Implementing a Tiered Pain Protocol in the Total Knee Arthroplasty Patient

Objective: Address the culture of pain management with physicians and nurses utilizing a tiered pain protocol in conjunction with non-pharmacological approaches to achieve improvement in pain satisfaction to a tolerable level.https://digitalcommons.centracare.com/nursing_posters/1044/thumbnail.jp

Comparison of Manual Versus Automated Data Collection Method for an Evidence-based Nursing Practice Study

OBJECTIVE: The objective of this study was to investigate and improve the use of automated data collection procedures for nursing research and quality assurance. METHODS: A descriptive, correlational study analyzed 44 orthopedic surgical patients who were part of an evidence-based practice (EBP) project examining post-operative oxygen therapy at a Midwestern hospital. The automation work attempted to replicate a manually-collected data set from the EBP project. RESULTS: Automation was successful in replicating data collection for study data elements that were available in the clinical data repository. The automation procedures identified 32 false negative patients who met the inclusion criteria described in the EBP project but were not selected during the manual data collection. Automating data collection for certain data elements, such as oxygen saturation, proved challenging because of workflow and practice variations and the reliance on disparate sources for data abstraction. Automation also revealed instances of human error including computational and transcription errors as well as incomplete selection of eligible patients. CONCLUSION: Automated data collection for analysis of nursing-specific phenomenon is potentially superior to manual data collection methods. Creation of automated reports and analysis may require initial up-front investment with collaboration between clinicians, researchers and information technology specialists who can manage the ambiguities and challenges of research and quality assurance work in healthcare

St. Cloud Hospital Hand Hygiene Achievers

Develop and adopt a culture change to increase hand hygiene compliance across all St. Cloud Hospital (SCH) inpatient and outpatient departments Hand hygiene is the best method to prevent the spread of infection (CDC, 2017). Historical data for SCH indicated below desired goal of 95% compliance with hand hygiene practices and continued identification of hospital associated infections. Employee engagement best achieved through promoting culture of safety supporting hand hygiene best practices (Piras et al., 2018). Educating staff on the WHO 5 Moments of Hand Hygiene, developing monitoring process for assessing opportunities to complete moments of hand hygiene, and providing detailed feedback can enhance results and improve culture (Haas, 2014). All staff survey identified best sources of performance feedback comes from peers and direct leadership.https://digitalcommons.centracare.com/nursing_posters/1115/thumbnail.jp

Innovative Use of EHR to Support Admission Screening for Emerging Pathogens

CentraCare hospitals were the first in Minnesota to identify a patient with Candida auris (C. auris), an emerging pathogen. 2018 Centers for Disease Control and Prevention (CDC) and state health department recommended adoption of enhanced admission screening process to allow for early identification of patients at risk of being colonized with C. auris/Carbapenem-Resistant Organisms (CROs). C. auris, a fungus, and CROs, comprised of organisms from the Enterobacteriaceae family resistant to carbapenems, are emerging multidrug resistant pathogens. Emphasis on identification and early isolation of at-risk patients decreases risk of transmission.https://digitalcommons.centracare.com/nursing_posters/1128/thumbnail.jp

Evaluating the Need for Routine Supplemental Oxygen in Postoperative Total Joint Replacement Patients

If you glance around the postanesthesia care unit (PACU), you will see the routine use of postoperative supplemental oxygen. Most postoperative recovery room and inpatient orthopaedic nurses continue the administration of supplemental oxygen after surgery regardless of whether or not the patient’s oxygen saturation (SpO2) readings are acceptable. However, administering oxygen may be falsely reassuring. This column presents an example of an evidence-based practice (EBP) project examining the effectiveness of the routine use of postoperative oxygen in total joint patients

