Implementing Best Practices for Decreasing Nurse Hesitancy to Call the Rapid Response Team: An Evidence-Based Quality Improvement Initiative.

Background: Nurses, regardless of experience, sometimes wait for the Modified Early Warning Score to indicate physiological decline before initiating the hospital's Rapid Response Team (RRT). The goal of this quality improvement initiative was to reduce nurse hesitancy to call the RRT, as indicated by the monthly number of proactive calls before the Modified Early Warning Score increased and triggered an automated page.

Method: Education, planned handoff communication, debriefing, and good catch emails were the educational strategies used in the implementation of the quality improvement initiatives, encouraging RRT calls sooner.

Why They Stay and Why They Leave: Stay Interviews With Registered Nurses to Hear What Matters the Most.

Registered nurse retention is declining, with a national turnover rate in 2021 of 27%. After implementing a toolkit, nursing leaders in 1 organization completed 75 stay interviews with nurses in a cardiothoracic telemetry and a cardiothoracic surgical intensive care unit. Nurses reported that unit culture, team/peers, and scheduling were important in decisions to stay in their positions, but respondents considered leaving for salary, growth/development, and traveling opportunities.

Ensuring Rapid Response Team Care Aligns With Patients' Limitations of Medical Therapy: A Quality Improvement Project.

Background: Rapid response teams (RRTs) are designed to improve patient care during deterioration in clinical condition.

Local Problem: Patients' desired limitations of medical therapy (LOMTs) were not documented or communicated to the RRT, and patients received care not aligned with their wishes.

Methods: A multidisciplinary team developed a process for improving documentation, communication of LOMTs, and care delivery on 3 medical cardiology units.

Implementing Trauma-Informed Strategies for Mothers of Infants with Neonatal Abstinence Syndrome.

Purpose: To improve outcomes of infants with neonatal abstinence syndrome (NAS) by implementing an evidence-based approach to care.

Methods: An interdisciplinary team developed and implemented an educational module about the elements and principles of trauma-informed care (TIC) and standardized education on NAS for mothers with substance use disorder (SUD). The team collaborated with community behavioral health professionals to secure the services of a certified recovery specialist.

Using Technology to Improve Capacity Management at a Pediatric Hospital.

Bed flow decisions should be based on current information about capacity. The purpose of this project was to develop a real-time, enterprise-wide, capacity management dashboard. The dashboard successfully used information from the electronic medical record to create a comprehensive standardized data source, which was used to drive patient flow decisions optimizing bed space, allocating resources and maintaining safety.

Health Care Provider in Triage to Improve Outcomes.

Problem: Emergency departments throughout the nation are experiencing crowding related to increased patient volumes and decreased hospital inpatient bed capacity. As a result of lengthy wait times, patients are leaving without having medical treatment, and satisfaction is poor. The purpose of this quality improvement initiative was placing a provider in triage to complement the existing split-flow process aimed to decrease wait times to see a provider, length of stay (LOS), left without being seen (LWBS) rates, and improve patient satisfaction.

Implementation of a Vital Sign Alert System to Improve Outcomes.

Background: Patients at risk for clinical deterioration often show changes in vital signs up to 24 hours before a critical event. Use of modified early warning scores has demonstrated effectiveness in identifying patients at risk for clinical deterioration and improving outcomes.

Local Problem: Documentation of vital signs, timely recognition of clinical deterioration, and compliance with the sepsis bundles remained a challenge.

Enhancing Cancer Pain Assessment and Management in Hospice.

Pain is one of the most common symptoms in individuals with cancer and is directly associated with significantly reduced quality of life. The purpose of this project was to enhance assessment and management of cancer-related pain for patients in the hospice setting. Nurse attitudes and knowledge about pain were evaluated using the Nurses' Knowledge and Attitudes Survey Regarding Pain before and 6 weeks after an educational program.

Good Catch Campaign: Improving the Perioperative Culture of Safety.

Although health care workers feel pressure to reduce adverse events in the perioperative department, a lack of education, communication, and leadership can prevent hospital personnel from reporting good catches. The purpose of this evidence-based quality improvement project was to improve the culture of safety in our perioperative department by implementing the Good Catch Campaign. An interprofessional team led staff member education after implementing a standardized electronic reporting system and debriefing process to occur after good catches.

Interprofessional Collaboration to Improve Sepsis Care and Survival Within a Tertiary Care Emergency Department.

Problem: Sepsis is a leading cause of death in the United States; however, health care providers struggle with timely recognition, diagnosis, and treatment of patients. Both the Centers for Medicare and Medicaid Services and the National Quality Forum have identified this diagnosis as a priority. Presently, many patients with sepsis are identified late, resulting in significant morbidity and death.

Improving the Patient's Experience With a Multimodal Quiet-at-Night Initiative.

This project describes a multifaceted noise reduction program on 2 hospital units designed to ensure a quiet hospital environment, with the goal of improving the patient experience. The noise committee in an urban city hospital developed a plan to control noise including scripted leadership rounding, staff education, a nighttime sleep promotion cart, and visual aids to remind staff to be quiet. Postintervention improvement in patient satisfaction scores was noted.

A review of barriers to effective asthma management in Puerto Ricans: cultural, healthcare system and pharmacogenomic issues.

Background: Among the Hispanic community, Puerto Ricans have the highest prevalence of asthma and manifest the worst outcomes. The expected growth of the Hispanic population in the USA in the next several decades make elimination of disparate care in Puerto Rican asthmatics a matter of national importance. The purpose of this review of the literature (ROL) is to examine a variety of health system, genetic and cultural barriers in the Puerto Rican community which have created disparities in asthma care and outcomes among adult and pediatric Hispanic populations.

Backyard mushroom ingestions: no gastrointestinal decontamination--no effect.

Treating the unintentional "backyard" mushroom ingestion continues to be controversial. A review of pediatric "backyard" mushroom ingestions was conducted. A Regional Poison Information Center (RPIC) conducted a retrospective review of all mushroom ingestions in children younger than 6 years of age.