RSSAll Entries Tagged With: "nurse leadership"

Joint Commission and FDA target alarm fatigue

by Matt Phillion, for the AHAP blog, April 22, 2011

The Joint Commission recently told The Boston Globe that it would work with the Food and Drug Administration (FDA) to make alarm fatigue a priority.

Alarm fatigue is a concern for many, and it’s no wonder as to why. Our colleagues at the Patient Safety Monitor Journal wrote about the dangers in their March 2011 issue in which Kathryn Pelczarski, director of the applied solutions group at the ECRI Institute, said that a nurse for an ICU might be dealing with 150-400 physiologic alarms per patient per day. A nurse in those units typically has one or two patients, but that doesn’t mean they don’t hear the alarms for all the other patients.

Nurses are hearing hundreds of alarms during their shift, some critical, some less important, with many false alarms, and patient safety is suffering as a result.

The Boston Globe article can be found here; to learn more about Patient Safety Monitor Journal, click here.

Click here to visit the AHAP blog.

Preceptor perspectives on a just culture

By Julie Harris, MSN, RN

Just culture. This term has been thrown around in the nursing literature for many years. Many nurses, including preceptors, might think that it was started in healthcare. Actually, healthcare borrowed the idea from the aviation industry. After a terrible plane crash, the aviation industry started a program to change and correct pilots’ behaviors.

About 20 something years later, the Institute of Medicine published a report, “To Err is Human: Building a Safer Health System,” that cited tens of thousands of preventable human deaths per year in United States’ hospitals. This report was a wake-up call to many healthcare leaders. After seeing the success of the aviation industry, many hospitals adapted a similar process and the phrase, “a just culture,” was born.

What does a just culture have to do with me, a preceptor? My answer would be everything. As a preceptor, you are a front line leader. Your peers turn to you for advice, education, and role modeling, especially when it comes to creating and sustaining a just culture in your clinical area. Here are a few points to ponder to determine your fit in a just culture:

  • Do you report near miss events?
  • Do you teach orientees to follow your institution’s policies?
  • Do you proactively report any potential safety hazards?

Over the next several posts, we will examine different aspects of a just culture. We will also explore in-depth a preceptor’s role in creating a just culture. So come along for the just culture ride!

Thomson Reuters names top 100 U.S. hospitals

Thomson Reuters has announced its annual study naming 100 top U.S. hospitals that have shown it’s possible to walk the fine line that all hospitals are trying to walk in today’s economy—boost patient care and cut costs.

Thomson Reuters researchers evaluated 2,914 short-term, acute care, non-federal hospitals on their overall organizational performance in 10 key areas: performance in mortality, medical complications, patient safety, average patient stay, expenses, profitability, patient satisfaction, adherence to clinical standards of care, post-discharge mortality, and readmission rates for heart attack, heart failure, and pneumonia.

According to researchers, if all Medicare inpatients received the same level of care as those treated in the award-winning facilities:

  • Nearly 116,000 additional patients would survive each year
  • More than 197,000 patient complications would be avoided annually
  • Expense-per-adjusted-discharge would drop by $462
  • The average patient stay would decrease by half a day

Hospitals that made the list include Beth Israel Deaconess Medical Center, Boston; Fairview Hospital, Cleveland; Blanchard Valley Hospital, Findlay, OH; Sutter Davis Hospital, Davis, CA; and Brigham and Women’s Hospital, Boston.

Brigham and Woman’s Hospital, along with five other hospitals on the list, also won the Everest Award for the greatest rate of improvement over five years.

Click here to see the full list.

Source: Thomson Reuters

AHAP Conference at Caesar’s Palace, Las Vegas

Save the date, and enter our contest, too!

HCPro’s Association for Healthcare Accreditation Professionals (AHAP) is hosting this year’s AHAP conference at Caesar’s Palace in Las Vegas on May 12-13th, 2011. Topics will include regulatory changes for 2011, core measures, risk assessments, and survey readiness, as well as a roundtable discussion where you can share your successes, challenges, and best practices about top accreditation and patient care issues.

Launched in September 2006, AHAP now has close to 500 members. The 2011 conference will be the association’s fifth annual conference, and you don’t have to be a member to attend.  This year’s conference is one you won’t want to miss. It will feature sessions about preparing for both The Joint Commission and CMS surveys, restraint, high risk procedures outside of the OR, effectively presenting data, infection control, as well as patient care, quality improvement, and more!

AHAP is also hosting a contest for best survey preparation tool, policy, or activity. To enter, submit a sample tool, policy, or a brief write-up about a recent (2010-2011) accreditation survey by Friday, April 8th.  Click here to read the full contest rules, and please send all of your entries directly to  The tools can be any examples that have helped you do your job better. Visit the AHAP Blog to see contest entries that have already been submitted. These sample documents will be posted to the AHAP Blog throughout the remainder of the month.

Choosing top-ranking hospitals for treatment could mean life or death

According to HealthGrades annual report Patient Safety in American Hospitals, certain medical errors are 46% less likely to occur at top-rated U.S. hospitals than bottom-ranked hospitals.

HealthGrades analyzed 40 million Medicare patient records from 2007 to 2009, focusing on 13 patient safety indicators, such as pressure ulcers, bloodstream infections from catheters, and foreign objects left in the body after procedures to identify medical errors that were largely preventable, and which hospitals were in the 5% for avoiding those errors.

The study found that four patient safety indicators—death among surgical inpatients with serious treatable complications, pressure ulcers, post-operative respiratory failure, and post-operative sepsis—accounted for more than two-thirds of all patient safety events, and were associated with $7.3 billion in additional costs.

