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Division of Psychiatric and Chemical Dependency Nursing staff at the University of Iowa Hospitals and Clinics developed an integrative framework for structuring a quality control program. Indicators of basic structural soundness and staff competence form the framework's foundation. Other framework components include patient care improvement processes that measure conformity and variance to performance standards, research projects that alleviate problems in care or infrastructure, and grave errors, known as sentinel events, that require intense scrutiny to prevent their reoccurrence.

* The authors propose a new metric for quantifying nursing unit resource needs that is more sensitive to the rapid turnover of patients and shorter lengths of stay than the traditional hours per patient day (HPPD) metric. * There was a felt need to capture intra-day census and/or demand-supply variations, skill mix variations, and other variables not adequately captured by midnight patient bed volume. * Criteria for developing any new system included the following: * Simple to understand automated system, * Uses existing data and requires no additional data collection staff, * Quick to implement with ample data expansion potential, and * Amenable to detailed user data analyses with basis for comparison across units. * One key difference was that the CPGR provides better disaggregate staffing need data via a series of snapshots throughout the day than the HPPD which only records midnight bed census. * These data have proved indispensable in budgeting and setting cost standards, providing timely information for nurse managers, and obtaining buy-in from front-line staff members who have more confidence in the quality of staffing decisions., CHANGES IN THE WAY hospitals are reimbursed for services have led to intense cost-containment efforts and pressure to control the use of resources, particularly human resources. Nursing staff typically compose [...]

A study was conducted to compare the perceived attractiveness of preterm infants with postnatal cranial molding to that of preterm and full‐term infants without this deformation. Forty‐two subjects who viewed photographs of infants selected preterm infants with postnatal cranial molding as the least attractive group of infants. Researchers have hypothesized that infant appearance is an antecedent to bonding and attachment. Nurses should implement measures such as the use of waterbed mattresses, which have been found to minimize the molding process, and include discussion of this measure when teaching parents about their preterm infants so that they are aware of causes and prevention of cranial molding. If an infant has developed postnatal cranial molding, the parents may require counseling to assist them in resolving their feelings about the discrepancy in the appearance of the infant and what they had anticipated prenatally.

A recently developed intraoral device is being used for infants who require orotracheal and orogastric intubation. The purpose of the appliance is to prevent complications associated with long-term intubation, such as palatal groove formation, acquired cleft palate, defective primary dentition, and chronic irritation of the airway. The nursing care required for an infant with this intraoral appliance is described. The procedure for daily removal of the appliance, oral hygiene, and assessment of the oral cavity is presented. Other nursing interventions addressed include provision of non-nutritive sucking, initiation of oral feedings, and parent teaching and support.