scholarly journals A strategic guide for the development of a corporate sepsis program

2021 ◽  
Vol 2021 (2) ◽  
Author(s):  
Ahmed Labib Shehatta ◽  
Nasser Al Naimi ◽  
Reham Hassan ◽  
Neelam Zafar
Keyword(s):  
Nursing Education ◽  
Healthcare Providers ◽  
Senior Leadership ◽  
Training Centre ◽  
Leadership Engagement ◽  
Safety Committee ◽  
Local Quality ◽  
Improvement Programs ◽  
Care Improvement ◽  
Enhance Patient Care

Background: Sepsis is a major health burden. Guidelines call for healthcare providers to establish sepsis care improvement programs to enhance patient care and outcome. A comprehensive sepsis program has been developed at Hamad Medical Corporation (HMC) and implemented across its 13 facilities before embarking on a bigger journey. Methods: Senior leadership engagement and collaboration with pertinent departments are key to any initiative's success. A subject matter expert was appointed as Clinical Lead and Chair of the Program and held accountable to sponsors. Stakeholders were identified and invited to participate in the corporate steering group. Given that facilities may have differing challenges, patient population, or resources, a facility-level sepsis committee was established adopting a similar structure to the corporate committee. Each facility committee reviewed, implemented, and reported to the respective local quality and safety committee. Training, reporting and monitoring were undertaken at the local followed by the corporate level. Standardized sepsis pathways and guidelines were developed and implemented. Monitoring is crucial to ensure a program remains on track. This was attained using a corporate dashboard in which all cases of sepsis, irrespective of facility, time or age were reported and reviewed. Regular reports were sent to the Corporate Quality Improvement and Safety Committee. This, subsequently, is discussed at the Executive Management Committee. Findings: The implementation of a Corporate Sepsis Program was successful and extended to include other organisations (Sidra Medicine, Primary Health Care Corporation and the Qatar Red Crescent). An education subcommittee designed and delivered a nursing training program and e-learning as a collaboration between the Hamad International Training Centre (HITC), clinical and nursing informatics, and medical and nursing education. This resulted in timely and appropriate management. Conclusion: HMC Sepsis Program improved sepsis outcome in Qatar. A systematic approach, application of evidence-based practice, staff empowerment, senior leadership engagement, a clear structure of governance, quality assurance and reporting are critical elements of its success.

Relationship between the religious attitudes of women with gynecologic cancer and mental adjustment to cancer

2020 ◽  
pp. 1-7
Author(s):  
Mesude Duman ◽  
Yeter Durgun Ozan ◽  
Özlem Doğan Yüksekol
Keyword(s):  
Nursing Education ◽  
Personal Information ◽  
Linear Regression Analysis ◽  
Gynecologic Cancer ◽  
Healthcare Providers ◽  
Attitude Scale ◽  
Spiritual Needs ◽  
Religious Attitudes ◽  
Mental Adjustment ◽  
Fighting Spirit

Abstract Objective This study was conducted to determine the relationship between religious attitudes of Muslim women with gynecologic cancer and mental adjustment to cancer. Methods Designed as a descriptive relational study, this study was conducted with 123 patients with gynecologic cancer. A personal information form, prepared in accordance with the literature, the Religious Attitude Scale (RAS), and the Mental Adjustment to Cancer Scale (MACS) were used as data collection tools. The data were assessed using descriptive statistics, Pearson's correlation analysis, and linear regression analysis. Results A positive correlation was determined between the RAS score and the fighting spirit subscale of the MACS (r = 0.65, p < 0.001). A negative correlation was found between the helplessness/hopelessness and anxious preoccupation subscales of the MACS and the RAS score (r = −0.40, p < 0.001; r = −0.30, p < 0.001, respectively). Significance of results The present results are helpful in understanding the influence of religious attitudes on the mental adjustment to gynecologic cancer patients. The results can serve as a reference for nursing education and clinical healthcare practice. Palliative healthcare providers can participate in improved care by recognizing spiritual needs and by advocating for attention to spiritual needs as a routine part of cancer care.

scholarly journals Nurses’ Adherence to Patient Safety Principles: A Systematic Review

