Central line-associated bloodstream infections (CLABSIs) result in approximately 28,000 deaths and $2.3 billion added costs to the U.S. healthcare system each year, yet, many of these are preventable. At two large health systems southeast United States, CLABSIs continue be an area opportunity. Despite strong evidence for interventions prevent CLABSI reduce associated patient harm, such as use chlorhexidine gluconate (CHG) bathing, adoption practice is poor. The primary objective this study...

Reynolds, Staci S. PhD, RN, ACNS-BC, CPHQ, FAAN; Blackwood, Elizabeth R. MSLS Author Information

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ABSTRACT Background: Nurses play an integral part in providing evidence-based care to patients with stroke, yet some receive unnecessary or even harmful care. The literature supports the use of multifaceted strategies promote implementation practice; however, there is a gap knowing which combinations are most successful. Purpose: purpose this study was determine if tailored, Stroke Competency Program would improve nurses’ knowledge and adherence practices stroke. This program bundled local...

Abstract Objective: Urine cultures collected from catheterized patients have a high likelihood of false-positive results due to colonization. We examined the impact clinical decision support (CDS) tool that includes catheter information on test utilization and patient-level outcomes. Methods: This before-and-after intervention study was conducted at 3 hospitals in North Carolina. In March 2021, CDS incorporated into urine-culture order entry electronic health record, providing education...

Introduction Quantitative research and quality improvement (QI) both seek to improve care provided patients. However, clinicians often blur the lines between how appropriately analyze data from these methodologies. Clinicians may inappropriately use statistical analyses for QI initiatives, rather than using run process control (SPC) charts improvements in outcomes. Objective The purpose of this article was address analytic methods used initiatives clinical setting an effort show identify...

Seizure action plans (SAPs) provide valuable information for patients to manage seizure emergencies, but are underutilized in adult epilepsy centers. The purpose of this project was implement a structured SAP with epilepsy.

Background: Optimal quality improvement in health care is based on research and other types of evidence. Critical appraisal evidence a fundamental component evidence-based practice (EBP) also needed to evaluate the (QI) projects. Problem: Currently available EBP or QI critical tools can be challenging for students learning process practicing clinicians who desire access standardized EBPQI approach inform decision-making. The currently are incomplete, too brief, complicated ease use education...

Evidence supports daily bathing using chlorhexidine gluconate (CHG) cloths to decrease preventable hospital-acquired central line-associated bloodstream infections (CLABSIs). However, implementation of this practice is inconsistent. Using multifaceted strategies promote supported in the literature, yet there a gap knowing which are most successful.Using Grol and Wensing Model Implementation as guide, purpose study was determine whether tailored, would improve CHG CLABSIs large neuro ICU.An...

BACKGROUND: Ischemic stroke continues to be a leading cause of serious disability within the United States, affecting 795 000 people annually. Approximately 12% 21% post-ischemic patients will readmitted hospital 30 days discharge. Studies suggest that implementation follow-up appointment 7 14 discharge improves 30-day readmission rates; however, these guidelines is uncommon, and visits recommended window are not often achieved. The purpose this project was evaluate impact an advanced...

Abstract Our surveys of nurses modeled after the Capability, Opportunity, and Motivation Model Behavior (COM-B model) revealed that opportunity motivation factors heavily influence urine-culture practices (behavior), in addition to knowledge (capability). Understanding these barriers is a critical step towards implementing targeted interventions improving practices.

The purpose of this study was to examine the impact nurse staffing on inpatient falls performance across a multi-hospital system.Evidence support which variables influence fall so that health care organizations can better allocate resources is lacking.A descriptive design used analyse and performance, with units dichotomized as either high or low performing based national benchmarking data. evaluated using 10 variables.A total nine were included (five four performing). Higher showed less use...

Clinicians are often familiar with quality improvement (QI) and evidence-based practice (EBP) processes, which provides guidance into what evidence should be implemented; however, these processes do not address how to successfully implement evidence.Clinicians would benefit from a deeper understanding of implementation science, along practical tools for use principles in QI EBP projects.We provide brief background the an overview current science models toolkit facilitate choosing using...

Expedited implementation of evidence into practice and policymaking is critical to ensure the delivery effective care improve health-care outcomes. Implementation science deals with designing methods strategies for increasing facilitating uptake policymaking. Nevertheless, process selecting implementing complicated because complexity settings where desired. Artificial intelligence (AI) has revolutionized a range fields, including genomics, education, drug trials, research, health care. This...

Clostridioides difficile (C. diff) infection causes significant morbidity for hospitalized patients. A large medical intensive care unit had an increase in C. diff rates.

ABSTRACT Background: Quality improvement (QI) initiatives help ensure patients are receiving high-quality care. Iterative Plan-Do-Study-Act (PDSA) cycles used to test change. Data evaluated over time, and tests of change can be modified or discarded as needed. Problem: Health care QI teams lack the flexibility conduct PDSA cycles, often conducting pre/post quasi-experimental research studies instead. Approach: This article reviews a case study “personal improvement” initiative an example...

The purpose of this study was to evaluate a bundle implementation strategies (local opinion leaders, printed educational materials, and outreach) increase neurocritical care nurses' knowledge adherence spinal cord injury guidelines.A preprogram, postprogram, follow-up design used outcomes.Adherence measured via self-reported anticipatory adherence; by an author-developed assessment. Repeated-measures ANOVA for data analysis.Improvements in nursing were found from preprogram postprogram time...

Background Prolonged duration of mechanical ventilation is associated with higher mortality and increased patient complications; conventional physician-directed weaning methods are highly variable permit significant time that inefficient ineffective. Objectives The primary objective this quality improvement project was to implement a registered nurse (RN)– respiratory therapist (RT)-driven protocol in medical intensive care unit (ICU) at tertiary academic center. Methods This used...