摘要:

A coordinated initiative for patients with heart failure was planned and implemented across this healthcare system to: (1) incorporate best evidence-based practice to rapidly stabilize the patient, and (2) establish early, coordinated patient education to promote self-care at home with the support of appropriate resources. Length of stay, readmission frequency, ACE inhibitor and beta blocker prescribing patterns at discharge were the outcomes selected for ongoing study and cross-site efforts toward improvement. These outcomes did improve following cross-site implementation with the collaboration of all appropriate disciplines and the coordination of new and existing services to serve this population.

ISSN:1057-3631    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Effective pain management is a critical patient care goal mandated by numerous health care organizations. There remains great opportunity to improve pain management across all sites of care. This article describes an interdisciplinary model for process improvement within an integrated health care system. An outcome-based approach to pain management resulted in the development of four key clinical indicators that are measured across sites, including acute care, long-term, ambulatory, and home care. Early outcome data are presented. Strategies for improving pain management focus on visibility, staff accountability, patient rights, and education.

ISSN:1057-3631    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Assuring that critical care nurses have the skill and knowledge necessary to accurately utilize the many diagnostic monitoring functions available within critical care is essential for optimizing patient outcomes. This performance improvement project focused on the hemodynamic monitoring skills and knowledge level of the critical care nurses in both a cardiovascular and medical/surgical intensive care unit. A four-step progressive intervention strategy was initiated based on our pre-implementation assessment. Post-implementation measures demonstrated a substantial increase in the skill and knowledge level of the nurses.

ISSN:1057-3631    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

A major challenge in health care today is to provide high-quality care that results in the best outcomes possible for patients and residents within the limits of available resources. Throughout the past decade, there has been a call from ethicists for health care institutions to integrate the ethics and quality improvement processes. This article describes how a transitional/extended care facility integrated the quality improvement process within an ethical framework to achieve high-quality care while controlling cost.

ISSN:1057-3631    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Dissatisfaction with doing a yearly written test to evaluate competency in the management of cardiopulmonary arrest led to our exploration of ways to change our processes at St. Joseph Regional Medical Center. Guided by our Mission, Vision, and Values, we strove to create a process that would deliver exceptional health care to our patients, while contributing to the personal and professional growth of our staff. Cardiopulmonary arrest is a low volume, high-risk occurrence, which is anxiety provoking for staff. Therefore, it is difficult for staff to feel comfortable and maintain competence in these situations. A process was implemented incorporating a hands-on approach to manage a simulated cardiopulmonary arrest on an annual basis for registered nurses (RNs) and assistive staff. The opportunity for hands-on practice and skill development has enhanced the confidence of RNs and assistive staff, affording them the ability to handle real emergencies.

ISSN:1057-3631    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Implementing outcomes in physician offices is a challenging area. Unlike hospitals, clinics typically have much fewer support staff and resources, electronic clinical data is difficult to access, and physician resistance may be significant. Yet, accountability for outcomes is coming to physician offices. In all outcome efforts, the key steps for guideline implementation are awareness, agreement, decision to adopt, and commitment to adherence. This article describes outcome management efforts in a 15-clinic medical group in the areas of diabetes, asthma, preventive health, pneumonia, heart failure, and patient satisfaction. Implementation strategies, barriers, impact, and outcome data results are described.

ISSN:1057-3631    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

The issues of recruitment, training, and retention of experienced nursing staff remains an ongoing business strategy of nursing service in many health care facilities. The implementation of a structured mentoring program recognizes the need to develop and maintain relationships between the new and the experienced nurses. The terms of mentor and mentee are defined within a structured orientation program, highlighting specific roles and responsibilities of each. The use of other staff as preceptors and resources is discussed as a mechanism to enhance diversity in skill and knowledge development. The value of clinical tracking forms, planning calendars, and feedback mechanisms are stressed to ensure success in monitoring this program in a longitudinal way. Problems associated with the assignment of mentors are addressed as an area for future investigation in different care settings.

ISSN:1057-3631    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

The incident report read, "His arm was tightly locked around my neck. His free arm was touching me while he said terrible, obscene things he intended to do. My heart was pounding. My mind was racing, unable to think rationally. I needed to focus on an escape plan. I was too terrified to think. I just aimlessly struggled. It seemed like an eternity, then, somehow I broke loose." Reading the words on the incident report was horrible. But, nothing compared to seeing the young nurse's eyes, as she stood, barely able to speak, in the office doorway of her manager. There was no doubt that immediate intervention was needed to improve safety at our home health agency.

ISSN:1057-3631    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

There is a critical relationship of time to treatment and myocardial salvage in the patient with acute myocardial infarction (AMI). The challenge lies in developing a process that minimizes delays in assessment and initiation of reperfusion therapy. Three target areas were identified—time to EKG, thrombolytic therapy, and primary PTCA. A multidisciplinary team reviewed the existing standard of care and identified critical areas that were causing delays. An emergency department algorithm was developed to minimize delays, while data analysis tracked our progress. A collaborative multidisciplinary effort can reduce delays in the treatment for the patient with AMI.

ISSN:1057-3631    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1057-3631    

出版商:OVID    

年代:2002

数据来源: OVID