Search

This study investigated perceptions of relatives of patients hospitalized in surgery ward and surgical intensive care unit and medical staff concerning relatives' needs. Overall rankings of the needs were similar. Assurance and anxiety reduction emerged as the most important need category. [ABSTRACT FROM AUTHOR]

The use of massage in hospitalized participants can aid in reducing anxiety, muscle tension, and pain. Findings of this study suggest massage can be a safe, pleasant treatment for hospitalized patients. Incorporating massage into patient care may yield positive results. [ABSTRACT FROM AUTHOR]

The article presents a study on trends in nursing care efficiency in acute care nursing units in the U.S. Topics discussed include adaptation of the Donabedian quality improvement model, definition of efficiency in the health care system and use of the data envelopment analysis to estimate efficiency. It discusses findings on changes in efficiency between Magnet and non-Magnet hospital units, teaching status and nurse staffing skills.

Physical assessment by registered nurses plays a key role in preventing sentinel events. Variables that may affect nurses' ability to perform physical assessment consistently were examined. [ABSTRACT FROM AUTHOR]

Anecdotal reports indicate some patients treated in the Emergency Department have used heat and non-evidence-based modalities for acute musculoskeletal injuries. The purpose of this study was to determine if race and ethnicity are associated with the initial home treatment used. [ABSTRACT FROM AUTHOR]

This descriptive study used mock codes and a written education intervention to address RN under-performance during patient emergencies. Units with shorter lengths of stay, more experienced RNs, and a greater percentage of RNs had higher mock code scores. [ABSTRACT FROM AUTHOR]

Many patients do not have a good understanding of their medications, including opioids, at the time of inpatient discharge. This lack of knowledge may contribute to patients' misuse and abuse of opioid prescriptions. This study found patients have a clearer understanding of safe opioid use when nurses also have a better understanding of safe practices around prescription opioids. [ABSTRACT FROM AUTHOR]

The article presents a research study published to present the critical-thinking process in practicing medical-surgical registered nurses (RNs) through self-reporting. Topics covered include the highlights of previous research articles relating to critical thinking, critical reasoning, and nurse thought, details relating to the Critical Thinking Diagnostic tool used in the study, and the need for all nurses to develop critical-thinking skills for job satisfaction and improved patient outcomes.

Interruptions decrease the efficiency of the medication administration process. In this study, interruptions were found in 63% of the medication passes on four medical-surgical units in a community hospital. However, interruptions do not always lead to negative outcomes. [ABSTRACT FROM AUTHOR]

The article presents a survey of nurses and physicians and residents on the efficacy of a pilot program on nurse-initiated protocol for HIV testing on an acute medical-surgical unit. It discusses findings on awareness of nurses of policies on routine offering of HIV testing, preparedness to offer routine HIV testing and educate patients about HIV, response of physicians to the protocol, and patients' responses to HIV screening.

The article presents a study on peripheral intravenous site care using Duffy's Quality-Caring Model. It discusses findings on the complication rates of phlebitis and infiltration between site rotation of peripheral intravenous catheters based on clinical assessment by nurses in a medical-surgical unit and length of time and implications for medical-surgical nursing practice and existing policies for venous access.

The article describes the manner the Mercy Medical Center utilized education to implement shared governance (SG) in less than two years. It details a descriptive, quasi-experimental study conducted to identify if implementation of shared governance could be done more efficiently and effectively using a comprehensive and robust education plan, to determine whether subscales of SG would increase post implementation, and whether characteristics had an impact on successful implementation of SG.

