Nursing Management (springhouse)最新文献_第9页

Building a safe unit culture with CUSP 用CUSP建立安全单位文化

Nursing Management (springhouse) Pub Date : 2016-12-01 DOI: 10.1097/01.NUMA.0000508266.49722.7d

J. Slade, R. Hata

引用次数: 0

Nursing Management (springhouse) Pub Date : 2016-12-01 DOI: 10.1097/01.NUMA.0000508264.64969.95

K. Drake

{"title":"Aim for high reliability","authors":"K. Drake","doi":"10.1097/01.NUMA.0000508264.64969.95","DOIUrl":"https://doi.org/10.1097/01.NUMA.0000508264.64969.95","url":null,"abstract":"M ic h a e l Tr in s e y Standardizing processes within your organization will affect the quality of care on your unit because doing so meets the principles of high reliability: sensitivity to operations, reluctance to accept “simple” explanations for problems, preoccupation with failure, deference to expertise, and resiliency.1 These principles fall into two categories: anticipation and containment. First, let’s address the principles in the anticipation category. Sensitivity to operations means that operations are complex and dynamic. Consistent rounding on your unit gives you firsthand knowledge of challenges, opportunities, and best practices. Being transparent increases attention to patient care processes. For instance, you’re observing medication administration using a recently added bar code reader and you notice the nurse pulling the device’s cord due to its short length and dropping it as a result. You share the information with other leaders and it’s determined that this is a common issue; as a result, the bar code reader cords are replaced with longer ones. Reluctance to accept “simple” explanations for problems means to dig deep into answers by performing a root cause analysis. Continuing with our bar code reader example, you discover that a nurse makes a medication error. On your organization’s reporting tool, you document the “simple” explanation for the error: the unit was short staffed that shift. However, upon further review, the root cause was that the nurse overrode a process due to bar code reader failure, which contributed to the error. There was no record of the device being reported as defective or any attempt to obtain another bar code reader before administering the medication. Preoccupation with failure means that leaders are looking at how processes may break. Evaluating the good catches in your environment may lead to preventing future failures. Also, being thoughtful and observant of what’s working well assists in error prevention. Replicating what’s working well in other areas is essential for high-reliability organizations. Now, let’s review the principles in the containment category: deference to expertise and resiliency. A common misconception regarding deferring to an expert is that it’s based on seniority or positional hierarchy. In some cases, the process expert is the clinical nurse who performs the task daily. That’s why it’s important when changing products that we ask staff members to evaluate them. Another example is that employees who are new to your organization may communicate best practices from previous employers. As a leader, refrain from saying “I know” because this deters employees from sharing ideas that may lead to improvements. Resiliency is the ability to recover quickly in times of high stress, adapt well to change, keep focused, and learn from adversity. A clinical example of nursing resilience is during a code. Nurses stay focused in what may be a rapidly changing situation and rebound quick","PeriodicalId":358194,"journal":{"name":"Nursing Management (springhouse)","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134276284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bridging gaps in rapid response systems 弥合快速反应系统的差距

Nursing Management (springhouse) Pub Date : 2016-12-01 DOI: 10.1097/01.NUMA.0000508260.11605.47

M. Douglas, M. Devita, R. Gilder, P. Lauer

{"title":"Bridging gaps in rapid response systems","authors":"M. Douglas, M. Devita, R. Gilder, P. Lauer","doi":"10.1097/01.NUMA.0000508260.11605.47","DOIUrl":"https://doi.org/10.1097/01.NUMA.0000508260.11605.47","url":null,"abstract":"lthough death is a part of everyday life for healthcare providers, avoidable death of hospitalized patients shouldn’t be. To reduce unnecessary mortality each year, hospital leaders across the nation focus on achieving the Institute for Healthcare Improvement’s (IHI) “Triple Aim.” This initiative aims to improve the patient care experience, including quality and satisfaction, and population health while reducing healthcare’s per capita cost.1-4 Rescuing a deteriorating patient before he or she progresses to a respiratory or cardiac arrest aligns with this focus. Failure to rescue a deteriorating patient in a hospital setting is now a nursing-sensitive measure reviewed by the Centers for Medicare and Medicaid Services.5 Studies show that early recognition of deterioration signs and implementation of prompt intervention can reduce permanent disability in stroke events and mortality associated with respiratory and cardiac arrests in hospitalized patients residing outside of the ICU.2,3,6,7 Historical background In 2004, the IHI recommended the implementation of rapid response teams (RRTs) to minimize unnecessary disabilities and deaths.6 As a result of this initiative, over 1,400 American hospitals implemented RRT programs by 2005.7 Before the June 2005 International Conference on Medical Emergency Teams, RRTs were commonly known as medical emergency teams or critical care outreach.8 Rapid response systems are designed to initiate RRT activation for stat assessment and treatment of patients whose clinical condition is deteriorating.8 In 2008, RRTs became a patient safety goal and a required component of hospital accreditation by The Joint Commission.7 Today, the Institute for Clinical Systems Improvement (ICSI) has created a healthcare protocol for RRTs to ensure quality. The protocol, based on evidence-based research, outlines key clinical strategies and recommendations for effective RRT implementation. According to the ICSI, eight areas need to be considered when implementing an RRT.3 (See Table 1.) Bridging gaps in rapid response systems","PeriodicalId":358194,"journal":{"name":"Nursing Management (springhouse)","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128186172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Vascular access devices: Setting your organization up for success 血管接入设备:让您的组织走向成功

