Work Systems Analysis of Emergency Nurse Patient Flow Management Using the Systems Engineering Initiative for Patient Safety Model: Applying Findings From a Grounded Theory Study.

Background: Emergency nurses actively manage the flow of patients through emergency departments. Patient flow management is complex, cognitively demanding work that shapes the timeliness, efficiency, and safety of patient care. Research exploring nursing patient flow management is limited.

Evaluation of a Novel Mechanical Compression Device.

Background: Venous thromboembolism (VTE) is a leading preventable cause of death in hospitalized patients. Current intermittent pneumatic compression (IPC) devices used to provide external mechanical compression for VTE prevention are associated with a multitude of clinical challenges that often result in subtherapeutic use. A comparative study was conducted of the real-world clinical use of a novel mechanical compression device (MCD) and a current IPC device.

Racial disparities among patients on venovenous extracorporeal membrane oxygenation in the pre-Coronavirus Disease 2019 and Coronavirus Disease 2019 eras: A retrospective registry review.

Objectives: Although many studies have addressed such disparities caused by COVID-19, to our knowledge, no study has focused on the association of race on outcomes for patients with COVID-19 requiring venovenous extracorporeal membrane oxygenation support. The goal of this study was to assess association of race on death and duration on venovenous extracorporeal membrane oxygenation in both the pre-COVID-19 and COVID-19 eras.

Methods: We retrospectively reviewed the Extracorporeal Life Support Organization registry and included adults (≥18 years) who required venovenous extracorporeal membrane oxygenation between January 2019 and April 2021.

Empowerment Through Academia.

This is the sixth article in a series on nurse innovators, which focuses on nurse-engineer partnerships and outlines working, replicable models of collaboration between the two disciplines. In this installment, we describe the role of academia in building the next generation of nurse-engineers, highlighting three novel academic programs that have reimagined nursing and engineering education to promote interdisciplinary partnership and innovation.

Impact of hospital-acquired pneumonia on the Medicare program.

Objective: Patient safety organizations and researchers describe hospital-acquired pneumonia (HAP) as a largely preventable hospital-acquired infection that affects patient safety and quality of care. We provide evidence regarding the consequences of HAP among 2019 Medicare beneficiaries.

Design: Retrospective case-control study.

Data-based program management of system-wide IV smart pump integration.

Purpose: Smart pump bidirectional interoperability offers automated infusion programming and documentation that can improve patient safety and workflow efficiency. This technology has been poorly implemented across US hospitals, and there is little guidance on the tracking or monitoring of interoperability systems. The purpose of this report is to describe the successful implementation of intravenous (IV) smart pump interoperability in a large health system.

Assessing the performance of the Cell Painting assay across different imaging systems.

Quantitative microscopy is a powerful method for performing phenotypic screens from which image-based profiling can extract a wealth of information, termed profiles. These profiles can be used to elucidate the changes in cellular phenotypes across cell populations from different patient samples or following genetic or chemical perturbations. One such image-based profiling method is the Cell Painting assay, which provides morphological insight through the imaging of eight cellular compartments.

Improving Bruise Detection in Patients with Dark Skin Tone.

This is the fifth article in a series on nurse innovators, which focuses whenever possible on nurse-engineer partnerships and outlines working, replicable models of collaboration between the two disciplines. In this installment, we profile Katherine N. Scafide, a forensic nurse and researcher, who has partnered with engineers over many years to improve bruise detection in patients with dark skin tone.

Comparative analysis of signal accuracy of three SpO monitors during motion and low perfusion conditions.

To compare pulse oximetry performance during simulated conditions of motion and low perfusion in three commercially available devices: GE HealthCare CARESCAPE ONE TruSignal SpO Parameter, Masimo RADICAL-7 and Medtronic Nellcor PM1000N. After IRB approval, 28 healthy adult volunteers were randomly assigned to the motion group (N = 14) or low perfusion (N = 14) group. Pulse oximeters were placed on the test and control hands using random assignment of digits 2-5.

Comparison of Three Reconstitution Devices: A Simulated Time and Use Study.

The objective of this study was to compare residual volume and time to prepare and reconstitute cefazolin using 3 different reconstitution devices while observing for use errors, participant feedback, and particulate after reconstitution. After demonstrations on the use of each device and practicing twice with each device, participants performed reconstitutions 3 times per device while being timed and observed on device preparation and assembly, mixing the drug with intravenous fluid into vials, and transfer of vial contents into the intravenous bags. Participants completed surveys to assess perceptions on use of each device.

Assessing the performance of the Cell Painting assay across different imaging systems.

Quantitative microscopy is a powerful method for performing phenotypic screens from which image-based profiling can extract a wealth of information, termed profiles. These profiles can be used to elucidate the changes in cellular phenotypes across cell populations from different patient samples or following genetic or chemical perturbations. One such image-based profiling method is the Cell Painting assay, which provides morphological insight through the imaging of eight cellular compartments.

Nurse-Engineer Partnerships in Academia.

