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Creator: Frist Avila, Patricia MSN, RN, NE-BC, OCN, AOCNS; Twibell, K. Renee PhD, RN, CNE; Demaree, Heather MSN, RN, CMSRN
Duration: 1:58
The management of healthcare-acquired infections (HAIs) challenges acute care facilities due to variability in practices. The purpose of this QI project was to decrease central line-associated bloodstream infection, catheter-associated urinary tract infection, and Clostridioides difficile using a visual management (VM) tool, called the Safety Tracker, to address practice variations. In 12 months, HAIs decreased from 9 events to 1 with a corresponding reduction of indwelling urinary catheter utilization and central line utilization. More than $160,000 were avoided in health care costs.
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Creator: Pate, Kimberly DNP, RN, ACCNS-AG, PCCN-K; Brelewski, Kiersten MSN, RN, AGCNS-BC, OCN; Rutledge, Sarah R. MSN, RN, ACCNS-AG, CCRN, OCN; Rankin, Veronica DNP, RN-BC, NP-C, CNL, NE-BC; Layell, Jessica BSN, RN, CIC
Duration: 4:43
Central line–associated bloodstream infections (CLABSIs) are an ongoing concern in health care. This was a QI project including a collaborative rounding approach supported by specialty nursing roles. In addition to implementing a variety of evidence-based interventions, the rounding team performed audits to assess performance and created focused education tools to address the identified opportunities within each individual unit. High levels of engagement as evidenced by increased audit completion resulted in CLABSI reductions. However, 2 peaks in CLABSI rates were associated with higher volumes of coronavirus disease (COVID-19) hospitalizations and decreased audits.
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Creator: Tschannen, Dana PhD, RN; Alexander, Catherine DNP, MPH, RN; Tovar, Elizabeth G. PhD, APRN; Ghosh, Bidisha MS; Zellefrow, Cindy DNP, MSEd, RN, LSN, PHNA-BC, EBP-C; Milner, Kerry A. DNSc, RN
Duration: 4:35
Frontline nurse engagement in quality improvement (QI) improves nurse-sensitive outcomes. The purpose of this study was to develop and psychometrically evaluate the Nursing Quality Improvement in Practice (N-QuIP) tool to measure nurses' competency, engagement, and barriers/facilitators to QI engagement. Item development was guided by an expert panel and literature review. Factor analysis and reliability indices were assessed through 681 surveys completed by nurses at one medical center. Preliminary data suggest that the N-QuIP is a valid and reliable tool for assessing nurse QI competence and engagement. Watch the video and read the article.
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Creator: Hogan Quigley, Beth DNP, MSN, RN, CRNP; Renz, Susan M. PhD, DNP, RN, GNP-BC; Bradway, Christine PhD, CRNP, FAAN, AGSF
Duration: 3:25
Journal: Journal of Nursing Care Quality
Reduction of falls in hospital patients remains a priority. Although fall rates were in the acceptable national safety standard guidelines, interventions were explored to further decrease falls using continuous video monitoring (CVM). Two-way cameras and a virtual sitter were used to observe fall risk patients. CVM with virtual sitters depicted a 14% decline in fall rates and a 6% decrease in fall-related injury rates with positive budget implications. Learn more about this QI project in the video and article. This article is offered for CE (see link at the end of the article).
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Creator: Becker, Sherry MSN-Ed, RN-BC, CWOCN; Hagle, Mary PhD, RN-BC, FAAN; Amrhein, Andra BSN, RN; Bispo, Jeffrey MSN, RN, CNL; Hopkins, Sarah MSN, RN, CNL; Kogelmann, Mary BSN, RN; Porras, Elizabeth BSN, RN; Smith, Melissa M. BSN, RN
Duration: 4:15
Journal: Journal of Nursing Care Quality Journal of Nursing Care Quality. 36(2):125-131, April/June 2021
Two evidence-based practice projects and an innovative model provided best evidence and a framework for the implementation and sustainment of a bedside shift report (BSR) quality improvement project. Facilitators and barriers were identified and addressed during planning. Key elements of BSR were incorporated. Implementation was completed in 4 months for 11 units. After 15 months, there was consistent BSR on 82% of the units and improved patient satisfaction with nurses taking time to listen. This is an excellent example of sustainability of a practice change: watch the video and be sure to read the article.
