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Do patients respond differently to nurses who wear uniforms on inpatient mental health units?
“Preferences of dress and address: views of attendees and mental health professionals of the psychiatric services.” Irish journal of psychological medicine 29.1 (2012)27.
Miller, Tracy, NancyMann, and Rodney DGrim. “Clothes encounter: patient perception of nursing attire in a behavioral health unit.” Journal of the American Psychiatric Nurses Association 16.3 (2010):178-183.
Adams, John. “Nursing in a therapeutic community: the Fulbourn experience, 1955-1985.” Journal of clinical nursing 18.19 (2009):2747-2753.
Lavender, A. “The effects of nurses changing from uniforms to everyday clothes on a psychiatric rehabilitation ward.” the British journal of medical psychology 60 pt. 2 (1987):189-199.
Sterling, F E. “Net positive social approaches of young psychiatric inpatients as influenced by nurses’ attire.” Journal of consulting and clinical psychology 48.1 (1980):58-62.
Trauer, T, and A V VMoss. “Psychiatric patients’ opinions of nurses ceasing to wear uniform.” Journal of advanced nursing 5.1 (1980):47-53.
Rinn, R C. “Effects of nursing apparel upon psychiatric inpatients’ behavior.” Perceptual and motor skills 43.3 pt. 1 (1976):939 -945.
Klein, R H, et al. “Psychiatric staff: uniforms or street clothes?” Archives of general psychiatry 26.1 (1972):19-22.
Walker, V J, GVoineskos, and D L LDunleavy. “The effects of psychiatric nurses ceasing to wear uniform.” British journal of psychiatry 118.546 (1971):581-582.
Leff, H S, R V VNydegger, and MBuck. “Effect of nurses’ mode of dress on behavior of psychiatric patients differing in information-processing complexity.” Journal of consulting and clinical psychology 34.1 (1970):72-79.
Petrovich, D V, J R Bennett, and J Jackson. “Nursing apparel and psychiatric patients: a comparison of uniforms and street clothes.” Journal of psychiatric nursing and mental health services 6.6 (1968):344-348.
Hawkins, E, J L Claghorn, and W Zentay. “Nursing dress, and experimental evaluation of its effect on psychiatric patients.” Journal of psychiatric nursing 4.2 (1966):148-157.
Databases searched: PubMed and CINAHL
Keywords: dress, uniform, attire, apparel, nurse*, psychiatric, mental health
Reviewed and updated 4/8/2014 ldt
What is the evidence on the effect of nurses’ sleep habits on patient safety?
A search of Joanna Briggs, PubMed, and CINAHL identified the following relevant references.
Joanna Briggs Institute
No documents focusing on sleep and patient safety
CINAHL
The search (MH “Nursing Staff, Hospital” OR MH “Nurses+”) AND (safety OR error*) AND sleep LIMITERS: Research articles identified observational studies on effects of sleep on safety, including Johsnon 2014, Lockley 2007, Admi 2008, Biddle 2011, and Muecke 2005. There was at least one study evaluating an intervention (Scott 2010). No articles by Geiger-Brown, who has written on nurses and sleep, appeared in search results above or in this search: sleep AND safety AND geiger-brown.
A search of Geiger Brown and sleep in CINAHL identified these papers.
PubMed
A search for articles by Geiger-Brown and sleep in PubMed identified an additional article that specifically mentions safety:
Sleep, sleepiness, fatigue, and performance of 12-hour-shift nurses. Chronobiol Int. 2012 Mar;29(2):211-219.
An additional search in PubMed for “Nurses”[Mesh] AND “Sleep”[Mesh] AND (“Safety”[Mesh] OR “Medical Errors”[Mesh]) found the following two articles.
Dorrian, Jillian, et al. “Sleep and errors in a group of Australian hospital nurses at work and during the commute.” Applied Ergonomics 39.5 (2008):605-613.
