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A symptom-triggered therapy protocol was initiated for treatment of alcohol withdrawal syndrome, with observed decreases in length of stay, transfers to higher level of care, and benzodiazepine use, proving it more effective and safer in managing patients than fixed-schedule dosing. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the impact of implementing hourly rounding on restraint use in the clinical setting. Study results indicate implementing an hourly rounding program had significant impact on restraint use. [ABSTRACT FROM AUTHOR]

Missed nursing care is defined as omitting or delaying the whole or part of required care for patients. This cross-sectional descriptive study assessed missed nursing care and related factors from the perspective of nurses in oncology departments of medical universities in southeastern Iran. [ABSTRACT FROM AUTHOR]

High-touch surfaces within the hospital setting such as keyboards can harbor bacteria and facilitate pathogen transmission. UV-C light is ideal for disinfecting electronic devices such as keyboards that are difficult to clean with traditional chemicals and wipes. This project suggested use of low-cost UV-C devices for keyboards may reduce bacteria. [ABSTRACT FROM AUTHOR]

The quality improvement project examined the impact of nurses' education on heart failure (HF) self-care management principles and use of the teach-back method on readmission in progressive care units. Educational interventions can increase nurses' knowledge of HF self-care management principles, and use of the teach-back method can help ensure patients receive optimal discharge instructions. [ABSTRACT FROM AUTHOR]

Simplification and standardization of fall risk assessment tools combined with specific bundled interventions, including patient education, help reduce fall events, promote consistency in assessments and interventions, and improve patient quality of life while lowering risks for injury and mortality. [ABSTRACT FROM AUTHOR]

Employing internationally educated nurses (IENs) to address the nursing workforce shortage is common in many countries, including the United States. This study examined the relationship between unit utilization of IENs and collaboration in U.S. hospitals. Results indicated more IENs on a unit did not significantly affect the collaboration among nurses and between nurses and physicians. The presence of IENs significantly influenced unit nursing characteristics, such as education attainment and unit tenure. [ABSTRACT FROM AUTHOR]

The pilot process used to implement purposeful hourly rounds as part of an existing fall protocol on a 112-bed medical-surgical unit is described. Outcomes achieved as a result of this quality improvement change are reviewed. [ABSTRACT FROM AUTHOR]

Basic staffing and scheduling methods of the past are not meeting the complex demands of the nurse scheduling problem (NSP). The overall goal of this study was to develop and implement a nurse scheduling forecasting model for a 33- bed inpatient nursing unit to address the challenges of the NSP during the schedule creation phase. Results revealed the nurse scheduling forecasting model improved schedule accu racy and aligned nurse needs to vary by day of the week. [ABSTRACT FROM AUTHOR]

A lack of communication during nursing shift report and memory lapse were found to be contributing factors in errors in the monitoring of therapeutic heparin infusions. The process of drawing blood also was found to be a contributing factor. Standardized nursing shift report and standardized anti-Xa testing draw times were implemented to improve monitoring of heparin infusions. [ABSTRACT FROM AUTHOR]

Reducing unplanned hospital readmissions to acute care hospitals is a national priority. The purpose of this quality improvement project was to reduce 30-day readmissions for heart failure by implementing an evidence-based transition program. Positive outcomes of the program were promising. [ABSTRACT FROM AUTHOR]

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 the effectiveness of transition from physician-driven to nurse-driven weight-based intravenous unfractioned heparin protocol in non-critical units in a hospital. It discusses comparisons of outcomes including comparative activated partial thromboplastin time, bleeding episodes and dosing errors.

The article presents a study on the "Discharge by 11:00 a.m. Program initiative at a 28-bed medical-surgical unit in an academic teaching hospital in southern California. It discusses findings on the correlation of patients discharged by 11:00 a.m. between Health Consumer Assessment of Healthcare Providers and Systems patient satisfaction scores, impact of the program on unit revenue, wait times in transferring departments and promoting culture of continuous improvement.

The article presents a double cohort observational retrospective study on outcomes of patient admitted to short-stay units (SSU) in a public academic medical center in northeastern Ohio. It discusses findings on 30-day readmission rates after SSU discharge compared with traditional inpatient medical unit discharge of patients with chronic obstructive pulmonary disease, heart failure, diabetes and pneumonia.

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.

A study of patient and nurse perceptions of the effectiveness of interventions to promote patient sleep are described. Feedback from the two groups also is provided on a noninvasive medical device for prototype development that may promote sleep for hospitalized patients. [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]

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]

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 conducted to evaluate the work and work environments of nurses in relation to repositioning patients to prevent pressure ulcers. Topics covered include the highlights of previous research articles about repositioning of adult patients, the samples, survey design and instruments used in the study, and the procedure of collecting data for the study. It also discusses the silent factors affecting the nurses' work in repositioning adult patients in acute care.

