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Purpose: To evaluate the effectiveness of a nurse-driven indwelling urinary catheter removal protocol in an acute care setting. Background: The most common hospital-acquired infection is catheter-associated urinary tract infection (CAUTI). These infections account for 40% of all hospital-acquired infections. Although indwelling urinary catheters may be a needed intervention, studies have demonstrated over half of the patients who receive a urinary catheter do not have a valid indication for its use. Methodology: A retrospective chart review allowed measurement of prevalence of catheter usage, dwell time, and CAUTIs before and after implementation of the protocol. Indwelling catheter usage was tabulated monthly from nursing clinical documentation. The sum of catheter days was divided by the total patient days and multiplied by 100 to get a percentage of catheter usage for each month. Dwell time was calculated by tabulating the length of time in days each patient had an indwelling catheter and dividing it by the total number of catheterized patients to determine the mean duration in days. The number of CAUTIs was divided by the total number of patients with urinary catheters and multiplied by 100 to get the percentage of CAUTI. Results: Prior to implementing the nurse-driven removal protocol, indwelling urinary catheter usage was 37.6%, mean dwell time was 3.35 days, and the CAUTI rate was 0.77%. After implementation of the protocol, catheter usage was 27.7%, mean dwell time was 3.46 days, and the CAUTI rate 0.35%. Implications for Nursing: Findings support the use of a nurse-driven protocol to reduce the incidence and duration of urinary catheterization, to decrease incidence of CAUTI, and to improve the quality of care for hospitalized patients. [ABSTRACT FROM AUTHOR]

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]

A health network in the southeastern United States piloted Mobility Circles as a strategy to help reduce falls on a medical renal department. Mobility Circles were used as visual cues to communicate the patient's mobility status, and promoted patient safety, teamwork, and satisfaction, and communication among disciplines, patients, and families. [ABSTRACT FROM AUTHOR]

The article discusses the results of a study that examines the effects of patient, organizational and nursing unit characteristics on patient safety and quality outcomes. It cites the major concepts of Systems Research Organizing Model including client characteristics, context, action focus and outcomes. It concluded that better outcomes can be achieved through effective communication and collaboration among health care professionals.

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]

The article discusses a study regarding the use of a cyanoacrylate protectant for the treatment of partial-thickness skin tears. It says that all patients with Payne-Martin I-III skin tears have been treated with topical cyanoacrylate skin protectant in one medical-surgical unit. It mentions that patients treated with such method for skin tears were assessed by a registered nurse (RN). Results show that anticoagulants were prescribed to 50% of the patients while 23% received corticosteroids.

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]

Understanding nurse relationships is crucial in determining if health care environments are healthy places of work. Highlighting the factors that foster positive nurse-to-nurse relationships and elements that impede such relationships can help nurses create and sustain healthy work environments. [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]

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.

The article discusses the study investigating that was developed on intervention of nurses to promote appropriate nursing knowledge and behaviors related to vancomycin and aminoglycoside administration. A method was developed to educate the nurses which resulted in substantial improvement related to the appropriate timing for therapeutic blood sampling of vancomycin and aminoglycosides.

The article discusses a study to evaluate the predictors of different kinds of falls with a focus on toileting-related falls occurring in adult acute patient care settings. Data from 547 fall incidents in a community, not-for-profit, suburban hospital located in Michigan was used. The findings revealed that a toileting-related fall tend to be associated with having a previous fall, having physical restraints in use, and being at risk for falling.

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 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.

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]

Staff members on a medical-surgical unit in a large community teaching hospital adapted the hourly rounding concept to their specific patient population. Lessons learned and strategies to assure continuous success with the rounding process are addressed. [ABSTRACT FROM AUTHOR]

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]

In this study, the differences in patient assignments between float pool nurses versus scheduled unit staff nurses were examined. Although there was a tendency for float pool nurses to receive more difficult patient assignments, this was not statistically significant (at alpha=0.05). [ABSTRACT FROM AUTHOR]

To address an increase in patient transfers to the intensive care unit because of respiratory distress, a respiratory care bundle utilizing incentive spirometry was developed for a medical general practice unit. This resulted in decreased respiratory complications over 12 months. [ABSTRACT FROM AUTHOR]

The article focuses on the implementation of patient-focused diaries or medical diary by hospitals for continual documentation of events throughout the hospital course. It says that the creation of the medical diary encompasses the aspects needed to provide patients with photographs of their hospital stay. It adds that the diary's pages detail the unit information, abnormal laboratory work, and notes for patients for references throughout the health care continuum.