Strategies for reducing interruptions and errors during medication administration

Posted on June 21, 2019 by Lisa

Here’s how to access a collection of 19 articles on strategies for reducing interruptions and errors during medication administration that are dated within the last five years. Strategies include wearing vests/tabards with signage, educating nurses about safe medication administration and strategies for handling interruptions, creating a safe zone/no interruption zone, involving and educating patients, using signs, using safety pictograms, using a card instructing nurses how to respond to interruptions, integrating mindfulness exercises in medication administration, implementing and supporting nurses’ rights of medication administration, employing behavioral management strategies, and making sure all nurses on a unit do not administer meds at the same time.

a. Go to the Woodruff Health Sciences Center Library homepage (http://health.library.emory.edu)
b. Click on PubMed.
c. Then paste the following links into your browser: https://tinyurl.com/y5dzngb3
d. The references will appear in PubMed. Click on a reference and you will see a Find it at Emory on the right side of the page which will provide links to full text within Emory University’s licensed resources. Emory Healthcare staff may send citations of needed articles they are unable to access to Ask a Librarian; a library staff person will request the article(s) from an outside library and email them to the EHC staff person upon arrival.

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Important message for Emory Decatur Nurses. The links will not work for you. To access these articles contact the Emory Decatur Library:

Emory Decatur Hospital
Jessica Callaway (Jessica.callaway@emoryhealthcare.org
404.501.1628

Non-adherence to immunosuppresant therapy in minority renal transplant patients.

Posted on April 17, 2019 by John

Ajay K. Israni, Francis L. Weng, Ye-Ying Cen, Marshall Joffe, Malek Kamoun, Harold I. Feldman Electronically-measured adherence to immunosuppressive medications and kidney function after deceased donor kidney transplantation Clin Transplant. Author manuscript; available in PMC 2013 Feb 7.

Coelho Gonçalves, P. R., Ferreira Reveles, A., Fernandes Martins, H. I., Rodrigues, I. L., & Miranda Rodrigues, S. M. (2016). Adherence to Immunosuppressive Therapy in Kidney Transplant Recipients: Integrative Literature Review. Revista de Enfermagem Referência, 4(8), 121–130

Francis L Weng, Sheenu Chandwani, Karen M Kurtyka, Christopher Zacker, Marie A Chisholm-Burns, Kitaw Demissie Prevalence and correlates of medication non-adherence among kidney transplant recipients more than 6 months post-transplant: a cross-sectional study BMC Nephrol. 2013; 14: 261.

Extending medicare immunosuppressive medication coverage. (2012). Journal of Health Care for the Poor and Underserved., 23(1), 20.

Wilkins, L., Nyame, Y., Gan, V., Lin, S., Greene, D., Flechner, S., & Modlin, C. (2018). A Contemporary Analysis of Outcomes and Modifiable Risk Factors of Ethnic Disparities in Kidney Transplantation. Journal of the National Medical Association., Journal of the National Medical Association. , 2018.

Yadav, K., Vock, D., Matas, A., Robiner, W., & Nevins, T. (n.d.). Medication adherence is associated with an increased risk of cancer in kidney transplant recipients: A cohort study. Nephrology Dialysis Transplantation., 34(2), 364-370.

De Castro Rodrigues Ferreira, F., Cristelli, M., Paula, M., Proença, H., Felipe, C., Tedesco-Silva, H., & Medina-Pestana, J. (n.d.). Infectious complications as the leading cause of death after kidney transplantation: Analysis of more than 10,000 transplants from a single center. J Nephrol, 30(4), 601-606.

Reese, P., Bloom, R., Trofe-Clark, J., Mussell, A., Leidy, D., Levsky, S., . . . Volpp, K. (n.d.). Automated Reminders and Physician Notification to Promote Immunosuppression Adherence Among Kidney Transplant Recipients: A Randomized Trial. American Journal of Kidney Diseases : AJKD : The Official Journal of the National Kidney Foundation., 69(3), 400-409.

Gaynor, J., Ciancio, G., Guerra, G., Sageshima, J., Hanson, L., Roth, D., . . . Burke, G. (n.d.). Graft failure due to noncompliance among 628 kidney transplant recipients with long-term follow-up: A single-center observational study. Transplantation., 97(9), 925-933.