Objectives To identify the needs of spouses, and develop professional relations and well-planned communication with health professionals. Background Having a partner with a serious illness has an enormous impact, both physically and mentally, on the life of the spouse. Emotional status of the spouse plays an important role in the patient's adaptation to illness. Design This study was designed as an explorative qualitative study using focus group interviews. Methods Focus group interviews with 11 spouses of patients admitted to a general surgical ward were conducted. Data were processed using qualitative content analysis. Results Two overall themes were identified: spouses' experiences of professional support, and professional communication. A majority of the spouses did not find health professionals to be adequately present during the hospital admission. Furthermore, spouses felt communication was lacking or incorrect information was unprofessional and created a feeling of uncertainty. Conclusion Lack of empathy from health professionals and a lack of well-planned communication toward the spouses could be perceived as a lack of involvement and have a negative effect on the spouses. Relevance to Clinical Practice For health professionals, support of spouses should be prioritized to enhance family-centered care. This could be of great benefit to the patient. [ABSTRACT FROM AUTHOR]

Introduction Ambulation after cardiovascular surgery is an important part of the recovery process. Despite the benefits of ambulation, patients lack motivation to ambulate postoperatively. Purpose The purpose of the Art to Heart study was to determine if visual art can be used as a motivational tool to increase patient ambulation after cardiovascular surgery. Method A quasi-experimental design was used to determine if artwork created by hospital staff and displayed on the walls along the ambulation route would motivate patients to ambulate more frequently and for longer distances. Participants were assigned to one of three groups and viewed the usual hospital artwork, no artwork, or artwork created by hospital staff. Frequency and distance of ambulation were recorded for each participant. Mood disturbance was assessed using the Profile of Mood States-Short Form upon admission and at discharge. The groups that viewed art on the walls also completed a six-question survey about their ambulation experience. Findings Ninety participants enrolled in the study. Data were analyzed for 86 participants. The majority were male (74%) with a median age of 63. Participants in the staff art group walked a median 370 feet the first day following study enrollment while the other groups walked a median 270 feet (p=0.05). A similar but nonsignificant pattern was noted on the second day following study enrollment. Total mood disturbance declined from admission to discharge for all patients but no difference was found in total mood disturbance among the three groups. Participants in the staff art group were more likely to report the art changed the way they felt about walking compared to the participants looking at usual hospital artwork (p<0.001). Conclusions Art can be used as a motivational tool during postoperative recovery. Patients do notice the art on hospital walls and the type of art displayed may impact ambulation after cardiovascular surgery. [ABSTRACT FROM AUTHOR]

The article focuses on the knowledge and significant role of nurses in delirium detection. It notes that insufficiency of nursing knowledge on delirium's general characteristics and the determination of its risk factors. The perception of nurses on their delirium recognition and management-related competency is evaluated.

Background: The purpose of rapid response teams (RRTs) is to reduce cardiopulmonary arrest and hospital mortality rates, and prevent failure to rescue (FTR). Silber, Williams, Krakauer, and Schwartz (1992) coined the term failure to rescue to describe the death of patients who suffered a post-surgical complication that was not addressed promptly. Between 2008 and 2010, 21,773 postoperative Medicare patients died in U.S. hospitals from FTR. The literature indicates RRTs are underutilized and underutilization of RRTs can lead to FTR. This comes in the form of delayed RRT activation or complete failure to activate the RRT when the patient's condition warrants. It indicates failures in the recognition of and reaction to sudden clinical deterioration, both of which require registered nurses (RNs) to utilize their critical thinking and decision-making skills. Increased frequency of RRT activation has been correlated to reduced patient mortality. Objective: The objective of this study was to determine the relationships between nurses' decision-making model during RRT activation and the frequency of RRT activation. Method: Participants in this study were 87 acute care RNs working in medical-surgical units who had activated the RRT at least once in the preceding 12 months. They completed a demographic questionnaire and self-reported the number of calls to the RRT in the preceding 12 months. The participants were asked to recall a time they had activated the RRT for a patient and then completed the Nurse Decision-Making Instrument (NDMI). The NDMI classified participant's decision-making process during RRT activation into one of three categories: analytic, analytic/intuitive (mixed model), or intuitive decision making. Results: Of the 87 RNs in this study, 70.1% (n=61) used an analytic/intuitive decision-making model, 21.8% (n=19) used an analytic decision-making model, and 8% (n=7) used an intuitive decision-making model during RRT activation. The frequency of RRT calls ranged from 1 to 15 (M=3.0, SD=2.6). Analytic decision makers had a mean of 4.7 RRT calls, analytic/intuitive decision makers had a mean of 2.56 RRT calls, and intuitive decision makers had a mean of 2.3 RRT calls. A one-way ANOVA indicated the differences in number of RRT calls between the three decision-making models was significant (p=0.003). The findings of this study indicated RNs who used analytical decision making activated the RRT with significantly greater frequency than either intuitive or mixed model decision makers. Discussion: The relationship between nurse decision-making models and patient outcomes needs to be investigated further. Because increased frequency of RRT activation has been associated with analytic decision making in this study and linked to decreased patient mortality rates in the literature, the potential to impact patient's outcomes positively, reduce hospital mortality rates, and reduce FTR exists. Nurses should be trained in analytical decision make and ongoing efforts should be made to support and enhance nurses' use of RRTs. [ABSTRACT FROM AUTHOR]

