RSSAll Entries in the "patient satisfaction" Category

Virtual reality a potential solution for pain management

This year has seen the release of multiple virtual reality (VR) headsets aimed at the home consumer. As they are becoming more affordable, hospitals and companies are researching the benefits in a healthcare environment, and the early results are positive.

Cedars-Sinai Medical Center and Children’s Hospital Los Angeles are conducting studies using the software, and the early results are positive. Cedars-Sinai researchers found that 20 minutes of using the VR software reduced patients’ pain by almost 25 percent; patients had an average pain score of 5.5 out of 10 before the VR experience and an average score of 4 after using the software. The researchers say this is a dramatic reduction, and not far from the effect of narcotics. At Stanford Children’s Health, they speculate that VR can be valuable for helping children get through tedious or uncomfortable procedures, such as physical therapy or imaging studies.

Though providers are cautiously optimistic about the possibilities, there are still some hurdles to overcome. It is difficult to find developers who want to target medical issues, because of the unclear path to profitability. One startup company, ApplieVR, is building a library of content designed to help patients “before, during, and after medical procedures” It’s also important to determine when the technology can helpful and when it can’t; some patients won’t respond to the applications as well as others, and researchers are careful not to oversell the value of VR at this early stage.

For more information, check out the MIT Technology Review article.

Do you think VR might replace Opoid use eventually? Let me know in the comments!

How nurses can reduce patient anxiety

Nurses face challenging patients and their families every day, but understanding the causes of patient stress can reduce the patient’s anxiety and ultimately make your job easier.

Healthcare can be confusing and distressing for many patients. Being admitted to a hospital for any reason can be one of the more stressful events in a person’s life. Because of this, it is important to remember that anxiety is the root cause for many conflicts in healthcare settings; so a difficult patient or family member isn’t necessarily a rude or ornery person most of the time, they may just be experiencing symptoms of anxiety.

The first step in mitigating a patient’s anxiety is to introduce yourself and explain your role in their treatment plan. Explain everything you are going to do and why you are doing it. Patients are inexperienced in healthcare procedures, and it can be easy to take your knowledge for granted. Come armed with hand-outs and as much information as you can; the more knowledgeable the patient feels, they more comfortable they will be.

Next, it is important to listen to your patient and take their needs seriously. Active listening techniques, such as asking open-ended questions, taking an interest in their lives, or checking in on their feelings, can be a vital lifeline to someone suffering from anxiety. Check in with them often, and give them a venue to voice their concerns.

Instead of instructing the patient to relax, demonstrate it! Your demeanor can have a profound effect on a patient’s emotional well-being, so staying cool and collected can relax them in turn. Consider using relaxation techniques like breathing exercises to help them cope with anxiety.

For more tips, click here.

National Time Out Day

Today is National Time Out day! For the 12th year in a row, the Association of periOperative Registered Nurses (AORN) want to remind medical professionals to take a moment before every procedure to make sure they are “operating on the right patient, the right site and the right procedure.” The Joint Commission reports that wrong site surgeries occur five times every day in the United States, and AORN hopes to raise awareness of the issue and improve patient safety.

For more information or to see how you can participate in National Time Out Day, visit AORN’s official website.

Nurses uniquely qualified for hospital design

The role of nurses has expanded greatly over the past few years, as nurses are moving from the bedside into all facets of healthcare. Hospitals have started to use nurses’ expertise to help design their facilities, with impressive results.

Hospital design can have a profound impact for both nurses and patients, but facilities are just starting to include nurses in the design process. Health Facilities Management (HFM) reports that involving nurses in design planning can help executives and contractors keep patient-care priorities in mind during construction. Seemingly small decisions, like the placement of sinks, computers, or wall outlets, can lead to an increase patient satisfaction. Nurses have been behind some of the pioneering new hospital designs, such as single-occupancy maternity rooms and the acuity-adaptable patient rooms. As one nurse told HFM, “Nurses spend the most time with the patient… we have a responsibility to be the voice of the patient, family and each other.”

Looking out for each other is another great reason for involving nurses in hospital design. A study published by Hassell and the University of Melbourne found that hospitals designed to accommodate nurses have a better chance of attracting and retaining nurse staff. The researchers identified a link between hospital workplace design and efficiency, health and safety for staff and patients, and staff morale. These factors play a significant role in staff retention, and who better to ensure a facility is attractive to nurses than nurse leaders?

Nurse-led design choices improve conditions for patients and nurses, but they can also help the bottom line. Nurses are involved in many different areas of the hospital, and their input can make operations more efficient and affordable. In one example reported by HFM, nurses saved the Parkland hospital project millions of dollars by eliminating unnecessary equipment and cabinetry in emergency rooms.

