scholarly journals Changing Behavior among Nurses to Track Indwelling Urinary Catheters in Hospitalized Patients

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Bona Yoon ◽  
Samantha D. McIntosh ◽  
Leslie Rodriguez ◽  
Alma Holley ◽  
Charles J. Faselis ◽  
...  
Keyword(s):  
Large Scale ◽  
Hospital Setting ◽  
Interdisciplinary Team ◽  
Hospitalized Patients ◽  
Learning Objectives ◽  
Small Scale ◽  
Urinary Catheters ◽  
First Line ◽  
Healthcare Interventions ◽  
Tract Infections

Catheter-associated urinary tract infections (CAUTIs) are preventable complications of hospitalization. An interdisciplinary team developed a curriculum to increase awareness of the presence of indwelling urinary catheters (IUCs) in hospitalized patients, addressed practical, primarily nurse-controlled inpatient risk-reduction interventions, and promoted the use of the IUC labels (“tags”). Five thirty-minute educational sessions were cycled over three daily nursing shifts on two inpatient medical floors over a 1-year period; participants were surveyed(n=152)to elicit feedback and provide real-time insight on the learning objectives. Nurse self-reported IUC tagging was early and sustained; after the IUC tag was introduced, there was a significant increase in tagging reported by the end of the block of educational sessions (from 46.2% to 84.6%,P=0.001). Early engagement combined with a targeted educational initiative led to increased knowledge, changes in behavior, and renewed CAUTI awareness in hospitalized patients with IUCs. The processes employed in this small-scale project can be applied to broader, hospitalwide initiatives and to large-scale initiatives for healthcare interventions. As first-line providers with responsibility for the placement and daily maintenance of IUCs, nurses are ideally positioned to implement efforts addressing CAUTIs in the hospital setting.

scholarly journals 1157. GET IT OUT! Nurses and Clinical Quality Improvement Specialists Drive Initiative to Reduce Standardized Utilization Ratios for Indwelling Urinary Catheters in Hospitalized Patients

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S413-S414
Author(s):  
Aldo Martinez ◽  
Deborah Parilla ◽  
Melissa Green ◽  
Anne Murphy ◽  
Sylvia Suarez-Ponce ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Urinary Tract ◽  
Night Shift ◽  
Healthcare Research ◽  
Hospitalized Patients ◽  
Urinary Catheters ◽  
Clinical Quality ◽  
Tract Infections ◽  
Clinical Quality Improvement ◽  
Critical Reviews

Abstract Background Urinary tract infections (UTIs) account for 34% of all healthcare-associated infections (HAI). Urinary catheters (UC) are placed in 15–25% of hospitalized patients and >75% of HAI UTIs are UC-related. Bacteria introduced via UC can colonize the bladder within 3 days. So, the greatest risk factor for acquiring a catheter-associated urinary tract infection (CAUTI) is prolonged use of indwelling UC. Nursing (RN) staff noted inconsistency with appropriate use of UC and commonly UC remained in place well after their original indication had expired. Methods As part of a multi-faceted approach for quality improvement and patient safety, we rolled out an Agency for Healthcare Research and Quality (AHRQ)-based initiative to reduce UC days/Standardized Utilization Ratio (SUR). Daily critical reviews of the indication for UC were conducted by two groups. First, frontline night shift RN staff identified patients who no longer had a valid justification for continued UC. They handed-off the information to day-shift RNs, who recommend removal of UC during daily rounds with the physician teams. A second review was performed by Clinical Quality Improvement Specialists (CQIS) based on defined criteria from our nursing decatheterization protocol. Their discontinue UC recommendations were also sent to the care teams. The critical reviews of UC for CAUTI reduction started with 4 ICUs in August 2018, with additional ICUs added in December, January and March. Monthly UC SURs were tracked Results Figure 1 shows the number of UCs recommended for removal by RNs vs. CQIS (bars), as well as the percent discordance between RNs and CQIS (line). CQIS identified many more removable UCs than the RNs (888 vs. 256). 211 UC were removed after RN recommendations, and an additional 386 UCs were removed as a result of the CQIS audits. Figure 2 shows the marked corresponding decline in our SUR over this intervention. Conclusion As more units participated in the initiative, we saw increasing numbers of “discontinue UC” recommendations. Over time there was also a moderate decrease in the discordance between RN and CQIS recommendations for UC removal. CQIS routinely identified many more UCs to be removed compared with RNs, and more than doubled the number of discontinued UC. Notably, the UC SUR markedly improved, decreasing from 0.98 to 0.78. Disclosures All authors: No reported disclosures.

scholarly journals Analysis of the composition of hospitalized patients with the new coronavirus infection COVID-19

2021 ◽  
Vol 65 (3) ◽  
pp. 183-190
Author(s):  
Igor S. Kitsul ◽  
Valery I. Vechorko ◽  
Dmitry V. Kats ◽  
Dmitry A. Sychev
Keyword(s):  
Medical Care ◽  
Prognostic Value ◽  
Large Scale ◽  
Age Groups ◽  
Hospital Setting ◽  
Hospitalized Patients ◽  
Point Of View ◽  
Coronavirus Infection ◽  
Almost All ◽  
First Time

