Effect Analysis of Hospital Nursing Management Based on Informatization

Objective: To explore the effect of hospital nursing management based on informatization. Methods: 167 inpatients from different departments in our hospital from June 2020 to November 2019 were randomly selected and divided into control group and observation group.83 cases in the control group were treated with traditional nursing management mode; 87 cases in the observation group used modern nursing information management system for information-based nursing management, and then compared the two groups in terms of nursing management efficiency, patient basic nursing, ward management, specialized nursing and nursing satisfaction, so as to verify the clinical application effect of information-based nursing management. Results: After the application of information-based nursing management mode, the construction and application of information management system made the nursing management process more standardized and accurate. Therefore, the clinical nursing efficiency, basic nursing, ward management, specialized nursing and nursing satisfaction of the observation group were better than those of the control group. Conclusion: In the practice of hospital inpatient nursing management, the scientific use of information technology and information management system can significantly improve the efficiency of patient nursing management and nursing satisfaction, and play a key role in improving the prognosis of patients. Therefore, it is worth popularizing and applying in the whole hospital and even the national grass-roots hospitals.

Reducing inappropriate urinary catheter use by involving patients via an app: the Participatient feasibility study (Preprint)

BACKGROUND The risk of urinary tract infections is increased by the inappropriate placement and the unnecessary prolongation of use of indwelling urinary catheters. Sustained behaviour change in infection prevention could be promoted through patient empowerment trough a smartphone app. OBJECTIVE We aimed to assess the feasibility and efficacy of implementation actions on patients’ use of Participatient on a clinical ward, and to compare three survey methods for urinary catheter use. METHODS Participatient was introduced for all admitted patients at the surgical nursing ward in a university hospital in the Netherlands. In three months, the number of new app users, days of use, and sessions were recorded. In a comparison of before-and-after the app, three methods for point prevalence surveys of catheter use were tested. Surveys were conducted through manual parsing of the text in the electronic medical records, checkbox surveys, and nurse-notes surveys. RESULTS In all, 475 patients were admitted to the ward, 42(8.8%) installed the app, with 1-5 new users per week. The actions with most ensuing app use were the kick-off with clinical lesson and the recruiting of the intake nurse. Between the survey methods, there was considerable variation in catheter prevalence. Therefore, we used the standard method of manual parsing in further analyses. Catheter use prevalence decreased from 38% to 27% after app introduction. CONCLUSIONS Clinical application of Participatient, the infection prevention app for patients, could be feasible when implementation actions are combined. For surveying indwelling urinary catheter use prevalence, manual parsing is best applicable.

Reactivating Hospital, Active Patients Through Special Design

Objective: With the reactivating hospital concept, it is our goal to provide a more active stay in a hospital for patients by diverting the focus away from “lying in bed.” We want to achieve this by changing the spatial environment of the nursing ward. These new spatial interventions are aimed toward helping the patients to be healthier during and after their admission to the hospital. Background: When it comes to hospitals, we tend to have a mindset that is basically focused on disease, not on health. The whole hospital is geared toward illness, waiting, lying in bed: a passive attitude of the patient in this medical stronghold. Staying in a hospital has a negative influence on the body, especially for vulnerable patients. However, when patients remain active during their hospital stay, fewer negative effects occur. The risk of complications reduces, and patients recover better and faster. Research shows that only 15% of patients actually need to stay in bed. In order to enable hospitals and their patients to benefit from these insights, Gortemaker Algra Feenstra Architects introduces the reactivating hospital concept: a set of scientifically based practical interventions intended for a change in organization and spatial design of hospitals. Design hypothesis: How can spatial interventions to a geriatric department contribute positively to activating elderly patients during their stay in the hospital? Research question: What impact does providing areas for activation away from a patient’s bed have on the quality of the patient’s experience? Method: The reactivating hospital concept no longer revolves around “lying in bed,” but around the notion of “making patients stronger.” We are introducing a new rhythm of 8 hr of activation, 8 hr of relaxation, and 8 hr of sleep. This requires a different mindset of patients and personnel and involves a totally different interpretation of space. To tackle the problem at its roots, the bed will be solely reserved for sleeping and all other activities will take place elsewhere in the nursing ward. To encourage patients to remain active, we soften the transition from bed to room, from room to corridor, from corridor to department, and from department to the rest of the hospital. These subtle transitions invite patients to move around, thus remaining active. To test these methods, we use qualitative and quantitative research methods such as observation, conversations with focus groups, and questionnaires during the research. Results: Reactivating hospital concept is a concept and a design research in progress in collaboration with the existing Diakonessenhuis hospital and the Netherlands Organisation for Applied Scientific Research (TNO). In this setting, there are different scales of innovation. In the first phase, we have been working on a completely new bed department with a new typology. In the second phase, we are currently testing significant changes in a room, corridor, and department level, within the context of the existing department, and we are measuring and monitoring the results. The first research results show a positive effect on the state of mind of patients as well as the nurses. At this moment, we are researching the positive effect on the exercise and health of patients, and we are expecting the first concrete results to come in at the end of the year. Conclusion: The initial feedback we have received from the Diakonessenhuis hospital has been positive. Furthermore, we have noticed that the reactivating hospital concept is receiving more and more support. Lying in bed has a negative effect on patients, and a lot of hospitals are aware of this and are therefore looking for alternatives.

