All Entries in the "nurse education" Category

Perception versus practice in quality of care

Patients’ perceived quality of care varied greatly from the actual quality of care as defined by adherence to guidelines, according to a study published in the Journal of Clinical Oncology last month. Researchers surveyed 374 women receiving treatment for early stage breast cancer at New York City hospitals and asked the patients to rate the care they received. Only 55% of women indicated that they received excellent care, despite the fact that 88% of the women received care that is considered in line with the best treatment guidelines. The findings of the study could have huge implications for hospitals and other healthcare organizations, particularly as insurers use performance and quality metrics to determine reimbursement.

Several factors influenced the women’s perception of care and patient satisfaction. The ease or difficulty of obtaining initial treatment correlated to the rating of quality: 60% of women who said they received excellent care also said the process of getting care was excellent, but only 16% of women who rated care as less-than-excellent said that the process of receiving care was excellent. Race also contributed to perceptions of quality. The survey found that African-American women were less likely to report excellent care and less likely to trust their doctor than Caucasian or Hispanic women, and were more likely to say they experienced racism during the treatment process, despite the fact that there was no difference in the actual quality of medical care the women received.

Communication and interactions with medical personnel also made a difference in the perception of quality. Women who reported having good communication with their physician, a clear understanding of which staff member to turn to with questions, and generally excellent  treatment from the medical staff were more likely to rate their overall quality of care as excellent. The same group of women also felt less mistrust of the medical system.

Although this study examined only a small sample of patients, its findings can be applicable at most institutions. The researchers on the study conclude that healthcare organizations should improve the perceived quality of care by making it easier for patients to obtain care and by establishing trust between patients and healthcare staff. In both instances, clear and detailed communication could aid in improving patient perceptions.

Has your organization noticed a difference in the actual quality of care patients receive and patients’ perceptions of quality? What have you done to align the two? Post a comment below.

Nurses Week: Contest to win a free webcast on preventing CAUTIs!

We’re marking the last day of HCPro’s Nurses Week celebration with a fun nursing quiz! Entrants who answer all questions correctly will be entered into a drawing for a chance to win a free seat to HCPro’s webcast on evidence-based methods to prevent catheter-associated urinary tract infections (CAUTI). The lucky winners will be able to bring their colleagues from nursing, quality, and other disciplines to learn about best practices for keeping patients safe.

The live webcast will be presented on May 30, 2012, and features Mikel Gray, PhD, PNP, FNP, CUNP CCCN, FAANP, FAAN, and Brian Koll, MD, FACP, FIDSA. Winners will also receive a free webcast-on-demand so they may share the training with others in their facility. Click here to learn more about the webcast.

To enter the contest, email your answers to the following questions to Rebecca Hendren at rhendren@hcpro.com.

1. When was Florence Nightingale’s famous Notes on Nursing first published?

2. What percentage of RNs in the United States are male?

3. What day marks the beginning of Nurses Week every year, and what is the day recognized as?

4. What is the significance of May 12?

5. What year did Florence Nightingale establish her nursing school at St. Thomas’ Hospital in London?

6. When was the American Nurses Association founded?

Entries must be received by May 18, 2012.

Nurses Week: Nursing catalogue discount

Looking for new resources and training materials for your nursing staff? You’re in luck, because today in honor of National Nurses Week, HCPro is offering a 30% discount on anything in our nursing catalogue.

You can find the HCPro 2012 Nursing Catalogue at http://www.hcpro.com/NursingCat2012. This is a great opportunity to check out our newest books, educational packages, and training materials.

Please enter source code NRSWK2012 at checkout to receive your 30% discount.

Tomorrow we will feature our final offer for Nurses Week. Be sure to brush up on your nursing knowledge and check back here!

Nurses Week: Training video discount

Today we’re celebrating Nurses Week by offering 30% off the price of any of our nursing training videos. Our videos cover topics such as effective mentoring, improved communication, nurse-to-nurse relationships, and accountability in nursing. Visit HCPro’s Healthcare Marketplace to browse our selection of training videos!

Please enter source code NRSWK2012 when placing your order to receive your 30% discount.

