The Journal of nursing administration
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The Institute of Medicine supports proposed changes in the overall delivery of healthcare and the nurses' work environment to achieve improved patient outcomes and protect the public from unnecessary harm. Allowing nurses to have a voice in decision making and influence over their practice, in an environment that fosters autonomy and interdisciplinary collaboration, enhances nurse satisfaction while improving the quality of patient care. The authors describe how a pediatric medical unit engaged in small tests of change to improve communication and patient satisfaction on an inpatient unit.
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The study compared certified nurses with noncertified nurses for symptom management of nausea, vomiting, and pain; patient satisfaction; and nurse satisfaction to determine the effect of certification in oncology nursing on those nursing-sensitive outcomes. A total of 93 nurses-35 (38%) of them certified in oncology nursing-and 270 patients completed surveys. Chart audits provided additional data on symptom management. ⋯ The study demonstrated that job satisfaction is fairly high for oncology nurses and patient satisfaction is high. In general, cancer pain and CINV were managed well but improvements can be made. Nurses and physicians continuously should be educated on evidence-based guidelines for symptom management of cancer pain and CINV, and a CINV knowledge and attitude assessment tool should be developed.
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As the conversion to an electronic health record intensifies, the question of which data-entry device works best in what environment and situation is paramount. Specifically, what is the best mix of equipment to purchase and install on clinical units based on staff preferences and budget constraints? The authors discuss their evaluation of stationary personal computers, workshops on wheels, and handheld tablets related to timeliness of data entry and their use of focus groups to ascertain the pros/cons of data-entry devices and staff preferences. An assessment of the implications for costs related to the timeliness of data entry is also presented.
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This program was designed to evaluate the effect of morbidity and mortality peer review conferences (MMPRCs) for ventilator-associated pneumonia (VAP) on nurse accountability and compliance with evidence-based VAP prevention practices. ⋯ The nonpunitive MMPRC process was cost-effective and should be considered for other nurse-sensitive indicators to increase nurse accountability and improve outcomes.
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The aim of this study was to examine the relationship of nurse staffing, skill mix, and Magnet(R) recognition to institutional volume and mortality for congenital heart surgery at children's hospitals. ⋯ Nursing characteristics varied in ICUs in children's hospitals treating congenital heart surgery but were not associated with mortality. There was a significant relationship between ICU nursing worked hours and institutional volume. Nursing skill mix was lower in Magnet hospitals.