scholarly journals Evaluating intentional quality rounding for undergraduate student nurse training during COVID-19

2022 ◽  
Vol 12 (5) ◽  
pp. 47
Author(s):  
Shea Polancich ◽  
Connie White-Williams ◽  
Laura Steadman ◽  
Kaitrin Parris ◽  
Gwen Childs ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Nursing Education ◽  
Clinical Education ◽  
Learning Experience ◽  
Critical Role ◽  
Care Transitions ◽  
Nurse Training ◽  
Evaluation Tool ◽  
Improvement Project ◽  
Body Of Knowledge

Nursing’s body of knowledge is ever expanding, incorporating new theoretical constructs such as quality and safety and care transitions we now consider central to the domain of nursing, and to nursing clinical education. The purpose of this article is to describe an educational quality improvement project, an alternative clinical learning experience during COVID-19 that enabled the implementation and evaluation of Bachelor of Science in Nursing (BSN) students in an intentional quality rounding process. We designed and implemented a retrospective, observational quality improvement educational project. Programmatic evaluation was used to obtain feedback from 273 pre-licensure students using a 10-item Likert scale evaluation tool in June 2020. Students averaged a 4.33 rating on the evaluation of the intentional quality rounding clinical experience as something they should incorporate into future nursing practice. A critical role for nursing education is the development of innovative teaching strategies and learning experiences that facilitate the student in the translation and application of complex constructs from nursing’s expanding body of knowledge, a task made more difficult by the COVID-19 pandemic.

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 Developing an integrated curriculum for patient safety in an undergraduate nursing program: a case study

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Yoonjung Ji ◽  
Hyeonkyeong Lee ◽  
Taewha Lee ◽  
Mona Choi ◽  
Hyejung Lee ◽  
...  
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Nursing Education ◽  
Nursing Students ◽  
Integrated Curriculum ◽  
Practical Training ◽  
Evaluation Tool ◽  
Study Approach ◽  
Nursing College

Abstract Background Nursing students’ practical training should begin when students can apply core knowledge, skills, and attitudes related to patient safety. This necessitates an integrated curriculum in nursing education that links practice to the theory concerning patient safety to enhance patient safety competencies and quality in nursing care. This study aimed to develop an integrated curriculum that incorporates patient safety factors in the existing curriculum to increase patient safety competencies in nursing students. Method A case study approach was adopted to explain the development processes of a new curriculum integrating patient safety in the existing outcome-based curriculum of a nursing college. Based on the existing outcome-based curriculum of a nursing college, a four-step process was performed to integrate patient safety component, including quality improvement, into the curriculum: 1) literature review, 2) analysis of course syllabus, 3) selection of courses related to patient safety topics, and 4) development of evaluation tool. Results The integrated patient safety curriculum was based on six topics: patient safety principles, teamwork, communication, patient engagement, risk management and, quality improvement, and International Patient Safety Goals. Based on the characteristics of the course according to the level of students in each year, the curriculum was integrated to address patient safety topics in seven courses (four theoretical and three practical). A Patient safety Competency self-assessment checklist was developed for students to naturally acquire patient safety competencies in clinical settings. Conclusions This study demonstrated that patient safety topics should be addressed in both theoretical and practical settings across the entire nursing curriculum per the continuity and sequence of education principles.

scholarly journals P009: Improving elderly care transitions through the local adaptation and implementation of the Acute Care for Elderly (ACE) program

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S80
Author(s):  
P.M. Archambault ◽  
H. Vaillancourt ◽  
V. Drouin ◽  
A. Dupuis ◽  
C. McGinn ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Elderly Patients ◽  
Care Transitions ◽  
Cognitive Capacity ◽  
Hospital Level ◽  
Post Discharge ◽  
Improvement Project ◽  
Visit Rate ◽  
National Quality ◽  
Ed Visits

