A Nursing Conference Focused on Quality and Safety, and a Big ‘What If?’

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By Maureen ‘Shawn’ Kennedy, AJN editor-in-chief

“What would quality in hospitals look like if health care institutions were as single-minded about serving clients as the Disney organization?”

Last week I attended the 2015 American Nurses Association Quality Conference in Orlando. The conference, which had its origins in the annual National Database of Nursing Quality Indicators (NDNQI) conference, drew close to 1,000 attendees. Here’s a quick overview of hot topics and the keynote speech by the new Secretary of the Department of Veterans Affairs, plus a note on an issue crucial to health care quality that I wish I’d heard more about during the conference.

Most sessions presented quality improvement (QI) projects and many were well done. There were some topics I hadn’t seen covered all that much, such as reducing the discomfort of needlesticks, enhancing postop bowel recovery, and promoting sleep. But projects aimed at preventing central line infections, catheter-associated urinary tract infections (CAUTIs), and pressure ulcers ruled the sessions. These of course are among the hospital-associated conditions that might cause a hospital to be financially penalized by the Centers for Medicare and Medicaid Services (CMS). The ANA also had a couple of sessions on preventing CAUTIs by means of a tool it developed in the Partnership for Patients initiative of the CMS to reduce health care–associated infections.

The keynote by Robert McDonald, the fairly new Secretary […]

When Timely Nurse Removal of Urinary Catheters Reduces UTI Rate

By Christine Moffa, MS, RN, AJN clinical editor

Ever since we started the Cultivating Quality column at AJN, manuscripts featuring evidence-based quality improvement projects have been pouring in. There is a lot of great work being done at the bedside by practicing nurses, and this column provides the opportunity to share their ideas with others.

This month’s Cultivating Quality installment, Reducing Rates of Catheter-Associated Urinary Tract Infection, comes from Joyce Wenger, MS, RN, the infection control performance improvement coordinator at Lancaster General Hospital, Lancaster, PA. According to the CDC, urinary tract infections (UTIs) account for more than 30% of hospital-associated infections, and almost all are “caused by instrumentation of the urinary tract.” Nursing staff were able to reduce catheter-associated urinary tract infection (CAUTI) rates using a three-pronged approach “beginning with education, progressing to tests of new and better products, and ending with the nurse-driven protocol for catheter removal.”

That last part is my favorite. In most facilities a doctor or nurse practitioner has to write an order before a Foley catheter can be removed from a patient. Patients may end up spending several days at increased risk for UTI because of an unnecessary urinary catheter in place. This hospital came up with a plan to give nurses the autonomy to remove them—which makes sense, since they’re the ones checking the patient daily. The team at Lancaster General created the following list of criteria that patients need to meet in order to maintain […]

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