Regional Spread of an Outbreak of Carbapenem-Resistant Enterobacteriaceae Through an Ego Network of Healthcare Facilities.

Background: In 2013, New Delhi metallo-β-lactamase (NDM)-producing Escherichia coli, a type of carbapenem-resistant Enterobacteriaceae uncommon in the United States, was identified in a tertiary care hospital (hospital A) in northeastern Illinois. The outbreak was traced to a contaminated duodenoscope. Patient-sharing patterns can be described through social network analysis and ego networks, which could be used to identify hospitals most likely to accept patients from a hospital with an outbreak.

An Interprofessional Approach to Amyotrophic Lateral Sclerosis Care.

Amyotrophic lateral sclerosis (ALS) is a progressive fatal neurodegenerative disease that is characterized by the death of motor neurons in the spinal cord, brain stem, and motor cortex that are responsible for voluntary movement. For unknown reasons, military veterans are approximately twice as likely as the public to be given a diagnosis of ALS. Currently, there is no cure for ALS.

Implementing the New ANA Standard 8: Culturally Congruent Practice.

The American Nurses Association (ANA) is responsible for the contract between society and the nursing profession, including the nursing scope and standards of practice. In 2015, an ANA workgroup produced Nursing: Scope and Standards of Practice, 3rd Ed during a time of social change and an increase of culturally and ethnically diverse consumers. Subsequently, a subset of workgroup members and an invited transcultural nursing expert led to the creation of the new Standard 8: Culturally Congruent Practice, describing nursing care that is in agreement with the preferred values, beliefs, worldview, and practices of the healthcare consumer.

Health Information Technology, Patient Safety, and Professional Nursing Care Documentation in Acute Care Settings.

The electronic health record (EHR) is a documentation tool that yields data useful in enhancing patient safety, evaluating care quality, maximizing efficiency, and measuring staffing needs. Although nurses applaud the EHR, they also indicate dissatisfaction with its design and cumbersome electronic processes. This article describes the views of nurses shared by members of the Nursing Practice Committee of the Missouri Nurses Association; it encourages nurses to share their EHR concerns with Information Technology (IT) staff and vendors and to take their place at the table when nursing-related IT decisions are made.

Improving Prediabetes Screenings at Rural Missouri County Health Departments.

With prediabetes criteria expanding in recent years, nurses offering prediabetes screenings require updates to stay abreast of current clinical guidelines. This study looked to improve rural Missouri health department nurses' understanding of prediabetes, improve the identification of prediabetes at participating health departments, and educate the nurses on existing prediabetes guidelines. A convenience sample of twenty-two nurses from seven rural Missouri health departments participated.

Regional infection control assessment of antibiotic resistance knowledge and practice.

Objective: Multidrug-resistant organisms (MDROs) are an increasing burden among healthcare facilities. We assessed facility-level perceived importance of and responses to various MDROs.

Design: A pilot survey to assess staffing, knowledge, and the perceived importance of and response to various multidrug resistant organisms (MDROs)

Setting: Acute care and long-term healthcare facilities

Methods: In 2012, a survey was distributed to infection preventionists at ~300 healthcare facilities.

Pseudo-outbreak of Mycobacterium gordonae Following the Opening of a newly constructed hospital at a Chicago Medical Center.

OBJECTIVE To identify the source of a pseudo-outbreak of Mycobacterium gordonae DESIGN Outbreak investigation. SETTING University Hospital in Chicago, Ilinois. PATIENTS Hospital patients with M.

Use of acid-fast bacilli staining to determine the need for airborne infection isolation precautions: a comparison of respiratory specimens.

Institution of appropriate airborne infection isolation (AII) precautions for patients with suspected Mycobacterium tuberculosis is critical to prevent disease transmission. We compared the yield of acid-fast bacilli smears from different types of respiratory specimens and found that smear sensitivity was highest for specimens obtained by endotracheal aspirates (92%), followed by sputum (79%), and then by bronchoalveolar lavage (37%). As a result of this study, our institutional policy regarding discontinuation of AII precautions was amended.

Identification, management, and clinical characteristics of hospitalized patients with influenza-like illness during the 2009 H1N1 influenza pandemic, Cook County, Illinois.

Objective: To describe the identification, management, and clinical characteristics of hospitalized patients with influenza-like illness (ILI) during the peak period of activity of the 2009 pandemic strain of influenza A virus subtype H1N1 (2009 H1N1).

Design: Retrospective review of electronic medical records.

Patients And Setting: Hospitalized patients who presented to the emergency department during the period October 18 through November 14, 2009, at 4 hospitals in Cook County, Illinois, with the capacity to perform real-time reverse-transcriptase polymerase chain reaction testing for influenza.

Clostridium difficile outbreak strain BI is highly endemic in Chicago area hospitals.

Objective: Describe the clinical and molecular epidemiology of incident Clostridium difficile infection (CDI) cases in Chicago area acute healthcare facilities (HCFs).

Design And Setting: Laboratory, clinical, and epidemiologic information was collected for patients with incident CDI who were admitted to acute HCFs in February 2009. Stool cultures and restriction endonuclease analysis typing of the recovered C.

