Wednesday, September 15, 2010

Day 1 is Over (That was Fast!)

Time flies with so many amazing presentations!

Thanks to the remaining members of Cohort 3 who presented findings this afternoon:

Nancy Donaldson and Carolyn Aydin examined the impact of: unit level nurse workload, staff nurse characteristics, selected risk assessment practices and preventive intervention processes of care on patient outcomes.  They found that unit and patient characteristics and workload can prevent medication errors.  They also noted that microsystem evidence suggested an association between hospital acquired pressure ulcers and rate of falls, suggesting that perhaps they witnessed a "culture of safety" factor.

Barbara Resnick and Sheryl Zimmerman tested the implementation of a function focused nursing approach to improve the quality of care provided to residents in assisted living communities.  They found that direct care workers and residents both embraced the function focused care and that despite fears of injury, there were no adverse events (deaths, falls) experienced in their intervention.  In fact, they found a significant decrease in hospital transfers of enrolled residents paired with improved balance and improvements in walking 50 feet.

Joanne Disch and Doug Wholey presented on their project which was designed to characterize nurse-physician co-leadership of heart failure care in the VA.  They noted that heart failure care is about more than routines and processes - it involves effective teamwork.  They found that teamwork effects readmissions through its effect on being prepared to provide individual care and that nurse-physician co-leadership improves teamwork.

Cindy Corbett and Stephen Setter presented on their work to empower home care nurses to efficiently resolve medication discrepancies.  In their work, they found that nurses resolved about 93% of the discrepancies they identified.  The pharmacists found twice as many discrepancies, but only resolved half of them. 

Ciaran Phibbs and Pat Stone discussed the impacts of nurse staffing, skill mix and experience on quality and costs in long term care.  They found that having more RNs, more LPNs and more stable staffing are all correlated with lower readmissions. Also, the number of nursing hours, skills mix, tenure and contract affect quality of care.

Sue Letvak and Sat Gupta presented on their team's project to determine the prevalence of nurse presenteeism (working when sick) due to muscoskeletal pain and depression and its impact on quality of care and costs.  The results were staggering - 18% of interviewed nurses reported some depression (compared to a national average of 9%), 70% reported pain and 61% reported presenteeism.  They found that the number of patient falls and medication errors both increased by about 18% with each unit of presenteeism score.  Additionally, there were significant cost losses due to productivity reduction, reduction in quality of care, increased fall and medication errors.

As you can tell, we had quite the day... and there is much more to come tomorrow!

Check back for updates and be sure to follow us via Twitter using hashtag #INQRI2010.

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