...Hourly Rounds Reduces Patients’ Frequent Call Lights and Improves Safety. Christian Oyibe NURS 8103 Evidence Based Practice. Governors State University Professor Somi Nagaraj, MSN, DNP. June 5, 2013. Introduction The nurse call light is an important tool in which patients used to get the attention of nurses during hospitalization. It is one of the many means by which patients can exercise control of their health care. It is done to seek the nurses’ attention for help during inpatient hospitalization. The ideal situation is that when the patient pushes the call light, the nurse or the staff will be there to find out what assistance the patient needs. However, when these calls are made by patients, and there were delays in response time, this will in turn lead to frustration in most cases, and the patient will attempt activities that threatened their safety, thereby leading to falls and other safety issues. In most inpatient hospital or other health care facilities, call lights are made by residents or patients who need bathroom or bedpan assistance. The problem associated...
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...Effects of Nursing Rounds on Patients’ Call light Use, Satisfaction, and Safety Introduction to Nursing Research Effects of Nursing Rounds This is a critique study on “effects of nursing rounds on patients’ call light use, satisfaction, and safety by Christine Meade, PHD, Amy Bursell, PHD and Lyn Ketelsen MBA,RN(2006)”outline as quasi-experimental research design. The author states in this article about patient’s frequent usage of call light in the hospital. Frequent call light usage seems to be an ongoing problem in the hospital setting. This study was to determine how to reduce the call light use and burn out staff, also increase patient satisfaction and safety. Protection of Human Participants. The Benefits of the study was to increase patient’s level of satisfaction in nursing care, improve patient safety, and reduce fall rate and reducing call light. Researcher assessed “humanistic” and “concrete” behaviors. Author found every one or two hour nursing rounds can reduce call light usage, reduce fall rate and improve patient satisfaction and safety. There wasn’t any informed consent used in this study. This was a nonrandom assignment of the hospital units. One and two hour rounding was approved by chief nursing officer and nurse manager. Researcher used a quasi-experimental nonequivalent group’s design study. Because of this design researchers need help from the nursing officers. Nursing units were asked several times to change the rounding...
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...study on “effects of nursing rounds on patients’ call light use, satisfaction, and safety by Christine Meade, PHD, Amy Bursell, PHD and Lyn Ketelsen MBA,RN(2006)”outline as quasi-experimental research design. The author states in this article about patient’s frequent usage of call light in the hospital. Frequent call light usage seems to be an ongoing problem in the hospital setting. This study was to determine how to reduce the call light use and burn out staff, also increase patient satisfaction and safety. Protection of Human Participants. The Benefits of the study was to increase patient’s level of satisfaction in nursing care, improve patient safety, and reduce fall rate and reducing call light. Researcher assessed “humanistic” and “concrete” behaviors. Author found every one or two hour nursing rounds can reduce call light usage, reduce fall rate and improve patient satisfaction and safety. There wasn’t any informed consent used in this study. This was a nonrandom assignment of the hospital units. One and two hour rounding was approved by chief nursing officer and nurse manager. Researcher used a quasi-experimental nonequivalent group’s design study. Because of this design researchers need help from the nursing officers. Nursing units were asked several times to change the rounding protocol to keep the sample stable (Meade, Bursell, Ketelsen , (2006). Data Collection Scheduled one-hour or two-hour rounds are the independent...
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...percentages of patients admitted, reported falling of at least once during an inpatient hospital stay period” (Oliver, Healey, & Haines, 2010). The author works at a city hospital located in Gilbert, Arizona and encounters a great amount of orthopedic patients along with other general surgery patients. All patients that are on that floor are at a risk of falls during the first 48 hours after surgery due to anesthesia that is still in the system and pain medication that is scheduled to help ease the patient during the post-surgical time frame. One of the side effects of anesthesia exiting the body is nausea and vomiting which can make the patient feel dizzy and lightheaded, thus making them a great risk for falls. This has been the reason that the topic was chosen; to attempt to improve this issue in the hospital setting and to provide a system in which all hospital staff collaborate to help increase the quality of patient care. The location that is being observed is the post-surgical/orthopedic floor where the author is currently working. A description of risks and concerns are provided and patient outcomes depend on implementing the proposed interventions. The two solutions that are presented are hourly rounding and the importance of an improved nurse call light button and education on proper usage. Each intervention is supported by evidence-based practice peer-reviewed journal articles. The proposal will show the improvements of patient safety and increased patient compliance to...
