What does research say about nurse fatigue and maximum consecutive hours worked?

An interventional approach for patient and nurse safety: a fatigue countermeasures feasibility study.” Nursing research 59.4 (2010):250.

Are extended work hours worth the risk? American Nurse Today 2013 vol:8 iss:5 pg:8

Tabone S. Data suggest nurse fatigue threatens patient safety: is prescribing the nurse’s work hours the only answer? Texas Nursing, 2004 Feb; 78 (2): 4-7.

Data suggest nurse fatigue threatens patient safety: is prescribing the nurse’s work hours the only answer?… From Nursing that Works, A publication of the Center for American Nurses, Edition #5, May 2004. Colorado nurse 2004 vol:104 iss:4 pg:22

Barker, Linsey M.; Nussbaum, Maury A. Fatigue, performance and the work environment: a survey of registered nurses. Journal of Advanced Nursing , 2011 Jun; 67 (6): 1370-82

Infants at risk: when nurse fatigue jeopardizes quality care.” Advances in neonatal care 6.3 (2006):120.

Streak, Judith Fatigue in the Perioperative Environment: Effects on Worker Performance and Best Practice Management Principles. 2013

How does the safety of medication administration compare when using barcode scanning versus manual methods?

Bottom line:  Properply used barcode medication administration technology reduces the rate of medication errors in acute care settings.

SummarySan TH, et al.  Factors affecting registered nurses’ use of medication administration technology in acute care settings: A systematic review.  JBI Library of Systematic Reviews. 10(8):471-512,  2012.
Although this systematic review addresses nurses’ attitudes and barries to using technology like barcode scanning, the Background section (p. 474), documents evidence on effectiveness of using barcodes in reducing medication errors.

Cited studies
Poon EG, Keohane CA, Yoon CS, Ditmore M, Bane A, Levtzion-Korach O, et al. Effect of bar-code technology on the safety of medication administration. New Engl J Med. 2010;362(18):1698-707.
Before and after study at academic medical center implementing barcode system. RESULTS: Investigators observed 14,041 medication administrations and reviewed 3082 order transcriptions. Observers noted 776 nontiming errors in medication administration on units that did not use the bar-code eMAR (an 11.5% error rate) versus 495 such errors on units that did use it (a 6.8% error rate). 41% reduction in error rate after the barcode system was implemented.

Morriss FH, Abramowitz PW, Nelson SP, Milavetz G, Michael SL, Gordon SN, et al. Effectiveness of a barcode medication administration system in reducing preventable adverse drug events in a neonatal intensive care unit: a prospective cohort study. Journal Ped. 2009;154(3):363 – 8.
Observational study conducted during the process of installing a barcode medication administration system in a neonatal ICU. RESULTS: 92 398 medication doses were administered to 958 subjects. Relative risk of medication errors when using the barcode system was 0.53 compared to not using the barcode system.

Other studies

See this PubMed search for a focus on quasi-experimental studies:
“Medication Systems, Hospital”[MAJR] AND “Medication Errors/prevention and control”[MAJR] AND (barcodes OR barcoding OR bar codes) AND (comparative OR before and after OR quasi-experimental)

To view a broader set of references on this topic:
“Medication Systems, Hospital”[MAJR] AND “Medication Errors/prevention and control”[MAJR] AND (barcodes OR barcoding OR bar codes)

Is there evidence on fall prevention audit tools and how to get nurses engaged in preventing falls?

Articles are arranged by topic.

Engagement of nurses in fall prevention efforts; these articles cover a variety of techniques

Colon Emeric, Cathleen S, et al. “CONNECT for Better Fall Prevention in Nursing Homes: Results from a Pilot Intervention Study.” Journal of the American Geriatrics Society 61.12 (2013):2150-2159.

Lea, Emma, et al. “Beyond the ‘tick and flick’: facilitating best practice falls prevention through an action research approach.” Journal of clinical nursing 21.13-14 (2012):1896-1905.

Barker, Anna, et al. “The 6-PACK programme to decrease fall-related injuries in acute hospitals: protocol for a cluster randomised controlled trial.” Injury prevention 17.4 (2011):e5-e5.

Bonuel, Nena, et al. “Best practice fall prevention strategies. CATCH!” Critical care nursing quarterly 34.2 (2011):154-158.

Healey, Frances. “A guide on how to prevent falls injury in hospitals.” Nursing older people 22.9 (2010):16-22.

Koh, S L, et al. “Impact of a fall prevention programme in acute hospital settings in Singapore.” Singapore medical journal 50.4 (2009):425-432.

Koh, Serena S L, et al. “Nurses’ perceived barriers to the implementation of a Fall Prevention Clinical Practice Guideline in Singapore hospitals.” BMC health services research 8(2008):105-105.

