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Nursing Clinics of North America

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https://read.qxmd.com/read/30712549/quality-improvement
#1
EDITORIAL
Treasa 'Susie' Leming-Lee, Richard Watters
No abstract text is available yet for this article.
March 2019: Nursing Clinics of North America
https://read.qxmd.com/read/30712548/quality-improvement-evolution-or-revolution
#2
EDITORIAL
Stephen D Krau
No abstract text is available yet for this article.
March 2019: Nursing Clinics of North America
https://read.qxmd.com/read/30712547/evaluation-of-telemetry-utilization-on-medical-surgical-units
#3
REVIEW
JoAnne Phillips, Rosemary C Polomano, Treasa 'Susie' Leming-Lee, Terri Davis Crutcher
Alarm fatigue is the most common contributing factor in alarm-related sentinel events. Researchers have demonstrated a 35% overuse of telemetry, a key factor in alarm fatigue. This project evaluates practice patterns for the ordering and discontinuation of telemetry on medical-surgical units. Practice patterns were reviewed to determine if they aligned with the American Heart Association evidence-based practice guidelines for telemetry monitoring and whether the order indication was congruent with the patient's clinical status...
March 2019: Nursing Clinics of North America
https://read.qxmd.com/read/30712546/implementation-of-a-nurse-driven-cauti-prevention-algorithm
#4
REVIEW
Jensine A Russell, Treasa 'Susie' Leming-Lee, Richard Watters
The cardiovascular thoracic step-down unit of an urban academic medical center had 4 catheter-associated urinary tract infections (CAUTIs) in 2 months compared with 5 in the previous year. The nursing literature showed that the implementation of nurse-driven algorithms for early removal of indwelling urinary catheters (IUCs) decreased the catheter days and risk of CAUTIs. Using the Model for Improvement, the nurse leader performed daily IUC rounds to enforce the removal algorithm and visual management tools to identify IUC removal barriers...
March 2019: Nursing Clinics of North America
https://read.qxmd.com/read/30712545/the-application-of-the-toyota-production-system-lean-5s-methodology-in-the-operating-room-setting
#5
REVIEW
Treasa 'Susie' Leming-Lee, Shea Polancich, Bonnie Pilon
The purpose of the Toyota Production System (TPS) Lean 5S methodology project is to improve the efficiency and effectiveness in a process by eliminating identified process waste of (1) defects (errors), (2) overproduction, (3) waiting, (4) confusion, (5) motion/travel, (6) excess inventory, (7) overprocessing, and (8) human potential. The specific aim of this quality improvement project was to evaluate the impact of the TPS 5S tool process, a problem-solving, space-organizing tool, on distractions and interruptions in the neurosurgery operating room (OR) workflow with a goal to decrease neurosurgery craniotomy infection rates in a neurosurgery OR suite within a 3-month period...
March 2019: Nursing Clinics of North America
https://read.qxmd.com/read/30712544/the-effects-of-a-targeted-history-question-on-patient-triage-nurse-communication
#6
REVIEW
Kristyn C Huffman
Fast tracks are widely used in emergency departments to increase patient throughput as annual visits continue to rise in the United States. A modified triage process known as QuickLook, which omits patients' past medical history, is used in some hospitals to further increase throughput. This article discusses the effects of QuickLook on patient placement, reviews the role of past medical history in triage, and discusses the impact of integrating a targeted history question into the QuickLook process of an emergency department in Arizona...
March 2019: Nursing Clinics of North America
https://read.qxmd.com/read/30712543/chart-it-to-stop-it-failure-modes-and-effect-analysis-for-the-reporting-of-workplace-aggression
#7
REVIEW
Gordon Lee Gillespie, Treasa 'Susie' Leming-Lee
The purpose of this quality improvement study was to describe the process for workplace aggression (WPA) reporting and the potential failures for this process in a pediatric emergency department. Interviews were conducted with 10 interdisciplinary employees. Findings yielded 7 tasks following WPA: contact security, contact police, contact clinical manager, notify emergency department director, call safety hotline, complete electronic safety form, and complete paper safety form. Focusing actions to prevent failure modes and causes for (1) notification of the emergency department director and (2) completion of an electronic safety form can garner the greatest improvement in overall risk for WPA reporting...
