What is the evidence for quality and safety benefits of a bedside shift report?

1. Go to http://health.library.emory.edu and then click on the PubMed link on right side of page.
2. When PubMed opens, copy/paste this search strategy in the search box and click “Search:”
bedside AND ((shift AND (report OR reports OR reporting)) OR (handoff OR handoffs)) AND (quality OR safety) NOT 22157495[uid] NOT 24264936 [uid] NOT 18989136[uid] NOT 17102266[uid] NOT 19540761[uid] NOT 21041119[uid]

The search will find at least 31 articles.

 

Are there studies on the safety of midline catheters?

Sharp, Rebecca, et al. “The safety and efficacy of midlines compared to peripherally inserted central catheters for adult cystic fibrosis patients: A retrospective, observational study.” International journal of nursing studies 51.5 (2014):694-702.

Alexandrou, Evan, et al. “Central venous catheter placement by advanced practice nurses demonstrates low procedural complication and infection rates–a report from 13 years of service.” Critical care medicine 42.3 (2014):536-543.

Kanokkantapong, C, N Leeaphorn, and T Kanjanabuch. “The effects of peritoneal dialysis catheter insertion using paramedian versus midline approach on CAPD patients.” Journal of the Medical Association of Thailand = Chotmaihet thanphaet 94 suppl. 4 (2011):S52-S57.

Amerasekera, S S H, et al. “Imaging of the complications of peripherally inserted central venous catheters.” Clinical radiology 64.8 (2009):832-840.

Griffiths, Vivien. “Midline catheters: indications, complications and maintenance.” Nursing standard 22.11 (2007):48-57.

Anderson, N R. “Midline catheters: the middle ground of intravenous therapy administration.” Journal of infusion nursing 27.5 (2004):313-321.

Applying current research to influence clinical practice: utilization of midline catheters.” Journal of intravenous nursing 21.5 (1998):271.

Complications related to intravenous midline catheter usage: a 2-year study.” Journal of intravenous nursing 21.2 (1998):76.

The risk of midline catheterization in hospitalized patients: a prospective study… republished with permission from Dr. Leonard Mermel. The risk of midline catheterization in hospitalized patients. Ann Intern Med. 1995; 123:841-844. 1996; 12.1:6

Initiating a pediatric peripherally inserted central catheter and midline catheter program.” Journal of intravenous nursing 17.4 (1994):201.

Reviewed and updated 4/8/2014 ldt

Should capnography be used in postoperative, unventilated patients?

There isn’t a consensus on whether capnography should be used in postoperative patients.

Eichhorn, John H. “Review article: practical current issues in perioperative patient safety.” Canadian journal of anesthesia 60.2 (2013):111-118.
The first paragraph of page 116 discusses the lack of consensus on how best to monitor postoperative patients for hypoventilation from postoperative pain medication.

Jarzyna, Donna, et al. “American Society for Pain Management Nursing guidelines on monitoring for opioid-induced sedation and respiratory depression.” Pain management nursing 12.3 (2011):118-145.e10.
Article states, “there is a paucity of information and no consensus about the benefits of technology supported monitoring, such as…capnography.”

Hutchison, Rob, and LesRodriguez. “Capnography and respiratory depression.” American journal of nursing 108.2 (2008):35-39.
This randomized prospective study of 54 postoperative orthopedic patients found a significantly higher rate of respiratory depression in the capnography group, concluding that “capnography may be more appropriate for use with postsurgical high-risk patients taking opioids” and “may have the added advantage of indicating those patients who may be at risk for obstructive sleep apnea.”

What medications are associated with high fall rates?

Among the medications discussed as contributing to higher rates of falls include psychotropics, analgesics, diuretics, and antihypertensives.

See <a href="” target=”_blank”>Falls > Possible Risk Factors > Medication effects.  In:  DynaMed.  References studies documenting medications associated with falls.

Click here to access collection of articles discussing medications and fall rates.

Are there methods that are effective at reducing nursing staff response time to patient call lights/bed alarms?