2020 ◽  
Vol 17 (6) ◽  
pp. 2028 ◽  
Author(s):  
Mojtaba Vaismoradi ◽  
Susanna Tella ◽  
Patricia A. Logan ◽  
Jayden Khakurel ◽  
Flores Vizcaya-Moreno
Keyword(s):  
Systematic Review ◽  
Patient Safety ◽  
Quantitative Methods ◽  
Healthcare Providers ◽  
Cardiac Monitoring ◽  
Care Process ◽  
Care Practice ◽  
Qualitative And Quantitative Methods ◽  
Systemic Factors ◽  
Care Improvement

Background: Quality-of-care improvement and prevention of practice errors is dependent on nurses’ adherence to the principles of patient safety. Aims: This paper aims to provide a systematic review of the international literature, to synthesise knowledge and explore factors that influence nurses’ adherence to patient-safety principles. Methods: Electronic databases in English, Norwegian, and Finnish languages were searched, using appropriate keywords to retrieve empirical articles published from 2010–2019. Using the theoretical domains of the Vincent’s framework for analysing risk and safety in clinical practice, we synthesized our findings according to ‘patient’, ‘healthcare provider’, ‘task’, ‘work environment’, and ‘organisation and management’. Findings: Six articles were found that focused on adherence to patient-safety principles during clinical nursing interventions. They focused on the management of peripheral venous catheters, surgical hand rubbing instructions, double-checking policies of medicines management, nursing handover between wards, cardiac monitoring and surveillance, and care-associated infection precautions. Patients’ participation, healthcare providers’ knowledge and attitudes, collaboration by nurses, appropriate equipment and electronic systems, education and regular feedback, and standardization of the care process influenced nurses’ adherence to patient-safety principles. Conclusions: The revelation of individual and systemic factors has implications for nursing care practice, as both influence adherence to patient-safety principles. More studies using qualitative and quantitative methods are required to enhance our knowledge of measures needed to improve nurse’ adherence to patient-safety principles and their effects on patient-safety outcomes.

Raising the safety bar: The hematology/oncology patient safety committee.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 144-144
Author(s):  
Myrna Rita Nahas ◽  
Jessica A. Zerillo ◽  
Stephen A. Cannistra ◽  
Cheryle Totte
Keyword(s):  
Patient Safety ◽  
Adverse Events ◽  
Peer Review ◽  
Healthcare Provider ◽  
Medical Center ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Oncology Patient ◽  
Near Misses ◽  
Safety Committee

144 Background: Enhancing patient safety can prevent unintended outcomes arising from defects in healthcare delivery systems. The Hematology/Oncology Patient Safety Committee (HOPSC) at Beth Israel Deaconess Medical Center (BIDMC) is a multidisciplinary team of healthcare providers that meets monthly to review inpatient and outpatient adverse events, near misses, and medical errors that impact patient safety. Methods: Our aim was to quantify and qualify the cases that the HOPSC has reviewed from 2012-2013. In order to identify trends in event reporting, we reviewed the number of events reported to the HOPSC in both the inpatient and outpatient settings. We further subdivided events into two categories: medication-related and non-medication related. Additionally, we delineated which healthcare provider initiated the reporting of each event. Results: Over the two-year period, a total number of 1,061 events were reported to the HOPSC. Of these, 259 were medication-related events. Of the events reported, 40 were by a physician/NP and 1,021 were by a nurse. There was a discrepancy in the type of event reported (24.4% medication vs. 75.6% non-medication related) as well as in the type of reporter (3.8% physician/NP vs. 96.2% nurse). Of all the events reported, 8 were escalated to the Department of Medicine Peer Review Committee. Conclusions: Through review of healthcare provider event reports, the HOPSC has identified several types of adverse events and near misses in the Hematology/Oncology division at BIDMC. The events are mostly reported by inpatient nurses and are primarily medication-related. Given this skewed reporting pattern, we will investigate the reasons why reporting by physicians, especially in the outpatient setting, is limited. Our reported outline of the HOPSC operations may also guide oncology practices elsewhere in their own development of patient safety peer review committees. [Table: see text]

Internationally Educated Nurses’ and Their Contributions to the Patient Experience

2016 ◽  
Vol 21 (1) ◽  
Author(s):  
Ndolo Njie-Mokonya
Keyword(s):  
Nursing Education ◽  
Patient Care ◽  
Patient Experience ◽  
Healthcare Providers ◽  
Background Information ◽  
Practice Research ◽  
Cultural Perspective ◽  
Internationally Educated Nurses ◽  
Care Experience ◽  
Education Practice

