SEP-1: Early Management Bundle, Severe Sepsis/Septic Shock

To educate, monitor, and improve the sepsis core measure SEP-1 results required by CMS.https://digitalcommons.centracare.com/nursing_posters/1073/thumbnail.jp

Developing Cultural Competence

Caring for patients from many cultures is an important part of health care today. Why learn about cultural competencies? Because developing cultural competencies benefits everyone. You can: help patients receive more effective care; help your facility meet standards of The Joint Commission; and improve your job performance.https://digitalcommons.centracare.com/nursing_posters/1036/thumbnail.jp

Implementing the 2005 American Heart Association guidelines, including use of the impedance threshold device, improves hospital discharge rate after in-hospital cardiac arrest

OBJECTIVE: To determine the impact of the 2005 American Heart Association cardiopulmonary resuscitation (CPR) guidelines, including use of an impedance threshold device (ITD), on survival after in-hospital cardiac arrest. METHODS: Two community hospitals that tracked outcomes after in-hospital cardiac arrest pooled and compared their hospital discharge rate before and after implementing the 2005 American Heart Association CPR guidelines (including ITD) in standardized protocols. In CPR we used the proper ventilation rate, allowed full chest-wall recoil, conducted continuous CPR following intubation, and used an ITD. We compared historical control data from a 12-month period at St Cloud Hospital, St Cloud, Minnesota, to data from a subsequent 18-month intervention phase. We compared historical control data from a 12-month period at St Dominic Hospital, Jackson, Mississippi to a subsequent 12-month intervention phase. 507 patients received CPR during the study period. Patient age and sex were similar in the control and intervention groups. RESULTS: The combined hospital discharge rate for patients with an in-hospital cardiac arrest was 17.5% in the control group (n=246 patients), which is similar to the national average, versus 28% in the intervention group (n=261 patients) (P=.006, odds ratio 1.83, 95% CI 1.17-2.88). The greatest benefit of the intervention was in patients with an initial rhythm of pulseless electrical activity: 14.4% versus 29.7% (P=.014, odds ratio 2.50, 95% CI 1.15, 5.58). Neurological function (as measured with the Cerebral Performance Category scale) in survivors at hospital discharge was similar between the groups. CONCLUSIONS: Implementation of improved ways to increase circulation during CPR increased the in-hospital discharge rate by 60%, compared to historical controls in 2 community hospitals. These data demonstrate that immediate care with improved means to circulate blood during CPR significantly reduces hospital mortality from inhospital sudden cardiac arrest

Disinfection of Shared Mobile Phones Carried by Registered Nurses: A Comparison of Two Methods

This study determined the efficacy of cleaning products on mobile phones. Previous research has demonstrated the risk for bacterial cross contamination between healthcare workers\u27 hands, close contact equipment, and mobile communication devices. There is extensive literature on survival of organisms on inanimate objects. Mobile communication devices can act as a reservoir for bacteria associated with nosocomial infection. Additional studies show cross contamination between the healthcare workers hands, the mobile phones, and the patient.https://digitalcommons.centracare.com/nursing_posters/1025/thumbnail.jp

You Missed a Spot! Disinfecting Shared Mobile Phones

The use of portable mobile devices has facilitated timely communication among healthcare team members. It\u27s now a common practice for hospital-owned mobile phones to be shared among healthcare employees from shift to shift. Despite the benefit of increased, timely communication between caregivers, sharing mobile devices can lead to the spread of healthcare-associated infections (HAIs). This article looks at the efficacy of two types of cleaning products on shared mobile phones carried by RNs at a 489-bed, Magnet-designated, Midwestern regional medical center. The cleaning methods evaluated were 70% isopropyl alcohol wipes and ethyl alcohol wipes

Bacteria on Shared Mobile Phones Can Lead to Infections

It\u27s now a common practice for hospital-owned mobile phones to be shared among healthcare employees from shift to shift. Despite the benefit of increased, timely communication between caregivers, sharing mobile devices can lead to the spread of healthcare-associated infections (HAIs) if they aren\u27t properly disinfected. The Guidelines for Disinfection and Sterilization in Healthcare Facilities describe non-critical environmental surfaces as items that are frequently touched by the hand and may pose a risk of secondary infection transmission

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

Developing, Implementing, and Evaluating a Professional Practice Model

This article describes how The Compass, a professional practice model (PPM), was developed through clinical nurse involvement, review of literature, expert opinion, and an innovative schematic. Implementation was supported through a dynamic video account of a patient story, interwoven with The Compass. Postproject evaluation of PPM integration demonstrates opportunities for professional nursing development and future planning

Using Research to Determine Support for a Policy on Family Presence During Resuscitation

National guidelines and professional organizations have recommended allowing family presence during resuscitation and bedside invasive procedures. Studies found that only 5% of critical care units have written policies. Periodic requests by family members prompted the creation of a task force, including nurses, physicians, and respiratory therapists, to develop this controversial policy. Before development, a research study of healthcare personnel attitudes, concerns, and beliefs toward family presence during cardiopulmonary resuscitation and bedside invasive procedures was done. This descriptive and correlational study showed support for family presence by critical care and emergency department nurses. Findings revealed both support and non-support for families to be present during resuscitative efforts. Providing family presence as an option offers an opportunity for reluctant healthcare team members to refuse their presence and an opportunity for those who support family presence to welcome the famil

Evidence into Practice: Hospital and Academic Partnership Demonstrating Exemplary Professional Practice in EBP

EVIDENCE-BASED PRACTICE (EBP) is an integral part of current nursing practice. Innovative methods for eliminating sacred cows and promoting EBP are needed.1 One approach that can be beneficial is developing strategic partnerships between practice and academics.2-4 In a large Midwestern hospital, nurse leaders, clinical nurses, students, and affiliated faculty members of the Nursing Research and/or Evidence-Based (EBP) Committee work together to support the implementation of EBP projects. Through collaborative work, innovative EBP ideas are generated and incorporated into the committee\u27s annual work plan