Both the survey and HFM article note that despite these benefits, nurses don’t always get a voice in hospital design. But as nurse-designed hospitals flourish, perhaps more facilities will involve nurses in design plans.

For more about Nursing and hospital design, check out: Take Five: How renewal rooms revive stressed out nurses

Shared decision making has benefits for minority patients

New evidence suggests that shared decision making (SDM) can improve the patient experience for minority groups, particularly LGBTQ patients of color.

Shared decision making aims to include the patient’s perspective when making care decisions and better educate patients about treatment options. SDM acknowledges that each patient is unique, so creating a dialogue between the provider and patient should increase patient engagement and result in better outcomes. As one researcher describes the shift: “It’s going from ‘I’m the expert, take my recommendation’ to ‘I am going to inform you and respect your wishes.’”

This idea of respecting and listening to a patient is at the heart of caring for all patients, but minority patients particularly benefit from an SDM approach. As we discussed in our post about transgender healthcare, an open dialogue and respect for how the patient would like to be addressed goes a long way to build trust for the patient; the same principle applies across minority groups.

The University of Chicago and the Agency for Healthcare Research and Quality have developed a new project called Your Voice! Your Health! aimed at researching SDM’s influence on minority healthcare and facilitate healthcare improvements for the LGBTQ racial and ethnic minority community. The researchers note that the confluence of minority statuses make it particularly difficult for LGBTQ patients of color; as Monica Peek MD, MPH, Associate Professor of Medicine at the University of Chicago Medicine told ScienceLife: “Racial/ethnic, sexual orientation, and gender identity minority status are all marginalized social identities, so they act in concert to further marginalize people who are trying to navigate the health care system.”

Because there is little existing research on LGBTQ patients of color, providers may not have the proper framework or tools for addressing their needs. Peek and her team developed a new conceptual model to illustrate how the patient and physician’s social identities effect SDM. As ScienceLife describes the strategy: “In the end, establishing trust boils down to how well a physician acknowledges her own identities in relation to those of her patients.” According to the group’s research, differences in social identity didn’t matter so long as the provider was compassionate and encouraged an educated dialogue, the hallmarks of a SDM approach.

program, Massachusetts General Hospital (MGH) reviewed what made the initiative a success. At first they relied on physicians to order decision aids and educational materials for patients to encourage informed discussion, but they didn’t see immediate results. Once they trained all staff and involved patients directly, the use of decision aids increased substantially. Leigh Simmons, MD, medical director of the MGH Health Decision Sciences Center, said of the initiative: “There now is a big push toward more team-based care in medicine; and once we started to engage the entire team – including front desk staff, medical assistants and most crucially, the patients – we saw the use of decision aids take off.” Once the full staff and patients embraced the program, physicians reported that they had more advanced discussions with patients and they are able to focus on what’s important to their patients.

Do you use shared decision making practices in your facility? Do you find it easier to connect with patients using these techniques? We would love to hear about it in the comments below!

For more information on the Your Voice! Your Health! project and a useful tool for establishing a patient dialogue, check out the full ScienceLife article.

Creating a transgender-friendly healthcare environment starts with nurses

Nurses are often the face of their hospital; they are typically the first staff member to interact with the patient, and nurses are integral to providing a positive patient experience. In the ever-shifting landscape of culture, healthcare providers need to avoid discrimination and work to make sure patients feel at ease. While we have many resources that address cross-cultural competency (like this article from our Strategies for Nurse Manager’s reading room or the Health and Human Services’ guide), the medical community is just beginning to address how to effectively treat transgender patients. The Association of American Medical Colleges (AAMC) recently released treatment guidelines for transgender patients, and it is vital that nursing staffs help battle unconscious bias and create a safe climate for all of their patients.

In 2010, Lambda Legal found that a staggering 70 percent of transgender people had experienced discrimination in a hospital setting, and a 2011 study by the National Center for Transgender Equality and the National LGBTQ Task Force reported that 19 percent of patients were denied healthcare because of their status (via the New York Times). Because of this, 28 percent of the respondents have postponed medical care when sick and 33 percent don’t pursue preventive care because of their past experiences with medical professionals.

Better nurse education would be a great start to counteract this trend of discrimination and improve the climate for transgender patients; and when it comes to educating your staff, a little can go a long way. Part of the problem is treatment knowledge, but many of the issues could be solved with improved sensitivity training. Basic language education, such as what pronouns to use and asking the patient how they’d like to be addressed, can make a transgender patient feel at ease. Adding a gender and preferred name component to medical records and ensuring that they are up to date can greatly improve the consistency and quality of care as well.