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]

A retrospective study was conducted to determine the effects of a well-functioning rapid response team (RRT) within one facility. A well-functioning RRT was associated with fewer cardiac arrests outside critical care settings and decreased critical care length of stay. [ABSTRACT FROM AUTHOR]

Immobility in hospitalized patients, particularly the elderly can lead to serious untoward events. A pragmatic ambulation program that could be incorporated easily into clinicians' practice routines significantly improved ambulation in hospitalized patients compared to usual care with no organized emphasis on ambulation. [ABSTRACT FROM AUTHOR]

Interprofessional bedside rounds are essential for patient-centered care. However, it may be difficult for nurses to round with physicians on medical-surgical units. Using a daily goals tool for indirect rounds improved nurse-physician communication and interprofessional care for patients. [ABSTRACT FROM AUTHOR]

Creating new norms is essential for success as acute care leaders seek to redesign care delivery. Through the structures of the registered nurse (RN) residency and utilizing a quality improvement process, new graduate RNs demonstrated success in creating a centralized float pool resource. [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 presents a retrospective cohort study on the risk of falls in patients with the use continuous peripheral nerve blocks as pain management strategy for patients undergoing total knee arthroplasty and total hip arthroplasty in an academic medical center in southern California. It discusses findings on description of fall trends, incidences of falls and number of falls. It also discusses the implications of the research for medical-surgery nurses in inpatient units.

The article describes an evidence-based practice (EBP) intervention for patient safety and falls prevention. It discusses the implementation of the EBP TeamSTEPPS® for communication and teamwork in reducing inpatient falls using the FOCUS-PDCA model for process reviews in quality improvement projects. It describes the formation of the Fall Safety Team including registered nurses, licensed vocational nurses and certified nursing assistants.

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.

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]

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 The results are presented from a grounded theory study that theorized nurse physician collaboration as a basic social process in which groups are formed and changed in harmony. Effective collaboration is essential to superior patient care and outcomes but a lack of theoretical basis for collaboration has hampered the study of collaboration and the optimization of patient care. Purpose The purpose of this study was to theorize collaboration as a basic social process occurring between nurses and physicians. Method Grounded theory was used to explore nurses' and physicians' experiences with collaboration to understand the process intrinsically. Following Institutional Review Board approval, 15 nurses and 7 resident physicians from various units within an academic medical center participated in face-to-face interviews regarding their experiences of collaboration. Data collection and constant comparison analysis continued concurrently until saturation was reached in the core and subsequent categories. Findings The basic social process of nurse-physician collaboration that emerged includes the core category of working together toward a common goal. It describes how nurses and physicians collaborate for patient care. The seven stages in the process are something needs our attention, knowing who to talk to, finding the right person, coming together, exchanging ideas and information, making it happen, and monitoring progress. Conclusion Working together toward a common goal is an empirically derived theory that can guide education and practice to improve patient outcomes, while saving money and lives. [ABSTRACT FROM AUTHOR]

The article discusses research on nurses' perception of their role, team performance and educational needs in the use of an electronic survey during resuscitation. Topics covered include cardiovascular disease as the top cause of death in the U.S. and how a high-performing team can surpass expectations in many instances.

The article discusses the process used to implement interdisciplinary plans of care (IPOC) on a pilot 32-bed stroke unit to meet Joint Commission requirements. Topics covered include the use of electronic solutions endorsed by the Institute of Medicine (IOM) to improve care quality for hospitalized patients.

The article discusses the implementation of Clinical Decision Units (CDUs) for patients with congestive heart failure in the U.S. Topics covered include the impact of CDU on clinical care, its financial benefits, and the opportunities it provide for the nurse leaders. The advantages and limitations of CDU are also mentioned.

The article discusses about oral anticoagulants and its significance in preventing stoke associated with atrial fibrillation (AF). Among the key notable anticoagulants in the market include aspirin, warfarin, and dabigatran. Information regarding patient education, laboratory monitoring, and nursing assessment, are also discussed.

The article discusses a study which examined whether the Patient Risk Assessment Profile which assesses patient characteristics and risk could guide staffing decisions and reduce adverse events and avoid unnecessary hospital costs. Topics covered include the primary goal for developing the Patient Risk Assessment Profile, the process to develop the Patient Risk Assessment Profile, and research findings including decreased adverse event rates for patient falls.

The article focuses on the perception of clinical partners (CPs) about acuity-based patient assignments. It discusses Treatment, Education, Activities of Daily Living, Medications and Vital Signs and its implementation. The necessity of CP incorporation with efficient and effective patient care is noted.

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.

Heart failure affects 5.1 million Americans. It is the leading cause of hospitalization in older adults and the most common cause of re-admissions, which cost approximately $12 billion annually. Re-admissions can be reduced through increased nurses’ knowledge in heart failure. [ABSTRACT FROM AUTHOR]

The article discusses the study which identifies the baseline diabetes knowledge level of nurses and evaluates educational module's efficacy that was made to identify level of diabetes knowledge of direct-care nurses. The study uses intervention, pre-test, and post-test design to identify the knowledge of nurses along with Diabetes Basic Knowledge Test (DBKT) and Diabetes Self-Report Tool (DSRT). Result shows an increase in nurse autonomy to manage hypoglycemia events.

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 evaluates the impact of installing medication cabinets in patients' rooms among nurses on a medical-surgical telemetry unit. Topics discussed include the use of medication cabinets, the increase of nurses' satisfaction when it comes to medical administration process, and the implications for nursing practice.

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.

The article discusses a study regarding the comparison of the completion time of rounds and health service utilization after hospital discharge between discharge planning (DP) rounds in a conference room and at the bedside. Topics include the use of a cross-sectional survey, emergency room visits, and determining the feasibility of DP rounds at conference room and at the bedside.