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... Use the two articles assigned by your facilitator to identify the following data collection, analysis, and measurement elements for the studies. Limit each box to no more than three sentences. | |Qualitative |Quantitative | | |Dance of the Call Bells |Effects of Nursing Rounds | |Data collection methods |The study used Ethnographic Methods to |The Quasi-Experimental Design was used over| | |examine problems related to answering |a 6-week period. A baseline data was taken | | |patients call lights on an inpatients unit.|during the first two weeks. An analysis was| | |The ethnographic methods of data collection|performed on data from 27 nursing units in | | |consist of five steps: mapping, |14 hospitals in which members of the | | |photography, observation, interviews, and |nursing staff performed rounds either at | | |analysis strategy phase. |one-hour or two-hour intervals. | |Data collection instruments |Maps were constructed showing the physical |Call light...
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...January 27, 2015 Professor Horton According to a recent survey, the quality of service of Davis Health Care needs improvement. Research suggests that patient safety measures like hourly rounding by nursing personnel positively impacts patient fall rates, call light usage and overall patient satisfaction (Olrich et al., 2012, p. 25). Patients are likely to recover and thrive in an environment where they know that they are being acknowledged, monitored and their concerns are being addressed. Health care facilities that have instituted hourly rounding, where nursing staff (e.g. registered nurses, licensed practical/vocational nurses and nurse aides) check in on the patients and inquire of the needs of patients on an hourly basis, have been faced with barriers prior to implementation. Many of the nursing staff would reluctant toward the idea of practicing hourly rounds as this is often perceived as time-consuming strategy. However, if we institute hourly rounding at Davis Health Care, we will notice remarkable improvement in our next survey scores. The Model for Evidence-Based Practice Change by Rosswurm and Larrabee (1999) suggests that the initial step is to search for where there is a need for change in the clinical setting. Once an improvement team (consisting of unit managers, nurse researchers, quality improvement nurses, a statistician, etc.) forms, we find ways to identify an improvement goal. Unstructured brainstorming allows the team to contribute ways in which to improve...
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...Applying the Ethics of Care to Your Nursing Practice “I feel the capacity to care is the thing which gives life its deepest significance.” Pablo Casals (2000) nurse’s caring consciousness and moral commitment to make an intentional connection with the patient. The third element, caring occasion/caring moment, is the space and time where the patient and nurse come together in a manner for caring to occur. U se of the theory of care ethics is discussed to help nurses determine if they are applying this theory effectively in their practice. After a basic definition of caring, including Watson’s caring theory, the evolution of the theory of ethics of care will be delineated briefly. A case will be used to illustrate Tronto’s (1993) four phases of caring and her four elements of care. Theory of the Ethics of Care Edwards (2009) described the evolution of the theory of ethics of care over the last 15 years in three versions. First, Gilligan (1982) began the discussion with a focus on the context of the situation versus impartial deliberation of the ethical issue. Impartial reflection is an element of justice-based moral deliberation and does not take into consideration the level of caring or closeness in the relationship. Gilligan was the first to move moral theorizing from a position where selves were seen as independent to a position where selves are interconnected and interdependent. Strangers would not receive the same level of caring as those for whom we experience a...
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...Chapter 33. Professional Communication and Team Collaboration Michelle O’Daniel, Alan H. Rosenstein Background In today’s health care system, delivery processes involve numerous interfaces and patient handoffs among multiple health care practitioners with varying levels of educational and occupational training. During the course of a 4-day hospital stay, a patient may interact with 50 different employees, including physicians, nurses, technicians, and others. Effective clinical practice thus involves many instances where critical information must be accurately communicated. Team collaboration is essential. When health care professionals are not communicating effectively, patient safety is at risk for several reasons: lack of critical information, misinterpretation of information, unclear orders over the telephone, and overlooked changes in status.1 Lack of communication creates situations where medical errors can occur. These errors have the potential to cause severe injury or unexpected patient death. Medical errors, especially those caused by a failure to communicate, are a pervasive problem in today’s health care organizations. According to the Joint Commission (formerly the Joint Commission on Accreditation of Healthcare Organizations, JCHAO), if medical errors appeared on the National Center for Health Statistic’s list of the top 10 causes of death in the United States, they would rank number 5—ahead of accidents, diabetes, and Alzheimer’s disease, as well as AIDS, breast...