User Assessment of a Specialized Health Portal PLIVAzdravlje

Pojavom interneta omogućen je razvoj novih metoda za suradnju i elektroničko komuniciranje bolesnika i liječnika. Time su bolesnici dobili aktivnu ulogu u očuvanju zdravlja i liječenju bolesti. Specijalizirani zdravstveni portal PLIVAzdravlje dostupan je na adresi www.plivazdravlje.hr i posjeduje međunarodni certifi kat za kvalitetu, pouzdanost i provjerenost informacija na medicinskim i zdravstvenim stranicama HON-Code (Health on the Net) Code of Conduct. Aktivan je od 2001. godine, dnevno u prosjeku bilježi između 5 000 i 6 000 posjeta i prvi je specijalizirani zdravstveni portal na hrvatskome jeziku. Za dobivanje detaljnijeg uvida u odnos korisnika prema portalu napravljeno je istraživanje o tome kako korisnici ocjenjuju pouzdanost i kvalitetu ponuđenih sadržaja, koje informacije najčešće traže i što bi još željeli naći na portalu. Istraživanje je napravljeno putem anonimne on-line ankete kojoj su ispitanici mogli pristupiti na portalu. Korisnici su anketirani na dobrovoljnoj bazi, uz prethodno ispunjavanje traženih sociodemografskih i obrazovnih podataka. Anketa je bila aktivna u prvom kvartalu 2005. godine, ispitivanje je trajalo 45 dana i ukupno su ispunjena 534 upitnika. Posjetitelji portala PLIVAzdravlje većinom su žene, u dobi od 15 do 55 godina, s rasponom obrazovanja od završene osnovne škole do završenog magisterija ili doktorata. Više od polovice korisnika traži razne vijesti iz područja medicine, gotovo polovica njih traži informacije o bolestima i simptomima bolesti, trećina o prehrani, a rjeđe se traže informacije o prevenciji bolesti i o seksualnosti. Većina ispitanika pronašla je tražene informacije na portalu PLIVAzdravlje, a pokazalo se da postoji želja posjetitelja da PLIVAzdravlje pruži više informacija o prevenciji bolesti, prehrani, lijekovima, seksualnosti i fi tnessu. Sva ponuđena obilježja zdravstvenog portala PLIVAzdravlje ocijenjena su visokim ocjenama. Činjenicom da posjetitelji znaju dobro procijeniti kvalitetu, pouzdanost, informativnost i aktualnost specijaliziranih zdravstvenih portala postavljeni su visoki standardi kod lansiranja novih stranica sličnog sadržaja na hrvatskome jeziku.The Internet enabled the development of new methods for cooperation and electronic communication between patients and physicians. Therefore, the patients took an active role in the preservation of health and treatment of diseases. Our specialized health portal www. plivazdravlje.hr has an international certifi cate of quality, reliability and credibility of information on health and medical Web sites, i.e. the HONcode (The Health on the Net Foundation Code of Conduct). It has been active since 2001 and the average daily visit count is between 5 000 and 6 000. It is the fi rst specialized health portal in the Croatian language. To assess user satisfaction, we conducted an on-line anonymous survey about the reliability and quality of provided information, most frequently browsed topics and other information our users would like to obtain on the portal. The survey was voluntary and the users only had to provide socio-demographic and educational information. The survey was active during the fi rst quarter of 2005, it lasted for 45 days and we received 534 completed questionnaires. The visitors of PLIVAzdravlje are mostly women aged between 15 and 55, with professional qualifi cations ranging from elementary school to master\u27s and doctoral degrees. More than half of our users search for news relating to medicine, almost half of them for information about diseases and symptoms, while one third are searching for information about nutrition. However, the information about the prevention of diseases and sexuality is searched less often. Most participants in our survey said that they had found the wanted information at PLIVAzdravlje. They said that they would also like to have more information about prevention, nutrition, medicines, sexuality and fi tness. All features of PLIVAzdravlje got high grades. The thorough user assessment of quality, reliability, information content and updating of information at specialized health portals set high standards for the launching of new web pages with similar contents in the Croatian language

Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia

Sarcopenia, the age-associated loss of skeletal muscle mass and function, has considerable societal consequences for the development of frailty, disability, and health care planning. A group of geriatricians and scientists from academia and industry met in Rome, Italy, on November 18, 2009, to arrive at a consensus definition of sarcopenia. The current consensus definition was approved unanimously by the meeting participants and is as follows: Sarcopenia is defined as the age-associated loss of skeletal muscle mass and function. The causes of sarcopenia are multifactorial and can include disuse, altered endocrine function, chronic diseases, inflammation, insulin resistance, and nutritional deficiencies. Although cachexia may be a component of sarcopenia, the 2 conditions are not the same. The diagnosis of sarcopenia should be considered in all older patients who present with observed declines in physical function, strength, or overall health. Sarcopenia should specifically be considered in patients who are bedridden, cannot independently rise from a chair, or who have a measured gait speed less that 1 m/s(-1). Patients who meet these criteria should further undergo body composition assessment using dual energy x-ray absorptiometry with sarcopenia being defined using currently validated definitions. A diagnosis of sarcopenia is consistent with a gait speed of less than 1 m\ub7s(-1) and an objectively measured low muscle mass (eg, appendicular mass relative to ht(2) that is 64 7.23 kg/m(2) in men and 64 5.67 kg/m(2) in women). Sarcopenia is a highly prevalent condition in older persons that leads to disability, hospitalization, and death