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

Nurse to nurse accountability on shift change

I searched PubMed on these concepts of shift change and nurse accountability.

Griffin, Terry. “Bringing change-of-shift report to the bedside: a patient- and family-centered approach.” The Journal of perinatal & neonatal nursing 24.4 (2010):348-53.

Powell, Suzanne K. “Handoffs and transitions of care: where is the Lone Ranger’s silver bullet?.” Lipincott’s case management 11.5 (2006):235-237.

Researchers provide new template for more effective handoffs.” Healthcare benchmarks and quality improvement 17.5 (2010):49-52.

Patterson, Emily S, and Robert LWears. “Patient handoffs: standardized and reliable measurement tools remain elusive.” The joint commission journal on quality and patient safety 36.2 (2010):52-61.

 

 

What are the orientation costs for registered nurses in a hospital setting?

Morris LL ; Pfeifer P ; Catalano R ; Fortney R ; Nelson G ; Rabito R ; Harap R Outcome evaluation of a new model of critical care orientation. American Journal of Critical Care, 2009 May; 18(3): 252-9

Greene, Mary Ann. Paying for nursing orientation: a huge cost to hospitals. Journal for Nurses in Staff Development, 2010 Nov-Dec; 26(6): E3-7

Recruitment & Retention Report. On the road to a meaningful, cost-effective orientation program. Nursing Management 2011 vol:42 iss:5 pg:10

Reiter, Margaret Decrease new graduate nurse orientation costs by using HESI exit exam scores. The Journal of nursing administration 2007 vol:37 iss:10 pg:459 -463

Kennedy, Julie Nursing department orientation: are we missing the mark? Journal for nurses in staff development 2012 vol:28 iss:1 pg:24 -26

Reviewed JKN 4/14

What are some strategies regarding nursing staff engagement?

A search of CINAHL on the concept of nursing staff engagement produced these results.

An intervention to enhance nursing staff teamwork and engagement. The Journal of nursing administration 2007 vol:37 iss:2 pg:77

Health facility design. Staff nurse engagement in health facility design. The Journal of nursing administration 2008 vol:38 iss:7-8 pg:315

Improving staff engagement and patient care: use of novel initiatives. British journal of nursing 2011 vol:20 iss:18 pg:1168

Perioperative nursing shines! Magnet designation reflected in staff engagement, empowerment and excellence. ACORN 2011 vol:24 iss:3 pg:34

Self-transcendence and work engagement in acute care staff registered nurses. Critical care nursing quarterly 2010 vol:33 iss:2 pg:138

Strategies for staff engagement within a nurse residency program. American Nurse Today 2012 vol:7 iss:8

The outcomes of magnet environments and nursing staff engagement: a case study. The Nursing clinics of North America 2011 vol:46 iss:1 pg:89

What are some strategies for facilitating uninterrupted meal breaks for nurses?

A search of CINAHL for (MM “Personnel Staffing and Scheduling”) AND ((breaks OR meal* OR rest)) retrieves articles discussing how to ensure breaks,  as well as articles on effect of work breaks on quality of care.   Below are article identified as more relevant to the question of how to facilitate break times.

Rest break guidelines needed to clarify shifts confusion. Harrison M; Nursing Standard.  2009; 23(41): 32-3.

Managers forum. Ensuring meal breaks.Detail Only Available Rietow N; Ingalls J; Kuell D; Proehl JA; Zimmermann PG; JEN: Journal of Emergency Nursing, 2003 Oct; 29 (5): 465-7, 495-502

One-hour, off-unit meal breaks.  Stefancyk AL; American Journal of Nursing, 2009 Jan; 109 (1):     64-6.

Penalties for missed breaks, lunch.  OR Manager, 2001 Jul; 17 (7): 6.

Reorganize staff to address mealtime challenges.  Senior Care Management, 2005 Jun; 8 (6): 69-70.

Rest break guidelines needed to clarify shifts confusion… Gerry Bolger and Annabel Morris (features June 3).  Harrison M.  Nursing Standard, 2009 Jun 17-23; 23 (41): 32-3.

The rules of rest and relaxation: minimizing fatigue to increase patient safety. Joint Commission Perspectives on Patient Safety, 2007 May; 7 (5): 1, 3-4, 8 (journal article) ISSN: 1534-5181

Work force management. Work breaks and patient safety.Detail Only Available Cavorous CA; Suby C; Journal of Clinical Systems Management, 2005 Jan-Feb; 7 (1-2): 7 (journal article)

Breaks are not a privilege, they are an employment right.  Lester J; Nursing Standard. 2008; 23(1): 33.

How do acuity-based nurse staffing models affect patient safety and overall nurse staffing?

Searching CINAHL, PubMed and Joanna Briggs, for the concepts of nurse, staffing, (acuity OR “patient classification”), safety, and outcomes, identifies the following resources:

General information on acuity systems:

Choi J, et al. Power up your staffing model with patient acuity. Nurs Manage. 2011 Sep;42(9):40-3.

Acuity systems dialogue and patient classification system essentials. Nursing administration quarterly 2007 vol:31 iss:4 pg:284

On patient safety and quality

PubMed:  “Nursing Staff, Hospital”[majr] AND (acuity OR “patient classification”) AND (safety OR mortality) which includes references such as

  • Kiekkas P, et al.   Association between nursing workload and mortality of intensive care unit patients.  J Nurs Scholarsh. 2008;40(4):385-90.
  • Massey D, et al. What factors influence suboptimal ward care in the acutely ill ward patient? Aust Crit Care. 2008 Aug;21(3):127-40.

CINAHL:   nurse staffing AND (acuity OR “patient classification”) AND (safety OR mortality OR quality OR outcome)    which includes references such as:

  • Butler M, et al.  Hospital nurse staffing models and patient and staff-related outcomes.  Cochrane Database of Systematic Reviews, 2011 (7).

Revision of post from Dec 13, 2011. JKN

What evidence has been published for mentoring programs for RNs, Nursing Aides, and Nursing Techs?

Below are two summaries of evidence on mentoring programs as well as a PubMed and CINAHL search  on nurses and mentoring.

Supervision and Mentoring within Health Teams (Evidence Summary) from JBI Connect- Joanna Briggs

The effectiveness of strategies and interventions that aim to assist the transition from student to newly qualified nurse Edwards D, Hawker C, Carrier J, Rees C
JBI Library of Systematic Reviews Vol  9(53) Pgs 2215-23  Date /9/29/11

PubMed Search

CINAHL Search

Reviewed by John Nemeth 4/14