Journal of nursing care quality
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Surgical safety checklists were introduced to improve patient safety. Urban and rural hospitals are influenced by differing factors, but how these factors affect patient care is unknown. This study examined time-out and checklist processes in rural and urban operating rooms and found that although checklist use has been adopted in many organizations, use is inconsistent across both settings. An understanding of these variations is needed to improve utilization.
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We examined whether an integrated nursing handover system-structured content and an electronic tool within the patient clinical information system with bedside delivery-would improve the quality of information delivered at nursing handover and reduce adverse patient outcomes. Using a pre/posttest evaluative design, improvements in the transfer of critical patient information and reductions in nursing clinical management incidents were demonstrated. No changes in falls or medication incident rates were identified.
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In this quality improvement project, our health system developed a comprehensive, patient-centered approach to improving inpatient pain management and assessed its impact on patient satisfaction across 21 medical centers. Using human-centered design principles, a bundle of 6 individual and team nursing practices was developed. Patient satisfaction with pain management, as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems pain composite score, increased from the 25th to just under the 75th national percentile.
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The effectiveness of a Rapid Response Team Intervention (RRTI) in preventing transfer to a higher level of care and decreasing in-hospital mortality has not been firmly established. This retrospective exploratory study examined differences between medical-surgical patients who had an RRTI and those who did not. Results yielded 5 statistically significant differences (P ≤ .05) between the 2 groups as well as a large variation (range, 0-238 minutes; SD = 87.73 minutes) between time of documentation of RRTI criteria to time in calling an RRTI.