Janis Booth, RN, shares a great example of how hospital staff can help a transgender person feel at ease from one of her readers:

“My new doctor saw my list of meds and knew immediately and opened with, ‘You look great…how long ago did you begin your transition?’ Put me right at ease, immediately, even though my name change had not caught up with their record keeping. I presented new IDs and they updated my info.”

Small things like asking the right questions in a gentle way can open up the patient and make them more comfortable, which will make your job much easier as well. Nurses get to set the tone of the patient’s experience, so properly training your staff on gender issues can make all the difference for a transgender patient in need.

Here are some great training resources on the topic:

  • You can download the full AAMC guide here.
  • WBUR has a list of tips to get you started.
  • Janis Booth’s full article has a lot of great information as well.
  • TransRecord and RAD Remedy are sites dedicated to gathering and sharing data on trans-friendly providers.

Evidence-Based Practice: Share your journey

Do you have an EBP story to share?

For nurses just getting started with evidence-based practice, the steps between deciding on an area to research and implementing a plan for improvement can be overwhelming. Identifying sources of qualified research, interpreting the results, translating procedures from theory to practice… It’s complicated, to say the least.

I’m looking for a few brave souls who would be willing to share what I’m calling “EBP notes from the field.” If you’ve gone through the process from start to finish, would you be willing to share ebpnotesyour story? I see these as 1-2 pages looking into the decision making process, the research you chose, the steps you took to get buy-in from management. What did you learn in the process? How did you implement your research? Have you been able to measure the results?

I’d like to include a few of these stories in an upcoming book project: a simple EBP guide for working professionals. It will be very practical, straightforward, and [more]

The value of nursing staff satisfaction

There is a connection between nurses’ feelings about
their work environments and nursing quality and safety

Rebecca Hendren recently posted about a June 2015 Healthleaders magazine article focusing on steps organizations are taking to measure and improve nursing staff satisfaction. For anyone who hasn’t yet read it, I just want to share my favorite quote from the article. In it, Linda Aiken, PhD, a nursing workforce researcher and director of the Center for Health Outcomes and Policy Research (U. Penn) is quoted as saying that

Nursing “is the single biggest factor
in how patients rate their hospitals”

Do you agree with this statement? Have you seen the impact of improvements in nursing staff satisfaction on care quality, outcomes, and patient ratings? What tools or strategies have you used to improve staff retention and satisfaction? Please leave a comment sharing your experiences with your fellow nurse leaders.

 


 

For more details on the kinds of nursing staff surveys conducted by organizations that have received designation as ANCC Magnet Recognition Program® hospitals as well as those that have not, plus the source of the headline quote (which no one would dispute!), click here to go to the HealthLeaders article.

Free Webcast: Techniques to improve critical-thinking skills

HCPro is celebrating and recognizing nurses all week long with special giveaways, prizes, and promotions.

OnDemandWebcastEnjoy this FREE webcast on us!

Critical Thinking and Patient Outcomes: Engaging Novice and Experienced Nurses

Join renowned critical thinking expert Shelley Cohen, RN, MSN, CEN, for a 90-minute webcast for nurse managers, educators, and nursing professional development specialists about strengthening nursing staff’s critical-thinking skills.

This program provides practical strategies for developing critical-thinking skills in novice and experienced nurses. It discusses how to foster an ongoing program that emphasizes critical-thinking skills and how improved critical thinking can impact patient outcomes.

To access this FREE webcast, enter discount code EW323823 at checkout.

And be sure not to miss…

Yesterday’s post has links to a 20% discount code on all nursing products, a BOGO on books and handbooks, and other activities of interest…

Happy Nurses Week: A thank you to our favorite nurses

Is there any doubt that nurses heal the spirit, as well as HappyNursesWeekthe body?

The stories in The Boston Globe annual “Patients Salute Their Nurses” piece offer an inspiring and humbling testament to all the nursing profession can be.

In 400 thank-you letters from grateful patients, family members, and colleagues, Boston’s nurses received personal acknowledgment and messages of love inspired by their deep commitment to the profession and their patients.

Here are snippets from some of my favorite letters:

Diane goes above and beyond, treating me with dignity and respect, even calling me weekly to check on my weight and well-being. Like a friendly drill sergeant, she reminds me to keep my weight down and to pay attention to what I eat.

Joe provided intense, meticulous, and sensitive care not only to Mike, but also to his extended family. Joe’s quiet and steady presence gave us hope and strength when we needed it most. Mike did not make it through the night, but the blow of his passing was softened by the gift of time that Joe made possible.
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