Journal of nursing care quality
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Delirium is an acute state of confusion that is often seen in older patients after major orthopedic surgical procedures. It is associated with increased costs of care, morbidity, delayed functional recovery, and prolonged hospital stay. Identification of predictive risk factors, early diagnosis and treatment, and implementation of environmental controls can minimize the impact of postoperative delirium. This project measured pre- and post intervention compliance with best practice in the prevention and management of postoperative delirium.
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Awareness for patient safety led a team to develop an electronic handoff communication tool for noncomplicated routine patients. The structure of SBAR (situation, background, assessment, and recommendation) was used when transferring patients to and from the progressive care unit and cardiac laboratories. The electronic SBAR gave staff a reliable and standard way to provide a patient handoff.
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Nurses have an obligation to disclose an error when one occurs. This study explored 1180 nurses' perceptions of error disclosure in the nursing home setting. ⋯ Registered nurse respondents and nurses who had prior experience disclosing a serious error were more likely to disclose a serious error. The study has implications to improve nursing education, policy, and patient safety culture in the nursing home setting.
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Nurses are in a key position to have an impact on the national quality agenda. However, many lack the quality and safety methods to lead this work. The Clinical Scene Investigator Academy provided 23 nurses from 7 regional hospitals with the knowledge and support necessary to implement nurse-led quality improvement projects. Not only did each Clinical Scene Investigator project improve patient and/or staff outcomes but 3 such projects also had a significant economic impact.
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Pathogens in the oropharynx may be transported to the lung parenchyma during intubation and cause ventilator-acquired pneumonia. This project evaluated 3 post intubation evidence-based practices in the emergency department: oral care, head-of-bed elevation, and suctioning above the endotracheal tube balloon. Ventilator-acquired pneumonia cases decreased 83% after implementing these practices. There is no need to wait for the patient to be admitted to intensive care to begin these evidence-based practices.