Journal of nursing care quality最新文献

Background: Clarity in the accurate reporting of evidence-based practice quality improvement (EBPQI) initiatives is essential to support sustainable, scalable change in clinical settings.

Problem: While there are separate reporting guidelines for evidence-based practice (EBP) and quality improvement (QI), there is currently no available reporting guideline for EBPQI initiatives that comprehensively combines the 2 types of inquiry.

Approach: This article introduces a new EBPQI reporting guideline grounded in the Mountain Model for EBPQI and aligned with a previously published EBPQI critical appraisal instrument. The 19-item guideline uses the IMRaD (Introduction, Methods, Results, Discussion) structure and includes specific, pragmatic guidance for reporting internal and external evidence, iterative tests of change, SMART aims, and QI-appropriate analysis methods.

Conclusion: This new guideline provides instruction for clinicians, researchers, and students in how to report robust EBPQI initiatives.

Background: There is a lack of evidence-based processes to support nurses in appropriately utilizing one-to-one observations for patients at risk of avoidable harm in acute hospitals.

Purpose: The purpose of this systematic review was to identify the decision-making processes surrounding one-to-one observations.

Methods: Five databases were searched in July 2020 and July 2024. Papers were included if they discussed decision-making processes for one-to-one observations for acute adult inpatients. Data were extracted to a review database and analyzed thematically.

Results: Sixteen publications were included. The decision-making tools described were assessment tools, local processes, and clinical judgement. The most common tool was an institutional decision-making process, which often was a combination of clinical assessment and clinical action guidance.

Conclusion: Various tools and processes are used to facilitate decision-making on the use of one-to-one observations but few of the tools are evidence-based.

Background: Surgical site infections (SSIs) pose significant challenges in obstetric nursing, affecting maternal and neonatal safety.

Purpose: This study aimed to evaluate the effectiveness of comprehensive strategies for preventing SSIs in obstetric nursing.

Methods: A retrospective analysis was conducted on 200 obstetric surgical patients from January 2018 to December 2022. The observation group received comprehensive SSI prevention strategies and the control group received routine nursing care.

Results: The observation group had a significantly lower SSIs rate (3.0% vs 10.0%, P = .045), fewer complications (1.0% vs 7.0%, P = .028), better incision healing (98.0% vs 91.0%, P = .028), fewer adverse events (4.0% vs 13.0%, P = .022), and lower pain scores on postoperative days 1 and 2.

Conclusion: Implementing comprehensive SSI prevention strategies in obstetric nursing significantly reduces SSIs, complications, and pain, while enhancing wound healing and recovery.

Background: Workplace violence negatively affects health care quality, staff health, and institutional costs.

Local problem: Our nursing unit had 151 workplace violence incidents reported in 2022, which led to 59 missed workdays and financial losses. Existing policies and training programs were insufficient to address this issue effectively.

Methods: To reduce workplace violence, we piloted a data-driven intervention and measured workplace violence incidence, associated costs, and hospital length of stay before, during, and after the intervention.

Interventions: We improved documentation systems, updated the policy and procedures for responses to violent incidents, and created a behavioral safety management plan that was initiated when the risk of violence was identified by a registered nurse.

Results: Violent incidents decreased by 37%, and assault-related injuries decreased to 0 in 2023, resulting in a cost savings of $29 891.

Conclusions: Our quality improvement intervention reduced workplace violence and fostered a safer health care environment.