The article presents a study which investigates the use of an alternative taping device to reduce the incidence of nasal pressure ulcers (NPUs) among patients. The study compares the impact of the commercially available device and conventional adhesive taping for nasogastric tubes (NGTs) and for NPUs. Results show that the commercially available device reduces the incidence of NPUs compared to conventional adhesive tape.

Researchers evaluated the agreement of temperatures measured with a temporal artery thermometer when sequentially used by the same person and a second user in 34 postoperative patients. The differences in two temperatures measured by a single user and between two persons were small and within the range of acceptable values set by experts when evaluating temperature devices for hospital use. [ABSTRACT FROM AUTHOR]

Purpose In this study, differences and relationships among variables in sleep quality/quantity and self-reported viral illness between day and non-day shift hospital nurses were examined. Design and Methods A descriptive, cross-sectional study used the 10-item Karolinska Sleep Questionnaire to measure quality of sleep in 1 31 direct-care nurses from a 246-bed community-owned hospital in the northwestern United States. Findings Non-day shift nurses used more techniques to stay awake while at work or aid in sleep at home. No differences were found between shifts in reported absenteeism for viral illness (m=2.9 days), or hours of reported sleep (m=7.5); significant differences were found in non-day shift quality of sleep compared to day shift nurses and between age groups. Conclusion Sleep disturbances are present among nurses and differ depending on shift worked and nurse's age. No association was found between sleep and reported viral illness. [ABSTRACT FROM AUTHOR]

Falls are an important measure of nursing quality and patient safety. In this study, a significant difference was found in the mean fall risk scores on the HIIFRM between persons (acute care patients with diagnoses of heart failure, diabetes, and stroke) who fell and those who did not (t = -2.371, p=0.02). [ABSTRACT FROM AUTHOR]

Introduction Hospitalized older adults experience more safety-related complications than younger patients, including increased falls and injurious falls, pressure ulcers, and adverse outcomes associated with restraint use. These clinical areas are dominantly under the control of nursing practice and thus are regarded as nursing-sensitive quality indicators. Certified nurses have demonstrated competency in evidence-based gerontological nursing care practice. However, the influence of nursing certification upon quality indicators is not established. Purpose The purpose of this study was to examine the relationship between nurse certification (in any specialty practice as well as gerontological) and unit-level, nursing- sensitive quality indicators in units that primarily serve older adults. Method In a sample of 44 medical and medical-surgical units in 25 NICHE (Nurses Improving Care for Healthsystem Elders) hospitals, a retrospective descriptive design used multivariate regression techniques. Findings Binary logistic regression modeling yielded a significant relationship between certification in any specialty and falls (chi-square wald=3.80, p=0.05, df=1). Conclusion Nursing-sensitive outcomes in hospitalized older adults may be influenced by nurse certification. The data from this pilot study support a larger prospective study that will investigate the relationship between nurse certification, workforce factors, and nursing-sensitive quality indicators in all types of units in both NICHE hospitals and non-NICHE hospitals. The inability of some program coordinators to obtain unit-level patient data points to the need for management tools and education related to quality improvement for mid-level managers. [ABSTRACT FROM AUTHOR]

