Increasing Nurse Confidence in Patient Teaching Using Motivational Interviewing.

This article describes a pilot study that involves nurses learning motivational interviewing techniques as a way to enhance confidence in educating patients about diabetes. The pilot study took place in the medical telemetry unit of a large teaching hospital in southwest United States. The intervention included a 2-hour session that involved didactic and role-playing components.

Evaluating venous pool technique for blood sampling in neonatal ICU.

Purpose: To evaluate venous pool technique (VPT) for obtaining neonatal blood samples as compared with the needlestick technique.

Method And Sample: An experimental design was used with subjects enrolled in two phases: an equivalence phase (N = 10) and a comparison phase (N = 64). In the equivalence phase, subjects weighing 1,500 g or more had two needlesticks.

The effect of completing a surrogacy information and decision-making tool upon admission to an intensive care unit on length of stay and charges.

Background And Purpose: Many critically ill patients in intensive care units (ICUs) are unable to communicate their wishes about goals of care, particularly about the use of life-sustaining treatments. Surrogates and clinicians struggle with medical decisions because of a lack of clarity regarding patients' preferences, leading to prolonged hospitalizations and increased costs. This project focused on the development and implementation of a tool to facilitate a better communication process by (1) assuring the early identification of a surrogate if indicated on admission and (2) clarifying the decision-making standards that the surrogate was to use when participating in decision making.

Work unit transformation to welcome new graduate nurses: using nurses' wisdom.

While providers, consumers, and administrators recognize the need to attract and retain nurses, recruiting, transitioning, and retaining new graduate nurses (NGRNs) remains problematic. The first 3-12 months of NGRN employment is a perilous and stressful time, with experiences during the transition period profoundly influencing their careers. The purpose of this project was to develop a dedicated transition unit using a theory-driven approach.

Polytetrafluoroethylene-covered stents: 15 years of hope, success and failure.

Even after almost 15 years, polytetrafluoroethylene-covered stents are an important part of the armory of cardiac catheterization laboratory. They are invaluable in the emergent management of coronary perforations and are also used in the treatment of coronary aneurysms and fistulae. However, they are no longer routinely used in the treatment of saphenous venous graft disease.

Evaluating central venous catheter care in a pediatric intensive care unit.

Background: Catheter-related bloodstream infection remains an important health problem for hospitalized children. Although placement of a central venous catheter is a life-saving intervention for critically ill children, these same central catheters are a potential source of infection.

Objectives: Few studies that directly address care of central venous catheters for children in intensive care units have been reported.

Implementing a rapid response team to decrease emergencies outside the ICU: one hospital's experience.

The literature describes use of a rapid response team (RRT) of critical care nurses and respiratory therapists who arrive at medical-surgical patients' bedsides within minutes of a crisis situation, yet, few articles detail the processes necessary for implementation. The rationale, planning, and evaluation of such an effort at a large, tertiary care hospital in the urban Southwest is described. By describing the development and phased deployment of the RRT, the authors provide key insights into the processes used as well as structures needed and lessons learned.

Cost effectiveness of a medical vigilance system to reduce patient falls.

Patient falls are a serious problem in hospitals, resulting in substantial morbidity, mortality, length of stay, and costs. The results of a small trial of a patient vigilance system in a post-neurosurgery unit of a large acute care hospital are reported. The system includes two components: (a) passive sensor array placed under the patient in a hospital bed, and (b) a bedside unit that connects to the nurse call system already in place at the hospital.

Influence of hospital context on cost and length of stay following cardiac catheterization.

This study attempted to link health care activities and outcomes, taking into account characteristics of the health care system, the work group, and the individual. Results indicated that organizational structure and work group process had a greater influence on cost and derived length of stay (a measure of efficiency) than did the individual-level variables. The findings of this study add to the body of knowledge that explains how the processes of nurses' work influence the outcomes of that work.

Using evidence and process improvement strategies to enhance healthcare outcomes for the critically ill: a pilot project.

Background: Although the value of evidence-based practice may seem obvious, the process needed to produce more effective delivery of evidence-based healthcare is not obvious. Furthermore, the continuing escalation of healthcare costs fuels the desire of providers and consumers to undertake only those treatments that have benefit. One way to effect necessary changes in healthcare organizations is through focused, interdisciplinary, collaborative projects related to evidence-based practice.

Nursing workforce management: using benchmarking for planning and outcomes monitoring.

The goal of maintaining the balance between demand for nursing care and the supply of nurses is the basis for state and regional planning to meet future nursing workforce needs. Projecting nursing supply needs solely on the basis of historical registered nurse to population ratios does not specifically consider the healthcare needs of the population. The authors present a model in which state population data and nursing resource data are compared with national data to assist state planning groups in developing an effective workforce management plan.