Journal of nursing care quality最新文献

Background: Sepsis is a leading cause of transfers to intensive care units (ICUs) and hospital mortality, often due to delayed recognition in medical-surgical units.

Local problem: Project site sepsis data showed that 19.4% of ICU transfers originated from medical-surgical units, accounting for 27% of sepsis mortality cases.

Intervention: This quality improvement project evaluated a sepsis-themed escape room to train medical-surgical nurses.

Results: After training, mean knowledge scores increased from 77.4% to 82.4% ( P = .068). Significant improvements were seen in self-reported confidence in identifying patients with sepsis ( P = .02), knowing how and what to monitor in patients with sepsis ( P = .007), and knowing initial management of patients with sepsis ( P = .008). ICU transfers for sepsis decreased by 33.3%.

Conclusions: Innovative escape room education for medical-surgical nurses can improve knowledge and confidence in managing patients with sepsis, which may lead to earlier recognition of deterioration and reduce sepsis-related ICU transfers.

Background: Medication administration incidents are a significant patient safety concern in health care, often driven by human and work system factors which contribute to errors.

Purpose: The purpose of this study was to develop a medication administration observation checklist tool tailored for a pediatric tertiary care center in Atlantic Canada.

Methods: We synthesized existing evidence on methodologies for observational tools in medication administration by nurses. Next, we engaged nursing knowledge users in Think Aloud sessions to iteratively refine the checklist's items.

Results: We share the development of a medication administration observation checklist tool. This process incorporated valuable feedback from frontline nurses and nurse managers, ensuring the checklist's relevance and usability in clinical practice.

Conclusions: Our findings underscore the importance of co-developing data collection tools with interdisciplinary teams, leveraging theoretical frameworks to capture complexities in workflow, and enhancing transparency in reporting methodologies to support replicability across diverse clinical contexts.

Background: Postoperative surgical site infections (SSIs) are a significant concern in cardiac surgery.

Purpose: To characterize clinical and perioperative factors associated with the absence of deep SSIs in a cohort of patients who underwent coronary artery bypass grafting (CABG) surgery.

Methods: A retrospective, single-center study was conducted, analyzing data from 214 patients between August 2023 and June 2024. Perioperative care measures included adherence to an established cardiothoracic SSI prevention bundle, consisting of preoperative chlorhexidine gluconate bathing, preoperative nasal decolonization, intraoperative antibiotics, and intraoperative and postoperative glycemic control.

Results: Adherence to the prevention bundle varied (82.7-98.6%). A statistically significant difference in postoperative glycemic control was observed between elective and urgent surgery cases.

Conclusion: This study's findings highlight the potential effect of rigorous protocol adherence and the critical role of standardized nursing care in SSI prevention. Future research to optimize patient care and outcomes during and after CABG surgery is recommended.

Background: Ensuring high-quality and safe patient care is a core goal of health care systems, and nurses' collaboration and care delivery practices are crucial in achieving this aim.

Purpose: This study examined the mediating role of missed nursing care in the effect of nurse-nurse collaboration on perceived care quality.

Methods: A descriptive, correlational design was employed, involving 305 nurses from 2 city hospitals in Ankara, Türkiye, who were selected through convenience sampling. Data were collected using a demographic form, the Nurse-Nurse Collaboration Scale, the General Care Quality Question, and the MISSCARE Survey.

Results: Missed nursing care was negatively associated with perceived care quality and explained 12.8% of the variance. Nurse-nurse collaboration significantly predicted perceived care quality, explaining 21.3% of the variance. Missed nursing care partially mediated this relationship.

Conclusions: Nurse leaders can enhance perceived care quality and minimize missed nursing care by promoting consistent communication, a supportive team climate, and shared responsibility.

Background: No-shows in ambulatory clinics negatively impact patient care, operational resources, and health outcomes.

Local problem: The average no-show rate of the local endocrinology medical practice office was consistently above its benchmark of 8%.

Methods: A quality improvement project utilized Plan-Do-Study-Act cycles and Pender's Health Promotion Model (HPM) to reduce no-shows.

Interventions: Interventions included identifying no-show appointment trends, educating nurse navigators on HPM and associated guidelines, conducting telephone call outreach to patients at high risk for no-shows, and implementing holistic nurse-patient interactions.

Results: Telephone call outreach had a 50.6% connection rate. No-show rates decreased from 14.9% to 13.9% over 8 weeks. Telephone calls provided insights into perceived experiences and social determinants of health factors.

Conclusion: The project reaffirmed the importance of a multimodal approach and human interaction in reducing no-shows, as well as highlighting the value of nursing care, evidence-based promotion, and the incorporation of theory when implementing operational improvements.

Background: Medication safety competence is critical, yet how workplace and psychological factors shape medication safety competence is unclear.

Purpose: To examine links among work environment, work-related stress, professional identity, and medication safety competence.

Methods: A cross-sectional survey of 641 nurses in China was conducted and structural equation modeling was used to test relationships.

Results: Professional identity predicted medication safety competence (β = .276, P < .001) and partially mediated effects of work environment (indirect = 0.098; 95% CI, 0.063-0.146) and stress (indirect = 0.036; 95% CI, 0.021-0.056).

Conclusions: Supportive environments and stronger professional identity are associated with higher medication safety competence, whereas stress is detrimental. Organizational strategies should enhance resources, reduce stressors, and cultivate professional identity to improve medication safety and ultimately improve patient safety outcomes.