What offer do we have in store next? You’ll have to visit again tomorrow to find out!

Does the solution to the nursing shortage start with education?

There has been a lot of discussion in recent months of a looming nursing shortage caused by the anticipated retirement of Baby Boomer nurses and an increase in demand for RNs. Karen Daley, president of the American Nurses Association, recently appealed to a congressional committee to request $251 million in funding for workforce development and nursing education. Daley noted in her testimony that although the Bureau of Labor Statistics projects a 26% growth in the number of practicing nurses by 2020, a retiring nursing workforce and an aging population will create a need for more than 1 million nurses. Without the funding to train and aid the next generation of nursing students, the shortage is inevitable, according to Daley.

Support from legislators could be crucial in minimizing the nursing gap, particularly when it comes to funding for educational programs. Take, for example, the state of California, which saw its overall number of nurse practitioners double between the years 2004 and 2008 and likewise saw enormous growth in the number of RNs employed in nursing following legislation for minimum nurse staffing ratios. The number of educational programs in California also increased, but the demand for nursing education still exceeded the available spots. A survey by the California HealthCare Foundation found that insufficient funding was one of the main barriers to program expansion.

If the findings in California are any indication, it seems that Daley is correct in stating that an increase in funding for nursing education is the place to start when assessing the anticipated nursing shortage. Creating more programs to meet the demand for nursing education will lead to an increase in the number of nurses entering the workforce, minimizing the gap caused by retiring nurses and growing healthcare demands.

What do you think? Will increasing the number of educational programs address the issue of the nursing shortage, or do you feel there are more effective initiatives to be explored? Let us know in the comments section below!

Room for improvement remains in preventing sharps injuries

Although there has been substantial progress in reducing needlestick injuries in U.S. healthcare settings since the Needlestick Safety and Prevention Act (NSPA) of 2000, there is still room for improvement, according to a statement released by the International Healthcare Worker Safety Center and endorsed by the American Nurses Association. Data collected from both the EPINet Sharps Injury Surveillance research group in Virginia and the Massachusetts Sharps Injury Surveillance System in recent years shows that nurses sustain approximately 35% of total sharps injuries, while workers such as housekeepers, administrative staff, and clinicians sustain 30% of sharps injuries. The most common settings for injuries are patient rooms and surgical settings, according to the statement.

The statement also identifies five key areas for progress in reducing sharps injuries in healthcare workers: improving sharps safety in surgical settings, understanding and reducing exposure risks in non-hospital settings such as clinics and home healthcare, involving frontline healthcare workers in the selection of safety devices, addressing gaps in safety devices, and enhancing education and training. Each improvement area includes statistical information and recommendations for action.

This statement serves as a pertinent reminder that laws alone cannot guarantee a safe and injury-free work environment. You must continue to educate your staff on safe practices when using and disposing of needles, and remind them of the hazards involved with sharps injuries, including exposure to bloodborne viruses. You must also act as an advocate for the selection of safer devices to further prevent the risk of injury; you and the members of your staff should have be able to voice opinions on which sharp devices best suit your needs.

Weigh in below: what has your organization done to reduce rates of needlestick injuries? How do you work to establish a culture of safety with regard to sharps injuries?

Cool app for nurses, but does it foster bad habits?

Robert Freeman, a registered nurse at Beth Israel Hospital in New York, designed an mobile app for nurses that includes a database of more than 10,000 medical abbreviations and a news feed specific to the nursing profession, according to the New York Daily News. Freeman said the idea for a nursing app came to him when a colleague could not decipher an abbreviation on a patient’s chart. He indicates that nursing students will benefit the most from using the app as a learning tool, but that it will also improve efficiency and productivity for all nurses by quickly answering queries.

Freeman spent three months researching the information necessary to design “Nurse Net,” his free app. The app includes tools such as the Credentialer, which clarifies the abbreviations for various certifications and credentials used by health professionals, and the Abbreviation Assistant, which interprets abbreviations found on medical charts. “Nurse Net” became available in the Apple Store in November and has been downloaded more than 12,000 times since then.