Introduction: Decreasing readmission rates and return emergency department (ED) visits represent a major challenge for health organizations. Seniors are especially vulnerable to discharge adverse events which can result in unplanned readmissions and loss of physical, functional and/or cognitive capacity. The ACE Collaborative is a national quality improvement initiative that aims to improve care of elderly patients. We aimed to adapt Mount Sinai’s Care Transitions program to our local context in order to decrease avoidable readmissions and ED visits among seniors. Methods: We performed a prospective pre/post implementation cohort study. We recruited frail elderly hospitalized patients (≥50 years old) discharged to home and at risk of readmission (modified LACE index score≥7/12). We excluded patients being discharged to long-term nursing homes or institutions. Our intervention is based on selected strategic ACE Care Transitions best practices: transition coach, telehealth personal response services and a structured discharge checklist. The intervention is offered to selected patients before hospital discharge. Our primary outcome is a 30-day post-discharge composite of hospital readmission and return ED visit rate. Our secondary outcomes are functional autonomy, satisfaction with care transition, quality of life, caregiver strain and healthcare resource use at recruitment and at 30-days follow-up. Hospital-level administrative data is also collected to measure global effect of practice changes. Results: The project is currently ongoing and preliminary results are available for the pre-implementation cohort only. Patients in this cohort (n=33) were mainly men (61%), aged 75±10 years and presented an OARS score (Activities of Daily Living instrument that ranges from 0-28) of 5.6±4.9. At 30 days post-discharge, the patients in our cohort had a 42.4% readmission rate (14 hospitalisations) and a 54.5% return ED visit rate (18 visits). For the same time period, readmission and return ED rates for all patients in the same corresponding age-group at the hospital level were 14.4% and 21.9%, respectively. Further results for our post-intervention cohort will be presented at CAEP 2017. Conclusion: Our cohort of elderly patients have high readmission and return ED visit rates. Our ongoing quality improvement project aims to decrease these readmissions and ED visits.

scholarly journals Reducing Unplanned Medical Oncology Readmissions by Improving Outpatient Care Transitions: A Process Improvement Project at the Cleveland Clinic

2016 ◽  
Vol 12 (5) ◽  
pp. e594-e602 ◽  
Author(s):  
Alberto J. Montero ◽  
James Stevenson ◽  
Amy E. Guthrie ◽  
Carolyn Best ◽  
Lindsey Martin Goodman ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Outpatient Care ◽  
Medical Oncology ◽  
Care Transitions ◽  
Cleveland Clinic ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Phone Calls ◽  
The Impact

Purpose: Reducing 30-day unplanned hospital readmissions is a national policy priority. We examined the impact of a quality improvement project focused on reducing oncology readmissions among patients with cancer who were admitted to palliative and general medical oncology services at the Cleveland Clinic. Methods: Baseline rates of readmissions were gathered during the period from January 2013 to April 2014. A quality improvement project designed to improve outpatient care transitions was initiated during the period leading to April 1, 2014, including: (1) provider education, (2) postdischarge nursing phone calls within 48 hours, and (3) postdischarge provider follow-up appointments within 5 business days. Nursing callback components included symptom management, education, medication review/compliance, and follow-up appointment reminder. Results: During the baseline period, there were 2,638 admissions and 722 unplanned 30-day readmissions for an overall readmission rate of 27.4%. Callbacks and 5-day follow-up appointment monitoring revealed a mean monthly compliance of 72% and 78%, respectively, improving over time during the study period. Readmission rates declined by 4.5% to 22.9% (P < .01; relative risk reduction, 18%) during the study period. The mean direct cost of one readmission was $10,884, suggesting an annualized cost savings of $1.04 million with the observed reduction in unplanned readmissions. Conclusion: Modest readmission reductions can be achieved through better systematic transitions to outpatient care (including follow-up calls and early provider visits), thereby leading to a reduction in use of inpatient resources. These data suggest that efforts focused on improving outpatient care transition were effective in reducing unplanned oncology readmissions.

