Wenbin He, Xiaofeng Lin, Nuo Chen, Yan Li, Bilong Feng, Fan Cheng, Xiaoyan Chen, Yibin Tan, Ying Zhang, Wenwen Wu, Ying Wang
{"title":"Frequent Hand Hygiene-Induced Skin Symptoms and Alterations in Hand Microbiota: A Neglected Form of Chronic Occupational Exposure Among Health Care Workers.","authors":"Wenbin He, Xiaofeng Lin, Nuo Chen, Yan Li, Bilong Feng, Fan Cheng, Xiaoyan Chen, Yibin Tan, Ying Zhang, Wenwen Wu, Ying Wang","doi":"10.1097/NCQ.0000000000000855","DOIUrl":"10.1097/NCQ.0000000000000855","url":null,"abstract":"<p><strong>Background: </strong>Frequent hand hygiene is essential for infection control among health care workers (HCWs) but may cause adverse skin effects.</p><p><strong>Purpose: </strong>To assess the relationships between frequent hand hygiene practices, skin symptoms, and microbiota alterations in HCWs.</p><p><strong>Methods: </strong>A comprehensive search of 7 databases was conducted to identify articles published between January 2014 and July 2024 in English and Chinese.</p><p><strong>Results: </strong>A total of 24 studies were included in the review. Frequent hand hygiene was associated with reduced microbial flora in 2 studies and high incidences of skin dryness, itching, peeling, erythema, fissures, burning, and pain in 18 studies. Fifteen studies linked frequent hand hygiene to eczema, dermatitis, acne, and folliculitis, while 1 study found higher Staphylococcus aureus detection in severe eczema cases.</p><p><strong>Conclusions: </strong>Prolonged frequent hand hygiene alters hand microbiota and induces various skin symptoms, necessitating attention to chronic occupational exposure among HCWs.</p>","PeriodicalId":16931,"journal":{"name":"Journal of nursing care quality","volume":" ","pages":"E50-E56"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Megan M Streur, Raelynn Cameron, Mrinal Yadava, Kate Smith, Jaimie Pechan, Jonathan Auld
{"title":"The Community Heart Failure Program: A Trauma-Informed Heart Failure Management Strategy.","authors":"Megan M Streur, Raelynn Cameron, Mrinal Yadava, Kate Smith, Jaimie Pechan, Jonathan Auld","doi":"10.1097/NCQ.0000000000000876","DOIUrl":"10.1097/NCQ.0000000000000876","url":null,"abstract":"<p><strong>Background: </strong>Individuals with heart failure (HF) and adverse social determinants of health (SDOH) experience significant health care disparities.</p><p><strong>Local problem: </strong>We noted high rates of acute care utilization by patients with adverse SDOH and unmet social needs.</p><p><strong>Methods: </strong>This pilot quality improvement project used a pre-post design.</p><p><strong>Intervention: </strong>A nurse-led, trauma-informed, community-based HF program (CHFP) was developed, providing care at each patient's chosen location (eg, shelter, tent). Guideline-directed medical therapy was adjusted to achieve patient goals.</p><p><strong>Results: </strong>Sixteen patients participated in the CHFP. Reductions were seen in the number of emergency department visits, mean number of hospitalizations, and days hospitalized. The number of patients with ≥1 hospitalization significantly decreased from 12 to 5 ( P = .07). Cardiology outpatient encounters significantly increased from 11.19 to 19.38 ( P = .02).</p><p><strong>Conclusions: </strong>CHFP reduced acute care utilization and has the potential to improve patient outcomes.</p>","PeriodicalId":16931,"journal":{"name":"Journal of nursing care quality","volume":" ","pages":"326-331"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sepsis Recognition by Electronic Health Record Screening in the Pediatric ICU.","authors":"Molly Zimmerman, Eryn Brown, Myra Schmaderer, Leeza Struwe","doi":"10.1097/NCQ.0000000000000868","DOIUrl":"10.1097/NCQ.0000000000000868","url":null,"abstract":"<p><strong>Background: </strong>Early recognition and intervention of sepsis in the pediatric population have been shown to decrease hospital length of stay and mortality rates. Stakeholders within a pediatric intensive care unit (PICU) identified a need to improve sepsis recognition in compliance with the Improving Pediatric Sepsis Outcomes Collaborative recommendations.</p><p><strong>Purpose: </strong>The purpose of this study was to identify appropriate screening variables in an electronic health record (EHR)-embedded sepsis screening tool to improve sepsis recognition in the PICU setting.</p><p><strong>Methods: </strong>A retrospective data analysis was conducted to test 3 versions of an EHR sepsis screen including triggers based on vital signs and/or laboratory results.</p><p><strong>Results: </strong>Of the 3 tested versions, the sepsis screen version that triggered based on both vital signs and laboratory findings showed the most promising results with a sensitivity of 83.3% and a specificity of 76%.</p><p><strong>Conclusions: </strong>EHR-embedded sepsis screens that monitor documented variables can identify potential sepsis while avoiding over-triggers.</p>","PeriodicalId":16931,"journal":{"name":"Journal of nursing care quality","volume":" ","pages":"358-362"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sara Price, Jessica Anderson, Cynthia Aubol, Laura Thomas, Scott B Harpin