I wonder how patient safety and quality professionals (yes, you) felt about these kind of apps. Personally, I worry about a nurse who, instead of clarifying an abbreviation (which may be a “do-not-use” abbreviation!) with the physician, consults an app. I would always prefer communication between humans when possible rather than consulting a third source, even if it is a bit of effort. Also, speaking directly with the physician might help avoid future issues with that physician’s notes. Is consulting the app a workaround here? And don’t forget, an app isn’t responsible for being right; it’s not responsible for being updated, and most importantly, isn’t responsible for keeping your patients safe. It’s a product, like anything else, even if it’s free and developed by a nurse with the best of intentions.

Are we teaching the right thing here? Weigh in below.

First published on Patient Safety Monitor Blog

Practical tips for implementing shared governance

Diana Swihart, PhD, DMin, MSN, CS, RN-BC, shares the following practical tips and best practices for ensuring success when building shared governance.

• Schedule a day-long retreat away from the organization to prepare organizational and nursing leaders to implement shared governance. Discuss the role shared governance plays in the ANCC Magnet Recognition Program(r) (MRP) journey. Have subject matter experts present topic discussions on specific points: leadership, shared governance partners, steering committee formation, design team for the shared governance model, a business case for MRP and shared governance, and roles of direct-care nurses and the multidisciplinary team members.
• Create expectations for staff contributions, beginning in the new employee orientation and continuing throughout their careers.
• Communicate, communicate, communicate! Have a nursing town hall meeting at least once a quarter to facilitate open communication among nursing staff and leaders.
• Administer the Index of Professional Nursing Governance surveys and see how your organization “measures up”-help build the repository of information on the efficacy and value of shared governance in healthcare settings.
• Use journal clubs, for example, to bring nursing research to the bedside and engage direct-care nurses in evidence-based practice for developing and implementing advanced decision-making and critical thinking.
• Let direct-care nurses meet each year to review organizational competencies and unit/area needs and determine which competencies they will focus on for that year (high-risk/time-sensitive, changed, problematic, and/or new).
• Train every registered nurse on each unit/area to be charge or lead nurse. Rotate the role and responsibilities to encourage leadership skills development and shared decision-making among all team members.

Source: Book excerpt adapted from Shared Governance: A Practical Approach to Transform Professional Nursing Practice by Diana Swihart, PhD, DMin, MSN, CS, RN-BC. Click here to visit www.hcmarketplace.com.

Patient safety and agency nurses

Medication errors are twice as likely to occur with agency and temporary emergency room (ER) nurses than with permanent staff, according to a new study from Johns Hopkins University School of Medicine.

There are many reasons for such findings, including the fact that temporary nurses are unfamiliar with their surroundings. They do not know the nurses, physicians, and multidisciplinary personnel they are working with, which can lead to communication problems and poor teamwork. They may be less comfortable speaking up if they have questions or concerns.

Bringing in agency staff is often the only way to ensure adequate staffing and they are a valuable resource for most organizations. So what should nurse managers do to mitigate the effects and improve patient safety?

1. Advocate for thorough orientation for new agency staff. Organizations should have competency-based orientation programs designed for temporary staff so they can quickly and easily learn what you need them to know.

2. When on the unit, assess for competency. Once the agency staff are on the unit, don’t just assume they can handle anything. Charge nurses should be involved in assessing them for competency and how they deal with situations. Don’t give them more than they can handle right off the bat. Assign more challenging situations to experienced staff until you know the agency staff member can handle more and you are confident in his or her decisions. [more]

Should all new nurses be required to obtain baccalaureate degrees?

New nurses need to have four-year degrees, according to the readers of www.StrategiesForNurseManagers.com.

We’ve been asking readers whether baccalaureate degrees should be required before new nurses can enter into practice. By a slight margin, the majority say yes. Forty-three percent say the profession of nursing needs a more highly educated workforce.

Forty-one percent don’t think it necessary for nurses to enter practice with a baccalaureate degree, but say nurses should be required to obtain one within a few years of entering practice.

Just 15% say associate degrees are sufficient and only 1% have no opinion.

What do you think?