RESUMEN
In healthcare, timely communication of critical information is imperative among workforce members. Nurse leaders struggle with how to reach clinical staff effectively when informing them of program updates, practice changes, or available resources. This article provides a review of the marketing and communication literature sharing best practices for improving visibility and program uptake for infrastructure supporting the conduct of inquiry projects among hospital employees using an evidence-based practice approach.
Asunto(s)
Comunicación , Enfermería Basada en la Evidencia/organización & administración , Difusión de la Información/métodos , Investigación en Enfermería/organización & administración , Adulto , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: Rising acuity levels in inpatient settings have led to growing reliance on observers and increased the cost of care. OBJECTIVES: Minimizing use of observers, maintaining quality and safety of care, and improving bed access, without increasing cost. DESIGN: Nursing staff on two inpatient psychiatric units at an academic medical center pilot-tested the use of a "milieu manager" to address rising patient acuity and growing reliance on observers. Nursing cost, occupancy, discharge volume, unit closures, observer expense, and incremental nursing costs were tracked. Staff satisfaction and reported patient behavioral/safety events were assessed. RESULTS: The pilot initiatives ran for 8 months. Unit/bed closures fell to zero on both units. Occupancy, patient days, and discharges increased. Incremental nursing cost was offset by reduction in observer expense and by revenue from increases in occupancy and patient days. Staff work satisfaction improved and measures of patient safety were unchanged. CONCLUSIONS: The intervention was effective in reducing observation expense and improved occupancy and patient days while maintaining patient safety, representing a cost-effective and safe approach for management of acuity on inpatient psychiatric units.
Asunto(s)
Pacientes Internos , Personal de Enfermería en Hospital/estadística & datos numéricos , Servicio de Psiquiatría en Hospital/estadística & datos numéricos , Carga de Trabajo/estadística & datos numéricos , Centros Médicos Académicos , Ocupación de Camas/economía , Ocupación de Camas/estadística & datos numéricos , Humanos , Personal de Enfermería en Hospital/economía , Alta del Paciente/economía , Alta del Paciente/estadística & datos numéricos , Seguridad del Paciente/economía , Seguridad del Paciente/estadística & datos numéricos , Proyectos Piloto , Servicio de Psiquiatría en Hospital/economía , Carga de Trabajo/economíaRESUMEN
OBJECTIVE: The objective of this descriptive qualitative study was to identify best practices of nursing research councils (NRCs) at Magnet®-designated hospitals. BACKGROUND: Nursing research (NR) is essential, adding to the body of nursing knowledge. Applying NR to the bedside improves care, enhances patient safety, and is an imperative for nursing leaders. METHODS: We interviewed NR designees at 26 Magnet-recognized hospitals about the structure and function of their NRCs and used structural coding to identify best practices. RESULTS: Most organizations link NR and evidence-based practice. Council membership includes leadership and clinical nurses. Councils conduct scientific reviews for nursing studies, supporting nurse principal investigators. Tracking and reporting of NR vary widely and are challenging. Councils provide education, sponsor research days, and collaborate interprofessionally, including with academic partners. CONCLUSIONS: Findings from this study demonstrate the need to create formal processes to track and report NR and to develop outcome-focused NR education.
Asunto(s)
Atención de Enfermería/organización & administración , Investigación en Enfermería/normas , Investigación Cualitativa , Proyectos de Investigación , Comités Consultivos , Humanos , Estados UnidosRESUMEN
The performance appraisal process is a key component of professional nursing practice. The peer review process is referred to frequently in Magnet Nursing Standards as a key element in professional nursing. The peer review process allows professionals from common practice areas to systematically assess, monitor, make judgments, and provide feedback to peers by comparing actual practice to established standards. Peer review can engage a multigenerational workforce and lead to more satisfied, engaged employees. As a component of the annual performance appraisal, peer review can create positive relationships, foster a better work environment, and allow peers to increase individual and group accountability. Peer review has many common elements that can be individualized to fit any type of unit or work culture. This article describes how to design, implement, and evaluate a unit-based peer review program. The content and steps outlined are intended to support nurse managers in implementing unit-specific peer review programs by focusing on existing expertise and best practices. The implementation steps are divided into 5 phases describing the introduction of concepts and getting nurses engaged, implementation guidelines, piloting the process, staff education, and ongoing evaluation. Staff involvement is the key to a successful unit-based peer review process.
Asunto(s)
Benchmarking/normas , Adhesión a Directriz , Enfermeras Administradoras/normas , Personal de Enfermería en Hospital/normas , Revisión por Pares , Desarrollo de Programa , Humanos , MarylandRESUMEN
The use of seclusion and restraint in the treatment of mentally ill patients is a highly controversial and potentially dangerous practice. A group of direct care psychiatric nurses in a large urban teaching hospital created an evidenced-based performance improvement program that resulted in a decrease in the use of seclusion and restraint. No additional funds were required to develop this program. The public health prevention model was the framework utilized. Early results show a 75% reduction in the use of seclusion and restraint with no increase in patient or staff injuries since its implementation.
Asunto(s)
Intervención en la Crisis (Psiquiatría) , Hospitalización , Trastornos Mentales/rehabilitación , Servicios de Salud Mental/organización & administración , Desarrollo de Programa , Restricción Física , Aislamiento Social , HumanosRESUMEN
Unit-based clinical nurse specialists influence the entire organizational system within a tertiary care setting at Johns Hopkins Hospital, Baltimore, Md.