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April/June 2017 - Volume 32 - Issue 2
pp: 95-185,E1-E19

AHRQ Commentary

Using Evidence to Change Practice

Quality from the Field

Nurses' Perceptions of Quality Care

Ryan, Catherine; Powlesland, Jean; Phillips, Cynthia; More

Journal of Nursing Care Quality. 32(2):180-185, April/June 2017.

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!
Duration: 3:15
Journal: Journal of Nursing Care Quality April/June 2017, Volume 32, Issue 2;
Many readers are interested in transitional care. This video and article provide the information you need. The authors describe their project to reduce readmissions through the establishment of a pilot program using the C-TraC program, which is a phone-based, protocol-driven, low-cost, nurse-led, transitional care model. The goal was to connect with the patients telephonically up to 30 days postdischarge to mitigate current confusion regarding the discharge plan and identify potential medication discrepancies. Learn about this effective transitional care model.
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.
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.
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.
Duration: 5:57
Telemetry monitoring is a limited resource. This quality improvement project describes a nurse managed telemetry discontinuation protocol to stop telemetry monitoring when it is no longer indicated. After implementing the protocol, data were collected for 6 months and compared to preintervention. There was a mean decrease in telemetry monitor usage and likelihood of remaining on a telemetry monitor until discharge. Learn about this nurse-managed telemetry discontinuation protocol – watch the video and then read the article.
Duration: 2:10
Journal: Journal of Nursing Care Quality April/June 2017, Volume 32, Issue 2;
Most health care quality improvement (QI) studies focus on the engagement of executive leadership and frontline staff as key factors for success. Little work has been done on understanding how mid-level unit/program managers perceive their role in QI and how capacity could be built at this level to increase success. In this video and article, the authors present an ethnographic study on the experience of hospital middle managers to consider how the expectations and capacity of their current position might influence QI progress organizationally.