scholarly journals Nurses’ Knowledge on Delirium Prevention and Detection in Hospitalized Adults: A Quality Improvement Project

2021 ◽  
Author(s):  
Kayla Deery
Keyword(s):  
Quality Improvement ◽  
Educational Intervention ◽  
Medical Condition ◽  
Hospital Setting ◽  
Chronically Ill ◽  
Measurement Model ◽  
Assessment Method ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Nurses Knowledge

Delirium, recognized as a medical and psychological emergency, is a symptom of an acute medical condition. Despite the prevalence of delirium in the hospital setting, it continues to be unrecognized, resulting in poor patient outcomes, and exorbitant healthcare cost. Patients with dementia who are chronically ill, as well as patients previously diagnosed with delirium, represent a vulnerable population and require closer surveillance due to their predisposing factors. This quality improvement project goal is to increase nurses’ knowledge and understanding of delirium. This was completed through providing education to medical-surgical nurses on the causes of delirium (predisposing and precipitating factors), prevention, use of the confusion assessment method (CAM) screening tool, and detection of delirium. The change in knowledge was measure through an investigator created, 10-question multiple choice, pretest-posttest measurement model. Of the 58 nurses, nine responded and completed the pretest (N=9, 15.5%), while seven completed the educational intervention posttest (N=7, 12%). Results of the quality improvement project yielded a 22.1% increase in nurses’ knowledge after the educational intervention. Despite the low participation rate, this project revealed a positive correlation between the educational intervention and nurses’ knowledge.

scholarly journals Assessing Nurses’ Knowledge of Noise in the Intensive Care Unit: An Educational Intervention Project

2021 ◽  
Author(s):  
Jennifer Fortes
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Quality Improvement ◽  
Educational Intervention ◽  
Quality Improvement Project ◽  
Minimal Risk ◽  
Improvement Project ◽  
Staff Members ◽  
Nurses Knowledge

Noise in the intensive care unit (ICU) has been studied for over thirty years, but it continues to be a significant problem and a top complaint among patients. Staff members are now reporting detrimental health effects from excessive noise. One of the significant factors of inadequate noise control in the ICU is that nurses have insufficient awareness regarding the hospital noise issue and its negative impact on health status. The level of knowledge of clinical staff on the topic of noise is not known. A quality improvement project to explore noise in the ICU could facilitate better understanding of the phenomenon and formulation of new ways to continue to reduce noise at a community hospital in Massachusetts. The purpose of this quality improvement project was to evaluate nurses’ knowledge of the potentially harmful effects of noise on patients as well as on nurses, to identify opportunities for improvement of the environment, and to conduct an educational intervention aimed at reducing noise in the intensive care unit. The methodology for this project included a pre-test, followed by an educational session, and completion of a post-test. The participants included registered nurse staff members in the Intensive Care Unit (ICU) and the Critical Care Unit (CCU). Exclusion criteria included staff members who are not registered nurses. The project posed minimal risk. No identifying or biographical data was collected, and results included analysis of aggregate data. Descriptive statistics were used to assist with analysis. Results were disseminated to the staff of the ICU and CCU, posted on a bulletin board in the critical care area, presented as a poster presentation at the Spring RIC MSN Symposium, and available as a manuscript on the RIC Digital Commons.

scholarly journals Telemetry Nurses Knowledge of Alarm Fatigue and Interventions for Change: An Education Program Development

2018 ◽  
Author(s):  
Samantha Cruz
Keyword(s):  
Quality Improvement ◽  
Program Development ◽  
Educational Intervention ◽  
Educational Program ◽  
Development Project ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Alarm Fatigue ◽  
Post Test ◽  
Nurses Knowledge