{"title":"Enhancing Emergency Obstetric Care Through Implementation of a Triage Acuity Score: A Quality Improvement Initiative.","authors":"Sara Price, Jessica Anderson, Cynthia Aubol, Laura Thomas, Scott B Harpin","doi":"10.1097/NCQ.0000000000000867","DOIUrl":"10.1097/NCQ.0000000000000867","url":null,"abstract":"<p><strong>Background: </strong>Maternal morbidity and mortality in the U.S. remain a significant concern, particularly in obstetric emergency settings where inefficient triage delays care and contributes to adverse outcomes.</p><p><strong>Local problem: </strong>The obstetric emergency department (OBED) faced challenges in aligning triage processes with acuity-based care, leading to delays in provider response times.</p><p><strong>Methods: </strong>A quality improvement initiative was conducted. Pre/post-implementation data were collected to evaluate the alignment of maternal-fetal triage index (MFTI) scores with provider-at-bedside (PAB) times.</p><p><strong>Interventions: </strong>The MFTI system was implemented to prioritize patients based on acuity, aligning provider response times with MFTI-advised targets.</p><p><strong>Results: </strong>Alignment between MFTI scores and PAB times improved from 40% to 90%. Documentation of MFTI scores and PAB times increased, while total visit times remained stable. Overall, survey data suggested providers were satisfied with the MFTI system.</p><p><strong>Conclusions: </strong>The MFTI system enhanced triage efficiency and care quality in the OBED without extending total visit times, supporting acuity-based triage in obstetric emergencies.</p>","PeriodicalId":16931,"journal":{"name":"Journal of nursing care quality","volume":" ","pages":"351-357"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Making Protocols Click: The Power of Short-Form Videos in Educating Nurses.","authors":"Rachel Lumbus, Amanda Foster, Haley Johnson, Heather Carter-Templeton","doi":"10.1097/NCQ.0000000000000882","DOIUrl":"10.1097/NCQ.0000000000000882","url":null,"abstract":"","PeriodicalId":16931,"journal":{"name":"Journal of nursing care quality","volume":" ","pages":"337"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reducing Medication Errors in an Ambulatory Medical Center.","authors":"Stacy Bentil, Tuba Sengül, Holly Kirkland-Kyhn","doi":"10.1097/NCQ.0000000000000856","DOIUrl":"10.1097/NCQ.0000000000000856","url":null,"abstract":"<p><strong>Background: </strong>Medication errors are a significant problem in ambulatory care, occurring at any stage, from prescribing to administration.</p><p><strong>Local problem: </strong>Medication error rates due to interruptions were high on an ambulatory medical unit.</p><p><strong>Methods: </strong>A quality improvement design was used for the project.</p><p><strong>Interventions: </strong>A Safe Zone protocol was developed by nurses, certified nursing assistants, and unit secretaries. Implementation included clear medication preparation areas, administration checklists, and staff and patient education.</p><p><strong>Results: </strong>The number of distractions decreased by 20% over a 90-day period. Medication errors decreased from a rate of 0.97 events per 1000 doses administered to a rate of 0.20 after implementing the Safe Zone protocol.</p><p><strong>Conclusions: </strong>Due to its flexibility and adaptability, the Safe Zone protocol offers a template that can be replicated in environments needing to address similar issues.</p>","PeriodicalId":16931,"journal":{"name":"Journal of nursing care quality","volume":" ","pages":"332-337"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Psychometric Analysis of the Safety Attitudes Questionnaire in Acute Care Nursing.","authors":"Muder Alkrisat, Manal Alatrash, Sarah Alkrisat","doi":"10.1097/NCQ.0000000000000872","DOIUrl":"10.1097/NCQ.0000000000000872","url":null,"abstract":"<p><strong>Background: </strong>Evaluating patient safety culture is vital for improving health care quality. The safety attitudes questionnaire (SAQ) is a well-established tool to measure attitudes toward safety in health care personnel, but its psychometric properties have not been extensively studied in the acute care nursing population.</p><p><strong>Purpose: </strong>This study examines the psychometric properties of the SAQ specifically within an acute care nursing sample.</p><p><strong>Methods: </strong>Reliability and validity of the SAQ were evaluated using correlation and confirmatory factor analysis (CFA) with a sample of nurses from acute care settings in California.</p><p><strong>Results: </strong>Cronbach's alpha was 0.78, with subscales ranging from 0.70 to 0.90, indicating moderate reliability. CFA revealed a 2-factor model demonstrating excellent fit.</p><p><strong>Conclusion: </strong>The SAQ subscales reliably measure their constructs. Strong factor loadings validate the 2-factor structure, affirming the tool's effectiveness in assessing patient safety attitudes in acute care nursing.</p>","PeriodicalId":16931,"journal":{"name":"Journal of nursing care quality","volume":" ","pages":"377-383"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lauren M Franker, Molly Pretet, Kristin Simmons, Barbara Douglas, Lisa Young
