Friday, July 30, 2010

Interrupting a Nurse Can Lead to Errors

In a new article in Pharmacy Practice News, "Unchaining Nurses From Drug Cabinets," Al Heller writes about efforts to prevent nurses from being interrupted as they administer medications.

"At South Jersey Healthcare (SJH), in Vineland, N.J., more than 95% of medications are stored in automated dispensing cabinets (ADCs) at patient care units. But to make the technology realize its potential, the hospital implemented a software system that has streamlined procedures, saved steps for nurses and leaves them less vulnerable to interruptions that could lead to potential medication administration errors."
Click here to access the full article.

INQRI researchers have addressed this important topic as well. A multi-disciplinary team at Rutgers University has identified changes in nursing care processes that are needed to prevent medication errors as well as adjustments in nurse staffing and the practice environment that are important to facilitate interception of such errors. This is the first study of its kind to show how predictive practice environments and nurse staffing levels are when it comes to medication errors. Preliminary findings reveal that there is a core cluster of nurse safety processes that are significantly associated with fewer medication errors. These include critical thinking and questioning, such as asking physicians to clarify or rewrite unclear orders, as well as independently reconciling patient medications and educating patients and families. This team also found that hospitals with supportive practice environments, including having front-line managers, allowing nurses to participate in organizational decisions, and having good collaborative relationships with physicians were key quality indicators. Finally, hospitals that had more RNs per patient were found to be places where nurses were more likely to engage in safer practices. The study also looked at the role of computerized physician order entry (CPOE). Findings reveal that full implementation of CPOE reduced medication errors significantly and is a predictor of fewer medication errors.

Click here to learn about other INQRI teams engaged in the process of preventing medication errors.

Thursday, July 29, 2010

New Resource from RWJF on Nursing Workforce

The Robert Wood Johnson Foundation's Human Capital portfolio has put together a new fact sheet and accompanying slideshow which provides a wealth of hard data on the nursing workforce.  The slides can be downloaded for use in your presentations and include the following information:
  • How many nurses are at work today and what their educational backgrounds are,
  • How diverse the nursing population is,
  • What the employment trends are,
  • How big the nursing gap will be in a few years, and more.
The fact sheet and slideshow will be updated periodically to incorporate new government employment data and projections.

Click here to access the fact sheet and slideshow.

Wednesday, July 28, 2010

Meet the Grantees

Are you interested in finding out more about INQRI's grantees?  Check out our selection of "Grantee Profiles" on the INQRI website to learn about our grantees' perceptions on the effect of nurse "presenteeism" on patient care quality, the effect of higher nurse staffing levels, the impact work environment has on NICU outcomes, methods for keeping patients safe and avoiding medication errors, and much more.

Tuesday, July 27, 2010

National Patient Safety Day

July 25 was National Patient Safety Day, a day to offer tribute to those who work tirelessly to prevent medical mistakes and a day to remember those who were lost due to mistakes that were not prevented.

Do you have a story to share about the importance of patient safety?  Or perhaps you could share with our readers how you commemorated the day.  Please comment below and share your thoughts.

In the meantime, check out a couple of sources:

Monday, July 26, 2010

Webinar: A New Way to Talk About the Social Determinants of Health

Tomorrow, July 27, is the last day to register for RWJF's upcoming webinar. The Robert Wood Johnson Foundation and Grantmakers in Health invite you to participate in this 90-minute webinar to share research and best practices in effective communication about the social determinants of health and the complex beliefs and conflicted values that come along with it. After four years of research, we now have a way to create more compelling, effective and persuasive messages that resonate across the political spectrum.

Scheduled for Thursday, July 29, 2010 at 3:00 p.m. (EST) / 2:00 p.m. (CST) / 1:00 p.m. (MST) / 12:00 noon (PST), this webinar will summarize research about this complicated aspect of health and share the most effective way to reach the widest audiences.

