Journal of nursing care quality
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Delirium is an emerging topic in patient safety. However, in Korea, delirium is still underrecognized despite high incidence rates in Korean hospitals. We studied the impact of delirium on patient outcomes in Korean intensive care units (ICUs) and found that delirium is associated with higher in-hospital mortality, shorter survival over the course of hospitalization, longer ICU and hospital stays, more frequent readmission to the ICU for the same hospitalization event, and higher health care costs.
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Alarm fatigue desensitizes nurses to alarm signals and presents potential for patient harm. This project describes an innovative method of communicating cardiac monitor alarms to pagers using an alarm escalation algorithm. This innovation was tested on 2 surgical progressive care units over a 6-month period. There was a significant decrease in mean frequency and duration of high-priority monitor alarms and improvement in nurses' perception of alarm response time, using this method of alarm communication.
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The purpose of this study was to determine whether early removal of urinary catheters in patients with thoracic epidurals resulted in urinary retention (>500 mL by bladder scanner). Patients were given up to 8 hours to void before further intervention. Of 61 patients, only 4 (6.6%) required urinary catheter reinsertion due to urinary retention. Early removal of urinary catheters after thoracic surgery in patients with thoracic epidurals was safe, with minimal urinary retention.
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Ventilator-associated pneumonia is associated with high mortality and morbidity and significantly increases intensive care unit length of stay and costs of care. In a pre- and postintervention study, we found that the majority of patients (63%) had an antecedent condition that necessitated emergent intubation prior to surgery. Efforts should be directed to developing strategies to minimize the risk of ventilator-associated pneumonia in emergent intubations, decrease reintubations, and reduce the use of blood products.
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Staff on a 28-bed surgical unit in a suburban 461-bed medical center implemented 3 interventions to improve patient satisfaction. This quality improvement study investigated the effects of nurse manager rounding, postdischarge phone follow-up, and improved discharge teaching skills on patients' ratings of their care. HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey scores demonstrated a steady upward trend over 18 months following implementation of the changes.