Occupational and Environmental Health Nursing Commons^™

The Effect Of Fall Prevention Programs With Hourly Rounding On Fall Rates Among Adults Patients In Neurological Unit, Oyinlola A. Ogundeji

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this QI project was to evaluate the effect of a structured hourly rounding program on patient fall rates in an adult neurological inpatient unit.

Background

Patient falls remain a major safety concern in acute care, particularly among hospitalized neurological patients with impairments in mobility, cognition, and balance. In an adult neurological unit within a Magnet-designated hospital, fall rates exceeded national benchmarks, underscoring the need for a targeted quality-improvement

Methodology

A pre–post QI design, guided by the Plan-Do-Study-Act framework, was implemented over 12 weeks in a 28-bed neurological unit. This intervention featured structured hourly rounding using the …

Effectively Addressing Hospital-Acquired Pressure Injuries With A Multidisciplinary Approach, Nicki Roderman, Shandlie Wilcox, Andrew Beal

HCA Healthcare Journal of Medicine

Background

Hospital-acquired pressure injuries (HAPIs) result in patient harm, discomfort, and even death, with an estimated 2.5 million HAPIs occurring annually in the United States. These pressure injuries from prolonged pressure on the skin and deeper tissues cause reduced blood flow and the breakdown of skin and tissues, resulting in wounds. Additionally, these injuries contribute to longer hospital stays and increased health care costs. Hospitals have programs aimed at reducing HAPIs as well as ongoing surveillance to identify new trends early on. This ongoing monitoring revealed a trend early at our institution that HAPIs were 66% higher than the national …

Central Line-Associated Bloodstream Infection Reduction In Hemodialysis Patients Across 9 Hospitals And 3 States, Nicki Roderman, Kasadi Moore, Shandlie Wilcox, Jennifer Jellerson, Zoey Bridges

HCA Healthcare Journal of Medicine

Background

This quality improvement project was initiated to reduce hospital-acquired catheter-associated bloodstream infections (CLABSI) in hospitalized patients receiving dialysis. A team dedicated to reducing hospital-acquired infections led the implementation of evidence-based interventions across all the included hospitals. This innovative approach demonstrated substantial enhancements in outcomes for patients on hemodialysis.

Methods

To enhance patient safety in patients receiving hemodialysis, new strategies were implemented, including (1) transitioning from a vendor model to an internal model, enabling dialysis program standardization, (2) empowering intensive care nurses with increased autonomy and ownership, (3) transitioning to a standardized dialysis machine, and (4) introducing chlorhexidine gluconate (CHG) …

Just Culture: It's More Than Policy, Linda Ann Paradiso, Nancy Sweeney

Publications and Research

Any healthcare organization’s top priority is effective and safe care. Despite this, medical error is the third-leading cause of death in the US. Hospitals are imperfect systems where nurses have competing demands and are forced to improvise and develop workarounds. Errors rarely occur in a vacuum, rather they’re a sequence of events with multiple opportunities for correction. Clinical nurses can have a significant impact on reducing errors due to their proximity to patients. When errors are identified, the events and impact on safe care need to be shared. Just culture is a safe haven that supports reporting. In a just …

Relationship Between Patient Safety Culture And Safety Outcome Measures Among Nurses, Jamie Kay Brown

Nursing Theses and Capstone Projects

Preventable errors in healthcare are a significant problem in today’s society, contributing to numerous adverse patient outcomes and even deaths on a daily basis. Identifying adverse outcomes is an imperative first step in creating a safer healthcare system, which can be followed by cause analyses and action plans to address systematic issues and improve process reliability. Despite the widespread use of voluntary reporting systems to identify adverse events, recent literature has found extreme limitations and severe underreporting with its use in healthcare facilities. A frequent theme in the literature implies that identifying reportable events and discouraging hesitation in reporting begins …

Relationship Between Psychotropic Drugs And Falls In The Geriatric Population, Lauren E. Fletcher Crotts

Nursing Theses and Capstone Projects

Falls in the geriatric population are extremely common and the risk for falls continues to increase with age. Falls are a leading cause of mortality in the geriatric population, and it is the number one reason for institutionalization in the United States. The purpose of this study was to explore the relationship of the prescribing effects of psychotropic medications such as antidepressants, benzodiazepines, and antipsychotics on falls in the geriatric population who live in a long term care community with a diagnosis of depression, dementia, anxiety, delirium, and Alzheimer's disease. The literature provided mixed conclusions on the effects of psychotropic …

Floating Nurses To Specialty Areas, Deborah S. Hickman

Nursing Theses and Capstone Projects

As the largest group of health care providers, nurses play a vital role in the safety and satisfaction of patients. Despite this vital role, the nursing shortage continues to grow. As a result of this shortage and to fix staffing insufficiencies, nurses are frequently assigned to work in an area that they are not familiar with. This reassignment of a nurse to a different unit from their normally assigned unit is referred to as "floating." Nurses that are reassigned to a different unit from their normally assigned unit are referred to as "float nurses." Some healthcare professionals believe the use …

Medication Safety: Improving Faculty Knowledge And Confidence, Sharon S. Cherry

Nursing Theses and Capstone Projects

The purpose of this capstone project was to increase knowledge and confidence among nursing faculty assisting pre-licensure nursing students with the medication administration process. The project administrator designed a one day Safe Medication Practices seminar that included a Medication Administration Toolkit to increase knowledge and confidence in faculty members about safety and efficiency in giving medications with multiple students on any clinical day. This toolkit included high-fidelity simulation medication scenario case examples as a teaching pedagogy, as well as other teaching strategies to utilize in the clinical environment. Bandura's Social Learning theory provided the framework for this capstone project. The …

Medication Errors: It's A Matter Of Time, Thomas D. Smith Jr.

Nursing Theses and Capstone Projects

A retrospective review of medication errors is presented as a measurement tool. Times of medication errors are separated into categories. The numbers of errors are associated with the numbers of medication administrations. The first data set contains errors that occurred within the first 8 hours of a 12-hour shift and the second data set contains errors that occurred during the last 4 hours of a 12-hour shift.

Data was obtained from a 108 bed critical care hospital in the southeastern United States. A time period will be reviewed between the months of September 2010 until August 2011. All reports of …

Evaluation Of Purposeful Rounding On Patient Falls, Stephanie Spittle

Nursing Theses and Capstone Projects

The purpose of this study was to evaluate the effectiveness of routine purposeful rounding on the total number of falls on a medical unit in an acute care hospital. The project was prompted by high fall rates within the hospital and the implementation of the purposeful rounding initiative. Staff training was provided in a two hour educational class which covered the purpose for the initiative as well as the specific functions that must be performed with each round. To evaluate the effectiveness of purposeful rounding on patient falls, pre and post rounding fall rates were compared. These initial results were …