Diabetic Ketoacidosis (DKA) Insulin Infusion Protocol Update Using Evidence-Based Practice: A Quality Improvement Project

Diabetic Ketoacidosis is a life-threatening side effect to Diabetes Mellitus. Standards of treatment and recommendations are made by the American Diabetes Association. The project was to evaluate and provide the latest evidence-based practice to update the hospital policy for the treatment of DKA in the Intensive Care Unit and Emergency Department. Retrospective chart reviews were conducted to review the number of patients admitted with diabetic ketoacidosis and treated on the DKA Insulin Infusion Protocol before and after the update. Rapid correction of blood glucose levels proved to be an issue at this facility both before and after the updates were made to the DKA Insulin Infusion Protocol. The data supports the need for change in protocol, staff development in the use of the protocol and the need for change in the emergency department as well as the intensive care unit

The Workforce Needs of New Jersey's Pharmaceutical and Medical Technology Industry

This report is based on an online survey conducted in spring 2006 of pharmaceutical and medical technology companies in New Jersey. It identifies the current and future workforce needs of the pharmaceutical and medical technology industry in New Jersey

Jefferson Review - Fall 2005

Contents 2 - Dean’s Column 3 - Spotlight on Faculty 4 - At the New Heart of Campus DEPARTMENTAL NEWS 7 - Bioscience Technologies 8 - General Studies 9 - Nursing 13 - Occupational Therapy 14 - Physical Therapy 14 - Radiologic Sciences 16 - OT, PT, RS: Exploring Cultural Contexts 17 - The Jefferson Foundation 18 - Events 19 - Admissions Office Moves to the Edison Lobby 20 - Class Notes 23 - JCHP Trains Jefferson Hospital Docs and Residents 24 - Bookshel

The Review - Fall 2001

IN THIS ISSUE 1 - Message From The Dean 2 - A Special Welcome for Alumni Babies 2 - A Very Special Offer for Our Alumni 3 - Farewell to Joann Ludwig 4 - The Admissions-Alumni Partnership 5 - JAVA is Brewing at Jefferson! 6 - What A Year! 8 - Alumni Update 10 - Alumni News Form 11 - Visiting Scholar 2001: A Nurse Alumna Sets the Agenda 12 - Michael Hartman Elected New CHP Alumni President 13 - Commencement 200

Building Excellence through Shared Governance and Continuous Process Improvement

Abstract Background: Nursing shared governance in the hospital setting is a well-established structure for shared decision-making between staff nurses and nurse leaders to improve nursing practice, quality of care, and patient safety. Establishing effective, shared governance can take several years: new skills must be acquired, new behaviors accepted, and new professional commitments made. Newcomers to shared governance require support, education, and the opportunity to acquire requisite skills; otherwise, interest, commitment, and achievement of desired outcomes cannot be sustained. Local Problem: A large hospital in California established a shared governance structure in 2018. Performance gaps between two high-performing Nursing Unit Councils (NUC) and the other 11 NUCs indicated the need for education and skill-building in performance improvement. Context: The sustainability of shared decision-making, nursing ownership of the practice, and nurse engagement in the organization would be threatened without an environment that supports and generates performance improvement. Interventions: Two comprehensive learning sessions, and a toolkit, introduced shared governance foundational components and a performance improvement framework to engage nurses in process improvement. Outcome Measures: The outcome measures were greater understanding of the IHI Model of Improvement, increased use of performance improvement methodology, and improved perception of shared governance. Results: Knowledge of performance improvement methodology and perceptions of shared governance improved in all focus areas. Familiarity with the IHI Model for Improvement increased by 29%, knowledge of SMART goals by 5%, and utilization of outcome measures by 47%. Staff nurse participation in the development and evaluation of policies rose 18%, staff nurses providing professional and educational programs increased 60%, and staff nurses\u27 access to nursing department goals and objectives improved 17%. Conclusion: Intentional education and development of nurses in performance improvement and shared governance yields mature shared decision-making and effective problem-solving. Keywords: shared governance, decision-making, nursing, performance improvemen

Patient Care Sitter Reduction and Fall Safety Improvement

The financial constraints imposed upon operational budgets by the frequent use of patient care sitters is well known among hospital leadership. Despite the high labor costs associated with direct and continuous observation, this intervention is routinely deployed by frontline care teams in an effort to preserve patients from harm, particularly from accidental falls. This reality creates an opportunity where significant budget savings can be achieved by supplanting the use of patient care sitters with more effective fall prevention strategies. This quality improvement (QI) project implemented a non-psychiatric sitter reduction and fall prevention initiative in two high volume adult acute care units. Through a collaborative process involving frontline staff, clinical subject matter experts, leadership stakeholders, and medical equipment vendor support, this project implemented a three-fold quality improvement effort including education, policy enhancement, and patient safety supply evaluation. This multi-tier engagement included a 60-day clinical evaluation of the program elements where sitter utilization, fall events, and falls with injury were compared to the organization’s historical performance. The project produced a 46% reduction in sitter utilization within the two trial units. Though fall outcomes were unaffected by this QI project, the initiative produced results commensurate with contemporary evidence that utilization of patient care sitters can be effectively reduced without risk to patient safety

Change Agent Impact on Pain Management Experience through Lavender Aromatherapy: Evidence-Based Practice Project

Inadequately controlled acute pain is a problem for hospitalized patients. Non-pharmacological pain management interventions (NPPMIs) are recommended but underutilized. Nurse-directed lavender aromatherapy is a feasible and effective NPPMI. Patients at a community hospital, including its surgical-orthopedic unit, reported lower patient pain management experience scores than the average score of Magnet Recognition status hospitals. The community hospital planned to improve pain management by implementing nurse-directed lavender aromatherapy. The purpose of this evidence-based practice project was to fortify the hospital’s nurse-directed lavender aromatherapy implementation with change agents. A logic model guided implementation. Project aims were to increase the surgical-orthopedic unit’s pain management experience scores and to offer nurse-directed lavender aromatherapy to all appropriate patients by close of the project. Change agents included a Doctor of Nursing Practice student and nurse pain champions. Interventions included Doctor of Nursing Practice student-led: (a) surgical-orthopedic unit Lunch & Learn presentations and Rounding for Results sessions and (b) implementation discussions with nurse pain champions from four units, including the surgical-orthopedic unit. Because of these interventions, surgical-orthopedic unit patient pain experience scores increased from 43rd percentile to 78th percentile. In five of six project weeks, all appropriate surgical-orthopedic unit patients were offered nurse-directed lavender aromatherapy. Adoption of the practice change was successful, but slower than anticipated because of slow adoption by the nurses. Nurse leaders responded to this slow adoption by adding additional change agent rounds. Logic model development and change agents are effective strategies for NPPMI implementation

A Primer for Work-Based Learning: How to Make a Job the Basis for a College Education

Provides an overview of the Jobs to Careers model, in which employers and colleges collaborate to embed curricula and training in the work process, as a way to meet healthcare labor force needs. Includes grantee profiles, lessons learned, and worksheets