Internationally educated nurses (IEN) are a group who reflect Canada’s diverse population as a result of rising immigration trends. There is increasing diversity of the general population in Canada and health service disparities exist. Reducing these disparities among the healthcare workforce and the patients they care for is important to meet language and other cultural needs of patients from different ethnic backgrounds. This article describes a study that examined internationally educated nurses’ transition experiences in the field of nursing with the objective of describing their unique contributions to the patient care experience. A review of the literature provides background information, followed by the study methods, findings, and discussion. Descriptive phenomenology guided this qualitative study that included 11 participants. Findings from this study illustrate how IENs perceive themselves as an asset to nursing and patient care. Implications for the future of nursing education, practice, research, and administration are offered. Healthcare providers that reflect the diversity of Canada’s population and can offer unique cultural perspective have potential to improve the patient experience during a hospital stay.

A Novel Prevention Bundle to Reduce Surgical Site Infections in Pediatric Spinal Fusion Patients

2016 ◽  
Vol 37 (5) ◽  
pp. 527-534 ◽  
Author(s):  
Jane M. Gould ◽  
Patricia Hennessey ◽  
Andrea Kiernan ◽  
Shannon Safier ◽  
Martin Herman
Keyword(s):  
Nursing Education ◽  
Spinal Fusion ◽  
Assessment Tool ◽  
Wound Care ◽  
Surgical Care ◽  
Surgical Site Infections ◽  
Standard Of Care ◽  
Improvement Project ◽  
Surgical Care Improvement Project ◽  
Care Improvement

BACKGROUNDThe Surgical Care Improvement Project bundle emphasizes operative infection prevention practices. Despite implementing the Surgical Care Improvement Project bundle in 2008, spinal fusion surgical site infections (SF-SSI) continued to be prevalent for this low-volume, high-risk surgery.OBJECTIVETo design a combined pre-, peri-, and postoperative bundle (PPPB) that would lead to sustained reductions in SF-SSI rates.DESIGNQuality improvement project, before-after trial with cost-effectiveness analysis.SETTINGChildren’s hospital.PATIENTSAll spinal fusion patients, 2008–2015.INTERVENTIONA multidisciplinary team developed the PPPB composed of Surgical Care Improvement Project elements plus improved wound care practices, nursing standard of care, dedicated nursing unit, dermatology assessment tool and consultation, nursing education tool using “teach back” technique, and a “Back Home” kit. SF-SSI rates were compared before (2008–2010) and after (2011-February 2015) implementation of PPPB. PPPB compliance was monitored.RESULTSA total of 224 SF surgeries were performed from 2008 to February 2015. Pre-PPPB analysis revealed median time to SF-SSI of 28 days, secondary to skin and bowel flora. Mean 3-year pre-PPPB SF-SSI rate per 100 SF surgeries was 8.2 (8/98) (2008: 13.3 [4/30], 2009: 2.7 [1/37], 2010: 9.7 [3/31]). Mean SF-SSI rate after PPPB was 2.4 (3/126) (January 2011-February 2015); there was a 71% reduction in mean SSI rate (P=.0695). No SF-SSI occurred in neuromuscular patients (P=.008) after PPPB. Compliance with PPPB elements has been 100%.CONCLUSIONSPPPB led to sustained improvement in SF-SSI rates over 50 months. The PPPB could be reproduced for other surgeries.Infect Control Hosp Epidemiol 2016;37:527–534

scholarly journals Using Popular Nursing Literature Critique to Help Nursing Students Explore Their Perceptions of Disability

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Charles Anyinam ◽  
Sue Coffey
Keyword(s):  
Nursing Education ◽  
Nursing Students ◽  
Healthcare Providers ◽  
Disabled People ◽  
Professional Students ◽  
Undergraduate Nursing ◽  
Perceptions Of Disability ◽  
Nursing Literature ◽  
Students Attitudes ◽  
Teaching Learning