Introduction Nursing documentation has shifted from the written medical record to the electronic health record (EHR) because use of the EHR is considered to be beneficial to the quality and safety of health care. After implementation of the EHR, improved communication between certified nursing assistants, dietary staff, social workers, and nurses should result in more timely referrals, treatments, and changes in care plans. The EHR provides a comprehensive template to remind nurses to record the pressure ulcer stage, size, location, risk assessment, nursing diagnoses, goals, and planned interventions. Purpose The purpose of this pilot project was to track the EHR documentation of pressure ulcers on a medical-surgical unit and compare the EHR with the written medical record. Method A pilot study was completed at a 560-bed hospital located in Miami, FL. A convenience sample of 139 medical and surgical patients who met the inclusion criteria was used. Recorded data on pressure ulcers were reviewed retrospectively. Data collection included patient demographics, Braden Scale scores, presence of pressure ulcer, and detailed documentation of pressure ulcer on both the EHR and written medical record. A descriptive study design was completed to compare the EHR to the written medical record. Findings Eleven patients (N=139) developed pressure ulcers. Inconsistencies were found in the nursing documentation of pressure ulcers when comparing the EHR to the written medical record. Conclusions Results of this pilot study illustrated that patients' records (EHR and written) are not reflective of routine hospital policies for the documentation of pressure ulcers. Education related to the use of the EHR for pressure ulcer documentation should be reinforced among nurses. In addition, a need exists for guidelines to standardize and routinely evaluate EHR documentation in clinical practice. [ABSTRACT FROM AUTHOR]

Introduction: Collaboration between nurses and physicians is essential in fostering interdisciplinary relationships. Specialty practice may influence the quality of this collaboration. Effective communication and collegial RN-MD relationships are critical to improved patient outcomes. Purpose: The purpose of this study was to identify differences in nurses' perceptions of collaborative efforts between nurses and physicians in medical-surgical (MSUs) units versus intensive care units (ICUs). Results: A descriptive survey methodology was employed. Nurses in three ICUs and eight MSUs within a 975-bed Magnet® hospital completed a 25-item Nurse- Physician Relationship survey, used in previous studies on RN-MD communication. The sample (N=170) consisted of 54% medical-surgical nurses and 46% ICU nurses. No statistically significant differences were found in the demographic variables between the MSU and ICU nurses except for educational degree. A greater percentage of ICU nurses held a bachelor's degree. This study found that although some differences existed in ICU and MSU nurses' perceptions of RN-MD collaboration, there are more similarities between the two areas. Overall, nurses were satisfied with RN-MD relationships, with 75% of ICU and 65% of MSU nurses reporting satisfaction (p=0.110). MSU nurses were less likely to participate in interdisciplinary rounds than ICU nurses (p<0.001). ICU nurses were more likely than MSU nurses to report that physicians treat nurses as handmaidens (p=0.056) and that physicians displayed unprofessional behavior (p=0.019). Conclusions: Certain nursing specialty areas are not immune to problems with RN-MD relationships. Rather, all clinical service lines should be concerned with fostering colle- giality between nurses and their physician partners. [ABSTRACT FROM AUTHOR]

The article discusses a study assessing different methods of allocating nurses to staff hospital wards to minimize the hospital costs. The methods illustrated using statistical analysis are nurse patient ratios (NPR) and Computer Nursing Dependency Management System (CNDMS). The analysis showed that NPR allocation required higher costs than CNDMS.

High beds are a safety concern. This qualitative study used pre-existing nurse interview data and confirmed nurses' awareness of the impor-tance of keeping patient beds in the lowest position. Lowering the bed helps promote patient safety and prevent falls. [ABSTRACT FROM AUTHOR]

The article discusses about a study examining the relationship between nurse staffing and the occurrence of medication errors. The results indicate that even a small number of Licensed Practical Nurses (LPNs) in staffing can contribute to medication errors. The article also suggests that increasing the number of Registered Nurses (RN) hours and decreasing or eliminating LPN hours can be used as a strategy to reduce medication errors.

Preventing falls in hospitalized patients, increasing patient satisfaction, and decreasing call light usage are constant challenges nurses face every day. This quasi-experimental study replicates Meade, Bursell, and Ketelsen's (2006) study on a rounding protocol, demonstrating improvements in the above variables. [ABSTRACT FROM AUTHOR]