Dorrian, Jillian, et al. “A pilot study of the safety implications of Australian nurses’ sleep and work hours.” Chronobiology international 23.6 (2006):1149-1163.
Reviewed and updated 4/8/2014 ldt
What evidence supports administering normal saline with blood transfusions?
Blood components: characteristics, indications, logistics and administration. In: Blood transfusion guideline. Utrecht (The Netherlands): Dutch Institute for Healthcare Improvement CBO 2011;18-59.
Australian & New Zealand Society of Blood Transfusion Ltd. Royal College of Nursing Australia. Guidelines for the administration of blood components. 2011.
Elgin, Kimberly, Maintaining Patency with Packed Red Blood Cell Infusions: Comparison of IV Normal Saline Infusion vs. Normal Saline Syringe Method. MEDSURG Nursing 2011 May-Jun; 20(3): 134-138.
Burdett, Edward Perioperative buffered versus non-buffered fluid administration for surgery in adults. Cochrane Database of Systematic Reviews 2012;12:CD004089 -CD004089.
Chung, H S Effects of liver function on ionized hypocalcaemia following rapid blood transfusion. Journal of international medical research 2012;40(2):572 -582.
Reviewed and updated 4/7/2014 ldt
What are the recommendations for use of graduated compression stockings in hospitalized patients?
For medical patients:
DVT prophylaxis for medical patients. In: DynaMed Plus. References two practice guidelines that address use of stockings in hospitalized medical patients.
American College of Chest Physicians (ACCP) suggests usage of the stockings or intermittent pneumatic compression if risk factors for VTE and high risk for bleeding are present. Chest. 2012; 141 (2 Supp). Section 2.7 reviews evidence for use of compression stockings or other mechanical devices in hospitalized medical patients.
American College of Physicians (ACP) does not recommend use of graduated compression stockings for thromboprophylaxis. Ann Intern Med 2011 Nov 1;1559):625-632.
The section “Comparative Effectiveness of Mechanical Devices versus No Mechanical Devices” (p. 627) summarizes evidence and references studies.
There are additional recommendations for compression stockings in medical patients in DynaMed Plus:See prevention section of entry for Deep Vein Thrombosis.
Documents from the Joanna Briggs Institute EBP Database reviewed evidence and provided recommendations for use of compression stockings in hospitalized patients but did not specifically discuss frequency of changing stockings or other aspects of their use other than using knee-length stockings in surgical patients who are for some reason unable to tolerate the thigh-length stockings. See these documents for summaries and references to the evidence.
To retrieve the following documents use the Joanna Briggs Institute EBP Database. Copy and paste the document title in the search box.
- Search for “Deep vein thrombosis prophylaxis” to find latest evidence summaries.
- Search for “Graduated compression stockings clinician information” to find latest evidence summaries.
For surgical patients:
See guidelines section in entry forDeep vein thrombosis (DVT) prophylaxis for surgical patients. In: DynaMed Plus. To view summary of specific evidence, view section for a surgical specialty (e.g., general and abdominal surgery, neurosurgery, etc.)
To retrieve the following documents use the Joanna Briggs Institute EBP Database. Copy and paste the document title in the search box.
- Search for “Hip fracture management older people” to find the latest recommended practices.
- Search for “Graduated compression stockings for the prevention of post-operative venous thromboembolism” to view a 2008 technical report.
Reviewed and updated 4/8/2014 ldt
Does hourly rounding reduce the risk of accidental falls in a cardiovascular surgical unit?
A CINAHL search for (rounds OR rounding) AND falls AND (cardiac OR coronary OR cardiovascular) did not retrieve any results.
A search for (rounds OR rounding) AND falls AND (surgical OR surgery OR postoperative) retrieved 13 references, including these studies in medical-surgical units:
Effects of rounding on patient satisfaction and patient safety on a medical-surgical unit. Woodward JL; Clinical Nurse Specialist: The Journal for Advanced Nursing Practice, 2009 Jul-Aug; 23 (4): 200-6.
