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A Nurse-Led QI Project to Reduce ED to ICU Transition Time

Countless studies conclude that the longer an admitted patient boards in an emergency department (ED) the greater the risk for negative outcomes such as falls and hospital-acquired conditions. ED patients waiting for admission to the intensive care unit (ICU) may be at the greatest risk, as they are categorized as critical.

Transporting critical patients from the ED to the ICU requires coordination of multiple clinicians from both units, which can lead to delays. Leading and managing these coordination efforts is a challenge. However we are optimistic as small tests of change have led us to advancements in the timeliness of ICU admissions and improvements in quality and safety.

-Jonathan Nover, MBA RN, senior director of nursing, Mount Sinai Queens

The Project

Geneline Barayuga, MSN RN

The ED and ICU teams at Mount Sinai Queens, a 165-bed hospital with 70,000 annual ED visits in Queens, New York, performed a quality improvement (QI) project by developing a collaborative approach between the ICU and ED charge nurses to reduce the median boarding time […]

2023-12-11T10:17:23-05:00December 11th, 2023|Nursing, Quality improvement|0 Comments
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Can Nursing Students Benefit from Using Artificial Intelligence?

A series of surprising developments including the release of generative chatbots like ChatGPT has rapidly increased awareness of the growing capabilities of artificial intelligence (AI), sending shock waves through the research, academic, and nursing education community. As a nurse educator, I initially became interested in the power of AI (in all its forms) to speed the research process and improve investigator workflows. Over time, it became evident that nursing students might benefit from AI in their study methods and when acquiring nursing knowledge to support their academic success.

Photo by John Schnobrich/Unsplash

To better understand this, it is helpful to consider the three fundamental stages in which nursing students acquire knowledge and explore how AI can play a pivotal role in each stage. This blog post will include an overview of AI-powered tools with example prompts to guide students’ academic efforts.

Preparation–Cognitive Stage

In this stage, nursing students are mastering knowledge foundational to nursing practice, including remembering and retaining facts and essential concepts. Students find themselves in this stage when they are learning new content. Open-access large language models (LLMs) in the form of chatbots can support students in this stage by providing concise summaries of pathophysiology, pharmacology, and disease management. AI can also serve as […]

2024-01-25T10:18:12-05:00November 15th, 2023|artificial intelligence (AI), Nursing, Technology|1 Comment
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Trust Your Gut: The Profound Implications of the Microbiome for Our Health

The transformative potential of the microbiome.

I’ve always considered the saying “trust your gut” to be a directive to respond to one’s innate instincts. However, as a gastroenterology clinical nurse specialist, I now recognize there can be a literal meaning to that phrase with the recent discovery of the microbiome and its implications for our health. The microbiome has yielded significant recent research discoveries for health promotion and has the potential to radically transform our diagnosis and management of disease and health disorders.

Microbiologists have actually suggested the microbiome be considered a human organ. Our CE article in AJN’s November issue, Current and Emerging Applications of Fecal Microbiota Transplantation, highlights how a disrupted microbiome, manifesting as Clostridium difficile (C. difficile) infection that is nonresponsive to first-line antibiotic treatment, can be effectively and quickly treated with transplantation of a diverse, microbiota-rich stool from a healthy donor.

But what is the microbiome?

The microbiome consists of the trillions of microorganisms that naturally live […]

2023-10-30T10:43:42-04:00October 30th, 2023|Nursing|0 Comments
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Minimum Nursing Home Staffing Standards: A Good Start, But Not Quite There

Jasmine Travers

The pandemic shone a troubling spotlight on the unnecessary suffering resulting from substandard conditions in nursing homes. On Sep 6, 2023, the Centers for Medicare and Medicaid Services (CMS) published a proposed rule for their widely anticipated minimum staffing requirements for long-term care facilities. A 2022 Nursing Home Staffing study that was convened to inform the development of these requirements followed an urgent plea from the Biden Administration and National Academies of Sciences, Engineering, and Medicine’s Committee on the Quality of Care in Nursing Homes for every nursing home to provide a sufficient number of staff so that the quality of care and safety in nursing homes might be addressed.

Tara Cortes

The proposed requirements.

An abundance of qualitative interviews, surveys, listening sessions, and comments from the public yielded the following staffing requirements:

  1. Minimum staffing hours per resident day (HPRD) for registered nurses (RNs)—0.55 HPRD—and nurse aides (NAs)—2.45 HPRD. Outside of these hours, sufficient additional nursing personnel, such […]
2023-10-19T10:05:15-04:00October 19th, 2023|Nursing, Nursing homes|1 Comment
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Navigating the Nursing Journey with Purpose

Nurses, what’s next?

As a labor and delivery nurse, I am part of one of life’s biggest moments for families I may never meet again. This calling requires a positive attitude and an ability to instill hope throughout each 12-hour shift. But at a certain point, I found myself feeling exhausted and disconnected from this work, and all my effort to maintain a cheerful demeanor and engagement only exacerbated the burnout. This toxic positivity, or pressure to exude optimism, had a pernicious effect on my well-being and I found myself at the polar opposite state from compassion.

I heard chatter in the break room and hallways from colleagues who were experiencing similar exhaustion, and although I was keenly aware of the tools and resources available from my organization—employee assistance programs, wellness calendars, etcetera—I didn’t know any nurses who used them, and I didn’t know how participating in these activities would alleviate my burnout.

Reconnecting to your purpose.

Photo by Heidi Fin on Unsplash

While pursuing my doctor of nursing practice degree, I began performing research on the impact of recognizing one’s purpose on job satisfaction and work engagement. Defining your purpose can be challenging. Simply saying “I am a labor and delivery nurse” doesn’t describe who I […]

2023-10-16T14:58:02-04:00October 16th, 2023|career, nursing career, wellness|2 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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