Journal of nursing care quality
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Randomized Controlled Trial
Incivility and Clinical Performance, Teamwork, and Emotions: A Randomized Controlled Trial.
Incivility has been identified as a common occurrence in health care settings. While anecdotal evidence exists that these behaviors negatively impact patient care, more robust evidence is lacking. ⋯ These findings support anecdotal evidence that exposure to incivility may contribute to errors in clinical performance.
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Nurses can be exposed to hundreds of alarms during their shift, contributing to alarm fatigue. ⋯ Monitoring only those patients who need it and only those physiologic values that are warranted, based on patient condition, may decrease alarm burden.
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We investigated the effect of using a fall risk screening tool in an electronic medical record system by using data for 25 039 patients in 24 general wards of a single institution. The probability of the occurrence of falls decreased after the tool was implemented, but using the tool did not reduce the actual occurrence of falls. This indicates that we must improve not only the assessment of the risk of falls but also the interventions to prevent falls.
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The purpose of this quality improvement initiative was to improve oropharyngeal dysphagia screening and reduce aspiration pneumonia rates on 3 inpatient hospital medical units. Guided by a Plan-Do-Study-Act methodology, an interdisciplinary health team developed and implemented a systematic process for oropharyngeal dysphagia screening and management. As a result, use of the screening protocol increased, timely initiation of speech language pathology consultations increased, and aspiration pneumonia rates decreased.
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The Johns Hopkins Fall Risk Assessment Tool (JHFRAT) is widely used but few studies have examined its psychometric properties. We examined the predictive validity of the JHFRAT for 13 574 patient admissions to medicine units at a large academic medical center in 2014. There were 204 patient falls reported. While patients who fell had higher JHFRAT total scores, a majority of patients who fell were classified by the JHFRAT as moderate or low risk.