Clinical outcomes of carbapenem-resistant Acinetobacter baumannii bloodstream infections: study of a 2-state monoclonal outbreak.

Objective: To characterize the clinical outcomes of patients with bloodstream infection caused by carbapenem-resistant Acinetobacter baumannii during a 2-state monoclonal outbreak.

Design: Multicenter observational study. Setting.

[Psychometric properties of Q-DIO, an instrument to measure the quality of documented nursing diagnoses, interventions and outcomes].

The instrument Q-DIO was developed in the years 2005 till 2006 to measure the quality of documented nursing diagnoses, interventions, and nursing sensitive patient outcomes. Testing psychometric properties of the Q-DIO (Quality of nursing Diagnoses, Interventions and Outcomes.) was the study aim.

Translating an evidence-based protocol for nurse-to-nurse shift handoffs.

Purpose: Ineffective communication is the most frequently reported cause of sentinel events in U.S. hospitals.

Development of an instrument to measure the quality of documented nursing diagnoses, interventions and outcomes: the Q-DIO.

Aims And Objectives: This paper aims to report the development stages of an audit instrument to assess standardised nursing language. Because research-based instruments were not available, the instrument Quality of documentation of nursing Diagnoses, Interventions and Outcomes (Q-DIO) was developed.

Background: Standardised nursing language such as nursing diagnoses, interventions and outcomes are being implemented worldwide and will be crucial for the electronic health record.

Implementing nursing diagnostics effectively: cluster randomized trial.

Aim: This paper is a report of a study to investigate the effect of guided clinical reasoning. This method was chosen as a follow-up educational measure (refresher) after initial implementation of standardized language.

Background: Research has demonstrated nurses' need for education in diagnostic reasoning to state and document accurate nursing diagnoses, and to choose effective nursing interventions to attain favourable patient outcomes.

Brief: nursing diagnostic applications derived from National Academy of Clinical Biochemistry (NACB) draft guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus.

This brief indicates how methods used by the National Academy of Clinical Biochemistry (NACB) in the development of its guidelines and recommendation for the laboratory analysis in the diagnosis and management of diabetes mellitus may be applied to advance nomenclature, clinical practice, and research development within nursing. Specifically, human response diagnoses require the identification of accurate tests to confirm or reject the diagnoses. Each test needs to be described in terms of its use, rationale, analytical, and emerging considerations.

[Nursing diagnoses, interventions and outcomes--application and impact on nursing practice: a systematic literature review].

The aim of this paper is to report a systematic literature review on the outcomes of nursing diagnostics. Specifically, it examines effects on documentation of assessment quality; frequency, accuracy and completeness of nursing diagnoses; and on coherence between nursing diagnoses, interventions and outcomes. Escalating health care costs demand the measurement of nursing's contribution to care.

Translating best practices in assessing capillary refill.

Purpose: A research roundtable was held in an urban community hospital in the United States to determine the strength, usefulness, and feasibility of empirical and clinical evidence evaluated in a systematic review assessing capillary refill.

Approach: The roundtable was undertaken to provide an additional dimension for the development of a best-practice guideline. Current practices and policies in this acute care hospital were examined concerning the strength of the evidence.

Testing the Q-DIO as an instrument to measure the documented quality of nursing diagnoses, interventions, and outcomes.

Purpose: To describe pilot testing of Quality of Diagnoses, Interventions and Outcomes (Q-DIO), an instrument to measure quality of nursing documentation.

Design: Instrument testing was performed using a random, stratified sample of 60 nursing documentations representing hospital nursing with and without implementation of standardized nursing language (30 for both strata) in a Swiss General Acute Hospital.

Methods: Internal consistency and intrarater and interrater reliabilities were tested.

A dialogue on the future of nursing practice.

Purpose: The challenges of health care; its safety, effectiveness, and efficiency; the quality of care; and the outcomes patients experience are issues central to nursing practice. This centrality needs to be affirmed as the profession shapes its practice over the next 50 years. The purpose of this article is to initiate a dialogue on the future of nursing practice.

A contextual and logical analysis of the clinical doctorate for health practitioners: dilemma, delusion, or de facto?

Growth of the number of practice or clinical doctorates in allied health and nursing is examined from several different points of view. These perspectives are first discussed contextually and then organized according to the dilemmas we face, the delusions we need to address, and the de facto reality we need to acknowledge. The article concludes with an overview of internal and external review practices and interprofessional considerations.

Is it time for a new category of nursing diagnosis?

Professional vigilance, the art of "watching out," is the essence of nursing. Vigilance is the mental process that makes the informed nursing actions of assessment, diagnosis, intervention, and evaluation possible and meaningful. Nursing vigilance must be described in our nursing terminology or it risks remaining invisible to others.

Improved quality of nursing documentation: results of a nursing diagnoses, interventions, and outcomes implementation study.

Purpose: To evaluate the impact of the quality of nursing diagnoses, interventions, and outcomes in an acute care hospital following the implementation of an educational program.

Method: In a pretest-posttest experimental design study, nurses from 12 wards of a Swiss hospital received an educational intervention--an introductory class and consecutive classes, using a case discussion method--to implement nursing diagnoses, interventions, and outcomes. Two sets of 36 randomly selected nursing records were evaluated before and after implementation.