Nurses' Perceptions of Barriers to Rapid Response System Activation: A Systematic Review.

Background: The rapid response system (RRS) was designed to identify and intervene on patients exhibiting clinical deterioration in the non-critical-care setting but is not always effectively activated by nurses, leading to adverse patient outcomes.

Objectives: The objective of this systematic review was to explore nurses' perceived barriers to RRS activation in the acute adult inpatient setting.

Method: A systematic review was completed utilizing the Preferred Reporting Items for Systematic Reviews and Meta-analysis checklist.

Challenges in Hospital-Associated Infection Management: A Unit Perspective.

Maintaining a successful unit-based continuous quality improvement program for managing hospital-associated infections is a huge challenge and an overwhelming task. It requires strong organizational support and unit leadership, human and fiscal resources, time, and a dedicated and motivated nursing staff. A great deal of effort goes into implementing, monitoring, reporting, and evaluating quality improvement initiatives and can lead to significant frustration on the part of the leadership team and nursing staff when quality improvement efforts fail to produce the desired results.

Withdrawal of life-sustaining treatment: a case study.

Withdrawal of life support is an option for patients with prolonged mechanical ventilation when all attempts at weaning have failed and it is deemed futile to continue the therapy, when quality of life is unacceptable, or when it is perceived that the patient is suffering. The purpose of this article is to present the nursing aspects of managing an adult patient undergoing the withdrawal of mechanical ventilation as an end-of-life procedure. Withdrawal of mechanical ventilation is a complex and difficult process that requires meticulous planning and management.

Progressive care units: different but the same.

Progressive care units are increasingly common in hospitals in the United States. These units are often used to bridge the gap between intensive care units and medical-surgical units, with the goal of providing cost-effective, high-quality, safe care. Although progressive care units today may seem to provide care for a wide variety of patients, these patients do share certain typical features: they require a high intensity of nursing care and/or a high level of surveillance.

Clinical nurse specialist orientation: ready, set, go!

Background: Both novice and experienced clinical nurse specialists (CNSs) need a consistent orientation to ensure that all in the role have the same knowledge base from an agreed upon set of role expectations.

Purpose: The purpose of this article was to describe an orientation process using the 3 spheres of CNS practice as the framework for a CNS competency validation tool that can be used in all practice specialties and settings. Additionally, the roles of CNS preceptor and CNS mentor are delineated.

Staff nurses' experiences of a change in the care delivery model: a qualitative analysis.

This qualitative study describes the staff nurses' perspective of change in the care delivery model and skill mix in an intermediate care unit. Data were collected in interviews in focus groups with the registered nurses affected by the change. Two major themes emerged: (1) autonomy and control and (2) interdependence.