Nurse staffing and Veteran outcomes in the Veterans Health Administration’s Community Living Centers Creator: Lana M. Brown, PhD, RN Duration: 5:07 Journal of Nursing Care Quality Journal of Nursing Care Quality. 38(4):297-303, October/December 2023 Show More Show Less The demand for nursing care is rising in the long-term care setting. Nurse staffing is a crucial measure linked to health care quality measure outcomes. This study assessed associations between nursing hours per patient day (NHPPD) and outcome measures in the Veterans Health Administration Community Living Centers. A significant linear association was found between average total NHPPD and falls with major injury (p=.02) and help with activities of daily living (p=.01). This study adds to the body of literature regarding the impact of nurse staffing on quality measures. Read the full article after watching this video. Play Favorite
Increasing Nurse-Physician Family-Centered Rounds Communication: A Quality Improvement Pilot Project Creator: John Kulesa, MD, MEd Duration: 4:56 Journal of Nursing Care Quality Journal of Nursing Care Quality. 38(4):304-311, October/December 2023 Show More Show Less High quality nurse-physician communication during family-centered rounds (FCR) can increase patient safety. Using quality improvement methodology, we measured nurses’ perceived awareness of components of the shared mental model, nurses’ attendance during FCR, compliance with completing FCR summaries, and average time spent per FCR encounter. A structured resident huddle took place prior to FCR. Residents used a tool to send individualized alerts to bedside nurses to prepare them for FCR, and sent a summary text to nurses who were unable to attend FCR. Over 16 weeks, nurses’ perceived awareness increased from 70% to 87%. Nurse attendance increased from 53% to 75%. We successfully piloted multiple interventions to improve nurse perceived awareness after FCR. Read the full article after watching this video. Play Favorite
Frequency of Medication Administration Timing Error in Hospitals: A systematic Review Creator: Trinity Pullam, MSN, RN, CNE Duration: 3:57 Journal of Nursing Care Quality Journal of Nursing Care Quality. 38(2):126-133, April/June 2023 Show More Show Less Medication administration timing error (MATE) leads to poor medication efficacy, harm, and death. Frequency of MATE is understudied. The purpose of this study was to determine MATE frequency and characteristics and quality of reporting studies. A systematic review of articles between 1999-2021 was conducted. Twenty three were included in this review. MATE was defined as administration beyond 60 minutes before or after the scheduled time in 13 (57%) of the included studies. Measurement procedures included data abstraction, self-report, and observation. Frequency of MATE was 1% to 72.6%. Moderate study quality was found in 78% of articles. Research on MATE is characterized by inconsistent definitions, measurements procedures, and techniques. High quality studies are lacking. Many research improvement opportunities exist. Read the full article after watching this video. Play Favorite
The Effectiveness of Remote Video Monitoring on Fall Prevention and Nurses' Acceptance Creator: Meriel McCollum Duration: 2:42 Journal of Nursing Care Quality Journal of Nursing Care Quality. ():10.1097/NCQ.0000000000000716, Show More Show Less The use of Remote Visual Monitoring (RVM) technology as a “telesitter” in hospitals can reduce falls, and increase the efficiency of patient observation. RVM was implemented within a health system in the Southeastern US. Falls data 6 months prior to and post-implementation were analyzed, and 106 nurses completed a survey evaluating their acceptance of the RVM technology. There was a significant 39.15% reduction in falls with injury (p=.006), and 70.6% of the RVM redirections were successful. Nurses’ acceptance and perceived usefulness of RVM was moderate. Implementing RVM has the potential to enhance patient safety by reducing falls with injuries, and is considered acceptable and useful by nurses. Read the full article after watching this video. Play Favorite
Implementing and Sustaining Bedside Shift Report for Quality Patient Centered Care 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 of Nursing Care Quality Journal of Nursing Care Quality. 36(2):125-131, April/June 2021 Show More Show Less 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. Play Favorite
Implementation and Evaluation of a Training Curriculum for Experienced Nurses in Care Coordination: The VA Rural Transitions Nurse Training Program Creator: Lynette Kelley Duration: 3:01 Journal of Nursing Care Quality Journal of Nursing Care Quality. 38(3):286-292, July/September 2023 Show More Show Less High-quality transitional care at discharge is essential for improved patient outcomes. Registered Nurses (RNs) play integral roles in transitions; however, few receive structured training. We sought to create, implement, and evaluate an evidence-informed nursing transitional care-coordination curriculum, the Transitions Nurse Training Program (TNTP). Following training, RNs reported high degrees of engagement, satisfaction, knowledge, and confidence, and achieved a mean score of 92% on clinical and communication skills. Results suggest TNTP is effective for creating engagement, satisfaction, acquired and sustained knowledge, and confidence for RNs trained in transitional care. Read the full article after watching this video. Credit: Kandice Porter Content Creator Play Favorite