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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
Journal: Journal of Nursing Care Quality Journal of Nursing Care Quality. 34(2):127-132, April/June 2019
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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Duration: 4:43
Journal: Journal of Nursing Care Quality January/March 2017, Volume 32, Issue 1;
The authors developed an evidence-based alarm management strategy and describe their project in this video. The alarm management program reduced alarms up to 30%. Evaluation of patients on continuous cardiac monitoring showed a 3.5% decrease in census. This alarm management strategy has the potential to save $136 500 and 841 hours of registered nurses' time per year. Make sure you read their article too.
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Creator: Gode, Autumn MS, APRN-CNS; Kozub, Elizabeth MS, APRN-CNS, CCNS, CNRN, CCRN; Joerger, Kyla BSN, RN-BC; Lynch, Cassandra BSN, NE-BC, OCN; Roche, Maren BSN, RN; Kirven, Justin MD
Duration: 2:15
Journal: Journal of Nursing Care Quality Journal of Nursing Care Quality. 36(2):149-154, April/June 2021
Delirium affects approximately 1 in 4 patients during their hospitalization and is associated with numerous complications. An evidence-based practice project was implemented to reduce the development of delirium through sleep promotion on 2 inpatient units. A dedicated time was selected, and key strategies were identified to promote sleep with minimal interruptions. Delirium decreased by 33% and 45% on the 2 units over 1 year. Overall, patient satisfaction for quietness at night survey responses also increased (P = .0005; CI, 0.05 to 0.67) with ongoing sustainment. Learn about this project in this video and article.
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Creator: Francisco, Mary Ann MSN, APN, AGCNS-BC, CCRN-K; Pierce, Nicole L. PhD, RN; Ely, Elizabeth PhD, RN; Cerasale, Matthew T. MD, MPH; Anderson, Daniela MD; Pavkovich, David MD, FACP, FAAP; Puello, Frances MD; Tummala, Sandeep MD; Tyker, Albina MD; D'Souza, Fel
Duration: 4:22
Journal: Journal of Nursing Care Quality Journal of Nursing Care Quality. 36(2):105-111, April/June 2021
Proning intubated ICU patients for the management of acute respiratory distress syndrome is an accepted standard of practice. We examined the nursing climate in 4 units and its impact on implementing a novel self-proning protocol to treat COVID-19 patients outside the ICU. Nurses from 4 nursing units were surveyed about the implementation process on the self-proning protocol. Their perception of unit implementation was assessed via the Implementation Climate Scale. Consistent education on the protocol, belief in the effectiveness of the intervention, and a strong unit-based climate of evidence-based practice contributed to greater implementation of the protocol.
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Creator: Marilyn Oermann
Duration:
Journal: Journal of Nursing Care Quality
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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Creator: Mundle, William RN, MN, CMSN(C); Howell-Belle, Carnett RN, MN; Jeffs, Lianne PhD, RN, FAAN
Duration: 4:10
Journal: Journal of Nursing Care Quality 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: Draus, Catherine DNP, RN, ACNS-BC, CCRN, MSNBC; Mianecki, Therese B. PhD, RN; Musgrove, Hannah MSN, APRN, AGCNS-BC, PMGT-BC; Bastien, Danielle J. DNP, APRN, FNP-BC; Greggs, Dana MSN, RN, ACNS-BC; Halash, Christine BSN, RN, CCRN; (Larry-Osman) Bellamy, Che
Duration: 4:34
Journal: Journal of Nursing Care Quality Journal of Nursing Care Quality. 37(2):110-116, April/June 2022
Second victims (SVs) are health care workers traumatized by unanticipated, adverse patient events. These experiences can have personal and professional effects on SVs. The purpose of the study was to determine the prevalence of nurses who identified as SVs. Of 359 participants, 159 (44.3%) identified as SVs. There was a significant relationship between work tenure and SVs (P = .009). A relationship was found between SVs and awareness and use of support resources, with debriefing being the preferred method after an event.
