nurse leaders to engage frontline staff in QI. Staff adopts evidence-based practice changes and actively engages in friendly competition to improve selected quality metrics. Data from compliance audits and automated outcome metric reports are used to identify top performing units. The Race project provides a focus for frontline staff by helping to correlate the impact on outcomes of providing quality patient care through best practices. The authors explain the project in this video and their article.

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Factors Leading to Rapid Response Team Interventions in Adult Medical-Surgical Patients

Creator:

Duration:

The authors examined the differences between medical-surgical patients who had a Rapid Response Team Intervention (RRTI) and those who did not. There were 5 significant differences between these 2 groups of patients. Watch this video and read the article to learn more about the effectiveness of the Rapid Response Team in this hospital.

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

Creator:

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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Higher Quality of Care and Patient Safety Associated with Better NICU Work Environments

Creator: Eileen Lake

Duration: 4:54

Dr. Lake and colleagues describe their study on the associations between the NICU work environment, quality of care, safety, and patient outcomes. A secondary analysis was conducted of responses of 1247 NICU staff nurses in 171 hospitals to a large nurse survey. Better work environments were associated with lower odds of nurses reporting poor quality, safety, and outcomes. Improving the work environment may be a promising strategy to achieve safer settings for at-risk newborns.

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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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Health Care Systems Redesign Project to Improve Dysphagia Screening

Creator: Virginia Daggett

Duration: 4:39

The authors improved dysphagia-screening processes in a tertiary Veterans Affairs Medical Center. The dysphagia-screening tool was redesigned on the basis of frontline clinician feedback, clinical guidelines, user satisfaction, and multidisciplinary expertise. The revised tool triggered a speech-language consult for positive screens and demonstrated higher scores in user satisfaction and task efficiency. Systems redesign processes were effective for redesigning the tool and implementing practice changes with clinicians involved in dysphagia screening.

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At Risk Care Plans: A Way to Reduce Readmissions and Adverse Events

Creator: Jan Bahle

Duration: 3:12

The goal of an At Risk Care Plan is to improve safety and quality care by proactively anticipating individual needs of patients at risk and to communicate those to the health care team. This innovative intervention has dramatically reduced hospital readmissions, costs, and adverse events for high-risk adult inpatients in a small community hospital.

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Please Release Me: Restraint Reduction Initiative in a Health Care System

Creator: Pam Cosper

Duration: 3:00

Multiple interventions were used to reduce restraint use in 4 acute care hospitals within a single health system: multidisciplinary rounds on restrained patients, increased availability of restraint alternatives, development of unit-based restraint champions, and education of staff. The health care system has maintained a quarterly restraint prevalence rate of less than 2.26% with 1 variant.

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Improving Deep Vein Thrombosis Prophylaxis With Mechanical Modalities in Surgical Intensive Care Unit

Creator: Paula Restrepo

Duration: 2:52

Deep vein thrombosis (DVT) remains a source of adverse outcomes in surgical patients. Nurses created a guideline for using non-invasive mechanical modalities for prophylaxis. Read more about this project.

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Implementing a Unit-Based CLABSI Project

Creator: Carla Jones

Duration: 3:08

Nurses decreased the rate of CLABSI infections on their medical surgical unit from 3.2 to 0.6 infections per 1000 catheter days by targeting improvement in central line maintenance. They used the Consolidated Framework for Implementation Research’s 5 interacting domains to guide their interventions.

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Fall Prevention

Creator: Michelle Kimrey

Duration: 4:04

Learn how this team used team training to reduce falls. The intervention group improved on all measures except teamwork perception. A 60% fall reduction rate was reported in the intervention group. Read more about this study.

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