Objectives: Disabled people have a history of disadvantage, discrimination, and disempowerment that continues to present day. Despite strong critique and activism by disabled people, popular understandings of disability as necessarily tragic, medically based, and individualistic requiring ‘fixing’ persist among health professionals.  Recent research demonstrates that health professional students often harbour negative attitudes that may directly affect their relationships with and care provided to disabled clients (Sabin & Akyol, 2010; Scullion, 1999). Further, personal accounts and research evidence suggests that the relationship between healthcare providers and disabled people is often unsatisfactory (Sabin & Akyol, 2010; Seccombe, 2007; Scullion, 1999).Methods: Nursing education has a responsibility to ensure that nursing practice with disabled people is enabling rather than disabling (Scullion, 1999a, 1999b, 2000; Sabin & Akyol, 2010). A key strategy is to imbed within curricula opportunities for students to engage in the processes of critical thinking towards and analysis of disability and the experiences of disabled people. This poster describes an approach to teaching-learning in which critique of ‘popular culture’ nursing literature is used to support student exploration of messaging about disability.Results and Conclusions: The purpose and description of the assignment, authors’ experiences, and outcomes for both teachers and learners will be presented. Application beyond nursing to other health professions will be described.ReferencesSabin, H. & Akyol, A. D. (2010). Evaluation of nursing and medical students' attitudes towards people with disabilities. Journal of Clinical Nursing, 19, 2271­2279.Scullion, P. A. (1999). Conceptualizing disability in nursing: Some evidence from students and their teachers. Journal of Advanced Nursing, 29, 648­657.Scullion, P. A. (2000). Enabling disabled people: Responsibilities of nursing education. British Journal of Nursing, 9(15), 1010-1015.Seccombe, J. A. (2007). Attitudes towards disability in an undergraduate nursing curriculum: A literature review. Nurse Education Today, 27, 459­465.

scholarly journals A mixed-methods research predicting intentions and perceptions about intimate partner violence screening among nursing students and nurse educators in Thailand

2019 ◽  
Author(s):  
◽  
Tipparat Udmuangpia
Keyword(s):  
Nursing Education ◽  
Nursing Students ◽  
Nurse Educators ◽  
Behavioral Control ◽  
Healthcare Providers ◽  
Subjective Norm ◽  
Subjective Norms ◽  
Nursing Curriculum ◽  
Perceived Behavioral Control ◽  
Nursing Clinical

IPV screening in healthcare settings is an effective secondary prevention strategy for IPV that can reduce negative consequences IPV survivors may experience. However, healthcare providers have not tended to screen patients or women who may experience IPV. Additionally, the curriculums of health professionals' students, particularly in the nursing curriculum, do not adequately prepare future healthcare providers for IPV screening. However, little research has addressed IPV screening or barriers to such screening regarding healthcare providers in global, particularly Thailand. This study was to examine the attitudes, subjective norms, and perceived behavioral controls of senior Thai nursing students to manage IPV and intention to perform of IPV screening. In addition, it also was to explore the perceptions of IPV screening in nursing education among senior-nursing students and nurse educators in Thailand. The Theory of Planned Behavior (TPB), which is a strong theory to predict intentional behavior, was used in this study as a theoretical framework. This study was conducted a mixed-methods, with primary data collection involving online surveys and focus groups with senior nursing students in Thailand and individual interviews with Thai nurse educators. The quantitative study was recruited by nursing students who were in the last years of nursing program and passed at least one nursing clinical practice course. The qualitative study, there were nursing students and nurse educators. The inclusion criteria were: nursing students who were in the last year of their nursing program and passed at least one nursing clinical practicum course: nurse educators who have at least ten years of experience in education and live in a province in Northeast Thailand. Nursing students who were studying in their first, second, and third year, and did not pass any nursing clinical practicum were excluded. Nurse educators who have less than ten years' experience were not recruited. The instruments of screening were developed by using attitudes, subjective norms, and perceived behavioral controls. There were 36 relevant items on a 5 Likert scales. The instruments were developed by previous studies and five experts. Two bilinguals experienced IPV experts did the forward-translation of the original English versions of the instruments into Thai. Institutional Review Board (IRB) was approval from University of Missouri and one of Boromarajonnani Colleges of Nursing in Northeast Thailand with waiver of documentation of consent. Analysis data as percentages, frequency, and standard deviation were described demographic data and attitudes, subjective norms, perceived behavioral control, and intention of IPV screening. Bivariate relationship as Spearman's Rho, Chi-square correlation, and Logistic regression were used to identify relationships between the variables. Content analysis with the Dedoose program was used. Categories were described. Totally 639 participants with nearly 60% have ever trained regarding IPV and 89.84% of participants has intended of screening. There was a medium positively significant correlation between the attitude, subjective norm, perceive behavioral control and intention (r = 0.43-0.46). Gender, GPA, experienced of IPV training, having screening tool at the clinical site, have seen screening, experienced of screening, experienced abused, and experienced family abused were significantly associated with intention of screening, but number hours of training was not associated. Mediation was tested and attitude and subjective norm were mediators of the relationship between having a tool at clinical site and intention to screen, but perceived behavioral control was not a mediator. Moreover, attitude and subjective norm were predicted intention by 33%. The findings from qualitative research explained that participants perceived that IPV is a critical issue in Thailand, but it is difficult to identify because of the cultural consideration. Participants feel not well-prepared by school in terms of knowledge and training experience. Nurse educators also feel not confident in supervising. Addressing IPV into the nursing curriculum was highly recommended. This study is the first study to specifically explore the perceptions of IPV in nursing education in Thailand. The findings contribute to improving the nursing curriculum regarding IPV. More research is related to prepare nursing students to deal with IPV issue would be required.

