scholarly journals Nurses' Knowledge of Hypoglycemia and Treatment in the Adult Hospitalized Patiend with Diabetes: A Quality Improvement Project

2017 ◽  
Author(s):  
Brittney O'Neale

<p>There are currently more than 29 million people in the United States with diabetes. With increasing numbers of diabetic patients across the nation, it is imperative that health care professionals receive the knowledge and skills required to manage them in the acute care setting. Hypoglycemia is the most common side effect of diabetes treatment (Borzi et al., 2016) and is defined by the American Diabetes Association (ADA) as a condition that occurs when one's blood glucose is lower than normal, usually less than 70 mg/dl. Nurses’ knowledge of hypoglycemia and their adherence to hospital protocols are essential to achieving positive patient outcomes. Research demonstrates that nurses in the acute care setting are not receiving consistent formal training on the care of adult diabetic patients and sometimes fail treat the patient according to evidence based hospital protocols. The purpose of this quality improvement project was to increase nurses’ knowledge of hypoglycemia and treatment in the adult hospitalized patient with diabetes. The project design was a pre-test, educational program and post-test on two medical-surgical units in a small community hospital in Rhode Island. Seventeen nurses completed the pre-test component (N=17, 22%) and eighteen nurses (N=18, 23%) attended the educational program and completed the post-test. Pre-test scores ranged from 11 to 94 out of a possible 100, with a mean score of 59.8%. Post-test scores ranged from 27 to 100, with a mean score of 76.5%. The average of post-test scores increased by about 16.7%. These findings suggest that providing hypoglycemia education can be successful in increasing nurses’ knowledge of hypoglycemia treatment and management in the adult hospitalized patient with diabetes.</p>

2018 ◽  
Author(s):  
Samantha Cruz

Alarm fatigue is known to be one of the top safety concerns in the healthcare setting. The Joint Commission recognized Alarm safety as one of the 2017 National Patient Safety Goals. Alarm fatigue occurs when a healthcare worker becomes overwhelmed and often desensitized to patient monitor alarms. It has been established that interventions including ECG daily electrode and battery changes, skin prep for electrode placement, and adjusting alarm parameters to fit patient needs can lead to a reduction in false or nuisance alarms. In order for these interventions to be carried out successfully, education of nurses regarding alarm fatigue and interventions for change needs to be completed. Education is one of the most important phases of creating change. The purpose of this program development project was to determine the effectiveness of an educational program on alarm fatigue awareness for telemetry unit nurses. A program development project was developed utilizing a pre-test, educational intervention, and a post-test design. Tests were used to evaluate the nurses’ knowledge improvement related to the educational intervention. Sixteen out of a possible 60 telemetry nurses completed the pretest portion of this quality improvement project. (N=16, 26.6%). Fourteen of a possible 60 nurses attended the educational session and completed the post-test portion of this quality improvement project. (N=14, 23%). For the purpose of presenting the first four questions, only those tests with matching pre-and-post responses were utilized, (N=14). The mean scores from pre-tests were 51.2% and mean post-test scores were 92% which revealed an increase by 40.8% after an educational intervention. The APRN can assist in establishing and implementing an educational program. This educational program can help to implement interventions and provide evidenced based research to support the prevention of alarm fatigue.


2017 ◽  
Vol 34 (09) ◽  
pp. 856-860 ◽  
Author(s):  
Alice Gong ◽  
Judith Livingston ◽  
Liza Creel ◽  
Elena Ocampo ◽  
Tiffany McKee-Garrett ◽  
...  

Objective Critical congenital heart disease (CCHD) is a leading cause of death in infants. Newborn screening (NBS) by pulse oximetry allows early identification of CCHD in asymptomatic newborns. To improve readiness of hospital neonatal birthing facilities for mandatory screening in Texas, an educational and quality improvement (QI) project was piloted to identify an implementation strategy for CCHD NBS in a range of birthing hospitals. Study Design Thirteen Texas hospitals implemented standardized CCHD screening by pulse oximetry. An educational program was devised and a tool kit was created to facilitate education and implementation. Newborn nursery nurses' knowledge was assessed using a pre- and posttest instrument. Results The nurses' knowledge assessment improved from 71 to 92.5% (p < 0.0001). Of 11,322 asymptomatic newborns screened after 24 hours of age, 11 had a positive screen, with 1 confirmed case of CCHD. Pulse oximetry CCHD NBS had sensitivity of 100%, specificity of 99.91%, false-positive rate of 0.088%, positive predictive value of 9.09%, and negative predictive value of 100%. Conclusion Our educational program, including a tool kit, QI processes, and standardized pulse oximetry CCHD NBS, is applicable for a range of hospital birthing facilities and may facilitate wide-scale implementation, thereby improving newborn health.


