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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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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.
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.
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.
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!
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).
Creator: Schwartz, Franklin, DNP, APRN, PMHNP-BC; Bjorklund, Pamela, PhD, APRN, PMHNP-BC, CNS-BC
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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.
Creator: Shoqirat, Noordeen, PhD; Mahasneh, Deema, PhD, MSc, RGN; Dardas, Latefa, PhD, PMHN; Singh, Charleen, PhD, MSc, RGN, Neuro-SN; Khresheh, Reham, PhD
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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.
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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.
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,
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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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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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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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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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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.
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.
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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.



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.
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.
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.
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!
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).
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Creator:
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