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Decreasing Premedication for Blood Transfusions: A Quality Improvement Project. 减少输血前用药:质量改进项目。
IF 2.5 4区 医学 Q1 NURSING Pub Date : 2024-08-01 Epub Date: 2024-07-25 DOI: 10.1097/01.NAJ.0001027116.67274.e3
Ashley Hole, Alexandra Budhai, Kerry King, P Dayand Borge

Background: Premedication administration to patients who are to receive blood transfusions continues despite evidence of a lack of benefit when given to prevent febrile nonhemolytic or mild allergic transfusion reactions. Reviews of ordering practices and staff surveys on an adult inpatient hematology-oncology unit in our multisite oncology medical center indicated a lack of standardization and overuse of premedication in blood transfusions and a lack of knowledge of when it was appropriate to use premedication.

Methods: A literature search was performed, and the evidence led to a proposal for a quality improvement (QI) project focused on development of an evidence-based algorithm to guide clinicians in when to administer which premedication, development of clear documentation for premedication plans, integration of the documented premedication plans into electronic orders for blood products, and staff education. Interventions included a hospital-wide algorithm and an electronic order to be integrated with a premedication plan for each patient on the adult hematology-oncology unit.

Results: Seven months after implementation of the intervention, premedication use among patients decreased by 57.6%, and the transfusion reaction rate decreased from 1% to 0.8%. Staff knowledge as measured by responses to pre- and postintervention surveys on the appropriate use of premedication also improved.

Conclusion: Evidence-based interventions can reduce the incidence of premedication use in patients receiving blood transfusions.

背景:尽管有证据表明输血前用药对预防发热性非溶血性或轻度过敏性输血反应并无益处,但对即将接受输血的患者进行输血前用药的做法仍在继续。我们的多点肿瘤医疗中心对成人住院血液肿瘤科的下单实践和员工调查进行了审查,结果表明输血预处理缺乏标准化和过度使用,而且对何时适合使用预处理缺乏了解:方法: 我们进行了文献检索,并根据证据提出了一项质量改进(QI)项目提案,该项目重点在于制定循证算法以指导临床医生何时使用何种预处理药物、为预处理计划制定清晰的文件记录、将文件记录的预处理计划整合到血液制品的电子订单中以及开展员工教育。干预措施包括为成人血液肿瘤科的每位患者制定全院范围内的算法和与用药前计划相结合的电子医嘱:干预措施实施 7 个月后,患者的用药前剂量减少了 57.6%,输血反应率从 1%降至 0.8%。根据干预前和干预后调查的结果,工作人员对如何合理使用预处理药物的认识也有所提高:以证据为基础的干预措施可以降低输血患者使用预处理药物的发生率。
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引用次数: 0
Coalition Seeks STEM Status for Nursing. 联盟为护理学争取 STEM 地位。
IF 2.5 4区 医学 Q1 NURSING Pub Date : 2024-08-01 Epub Date: 2024-07-25 DOI: 10.1097/01.NAJ.0001027640.03611.a0
Karen Roush

The designation would open up funding for research and other initiatives.

这一指定将为研究和其他活动提供资金。
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引用次数: 0
Additional Safety Risks Added to Fluorouracil Labeling. 氟尿嘧啶标签中增加了额外的安全风险。
IF 2.5 4区 医学 Q1 NURSING Pub Date : 2024-08-01 Epub Date: 2024-07-25 DOI: 10.1097/01.NAJ.0001027688.31411.08
Diane Aschenbrenner
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引用次数: 0
News Brief: NP care makes a difference in nursing home residents with dementia. 新闻简报:NP 护理让患有痴呆症的疗养院居民与众不同。
IF 2.5 4区 医学 Q1 NURSING Pub Date : 2024-08-01 Epub Date: 2024-07-25 DOI: 10.1097/01.NAJ.0001027644.82128.27
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引用次数: 0
Palliative Care in Rural Communities. 农村社区的姑息关怀。
IF 2.5 4区 医学 Q1 NURSING Pub Date : 2024-08-01 Epub Date: 2024-07-25 DOI: 10.1097/01.NAJ.0001027716.70431.35
Tracy Fasolino, Megan E Mayfield, Kathleen Valentine, William E Rosa, Anne Koci

