The document discusses bedsores (pressure sores) in VA facilities. It notes that the US VA system has over 1000 facilities including 152 medical centers and 1400 clinics. About 12.3% of VA facilities reported increased rates of bedsores, especially in long-term care facilities. Bedsores are caused by prolonged pressure, friction, and shear on skin over bony areas and can develop into four stages of severity. The document proposes creating a program to educate patients and clinicians on bedsore prevention to help reduce facility-acquired bedsores by 20% in six months. It involves developing an instructional class to teach clinicians how to educate patients on proper turning methods and risk factors to prevent bedsores.
Tricia Strusowski, MS, RN
Director, Cancer Care Management
Helen F. Graham Cancer Center
Christiana Care Health System
Sharon Gentry, RN, MSN, AOCN, CBCN
Breast Health Navigator
Derrick L. Davis Forsyth Regional Cancer Center
Treatment Compliance, Therapeutic Education And Phosphorus MissionFrederique Quinio
Phosphorus Mission Educational Tool - Partnership between EDTNA/ERCA and Sanofi
Phosphorus Mission Educational Tool is a software package developed by Sanofi for use by dialysis nurses to educate their patients on how to maintain healthy phosphorus levels.
The patients themselves will also have the option of downloading Phosphorus Mission Educational Tool onto their computers or their mobile telephones outside of a clinic setting.
EDTNA/ERCA validated and accredited this educational tool.
This internship summary provides an overview of the student's internship at the Greenville Health System Center for Integrative Oncology and Survivorship (CIOS) from August to December 2016. As an intern, the student gained exposure to holistic and patient-centered cancer care through clinical observations, administrative duties, and projects. Responsibilities included shadowing various health care providers, attending support classes, inputting patient data, and conducting interviews with CIOS staff. The internship allowed the student to experience firsthand how CIOS addresses all aspects of a cancer patient's physical, emotional, and social needs through its multidisciplinary team approach.
This document outlines the structure and contents of a research study on assessing the knowledge of staff nurses regarding prevention and management of perineal tears during normal delivery. It includes 6 chapters that discuss the introduction, literature review, methodology, data collection process, data analysis plan, and expected outcomes including conclusions and recommendations. The study aims to assess nurses' current knowledge and identify any associations between knowledge and demographic factors, with the goal of developing an educational module to improve nurses' understanding of perineal tears.
2011/2012 Always Event℠ Challenge Grant Recipient Project OverviewsPicker Institute, Inc.
This document describes grant recipients for the 2011/2012 Picker Institute Always Events Challenge. It provides summaries of 6 recipient organizations and their proposed projects:
1) Quality Partners of Rhode Island will use PictureRx software to provide visual medication schedules to patients before discharge from nursing homes.
2) Massachusetts General Hospital aims to ensure patients always know their care team and receive timely responses through strategies like welcome videos and identification boards.
3) Planetree/Griffin Hospital will utilize an online patient assessment tool and care partners to ensure alignment between patients, caregivers and providers across healthcare settings.
4) St. Jude Children's Research Hospital will implement a parent mentor program to support newly diagnosed families through treatment and beyond
Gynecological Oncology Navigation by Penny Daugherty, RN, MS, OCN, ONN-CGPennyDaughertyRNMSOC
This session defines the various diagnoses classified as gynecological malignancies and address the discreet nuances of each disease, as well as recognition and management of specific side effects associated with individual syndromes. Conventional and targeted therapies are reviewed as well as discussions assisting patients in the selection of integrative approaches to care.
Putting it all together: Personalized care for cancer survivors Carevive
This document discusses barriers to quality cancer survivorship care and potential solutions. It notes that there are over 13 million cancer survivors in the US who face long-term effects of treatment and prevalent unmet needs. The Institute of Medicine recommends that survivors receive a comprehensive treatment summary and care plan. However, creating these plans can be time-consuming. New technologies like the On Q Health system aim to generate personalized care plans more efficiently based on patient-reported outcomes and guidelines. The system covers symptoms, surveillance, late effects and aims to improve quality and coordination of care across the cancer journey.
This document summarizes a case study on reengineering processes at Nethrajyoth International Hospital in southern India. [1] The hospital aimed to increase services for poor patients without increasing fees for other patients, but faced constraints on resources and staff. [2] The old process involved patients moving between departments with long wait times. Reengineering focused on eliminating wait times using a centralized IT system. [3] The reengineered system links 60 terminals to schedule appointments, registration, payments, and hand patients between departments, cutting perceived wait times for a better patient experience.
Tricia Strusowski, MS, RN
Director, Cancer Care Management
Helen F. Graham Cancer Center
Christiana Care Health System
Sharon Gentry, RN, MSN, AOCN, CBCN
Breast Health Navigator
Derrick L. Davis Forsyth Regional Cancer Center
Treatment Compliance, Therapeutic Education And Phosphorus MissionFrederique Quinio
Phosphorus Mission Educational Tool - Partnership between EDTNA/ERCA and Sanofi
Phosphorus Mission Educational Tool is a software package developed by Sanofi for use by dialysis nurses to educate their patients on how to maintain healthy phosphorus levels.
The patients themselves will also have the option of downloading Phosphorus Mission Educational Tool onto their computers or their mobile telephones outside of a clinic setting.
EDTNA/ERCA validated and accredited this educational tool.
This internship summary provides an overview of the student's internship at the Greenville Health System Center for Integrative Oncology and Survivorship (CIOS) from August to December 2016. As an intern, the student gained exposure to holistic and patient-centered cancer care through clinical observations, administrative duties, and projects. Responsibilities included shadowing various health care providers, attending support classes, inputting patient data, and conducting interviews with CIOS staff. The internship allowed the student to experience firsthand how CIOS addresses all aspects of a cancer patient's physical, emotional, and social needs through its multidisciplinary team approach.
This document outlines the structure and contents of a research study on assessing the knowledge of staff nurses regarding prevention and management of perineal tears during normal delivery. It includes 6 chapters that discuss the introduction, literature review, methodology, data collection process, data analysis plan, and expected outcomes including conclusions and recommendations. The study aims to assess nurses' current knowledge and identify any associations between knowledge and demographic factors, with the goal of developing an educational module to improve nurses' understanding of perineal tears.
