scholarly journals Diabetes Knowledge of Critical Care Nurses: A Quality Improvement Project

2019 ◽  
Author(s):  
Sarah Huley
Keyword(s):  
Critical Care ◽  
Quality Improvement ◽  
Diabetes Management ◽  
The United States ◽  
Educational Programs ◽  
Quality Improvement Project ◽  
Diabetic Patients ◽  
Diabetes Knowledge ◽  
Improvement Project ◽  
Actual Knowledge

Diabetes mellitus continues to become more prevalent in the United States, with approximately 1.5 million new cases diagnosed each year (ADA, 2018). Nurses play a key role in providing education to diabetic patients on the management of this disease. This encompasses a multitude of topics such as diabetic medications, treatments, and lifestyle choices that ultimately may aid in decreased morbidity and mortality otherwise associated with the disease and its co-morbidities. However, nurses’ own perceived diabetes knowledge has been found to be overestimated when compared to actual nursing knowledge (Alotaibi, Ghlizadeh, Al-Ganmi&Perry, 2017; Wakefield&Wilson, 2014). Research also illustrates that the actual knowledge of diabetes care is suboptimal, and educational programs specifically tailored to diabetes management knowledge result in an improvement from pre-test scores with subsequent retention of the materials presented (Moattari, Moosavinasab, Dabaghmanesh,&SarifSanaiey, 2014; Sweeney, Kenny and Schubert, 2013). The following literature review appraises current practice in diabetes management and evaluates literature regarding actual knowledge of nurses caring for inpatient diabetics. The purpose of this quality improvement project was to determine whether the implementation of a diabetic education program improves nurses’ knowledge in the medical management, treatment, and care of the adult critical care patient with hyperglycemia. Results demonstrated variability in baseline knowledge and overall significant improvement in scores which validated the need for this program and may indicate a need to focus future educational programs on the care of the patient with diabetes.

scholarly journals Effect of Clinical Opiate Withdrawal Scale Educational Intervention on Intensive Care Unite Nurses' Knowledge and Confidence

2021 ◽  
Author(s):  
Lauren Schneider
Keyword(s):  
Critical Care ◽  
Quality Improvement ◽  
Educational Intervention ◽  
The United States ◽  
Opioid Withdrawal ◽  
Quality Improvement Project ◽  
World Health ◽  
Opiate Withdrawal ◽  
Percentage Increase ◽  
Improvement Project

The opioid epidemic is a significant concern for the United States. Forty-eight and a half million Americans have either used illicit drugs such as heroin or have misused prescription opioid drugs. The exponential rise in opioid use increases the risk of opioid withdrawal, thus making opioid withdrawal assessment a top priority, especially for hospitalized individuals. The Clinical Opiate Withdrawal scale (COWS) is highly recommended to assess opioid withdrawal in hospitalized individuals and is well supported by the American Society of Addiction Medicine National Practice guideline and the World Health Organization. Despite the availability of reliable opioid withdrawal assessment scales, improper use and underuse of these scales are reported. Nurses education on the use of the COWS could address this gap. The purpose of this quality improvement project was to determine the effectiveness of an educational intervention concentrating on the COWS to improve critical care nurse’s knowledge and confidence in scale use. The quality improvement project utilized a pre-test, educational intervention and a posttest design. Twenty-eight out of the possible 60 critical care nurses participated in the quality improvement session. The mean scores on the pretest and post-test were 41.2 % and 83.5%, respectively. This showed a percentage increase in knowledge of 42.3. Furthermore, participants reported higher level of confidence in their ability to utilize the COWS. Receipt of COWS education could promote proper use of the scale. The advanced practice nurse can assist in establishing and implementing educational programs that focus on the importance of opioid withdrawal assessment through evidence-based practice.

scholarly journals Assessing Nurses’ Knowledge of Noise in the Intensive Care Unit: An Educational Intervention Project

2021 ◽  
Author(s):  
Jennifer Fortes
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Quality Improvement ◽  
Educational Intervention ◽  
Quality Improvement Project ◽  
Minimal Risk ◽  
Improvement Project ◽  
Staff Members ◽  
Nurses Knowledge

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.