What you will learn:
• Better frames and messages for “social determinants”
• Best practices and principles in language
• How to use data to support your case
• Deeply held perspectives that affect how policymakers see health disparities

Panelists will include:
• Ann Christiano, Senior Communications Officer, RWJF
• Drew Westen, Ph.D., Professor in the Departments of Psychology and Psychiatry and Behavioral Sciences at Emory University.
• Elizabeth Carger, Senior Project Manager, Olson Zaltman Associates

Following the 60-minute presentation, all panelists will answer your questions during a 30-minute Q&A session.
The deadline to register for this event is tomorrow, Tuesday, July 27. All participants will also receive a copy of our new messaging guide on the social determinants of health. To register:
1. Go to http://rwjf.webex.com/rwjf/onstage/g.php?t=a&d=578090934.
2. Select Register.
3. On the registration form, enter your information and then select Submit.

To learn about Grantmakers in Health and fostering communication and collaboration among grantmakers, visit http://www.gih.org/.

Friday, July 23, 2010

What Do You Think Is the Biggest Healthcare Story of the Year?

Modern Healthcare recently published the results of a readers' poll which found that by far, most readers (56%) feel that the passing of the Patient Protection and Affordable Care Act was the biggest healthcare story of the first six months of 2010.

Click here to download a chart of the findings.

Click here to watch a video featuring Managing Editor Neil McLaughlin discussing three of the stories with the reporters who covered them.

Do you agree with the readers?  Comment below and tell us what you think.

Thursday, July 22, 2010

New Thoughts About Reducing Central Line Infections

Two articles came out last week discussing the challenges associated with reducing central line infections. In a piece for Health Leaders Media, Cheryl Clark wrote about a study of more than 2,000 health providers which found that just 3/10 hospital administrators are willing to spend the necessary funds to prevent catheter-related bloodstream infections. The study also found that less than 1/5 providers believe that their institutions have the capability to train staff in infection prevention strategies. For an article published in FierceHealthcare, author Sandra Yin quotes Peter Pronovost who suggests that pessimism is to blame for failure to prevent these infections. "By far, the biggest barrier is people just don't believe they can do it," he said.

Click here to read "Failure In Central Line Infection Prevention, Survey Says" on the Health Leaders Media website.

Click here to read "Pessimism about conquering infections is the biggest obstacle, Pronovost says" on the FierceHealthcare website.

Previous INQRI blog posts on this topic include:

Wednesday, July 21, 2010

"Nursing's Growing Role"

Health Leaders Media featured a fabulous new article last week by Rebecca Hendren, which discusses "Nursing's Growing Role," including as leaders at the bedside and in other clinical roles.
"As nurses break out of anachronistic models, the new focus is on nurse-led care delivery systems and harnessing the economic power of nursing."
Click here to read the article.

Tuesday, July 20, 2010

New Articles on the Impact of Nurse Staffing on Patient Care

Two new articles were recently published addressing the impact of nurse staffing on patient care.  The articles, "Using Clinical Data to Capture Nurse Workload: Implications for Staffing and Safety" and "Nurse Staffing and Post-Surgical Complications Using the Present on Admission Indicator" discuss very different staffing issues.

In the first piece, authors Marianne Baernholdt, Kathleen Cox and Ken Scully used a hospital clinical data repository to calculate workload measures and a unit activity index.  In the second article, authors Barbara Mark and David Harless evaluated the relationship between registered nurse staffing and six post-surgical complications.
Click here to access the Baernholdt-Cox-Scully article on the Computers, Informatics, Nursing website.
Click here to access the Mark-Harless article on the Research in Nursing and Health website.
INQRI has funded quite a few studies that discuss a variety of issues surrounding nurse staffing because we believe that nurses are leading efforts to understand what drives better nursing care to keep patients safe.
Click here to download a synthesis of our findings relating to nurse staffing and work environments.

Friday, July 16, 2010

Recap of the Donaghue Foundation's "Beyond Eureka!" Conference

Highlights from Donaghue's "Beyond Eureka!" conference held on April 21, 2010 are now available on the Donaghue website.

