Nursing Archives - Page 296 of 406

A QI Project to Increase Nurses’ Use of ‘Smart’ Pump Libraries

By Sylvia Foley, AJN senior editor

In January 2009 an independent community hospital in Massachusetts switched from using older, outmoded IV pumps to using “smart” pumps—pumps that have built-in computers with libraries of information on selected drugs and fluids, including predetermined concentrations and volumes with relevant administration limits. Library subsets (called profiles) contain information specific to certain patient populations or care areas. When properly implemented, these devices can be invaluable tools in reducing the risk of medication errors and improving patient safety.

But when the hospital conducted a review, it found that smart pump libraries had been used in only 37% of all smart pump infusions done between January and June. One reason was that no “owner” had been assigned to oversee the implementation process. So the hospital’s nursing quality team (NQT) and pharmacy quality team began collaborating to find ways to increase nurses’ use of the pump libraries.

From July through October 2009 the NQT implemented several interventions. Author Andrew D. Harding describes the project as it evolved and reports on the results in this January CE feature, “Increasing the Use of ‘Smart’ Pump Libraries by Nurses: A Continuous Quality Improvement Project.” […]

Guest Author2016-11-21T13:10:50-05:00February 1st, 2012|nursing perspective|1 Comment

Clinic Vision

By Marcy Phipps, RN, a regular contributor to this blog. Her essay, “The Soul on the Head of a Pin,” was published in the May 2010 issue of AJN.

By Ctd 2005, via Flickr

I’ve begun volunteering at a local free clinic. While it’s been rewarding and satisfying, it’s also been fraught with challenges I didn’t expect; I’ve only worked in an ICU, and the assessment skills specific to critical care don’t translate smoothly to the clinic setting. I’m out of my professional comfort zone, and I feel so inexperienced.

Here’s what I’m used to: By the time a patient is admitted to the ICU, they’ve already been “worked up” in the emergency room. Physicians have been assigned and a preliminary diagnosis is in place. The patients are connected to equipment that displays their vital data continuously, on monitors I can see from almost anywhere, and alarms are triggered by any alterations. I’ve got easy access to radiology reports and films, laboratory values, and microbiology reports. The nursing physical assessment is thorough and paramount; I know what I’m looking for, what I’m listening and feeling for, what certain smells indicate, and I trust my instincts. I’m accustomed to not only the forced intimacy that comes with the in-depth physical assessments of critical care, but the technology and data that supplement my assessments, as well.

At the clinic my nursing role is quite different. I sit at a desk. I am […]

Marcy Phipps, BSN, RN, CCRN, CFRN2016-11-21T13:10:52-05:00January 26th, 2012|nursing perspective, Patients, Public health|2 Comments

Magnet Hospitals: It’s About the Process, Not the Designation

By Shawn Kennedy, AJN editor-in-chief

When I had a recent medical emergency, I went to the local community hospital near my home in northern New Jersey. I had been there before for outpatient testing or to the ER with a child and found the care attentive and efficient and the staff friendly and professional. Besides, it was a Magnet-designated hospital, so I was confident that I’d receive good care.

The ancillary staff was wonderful, but I found myself disappointed with the nurses on the acute med/surg unit where I was located. There was no rounding that I was aware of, and they seemed to only show up when it was time to administer meds. Only a few nurses introduced themselves, and only two nurses over three days really engaged me in any conversation. Nurses seemed to respond to call lights only for those patients to whom they were assigned. The unit clerk who promptly answered the call light intercom would say, “I’ll let your nurse know and she’ll be in soon”—when I asked for pain medication, she told me “your nurse is giving report; I’ll let her know when she’s finished.” I waited uncomfortably for more than half an hour.

There were whiteboards, but often the information—especially regarding the date and the name of the nurse—was unchanged from day to […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:10:53-05:00January 23rd, 2012|nursing perspective|6 Comments

Remembering the Big Picture, Hypothermia, Nursing Books of the Year

From its earliest beginnings, nursing has embraced a holistic view of health. What we eat, the environments in which we work and live, our social relationships—all these influence health. Yet, as nurses, many of us shy away from looking at the big picture; instead we narrow our focus, addressing only the immediate problems of this patient, this family. It’s true that many patients treated in hospitals or outpatient clinics are there only for a short time. But how will such patients and their families fare in the long run if they lack access to public transportation to get to their follow-up appointments? How can patients recover from illness when they must choose between paying the mortgage and filling prescriptions?

That’s an excerpt from “Voices Rising,” the editorial in the January issue of AJN by Shawn Kennedy, editor-in-chief. We hope you’ll take a moment to read the whole thing and give it some thought.

Also in the January issue, you’ll find plenty of reading suggestions in the AJN 2011 Book of the Year Awards; a CE on the causes, diagnosis, and management of hypothermia; and a great deal more, including a feature, “Cardiac Catheterization Through the Radial Artery,” that advocates the use of the transradial artery rather than the femoral artery for cardiac catheterization in certain situations.—JM, senior editor

Jacob Molyneux, senior editor/blog editor2016-11-21T13:10:54-05:00January 20th, 2012|Nursing|1 Comment

Poll: What Can We Actually Do About Hospital Room Noise?

: By ArtsieApsie, via Flickr

Fierce Healthcare reports this week on the latest findings about hospital room noise: “hospital rooms can be as noisy as chainsaws, according to a new study [subscription required] published this week in the Archives of Internal Medicine….The average noise level in patient rooms was close to 50 decibels….The noise disruptions mostly come from staff conversation, roommates, alarms, intercoms and pagers….Loud hospital rooms are associated with clinically significant sleep loss among patients and even may hinder recovery.”

So, nurses (and patients, MDs, others): can anything be done about this? Does your hospital do anything? Take our poll, and also of course feel free to leave a comment on this post.—JM, senior editor

[polldaddy poll=5850198]