Abstract: Rural communities in the United States are frequently marginalized and misrepresented. These communities face unique challenges, such as limited access to health care, nutritious food, and clean water, that contribute to persistent health disparities. This article presents the CARE (Complex, Access, Resourceful, Extraordinary) framework, which illustrates the dichotomy of rurality-its negative and positive aspects-in order to inform the development of palliative care delivery in rural settings. Various palliative care models are described that address access gaps, bolster provider capacity, and increase the provision of specialty palliative care. However, workforce shortages and reimbursement structures restrict the expansion of these services. Nurses, the largest segment of the health care workforce and the most trusted professionals, must partner with interdisciplinary colleagues and rural communities to advocate for equitable and inclusive care.

摘要:美国的农村社区经常被边缘化和被歪曲。这些社区面临着独特的挑战,如获得医疗保健、营养食品和清洁水的机会有限,这导致了持续的健康差距。本文介绍了 "CARE"(Complex, Access, Resourceful, Extraordinary)框架,该框架说明了农村的二分法--其消极和积极的方面,从而为在农村环境中提供姑息关怀服务提供参考。该框架描述了各种姑息关怀模式,以解决获取途径的差距,提高医疗服务提供者的能力,并增加专业姑息关怀的提供。然而,劳动力短缺和报销结构限制了这些服务的扩展。护士是医疗队伍中人数最多的部分,也是最值得信赖的专业人员,他们必须与跨学科的同事和农村社区合作,倡导公平和包容性的医疗服务。
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引用次数: 0
Implicit Bias in Patient Care Assignments. 病人护理分配中的隐性偏见。
IF 2.5 4区 医学 Q1 NURSING Pub Date : 2024-08-01 Epub Date: 2024-07-25 DOI: 10.1097/01.NAJ.0001027672.07497.cc
Macy Mosher, Sonique Sailsman

Identifying and acknowledging biases and working to eliminate them.

识别并承认偏见,努力消除偏见。
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引用次数: 0
Addressing Compassion Fatigue. 解决 "同情疲劳症"。
IF 2.5 4区 医学 Q1 NURSING Pub Date : 2024-08-01 Epub Date: 2024-07-25 DOI: 10.1097/01.NAJ.0001027736.33099.a0
Robin Harper, Tracy A Ortelli

Resources to improve nurses' well-being.

改善护士福祉的资源。
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引用次数: 0
Patient Falls Again Top Annual Sentinel Events List. 患者跌倒再次成为年度哨点事件榜首。
IF 2.5 4区 医学 Q1 NURSING Pub Date : 2024-08-01 Epub Date: 2024-07-25 DOI: 10.1097/01.NAJ.0001027660.98294.27
Karen Roush

Events overall held steady after rising for several years.

活动在连续几年上升之后,总体保持稳定。
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引用次数: 0
News Brief: Substantial number of patients whose life-sustaining treatment was withdrawn might have survived, study finds. 新闻简报:研究发现,相当多的病人在生命维持治疗被撤消后可能会存活下来。
IF 2.5 4区 医学 Q1 NURSING Pub Date : 2024-08-01 Epub Date: 2024-07-25 DOI: 10.1097/01.NAJ.0001027664.41318.42
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引用次数: 0
A Case of Symptomatic Bradycardia After Valve Replacement. 一例瓣膜置换术后出现症状性心动过缓的病例
IF 2.5 4区 医学 Q1 NURSING Pub Date : 2024-08-01 Epub Date: 2024-07-25 DOI: 10.1097/01.NAJ.0001027708.35102.fe
Nicole Kupchik, Sarah Vance

Editor's note: This is the next installment in a series on electrocardiogram (ECG) interpretation. Nurses in all settings should know the basics, as medications and physiological changes can cause cardiac arrhythmias. Each article will start with a brief case scenario and an ECG strip and then take you step by step through analyzing the heart rhythm.

编者按:这是心电图(ECG)解读系列的下一篇。由于药物和生理变化可能导致心律失常,因此各种环境下的护士都应了解基本知识。每篇文章都将从一个简短的病例场景和一张心电图条开始,然后一步步带您分析心律。
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引用次数: 0
期刊
American Journal of Nursing
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