2020 ◽  
Author(s):  
Bruce Gillard

A quality improvement project was developed using a pre-test, education intervention, post-test design to assess nurse’s ability identify STEMI ECGs from non-STEMI ECGs and to assess the impact of a brief educational program on nurses’ performance. The pre-tests were available to nursing staff over a two-week period to obtain the nurses’ baseline knowledge. Following the pre-test period nurses were provided the educational sessions followed immediately by distribution of the post-test. The pre-tests were then compared to the post-tests to assess whether or not the education improved nurses’ performance in STEMI recognition.


2014 ◽  
Author(s):  
Ann Garris

<p>Heart Failure is a complex syndrome which continues to be a major health issue in the United States and worldwide. Strategies and educational interventions implemented by hospitals to reduce hospital admissions and readmissions for this costly chronic disease have not been consistently successful. Patient education is an important strategy for the management of HF to improve quality of life, optimize patient outcomes, and reduce the use of healthcare resources by reducing readmissions. The purpose of this program development was to increase nurses’ knowledge regarding HF education to be provided to HF patients prior to discharge from the acute care setting. A quasi-experimental program design with a pre and post-test intervention was performed on a 38 bed medical telemetry unit at RI Hospital a Level 1 trauma center in Providence, RI. Registered nurses were asked to complete a pre and post-test survey, <em>Nurse Knowledge of Heart Failure </em>by Albert et al (2002). Nine RNs out of thirty two (28.8%) agreed to participate and completed the pre-test, attended one of the HF education classes followed by completion of the post-test. Pre-tests scores ranged from 60-90 out of possible 100, with a mean score of 73.3%. Post-test scores ranged from 70-95 out of possible 100, with a mean score of 86.1%, an increase of almost 13%. These findings suggest that providing HF education can be successful in increasing nurses’ knowledge regarding HF education provided to HF patients prior to discharge from the acute care setting.</p>


2016 ◽  
Author(s):  
Carly Shields-Pirri

<p>Initially viewed as doubtful and plagued with uncertainty, the process of organ/tissue transplantation has proved to be one of the most successful medical breakthroughs of modern medicine. From the initial documented success of organ/tissue donation and subsequent transplantation, the need for organ/tissue donation exceeds the available resources. Many individuals are aware of the need for organ/tissue donation for life-saving transplantation but do not take the necessary steps to become a donor or share that desire with family and/or loved ones. There are no national programs or efforts in place for standardized nursing education about organ/tissue donation and transplantation. The purpose of this quality improvement project was to increase nurses’ knowledge of the New England Organ Bank (NEOB) guidelines for organ and tissue donation. The project design was a pre-test, an educational program, and post-test. Twenty-two nurses completed the pre-test component (N=22, 63%) and fourteen nurses completed the post-test (N=14, 40%). Results indicated nurses had better overall better knowledge of organ donation then specifically tissue donation. Nursing staff demonstrated increased knowledge of NEOB guidelines and the nurse’s role in timely reporting after the educational program on organ donation with improved post-test over pre-test scores. Future replication of education related to NEOB guidelines for donation of organs and tissues and nurse responsibility for timely reporting should increase emphasis on the area of tissue donation. A need based assessment to determine specific areas of deficit may aid in promoting positive outcomes in future replication.</p>


Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Ann Smith ◽  
Kathleen Bledsoe ◽  
Thomas Madden ◽  
Jamie Artale ◽  
Ted Sindlinger