Alarm fatigue is known to be one of the top safety concerns in the healthcare setting. The Joint Commission recognized Alarm safety as one of the 2017 National Patient Safety Goals. Alarm fatigue occurs when a healthcare worker becomes overwhelmed and often desensitized to patient monitor alarms. It has been established that interventions including ECG daily electrode and battery changes, skin prep for electrode placement, and adjusting alarm parameters to fit patient needs can lead to a reduction in false or nuisance alarms. In order for these interventions to be carried out successfully, education of nurses regarding alarm fatigue and interventions for change needs to be completed. Education is one of the most important phases of creating change. The purpose of this program development project was to determine the effectiveness of an educational program on alarm fatigue awareness for telemetry unit nurses. A program development project was developed utilizing a pre-test, educational intervention, and a post-test design. Tests were used to evaluate the nurses’ knowledge improvement related to the educational intervention. Sixteen out of a possible 60 telemetry nurses completed the pretest portion of this quality improvement project. (N=16, 26.6%). Fourteen of a possible 60 nurses attended the educational session and completed the post-test portion of this quality improvement project. (N=14, 23%). For the purpose of presenting the first four questions, only those tests with matching pre-and-post responses were utilized, (N=14). The mean scores from pre-tests were 51.2% and mean post-test scores were 92% which revealed an increase by 40.8% after an educational intervention. The APRN can assist in establishing and implementing an educational program. This educational program can help to implement interventions and provide evidenced based research to support the prevention of alarm fatigue.

scholarly journals Integration of Early Palliative Care in Oncology Patients: Improving Nursing Knowledge and Confidence

2019 ◽  
Author(s):  
Jacqueline Hurteau
Keyword(s):  
Palliative Care ◽  
Quality Improvement ◽  
Nursing Education ◽  
Program Development ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Early Palliative Care ◽  
Early Implementation ◽  
Oncology Care ◽  
Nurses Knowledge

Palliative care integrated with standard oncology care in cancer patients has been shown to provide a number of beneficial clinical outcomes. Despite the evidence, the utilization of palliative care in the oncology population continues to be inadequate. The purpose of this program development, quality improvement project was to improve nurses’ knowledge regarding palliative care and the benefits of its early implementation in the oncology population, as well as to improve their confidence regarding palliative care consultations to providers. An educational intervention was designed and a pre and posttest were utilized to determine the effect of the intervention. This program development, quality improvement project demonstrated that the implementation of nursing education regarding palliative care within the oncology population increased nurses’ knowledge in palliative care, specific to the oncology population, as well as confidence in recommending appropriate palliative care consultations to providers.

scholarly journals Implementation of a multicomponent intervention sign to reduce delirium in orthopaedic inpatients (MIND-ORIENT): a quality improvement project

2021 ◽  
Vol 10 (1) ◽  
pp. e001186
Author(s):  
Christina Reppas-Rindlisbacher ◽  
Shailee Siddhpuria ◽  
Eric Kai-Chung Wong ◽  
Justin Yusen Lee ◽  
Christopher Gabor ◽  
...  
Keyword(s):  
Older Adults ◽  
Quality Improvement ◽  
Clinical Care ◽  
Assessment Method ◽  
Quality Improvement Project ◽  
Evidence Based ◽  
Pharmacological Interventions ◽  
Improvement Project ◽  
Absolute Increase ◽  
Delirium Prevention

Delirium is a serious and common condition that leads to significant adverse health outcomes for hospitalised older adults. It occurs in 30%–55% of patients with hip fractures and is one of the most common postoperative complications in older adults undergoing orthopaedic surgery. Multicomponent, non-pharmacological interventions can reduce delirium incidence by up to 30% but are often challenging to implement as part of routine care. We identified a gap in the delivery of non-pharmacological interventions on an orthopaedic unit. This project aimed to implement a bedside sign on an orthopaedic unit to reduce the occurrence of delirium by prompting staff to use multicomponent evidence-based delirium prevention strategies for at-risk older adults. Quality improvement methods were used to integrate and optimise the use of a bedside ‘delirium prevention’ sign on an orthopaedic unit.The sign was implemented in four target rooms and sign completion rates increased from 47% to 83% (95% CI 71.7% to 94.9%; p<0.001) over a 10-month period. The sign did not have a significant impact on delirium prevalence. The mean Confusion Assessment Method (CAM)+ rate during the baseline period was 8% with an absolute increase in the intervention period to 11.4% (95% CI 7.2% to 15.8%; p=0.31). There were no significant shifts or trends in the run chart for the proportion of patients with CAM+ scores over time. The sign was well received by staff, who reported it was a worthwhile use of time and prompted use of non-pharmacological interventions. This quality improvement project successfully integrated a novel, low-cost, feasible and evidence-based approach into routine clinical care to support staff to deliver non-pharmacological interventions. Given the increased pressures on front-line staff in hospital, tools that reduce cognitive load at the bedside are important to consider when caring for a vulnerable older adult patient population.

