Educational Program for Physiologic Monitor Use and Alarm Systems Safety: A Toolkit.

Clinical alarm systems safety is a national healthcare concern in the United States. Physiologic monitors are the medical devices associated with the highest number of false and clinically insignificant alarms, producing alarm fatigue and a challenge to meet the national clinical alarm systems safety goal. Modern physiologic monitors are high-tech complex devices with multimeasurement modalities and high sensitivity for alarms.

Complex Medical Technology: Strategies for Selection, Education and Competency Assessment, and Adoption.

The prevalence of complex technology in the health care arena has increased dramatically in the 21st century. Nurses working in acute and critical care have the greatest interaction with technology, using it to manage patients and optimize clinical outcomes as well as to prevent errors and adverse events. The successful implementation of complex medical technology is, in itself, a complex process.

Evaluation of Telemetry Utilization on Medical-Surgical Units.

Alarm fatigue is the most common contributing factor in alarm-related sentinel events. Researchers have demonstrated a 35% overuse of telemetry, a key factor in alarm fatigue. This project evaluates practice patterns for the ordering and discontinuation of telemetry on medical-surgical units.

Research: Use of Monitor Watchers in Hospitals: Characteristics, Training, and Practices.

Monitor watchers, or personnel whose job it is to watch the central cardiac monitor and alert clinicians of patient events, are used in many hospitals. Monitor watchers may be used to improve timely response to alarms and combat the effects of alarm fatigue. However, little research has been done on the use of monitor watchers, and their practices have not been well described.

Pre-Exposure Prophylaxis (PrEP) for Safer Conception Among Serodifferent Couples: Findings from Healthcare Providers Serving Patients with HIV in Seven US Cities.

Pre-exposure prophylaxis (PrEP) can reduce the risk of HIV transmission among serodifferent couples trying to conceive, yet provider knowledge, attitudes, and experience utilizing PrEP for this purpose are largely unexamined. Trained interviewers conducted phone interviews with healthcare providers treating patients with HIV in seven cities (Atlanta, Baltimore, Houston, Kansas City, Newark, Philadelphia, and San Francisco, N = 85 total). Quantitative and qualitative data were analyzed to describe experience, concerns, and perceived barriers to prescribing PrEP for safer conception.

The influence of psychological factors on post-partum weight retention at 9 months.

Objectives: Post-partum weight retention (PWR) has been identified as a critical pathway for long-term overweight and obesity. In recent years, psychological factors have been demonstrated to play a key role in contributing to and maintaining PWR.

Design: Therefore, the aim of this study was to explore the relationship between post-partum psychological distress and PWR at 9 months, after controlling for maternal weight factors, sleep quality, sociocontextual influences, and maternal behaviours.

Resident and RN perceptions of the impact of a medical emergency team on education and patient safety in an academic medical center.

Objective: To assess the perceptions of residents and RNs about the effects of a medical emergency team on patient safety and their own educational experiences.

Design: Survey-based study.

Setting: A single academic medical center.

Improving sepsis care through systems change: the impact of a medical emergency team.

The Hospital of the University of Pennsylvania achieved a significant reduction in the time between prescription and administration of antibiotics by embedding a pharmacist in an MET to facilitate antibiotic delivery.

Clinical alarms: complexity and common sense.

In 2002, the Joint Commission on Accreditation of Health Care Organizations (JCAHO) reviewed 23 reports of death or injury that were related to mechanical ventilation. Nineteen of those events resulted in death, and 4 resulted in coma; 65% were related to alarms. The issues included delayed or no response to the alarm; the alarm was off or set incorrectly; no alarms for certain types of ventilator disconnections; or the alarm was not audible in all areas of patient care.

Neuroscience critical care: the role of the advanced practice nurse in patient safety.

The Institute of Medicine report published in 1999 described a healthcare system in which 44,000 to 98,000 patients die each year from preventable medical errors. The healthcare industry has been charged with identifying and ameliorating risks to patients. The advanced practice nurse is in the optimal position to influence the patient care environment and contribute to a culture of patient safety.

Clinical alarms: improving efficiency and effectiveness.

The clinical environment contains a plethora of bells, beeps, and buzzers. As clinicians, each audible disruption in the care environment must be analyzed to decide if the sound or visual is clinically significant. Alarms may signal a clinically significant change in a patient's condition (true positive), an alarm violation that is clinically insignificant (false positive), or a reflection of poorly set monitoring parameters.

Prone positioning does not affect cannula function during extracorporeal membrane oxygenation or continuous renal replacement therapy.

Introduction: Prone positioning in respiratory failure has been shown to be a useful adjunct in the treatment of severe hypoxia. However, the prone position can result in dislodgment or malfunction of tubes and cannulae. Certain patients receiving extracorporeal membrane oxygenation (ECMO) or continuous renal replacement therapy (CRRT) may also benefit from positional therapy.