2011/2012 Always Event℠ Challenge Grant Recipient Project OverviewsPicker Institute, Inc.
This document describes grant recipients for the 2011/2012 Picker Institute Always Events Challenge. It provides summaries of 6 recipient organizations and their proposed projects:
1) Quality Partners of Rhode Island will use PictureRx software to provide visual medication schedules to patients before discharge from nursing homes.
2) Massachusetts General Hospital aims to ensure patients always know their care team and receive timely responses through strategies like welcome videos and identification boards.
3) Planetree/Griffin Hospital will utilize an online patient assessment tool and care partners to ensure alignment between patients, caregivers and providers across healthcare settings.
4) St. Jude Children's Research Hospital will implement a parent mentor program to support newly diagnosed families through treatment and beyond
Gynecological Oncology Navigation by Penny Daugherty, RN, MS, OCN, ONN-CGPennyDaughertyRNMSOC
This session defines the various diagnoses classified as gynecological malignancies and address the discreet nuances of each disease, as well as recognition and management of specific side effects associated with individual syndromes. Conventional and targeted therapies are reviewed as well as discussions assisting patients in the selection of integrative approaches to care.
Putting it all together: Personalized care for cancer survivors Carevive
This document discusses barriers to quality cancer survivorship care and potential solutions. It notes that there are over 13 million cancer survivors in the US who face long-term effects of treatment and prevalent unmet needs. The Institute of Medicine recommends that survivors receive a comprehensive treatment summary and care plan. However, creating these plans can be time-consuming. New technologies like the On Q Health system aim to generate personalized care plans more efficiently based on patient-reported outcomes and guidelines. The system covers symptoms, surveillance, late effects and aims to improve quality and coordination of care across the cancer journey.
This document summarizes a case study on reengineering processes at Nethrajyoth International Hospital in southern India. [1] The hospital aimed to increase services for poor patients without increasing fees for other patients, but faced constraints on resources and staff. [2] The old process involved patients moving between departments with long wait times. Reengineering focused on eliminating wait times using a centralized IT system. [3] The reengineered system links 60 terminals to schedule appointments, registration, payments, and hand patients between departments, cutting perceived wait times for a better patient experience.
This document provides an overview of an 8-week online nursing course on advanced pathophysiology and pharmacology for nurse educators. It includes discussion questions for each week covering topics like genetic disorders, immunizations, electrolyte imbalances, respiratory diseases, cardiovascular conditions, genitourinary infections, neurological disorders, and endocrine disorders. Students are asked to analyze case studies, compare conditions, research treatments, and consider implications for patient education. The course aims to enhance understanding of disease processes and pharmacology to inform nursing practice.
This document provides a summary of a book on advanced practice nursing. It discusses:
- The book is a second edition that was copyrighted in 2005 and focuses on emphasizing common roles among advanced practice nurses.
- It includes chapters on the evolution of advanced practice nursing roles like certified nurse midwives, nurse anesthetists, clinical nurse specialists, and nurse practitioners. It also discusses the current sociopolitical environment for advanced practice nursing and implications of the American health care system.
- Additional chapters cover theories and models relevant to advanced practice nursing, primary care and its past/present/future, and the evolution of specialty and acute care advanced practice nursing roles. The final chapter discusses credentialing and clinical privileges for
This document summarizes key issues related to independent nursing and midwifery practice. It discusses nurse practitioners, who have graduate nursing education and provide comprehensive patient assessments. It also outlines areas of independent nursing practice like consultancy and various medical specialties. Responsibilities of independent nurses are described, including documentation and emergency procedures. Independent midwifery practice is also covered, defining midwives and outlining standards of care and challenges faced by midwives in India, such as gaining recognition as independent practitioners and developing educational programs.
HRSA Comprehensive Geriatric Education Grant Posternomadicnurse
This grant funds a Clinical Nurse Specialist position to work with current Gerontological CNS in providing education, mentoring / support, developing / measuring outcomes for knowledge, practice change and patient outcomes by:
Expanding NICHE training at Piedmont Hospital in Atlanta beyond Acute Care nurses to include Emergency Department nurses;
2) Introducing NICHE training at Piedmont Fayette, Piedmont Newnan and Piedmont Mountainside for Acute Care and Emergency Department nurses;
3) Introducing NICHE training for nursing staff at two of our Long-Term Care facility partners; and
4) Disseminating program materials and information to other healthcare entities throughout Georgia and the U.S. through local workshops and presentations at national healthcare conferences.
This document provides an overview of the history and development of nursing as a profession. It discusses how nursing has evolved from focusing primarily on providing comfort and care to also emphasizing health promotion and prevention. Key figures who helped establish nursing standards and education are highlighted, such as Florence Nightingale, who opened the first nursing school. The roles, responsibilities, and scope of nursing practice are also outlined, as well as the importance of critical thinking and use of the nursing process in clinical decision making. Professional nursing organizations and trends that continue to shape the profession are also reviewed.
The Always Events Recognition Program aims to recognize healthcare organizations that have implemented programs meeting the criteria of an Always Event - actions that should always be performed to provide an optimal patient experience. Organizations can apply by submitting a letter describing their program and how it meets the Always Events criteria of being significant, evidence-based, measurable, and affordable. The letter must also outline how the program involves patients/families, has leadership support, engages staff, and is evaluated for effectiveness. Registered programs will be listed on the Always Events website and organizations can promote their work using the Always Events brand.
This document describes several programs from Innovent Oncology aimed at improving cancer care quality and managing costs:
1) Level I Pathways provide evidence-based treatment guidelines developed by community oncologists to standardize care and limit unnecessary variation.
2) Advance Care Planning facilitates discussions around end-of-life care preferences to reduce futile treatment and increase patient/family satisfaction.
3) Patient Support Services provide disease management education and support to improve adherence, reduce emergency visits, and increase satisfaction.