Nursing Management (springhouse) Pub Date : 2016-12-01 DOI: 10.1097/01.NUMA.0000508272.73964.EB

Lorelle Wuerz

引用次数: 3

Make the most of health IT 充分利用医疗信息技术

Nursing Management (springhouse) Pub Date : 2016-12-01 DOI: 10.1097/01.NUMA.0000508263.57346.E8

J. Sensmeier

引用次数: 1

Screen and intervene: Depression's effect on CHF readmission 筛选和干预:抑郁症对心力衰竭再入院的影响

Nursing Management (springhouse) Pub Date : 2016-12-01 DOI: 10.1097/01.NUMA.0000508257.88733.0c

S. Linder, S. Lizer, A. Doughty

引用次数: 2

Reimplementing bedside shift report at a community hospital 某社区医院床边值班报告的重新实施

Nursing Management (springhouse) Pub Date : 2016-12-01 DOI: 10.1097/01.NUMA.0000508265.42099.cc

Bonnie Boshart, Mary C Knowlton, Ramona Whichello

{"title":"Reimplementing bedside shift report at a community hospital","authors":"Bonnie Boshart, Mary C Knowlton, Ramona Whichello","doi":"10.1097/01.NUMA.0000508265.42099.cc","DOIUrl":"https://doi.org/10.1097/01.NUMA.0000508265.42099.cc","url":null,"abstract":"Bedside shift report aids in the development of employee teamwork, ownership, and accountability, and has been shown to increase nurse satisfaction.1 It allows for the rapid determination of a patient’s condition, surroundings, and treatment, which facilitates identification of medication errors, prevents patient falls, and provides the opportunity for nurses to recognize a change in a patient’s clinical status.2 Moving shift report to the bedside promotes effective communication between patients and caregivers through transparency and open dialogue. Promotion of patient involvement in their own care plan enforces selfefficacy and adherence to treatment. The goal of bedside shift report is to help improve the patient experience and ensure safe handoff of care between nurses by involving the patient and family.3 To improve the patient experience, we must change the way nurses practice and communicate with each other and their patients.4 One of the ways to change nursing culture is to introduce different techniques to communicate patient-specific care at shift change. By reporting at the bedside in the presence of the patient, a culture shift can occur. The purpose of this project was to use a quality improvement process to reintroduce bedside shift reporting at a 294-bed community hospital in eastern North Carolina. The hospital consists of two medical-surgical units, a telemetry unit, an ICU, an ED, women and children’s services, and a labor and delivery suite. It employs 1,100 staff members, 250 of who are RNs. Standard practice at this facility included nurse-to-nurse shift report at the nurses’ station or in a conference room away from the bedside. Although bedside shift report had been introduced 2 years prior, the implementation failed. To better understand the reasons for the failure, clinical nurses and staff development specialists involved with the initial implementation were informally interviewed. It became apparent that the cause of the failure was multifaceted: inadequate staff education, lack of buy-in by nursing staff and leadership, and lack of accountability and supervision from nursing leadership. Education about bedside shift reporting provided to clinical nurses was substandard; nurses reported a lack of understanding of the benefits and rationale. Because clinical nurses didn’t understand the reason for the change, there was resistance to adopt the new method of patient handoff. Follow-up hadn’t been carried out effectively and there was a lack of buy-in by not only clinical nurses, but also directors, unit managers, and supervisors who were responsible for ensuring the nurses’ participation. Without leadership holding clinical nurses accountable for implementation of bedside shift report, they slowly reverted to the previous behavior of giving report at the nurses’ station.","PeriodicalId":358194,"journal":{"name":"Nursing Management (springhouse)","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131978798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 7

Prioritize the patient experience. 优先考虑病人的体验。

Nursing Management (springhouse) Pub Date : 2016-11-01 DOI: 10.1097/01.NUMA.0000502799.06930.17

Jeffrey N. Doucette

引用次数: 0

To know is to care...transformation through satisfaction 知道就是关心……满足转化

Nursing Management (springhouse) Pub Date : 2016-11-01 DOI: 10.1097/01.NUMA.0000502800.84058.31

F. Collins

引用次数: 2

How do patients perceive hourly rounding? 病人如何看待每小时就诊?

Nursing Management (springhouse) Pub Date : 2016-11-01 DOI: 10.1097/01.NUMA.0000502807.60295.c5

Linda Bragg, A. Bugajski, M. Marchese, R. Caldwell, Lisa Houle, R. Thompson, R. Chula, Corey Keith, A. Lengerich

引用次数: 7