A search of PubMed, CINAHL, and ECRI (a quality and risk management resource) for combinations of these terms:
Call lights, call buttons, intercoms, stimuli
Patients, beds, rooms
Nurses, nursing
Response time, reaction time, attention
(call lights OR call buttons OR alarms) AND (patients OR beds OR rooms) AND (nurses OR nursing) AND (response time OR reaction time)…identified many articles about reducing the rate of call light use by implementing hourly/intentional/comfort rounding, as well as the association between call light use and falls. Below are a couple of references that explore how psychological factors may be associated with response time.

Kalisch BJ, et al. Nursing teamwork and time to respond to call lights: an exploratory study. Rev Lat Am Enfermagem. 2013 Jan-Feb;21 Spec No:242-9.

Tzeng HM. Perspectives of staff nurses toward patient- and family-initiated call light usage and response time to call lights. Appl Nurs Res. 2011 Feb;24(1):59-63. doi: 10.1016/j.apnr.2009.03.003. Epub 2009 Jul 9.

A Google search for no pass zone patient call lights identified several hospitals that have rolled out campaigns with this name, but there doesn’t seem to be anything in the traditional published literature about them. Here is information from a couple of hospitals in case you want to contact them directly for additional information.

http://nursing.advanceweb.com/News/Regional-News/Bronx-NY-Montefiore-Establishes-No-Passing-Zone.aspx

http://healthleadersmedia.com/content/NRS-250810/Nurses-Find-Simple-Ways-to-Improve-Satisfaction##

http://1199seiubenefits.org/wp-content/uploads/2012/01/Mt.-Sinai-Powerpoint.pdf

This question seems to be similar to alert fatigue with use of alerts in clinical systems. After browsing some of those references in PubMed, I applied the subject headings
(“Human engineering”[mesh] OR “Hospital communication systems”[mesh]) AND (“Reaction time”[mesh] OR “time factors”[mesh]) AND nurses AND (falls OR patient satisfaction)
The most relevant reference in this search is below. It discusses use of a different technology.
Guarascio-Howard L. Examination of wireless technology to improve nurse communication, response time to bed alarms, and patient safety. HERD. 2011 Winter;4(2):109-20.

What is the prevalence of physical restraint use in medical and geriatric psychiatry units?

PubMed search:  restraint AND prevalence AND (hospitals OR wards OR units) AND psychiatric

restraint AND prevalence AND (hospitals OR wards OR units) AND (geriatric OR elderly) AND acute care

Riv Psichiatr. 2013 Jan-Feb;48(1):10-22. doi: 10.1708/1228.13611.
Prevalence and risk factors for the use of restraint in psychiatry: a systematic review.
Beghi M, et al.

Clin Nurs Res. 2013. DOI: 10.1177/1054773813493112. Physical Restraint Usage at a Teaching Hospital: A Pilot Study. Barton-Gooden A, et al.

Psychiatry Res. 2013 Aug 30;209(1):91-7. doi: 10.1016/j.psychres.2012.11.017. Epub 2012 Dec 6.  Mechanical and pharmacological restraints in acute psychiatric wards–why and how are they used?  Knutzen M, et al.

 

 

Reactions during blood transfusions

Sapatnekar, Suneeti 1; Sharma, Girish 2; Downes, Katharine A. 2; Wiersma, Susan 3; McGrath, Claire 1; Yomtovian, Roslyn 2, Acute Hemolytic Transfusion Reaction in a Pediatric Patient Following Transfusion of Apheresis Platelets. Journal of Clinical Apheresis. 20(4):225-229, December 2005.

Barnes, H M Febrile transfusion reaction following initial transfusion in a man with immunoblastic lymphadenopathy and granulocyte autoantibodies. American journal of hematology 1983 vol:14 iss:1 pg:97 -100

Thompson CL; Edwards C; Stout LBlood transfusions 1: how to monitor for adverse reactions.
Transfusion Liaison Nurse, National Blood Service, Leeds and Newcastle
Nursing Times, 2008 Jan 15-21; 104 (2): 32-3.

Sacks DA; Nelson JM Transfusion reactions. Physician Assistant (PHYSICIAN ASSIST), 1992 May; 16 (5): 35-6, 38, 40 passim.