March 2019: Nursing Clinics of North America
https://read.qxmd.com/read/30712542/barriers-to-the-implementation-of-pediatric-overweight-and-obesity-guidelines-in-a-school-based-health-center
#8
REVIEW
Lydia J Yeager, Sharon M Karp, Treasa 'Susie' Leming-Lee
This project applied a quality improvement design to assess perceived barriers to pediatric overweight and obesity guideline implementation in school-based health centers. An electronic survey was administered to nurse practitioners and licensed practical nurses working in school-based health centers in New York. The most commonly cited primary care-based barriers were lack of patient compliance, family lifestyle, and the poor dietary practices and sedentary behaviors common in America. The most commonly cited school-based barriers were that children have little control over the groceries purchased and foods cooked at home and the lack of parent presence during appointments...
March 2019: Nursing Clinics of North America
https://read.qxmd.com/read/30712541/diabetes-self-management-education-provision-by-an-interprofessional-collaborative-practice-team-a-quality-improvement-project
#9
REVIEW
Adelaide N Harris
Please note that citations/references numbers are not included in abstracts; please modify if needed: Diabetes is a major health problem and requires patients with diabetes to gain knowledge to manage their care effectively. The shift in diabetes care is to focus teaching on self-management to engage and empower patients with diabetes to live the best quality of life. Health care providers may not always be aware of diabetes self-management education available to patients. The American Association of Diabetes Educators has identified 7 essential self-care behaviors known as AADE7...
March 2019: Nursing Clinics of North America
https://read.qxmd.com/read/30712540/screening-for-social-determinants-of-health-at-well-child-appointments-a-quality-improvement-project
#10
REVIEW
Kimberly Higginbotham, Terri Davis Crutcher, Sharon M Karp
Children living in poverty are vulnerable to the adverse effects associated with unmet basic needs, such as food and housing. Poverty threatens the overall growth and development of children placing them at risk for poor cognitive, behavioral, and psychological outcomes. Addressing social determinants of health in the pediatric primary care setting is within the role of the pediatric primary care provider. The Model for Improvement guided this quality improvement project in the implementation of food and housing insecurity screening during well-child appointments in a rural health clinic...
March 2019: Nursing Clinics of North America
https://read.qxmd.com/read/30712539/reducing-pressure-injuries-in-the-pediatric-intensive-care-unit
#11
REVIEW
Kristin A Cummins, Richard Watters, Treasa 'Susie' Leming-Lee
This quality improvement project used the Model for Improvement including the Plan-Do-Study-Act cycle of change framework to educate pediatric intensive care unit (PICU) nurses on risk factors for pediatric pressure injuries and prevention strategies, improve turning compliance for PICU patients, and implement an electronic trigger to order nutrition consultations on all patients with a Braden Q score less than 16. The quality improvement project decreased preventable patient harm to PICU patients by decreasing the pressure injury incidence rate from 8% to 3% in the 6-week time period...
March 2019: Nursing Clinics of North America
https://read.qxmd.com/read/30712538/impact-of-nurse-led-interprofessional-rounding-on-patient-experience
#12
REVIEW
Denise K Gormley, Amy J Costanzo, Jane Goetz, Jahmeel Israel, Jessica Hill-Clark, Tracy Pritchard, Katherine Staubach
Interprofessional collaborative practice (IPCP) was recommended to improve siloed and fragmented patient care. The Institute of Medicine recommended nurses lead this change through innovative models of patient-centered care and IPCP participation. One strategy to improve patient experience is rounding. This project presents a nurse-led interprofessional bedside rounding model to improve communication and collaboration between providers and with patients on a complex inpatient unit. Outcomes were analyzed using Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores to examine patient experience...