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Creator: Misto, Kara, PhD, RN; Padula, Cynthia, PhD, RN; Bryand, Elizabeth, BSN, RN-BC; Nadeau, Kate, MPH, RN
Duration: 5:16
Journal: Journal of Nursing Care Quality Journal of Nursing Care Quality. 34(2):163-168, April/June 2019
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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Duration: 3:07
Journal: Journal of Nursing Care Quality July/September 2016, Volume 31, Issue 3;
The purpose of this QI project was to determine the feasibility of using provider-led participatory visual methods to scrutinize 4 hospital units' infection prevention and control practices. Methods included provider-led photo walkabouts, photo elicitation sessions, and postimprovement photo walkabouts. Nurses readily engaged in using the methods to examine and improve their units' practices and reorganize their work environment.
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Creator: Hedges, Christine, PhD, RN, NE-BC; Hunt, Candice, MHA; Ball, Pamela, BSN, RN, NE-BC
Duration: 2:44
Journal: Journal of Nursing Care Quality July/September 2019, Volume 34, Issue 3;
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).
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Duration: 3:41
Learn about this project to develop and implement a nurse-driven protocol to remove urinary catheters using evidence-based criteria. The specific aim was to decrease average catheter dwell time with the use of a nurse-driven protocol in MICU patients. In this video the author explains the need for the practice change and how she improved care on the unit. After watching the video, be sure to read the article.
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Creator:
Duration: 3:34
Journal: Journal of Nursing Care Quality January/March 2019, Volume 34, Issue 1;
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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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: 2:41
Journal: Journal of Nursing Care Quality April/June 2017, Volume 32, Issue 2;
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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Creator: Montgomery, Aoyjai P. PhD, BSN; Patrician, Patricia A. PhD, RN, FAAN; Azuero, Andres PhD, MBA
Duration: 2:02
Journal: Journal of Nursing Care Quality Journal of Nursing Care Quality. 37(1):87-93, January/March 2022
This study examined nurse-reported patient safety grade and its relationship to both burnout and the nursing work environment. A cross-sectional electronic survey was conducted among 928 nurses in acute care Alabama hospitals. All burnout dimensions of the Copenhagen Burnout Inventory and work environment were related to patient safety grade after controlling for nurse characteristics. Health care organizations can reduce negative patient safety ratings by reducing nurse burnout and improving the work environment at the organization level. Learn more about this study in the video and article.
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Duration: 3:11
Journal: Journal of Nursing Care Quality January/March 2018, Volume 33, Issue 1;
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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Creator: Marilyn Oermann
Duration:
Journal: Journal of Nursing Care Quality
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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Creator: Russell, Cynthia K. DNP, RN-BC; McNeill, Margaret PhD, RN, APRN-CNS, CCRN-K, TCRN, CPAN, NE-BC, NHDP-BC, FCNS, FAAN
Duration: 3:53
Lung cancer is prevalent worldwide, with 2.1 million new cases and 1.8 million deaths in 2020. Our community residents were more likely to be diagnosed with lung cancer in later stages (62%) compared with 56% nationally, resulting in an increased community mortality rate. Evidence-based changes in an electronic health record system supported identification and referral of high-risk patients for low-dose computer tomography to improve early lung cancer detection rates. Early-stage lung cancer detection increased 24%. Learn more in this video and article about how the authors improved early-stage lung cancer detection.
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Creator: Havaei, Farinaz PhD, RN, MERM; Ji, Xuejun Ryan PhD, MEd; Boamah, Sheila A. PhD, RN
Duration: 3:05
Journal: Journal of Nursing Care Quality
Working in unhealthy environments is associated with negative nurse and patient outcomes. The purpose of this study was to identify the most important workplace factors predicting nurses’ provision of quality and safe patient care. A cross-sectional correlational survey involving 4029 direct care nurses in British Columbia was conducted using random forest data analytics methods. Nurses’ reports of healthier workplaces, particularly workload management, psychological protection, physical safety and engagement, were associated with higher ratings of quality and safe patient care. After watching the video. read the article – it is Open Access
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Duration: 5:48
Journal: Journal of Nursing Care Quality January/March 2016, Volume 31, Issue 1;
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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Duration: 7:21
Journal: Journal of Nursing Care Quality April/June 2016, Volume 31, Issue 2;
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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