End-of-Life Care Planning for Diverse Individuals Across Age Groups: A Proposed Conceptual Model of Creator: Zahra Rahemi, PhD, RN Duration: 3:00 Journal of Nursing Care Quality Journal of Nursing Care Quality. 38(4):319-326, October/December 2023 Show More Show Less End-of-life planning helps nurses meet the needs of their patients at a crucial time of life. This paper presents a conceptual model of end-of-life care planning for nurses focusing on holistic nursing views. Based on a literature review, we developed a new conceptual model illustrating the concepts and dimensions of end-of-life care planning among diverse individuals across countries, lifespans and age groups, ethnographies, and residential statuses. This conceptual model includes 3 concepts: personal factors, stakeholders, and environmental and social factors. The concepts are interrelated and directly related to end-of-life care planning. This work addresses the need for a comprehensive end-of-life care planning model and can help enhance the quality of end-of-life care. Read the full article after watching this video. Play Favorite
Recommendations for Fall Related Injury Prevention: A 1-Year Review of Fall Related Root Cause Analyses in the Veterans Health Administration Creator: Soncrant, Christina MPH; Neily, Julia RN, MS, MPH; Bulat, Tatjana MD, CMD; Mills, Peter D. PhD, MS Duration: 8:08 Journal of Nursing Care Quality January/March 2020, Volume 35, Issue 1; Show More Show Less Injurious falls continue to challenge health care. Learn about this study that analyzed root cause analysis reports on falls and coded injury type, fall type, location, and root causes. There were 154 reported fall RCAs during the study period. Most (83%, n = 128) falls resulted in major injury: hip fractures (43%, n = 66), other fractures (25%, n = 38), and head injury (16%, n = 24). Most falls were unwitnessed (75%, n = 116). Patients who fell were not wearing hip or head protection. These interventions may help prevent future injurious falls. After you watch this informative video, read the full article. Play Favorite
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 Journal of Nursing Care Quality Journal of Nursing Care Quality. 34(2):163-168, April/June 2019 Show More Show Less 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 Favorite
QSEN Institute RN-BSN Task Force White Paper on Recommendation for Systems-based Practice Competency Creator: Duration: 4:40 Journal of Nursing Care Quality October/December 2017, Volume 32, Issue 4; Show More Show Less The QSEN RN-BSN Task Force developed recommendation for a systems-based practice competency. Recommendations are to integrate systems-based practice into both education and practice settings. Watch the video and read the article to learn more about this proposed QSEN competency. Play Favorite
Fall Prevention and Injury Reduction Utilizing Continuous Video Monitoring in Hospitalized Patients: A Quality Improvement Initiative 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 of Nursing Care Quality Show More Show Less 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). Play Favorite
Nurses' Perceived Skills and Attitudes about Updated Safety Concepts: Impact on Medication Administration Errors and Practices Creator: Duration: 3:53 Journal of Nursing Care Quality Journal of Nursing Care Quality. 32(3):226-233, July/September 2017 Journal of Nursing Care Quality. 32(2):E3-E10, April/June 2017 Show More Show Less Approximately a quarter of medication errors in the hospital occur at the administration phase, which is solely under the purview of the bedside nurse. Dr. Gail Armstrong reports on her study that assessed bedside nurses' perceived skills and attitudes about updated safety concepts and examined their impact on medication administration errors and adherence to safe medication administration practices. Findings supported the premise that medication administration errors result from an interplay among system-, unit-, and nurse-level factors. Watch this video and then read Dr. Armstrong’s articles about the study and tool development. Play Favorite
Effects of Implementing an Acuity Tool on a Psychiatric Intensive Care Unit Creator: Kucera, Patricia MSN, RN; Kingston, Eileen DNP, BSN, RN, MPA; Ferguson, Tysa DNP, RN, CNML; Jenkins, Katie MSN, RN; Fogarty, Melissa MSN, RN; Sayles, Harlan MS; Cohen, Marlene Z. PhD, RN, FAAN Duration: 10:37 Journal of Nursing Care Quality Journal of Nursing Care Quality. 37(4):313-318, October/December 2022 Show More Show Less Staff shortages, reduced budgets, and high acuity of violent psychiatric patients create challenges in psychiatric intensive care units. Staffing in our unit was based on patient census rather than evidence-based practices. A pre-/postintervention design was used to examine changes in nursing satisfaction and patient outcomes after implementing a psychiatric specific acuity tool. NDNQI survey results improved with the largest increase for the quality-of-care summary measure. An acuity tool can help standardize practice, determine fair patient assignments among staff, increase nurse satisfaction, and promote best practices for patient safety. Read the full article after watching this video. Play Favorite