The document discusses palliative care for patients with stomach cancer. It defines palliative care as patient-centered care focused on improving quality of life through early identification and treatment of pain and other physical, psychosocial and spiritual problems associated with life-threatening illness. The document outlines that palliative care provides relief from pain and discusses issues, focuses on life and death concerns, and integrates all aspects of the patient. It also notes that palliative care provides a support system and advises on active living and coping strategies. Finally, the document discusses pain associated with stomach cancer and options for pain management, including prescription medications, nerve blocks, physical therapy, and relaxation techniques.
Co-Chairs Laura S. Wood, RN, MSN, OCN, and Sumanta Kumar Pal, MD, and presenter Kathleen Burns, RN, MSN, AGACNP-BC, OCN, prepared useful Practice Aids pertaining to renal cell carcinoma for this CME/MOC/NCPD/ILNA activity titled “The New Therapeutic Era in Renal Cell Carcinoma: Essentials for Team-Based Patient Care.” For the full presentation, downloadable Practice Aids, complete CME/MOC/NCPD/ILNA information, and details on applying for credit, please visit us at https://bit.ly/30jWypm. CME/MOC/NCPD/ILNA credit will be available until May 16, 2022.
Rehabilitation aims to help individuals regain function and independence after injury or illness through processes like relearning skills, adapting to new abilities, and promoting maximum quality of life. It involves an interdisciplinary team that may include physicians, nurses, therapists and social workers. As part of the team, nurses play several key roles like educating and caring for patients, collaborating with other providers, and advocating for patients' needs and goals. The overall focus is on empowering patients and helping them optimize their capabilities.
The document describes a simulation-based training program developed by Dartmouth-Hitchcock Medical Center to improve physician-patient communication skills. The program engaged Patient Family Advisers as subject matter experts to design, deliver, and evaluate a two-hour module focusing on sharing bad news. Residents participated in simulated patient encounters and debriefing sessions. Evaluation measures included pre-and post-training assessments of resident confidence and standardized patient evaluations of resident performance. The program aimed to better utilize the medical center's simulation center and address communication skills and professionalism training.
The annual report summarizes the accomplishments of the Department of Emergency Medicine from July 1, 2014 to June 30, 2015. It highlights increased faculty and resident numbers, the opening of a new emergency department, and expanded research, education, and clinical programs. It provides details on faculty awards, publications, grants, and leadership roles both within the department and for professional organizations. The report demonstrates the significant growth and achievements of the department during the past academic year.
Compassion fatigue and burnout are significant issues for nurses that can lead to negative consequences if left unaddressed. Both result from the stress of caring for patients, though burnout has a gradual onset due to work environment stressors, while compassion fatigue occurs acutely from caring for suffering clients. Clinical manifestations are similar and include desensitization, increased medical errors, and lack of attention to detail. Hospitals can decrease these issues by improving communication, providing education on coping mechanisms, encouraging work-life balance, instituting debriefing sessions, and promoting an accepting work environment as per Jean Watson's Humanbecoming Theory.
This document discusses difficult communications in healthcare and their impact on patient safety. It identifies types of difficult communications such as hierarchical relationships, oppressive communication patterns, and lateral violence between nurses. Consequences of difficult communications include injuries to dignity and reduced confidence, which can cause nurses to leave the profession. Strategies are presented for managing difficult communications, including cognitive rehearsal, safety strategies like SBAR, and de-escalation techniques. The goal is to empower nurses to address difficult communications professionally and break the cycle to improve culture and patient safety.
The document provides a summary of qualifications and experience for Kristen R. Earle, MD. She has over 20 years of experience in various medical and leadership roles, including as a bariatric medical director, medical scientific liaison, independent medical reviewer, and partner in a general surgery practice. She has expertise in areas such as clinical trials, new program development, public speaking, and medical education and mentoring.
This document summarizes a participatory co-design process to refine a prototype support bra for breast radiotherapy. Ten patients and ten healthcare practitioners provided feedback over five workshops. The workshops explored challenges with the current radiotherapy pathway and identified opportunities to empower patients and improve care. Analysis revealed patients often feel a lack of control and voice in care. Healthcare practitioners were concerned a support bra could impede monitoring skin reactions. The refined prototype and supplementary booklet aim to enhance patient involvement and communication during treatment. Further testing of the support bra and booklet is ongoing to evaluate their clinical feasibility.
A team of nurses at an adult acute medicine unit conducted a quality improvement project to improve patients' pain management experiences and satisfaction scores. They assessed nurses' knowledge and attitudes around pain management and found gaps. The team implemented strategies like providing education to nurses, creating a Comfort Menu for patients, and involving patients in their pain plans. Patient surveys showed these interventions helped patients feel included in their care and had their pain needs met at higher rates. The unit's patient satisfaction scores on pain control increased from 81.4 to 85.2 over 12 months.
Bed Sores: Classification and ManagementJay-ar Palec
This document discusses bed sores (also known as pressure ulcers or decubitus ulcers), including their causes, risk factors, common areas, stages, assessment using the Braden scale, and treatment. Prolonged pressure on bony areas can lead to reduced blood flow and skin breakdown. The sacrum, elbows, knees, and ankles are most common. Risk increases with age, incontinence, poor nutrition, diabetes, and smoking. Bedsores are caused by pressure, shear forces, and friction. They are classified in stages based on depth of tissue damage. Treatment focuses on relieving pressure and proper wound care like debridement and dressing.
A pressure ulcer is an injury to the skin caused by prolonged pressure that cuts off blood flow. Ulcers are common in people who are confined to beds or wheelchairs and cannot shift positions to relieve pressure. Factors like limited mobility, incontinence, poor nutrition, and aging can increase risk. Ulcers are staged from 1 to 4 based on their depth, with stage 1 being the least severe. Preventing ulcers involves regularly shifting positions, using special beds and cushions, keeping skin clean and moisturized, and addressing other risk factors through diet and exercise.