Introduction. In the context of the growing epidemic of the new coronavirus infection COVID-19, the Russian health system, for the first time in recent history, faced the need for large-scale mobilization and conversion of many existing hospitals into infectious diseases hospitals. At the same time, the composition of hospitalized patients has not been studied, and the availability of data on it is crucial for the organization and planning of medical care. Purpose of study. To study the composition of hospitalized patients with a new coronavirus infection COVID-19 from the point of view of their age, gender, the severity of the condition, the presence of pneumonia and concomitant diseases to optimize the planning and objectification of the assessment of the need for medical care in a hospital setting. Material and methods. The data was studied, and the analysis of hospitalizations of 1037 patients in the country’s largest repurposed infectious hospital for the treatment of patients with the new coronavirus infection COVID-19 was carried out. Results. For the first time analyzed the main regularities of the formation of hospitalized patients, which characterize features of the disease and have a high prognostic value both from the point of view of organization of specialized medical care in stationary conditions and assess the need for diagnostic and diagnostic and treatment activities and their resource provision. It is established that adult patients of almost all age groups receive medical care in a hospital setting, but as the age increases, the need for hospitalization tends to increase. Conclusions. The severity of hospitalized patients with COVID-19 is determined by their age and the presence of concomitant pathology, which is of important prognostic value from the point of view of optimal planning of this type of medical care.

scholarly journals Reducing urinary catheter use using an electronic reminder system in hospitalized patients: A randomized stepped-wedge trial

2019 ◽  
Vol 40 (4) ◽  
pp. 427-431 ◽  
Author(s):  
Brett G. Mitchell ◽  
Maria Northcote ◽  
Allen C. Cheng ◽  
Oyebola Fasugba ◽  
Philip L. Russo ◽  
...  
Keyword(s):  
Focus Group ◽  
Urinary Catheter ◽  
Hospital Setting ◽  
Hospitalized Patients ◽  
Ease Of Use ◽  
Cox Proportional Hazards Model ◽  
Urinary Catheters ◽  
Electronic Reminder ◽  
Reminder System ◽  
The Mean

AbstractObjective:To determine the effectiveness and ease of use of an electronic reminder device in reducing urinary catheterization duration.Design:A randomized controlled trial with a cross-sectional anonymous online survey and focus group.Setting:Ten wards in an Australian hospital.Participants:All hospitalized patients with a urinary catheter.Intervention:An electronic reminder system, the CATH TAG, applied to urinary catheter bags to prompt removal of urinary catheters.Outcomes:Catheterization duration and perceptions of nurses about the ease of use.Methods:A Cox proportional hazards model was used to assess the rate of removal of catheters. A phenomenological approach underpinned data collection and analysis methods associated with the focus group.Results:In total, 1,167 patients with a urinary catheter were included. The mean durations in control and intervention phases were 5.51 days (95% confidence interval [CI], 4.9–6.2) and 5.08 days (95% CI, 4.6–5.6), respectively. For patients who had a CATH TAG applied, the hazard ratio (HR) was 1.02 (95% CI, 0.91–1.14; P = .75). A subgroup analysis excluded patients in an intensive care unit (ICU), and the use of the CATH TAG was associated with a 23% decrease in the mean, from 5.00 days (95% CI, 4.44–5.56) to 3.84 days (95% CI, 3.47–4.21). Overall, 82 nurses completed a survey and 5 nurses participated in a focus group. Responses regarding the device were largely positive, and benefits for patient care were identified.Conclusion:The CATH TAG did not reduce the duration of catheterization, but potential benefits in patients outside the ICU were identified. Electronic reminders may be useful to aid prompt removal of urinary catheters in the non-ICU hospital setting.

Scaling-up NLP Pipelines to Process Large Corpora of Clinical Notes

2015 ◽  
Vol 54 (06) ◽  
pp. 548-552 ◽  
Author(s):  
M. Carter ◽  
A. Redd ◽  
Q. Zeng ◽  
K. Gupta ◽  
B. Trautner ◽  
...  
Keyword(s):  
Big Data ◽  
Language Processing ◽  
Salt Lake ◽  
Scale Up ◽  
Scaling Up ◽  
Hospitalized Patients ◽  
Small Scale ◽  
Original Algorithm ◽  
Clinical Notes ◽  
Tract Infections