Ireland, Sandra, et al. “The real world journey of implementing fall prevention best practices in three acute care hospitals: a case study.” Worldviews on evidence-based nursing 10.2 (2013):95-103.

Saint, Sanjay, et al. “Introducing the patient safety professional: why, what, who, how, and where?” Journal of patient safety 7.4 (2011):175-180.

Tzeng, Huey-Ming. “Nurses’ caring attitude: fall prevention program implementation as an example of its importance.” Nursing forum 46.3 (2011):137-145.

Unruh, Lynn, ManishaAgrawal, and SusanHassmiller. “The business case for transforming care at the bedside among the “TCAB 10” and lessons learned.” Nursing administration quarterly 35.2 (2011):97-109.

Stetler, C B, et al. “Integration of evidence into practice and the change process: fall prevention program as a model.” Outcomes management for nursing practice 3.3 (1999):102-111.

Dean, Erin. “Reducing falls among older people in hospital.” Nursing older people 24.5 (2012):16-16, 19.

Rask, Kimberly, et al. “Implementation and evaluation of a nursing home fall management program.” Journal of the American Geriatrics Society 55.3 (2007):342-349.

Audit

Audit criteria

Chapman, Joanne, Deborah Bach, and Kristiina HyrkÃs. “Testing the sensitivity, specificity and feasibility of four falls risk assessment tools in a clinical setting.” Journal of nursing management 19.1 (2011):133-142.

Poe, Stephanie S, et al. “The Johns Hopkins Fall Risk Assessment Tool: postimplementation evaluation.” Journal of nursing care quality 22.4 (2007):293-298.

Perell, K L, et al. “Fall risk assessment measures: an analytic review.” The journals of gerontology. Series A, Biological sciences and medical sciences 56.12 (2001):M761-M766.

Oliver, D, et al. “Development and evaluation of evidence based risk assessment tool (STRATIFY) to predict which elderly inpatients will fall: case-control and cohort studies.” BMJ. British medical journal 315.7115 (1997):1049-1053.

Taylor, Jo A, et al. “A model quality improvement program for the management of falls in nursing homes.” Journal of the American Medical Directors Association 8.3 Suppl (2007):S26-S36.

Milisen, Koen, AnneliesGeeraerts, and EddyDejaeger. “Use of a fall prevention practice guideline for community-dwelling older persons at risk for falling: a feasibility study.” Gerontology 55.2 (2009):169-178.

Wong Shee, Annkarin, BevPhillips, and KeithHill. “Comparison of two fall risk assessment tools (FRATs) targeting falls prevention in sub-acute care.” Archives of gerontology and geriatrics 55.3 (2012):653-659.

Koh, Serena Siew Lin, et al. “Fall incidence and fall prevention practices at acute care hospitals in Singapore: a retrospective audit.” Journal of evaluation in clinical practice 13.5 (2007):722-727.

Reviewed by John Nemeth 4/14

Are there studies on training programs for clinical care coordinators/patient technicians in communication skills?

Searches of PubMed and CINAHL for your concepts of nurses aides, communication, and education found the following articles.

Fukaya, Yasuko, et al. “Education to promote verbal communication by caregivers in geriatric care facilities.” Japan journal of nursing science 6.2 (2009):91-103.

McGilton, Katherine S, et al. “A systematic review of the effectiveness of communication interventions for health care providers caring for patients in residential care settings.” Worldviews on evidence-based nursing 6.3 (2009):149-159.

Levy Storms, Lené. “Therapeutic communication training in long-term care institutions: recommendations for future research.” Patient education and counseling 73.1 (2008):8-21.

Williams, Kristine N, Teresa BIlten, and HelenBower. “Meeting communication needs: topics of talk in the nursing home.” Journal of psychosocial nursing and mental health services 43.7 (2005):38-45.

Cunningham, Adrian. “Developing a communications course for health care assistants.” Nursing times 100.47 (2004):36-38.

Williams, Kristine Enhancing communication with older adults: overcoming elderspeak. Journal of Gerontological Nursing 2004 vol:30 iss:10 pg:17 -25

Stevens Roseman, Ellen S, and PatrickLeung. “Enhancing attitudes, knowledge and skills of paraprofessional service providers in elder care settings.” Gerontology & geriatrics education 25.1 (2004):73-88.

Counsell, Colleen M, and RoseRivers. “Inspiring support staff employees.” The Journal of nursing administration 32.3 (2002):120-121.

Burgio, L D, et al. “Come talk with me: improving communication between nursing assistants and nursing home residents during care routines.” Gerontologist, The 41.4 (2001):449-460.