Hourly Rounding: A Replication Study. Olrich, Todd; Kalman, Melanie; Nigolian, Cindy; MEDSURG Nursing, 2012 Jan-Feb; 21 (1): 23-36.
A search in PubMed found these two additional articles.
Krepper, Rebecca, et al. “Evaluation of a Standardized Hourly Rounding Process (SHaRP).” Journal for healthcare quality 36.2 (2014):62-69.
The first took place in two 32-bed cardiovascular surgery nursing units.
Ciccu Moore, Rita, et al. “Care and comfort rounds: improving standards.” Nursing management 20.9 (2014):18-23.
This study took place in an orthopaedic and surgical rehabilitation ward.
See also Does hourly or intentional rounding reduce the rate of accidental falls in acute care facilities?
See also Are inpatients with cardiac conditions or on diuretic therapy at risk for falls and is there any evidence of interventions to reduce falls in this population?
This blog entry references a couple of papers in the search results that include patients with cardiac conditions in their populations. You might be able to extrapolate strategies to your population.
Reviewed and updated 4/8/2014 ldt
Are inpatients with cardiac conditions or on diuretic therapy at risk for falls and is there any evidence of interventions to reduce falls in this population?
PubMed search for falls AND (inpatients OR hospitalization) AND ((drugs AND adverse effects) OR diuretics OR cardiac OR cardiovascular OR heart)
Risk
Several papers report on risk of falling associated with these conditions.
These look at conditions, including cardiac, associated with falls: Belita (2013), Forrest (2012), de Carle (2001), Tutuarima (1997)
These studies report on association of drugs: Williams (2014), de Groot (2013), Butt (2013), Payne (2010), Shuto (2010), Tanaka (2008), Gales (1995).
Prevention
Belita (2013) describes a project that focused on cardiac-related falls and injuries. Forrest (2012) addresses prevention of falls in patients on a rehabilitation unit, including those with cardiac admission diagnosis.
Williams, Tamara, Marilyn Szekendi, and StephenThomas. “An analysis of patient falls and fall prevention programs across academic medical centers.” Journal of nursing care quality 29.1 (2014):19-29.
de Groot, Maartje, JP van Campen, MA Moek, et al. “The effects of fall-risk-increasing drugs on postural control: a literature review.” Drugs & aging 30.11 (2013):901-920.
Butt, D A, et al. “The risk of falls on initiation of antihypertensive drugs in the elderly.” Osteoporosis international 24.10 (2013):2649-2657.
Belita, Lydia, P Ford, and H Kirkpatrick. “The development of an assessment and intervention falls guide for older hospitalized adults with cardiac conditions.” European journal of cardiovascular nursing 12.3 (2013):302-309.
Payne, Rupert A, et al. “Association between prescribing of cardiovascular and psychotropic medications and hospital admission for falls or fractures.” Drugs & aging 30.4 (2013):247-254.
Forrest, George, “Falls on an inpatient rehabilitation unit: risk assessment and prevention.” Rehabilitation nursing 37.2 (2012):56-61.
Shuto, Hideki, et al. “Medication use as a risk factor for inpatient falls in an acute care hospital: a case-crossover study.” British journal of clinical pharmacology 69.5 (2010):535-542.
Tanaka, Mamoru, et al. “Relationship between the risk of falling and drugs in an academic hospital.” Yakugaku zasshi 128.9 (2008):1355-1361.
de Carle, A J, and R Kohn. “Risk factors for falling in a psychogeriatric unit.” International journal of geriatric psychiatry 16.8 (2001):762-767.
Tutuarima, J A, et al. “Risk factors for falls of hospitalized stroke patients.” Stroke 28.2 (1997):297-301.
Gales B J, and S M Menard. “Relationship between the administration of selected medications and falls in hospitalized elderly patients.” The annals of pharmacotherapy 29.4 (1995):354-358.
Reviewed and updated 4/7/2014 ldt
Evidence Matters 