Gambaran Pelaksanaan Serah Terima Antar Shift di Rumah Sakit X Jakarta

A description of handover processes in hospital: A survey from Jakarta, IndonesiaBackground: Handover at the change of nurse shift is one of an important role in patient safety and continuiting quality of care.Purpose: To optimization of implementation of handover processes in hospital: A survey from Jakarta, IndonesiaMethod: An analysis study with approach fishbone diagram, start with filling in questionnaires, observations and interviews and then analyzed using fishbone diagrams. Based on fishbone diagrams, the problem was obtained that the implementation of handover of patient patients was not optimal.Results: To optimize the implementation of handover, implementation was carried out in the form of improving SPO, improving nurses' effective communication with SBAR and making role play video handover.Conclusion: The result is the handover can be optimal with the role and function of management of the head nurse especially a directing role. Recommendations given by follow up and revising the hand over standars, make a pilot project nursing ward and evaluate the implementation of the patient's handover through regular supervision.Keywords: Fishbone Diagram; Handover; Head Nurse; Optimization; DirectingPendahuluan: Serah terima perawat antar shift jaga merupakan salah satu komponen penting dalam mencapai keselamatan pasien dan mempertahankan kualitas asuhan.Tujuan: Meningkatkan optimalisasi fungsi pengarahan kepala ruang dalam pelaksanaan serah tertima antar shift di RS X Jakarta.Metode: Menggunakan study analysis situasi dengan pendekatan diagram tulang ikan, dimulai dengan mengisi kuesioner, observasi dan wawancara dan kemudian dianalisis menggunakan diagram tulang ikan. Berdasarkan diagram tulang ikan, masalah diperoleh bahwa pelaksanaan serah terima pasien pasien belum optimal.Hasil: Untuk mengoptimalkan pelaksanaan serah terima, implementasi dilakukan dalam bentuk meningkatkan SPO, meningkatkan komunikasi efektif perawat dengan SBAR dan membuat role play video serah terima.Simpulan: Hasilnya adalah serah terima dapat dioptimalkan dengan peran dan fungsi manajemen kepala ruang khususnya fungsi pengarahan. Rekomendasi yang diberikan dengan menindaklanjuti dan merevisi SOP serah terima, membuat ruang percontohan dan mengevaluasi pelaksanaan serah terima pasien melalui pengawasan rutin.

Evaluation of the performance of the modified early warning score in a Brazilian public hospital

ABSTRACT Objective: To evaluate the performance of the modified early warning score (Mews) in a nursing ward for patients in clinical deterioration. Method: This is an analytical, quantitative and predictive study. Mews’ parameters (systolic blood pressure, heart rate, respiratory rate, temperature and level of consciousness) were evaluated every six hours. The following events were reported: death, cardiopulmonary arrest and transfer to intensive care. The evaluations were performed in a hospital of reference in the state of São Paulo, Brazil. Results: A total of 300 patients were included (57 ± 18 years old, males: 65%). There number of combined events was observed to be greater the higher the score’s value (00%; 00%; 01; 09%; 19%; 28%; 89%, respectively, for Mews 0; 1; 2; 3; 4; 5 and 6; p < 0.0001). Mews ≥ 4 was the most appropriate cut-off point for prediction of these events (sensitivity: 87%, specificity: 85% and accuracy: 0.86). Conclusion: Mews properly measured the occurrence of severe events in hospitalized patients of a Brazilian public hospital’s nursing ward. Mews ≥ 4 seems to be the most appropriate cut-off point for prediction of these events.

