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JNCQ-D-14-00039R1 Lewis et al. Relationship of Adverse Events and Support to RN Burnout

Video Author: Erica Lewis
Published on: 03.02.2015

Registered nurse (RN) “second victims” are RNs who are harmed from their involvement in medical errors. This study found a relationship between RN involvement in preventable adverse events and 2 domains of burnout: emotional exhaustion (P = .009) and depersonalization (P = .030). Support to RNs involved in preventable adverse events was inversely related to RN emotional exhaustion (P < .001) and depersonalization (P = .003) and positively related to personal accomplishment (P = .002).

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Creator: Hedges, Christine, PhD, RN, NE-BC; Hunt, Candice, MHA; Ball, Pamela, BSN, RN, NE-BC
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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
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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.
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
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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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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
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Duration:
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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.
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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.
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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.
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
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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
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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.
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: 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.”
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:
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)
Creator:
Duration:
Learn about this QI initiative to improve oropharyngeal dysphagia screening and reduce aspiration pneumonia rates on inpatient hospital medical units. Guided by a Plan-Do-Study-Act methodology, an interdisciplinary health team developed and implemented a systematic process for oropharyngeal dysphagia screening and management. As a result, use of the screening protocol increased, timely initiation of speech language pathology consultations increased, and aspiration pneumonia rates decreased. After watching this video, be sure to read the article.
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Duration: 2:33
The purpose of this project was to determine whether patients with COPD receiving in-home visits by a nurse practitioner (NP) in a program called Community Cares had fewer hospital encounters such as ED visits, observation stays, and inpatient admissions. With in-home NP visits, inpatient encounters decreased by 71%; ED visits decreased by 68%; and there was an 84% reduction in 30-day readmissions. Learn more about this program (from a patient and NPs). Don’t miss this video and then read the article.
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Duration: 2:55
The demand for acute care clinical sites, along with the need to prepare CNLs for a role in health promotion, disease prevention, and population health management, created an opportunity for these authors to expand the CNL role outside of the acute care setting. The goal was to allow CNL students to develop competencies in improving patient and population health. Learn how they developed and implemented the course: after watching the video, read the full article. Be sure to access the supplemental content on strategies for clinical site development for CNL in primary care.
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Duration: 4:14
As part of an outcome improvement initiative in an intermediate ICU at the Health Sciences Centre, Winnipeg, Manitoba, Canada, patients participated in an innovation on the effects of collaborative goal setting and activity tracking through a visual display of the goals achieved. Patients had a high degree of engagement in setting their goals. Displaying patients’ progress had an effect on their quality of life and self-efficacy. Learn more about this project in the video and article: this is a project you can easily implement in your settings, and the authors explain how to do it.
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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).
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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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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.
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Duration: 3:15
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Duration: 2:41
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Duration: 4:04
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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.
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Duration: 4:43
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Duration: 16:32
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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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Duration: 7:29
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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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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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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%.
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.
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.
Creator: Erica Lewis
Duration: 4:51
Registered nurse (RN) “second victims” are RNs who are harmed from their involvement in medical errors. This study found a relationship between RN involvement in preventable adverse events and 2 domains of burnout: emotional exhaustion (P = .009) and depersonalization (P = .030). Support to RNs involved in preventable adverse events was inversely related to RN emotional exhaustion (P < .001) and depersonalization (P = .003) and positively related to personal accomplishment (P = .002).
Creator: Jan Bahle
Duration: 3:12
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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.
Creator: Shelby Garner and Ramona Traverse
Duration: 4:44
Sleep-disordered breathing can lead to negative health outcomes for patients with heart failure. The authors evaluated a new multifaceted sleep disordered breathing screening protocol in a heart failure disease management clinic. Read their article to learn more about the protocol and its effectiveness.
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.