More than 350 conference attendees explored the theme of Why is getting healthy so hard? And what we can do about it with keynote speakers Dan Ariely, behavioral economist and bestselling author, and Val Curtis, cultural anthropologist from London School of Hygiene and Tropical Medicine and a founder of the Global Public-Private Partnership for Handwashing with Soap.

Click here to watch video clips and see photos from the event.


For more information about the Donaghue Foundation and past conferences please visit their website or email the Foundation at conference@donaghue.org.

***

On July 8 and 9, 2009, the Donaghue Foundation and the Robert Wood Johnson Foundation's Interdisciplinary Nursing Quality Research Initiative hosted a health funders forum in Princeton, NJ. For more information on this unique event, "Creating Opportunities and Breaking Down Barriers to Adoption," please contact Heather Kelley.

Thursday, July 15, 2010

The Importance of Physical Activity... and How Nurses Play a Key Role

In a new article in the American Journal of Nursing, authors Todd Ruppar and Vicki Conn present their findings from a meta-analysis designed to synthesize findings from 163 studies related to promoting physical activity in adults with chronic illness. They found that there are several interventions that effectively promote physical activity across a variety of patient populations.
"On average, intervention increased physical activity the equivalent of 945 steps per day, or 48 minutes of physical activity per week, per patient—an amount that's likely to be clinically important for sedentary, chronically ill adults. Among the numerous intervention attributes and practices, however, the effect on physical activity varied considerably. This article addresses the implications of these meta-analysis findings in order to provide nurses with reliable evidence supporting or negating the purported benefits of common strategies and practices used to promote physical activity among chronically ill adults."
Click here to read the article.

INQRI commends the authors on this important work. In fact, INQRI researchers at the University of Maryland are in the final stages of a randomized controlled trial to test a restorative care intervention for assisted living (AL). This project was designed to maintain or improve the residents' physical activity, physical status, function, and length of stay in the facility. The secondary aim related to residents focuses on mood, life satisfaction, resilience, self-efficacy and outcome expectations, social-support for exercise, and person-environment fit. The project incorporates patient centered outcomes (falls); nursing centered outcomes (restorative care services); and system-centered outcomes (staff turnover) as designated by the National Quality Forum. This team is co-led by Barbara Resnick, PhD, CRNP, a nurse researcher, and Sheryl Zimmerman, PhD, MSW, a social worker.

Click here to read the team's recent article from the May-June 2010 edition of Geriatric Nursing.

Wednesday, July 14, 2010

Call for Abstracts: 7th Annual National Patient Safety Conference

Call for Abstracts
Podium or Poster

7th Annual National Patient Safety Conference

November 18th & 19th, 2010 – Philadelphia, PA
Sponsored by the University of Pennsylvania School of Nursing

TRANSFORMING THE HEALTHCARE EXPERIENCE:
ADVANCING PATIENT & FAMILY CENTERED CARE

The aim of this year’s conference is to address the multi-faceted challenges, best practices and promising system changes that will provide participants a roadmap for the Design of a Patient and Family Centered Healthcare System. Presentations and discussions will focus on dissemination of evidence-based practices to assist health care providers and organizations to develop and implement successful and innovative strategies for addressing Patient and Family Centered Care. An overview of the new Joint Commission’s 2011 National Patient Safety Goal related to Patient and Family Centered Care will be discussed. The conference will provide a forum for health care professionals to exchange experiences and research related to goals of Patient and Family Centered Care, quality and patient safety. Poster sessions are intended to highlight the use of leading edge patient safety models as they support the National Patient Safety Goals.

Submission Deadline: September 15, 2010.

Program Contact: Janet Tomcavage at 215-898-4522 or tomcavag@nursing.upenn.edu.

Tuesday, July 13, 2010

INQRI Team Receives Funding from the Greenwall Foundation

Congratulations to our INQRI team at the University of Pittsburgh (Mary Beth Happ, Amber Barnato and team) who were recently awarded a grant from the Greenwall Foundation Kornfeld Program on Bioethics and Patient Care for a companion study to their INQRI project.