Abstract 184: Quality Improvement of Statin Therapy Appropriateness in Type 2 Diabetic Patients

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Dan L Li ◽  
Erika Diaz Narvaez ◽  
Chioma Onyekwelu ◽  
Eleanor M Weinstein ◽  
Robert T Faillace
Keyword(s):  
Quality Improvement ◽  
Statin Therapy ◽  
High Intensity ◽  
Quality Improvement Project ◽  
Planning System ◽  
Diabetic Patients ◽  
Improvement Project ◽  
Medicine Clinic ◽  
Ascvd Risk ◽  
Statin Dose

Objectives: The 2013 ACC/AHA guidelines recommend statin therapy for all diabetic patients between the ages of 40 to 75. The intensity of statin therapy is guided by the 10-year atherosclerosis cardiovascular disease (ASCVD) risk for a given patient. A quality-improvement project was carried out in the Jacobi Medical Center (JMC) Primary Care Medicine clinic to help clinicians improve statin therapy appropriateness. Interventions included: Intense education to house staff and clinic faculty members beginning in November 2015; Establishment of a pre-visit planning system beginning in August 2016 whereby nursing staff would preview the lipid panel of diabetic patients and alert providers when the LDL was above 100 mg/dl. A retrospective study was carried out to evaluate statin therapy appropriateness before and after this quality improvement project. Methods: Type 2 Diabetes Mellitus (T2DM) patients (age between 40-75) were selected from the JMC Medicine Clinic visits in September 2015 (baseline), May 2016 (after intense education), and September 2016 (after launching the pre-visit planning system). Exclusion criteria included: heart failure, ESRD on hemodialysis, active malignancy, and missing information for ASCVD risk calculation. In patients with LDL > 70 and with no history of CVD, the 10-year ASCVD risk was calculated and statin appropriateness was determined by comparing the actual statin prescription with the statin intensity suggested by the 2013 ACC/AHA guidelines. For patients who had an established diagnosis of CVD, statin therapy appropriateness was evaluated by whether the patients were on high-intensity statin therapy. Comparisons among groups were performed using chi-square analysis. Results: The numbers of patients in each of the three months after the exclusions were 371, 346 and 358; among which, 68, 70 and 77 patients had existing CVD respectively. Overall, 38.8% of the patients seen in September 2015 were prescribed an appropriate statin dose; the number rose to 42.2% in May 2016, and further to 50.0% in September 2016 ( p = 0.0086). For primary prevention of CVD, 35.3% of patients received an appropriate statin dose in September 2015; this number improved to 38.5% in May 2016, after intense education; and to 44.2% in September 2016. ( p = 0.089) For secondary prevention of CVD events in patients with clinical CVD, 54.4% of the patients in September 2015 were given high-intensity statins. The high-intensity statin prescription rate was 57.1% in May 2016, and subsequently increased to 70.1% in September 2016. ( p = 0.11) Conclusions: Significant improvement in compliance with the 2013 ACC/AHA guideline-based statin dose for lipid management in the JMC Primary Care Medicine Clinic was found to be associated with the implementation of a quality-improvement project consisting of intense physician education and a pre-visit planning system.

scholarly journals Improving heart failure transitional care after hospital discharge: A quality improvement project

2020 ◽  
Vol 10 (11) ◽  
pp. 62
Author(s):  
Janelle N. Akomah ◽  
Lynn Richards-McDonald ◽  
Diana-Lyn Baptiste
Keyword(s):  
Heart Failure ◽  
Quality Improvement ◽  
Education Program ◽  
Hospital Readmission ◽  
Transitional Care ◽  
Health Care Expenditures ◽  
The United States ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Care Clinic