Walking the tightrope: how rebels “do” quality of care in healthcare organizations

Purpose The purpose of this paper is to empirically explore and conceptualize how healthcare professionals and managers give shape to the increasing call for compassionate care as an alternative for system-based quality management systems. The research demonstrates how quality rebels craft deviant practices of good care and how they account for them. Design/methodology/approach Ethnographic research was conducted in three Dutch hospitals, studying clinical groups that were identified as deviant: a nursing ward for infectious diseases, a mother–child department and a dialysis department. The research includes over 120 h of observation, 41 semi-structured interviews and 2 focus groups. Findings The research shows that rebels’ quality practices are an emerging set of collaborative activities to improving healthcare and meeting (individual) patient needs. They conduct “contexting work” to achieve their quality aims by expanding their normative work to outside domains. As rebels deviate from hospital policies, they are sometimes forced to act “under the radar” causing the risk of groupthink and may undermine the aim of public accounting. Practical implications The research shows that in order to come to more compassionate forms of care, organizations should allow for more heterogeneity accompanied with ongoing dialogue(s) on what good care yields as this may differ between specific fields or locations. Originality/value This is the first study introducing quality rebels as a concept to understanding social deviance in the everyday practices of doing compassionate and good care.

The Nurse Approach Towards the Detection of Antecedent Signs and Symptoms of Sepsis in Patients at a Nursing Ward / O Enfermeiro na Detecção dos Sinais e Sintomas que Antecedem Sepse em Pacientes na Enfermaria

Objetivo: Descrever os sinais e sintomas que antecedem a sepse em pacientes internados na Clínica Médica de um Hospital Federal no Rio de Janeiro identificados pelo Enfermeiro; analisar como o Enfermeiro correlaciona os sinais e sintomas com a Sepsis-1, Sepsis-2 e Sepsis-3. Métodos: Estudo descritivo com abordagem quantitativa, a população foram 10 Enfermeiros em plantões diurnos na enfermaria da Clínica. A coleta de dados foi um questionário estruturado, abordando identificação dos sinais e sintomas que antecedem a sepse, englobando as características e particularidades da sepse. Resultados: Evidenciou-se que possuem entendimento sobre o conceito de sepse, entretanto apresentaram dificuldades em correlacionar alguns dos sinais e sintomas dos tipos de sepse. Conclusão: Ciente que a sepse é um problema de saúde e o Enfermeiro presta cuidado direto ao paciente, percebe-se a importância na identificação dos sinais e sintomas que a antecedem para oferecer assistência de qualidade e auxiliar na redução dos casos.Descritores: Enfermagem, Sepse, Sinais e sintomas, Síndrome de resposta inflamatória sistêmica.

PENGEMBANGAN ELECTRONIC_PRESSURE INJURY ALARM (E_PIA) DALAM UPAYA PENINGKATAN PERILAKU PENCEGAHAN CEDERA TEKAN DI RUMAH SAKIT

Angka insiden cedera tekan merupakan indikator mutu pelayanan keperawatan. Insiden cedera tekan akan menunjukkan kualitas pelayanan suatu rumah sakit dan memberikan dampak terhadap pasien, keluarga dan petugas yang merawatnya. Tujuan penulisan untuk menganalisis faktor- faktor yang mempengaruhi terjadinya peningkatan angka insiden cedera tekan di rumah sakit. Metode yang dipakai menggunakan studi kasus analisis situasi dengan pendekatan diagram fishbone dengan mengelompokan kedalam 5 tools manajemen man, money, method, material, machine untuk mendapatkan akar masalah. Masalah utama yang didapatkan adalah belum optimalnya pelaksanaan pencegahan cedera tekan di rumah sakit. Hasil yang didapatkan adalah perlu dikembangkannya suatu teknologi sebagai inovasi alternatif. Berdasarkan hal tersebut dikembangkan inovasi yang disebut electronic_Pressure Injury Alarm (e_PIA). Inovasi e_PIA yang telah dikembangkan, perlu disempurnakan dan di uji lebih lanjut agar dapat diterapkan untuk membantu menurunkan angka insiden cedera tekan. Kata kunci: Cedera tekan, Diagram fishbone, e_PIA. Abstract Electronic_Pressure Injury Alarm (e_PIA) development in term of pressure injury’s preventions’s habit in hospital. It would give impact to quality of care for patient and their family.The purpose of this study was to analyze the factors that would increase the incidence of pressure injury in hospital. This case study analyze the situation in nursing ward using fishbone diagram which include 5 management tools (man, money, methods, method, material, and machine) to finds the main problem which is the implementation of pressure injury’s preventions in hospital was not optimal. This study found there was an urge to develop an alternative technology called electronic_Pressure Injury Alarm (e_PIA). The lattest develop of e_PIA still need to re-assure and re-test so it could be used to decrease the incidence of pressure injury. Keywords: Pressure injury, Fishbone diagram, e_PIA.