This is the fourth article in a series on nurse innovators, which focuses whenever possible on nurse-engineer partnerships and outlines working, replicable models of collaboration between the two disciplines. In this installment, we explore the work of four engineers who are forging a path to strengthen nurse-engineer partnerships through their work in academia. Their experiences exemplify the work of nurse-engineer teams, inform ways to employ these teams, and reveal the insights that result when these disciplines collaborate in real time to solve health care problems.

Early and progressive mobility in a community hospital: A new interdisciplinary safe patient handling and mobility model.

An early mobility program in a small community hospital resulted in high levels of staff engagement and decreased rates for falls and heel and sacral pressure injuries.

Heart Allocation Change and Multiple Temporary Circulatory Support as Bridge-to-Bridge.

Introduction: We investigated how the 2018 Organ Procurement and Transplantation Network heart allocation policy change was associated with changes in characteristics and outcomes of candidates receiving multiple temporary mechanical circulatory support (mtMCS) devices.

Materials And Methods: We included adult heart transplant candidates listed October 2014-January 2018 and October 2018-January 2022 in the United Network of Organ Sharing dataset. Prepolicy and postpolicy mtMCS recipients were compared at listing, transplant, 90-days, and 1-year post-transplant.

Outcomes after heart transplantation in patients who have undergone a bridge-to-bridge strategy.

Objectives: We compared posttransplant outcomes between patients bridged from temporary mechanical circulatory support to durable left ventricular assist device before transplant (bridge-to-bridge [BTB] strategy) and patients bridged from temporary mechanical circulatory support directly to transplant (bridge-to-transplant [BTT] strategy).

Methods: We identified adult heart transplant recipients in the Organ Procurement and Transplantation Network database between 2005 and 2020 who were supported with extracorporeal membrane oxygenation, intra-aortic balloon pump, or temporary ventricular assist device as a BTB or BTT strategy. Kaplan-Meier survival analysis and Cox regressions were used to assess 1-year, 5-year, and 10-year survival.

ATP-Sensitive Potassium Channel Opener Diazoxide Reduces Myocardial Stunning in a Porcine Regional With Subsequent Global Ischemia Model.

Background ATP-sensitive potassium channels are inhibited by ATP and open during metabolic stress, providing endogenous myocardial protection. Pharmacologic opening of ATP potassium channels with diazoxide preserves myocardial function following prolonged global ischemia, making it an ideal candidate for use during cardiac surgery. We hypothesized that diazoxide would reduce myocardial stunning after regional ischemia with subsequent prolonged global ischemia, similar to the clinical situation of myocardial ischemia at the time of revascularization.

A Nurse Innovator Paves the Way for Other Nurses.

This is the third article in a series on nurse innovators, which focuses whenever possible on nurse-engineer partnerships and outlines working, replicable models of collaboration between the two disciplines. In this installment, we profile Brian Mohika, BSN, RN, creator of CathWear-a wearable medical device that supports patients with catheter drainage leg bags. His nine-year journey of successes and challenges highlights the value of early, real-time collaboration with an interdisciplinary team, and underscores the need for nurses to see themselves as innovators.

Patent anomalous circumflex coronary artery stent occlusion following aortic valve replacement with coronary artery bypass.

An anomalous left circumflex artery branching arising from the right coronary artery is one of the most common congenital coronary artery abnormalities. Despite this, the incidence is low and our clinical understanding of the nuances in patients with such abnormalities remains limited. We present a case of a 73-year-old male with coronary artery disease status-post stenting of an anomalous circumflex artery who subsequently underwent coronary artery bypass grafting and surgical aortic valve replacement with EKG changes post-operatively.

Intravenous Smart Pumps at the Point of Care: A Descriptive, Observational Study.

Objective: This study was conducted to advance understanding of intravenous (IV) smart pump medication administration practices using the Baxter Spectrum IQ. The primary objective was to observe adherence with manufacturer required IV smart pump system setup at the point of care during actual clinical use.

Methods: The study was conducted in a 285-bed acute care community hospital near Boston, Massachusetts.

The association between accessing dental services and nonventilator hospital-acquired pneumonia among 2019 Medicaid beneficiaries.

In this 2019 cross-sectional study, we analyzed hospital records for Medicaid beneficiaries who acquired nonventilator hospital-acquired pneumonia. The results suggest that preventive dental treatment in the 12 months prior or periodontal therapy in the 6 months prior to a hospitalization is associated with a reduced risk of NVHAP.

Collaborative Nurse-Engineer Product Innovation.

This is the second article in a series on nurse innovators, which focuses whenever possible on nurse-engineer partnerships and outlines working, replicable models of collaboration between the two disciplines. In this installment, we profile Lindsey Roddy, a nurse, and Kyle Jansson, an engineer-partners who collaborated on an innovative medical device called SecureMove-TLC, designed to improve caregiver workflow, reduce health care costs associated with line dislodgment, and promote safety for both patients and caregivers.