This document provides an overview of an 8-week online nursing course on advanced pathophysiology and pharmacology for nurse educators. It includes discussion questions for each week covering topics like genetic disorders, immunizations, electrolyte imbalances, respiratory diseases, cardiovascular conditions, genitourinary infections, neurological disorders, and endocrine disorders. Students are asked to analyze case studies, compare conditions, research treatments, and consider implications for patient education. The course aims to enhance understanding of disease processes and pharmacology to inform nursing practice.
This document provides a summary of a book on advanced practice nursing. It discusses:
- The book is a second edition that was copyrighted in 2005 and focuses on emphasizing common roles among advanced practice nurses.
- It includes chapters on the evolution of advanced practice nursing roles like certified nurse midwives, nurse anesthetists, clinical nurse specialists, and nurse practitioners. It also discusses the current sociopolitical environment for advanced practice nursing and implications of the American health care system.
- Additional chapters cover theories and models relevant to advanced practice nursing, primary care and its past/present/future, and the evolution of specialty and acute care advanced practice nursing roles. The final chapter discusses credentialing and clinical privileges for
This document summarizes key issues related to independent nursing and midwifery practice. It discusses nurse practitioners, who have graduate nursing education and provide comprehensive patient assessments. It also outlines areas of independent nursing practice like consultancy and various medical specialties. Responsibilities of independent nurses are described, including documentation and emergency procedures. Independent midwifery practice is also covered, defining midwives and outlining standards of care and challenges faced by midwives in India, such as gaining recognition as independent practitioners and developing educational programs.
HRSA Comprehensive Geriatric Education Grant Posternomadicnurse
This grant funds a Clinical Nurse Specialist position to work with current Gerontological CNS in providing education, mentoring / support, developing / measuring outcomes for knowledge, practice change and patient outcomes by:
Expanding NICHE training at Piedmont Hospital in Atlanta beyond Acute Care nurses to include Emergency Department nurses;
2) Introducing NICHE training at Piedmont Fayette, Piedmont Newnan and Piedmont Mountainside for Acute Care and Emergency Department nurses;
3) Introducing NICHE training for nursing staff at two of our Long-Term Care facility partners; and
4) Disseminating program materials and information to other healthcare entities throughout Georgia and the U.S. through local workshops and presentations at national healthcare conferences.
This document provides an overview of the history and development of nursing as a profession. It discusses how nursing has evolved from focusing primarily on providing comfort and care to also emphasizing health promotion and prevention. Key figures who helped establish nursing standards and education are highlighted, such as Florence Nightingale, who opened the first nursing school. The roles, responsibilities, and scope of nursing practice are also outlined, as well as the importance of critical thinking and use of the nursing process in clinical decision making. Professional nursing organizations and trends that continue to shape the profession are also reviewed.
The Always Events Recognition Program aims to recognize healthcare organizations that have implemented programs meeting the criteria of an Always Event - actions that should always be performed to provide an optimal patient experience. Organizations can apply by submitting a letter describing their program and how it meets the Always Events criteria of being significant, evidence-based, measurable, and affordable. The letter must also outline how the program involves patients/families, has leadership support, engages staff, and is evaluated for effectiveness. Registered programs will be listed on the Always Events website and organizations can promote their work using the Always Events brand.
This document describes several programs from Innovent Oncology aimed at improving cancer care quality and managing costs:
1) Level I Pathways provide evidence-based treatment guidelines developed by community oncologists to standardize care and limit unnecessary variation.
2) Advance Care Planning facilitates discussions around end-of-life care preferences to reduce futile treatment and increase patient/family satisfaction.
3) Patient Support Services provide disease management education and support to improve adherence, reduce emergency visits, and increase satisfaction.
The document discusses palliative care for patients with stomach cancer. It defines palliative care as patient-centered care focused on improving quality of life through early identification and treatment of pain and other physical, psychosocial and spiritual problems associated with life-threatening illness. The document outlines that palliative care provides relief from pain and discusses issues, focuses on life and death concerns, and integrates all aspects of the patient. It also notes that palliative care provides a support system and advises on active living and coping strategies. Finally, the document discusses pain associated with stomach cancer and options for pain management, including prescription medications, nerve blocks, physical therapy, and relaxation techniques.
Co-Chairs Laura S. Wood, RN, MSN, OCN, and Sumanta Kumar Pal, MD, and presenter Kathleen Burns, RN, MSN, AGACNP-BC, OCN, prepared useful Practice Aids pertaining to renal cell carcinoma for this CME/MOC/NCPD/ILNA activity titled “The New Therapeutic Era in Renal Cell Carcinoma: Essentials for Team-Based Patient Care.” For the full presentation, downloadable Practice Aids, complete CME/MOC/NCPD/ILNA information, and details on applying for credit, please visit us at https://bit.ly/30jWypm. CME/MOC/NCPD/ILNA credit will be available until May 16, 2022.
Rehabilitation aims to help individuals regain function and independence after injury or illness through processes like relearning skills, adapting to new abilities, and promoting maximum quality of life. It involves an interdisciplinary team that may include physicians, nurses, therapists and social workers. As part of the team, nurses play several key roles like educating and caring for patients, collaborating with other providers, and advocating for patients' needs and goals. The overall focus is on empowering patients and helping them optimize their capabilities.
The document describes a simulation-based training program developed by Dartmouth-Hitchcock Medical Center to improve physician-patient communication skills. The program engaged Patient Family Advisers as subject matter experts to design, deliver, and evaluate a two-hour module focusing on sharing bad news. Residents participated in simulated patient encounters and debriefing sessions. Evaluation measures included pre-and post-training assessments of resident confidence and standardized patient evaluations of resident performance. The program aimed to better utilize the medical center's simulation center and address communication skills and professionalism training.
The annual report summarizes the accomplishments of the Department of Emergency Medicine from July 1, 2014 to June 30, 2015. It highlights increased faculty and resident numbers, the opening of a new emergency department, and expanded research, education, and clinical programs. It provides details on faculty awards, publications, grants, and leadership roles both within the department and for professional organizations. The report demonstrates the significant growth and achievements of the department during the past academic year.
