Developing, Implementing, Evaluating Electronic Apparent Cause Analysis Across a Health Care System.

An interdisciplinary team developed, implemented, and evaluated a standardized structure and process for an electronic apparent cause analysis (eACA) tool that includes principles of high reliability, human factors engineering, and Just Culture. Steps include assembling a team, describing what happened, determining why the event happened, determining how defects might be fixed, and deciding which defects will be fixed. The eACA is an intuitive tool for identifying defects, apparent causes of those defects, and the strongest corrective actions.

Using Evidence to Create a Toolkit to Enable Sleep Among Hospitalized Patients.

Studies show sleep deprivation impacts patients' ability to perform physical activities and can lead to delirium, depression, and other psychiatric impairments. One of the Choosing Wisely® recommendations is "Do not wake the patient for routine care unless the patient's condition requires it." The authors discuss the development of an evidence-based toolkit to facilitate opportunities for patients to sleep during hospitalization, exemplifying the translation of a Choosing Wisely recommendation into clinical practice.

Research Outcomes of Implementing CEASE: An Innovative, Nurse-Driven, Evidence-Based, Patient-Customized Monitoring Bundle to Decrease Alarm Fatigue in the Intensive Care Unit/Step-down Unit.

Introduction: The research literature is replete with evidence that alarm fatigue is a real phenomenon in the clinical practice environment and can lead to desensitization of the need to respond among nursing staff. A few studies attest to the effectiveness of incorporating parts of the American Association of Critical-Care Nurses recommended nursing practices for alarm management. No studies could be found measuring the effectiveness of the American Association of Critical-Care Nurses recommendations in their entirety or the effectiveness of a nursing-driven, evidence-based, patient-customized monitoring bundle.

Practical Application of High-Reliability Principles in Healthcare to Optimize Quality and Safety Outcomes.

Application of high-reliability (HR) principles into daily healthcare processes can drive culture change, safety, and quality outcomes. Understanding foundational practices to full HR principle integration in an organization's quality and safety programs strengthens evidence-based practices, reduces clinical variation, and improves nurse-sensitive patient outcomes. Quantifying the cost impact of reduction in preventable harm and improved nurse-sensitive patient outcomes is an initial attempt to formulate an empiric measure of nursing value.

Description of Nurse Scientists in a Large Health Care System.

Replicating a research study that described the work of nurse scientists in children's hospitals, the purpose of the study was to describe the role, activities, and outcomes of nurse scientists employed in a national health care organization. The characteristics of nurses filling the nurse scientist role in clinical settings and outcomes associated with the role have not been extensively described. The setting of this study is ideal since the organization includes facilities of various sizes located in rural, urban, and suburban areas in 18 states.

Striving for the impossible.

Mrs Kinnon has just had a knee replacement and is in a ward. She has specific ambulation and fall precautions, and needs a bed alarm at night. She has been prescribed a blood thinner and is especially vulnerable to injury.

Special needs population: Care of the geriatric patient population in the perioperative setting.

The geriatric population, defined as people 65 years of age and older, undergoing surgical procedures is a vulnerable population. Age, once considered a contraindication for a surgical procedure, is no longer a constraint for individuals requiring surgical intervention. However, older adult patients are at increased risk for developing a variety of complications.