Quality improvement Archives

Ketamine as a Therapeutic Option, AI and Nurse Staffing, Naloxone Training, and Other March Issue Highlights

The March issue of AJN is now live.

Here are some highlights. Some articles are open access or temporarily free; others will require log-in for access.

In this month’s editorial, “A Turning Point in Psychiatry,” AJN‘s editor-in-chief Carl Kirton discusses key aspects of the current mental health crisis and explores whether a paradigm shift to more rapid treatment with drugs like ketamine and MDMA may be in sight for at least some percentage of those in need (the editorial is always free). Writes Kirton:

“The promise of ketamine therapy is not that it will ‘replace’ everything else, but that it may signal a broader turning point: psychiatry moving beyond slow-onset, monoamine-focused treatments toward interventions that target rapid symptom relief.”

In addition, the CE article (CE articles are free) in the March issue reviews current evidence on ketamine as a mental health treatment. Discussing the use of ketamine for treatment-resistant depression, the authors write:

This article provides “a foundation of clinical information that nurses should understand as they advise patients who are receiving or curious about ketamine” and discusses “the regulatory, ethical, and nursing implications of using ketamine in the treatment of mental health disorders.”

The Viewpoint in this issue, “

Jacob Molyneux, senior editor/blog editor2026-02-24T09:19:20-05:00February 24th, 2026|Nursing, Nursing education, nursing research, Quality improvement|0 Comments

Clarifying the DNP Role, Assessing Discharge Readiness: Highlights in our February Issue

The February issue of AJN is now live. Here are some highlights.

In this issue, a review article (CE credit available), “Nurses in the Fight to End Food Insecurity: An Integrative Review,” synthesizes and analyzes findings of nurse-involved studies that address food insecurity, identifying key interventions and outcomes across diverse health care and community settings.

Notably, there are a number of open access articles in this issue:

“Assessing Discharge Readiness and Influencing Factors Among Patients with Aortic Dissection: A Cross-Sectional Study” is an original research (and open access) article. The authors note that this study “revealed that patients with aortic dissection generally had discharge readiness scores at the lower end of the moderate range, indicating the need for improvement. It’s imperative that health care providers emphasize patient education prior to discharge and develop and implement personalized discharge plans.”

The second open access original research article in our February issue is “An Examination of Factors Affecting Bowel Preparation for Colonoscopy: A Meta-Analysis.” According to the authors, “Health care providers, including nurses, should consider these determinants of bowel preparation effectiveness and implement appropriate interventions in a timely manner to enhance patient education and care.”

Our […]

Jacob Molyneux, senior editor/blog editor2026-01-22T15:16:34-05:00January 22nd, 2026|Nursing, Nursing education, nursing research, Quality improvement|0 Comments

How Two ‘Sister Hospitals’ Achieved a Zero Vacancy Rate in the Emergency Departments

The Mount Sinai Morningside (MSM) and Mount Sinai West (MSW) hospitals are sister hospitals in a seven hospital enterprise in New York City. As with many hospitals and emergency departments (EDs), staffing levels have been a significant concern since the COVID-19 pandemic. In 2021 the national registered nurse (RN) turnover rate was 27.1%. This rate remains elevated, despite a decrease on a national level to 18.4% in 2023.

A story of progress and stability.

In 2021, the MSM ED had a turnover rate of 27% and MSW ED a turnover rate of 21%. These rates have since trended down, ending 2024 at MSM ED with a 12% turnover rate and MSW ED 7.25%. Today, in 2025, both sites are boasting zero vacancies. This is credited to strategic planning, talent development commitment, and strong partnerships.

A different approach to utilizing travel RNs.

MSM and MSW strategically utilized travel RNs to bridge staffing gaps. However, instead of viewing them as temporary fixes, leadership integrated them into the department culture, ensuring collaboration with permanent staff. A certain percentage of travel nurses ultimately converted to full-time roles, drawn by MSM and MSW ED’s supportive environment and strong team cohesion.

To help strengthen workplace loyalty, […]

Guest Author2025-03-17T10:00:25-04:00March 17th, 2025|nurse staffing, Nursing, Quality improvement|1 Comment

Why Nurses Assist Falling Patients Despite the Risk

A too-common scenario.

Joe opens his eyes and looks through the window of his hospital room. He has always been early to rise. Even at age 82, he can’t shake the habits he learned when he was young.

“I’m woozy again,” Joe thinks as he sits up in bed. His medication sometimes makes him feel that way. Joe presses the call light so a nurse can help him to the bathroom. The nurses have been reminding him to do that so he won’t fall.

Then he reconsiders. “I can make it on my own. I don’t want to bother the nurses. They need to help the patients who really need it.” Joe moves to the edge of his bed. His walker isn’t nearby, but he urgently needs to reach the bathroom. Still dizzy, Joe holds onto the bed for a moment to keep from falling forward. After a moment, he manages to stand up and walk to the bathroom. As he enters the room, his dizziness returns, and his legs suddenly feel weak. A feeling of dread washes over Joe as he begins to fall…

Nurse Smith starts her rounds and is looking forward to seeing Joe. He is always up early to greet her with a smile and a joke. As she opens the door to his room, she sees him entering his bathroom without his walker. She moves quickly toward him, but he suddenly sways forward. She knows he is going to fall. Reacting immediately, she grabs him by the torso […]

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Guest Author2024-02-20T10:44:39-05:00February 20th, 2024|Nursing, nursing research, patient safety, Quality improvement|1 Comment

Implementation Science: Systematic, Sustainable, Evidence-Based Change

By Cagkan/Adobe Stock

Reading the article by Russell-Babin and colleagues in the December 2023 issue of AJN made me grateful for all the work that went into developing the nursing implementation science (IS) program at Inova. As a nurse working at this health care system, I’d like to share how I benefited from being in the first cohort of nurses trained and engaged in IS over the last three years.

For the past eight years, I’ve been a clinical coordinator of two different disease-specific programs—first stroke and now sepsis. In these roles, I’ve been engaged in many different quality improvement (QI) projects and have become familiar with the tools and processes used to improve patient care and outcomes.

Towards more comprehensive and systematic evidence-based change.

However, as I was invited to step into the world of IS, I began to realize that a strict QI approach cannot alone bring about all the changes we desire within the complex systems of health care. The fact is that […]

Guest Author2024-01-11T10:06:42-05:00January 11th, 2024|Nursing, nursing roles, Quality improvement|1 Comment