Mitigating a Nursing School's Impact on Climate Change: A Quality Improvement Project

2019 ◽  
Vol 25 (3) ◽  
pp. e15-e24
Author(s):  
Bee Yang ◽  
Shanda Demorest ◽  
Breanne Krzyzanowski
Keyword(s):  
Climate Change ◽  
Higher Education ◽  
Quality Improvement ◽  
Waste Disposal ◽  
Higher Education Institutions ◽  
Critical Role ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Environmentally Sustainable ◽  
The Impact

BackgroundMitigation is one approach to addressing climate change, which focuses on reducing carbon dioxide and greenhouse gas emissions. Nurses play a critical role in mitigation to prevent the health impacts of climate change. Recommendations to mitigate climate change in higher education institutions reflect four themes: policy, people, process, and practice. This quality improvement project aimed to mitigate a metropolitan nursing school's impacts on climate change.MethodsA Sustainability Champion Workgroup was formed to address gaps identified in the organizational needs assessment. A No Waste November (NWN) campaign and a sustainability dashboard were created to engage participants and increase awareness about climate change and environmentally sustainable behaviors. A pre- and post-NWN survey, adapted from the Nurses' Environmental Awareness Tool, and waste disposal measurements over 6 weeks were used to assess the impact of these interventions.ResultsThe post-NWN survey showed the greatest increases in mean scores for the following environmentally sustainable behaviors: biking, walking, carpooling, or taking public transportation to work; leading or participating in recycling initiatives; serving on committees that purchase sustainable supplies; and composting. Waste disposal measurements revealed a higher proportion of recycling to landfill waste during 5 out of the 6 weeks of measurement.ConclusionNurses and higher education institutions play an important role in mitigating the human impacts on climate change through environmental sustainability initiatives. Barriers to adopting environmentally sustainable behaviors and incentives to support these behaviors also need to be examined and addressed in future projects.

scholarly journals 1155. CAUTI Path to Zero: A Triple-Pronged Approach to Minding Our Pees and Cues

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S412-S413
Author(s):  
Sharen Henry ◽  
Doramarie Arocha ◽  
Dawn Brown ◽  
Hope Sutterfield ◽  
Lisa Kielpinkski ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Nursing Education ◽  
Bloodstream Infections ◽  
Average Dwell Time ◽  
University Hospital ◽  
University Hospitals ◽  
Improvement Project ◽  
Indwelling Catheters ◽  
Output Monitoring ◽  
Tract Infections

Abstract Background Catheter-associated urinary tract infections (CAUTIs) account for nearly 30% of all hospital-acquired infections. From 2009 to 2013, the frequency of CAUTIs increased by 6% with associated increases in length of stay, antibiotic usage and mortality (2.3%); they are also a risk factor for secondary bloodstream infections. In 2017, the CAUTI SIR for the UTSW University hospitals was 0.990 for Clements University Hospital (CUH) and 1.224 for Zale-Lipshy (ZL), placing UTSW above the 50th percentile compared with similar academic medical centers. By the end of 2018, the aim of the quality improvement project was to reduce CAUTIs by 25% or improve the SIR to 0.78, which is at or below the 50th percentile. Methods Baseline data included identifying indications and duration of catheter placement as well as performing debriefings on all CAUTIs along with analysis of adherence to the CAUTI bundle. Using evidence-based guidelines, the three primary interventions were (1) streamlining indications for insertion, (2) ensuring prompt removal and (3) providing alternative care pathways after removal. We observed insertion technique and catheter care; nursing services were engaged to understand barriers to catheter removal and subsequently informed of other options such as in-and-out protocols, bladder scanners and female external catheters. Nursing leadership also performed daily necessity audits of all patients with indwelling catheters. Results Urine output monitoring in acute/critical illness and urinary obstruction/retention were the top two indications for use. Catheter utilization rates have decreased since 2016. The average dwell time at CUH was 51 hours (excl. urology) and 40 hours at ZL. There was actually a 34% decrease in the total number of CAUTIs from 38 in 2017 to 25 in 2018, exceeding the goal of 25% reduction; the 2018 SIR for CUH was 0.818 and 0.496 for ZL. The prevention of 13 CAUTI events from 2017 to 2018 resulted in ~$180,000 savings. Conclusion Successful reduction of CAUTI is an interdisciplinary effort requiring consistent attention and support from infection prevention, nursing, education, quality improvement, IT and hospital administration. Empowering nursing staff, providing clear protocols post-removal and options for alternative external urinary devices is key. Disclosures All authors: No reported disclosures.

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