Compassion fatigue and burnout are significant issues for nurses that can lead to negative consequences if left unaddressed. Both result from the stress of caring for patients, though burnout has a gradual onset due to work environment stressors, while compassion fatigue occurs acutely from caring for suffering clients. Clinical manifestations are similar and include desensitization, increased medical errors, and lack of attention to detail. Hospitals can decrease these issues by improving communication, providing education on coping mechanisms, encouraging work-life balance, instituting debriefing sessions, and promoting an accepting work environment as per Jean Watson's Humanbecoming Theory.
This document discusses difficult communications in healthcare and their impact on patient safety. It identifies types of difficult communications such as hierarchical relationships, oppressive communication patterns, and lateral violence between nurses. Consequences of difficult communications include injuries to dignity and reduced confidence, which can cause nurses to leave the profession. Strategies are presented for managing difficult communications, including cognitive rehearsal, safety strategies like SBAR, and de-escalation techniques. The goal is to empower nurses to address difficult communications professionally and break the cycle to improve culture and patient safety.
The document provides a summary of qualifications and experience for Kristen R. Earle, MD. She has over 20 years of experience in various medical and leadership roles, including as a bariatric medical director, medical scientific liaison, independent medical reviewer, and partner in a general surgery practice. She has expertise in areas such as clinical trials, new program development, public speaking, and medical education and mentoring.
This document summarizes a participatory co-design process to refine a prototype support bra for breast radiotherapy. Ten patients and ten healthcare practitioners provided feedback over five workshops. The workshops explored challenges with the current radiotherapy pathway and identified opportunities to empower patients and improve care. Analysis revealed patients often feel a lack of control and voice in care. Healthcare practitioners were concerned a support bra could impede monitoring skin reactions. The refined prototype and supplementary booklet aim to enhance patient involvement and communication during treatment. Further testing of the support bra and booklet is ongoing to evaluate their clinical feasibility.
A team of nurses at an adult acute medicine unit conducted a quality improvement project to improve patients' pain management experiences and satisfaction scores. They assessed nurses' knowledge and attitudes around pain management and found gaps. The team implemented strategies like providing education to nurses, creating a Comfort Menu for patients, and involving patients in their pain plans. Patient surveys showed these interventions helped patients feel included in their care and had their pain needs met at higher rates. The unit's patient satisfaction scores on pain control increased from 81.4 to 85.2 over 12 months.
Bed Sores: Classification and ManagementJay-ar Palec
This document discusses bed sores (also known as pressure ulcers or decubitus ulcers), including their causes, risk factors, common areas, stages, assessment using the Braden scale, and treatment. Prolonged pressure on bony areas can lead to reduced blood flow and skin breakdown. The sacrum, elbows, knees, and ankles are most common. Risk increases with age, incontinence, poor nutrition, diabetes, and smoking. Bedsores are caused by pressure, shear forces, and friction. They are classified in stages based on depth of tissue damage. Treatment focuses on relieving pressure and proper wound care like debridement and dressing.
A pressure ulcer is an injury to the skin caused by prolonged pressure that cuts off blood flow. Ulcers are common in people who are confined to beds or wheelchairs and cannot shift positions to relieve pressure. Factors like limited mobility, incontinence, poor nutrition, and aging can increase risk. Ulcers are staged from 1 to 4 based on their depth, with stage 1 being the least severe. Preventing ulcers involves regularly shifting positions, using special beds and cushions, keeping skin clean and moisturized, and addressing other risk factors through diet and exercise.
this topic is on bed sores. discusses the definition, etiology , pathophysiology of bed sore development as well as prevention and managemene of pressure sores
Pressure ulcers, also known as bedsores or decubitus ulcers, are localized areas of tissue necrosis that occur when soft tissue is compressed between a bony prominence and an external surface for a prolonged period. They are commonly staged from Stage 1 to Stage 4 based on depth of tissue damage. Key risk factors include immobility, moisture, malnutrition, and aging. Prevention focuses on risk assessment, pressure relief, skin care, and nutrition. Treatment involves debridement, dressings, management of bacterial infection, and surgery for advanced cases. Complications can include infection, osteomyelitis, and rarely, cancer.
Pressure ulcer assessment and managementFurqan Khan
This document provides information on pressure ulcer assessment and management. It defines pressure ulcers and describes the common sites where they occur. It also outlines the classification system for staging pressure ulcers from Stage I to IV, as well as categories for suspected deep tissue injury and unstageable ulcers. For each stage and category, the document details approaches for assessment, wound cleaning, debridement if needed, dressing selection, and offloading of pressure. It lists causative factors for pressure ulcer development and nursing interventions for prevention.
This document discusses research hypotheses. It defines a hypothesis as a tentative, testable statement about the relationship between two or more variables. A hypothesis helps translate research problems into clear predictions about expected outcomes. Hypotheses are derived from literature reviews and conceptual frameworks. The main types discussed are research hypotheses, null hypotheses, and testable hypotheses. Research hypotheses make predictions, while null hypotheses predict no relationship. Testable hypotheses involve measurable variables. Variables are also discussed, including independent, dependent, extraneous, and demographic variables. Assumptions and limitations of research are briefly covered.
The document outlines a quality improvement initiative at Sun Coast Regional Hospital to reduce their inpatient fall rate of 50% per 1,000 patients annually. The team aims to reduce the rate by 90% through interventions targeting materials (patient/staff education), physical environment (facility design), and workforce (increasing staffing). They conduct a fishbone analysis, implement interventions using the PDSA model, measure quarterly results, and continue refining interventions such as enforcing footwear/wristband rules and routine physiotherapy checks.
This document outlines a proposal for a presurgical education program at War Memorial Hospital. It begins with an executive summary that notes the program will promote patient knowledge and reduce costs through reducing postoperative complications. It then provides details on the current limited education program and recommendations for a new comprehensive presurgical education program, including conducting classes, providing education before and after surgery, and ensuring adequate resources. Financial projections estimate the program would reach break-even within 3 months and be profitable thereafter by reducing complication costs.
2011/2012 Always Event℠ Challenge Grant Recipient Project OverviewsPicker Institute, Inc.