Introduction: The utility of pharmacist-managed collaborative practice agreements (CPA) in the management of hypertension is well established in the outpatient setting. There has been little evaluation of the use of CPAs in the inpatient acute care setting, and none described specifically in the vascular neurology population. Treatment of hypertension is a critical intervention for the secondary prevention of acute ischemic stroke. This quality improvement project evaluated the implementation of a CPA for the inpatient acute care management of hypertension in vascular neurology patients at University of Virginia Health. Methods: A CPA was developed between the neurosciences clinical pharmacist group and the inpatient vascular neurology service, legally vetted, and implemented in June 2019. All vascular neurology patient charts in which an electronic CPA referral was placed from June 2019 through June 2020 were reviewed. Patients were excluded if they were discharged within 24 hours of the referral being placed. The primary objective was to describe and evaluate the implementation of a pharmacist-driven hypertension management practice in the inpatient acute care setting. All patient demographic and clinical data were analyzed using descriptive statistics. Secondary safety outcomes included documented hypotensive events (SBP <90) and acute kidney injury (AKI, increase in SCr by 0.3 mg/dl within 48 hours). Results: During the study period, 26 referrals were placed, and 19 patients were included for review. On average, patients were on 2 anti-hypertensive medications prior to admission. From the time of referral to discharge (mean 6 days), systolic blood pressure (SBP) was reduced on average by 36 mmHg (mean percentage reduction 20%) and diastolic blood pressure (DBP) by 12 mmHg (mean percentage reduction 7%). Ten patients (53%) met the goal of SBP < 140 at discharge. There were 5 hypotensive events and 4 instances of AKI, all of which were mild and recovered prior to discharge. Conclusion: A pharmacist-managed hypertension CPA was successfully implemented in vascular neurology patients in the inpatient acute care setting. The practice demonstrated improved blood pressure control and minimal adverse outcomes.


2021 ◽  
Author(s):  
Jennifer Fortes

Noise in the intensive care unit (ICU) has been studied for over thirty years, but it continues to be a significant problem and a top complaint among patients. Staff members are now reporting detrimental health effects from excessive noise. One of the significant factors of inadequate noise control in the ICU is that nurses have insufficient awareness regarding the hospital noise issue and its negative impact on health status. The level of knowledge of clinical staff on the topic of noise is not known. A quality improvement project to explore noise in the ICU could facilitate better understanding of the phenomenon and formulation of new ways to continue to reduce noise at a community hospital in Massachusetts. The purpose of this quality improvement project was to evaluate nurses’ knowledge of the potentially harmful effects of noise on patients as well as on nurses, to identify opportunities for improvement of the environment, and to conduct an educational intervention aimed at reducing noise in the intensive care unit. The methodology for this project included a pre-test, followed by an educational session, and completion of a post-test. The participants included registered nurse staff members in the Intensive Care Unit (ICU) and the Critical Care Unit (CCU). Exclusion criteria included staff members who are not registered nurses. The project posed minimal risk. No identifying or biographical data was collected, and results included analysis of aggregate data. Descriptive statistics were used to assist with analysis. Results were disseminated to the staff of the ICU and CCU, posted on a bulletin board in the critical care area, presented as a poster presentation at the Spring RIC MSN Symposium, and available as a manuscript on the RIC Digital Commons.


2021 ◽  
Author(s):  
Kayla Deery

Delirium, recognized as a medical and psychological emergency, is a symptom of an acute medical condition. Despite the prevalence of delirium in the hospital setting, it continues to be unrecognized, resulting in poor patient outcomes, and exorbitant healthcare cost. Patients with dementia who are chronically ill, as well as patients previously diagnosed with delirium, represent a vulnerable population and require closer surveillance due to their predisposing factors. This quality improvement project goal is to increase nurses’ knowledge and understanding of delirium. This was completed through providing education to medical-surgical nurses on the causes of delirium (predisposing and precipitating factors), prevention, use of the confusion assessment method (CAM) screening tool, and detection of delirium. The change in knowledge was measure through an investigator created, 10-question multiple choice, pretest-posttest measurement model. Of the 58 nurses, nine responded and completed the pretest (N=9, 15.5%), while seven completed the educational intervention posttest (N=7, 12%). Results of the quality improvement project yielded a 22.1% increase in nurses’ knowledge after the educational intervention. Despite the low participation rate, this project revealed a positive correlation between the educational intervention and nurses’ knowledge.


2019 ◽  
Author(s):  
Jacqueline Hurteau

Palliative care integrated with standard oncology care in cancer patients has been shown to provide a number of beneficial clinical outcomes. Despite the evidence, the utilization of palliative care in the oncology population continues to be inadequate. The purpose of this program development, quality improvement project was to improve nurses’ knowledge regarding palliative care and the benefits of its early implementation in the oncology population, as well as to improve their confidence regarding palliative care consultations to providers. An educational intervention was designed and a pre and posttest were utilized to determine the effect of the intervention. This program development, quality improvement project demonstrated that the implementation of nursing education regarding palliative care within the oncology population increased nurses’ knowledge in palliative care, specific to the oncology population, as well as confidence in recommending appropriate palliative care consultations to providers.


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