Effect of Joint Camp on Patient Outcomes Following Total Joint Replacement Creator: Duration: 3:54 Journal of Nursing Care Quality July/September 2018, Volume 33, Issue 3; Show More Show Less Two major cost concerns related to joint replacement surgery are patient length of stay (LOS) and 30-day hospital readmission rates. Dr Ashcraft describes a QI project to evaluate the impact of a joint replacement program on patient readmissions and hospital LOS. A total of 1425 patients older than 50 years participated. At the end of the project period, readmission rates decreased from 6.19% to 2.8%, and average LOS decreased from 5.87 days to 2.7 days. After watching the video be sure to read the article. The authors share strategies for adopting this program in your own setting. Play Favorite
Alarm Fatigue: Use of an Evidence-based Alarm Management Strategy Creator: Duration: 4:43 Journal of Nursing Care Quality January/March 2017, Volume 32, Issue 1; Show More Show Less 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. Play Favorite
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 Journal of Nursing Care Quality October/December 2019, Volume 34, Issue 4; Journal of Nursing Care Quality. 34(4):325-329, October/December 2019 Show More Show Less 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 Favorite
Reducing Delirium in Hospitalized Adults Through a Structured Sleep Promotion Program 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 of Nursing Care Quality Journal of Nursing Care Quality. 36(2):149-154, April/June 2021 Show More Show Less 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. Play Favorite
Five-For-Life in a Nutshell Creator: Ruth Bala-Kerr, DNP, RN, MSN, CNS, CPHQ, NE-BC Brittany Sullivan, RN, BSN Shelley Martin, RN Duration: 2:12 Journal of Nursing Care Quality Journal of Nursing Care Quality. 38(1):40-46, January/March 2023 Show More Show Less Poor leadership and teamwork in CPR are associated with poor patient outcomes. Frontline nursing staff frequently identify patients in cardiac arrest but may not have the initial leadership and teamwork skills to organize their initial rescue response. The Five-4-Life QI program was pilot tested in a pediatric unit within a 510- bed acute care hospital. Descriptive statistical tests indicated a significant improvement in leadership, teamwork, and task management scores pre- and post-program, and sustained after the program. Implementing the Five-4-Life QI program is feasible in improving leadership, teamwork, and task management of first responding frontline nurses. Read the full article after watching this video. Play Favorite
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 Journal of Nursing Care Quality Journal of Nursing Care Quality. 35(1):83-87, January/March 2020 Show More Show Less 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 Favorite
Relationship Between Psychological Safety and Reporting Non-adherence to a Safety Checklist Creator: Duration: 3:11 Journal of Nursing Care Quality January/March 2018, Volume 33, Issue 1; Show More Show Less 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). Play Favorite
Environmental and Economic Assessment of Incontinence Underpads: A Step in Decarbonization for Hospitals, Laundry firms, and Health Care Creator: Griffing, Evan PhD; Overcash, Michael PhD Duration: 3:16 Journal of Nursing Care Quality Journal of Nursing Care Quality. 38(3):278-285, July/September 2023 Show More Show Less Objectives of quality principles in the clinical setting present nursing with opportunities for quality patient care, but at lower environmental footprint. This affects patients, hospital personnel, and community since choices reduce climate change and thus supports an innovative nursing role. This article aims to support nursing knowledge to include environment in decisions regarding patient care and reusable versus disposable incontinence underpads (IUP). A life cycle analysis was conducted to assess environmental impact. Reusable IUPs reduced total natural resource energy consumption by 71%, greenhouse gas emissions by 61%, blue water consumption by 57%, and solid waste by 97%. The nursing community can use this information in their health care organizations regarding IUP to advocate for decisions to select reusable IUPs that benefit our environment. Read the full article after watching this video. Play Favorite
JNCQ-D-15-00125R1 Radwin et al. An Expanded Theoretical Framework of Care Coordination across Transitions in Care Settings Creator: Duration: 7:42 Journal of Nursing Care Quality Show More Show Less Ensuring optimal care coordination requires a clear understanding of how clinician activities and continuity during transitions affect patient-centered care and quality outcomes. Dr. Radwin describes an expanded theoretical framework to better understand care coordination. She provides a clear explanation of concepts. Watch the video and read her article to understand the framework and how you can use it to guide care coordination in your own setting. Play Favorite