Quality and Safety

2015 ◽  
pp. 16-35
Author(s):  
Daniel Rubin ◽  
Avery Tung
Keyword(s):  
Quality Improvement ◽  
Surgical Care ◽  
Large Database ◽  
Improvement Project ◽  
Quality Improvement Process ◽  
Quality Programs ◽  
Improvement Programs ◽  
Surgical Care Improvement Project ◽  
Care Improvement ◽  
Quality Improvement Programs

Quality improvement is a goal of all institutions but effective quality improvement programs have been difficult to create and sustain. Cardiac surgery has long been a pioneer in the quality improvement process through protocolization, large database analysis, and evidence based research. This chapter will discuss the theoretical foundation for quality improvement in medicine, and address current quality improvement strategies in the cardiothoracic ICU including care bundles, large database review, and externally promulgated quality programs such as the Surgical Care Improvement Project (SCIP) or the Physician Quality Reporting Initiative (PQRS). Controversies from national quality improvement programs including SCIP, extended staffing, and the value of quality culture will be discussed.

Nursing education

2015 ◽  
pp. 1009-1027
Author(s):  
Pamela Malloy
Keyword(s):  
Palliative Care ◽  
Nursing Education ◽  
Continuing Education ◽  
Healthcare Providers ◽  
Student Nurses ◽  
Nursing Schools ◽  
Futile Care ◽  
Education Courses

Student nurses are exposed primarily to curative-oriented, sometimes futile care and are less likely to encounter comfort-oriented care. Although many healthcare providers work with people at the end of their lives, nurses spend the most time with the dying and their families. Most nurses will provide palliative care to patients and their families no matter where they practice. This chapter suggests that education in palliative care should begin in the nursing schools and extend through clinical inservices, continuing education courses, and professional conferences.

Facilitating Knowledge of Women on Importance of Iodine in Foetal Brain Development through Nursing Education: An Evidence-Based Educational Intervention

2018 ◽  
Vol 3 (01) ◽  
Author(s):  
BINDU KAIPPARETTU ABRAHAM
Keyword(s):  
Nursing Education ◽  
Brain Development ◽  
Educational Intervention ◽  
Iodine Deficiency ◽  
Healthcare Providers ◽  
Fetal Brain ◽  
Public Health Nurse ◽  
Evidence Based ◽  
Iodine Deficiency Disorders ◽  
Fetal Brain Development

The purpose of the evidence-based practice educational intervention was to a) assess the knowledge of women on the importance of iodine in fetal brain development b) find the effectiveness of planned teaching program on women. Iodine Deficiency Disorders can impact on people of all ages, but most severely on the baby while it is developing in the womb. During pregnancy, it can cause maternal and fetal hypothyroidism and impair neurological development of the fetus.  This study showed that women did not have enough knowledge regarding the importance of iodine in fetal brain development. So there was lack of knowledge in some aspects regarding the importance of iodine in fetal brain development among women residing in the rural area The nurses have an influential role in imparting knowledge on the importance of iodine in fetal brain development. They can utilize their opportunities to spread awareness about the importance of iodine deficiency disorders leading to brain damage.  Providing EBP educational intervention on this topic positively impacted on their knowledge. The findings underscore evidence-based nursing is one approach that may enable future healthcare providers to manage the explosion of new literature and technology and ultimately may result in improved patient outcomes. Hence it helps to implement in their caregiving as a nurse educator, midwife, and as public health nurse.

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