{"title":"The Crani Bundle: Chlorhexidine Gluconate Bathing, Patient Hand Hygiene, and Surgical Site Dressing Care in Preventing Surgical Site Infections.","authors":"Lauren M Franker, Molly Pretet, Kristin Simmons, Barbara Douglas, Lisa Young","doi":"10.1097/NCQ.0000000000000869","DOIUrl":"10.1097/NCQ.0000000000000869","url":null,"abstract":"<p><strong>Background: </strong>Surgical site infections (SSIs) are preventable complications. The Joint Commission (TJC) National Patient Safety Goal® (NPSG) 7 focuses on decreasing health care-associated infections (HAIs), such as SSIs.</p><p><strong>Local problem: </strong>The neurosurgery service line encountered 4 SSIs from craniotomy procedures over a 27-month period with 2 occurring in 1 month requiring immediate attention.</p><p><strong>Methods: </strong>A pre- (January 2018 to March 2020)/post-implementation (April 2020 to July 2022) design, using rapid Plan-Do-Study-Act cycles, guided this evidenced-based practice quality improvement project.</p><p><strong>Interventions: </strong>The Crani Bundle, a nurse-led SSI prevention initiative focusing on patient hand hygiene and postoperative chlorhexidine gluconate bathing, was developed and implemented to reduce SSI after craniotomy (SSI-CRAN).</p><p><strong>Results: </strong>Implementation of the Crani Bundle decreased SSI-CRAN from 3.38% ( n = 4/118) to 0.0% ( n = 0/87).</p><p><strong>Conclusions: </strong>The Crani Bundle was effective in reducing SSI-CRAN, meeting TJC NPSG® of preventing HAIs and improving patient safety.</p>","PeriodicalId":16931,"journal":{"name":"Journal of nursing care quality","volume":" ","pages":"363-369"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mei He, Ying Wang, Hui Wang, Mei Wang, Mei J Du, Jie Xiong, Chun L Li, Shu Huang, Xin Y Zhang
{"title":"Reducing Diarrhea in Critically Ill Patients Receiving Enteral Nutrition Support: An Evidence-Based Quality Improvement Project.","authors":"Mei He, Ying Wang, Hui Wang, Mei Wang, Mei J Du, Jie Xiong, Chun L Li, Shu Huang, Xin Y Zhang","doi":"10.1097/NCQ.0000000000000901","DOIUrl":"10.1097/NCQ.0000000000000901","url":null,"abstract":"","PeriodicalId":16931,"journal":{"name":"Journal of nursing care quality","volume":" ","pages":"383"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amit Bahl, Matthew Drogowski, Akhil Gutta, Christopher Lehman, Edmond Younes, Emily DiLoreto, Chen Shen
{"title":"Upper Arm Versus Forearm Placement of Long Peripheral Catheters for Blood Sampling: A Randomized Controlled Trial.","authors":"Amit Bahl, Matthew Drogowski, Akhil Gutta, Christopher Lehman, Edmond Younes, Emily DiLoreto, Chen Shen","doi":"10.1097/NCQ.0000000000000857","DOIUrl":"10.1097/NCQ.0000000000000857","url":null,"abstract":"<p><strong>Background: </strong>The impact of site selection on blood sampling and catheter functionality for long peripheral catheters (LPCs) is unclear.</p><p><strong>Purpose: </strong>To compare outcomes of LPCs placed in the upper arm vs the forearm.</p><p><strong>Methods: </strong>A single-site, randomized trial was conducted among adult patients requiring an LPC for difficult venous access or prolonged therapy. Participants were randomized to receive an 8 cm, 20-gauge LPC in either the forearm or upper arm. Outcomes included blood sampling success, catheter survival, and catheter-associated thrombosis.</p><p><strong>Results: </strong>Among 88 patients, blood sampling failure was common, with no significant difference between forearm (83.3%) and upper arm (78.1%) groups (P = .769). Mean dwell time (74.27 vs 115.52 hours, P = .394) and time to first blood sampling failure (70.19 vs 112.90 hours, P = .359) were similar. While overall blood sampling success and thrombosis rates did not differ, trends favored upper arm placement over time.</p><p><strong>Conclusions: </strong>This study found no statistically significant differences in blood sampling capability or functionality between placement sites.</p>","PeriodicalId":16931,"journal":{"name":"Journal of nursing care quality","volume":" ","pages":"310-317"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}