This document summarizes grant recipients for the 2011/2012 Picker Institute Always Events Challenge. It includes summaries of 11 recipient organizations that will implement Always Events focused on improving patient-centered care and care transitions. The Always Events involve enhancing medication safety education, ensuring patients know their care team members, improving communication during care handoffs, and other initiatives aimed at putting patients at the center of their care.
20140910 RN LPN Delegation Discussion Outline For NUR 265 StudentsAmanda Summers
This document discusses nursing delegation, including definitions of delegation, responsibilities of registered nurses (RNs) and licensed practical nurses (LPNs), the American Nurses Association's "Five Rights of Delegation", tasks that can and cannot be delegated, and how delegation relates to the NCLEX-RN exam. It provides examples of direct patient care activities and indirect activities that may be delegated, as well as activities that cannot be delegated. The document concludes with a practice quiz on delegation-related scenarios.
Many organizations have historically focused hand hygiene improvement efforts on the health care provider's and visitors they interact with daily. However, have we stopped to consider that perhaps we are forgetting the most important people within the health system, the patients!
The patient is a 69-year-old male admitted to the hospital with respiratory failure due to chronic obstructive pulmonary disease (COPD) from long-term smoking. His medical history and current symptoms will be assessed using the nursing process framework. This will include evaluating lab results and medications to understand the pathophysiology of his COPD and related conditions. Developing a comprehensive care plan is important to address his acute needs and support his long-term health management.
Nursing Practice Field Experience Essay
Unit 2 Health And Social Care Study
Nursing Case Study Sample
Nursing Concept Analysis Essay
Nursing Case Report Essay
Nursing Care Study Essays
PACU Nurse Observation Essay
Nursing Case Studies Essay
Diabetes Care Study Essay
Advanced Practice Nursing Essay examples
Acute Care Nursing Essay
Activities of Living-Case Study
Advanced Nursing Practice Essay
Nursing Assessment and Patient Care Essay
Essay On Acute Care Nursing
Masters Prepared Nurse Essay
Reflective Essay: My Role As A Care Assistant
Essay on Nursing Care Plan
Caring Nursing Student Analysis
Essay Nursing Care Plan
Futuristic nursing will leverage new technologies like robotics, telemedicine, 3D printing, and portable diagnostics to enhance patient care. Nurses will be able to spend more time with patients by using robots to assist with repetitive tasks. Telemedicine will allow nurses to reach remote communities. 3D printing can be used to create models to better explain medical procedures. Portable devices will give nurses diagnostic tools to improve care. Overall, technology will help transform nurses into "super heroes" who can provide more advanced care.
Futuristic nursing will leverage new technologies like robotics, telemedicine, 3D printing, and portable diagnostics to enhance patient care. Nurses will be able to spend more time with patients by using robots to assist with repetitive tasks. Telemedicine will allow nurses to reach remote communities. 3D printing can be used to create models to better explain medical procedures. Portable devices will give nurses diagnostic tools to improve care. Overall, technology will help transform nurses into "super heroes" that provide more advanced care.
The document provides guidance for conducting simulation training to improve obstetric emergency response in Indian hospitals. It outlines steps for setting learning objectives, creating scenarios, conducting briefings and simulations, and debriefing sessions. The goal is to help medical teams practice communication, leadership, and use of checklists to efficiently treat postpartum hemorrhage and other obstetric emergencies. Simulation is presented as a way to identify systems issues and optimize team performance to improve patient safety.
The document describes Always Events, which are practices that should always occur to improve the patient experience. It then summarizes initiatives from 20 organizations to address common healthcare challenges through Always Events. One area is care transitions, where several grantees developed Always Events focusing on hospital discharge, handoffs between providers, and reducing readmissions. For example, one organization implemented a "SMART Discharge Protocol" to ensure key information is discussed at discharge. Another developed a "Patient-Centered Bedside Shift-to-Shift Handoff" process to include patients in shift changes. The document provides contact information for each program to allow other organizations to learn from their work.
Grand rounds are a teaching methodology where physicians present clinical cases to colleagues, residents, and medical students. During grand rounds, physicians discuss a patient's medical history, presentation of symptoms, diagnostic testing and imaging results, treatment plans, and learning objectives. The goal is to enhance medical education and support collaborative care across specialties. Modern grand rounds also use data-driven approaches and technology to continuously improve patient outcomes and healthcare value.
A review of support available for loss in early and late pregnancyNHS Improving Quality
A review of support available for loss in early and late pregnancy
It has been well documented that the loss of a pregnancy at any stage is an emotional and stressful time and affects every family member in some way. Some still feel that miscarriage and stillbirth, along with neonatal death, are taboo subjects as pregnancy and childbirth are seen as happy life events. This is compounded by a western culture which still struggles to talk about death openly. There are particular challenges for women who miscarry early in pregnancy as they may not have shared their news with family, friends and work colleagues but may have known of the pregnancy very early due to the sophistication of home pregnancy testing.
This report:
- Scopes what support currently exists for women and families across England who experience loss at less than 24 weeks gestation
- Scopes what support exists for women and families across England who experience loss at greater than 24 weeks gestation
- Scopes what support exists for stillbirth, pre and post-delivery, identifies the key charities involved in this and determines what they offer
- Identifies areas of good practice, soft intelligence and stories from women with experience of loss.
What can a Clinical Nurse Leader do for your critical care nursing unit? Plenty! Consider this new nursing role as one that can improve patient outcomes and increase satisfaction for both clients and staff. Successful microsystems begin with empowering patients, families and front line nurses.
Ipposi conf 2018 - Eidin Ni She, University College Dublinipposi
This document summarizes a research project that aims to improve care for frail older patients through a co-design approach. Key points:
- Researchers from University College Dublin are partnering with healthcare practitioners and patient advocacy groups to design and test a frailty care pathway at St. Vincent's University Hospital.
- Five co-design workshops over two years have brought together stakeholders to share perspectives and collaboratively develop solutions. This has helped build a shared understanding of challenges from all viewpoints.