March 2019: Nursing Clinics of North America
https://read.qxmd.com/read/30712537/translation-of-evidence-based-practice-quality-improvement-and-patient-safety
#13
REVIEW
Treasa 'Susie' Leming-Lee, Richard Watters
Using knowledge gained from the disciplines of nursing, medicine, health care management, and medical and health services research, the quality improvement movement attempts to mobilize people within the health care system to work together in a systematic way using evidence based strategies and tactics to improve the care they provide. In this valuable work, discipline-specific knowledge is combined with experiential learning and discovery to make improvements. Quality improvement provides a knowledge-based framework and methods for the change agent to work toward a more predictable, effective, efficient, reliable, equitable, patient-centered care health care system...
March 2019: Nursing Clinics of North America
https://read.qxmd.com/read/30388986/nephrology-innovations-in-clinical-practice
#14
EDITORIAL
Deborah Ellison, Francisca Cisneros Farrar
No abstract text is available yet for this article.
December 2018: Nursing Clinics of North America
https://read.qxmd.com/read/30388985/renal-disease-a-complicated-phenomenon
#15
EDITORIAL
Stephen D Krau
No abstract text is available yet for this article.
December 2018: Nursing Clinics of North America
https://read.qxmd.com/read/30388984/psychosocial-issues-and-lifestyle-changes-for-the-renal-patient
#16
REVIEW
Linda C Cole
This article provides an overview of the psychosocial issues faced by those with renal disease. The article discusses the physiologic connection between anxiety, depression, and pain-symptoms commonly seen in renal disease and other chronic illnesses. The application of integrative medicine or nonallopathic medicine and its role in the management of anxiety, depression, and pain are presented. Also presented is evidence surrounding several frequently used nonallopathic modalities appropriate for incorporation into a comprehensive management regimen for renal patients to reduce symptom burden...
December 2018: Nursing Clinics of North America
https://read.qxmd.com/read/30388983/complications-of-kidney-disease
#17
REVIEW
Sandy Murabito, Beth Fentress Hallmark
Understanding the physiology of the kidney and the pathophysiology of common complications of chronic kidney disease (CKD) is essential. The rise of CKD across the United States demands that nurses be prepared to care for these patients. Cardiovascular complications, anemia, and bone formation issues are the most common complications. Approximately 30 million people (15% of adults) are reported to have CKD. By 2020 there will be a 14.4% increase in the prevalence of CKD, and by 2030, the increase will be up by 16...
December 2018: Nursing Clinics of North America
https://read.qxmd.com/read/30388982/obstructive-kidney-disease
#18
REVIEW
Sherri Stevens
Obstructive kidney disease is a common urologic diagnosis and includes kidney stones, polycystic kidney disease, and renal artery stenosis. Kidney stones are a common emergency department admission in the United States. Men are affected more than women. Polycystic kidney disease is a genetic renal disease that may not reveal symptoms until an individual reaches age 30 years. Renal artery stenosis contributes to decreased perfusion to the kidneys, which contributes to hypertension and end-stage renal disease...
December 2018: Nursing Clinics of North America
https://read.qxmd.com/read/30388981/clinical-management-of-glomerular-diseases
#19
REVIEW
Patty Orr, Bettina Cobb Shank, Shondell Hickson, Jennifer Cooke
Progressive glomerular damage can occur as a result of various etiologic factors including infections, medications, diseases, and autoimmune disorders. This article discusses the clinical management of the leading conditions associated with glomerular disease, including glomerulosclerosis, diabetic nephropathy, focal segmental glomerulosclerosis, and membranous nephropathy. Glomerular damage and disease progression may lead to end stage renal disease. Clinical management is individualized, as based on causative factors and clinical manifestations, with the overall goal of limiting glomerular damage...
December 2018: Nursing Clinics of North America
https://read.qxmd.com/read/30388980/infection-related-glomerular-disease
#20
REVIEW
Maria A Revell
Glomerular disease results from a complex process. It can occur following acute illnesses or chronic diseases from other organs and body parts that promote bacterial invasion. Assessment and initial identification of the cause of this process is important in order to initiate interventions that promote a return to wellness. Prudent clinician judgment is necessary in client management in order to reduce the potential for long-standing renal disease. Medicinal intervention should be combined with patient education in addressing infection-related glomerular disease...
December 2018: Nursing Clinics of North America
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