Redesigning the Patient Observer Model to Achieve Increased Efficiency and Staff Engagement on a Surgical Trauma Inpatient Unit.

Background: Provision of safe and efficient observer care to inpatients whose behavior puts them at risk for injury is a clinically challenging and costly endeavor for hospitals. At Massachusetts General Hospital (MGH; Boston), process improvement strategies were deployed to provide staff with an improved clinical model for patient observation, unit-based responsibility for allocating resources, and strategies to maintain a safer environment.

Methods: In a surgical trauma unit at MGH, a team of nursing leaders and clinicians created an innovative process to identify, assess, and develop best practices for ensuring patient safety in the hospital environment.

Development and evaluation of targeted psychological skills training for oncology nurses in managing stressful patient and family encounters.

Purpose/objectives: To reduce workplace stress by developing a brief psychological skills training for nurses and to evaluate program feasibility, acceptability, and preliminary efficacy in decreasing burnout and stress.

Design: Intervention development and evaluation.

Setting: Outpatient chemotherapy unit at a comprehensive cancer center.

Falls in the general hospital: association with delirium, advanced age, and specific surgical procedures.

Background: Falls and delirium in general-hospital inpatients are related to increases in morbidity, mortality, and healthcare costs. Patients fall despite safeguards and programs to reduce falling.

Objective: The authors sought to determine the prevalence of diagnosed and undiagnosed delirium in patients who fell during their hospital stay.

Successful implementation of an alcohol-withdrawal pathway in a general hospital.

Background: Although alcohol use and abuse are common among general-hospital inpatients, many patients are inadequately assessed and treated for alcohol withdrawal.

Objective: The purpose of this study was to determine whether the implementation of a clinical pathway for the treatment of alcohol withdrawal in medical inpatients would result in improvements in clinical practice and patient outcomes.

Method: Authors retrospectively reviewed 80 patient records (including 40 of those treated before the implementation of a pathway and 40 of those treated after pathway implementation).

Is your medical/surgical patient withdrawing from alcohol?

Look beyond the stereotype. Any hospitalized patient could be dependent on alcohol-and at risk for alcohol withdrawal syndrome.