Journal of nursing care quality最新文献

Background: The impact of site selection on blood sampling and catheter functionality for long peripheral catheters (LPCs) is unclear.

Purpose: To compare outcomes of LPCs placed in the upper arm vs the forearm.

Methods: A single-site, randomized trial was conducted among adult patients requiring an LPC for difficult venous access or prolonged therapy. Participants were randomized to receive an 8 cm, 20-gauge LPC in either the forearm or upper arm. Outcomes included blood sampling success, catheter survival, and catheter-associated thrombosis.

Results: Among 88 patients, blood sampling failure was common, with no significant difference between forearm (83.3%) and upper arm (78.1%) groups (P = .769). Mean dwell time (74.27 vs 115.52 hours, P = .394) and time to first blood sampling failure (70.19 vs 112.90 hours, P = .359) were similar. While overall blood sampling success and thrombosis rates did not differ, trends favored upper arm placement over time.

Conclusions: This study found no statistically significant differences in blood sampling capability or functionality between placement sites.

Background: Hourly rounding is a structured process where staff check on patients hourly to ensure their comfort and safety. Through checking on patients with purpose, we aim to enhance patient experience, strengthen nurse-patient relationships, and reduce safety risks.

Problem: A cross-campus survey focusing on organizational culture of hourly rounding revealed that nursing staff perceived the process as burdensome and an additional task rather than an integrated practice.

Approach: Program leaders launched a campus-wide video campaign showcasing purposeful rounding in action, followed by in-person training which equipped staff with leadership and appreciative coaching skills necessary to improve their daily rounding practices.

Outcomes: Patient experience scores related to responsiveness improved by up to 7.9% on inpatient and outpatient surveys.

Conclusions: This program provided a sustainable framework for staff to consistently and proactively address patient needs, improving the overall patient experience through enhanced human connection.

Background: Post-percutaneous coronary intervention (PCI) management is essential for improving patient outcomes. Digital health services (DHS) offer the potential to enhance recovery outcomes and care quality through real-time monitoring and personalized interventions.

Purpose: This systematic review and meta-analysis aims to evaluate the effectiveness and safety of DHS in improving outcomes for post-PCI patients.

Methods: A systematic search of databases was conducted for randomized controlled trials on DHS for post-PCI patients.

Results: Eleven studies involving 2568 patients were included. DHS significantly improved quality of life, 6-minute walk test performance, medication adherence, patient satisfaction, and smoking cessation rates, while reducing complications and readmission rates. Subgroup analysis showed DHS was particularly effective for patients over 60 years.

Conclusion: DHS significantly improve post-PCI management and patient outcomes, with marked benefits for older patients. Further large-scale, long-term studies are recommended to confirm these findings.

Background: The subjective nature of symptoms makes them challenging for providers to effectively assess. Implementing electronic patient-reported outcome (ePRO) surveys could improve symptom recognition and decrease emergency department (ED) visits and symptom severity while increasing psychosocial discussions.

Local problem: An oncology clinic's initial symptom assessment process focused on common oncological complaints, leading to unmet symptom management needs and resulting in approximately 23 monthly ED visits.

Methods: Iterative Plan-Do-Study-Act cycles were used to guide this project.

Intervention: Patients completed ePRO surveys which allowed visits to be focused on self-identified severe symptoms.

Results: The average number of monthly ED visits declined from 23.25 to 19.5 (P = .10), and severe adverse events decreased from 0.27 to 0.25 (P = .95). Discussions concerning depression rose from 21% to 23.3% (P = .78).

Conclusions: Implementing ePRO surveys was associated with a reduction in ED visits and an increase in psychosocial conversations, indicating that ePROs may contribute to improved value-based care.