Journal of nursing care quality
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Electronic access to standards of care is viewed as a promising strategy for increasing evidence-based practice. Before determining whether electronic access to standards will increase nurses' use of standards of care, data on their current rate of utilization are needed. Using 2 standards of care, Fluid Volume Excess and Manic Behavior, we used retrospective chart reviews to gather baseline information. Insights from these findings are presented.
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Nursing staff chose to eliminate hospital-acquired pressure ulcers in their intensive care unit through implementation of an intervention bundle. A bundle of 7 interventions (pressure ulcer bundle, PUB) was developed through review of current evidence. After implementation, quarterly hospital-acquired pressure ulcer rates decreased and continued to remain below 1% throughout the year, and the goal of no pressure ulcers was met for 2 months. The PUB interventions have potential for use in a variety of settings where there are bed-bound patients.
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Catheter-associated urinary tract infections account for 40% of all health care-associated infections. An evidence-based, nurse-driven daily checklist for initiation and continuance of urinary catheters was implemented in 5 adult intensive care units. Measures of compliance, provider satisfaction, and clinical outcomes were recorded. Compliance with the checklist was 50 to 100%: catheter-associated urinary tract infections decreased from 2.88 to 1.46 per 1000 catheter days and catheter days decreased in 2 intensive care units.
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This study was a cross-sectional descriptive survey of acute care hospitals in California to describe staff hand hygiene compliance and related predictors and explore the relationship between hand hygiene adherence and health care-associated infections. Although there was a relatively small sample size, institutions with morning huddles reported a significantly higher proportion of 95% or more hand hygiene compliance. Huddles are an organizational tool to improve teamwork and communication and may offer promise to influence hand hygiene adherence.