SummaryIntroduction: This article is part of the Focus Theme of Methods of Information in Medicine on “Big Data and Analytics in Healthcare”.Objectives: This paper describes the scale-up efforts at the VA Salt Lake City Health Care System to address processing large corpora of clinical notes through a natural language processing (NLP) pipeline. The use case described is a current project focused on detecting the presence of an indwelling uri-nary catheter in hospitalized patients and subsequent catheter-associated urinary tract infections.Methods: An NLP algorithm using v3NLP was developed to detect the presence of an indwelling urinary catheter in hospitalized patients. The algorithm was tested on a small corpus of notes on patients for whom the presence or absence of a catheter was already known (reference standard). In planning for a scale-up, we estimated that the original algorithm would have taken 2.4 days to run on a larger corpus of notes for this project (550,000 notes), and 27 days for a corpus of 6 million records representative of a national sample of notes. We approached scaling-up NLP pipelines through three techniques: pipeline replication via multi-threading, intra-annotator threading for tasks that can be further decomposed, and remote annotator services which enable annotator scale-out.Results: The scale-up resulted in reducing the average time to process a record from 206 milliseconds to 17 milliseconds or a 12-fold increase in performance when applied to a corpus of 550,000 notes.Conclusions: Purposely simplistic in nature, these scale-up efforts are the straight forward evolution from small scale NLP processing to larger scale extraction without incurring associated complexities that are inherited by the use of the underlying UIMA framework. These efforts represent generalizable and widely applicable techniques that will aid other computationally complex NLP pipelines that are of need to be scaled out for processing and analyzing big data.

Assessing Immediate Bed Availability and Barriers to Discharge in a United States Children’s Hospital

2020 ◽  
pp. 1-5
Author(s):  
M. Catherine Burgess ◽  
Debbie DeLorenzo ◽  
Carl Eriksson
Keyword(s):  
United States ◽  
Large Scale ◽  
Pediatric Population ◽  
Hospital Setting ◽  
Hospitalized Patients ◽  
Treatment Needs ◽  
Children's Hospital ◽  
Discharge Plan ◽  
Children’S Hospital ◽  
Total Capacity

ABSTRACT Objectives: The aim of this study was to quantify immediate bed availability (IBA) in a United States children’s hospital and treatment needs of hospitalized patients whose needs could be met outside a traditional hospital setting. Methods: Using a novel tool to capture census, scheduled discharges, and resource needs for hospitalized patients, we surveyed our hospital’s 5 non-neonatal inpatient pediatric units on 4 d over 1 y. Results: Median ward occupancy was 81% (range, 58-79), median intensive care unit occupancy was 80% (range, 7-19), and median IBA was 42% (range, 34-59). A median of 14 patients per day (13% of total capacity) had treatment needs that could be met by providing limited support in a nontraditional setting; the most common reason for requiring ongoing hospitalization in this group of patients was a safe discharge plan. Conclusions: Our median IBA of 42% exceeds federal recommendations, but varies widely between days surveyed. Even on days when IBA percentage is high, our total number of available beds is unlikely to meet pediatric population needs in a large-scale public health emergency.

scholarly journals I-DECIDED® – A decision tool for assessment and management of invasive devices in the hospital setting

2021 ◽  
Vol 15 (3) ◽  
pp. 7-14
Author(s):  
Gillian Ray-Barruel
Keyword(s):  
Patient Safety ◽  
Vascular Access ◽  
Medical Devices ◽  
Hospital Setting ◽  
Hospitalized Patients ◽  
Evidence Based ◽  
Urinary Catheters ◽  
Decision Tool ◽  
Safety Priority

Indwelling medical devices, including vascular access and urinary catheters, pose a risk for infection, and therefore daily assessment and consideration of their continued need is a patient safety priority. The I-DECIDED® device assessment and decision tool is an evidence-based checklist, designed to improve the assessment, care, and timely removal of invasive devices in acute hospitalized patients. This paper explains each step of the tool, with rationale for inclusion.

Small-Scale Science to Large-Scale Profession

2000 ◽  
Vol 45 (4) ◽  
pp. 396-398
Author(s):  
Roger Smith
Keyword(s):  
Large Scale ◽  
Small Scale

Development of Physics Learning Module Based on Guided Inquiry with Light Wave Material in Class XI of Senior High School

2020 ◽  
Vol 1 (1) ◽  
pp. 1-10
Author(s):  
Evi Rahmawati ◽  
Irnin Agustina Dwi Astuti ◽  
N Nurhayati
Keyword(s):  
Large Scale ◽  
Learning Strategy ◽  
Student Response ◽  
Average Score ◽  
Small Scale ◽  
Design Development ◽  
Teacher Response ◽  
Student Responses ◽  
Analysis Design ◽  
Scientific Skills

IPA Integrated is a place for students to study themselves and the surrounding environment applied in daily life. Integrated IPA Learning provides a direct experience to students through the use and development of scientific skills and attitudes. The importance of integrated IPA requires to pack learning well, integrated IPA integration with the preparation of modules combined with learning strategy can maximize the learning process in school. In SMP 209 Jakarta, the value of the integrated IPA is obtained from 34 students there are 10 students completed and 24 students are not complete because they get the value below the KKM of 68. This research is a development study with the development model of ADDIE (Analysis, Design, Development, Implementation, and Evaluation). The use of KPS-based integrated IPA modules (Science Process sSkills) on the theme of rainbow phenomenon obtained by media expert validation results with an average score of 84.38%, average material expert 82.18%, average linguist 75.37%. So the average of all aspects obtained by 80.55% is worth using and tested to students. The results of the teacher response obtained 88.69% value with excellent criteria. Student responses on a small scale acquired an average score of 85.19% with highly agreed criteria and on the large-scale student response gained a yield of 86.44% with very agreed criteria. So the module can be concluded receiving a good response by the teacher and students.

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