The Economic and Clinical Impact of Sustained Use of a Progressive Mobility Program in a Neuro-ICU.

Objective: To investigate a progressive mobility program in a neurocritical care population with the hypothesis that the benefits and outcomes of the program (e.g., decreased length of stay) would have a significant positive economic impact.

A prospective time-series quality improvement trial of a standardized analgesia protocol to reduce postoperative pain among neurosurgery patients.

OBJECTIVE The inclusion of the pain management domain in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey now ties patients' perceptions of pain and analgesia to financial reimbursement for inpatient stays. Therefore, the authors wanted to determine if a quality improvement initiative centered on a standardized analgesia protocol could significantly reduce postoperative pain among neurosurgery patients. METHODS The authors implemented a 10-month, prospective, interrupted time-series trial of a quality improvement initiative.

Prospective quality initiative to maximize dysphagia screening reduces hospital-acquired pneumonia prevalence in patients with stroke.

Background And Purpose: Dysphagia can lead to pneumonia and subsequent death after acute stroke. However, no prospective study has demonstrated reduced pneumonia prevalence after implementation of a dysphagia screen.

Methods: We performed a single-center prospective interrupted time series trial of a quality initiative to improve dysphagia screening.

The effect of increased mobility on morbidity in the neurointensive care unit.

Object: The detrimental effects of immobility on intensive care unit (ICU) patients are well established. Limited studies involving medical ICUs have demonstrated the safety and benefit of mobility protocols. Currently no study has investigated the role of increased mobility in the neurointensive care unit population.

Reduction of catheter-associated urinary tract infections among patients in a neurological intensive care unit: a single institution's success.

Object: To date, there has been a shortage of evidence-based quality improvement initiatives that have shown positive outcomes in the neurosurgical patient population. A single-institution prospective intervention trial with continuous feedback was conducted to investigate the implementation of a urinary tract infection (UTI) prevention bundle to decrease the catheter-associated UTI rate.

Methods: All patients admitted to the adult neurological intensive care unit (neuro ICU) during a 30-month period were included.

Improving patient care through patient-family education programs.

The author's purpose of this study was to investigate patients' beliefs about the effectiveness of a patient education program. The authors interviewed general medicine and cardiac patients and their families at a large teaching hospital. They asked participants to describe the kind of information the hospital provided about patients' illnesses, pain management, and self-care following discharge and asked participants if they were satisfied with the information provided.

Establishing an end-of-life program in an academic acute care hospital.

The primary goal of end-of-life (EOL) care is to relieve suffering through measures that improve comfort and address the psychological, social, and spiritual needs of the dying. This article discusses the components of a pilot project that focused on palliative EOL care at an academic acute care hospital. An interdisciplinary team of nurses, social workers, chaplains, patient care coordinators, and advanced practice nurses established a common vision for the care of patients who were "in the dying process," or were expected to die during their hospitalizations.

Assessing patient satisfaction and quality of care through observation and interview.

The purpose of this study was to investigate patient satisfaction using an in-depth approach rather than the more common patient survey method. The authors conducted patient interviews and participant-oriented observations between patients, family members, and medical staff in a large teaching hospital to assess patients' perceptions of the quality of care provided on a medical-surgical unit. The observations were classified according to the Donabedian model of quality of care: technical care, interpersonal care, and amenities of care.

Exploring family needs during withdrawal of life support in critically ill patients.

Withdrawal of life support is a process where medical interventions are taken away from the patient with the expectation that the patient will die. This deliberate decision occurs when it is determined that medical options are exhausted and the prognosis is terminal. With this study, the primary family member of twenty adult patients who had undergone withdrawal of life support was contacted and interviewed by the research team 3-5 weeks after the patients' death.

Round out your department.

Clinical teaching rounds extend the staff orientation process without extending the budget.