- Emerging ideas from workshops include improved communication, mobility, nutrition, hydration and information for patients. Intentional rounding is being tested as a method to regularly check on patients' needs.
- The pilot of
NurseReview.Org - Test Taking Strategies For Nursing StudentsNurse ReviewDotOrg
1) The document provides test taking strategies for nursing students, including identifying critical thinking as the cornerstone of functioning in society and applying the nursing process to test questions.
2) It recommends preparing for tests by reading material before class, taking notes during lecture, and outlining notes according to concepts like ABCs and Maslow's hierarchy of needs.
3) The document reviews components of test questions and provides examples of questions and answers to demonstrate strategies for identifying correct responses and distractor answers.
1) The document provides test taking strategies for nursing students, including identifying critical thinking as the cornerstone of functioning in society and applying the nursing process to test questions.
2) It recommends preparing for tests by reading material before class, taking notes during lecture, and outlining notes according to concepts like ABCs and Maslow's hierarchy of needs.
3) The document reviews components of test questions and provides examples of questions and answers to demonstrate strategies for identifying correct responses and distractor answers.
Team-Based Care 101 for Health Professions Students CHC Connecticut
This webinar provided an overview of team-based care for health professions students. Speakers from Community Health Center, Inc. and the National Nurse-Led Care Consortium discussed key components of effective teams, including clear roles and communication. Specific tools for communication, such as SBAR and huddles, were reviewed. The webinar aimed to describe high-performing teams, effective communication strategies, and how to optimize team roles.
The document discusses nursing rounds and reports. Nursing rounds involve a small group of nursing professionals and students gathering at a patient's bedside to discuss care, ensuring efficient nursing care and teaching students. Rounds provide learning experiences for students. Nursing reports communicate information about patient care between shifts and healthcare team members. Reports avoid duplication of work and indicate team efficiency. Types of reports discussed include oral, written, change of shift, transfer, incident, and evaluation reports.
This presentation is part of the theoretical and practical training course for oncology nurses of Bugando Medical Centre (Tanzania) that our institute organized in collaboration with Dr Nestory Masalu, Prof Dino Amadori, Dr Patrizia Serra, Dr Carla Masini, Dr Marina Bragagni and Dr Ivana Barlati. It was for all of us an amazing experience sharing with Tanzanian Colleagues these information.
Similar to VA Facilities and Reducing Bedsores (20)
2. Veteran Affairs facilities
● The US has the most comprehensive system of assistance for
Veterans of any nation around the world. (Veteran Affairs,
2016)
● There are over 1000 VA facilities across the US
● The VA Health Administration’s system has 152 medical
centers along with almost 1400 community based outpatient
clinics, community living centers.
3. Bedsores found on patients
● Definition: Bedsores — also called pressure sores or pressure ulcers — are injuries to skin and underlying
tissue resulting from prolonged pressure on the skin.
○ They most often occur on skin that covers bony areas such as hips, heels, ankles, etc.
● Causes:
○ Sustained Pressure
○ Friction
○ Shear
● Four Stages of Severity:
○ Stage one
○ Stage two
○ Stage three
○ Stage four
○ Unstageable
Bedsores (pressure sores). (2014, December 13). Retrieved April 19, 2016, from http://www.mayoclinic.org/diseases-conditions/bedsores/basics/causes/con-20030848
4. Bedsores vs. VA facilities
● About 12.3% of all facilities reported increased
rates of bedsores
● Highest increased rates were long-term care
facilities
● One severe bedsore can cost a facility up to
$70,000
● Throughout the United States $17 billion is
spent on treatments for bedsore per year
● Medical and Medicare see bedsore as
preventable, so in many occasions will not
reimburse for additional services
Peterson MJ, Gravenstein N, Schwab WK, van Oostrom JH, Caruso LJ. Patient repositioning and pressure ulcer risk—Monitoring interface pressures of at-risk patients. J Rehabil Res Dev.
2013;50(4):477–88. Retrieved April 19, 2016, from http://dx.doi.org/10.1682/JRRD.2012.03.0040
5. Fishbone Diagram
Patients
developing
bedsores.
People
Environment
Patient Risk
Factor Equipment
In adequate amount
of nurses
Age
Lack of knowledge about
bedsores
Patients staying in one position
for a long period of time.
Nurses lack enough time
to turn and check patients
every two hours
Monitoring the amount of
times patients have been turned
Moist and Warm environment
Poor nutrition and hydration Patients need of higher surface to
spread body weight
Patients on certain medications or
with certain medical conditions
Outdated beds and
wheelchairs
Changing wound dressings frequently to
prevent moisture and bacteria from forming
● Bedsores (pressure sores). (2014, December 13). Retrieved April 19, 2016, from http://www.mayoclinic.org/diseases-conditions/bedsores/basics/causes/con-20030848
6. Current state of issues
• Statewide comprehensive bedsore prevention and policies
needed
• Improve reporting and documenting bedsores
• 75% of our patients need to be educated on bedsores and
bedsore prevention
• Increase of 24% of patients need to be educated on
bedsores and bedsore prevention
7. Purpose Statement
To develop a reliable system to help decrease the
amount of facility acquired bedsores on patients while
staying in VA facilities.
8. Goals
● To design a program that would reduce the amount
of uneducated patients by 50 patients (21%)
● To prevent the development of bedsores, while
decreasing cost and patient complications.
9. Scope
● 240 Patients of whom developed bedsores during
their stay at 24 VA facilities
10. Data Points
Data Points Source How Long? How Often? Baseline
A quarterly survey
that will show the
percentage of
facilities being
informed on
bedsores
Quarterly survey 1 year 1 time/month 8 of 24 (33%) of
facilities
Frequency of
reported education
on bedsores to
patients
Documentation
(reports of education
on bedsores for
patients by staff)
6 months As it occurs 117/240 (49%)
patients
http://www.va.gov/oig/54/reports/VAOIG-05-00295-109.pdf
11. Data Points
Data Points Bedsores development during
Hospitalization- Baseline
Target
Patients NOT being educated on
bedsores
123 (51% of patients) Reduce to 50 patients (21%)
Percentage of facilities requiring
clinicians to educate their patients
on bedsores
8 of 24 (33%) of facilities Increase by 10 facilities (18
facilities in total, 75%)
http://www.va.gov/oig/54/reports/VAOIG-05-00295-109.pdf
12.