Malat, G., Culkin, C., Palya, A., Ranganna, K., & Kumar, M. (2009). African American kidney transplantation survival: The ability of immunosuppression to balance the inherent pre- and post-transplant risk factors. Drugs., 69(15), 2045-2062.

Brown, K., El-Amm, J., Doshi, M., Singh, A., Cincotta, E., Morawski, K., . . . Gruber, S. (n.d.). Outcome predictors in African-American deceased-donor renal allograft recipients. Clinical Transplantation., 23(4), 454-461.

Continuous vs. intermittent tracheal suctioning

Posted on April 12, 2019 by John

Seguin, P., Perrichet, H., Pabic, E. L., Launey, Y., Tiercin, M., Corre, R., … Laviolle, B. (2018). Effect of Continuous versus Intermittent Subglottic Suctioning on Tracheal Mucosa by the Mallinckrodt TaperGuard Evac Oral Tracheal Tube in Intensive Care Unit Ventilated Patients: A Prospective Randomized Study. Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine, 22(1), 1–4.

Rouzé, A., Martin-Loeches, I., & Nseir, S. (2018). Airway Devices in Ventilator-Associated Pneumonia Pathogenesis and Prevention. Clinics in Chest Medicine., 39(4), 775-783.

Chan, M., Chow, B. K., Lo, T., Ko, F. W., Ng, S. S., Gin, T., & Hui, D. S. (2018). Exhaled air dispersion during bag-mask ventilation and sputum suctioning – Implications for infection control. Scientific reports, 8(1), 198.

Rozycki, S., Dixon, F., Yopp, M., Maxvold, N., & Rubin, B. (n.d.). Endotracheal Tube Seal and Suction Performance in a Novel Biorealistic Tracheal Model. Respiratory Care : The Official Journal of the American Association for Respiratory Therapy., 60(8), 1113-1119.

Suys, E., Nieboer, K., Stiers, W., De Regt, J., Huyghens, L., & Spapen, H. (2013). Intermittent subglottic secretion drainage may cause tracheal damage in patients with few oropharyngeal secretions. Intensive and Critical Care Nursing., 29(6), 317-320.

Pressure changes during tracheal suctioning – a laboratory study. (2013). Anaesthesia., 68(6), 576.

Hospital-acquired pressure ulcers

Posted on January 24, 2019 by John

Dramatic Reduction in Hospital-Acquired Pressure Injuries Using a Pink Paper Reminder System. (2018). Advances in Skin & Wound Care., 31(3), 118.

Implementation of a Nurse Driven Pathway to Reduce Incidence of Hospital Acquired Pressure Injuries in the Pediatric Intensive Care Setting. (2018). Journal of Pediatric Nursing., 41, 104.

Does Incremental Positioning (Weight Shifts) Reduce Pressure Injuries in Critical Care Patients? (2017). Journal of WOCN : Wound, Ostomy, and Continence Nursing., 44(4), 319.

Predictors of superficial and severe hospital-acquired pressure injuries: A cross-sectional study using the International Pressure Ulcer Prevalence™ survey. (2019). International Journal of Nursing Studies., 89, 46.

Reducing Pressure Injuries in a Pediatric Cardiac Care Unit: A Quality Improvement Project. (2018). Journal of WOCN : Wound, Ostomy, and Continence Nursing., 45(6), 497.

INTERPROFESSIONAL STRATEGIES SUCCESSFULLY REDUCE HOSPITAL-ACQUIRED PRESSURE INJURY PREVALENCE IN A REGIONAL NONTEACHING HOSPITAL…WOCN Society’s 49th Annual Conference, Salt Lake City, Utah, May 19-23, 2017. (2017). Journal of WOCN : Wound, Ostomy, and Continence Nursing., 44, S35.

Outcomes of a Quality Improvement Program to Reduce Hospital-acquired Pressure Ulcers in Pediatric Patients. (2018). Ostomy/wound Management., 64(11), 22.

