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Background: Poor dietary intake is common in hospitalised older people. A targeted mealtime intervention is needed to improve nutrition care and dietary intake, especially for those at risk of malnutrition. Objectives: This quality improvement project designed, implemented and evaluated a mealtime assistance bundle consisting of care measures driven by the hospital nursing team. The aims were to improve the mealtime care process to promote dietary intake of the hospitalised older people and to improve nursing staff's knowledge, attitude and practice in malnutrition. Methods: This project adopted a pre–post design, targeting older people aged 65 years and above, who were admitted to a general medical unit in a regional hospital in Singapore. A mealtime assistance bundle consisting of seven care measures, using the acronym CANFEED, was implemented for older adults at risk of malnutrition. Outcome measures on the amount of dietary intake during meals through chart reviews and surveys of nursing staff using Malnutrition Knowledge, Attitudes and perceived Practices (M‐KAP) questionnaire were performed before and after implementation. Results: There were fewer older adults with poor intake in the post‐implementation group than the pre‐implementation group. Among those at risk of malnutrition, older adults in the post‐implementation group had higher average intake of all provided meals as well as the protein‐dense main dish. Significant improvements were noted in the total scores rated by the nursing staff in both the Knowledge‐Attitude subscale and Practice subscale of the M‐KAP questionnaire. Conclusions: Integrating a nurse‐driven mealtime assistance bundle into usual care may have positive outcomes on nutritional intake of hospitalised older people at risk of malnutrition, and on knowledge, attitude and practice of hospital nurses in nutrition care. Implications for Practice: Nurses play a critical role in nutrition care for hospitalised older people. Continuing efforts to improve nutritional intake of hospitalised older people should focus on staff education, building a multidisciplinary food‐promoting culture and patient, family and community empowerment. More efficient clinical processes incorporating information technology with the EMR to support better nutrition care of the hospitalised older people are needed. [ABSTRACT FROM AUTHOR]

Patients suffering from mental illness are often less likely to engage in treatment at an outpatient level. Lack of communication and coordination of care between providers has negative results for the health system and the patient. Improved communication has shown improved satisfaction of providers in health care. Using prior research, an electronic reminder and standardized documentation of communication was added to the health system's electronic health record. The aim of this quality improvement (QI) project was to compare pre-/postintervention communication and satisfaction between emergency department and outpatient psychiatric providers. The QI project was conducted on a convenience sample of 13 outpatient psychiatric providers at a large academic medical center. Using a pre-/postintervention design, QI project data were collected via chart reviews and pre-/postsurveys. The chart review results revealed the communication rate increased significantly from pre (22%) to post (85%), p <.001. The survey results revealed overall satisfaction had statistically significant increase from pre- (Mdn = 3, neutral) to postintervention (Mdn = 5, very satisfied), Z = −2.21, p =.027. The survey results revealed a statistically significant increase in frequency of direct communication from pre- (21%–40%) to postintervention (81%–100%), Z = −2.06, p =.039. The QI project documents an increase in both provider satisfaction and communication post-intervention. [ABSTRACT FROM AUTHOR]

A quality improvement project was conducted to increase adherence to the 3-hour sepsis bundle tasks following implementation of a sepsis response team (SRT). Although the SRT was underused, preliminary data suggested an increase in adherence to 3-hour bundle tasks. [ABSTRACT FROM AUTHOR]

This quality improvement (QI) project evaluates a comprehensive, patient-centered plan to reduce the emergency department (ED) revisit rate by improving outpatient follow-up after initial ED visits. Patients with low-acuity complaints discharged from the ED are often instructed to schedule a follow-up appointment with their primary care team or a specialty service after leaving the ED. In this QI project, patients either had a follow-up visit scheduled at the time of ED discharge or received a phone call within 2 days of discharge to schedule outpatient follow-up visit. The number of ED visits per patient was significantly reduced following implementation of scheduling at the time of ED discharge. [ABSTRACT FROM AUTHOR]

Sickle cell disease (SCD) is a severe chronic disease that leads to premature mortality caused by serious complications of the disease such as acute chest syndrome, stroke, and sepsis. Patients presenting to the emergency department (ED) with pain due to vaso-occlusive crisis (VOC) are at a higher risk for complications, making it imperative that emergency nurses, nurse practitioners, and physicians are knowledgeable about SCD and understand the other associated complications besides VOC. Because of the complexity of disease and misperceptions about SCD among ED nurses, physicians, and nurse practitioners, a quality improvement (QI) framework for treatment of adults with SCD in EDs was developed. The Emergency Department Sickle Cell Assessment of Needs and Strengths (ED-SCANS) is a research-based QI framework consisting of 7 distinct algorithms that serve to guide all ED team members in assessment and management of the complexity of care that patients with SCD require. [ABSTRACT FROM AUTHOR]

Background: Alcohol misuse is prevalent among college students and negatively affects their health, relationships, and academics. Alcohol misuse screening for this age group is advised but often overlooked. Objective: The aim of this study was to implement an evidence-based alcohol screening tool, the Alcohol Use Disorders Identification Test-Consumption, at a southern university health clinic. Methods: This quality improvement project used a preintervention/postintervention, mixed-methods design. A survey containing the Alcohol Use Disorders Identification Test-Consumption screening tool is used to identify students with alcohol misuse who are then offered education and follow-up. Students who were found to misuse alcohol were retested 1 month later. Qualitative comments were also gathered about the success of the project. Results: Alcohol misuse at this location is high and usually missed during the student health encounter. Screening and identification of alcohol misuse were increased. The follow-up survey showed a reduced number of students misusing alcohol. Conclusion: Alcohol screening and treatment in a university health setting may result in decreased alcohol-related problems. The potential to improve student outcomes at other colleges and universities should be considered. [ABSTRACT FROM AUTHOR]