According to the report, the 10 cities with the best performing hospitals included: Minneapolis-St. Paul; Wichita, KS; Cleveland and Toledo, OH; Wilkes-Barre, PA; Boston; Greenville, SC; Honolulu; Charlotte, NC; and Oklahoma City.

The study also found that patients in top-ranked hospitals were:

  • Thirty percent less likely to contract a hospital-acquired bloodstream infection
  • Thirty-nine percent less likely to suffer from post-surgical sepsis than those at low-rated hospitals
  • Fifty-two percent percent less likely to experience a central-line bloodstream infection

To view the annual report, click here.

Source: HealthDay

Washington, DC, nurses strike again

After almost a year of on-again, off-again contract talks and labor disputes over wages, benefits, staffing, and patient safety, nurses at the Washington Hospital Center—the region’s largest hospital—began a 24-hour strike on the morning of Friday, March 4.

Between 200 and 250 nurses picketed outside the hospital complex, chanting slogans and wearing red scrubs, the trademark color of National Nurses United, which represents the 1,600 nurses at Washington Hospital Center and is the nation’s largest nurses union.

According to The Washington Post, the nurses were picketing over potential cuts in wages, the need for more nurses, and benefit disputes—the same topics that have been an issue for the past year.  A hospital spokesperson told The Washington Post that of the 313 nurses scheduled to work the 7 a.m. to 7 p.m. shift that day, more than 150 came in, and that replacement nurses were hired to fill in for the rest. The paper also reported that 125 hospital physicians had signed a petition requesting nurses to stay at patients’ bedsides.

The protest was supposed to last until the morning of Saturday, March 5, at 7 a.m., but hospital officials said they would lock out striking nurses for five days without pay, because the hospital is obligated to pay the replacement nurses for at least 60 hours of work.

To read more about the disputes at the Washington Hospital Center, click here.

Changing the public’s image of nursing

How the media portrays the nursing profession and how the public views nurses has been a longstanding concern for RNs and healthcare professionals.

Television shows like Nurse Jackie and HawthoRNe often feature a positive image of nursing (although there are real-life nurses and healthcare professionals who would disagree with that assessment), while shows like HOUSE and ER show physicians doing nurses’ jobs or just don’t show nurses at all. The news is inundated with conflicting reputations; from outstanding nurses who pioneer for patient care, to nurses who steal their patients’ pain medication for surgery.

I’ve always been one to look on the bright side of things, and luckily there are a wealth of nurses out there who advocate for a positive image of nursing. Kathleen Bartholomew, RN, MN, an expert on improving communication, patient safety, and the image of nursing, and author of several books about nurses and their role in the healthcare setting, is speaking at a conference held by The Truth About Nursing, a non-profit organization that seeks to educate the public on the positive and negative images of nursing in the media through reviewing TV shows, commercials, music, and books that feature these images.

The organization is hosting its conference on April 15-17 in New Orleans, will feature nursing leaders, and discuss why the media’s portrayal of nursing puts people at risk, how to improve relationships with colleagues, and how to get the voice of nurses heard in politics.

To see the conference agenda and get more information, click here.

2011 HCPro Nursing Image Awards

The search is on! HcPro is once again looking for nurse leaders and staff who have helped to promote a nursing image of excellence.

HcPro hosts this nationwide search to find and recognize nurses who contribute to improving patient care, quality outcomes, nurse satisfaction, and the healthcare environment, and celebrate their individual or team work that occurs in healthcare organizations on a daily basis.

Awards are broken down into two categories:

The image of nursing in clinical practice— this award honors nurses whose clinical work portrays a positive image of nursing, and has played a significant role in improving patient outcomes, patient safety/quality initiatives, staff satisfaction, practice changes, research or evidence-based practice projects, interdisciplinary collaboration, or organizational goals.

The image of nursing in leadership—this award honors nurses who have created a positive image of nursing by serving as an inspiring leader, mentor, and role model to nurses, and who strive to demonstrate professionalism in all that they do whether by overcoming challenges, spearheading change, or inspiring teamwork that resulted in achievement of operational goals/objectives.

Do you know someone you’d like to nominate? Click here to find out more details on eligibility, official rules, and how to enter someone you think should receive this award. Entries are being accepted until midnight on July 31st, 2011.

Preceptor Perspectives: I’m a leader, too!

In a complex healthcare environment, nurses seek out other team members they can count on. They want to work with people they can rely on and who can tackle and conquer daily problems. They are looking for leaders.

Leaders demonstrate traits and qualities that help them address nursing issues head on. They motivate other nurses to do their best. Does this description sound familiar? Of course it does – because preceptors are leaders!


Look-alike drugs add to pile of medication errors

U.S. researchers report that confusion caused by look-alike and sound-alike drugs account for a large portion of the medication prescription errors found in hospitals.

Researchers reviewed 714,290 orders for painkillers in a large database of pharmacist detected and prevented prescribing errors, and found the overall error rate to be 2.87 per 1,000 prescriptions and that the rate for potentially serious prescribing errors was 0.63 per 1,000. The study found that error rates were even higher when prescribing for children—243 errors in 40,996 orders. The highest rates were due to errors involving drugs that were infrequently prescribed.

Errors were evaluated on a number of contributing factors, such as inadequate drug therapy knowledge, inappropriate use of a dosage form, and failure to modify therapy based on patient-specific information.

Source: HealthDay