"SPEACS 2: Improving Patient Communication and Quality Outcomes in the ICU" is their INQRI-funded study, which examines the value of a nurse-generated and nurse-led innovation by testing the impact of a computer-based nurse communication training and materials program (SPEACS-2) on patient care outcomes: nursing care quality (coma-free days, physical restraint use, pain symptom management, pressure ulcers, patient/family satisfaction with communication), clinical outcomes(ventilator-free days, ICU/hospital days discharge disposition) and cost.

Their new grant from Greenwall will allow them to complete a new study: "Patient Participation in Treatment Decisions Before and After a Program to Facilitate Patient Communication in the ICU."  The overall goal of this project is to explore the participation of nonspeaking critically ill patients in decisions about life-sustaining treatment (LST) and the clinical ethical implications of such participation. This companion study provides a unique opportunity to illuminate potential changes and ethical considerations regarding patient self-determination through participation in LST decisions in the ICU.

Congratulations!

Monday, July 12, 2010

"A Legacy Lives On"

Nursing Spectrum recently profiled INQRI program director, Dr. Mary Naylor, as an exemplary nurse and legend in the profession for her work preparing for aging baby boomers.

Click here to read the profile, "A Legacy Lives On: Mary D. Naylor."

Friday, July 9, 2010

Nurses Can Tell Us What Goes Wrong "Off-Peak"

In the newest edition of Healthcare Risk Management, INQRI researcher Patti Hamilton was interviewed about her project, "The Effect of Off-peak Hospital Environments on Nurses' Work: an Institutional Ethnography." 

Research confirms that off-peak hours in health care facilities pose a higher risk of medical errors.  Hamilton's team believes that nurses can help us to understand what happens on off-peak shifts that may lead to negative patient outcomes. 
  • Although the newsletter does not go to print until July 20, you can download a preview copy here.
  • Hamilton was also recently interviewed about her work for an NPR affiliate in Quincy, Illinois.  Click here to listen in.
  • Click here to access the team's March 2010 article, "Expanding What We Know About Off-peak Mortality in Hospitals" on the Journal of Nursing Administration's website.
  • Click here to visit the team's website, featuring study findings, videos and more.

 

Thursday, July 8, 2010

Nurses on Twitter

Do you Tweet?

Of course, we all know about Twitter, the free online service that lets users post updates, or tweets, in text-based posts of up to 140 characters in length. These short messages are sent to other users who have subscribed, or "follow," the user.

Although Twitter is a fun way to learn about what your friends and family are up to in their daily lives, it's also a great way to find out what others are saying about current events and healthcare. If you are new to the medium and need to find some great people to follow, check out who INQRI is following by clicking here. Also, be sure to check out #RNChat, a weekly Twitter chat focused on all things nursing.

Are you following someone that we shouldn't miss? Leave a comment below.

Wednesday, July 7, 2010

Read Your Medication Labels

Michael Cohen of the Institute for Safe Medication Practices (ISMP) was a guest blogger today for the Philadelphia Inquirer, urging readers to "Avoid the ER, read your medication labels."  The INQRI program is strongly committed to reducing medication errors and we have worked with Cohen previously - as a participant in our Medication Management convening (co-sponsored with the Gordon and Betty Moore Foundation) and as a speaker during our subsequent webinar series.

Click here to read his blog post at Philly.com.
Click here to learn about the webinar that Cohen hosted with Susan Paparella from ISMP.
Click here to learn about INQRI's focus on preventing medication errors.

Tuesday, July 6, 2010

RWJF on Building the Capacity of Nursing Education

The Robert Wood Johnson Foundation's latest edition of "Charting Nursing's Future" is a policy brief focusing on building nursing education capacity.

Check it out here.

Thursday, July 1, 2010

AcademyHealth ARM 2010 Materials Now Available

If you missed AcademyHealth's Annual Research Meeting this week (or just want to go back and download all of those INQRI grantee presentations), check out the materials which are now available online:

All session slides are available for download.

Plus, check out the daily summaries, which highlight key events during the conference:

Sunday, June 27
Monday, June 28