RSSAll Entries Tagged With: "Patient Safety"

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!

Game teaches nurses about med management

A new board game might help nurses minimize medication errors.

Many nurses report that medicine management is a difficult aspect of their responsibilities. Focus Games Ltd and healthcare academics have developed an educational board game designed to help “frontline healthcare professionals understand, recognize and minimize medication errors.” The Drug Round Game, an adaptation of “Snakes and Ladders,” hopes to teach nurses and nursing students about medication management, while giving them the opportunity to practice drug calculations and have big picture discussions in a low-stakes environment.

Nursing students that have tried the game describe it as fun and engaging, while improving their nursing knowledge and practicing what they’ve learned. Professors who’ve played the game with staff and students say that the game is enjoyable yet challenging, and an effective way to practice and refine their skills.

For more information about the game, check out City University of London’s press release.

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.

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.

Temp is not the same as terrible: Study finds supplemental nurses have no negative effect on quality

What do you do when you don’t have enough nurses on staff and don’t have the funds to hire additional staff? A possible solution is to hire temporary nurses to fill the gaps made by retiring staff, seasonal needs, or new medical programs.

The Department of Health and Human Services found that there are 88,495 temporary nurses working in the U.S., making up 3.4% of the total nursing population. Most temporary nurses are experienced travel nurses who work with a hospital on three- to six-month contracts before moving on.

Yet many nurse managers are leery of using temp nurses because of a longstanding stigma associating such nurses with lower quality care. This belief has been reinforced by media exposés on shoddy temp agencies skimping on background checks and allowing temps to jump from hospital to hospital to avoid misconduct charges. [more]

Reduce clinical alarm fatigue with new HCPro webcast

hcpro webcast-liveThe problem of clinical alarm fatigue is so pervasive in hospitals that The Joint Commission created a new National Patient Safety Goal to address it. With so many device alarms going off, staff may tune them out and miss important warnings that can lead to adverse patient events.

In this webcast scheduled for Wednesday, October 4 at 1 p.m. Eastern, Deborah Whalen and Jim Piepenbrink of Boston Medical Center will explain how their facility successfully reduced alarm fatigue through process management, collaboration, and governance.

Register today for Clinical Alarm Management: Reduce Alarm Fatigue and Meet The Joint Commission’s National Patient Safety Goal and get the knowledge you need to improve alarm management in your facility.

Visit the webpage for more information or to register, here.

Live webcast: Active Shooters in Healthcare Facilities

Develop Your Active Shooter Prevention and Response Plan

Upcoming webcast: September 23, 2015, 1:00-2:30 p.m. ET

Active shooters and armed violence represent a rapidly growing issue in America’s hospitals and healthcare facilities. These incidents occur on a near-weekly basis, which means it is time to face the fact that they can hcpro webcast-livealso happen in your facility.

Don’t wait until it is too late to develop an emergency response plan! Join HCPro for a live webcast presented by healthcare safety experts Lisa Pryse Terry, CHPA, CPP, and Christian M. Lanphere, PhD, FP-C, NRP, CEM. They will teach participants how to lessen the risk of a violent confrontation and how to prepare facility staff in the event an armed intruder comes through their doors. [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.

Assessing nursing quality and patient safety

Interest in using a variety of nursing engagement surveys as a reportable quality indicator is growing.

This article, written by Cheryl Clark, appears in the June 2015 issues of HealthLeaders magazine.

Do your hospital’s nurses feel empowered? Are nurses’ relationships with physicians strong enough that nurses can call out errors or ask questions without fear? Do they think their hospital hires enough nurses with appropriate skills and provides enough resources to provide safe and timely care? Are nurses involved in making policy?

When nurses are surveyed on these and related questions, which they increasingly are, poor scores may indicate troublesome systemic issues that could, directly or indirectly, affect quality of care, even adverse events. A drop in scores can often be tracked down to a specific hospital unit, research has shown. And poor scores may correlate to “nursing sensitive” patient outcomes, such as patient falls, lengths of stay, pressure ulcers, and infections.

Simply put, this measure is asking nurses what they think about the organization for which they work and how well they trust the care they deliver in their work environments.

Read the full article here.