Medsurg nursing : official journal of the Academy of Medical-Surgical Nurses
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Customer demands and financial pressures have forced hospitals to reassess the quality of their services and the efficiency with which they are delivered. A number of institutions have turned to continuous quality improvement methods to help streamline specific processes. For institutions to survive, however, they must look beyond specific processes to broader issues of scope of practice. One hospital's use of Juran's BPQM framework helped position the institution for future economic demands.
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A physician-nurse collaborative team developed and implemented a research-based protocol and algorithm for improving vital signs monitoring and early intervention for at-risk patients. Project evaluation showed that in general the protocol and algorithm were used appropriately and consistently and prevented negative patient outcomes.
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Current clinical research studying the administration of local anesthetics, opioids, and nonsteroidal anti-inflammatory agents prior to various types of surgery are reviewed. These agents can reduce pain and improve patient management in the postoperative period, but this technique can be controversial. Implications for nurses are discussed.