Increasing Awareness of Palliative Medicine With the Emergency Department: A Quality Improvement Project

2021 ◽  
pp. 104990912110218
Author(s):  
Carolina De Elia ◽  
Phyllis Macchio ◽  
Wardah Khan ◽  
Lindsay Perigini ◽  
Alan Kaell ◽  
...  
Keyword(s):  
Emergency Department ◽  
Quality Improvement ◽  
Educational Intervention ◽  
Palliative Medicine ◽  
Hospice Care ◽  
Quality Improvement Project ◽  
Treatment Team ◽  
Improvement Project ◽  
Service Training ◽  
Seriously Ill Patients

Palliative medicine can be essential in helping to align patients’ goals of care with their treatment team. Referrals for palliative medicine are more advantageous when initiated in the emergency department as this is the first point of contact for seriously ill patients being admitted to the hospital. This paper highlights a quality improvement project initiated to address knowledge gaps in palliative medicine with emergency department (ED) staff and to increase referrals for palliative medicine from the ED. The palliative medicine staff held an in-service training with the ED staff which focused on defining palliative medicine and the importance of early consults when the patient presents in the ED. Palliative medicine staff also highlighted the differences between palliative medicine and hospice care, when and how to initiate a consult for palliative medicine, as well as how to contact the palliative medicine division. The results showed that after this educational intervention the number of palliative medicine consults increased three-fold. Before the educational intervention, monthly averages for palliative medicine were 6 and after rose to 18.9 per month.

scholarly journals Effect of Clinical Opiate Withdrawal Scale Educational Intervention on Intensive Care Unite Nurses' Knowledge and Confidence

2021 ◽  
Author(s):  
Lauren Schneider
Keyword(s):  
Critical Care ◽  
Quality Improvement ◽  
Educational Intervention ◽  
The United States ◽  
Opioid Withdrawal ◽  
Quality Improvement Project ◽  
World Health ◽  
Opiate Withdrawal ◽  
Percentage Increase ◽  
Improvement Project

The opioid epidemic is a significant concern for the United States. Forty-eight and a half million Americans have either used illicit drugs such as heroin or have misused prescription opioid drugs. The exponential rise in opioid use increases the risk of opioid withdrawal, thus making opioid withdrawal assessment a top priority, especially for hospitalized individuals. The Clinical Opiate Withdrawal scale (COWS) is highly recommended to assess opioid withdrawal in hospitalized individuals and is well supported by the American Society of Addiction Medicine National Practice guideline and the World Health Organization. Despite the availability of reliable opioid withdrawal assessment scales, improper use and underuse of these scales are reported. Nurses education on the use of the COWS could address this gap. The purpose of this quality improvement project was to determine the effectiveness of an educational intervention concentrating on the COWS to improve critical care nurse’s knowledge and confidence in scale use. The quality improvement project utilized a pre-test, educational intervention and a posttest design. Twenty-eight out of the possible 60 critical care nurses participated in the quality improvement session. The mean scores on the pretest and post-test were 41.2 % and 83.5%, respectively. This showed a percentage increase in knowledge of 42.3. Furthermore, participants reported higher level of confidence in their ability to utilize the COWS. Receipt of COWS education could promote proper use of the scale. The advanced practice nurse can assist in establishing and implementing educational programs that focus on the importance of opioid withdrawal assessment through evidence-based practice.

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