Pressure Injuries: Preventing Medical Device Related Pressure Injuries.
Wound Healing and Management Node. Haesler, E. [PhD].
[Evidence Summaries]
AN: JBI18873
Year of Publication
2017

Use of mobility subscale for risk assessment of pressure ulcer incidence and preventive interventions: A systematic review.
Mordiffi, Siti Zubaidah [MHlthSc(Edun), BN, OTNC, RN.]. Kent, Bridie [PhD, BSc(Hons), FCNA(NZ), RNT, RN.]. Phillips, Nicole [PhD, MNS, GDipAdvNsg(Educ), BN, DipAppSc(Nsg), RN.]. Tho, Poh Chi [AdvDipNsg(Ortho), RN.].
JBI Database of Systematic Reviews & Implementation Reports. 9(56):2417-2481, 2011.
[Systematic Reviews]
AN: JBI5804
Year of Publication
2011

Prevention of surgical site infections (SSIs)

Posted on September 7, 2018 by Lisa

A collection of 71 articles in PubMed has been compiled on prevention of surgical site infections (SSIs). It consists of systematic reviews, meta-analyses, and guidelines from various sources, including Cochrane, WHO and CDC. There is a wide variety of topics: sterile technique, patient engagement, coated sutures, operating room traffic, preoperative bathing, physician 360-degree reporting, forced-air warming, dressings, teamwork and collaboration, and much more. Articles on usage of antibiotics are not included.

To read abstracts and access full text (where available), first go to Emory’s instance of PubMed and copy/paste this URL into the same browser window. Use the “Find It @ Emory” button to access an article’s full text.

The Agency for Healthcare Research and Quality (AHRQ) has several reports and information on prevention of SSIs. Here are some items from their website:

Toolkit to Promote Safe Surgery helps identify opportunities to improve care and safety practices and implement evidence-based interventions to prevent SSIs. The toolkit includes two guides, supplemental tools for each guide, and 15 instructional modules within three phases (on-boarding, implementation, sustainability) to support change at the unit level.

Toolkit to Improve Safety in Ambulatory Surgery Centers addresses what can be done to prevent SSIs and other complications.

Proactive Risk Assessment of Surgical Site Infections in Ambulatory Surgery Centers includes a list of patient factors that make them high-risk, such as obesity, but also includes things that staff do that lead to increasing rates of infection, such as “fail to remove watch/jewelry/fake nails.”

Creating a Culture of Safety in the Ambulatory Surgery Environment Implementation Guide states that an anticipated benefit for ASCs participating in the program includes a reduction in SSIs and other surgical complications.

Advances in the Prevention and Control of HAIs includes a chapter entitled “Development and Implementation of a Consensus Algorithm to Optimize Preoperative Antimicrobial Prophylaxis and Decrease Gram-Positive Surgical Site Infections for Cardiac and Orthopedic Procedures.”

AHRQ has an ongoing safety program for improving surgical care and recovery. One outcome of the 5-year project will be creation of a toolkit. Visit their website for information on the project and how to enroll a hospital in the program.

Risk factors for developing clostridium difficile (aka c. diff) and/or risk stratification for development and reoccurrence of C. Diff

Posted on July 25, 2018 by Lisa

This collection contains 36 articles on risk factors for developing clostridium difficile (aka cdiff) and/or risk stratification for development and reoccurence of cdiff.

Here is one search technique that was used to find articles in PubMed: ((“Clostridium Difficile”[Mesh] OR “clostridium difficile”[ti] OR “c diff”[ti] OR cdiff[ti]) AND (“Risk Factors”[Mesh] OR “risk factors”[ti]) AND (systematic[sb] OR Meta-Analysis[ptyp])) OR ((“Clostridium Difficile”[Mesh] OR “clostridium difficile”[ti] OR “c diff”[ti] OR cdiff[ti]) AND ((risk OR risks) AND (stratify OR stratifies OR stratified OR stratifying OR stratification)))

To access the collection and to read abstracts and access full text (where available) using the Find it @ Emory button, please first open Emory’s instance of PubMed. Once you have accessed PubMed, copy/paste the following url into the same browser window: https://www.ncbi.nlm.nih.gov/myncbi/collections/56047643/
If are an Emory Healthcare employee and do not have access to an article you need, send the citation(s) to Ask a Librarian.

Criteria for unavoidable pressure ulcers

Posted on February 15, 2018 by Lisa

Seven articles were found that provide information on criteria for unavoidable pressure ulcers.

In order to be able to use the Find it @ Emory button within article entries to look at the full text, please use these instructions to access the collection.
1. Go to the Woodruff Health Sciences Center Library’s homepage at http://health.library.emory.edu/
2. Click on “PubMed.”
3. Copy and paste the url into the address bar of your browser: https://www.ncbi.nlm.nih.gov/myncbi/collections/54337732/?reload=updatePermissionSuccess

Evidence Matters

Evidence-based information for Emory

Category Archives: Patient Safety