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.

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.

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.

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.

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.

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.

Incidence, mortality, and cost trends in nonventilator hospital-acquired pneumonia in medicaid beneficiaries, 2015-2019.

Nonventilator hospital-acquired pneumonia is associated with substantial morbidity, mortality, and costs during an episode of acute care. We examined NVHAP incidence, mortality, and costs of Medicaid beneficiaries over a 5-year period (2015-2019). Overall NVHAP incidence was 2.

INNOVATE: Preparing Nurses to Be Health Care Innovation Leaders.

A new certificate program has been designed that augments the traditional undergraduate nursing education with a curriculum of innovation and entrepreneurship. The goal of the Integrated Innovation & Entrepreneurship Certificate in Nursing Program (INNOVATE) is to empower nurses to collaboratively solve health care challenges and become thought leaders in health care products, technologies, and processes, as well as service and delivery methods, with a particular focus on the needs of vulnerable populations. Toward this goal, INNOVATE is built on an integrative, immersive curriculum, experiential learning, intentional cohort building, peer and faculty support, real-world connections, and the prioritization of diversity, inclusivity, and equity to build of a cohort of nursing students ready for careers in clinical and health care innovation.

Gabapentinoids and Acetaminophen as Adjuvants for Managing Postoperative Pain.

With the current opiate epidemic in the United States, there is renewed interest in evaluating non-opiate adjuvant medications as effective alternatives for the prevention and treatment of postoperative pain. A systematic review of randomized, controlled trials on Pub Med, Medline, and Embase was conducted looking on postoperative pain management from 2008 to 2018. Studies were included if they used a gabapentenoid with or without acetaminophen and evaluated supplemental opiate use.

A qualitative analysis of intravenous smart pump usability.

Aim: To understand the experience of critical care nurses when performing common, yet error-prone, programming tasks on two unfamiliar intravenous smart pumps.

Design: A qualitative descriptive study using data collected during a previous quantitative pilot study.

Methods: Following completion of common intravenous programming tasks each participant was interviewed using a semi-structured interview guide.

Reprint from AJN: Secondary Medication Administration and IV Smart Pump Setup: What every nurse needs to know.

Secondary infusion by large-volume iv smart pump is used extensively in the acute care setting for one-time or intermittent administration of medications such as antibiotics, electrolyte replacements, and some oncology drugs. Consistent and accurate delivery of secondary medications requires a full understanding of the system and setup requirements. Unfortunately, it is not uncommon for nurses to find a secondary medication only partially administered when their programming should have resulted in a complete infusion.

Oral health status and the etiology and prevention of nonventilator hospital-associated pneumonia.

Nonventilator hospital-associated pneumonia has recently emerged as an important preventable hospital-associated infection, and is a leading cause of healthcare-associated infection. Substantial accumulated evidence links poor oral health with an increased risk of pneumonia, which can be caused by bacterial, viral, or fungal pathogens, each with their own distinct mechanisms of transmission and host susceptibility. These infections are frequently polymicrobial, and often include microbes from biofilms in the oral cavity.

Health Care Innovation: Embracing the Nurse-Engineer Partnership.

This article introduces a series on nurse innovators, focusing whenever possible on nurse-engineer partnerships and outlining working, replicable models of collaboration between the two disciplines. This first column highlights the similarities between nursing and engineering, provides a case example, and discusses barriers to nurse-engineer partnerships as well as recommendations for success. Listen to a podcast with the authors at www.

Secondary Medication Administration and IV Smart Pump Setup.

Secondary infusion by large-volume IV smart pump is used extensively in the acute care setting for one-time or intermittent administration of medications such as antibiotics, electrolyte replacements, and some oncology drugs. Consistent and accurate delivery of secondary medications requires a full understanding of the system and setup requirements. Unfortunately, it is not uncommon for nurses to find a secondary medication only partially administered when their programming should have resulted in a complete infusion.

Nonventilator hospital-acquired pneumonia: A call to action.

In 2020 a group of U.S. healthcare leaders formed the National Organization to Prevent Hospital-Acquired Pneumonia (NOHAP) to issue a call to action to address non-ventilator-associated hospital-acquired pneumonia (NVHAP).