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...Qual Vol. 27, No. 1, pp. 6–12 Copyright c 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Missed Nursing Care, Staffing, and Patient Falls Beatrice J. Kalisch, PhD, RN, FAAN; Dana Tschannen, PhD, RN; Kyung Hee Lee, MPH, RN Patient falls in hospitals continue to be a major and costly problem. This study tested the mediating effect of missed nursing care on the relationship of staffing levels (hours per patient day [HPPD]) and patient falls. The sample was 124 patient units in 11 hospitals. The HPPD was negatively associated with patient falls (r = − 0.36, P < .01), and missed nursing care was found to mediate the relationship between HPPD and patient falls. Key words: falls, missed nursing care, staffing P to 12% of hospitalized patients experience at least 1 fall during their hospital stay.1 A fall is defined as any event in which patients are found on the floor (observed or unobserved) or an unplanned lowering of the patient to the floor by staff or visitors.2 In 2008, and 2010, falls were identified as one of the top 10 sentinel event categories by the Joint Commission.3 Fall rates in hospitals range from 4 to 14 falls per 1000 patient days.4 With the adoption of the Centers of Medicare and Medicaid rule, which no longer reimburses hospitals at the higher diagnosis related group for the care and treatment associated with patient falls that occur during hospitalization, a clearer understanding of what factors U Author Affiliations: School of Nursing, University...
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...safe handover : safe patients guidance on clinical handover for clinicians and managers diSclaimer This publication has been produced as a service to ama members. although every care has been taken to ensure its accuracy, this publication can in no way be regarded as a substitute for professional legal or financial advice and no responsibility is accepted for any errors or omissions. The ama does not warrant the accuracy or currency of any information in this publication. The australian medical association limited disclaims liability for all loss, damage, or injury, financial or otherwise, suffered by any persons acting upon or relying on this publication or the information contained in it, whether resulting from its negligence or from the negligence of employees, agents or advisers or from any cause whatsoever. cOPyriGhT This publication is the copyright of the australian medical association limited. Other than for bona fide study or research purposes, reproduction of the whole or part of it is not permitted under the copyright act 1968, without the written permission of the australian medical association limited. safe handover : safe patients guidance on clinical handover for clinicians and managers PREPARED BY THE AUSTRALIAN MEDICAL ASSOCIATION LIMITED ABN: 37 008 426 793 2006 Adapted from the British Medical Association’s resource ‘Safe Handover: Safe Patients.’ Dr Mukesh Haikerwal President, Australian Medical Association Dr Geoff Dobb Chair, AMA Coordinating...
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...directly on the physical aspects of the body and treatments were rendered accordingly. Modalities of treatment in this era were based upon the part of the body that was not functioning properly and cured by medication or surgery (Koerner, 2011). For example, everyday people are newly diagnosed with hypertension. According to the Era 1 phase, the physician would simply give the patient a medication that would bring down the blood pressure without paying any attention to the patient’s thoughts and feelings about their illness and the different factors, internal or external, that may be influencing the body’s reaction to this particular disease. In today’s society, healing is provided based on the wholeness of a human being. Era III of Larry Dossey’s approach to medicine characterizes a new era of healing that focuses on a person’s mind, body, and spirit and their influential guidance of healing within ourselves and others. This era is known as the “nonlocal mind.” This modern developmental milestone in healthcare further encompasses the power of the conscious mind as a whole and it’s transcending effects on individual well-being, as well as the well-being of others. Era III is an illumination of connecting minds that unite as one. As humans, this gives us the ability to connect with others and share mutual life experiences, whether it be physically, mentally, emotionally, and/or spiritually. The divine connection of faith and healing has become an alternative approach...