13. Patients
develop
bedsores
Improper
assessment
Reduce the development of facility
acquired bedsores while in the VA
Facilities by 20% in the next six months
Contribution
20% of patients
developing bedsores
during
hospitalization
70% currently
developing bedsores
during hospitalization
Bedsore
development
rate is at 50%
above the
expected target
of 20%
{Ultimate Goal}
{Current Situation}
Facilities must
have clinician
spend 3 minutes
educating the
patients on bed
sores
Patients need to
become educated
on bedsores
{Problem To Tackle}
{Target}
{Process}
Patients are
not turning or
adjusting
themselves
Clinicians are
not educating
patients about
bedsores
Facility policies
are not addressing
bedsore education
to clinicians
Patients are
not being
turned
Clinicians are
busy
Patients are
not educated
on bedsores
Clinicians
assess
patient for
bedsores
Patient is
classified
“at risk”
Clinician
explains
care plan to
patient
Clinician
reassesses
patient for
bedsores
Clinicians
and team
create a care
plan
14. Target Condition
Target: Facilities must have a policy in place which has clinicians need to spend at least 3
minutes educating the patient on bedsores
● Causes of bedsores needs to be discussed
● Proper turning methods and weight shifting
● Q2H turning importance
● Risk factors and prevention
In order to achieve the target:
● The education department needs to create an instructional class which prepares
clinicians on how to educate their patients on bedsore prevention.
15. Break Down the Problem
Reasons for developing Hospital Acquired Bedsores:
1. Patients not turning themselves (We are addressing this one)
a. High severity and easier to address
b. Allows for repositioning without clinician interaction (problem 2)
2. Patients not being turned by clinicians
a. Due to clinician unavailability from distractions and interruptions
b. Harder to address
3. Initial assessments flawed
a. Assessments deal with risk factors and not actual causes
b. Requires more data from multiple departments
16. Analyze the Root Cause
● Patients are developing Facility Acquired bedsores
● Patients apply pressure to at risk locations
● Patients are not being turned and are not turning themselves
● Patients do not have the proper education to turn themselves
● Clinicians are not educating patients on bedsores
● No facility wide policies to address teaching patients on
bedsores
17. Implementation Projects
Phase one: Education departments need data on proper teaching and
proper turning and prevention
Phase two: Create classes either online clinician portal or in
classroom
Phase three: Application to patient
Phase four: Monitoring amount of facility acquired bedsores
18. Counter-Measure Plan
Who will be involved in test? All VA facilities, Education departments, Clinician staff, patients
What specifically are they going to do? Education department is going to create an informational program for
nurses in order to teach patients about bedsores and bedsore prevention. Clinicians will use new information to teach
patients about bedsores and bedsore prevention. Patients with the new information will know the importance of
bedsore prevention and will turn themselves.
When will we test? Day? Time of day? How many times? We will test Mondays and Fridays of each week. 7am
to 7pm per admission. Within four hours of each admission with 7am and 7pm.
Where will we do it? The patients rooms and the training at an off site location.
How will we know if the changes worked? A decrease in facility acquired bedsores from educated patients.
Risk in implementing the counter-measure? Clinicians may not have enough time to do this. Some patients will
not be able to turn themselves due to current conditions. Some patients might refuse to turn themselves. Patients
might forget to change positions.
19. Data Points
Data Points Baseline Target Expected Results
Patients NOT being
educated on bedsores
123 (51% of patients) Reduce to 50 patients
(21%)
80 patients (33% of
patients)
Percentage of facilities
requiring clinicians to
educate their patients on
bedsores
8 of 24 (33%) of facilities Increase by 10 facilities
(18 facilities in total, 75%)
15 of 24 (62%) of facilities
20. Our Reflection: Team
Ohana and Project
Ohana: means family, family means no one gets left behind.
. Develop and describe the team meeting management skills used to
accomplish your project to tell a story (Includes Team Dynamics)
• Darren being Type 1 was able to come up with options that has helped
the group decide on what to do to make the project better as well as
improved listening skills and explained very well about the details
needed to cleared up.
• Yesenia being Type 2 was able to work with everyone in the group as
well as helped with connecting with Youngjae to clarify any of the issues
that occurred during the project completion.
• Lauren being Type 2 was able to give and find the group information that
was needed to complete the project.
• Jennifer being Type 3 was able to connect all group members together to
make sure things were getting done. Also helped set up our PowerPoint.
• Morgan being Type 4 helped explain the group's’ confusion as well as
helped manage how the group was able to complete the project.
- Darren Type 1: Controller
- Yesenia Type 2:
Persuader
- Lauren Type 2: Persuader
- Jennifer Type3:
Organizer
- Morgan Type 4: Analyzer
Overall with a group that has all types of personalities, we were able to come
together and figure out the issues of our project, settle confusion, and come to a
compromise of opinions and really listen to everyone to finally make this
project happen.
21. Reference
About VA. (n.d.). Retrieved March 30, 2016, from http://www.va.gov/about_va/vahistory.asp
Peterson MJ, Gravenstein N, Schwab WK, van Oostrom JH, Caruso LJ. Patient repositioning and pressure ulcer
risk—Monitoring interface pressures of at-risk patients. J Rehabil Res Dev. 2013;50(4):477–88. Retrieved April 19,
2016, from http://dx.doi.org/10.1682/JRRD.2012.03.0040
Bedsores (pressure sores). (2014, December 13). Retrieved April 19, 2016, from http://www.mayoclinic.
org/diseases-conditions/bedsores/basics/causes/con-20030848
Watrous, J. (2006, March 22). Management of Patients with Pressure Ulcers in Veterans Health Administration
Facilities. Retrieved February 22, 2016, from http://www.va.gov/oig/54/reports/VAOIG-05-00295-109.pdf