McCallion, P, et al. “Educating nursing assistants to communicate more effectively with nursing home residents with dementia.” Gerontologist, The 39.5 (1999):546-558.

Thomas, L H. “A comparison of the verbal interactions of qualified nurses and nursing auxiliaries in primary, team and functional nursing wards.” International journal of nursing studies 31.3 (1994):231-244.

Have professional practice models in nursing increased nursing engagement?

A search in PubMed and CINAHL  using search terms professional development models AND nursing engagement produced these results:

Carter, Matthew R, and Ann ETourangeau. “Staying in nursing: what factors determine whether nurses intend to remain employed?.” Journal of advanced nursing 68.7 (2012):1589-1600

Bargagliotti, L A. “Work engagement in nursing: a concept analysis.” Journal of advanced nursing 68.6 (2012):1414-1428.

Spence Laschinger, Heather K, et al. “Predictors of new graduate nurses’ workplace well-being: testing the job demands-resources model.” Health care management review 37.2 (2012):175-186.

Adams, Jeffrey M, DebraDenham, and Irene RNeumeister. “Applying the Model of the Interrelationship of Leadership Environments and Outcomes for Nurse Executives: a community hospital’s exemplar in developing staff nurse engagement through documentation improvement initiatives.” Nursing administration quarterly 34.3 (2010):201-207
Lai, Hui-Ling, et al. “Intensive care unit staff nurses: predicting factors for career decisions.” Journal of clinical nursing 17.14 (2008):1886-1896.

More PubMed Results

Reviewed 4/22/14 AA

Do interventions to orient new nurses to a unit/hospital affect staff retention?

The results below include several case studies and evaluations of programs to orient/train/acclimate new hospital nursing staff, including effects on turnover/retention, including:

  • NURSING U: a new concept for nursing orientation.Detail Only Available Cullevy, Thomas; Babbie, Andrea; Clancey, Jeanne; Clouse, Kathy; Hines, Rosemerry; Kraynek, Monica; Tutro, Josephine; Wittman, Susanne; Nursing, 2011 Nov; 41 (11): 59-61
  • Structured orientation for new graduates: a retention strategy.  Marcum EH; West RD; Journal for Nurses in Staff Development, 2004 May-Jun; 20 (3): 118-26.
  • Designing an outcome-focused model for orienting new graduate nurses.Detail Only Available Journal for Nurses in Staff Development, 2011 Nov-Dec; 27 (6): E6-7.
  • Strategies for easing the role transformation of graduate nurses.Detail Only Available (includes abstract) Young ME; Stuenkel DL; Bawel-Brinkley K; Journal for Nurses in Staff Development, 2008 May-Jun; 24 (3): 105-12.
  • Tool kit for the staff mentor: strategies for improving retention. Butler MR; Felts J; Journal of Continuing Education in Nursing, 2006 Sep-Oct; 37 (5): 210-3.

Results of the CINAHL search
((MH “Personnel Turnover”) OR (MH “Personnel Turnover”)) AND ( (orientation OR mentorship OR (MH “Work Environment” AND attitude*) OR MH “Support, Psychosocial”) AND nurses AND (new N3 (hire* OR employee* OR staff OR graduate*)) AND hospital* )

A search of CINAHL using these concepts:
Personnel turnover, personnel retention
Orientation, mentorship, (subject heading for work environment combined with the term attitude), subject heading for psychosocial support
Nurses
New staff, new employees, new hires, new graduates
Hospitals

What are the evidence-based recommendations for orientation time for new graduate nurses in terms of safety and readiness to practice?

Search was done in PubMed and Joanna Briggs using these search terms: new graduate nurses AND (transition OR residency OR internship).

Bottom Line: Literature search revealed very broad time line in nurse residency from 6 weeks to one year  and time by (department or area not discussed).
Park, Mihyun, and Cheryl B Jones. A retention strategy for newly graduated nurses: an integrative review of orientation programs. Journal for nurses in staff development 26.4 (2010):142-149.  See TABLE 1 The Summary of Program Outcomes

Holland, Cindra, and Gail RModdeman. Transforming the journey for newly licensed registered nurses. The Journal of Continuing Education in Nursing 43.7 (2012):330-336.

Kramer, Marlene, et al. The organizational transformative power of nurse residency programs. Nursing administration quarterly 36.2 (2012):155-168.

Purling, Amy, and LindyKing. A literature review: Graduate nurses’ preparedness for recognising and responding to the deteriorating patient. Journal of clinical nursing 21.23-24 (2012):3451-3465.

The effectiveness of strategies and interventions that aim to assist the transition from student to newly qualified nurse. (Systematic Review). The JBI Library of Systematic Reviews & Implementation Reports. 9(53):2215-2323, 2011.

More references from PubMed