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...peripheral nervous system. (Carolyn Jarvis, Physical Examination and Health Assessment, 3rd ed., pages 688-692 Structure and function of the CNS and PNS --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- Potter and Perry, Fundamentals of nursing (8th), Chapter 16 p. 210-211 Types of Data --There are two primary sources of data: subjective and objective. Subjective data are your patients’ verbal descriptions of their health problems. Only patients provide subjective data. For example, Mr. Jacobs's report of incision pain and his expression of concern about whether the pain means that he will not be able to go home as soon as he hoped are subjective findings. Subjective data usually include feelings, perceptions, and self-report of symptoms. Only patients provide subjective data relevant to their health condition. The data sometimes reflect physiological changes, which you further explore through objective data collection. --Objective data are observations or measurements of a patient's health status. Inspecting the condition of a surgical incision or wound, describing an observed behavior, and measuring blood pressure are examples of objective data. The measurement of objective data is based on an accepted standard such as the Fahrenheit or Celsius measure on a thermometer, inches or centimeters on a measuring...
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...Chapter 51. Enhancing Patient Safety in Nursing Education Through Patient Simulation Carol Fowler Durham, Kathryn R. Alden Background The alarming rise in morbidity and mortality among hospitalized patients throughout the United States heightens concerns about professional competency.1 Nurses and other health care professionals are under increased scrutiny to provide safe, effective care. Likewise, nursing education programs are faced with increased pressure to produce graduates who are capable of providing safe patient care. Toward that end, nursing education programs develop curricula, hire qualified faculty, and select learning experiences for students in an effort to train and graduate competent, effective nurses. The instructional strategies utilized in both didactic and clinical components of nursing education courses are highly influential in determining critical thinking and clinical decisionmaking ability as well as in developing the psychomotor skill performance of new graduates. Of course, it is unrealistic to think that graduates of nursing education programs have received all the training they need when they depart the doors of academia. Orientation programs for new graduates and continuing education for nurses are essential tools to help practitioners improve their knowledge, skills, and expertise so that quality patient care is provided and outcomes are optimized while errors are minimized. Ongoing evaluation of nursing competence is necessary...
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...Professional Presence & Influence Janene Mills Loga Western Governor's University Professional Presence and Influence C351 Professional Presence & Influence Introduction In these days of HCAHPS scores, and patient satisfaction being tied to reimbursement, it can be vitally important for the success of a healthcare facility, to have nurses who strive for quality relationships with their patients because this can influence the perception of the care received. A very important part of this is the professional presence the nurse conveys. A nurse’s professional presence is uniquely personalized; it is influenced by their own views on health and medicine, individual personality traits, how mindful they are in their practice, and in the type of healing environment in which they may be practicing. Professional Presence Models of Health and Healing Dr. Larry Dossey, MD describes his theory of Western Medicine as having three Eras’. (Dossey) Era One, which he states to have started in the 1860’s and continued to the 1940’s. Era Two, which he proposes to have begun in the post World War II period to recent times. Era Three is the most recent which he states is an emerging shift to a new focus which he calls “Transpersonal Medicine”. In Era One, Dr. Dossey describes the practice of medicine as being only physical in nature. He equates this era as focusing on the body and mind, and their functioning only in a physical way, not related to one another. He describes...
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...2009 Malcolm Baldrige National Quality Award Application TABLE OF CONTENTS Glossary of Terms and Abbreviations Organizational Profile i Responses Addressing All Criteria Items Category 1: Leadership 1 Category 2: Strategic Planning 6 Category 3: Customer Focus 10 Category 4: Measurement, Analysis, and Knowledge Management 14 Category 5: Workforce Focus 18 Category 6: Process Management 23 Category 7: Results 7.1: Best Quality (Healthcare Outcomes) 27 7.2: Best Customer Service (Customer Focused Outcomes) 32 7.3: Best Financial Performance & Growth (Financial & Market Outcomes) 35 7.4: Best People and Workplace (Workforce Focused Outcomes) 38 7.5: Best 5 Bs (Process Effectiveness Outcomes) 41 7.6: Best 5 Bs (Leadership Outcomes) 45 GLOSSARY OF TERMS AND ABBREVIATIONS APP: Annual Planning Process 5Bs: AtlantiCare’s five “Bests” or performance excellence commitments – Best People and Workplace, Best Quality, Best Customer Service, Best Financial Performance, Best Growth ARMC : AtlantiCare Regional Medical Center ASC: Ambulatory Surgery Center ASPP: Annual Strategic Planning Process A AAAHC: Accreditation Association for Ambulatory Health Care AAI: AtlantiCare Administrators Incorporated AAP: Annual Action Plan B BFP: Best Financial Performance Big Dots: The system-level measurements or targets for each of the 5 Bs (performance excellence commitments). Business units...
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