Background and objective: The burden of heart failure is growing, affecting more than 6 million Americans and an estimated of 26 million worldwide. Heart failure is the most common cause of hospital readmission in the United States and is identified as a marker of poor health outcomes. Thirty day readmission contribute to more than $30 billion dollars in health care expenditures, underscoring a need for the development and implementation of programs that reduce readmission and improve outcomes for individuals with heart failure. The purpose of this quality improvement project was to implement a heart failure education program to increase attendance to a transitional care clinic and reduce 30-day readmissions.Methods: We included 22 individuals who received heart failure education, focused on symptom management and transitional care. Descriptive and statistical analyses were performed to examine attendance to the transitional care clinic and 30-day readmission.Results: There was a statistical significance between individuals attending follow-up at the designated transitional care clinic and 30-day hospital readmission (p ≤ .05). Of the (N = 22) participants, 64% were not readmitted into the hospital 30 days after discharge.Conclusions: The findings of this project demonstrate that a nurse-led evidence-based heart failure education program can improve attendance to transitional care programs and reduce 30-day readmissions. A well-designed plan for transitional care remains a critical component of patient care necessary to address complications and optimize continuity of care after discharge.

scholarly journals Nurse’s Knowledge of Early Ambulation of the Post Operative Patient and Complication Prevention: A Quality Improvement Project

2021 ◽  
Author(s):  
Meghan Carides
Keyword(s):  
Quality Improvement ◽  
Patient Outcomes ◽  
Nursing Intervention ◽  
Educational Programs ◽  
Quality Improvement Project ◽  
Complication Rates ◽  
Improvement Project ◽  
Nursing Knowledge ◽  
Early Ambulation ◽  
The Mean

Ambulation is the single most important nursing intervention in the prevention of postoperative complications. It is also a key component in maintaining optimal patient outcomes. Current literature has revealed that when ambulation is initiated early there is a marked decrease in pain, length of hospital admission, and overall complication rates. However, even with this depth of evidence early postoperative ambulation on the two surgical units at a teaching hospital in Rhode Island, patient ambulation continues to be inconsistent. The purpose of this quality improvement project is to improve nursing knowledge regarding early ambulation after surgery for the prevention of post-operative complications. This project utilized a pretest, educational in-service intervention, and posttest design. Seventeen out of a possible 22 surgical nurses participated in this project (N= 17, 77%). The educational in-service sessions combined information from an extensive literature review in the form of a 10-minute Power Point presentation. Pre and post tests were made up of 5 knowledge-based and 5 opinion-based questions. The mean scores for the pretest were 74% while the mean scores for the posttest were 95.2%. There was a 35% increase in overall scores following the educational intervention. APRNs play a pivotal role in establishing and implementing educational programs. This project aimed to recognize a need for ongoing education about postoperative ambulation for the surgical unit nurses. Educational programs about postoperative ambulation and complication prevention should be routinely incorporated in future trainings to ensure improved nursing knowledge and patient outcomes.

scholarly journals Using the National Surgical Quality Improvement Project (NSQIP) to Perform Clinical Research in Colon and Rectal Surgery

2019 ◽  
Vol 32 (01) ◽  
pp. 041-053 ◽  
Author(s):  
Sarah Stringfield ◽  
Stefan Holubar ◽  
Samuel Eisenstein
Keyword(s):  
Quality Improvement ◽  
Clinical Research ◽  
Rectal Surgery ◽  
The United States ◽  
Quality Improvement Project ◽  
Colon And Rectal Surgery ◽  
Surgical Quality ◽  
Improvement Project ◽  
The Individual ◽  
Methodological Considerations

AbstractThe American College of Surgeons' National Surgical Quality Improvement Project (ACS-NSQIP) is probably the most well-known surgical database in North American and worldwide. This clinical database was first proposed by Dr. Clifford Ko, a colorectal surgeon, to the ACS, and NSQIP first started collecting data ca. 2005 with the intent of comparing hospitals (benchmarking) and for hospital-level quality improvement projects. Since then, its popularity has grown from just a few participating hospitals in the United States to more than 708 participating hospitals worldwide, and collaboration allows regional or disease-specific data sharing. Importantly, from a methodological perspective, as the number of hospitals has grown so has the hospital heterogeneity and thus generalizability of the results and conclusions of the individual studies. In this article, we will first briefly present the structure of the database (aka the Participant User File) and other important methodological considerations specific to performing clinical research. We will then briefly review and summarize the approximately 60 published colectomy articles and 30 published articles on proctectomy. We will conclude with future directions relevant to colorectal clinical research.

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