Journal of nursing care quality最新文献

Background: Evidence-based practice (EBP) is regarded as a fundamental approach to ensuring patient safety and enhancing the quality of nursing care. Staff nurses' patient-centered care (PCC) competency and shared leadership can serve as facilitating factors for EBP implementation.

Purpose: This study aims to examine the influences of staff nurses' PCC competency and shared leadership on EBP implementation.

Methods: This study employed a descriptive correlational design.

Results: A total of 177 nurses completed the survey. The most influential factor in EBP implementation was promoting patient involvement in care processes, a subdomain of PCC competency. Nurses with less than 3 years of clinical experience showed lower, and those with 3 to less than 5 years showed higher levels of EBP implementation compared to nurses with 7 or more years of experience.

Conclusions: Systematic EBP education and accessible evidence databases are needed to promote its implementation in practice.

Background: Timely administration of STAT antibiotics is critical in emergencies like sepsis yet delays often result from communication gaps between physicians and nurses.

Purpose: This study evaluated the effectiveness of the Automated Stat-Order Alert System (ASOS), which delivers real-time alerts to nurses to reduce delays in antibiotic administration in a tertiary hospital in Singapore.

Methods: A quasi-experimental design was used to analyse 4,003 STAT antibiotic orders. The Mann-Whitney U-test compared administration times before and after ASOS implementation.

Results: Automated Stat-Order Alert System implementation significantly reduced mean administration time from 75.1 min (SD 53.3) to 67.6 min (SD 44.5) (P = .005), with significantly fewer delays beyond 120 min (χ2 = 25.387, P < .001).

Conclusion: The ASOS improved Stat-Order Alert System improved the timeliness, consistency, and distribution of STAT antibiotic administration. Further system and workflow optimization is needed to meet the 60-min target consistently.

Background: Nursing homes (NHs) face persistent challenges implementing evidence-based quality improvement (QI). Many barriers were intensified during the COVID-19 pandemic.

Purpose: To identify barriers and facilitators to nurse practitioner (NP)-led QI implementation in NHs and share lessons learned.

Methods: Fifty-six NHs in middle Tennessee were each assigned an NP mentor to support QI efforts during the COVID-19 pandemic. Structured qualitative interviews with project NPs identified barriers and facilitators to QI implementation using the Consolidated Framework for Implementation Research.

Results: Facilitators included leadership engagement, QI champions, a supportive culture, and evidence strength. Barriers included low prioritization, limited resources, low staff efficacy, and adaptability challenges.

Conclusions: NP-led QI is feasible in NHs but requires leadership support, adequate staffing, and an organizational culture that values improvement.

Background: Given an increase in central-line-associated bloodstream infections (CLABSIs) since the COVID-19 pandemic and low compliance with the CLABSI prevention bundle among intensive care unit (ICU) registered nurses (RNs), it is imperative to identify barriers to implementation in the critical care setting.

Purpose: To explore ICU RNs' perceptions of barriers and interventions related to CLABSI prevention bundle compliance.

Methods: A descriptive mixed-methods survey was used to assess ICU RNs' perceptions of barriers and interventions.

Results: Of the 35 respondents, most were staff RNs (94%) in adult ICUs (97%). Over half of the respondents (65%) had not received feedback on CLABSI prevention bundle implementation. Barriers included busy unit workflow, nurse-to-patient ratios, and burnout. RNs suggested interventions such as staffing support, structured feedback, and workflow adjustments.

Conclusions: ICU RNs perceive multiple barriers and suggest actionable strategies beyond education. Incorporating staff input into future quality improvement initiatives may improve bundle compliance and patient safety.

Background: Bone marrow transplantation (BMT) is a high-complexity procedure requiring specialized nursing to ensure care safety and quality.

Purpose: The purpose of this study is to map safe nursing practices for patients undergoing BMT.

Methods: A scoping review was conducted following Joanna Briggs Institute and PRISMA-ScR guidelines. The search, based on the PCC (Population, Concept, Context) framework, was conducted across 5 databases: MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Academic Search Complete, Scopus, and Web of Science. Studies published between 2014 and 2024 in English, Portuguese, or Spanish were considered.

Results: Six studies were included. Key practices identified included structured medication administration protocols, infection prevention strategies, transfusion safety, graft infusion techniques, and the importance of professional training.

Conclusion: Safe nursing practices are essential for minimizing risks and ensuring quality care in BMT. The findings highlight the relevance of evidence-based protocols and continuous education to support clinical decision-making and improve patient outcomes.