Comparative intervention assessing a catheter stabilization device on peripheral intravenous line loss.

BACKGROUND: Short peripheral intravenous catheters are the most common invasive procedure used to deliver medications, blood products, and fluids to patients, and failure has the potential to impact the quality of care. METHODS: This study compared IVs stabilized with current transparent film dressing to those using an engineered stabilization device. The first phase of the study evaluated documentation; data from patient records were found less than optimal but most complete for securement and removal, the two fields most critical to the study. The second phase measured IV dwell time, restart rates, and time between IV loss and restarts. RESULTS: Although there were no statistically significant differences in restarts, the IV dwell time was longer when the engineered device was in place, helping to extend the life of the IV and prevent interruption of care. In the absence of data on the cost of infections and other complications, the use of an engineered device increased the cost of IV starts. CONCLUSIONS: Adding an engineered stabilization device increases the cost of peripheral IV starts, but contributes to reducing IV restarts and preventing IV complications due to destabilized IVs. Although there were no statistically significant differences in restarts, the IV dwell time was longer when the device was in place, helping to extend the life of the IV and prevent interruption of care. Complete and accurate documentation and improved quality depended upon the ability to abstract unit-level data, which is vital for capturing the appropriate healthcare indicators. Clinical nurses must be involved in the decision-making regarding health records and operability at the unit level.

Medical surgical nurses describe missed nursing care tasks-Evaluating our work environment.

PURPOSE: The purpose of the study was to explore the nurse work environment by evaluating the self-report of missed nursing care and the reasons for the missed care. METHODS: A convenience sample of medical surgical nurses from four hospitals was invited to complete the survey for this descriptive study. The sample included 168 nurses. The MISSCARE survey assessed the frequency and reason of 24 routine nursing care elements. RESULTS: The most frequently reported missed care was ambulation as ordered, medications given within a 30 minute window, and mouth care. Moderate or significant reasons reported for the missed care were: unexpected rise in volume/acuity, heavy admissions/discharges, inadequate assistants, inadequate staff, meds not available when needed, and urgent situations. CONCLUSION: Identifying missed nursing care and reasons for missed care provides an opportunity for exploring strategies to reduce interruptions, develop unit cohesiveness, improve the nurse work environment, and ultimately leading to improved patient outcomes.

Comparison of a Padded Patient Litter and Long Spine Board for Spinal Immobilization in Air Medical Transport.

OBJECTIVE: The long spinal board is the immobilization standard during prehospital transport. The flat surface of the board increases the pressure placed on both the thoracic kyphosis and the sacrum and increases the risk for pressure ulcers. This study compared patient stability and comfort between a padded litter system used in air medical transport and the long spine board. METHODS: The study was completed at a large 350-bed Magnet Recognized nonteaching hospital. The hospital owns and operates an air medical transport service. Subjects were secured to a padded litter and a long spinal board with a cervical collar and head blocks and 3 straps. Laser pointers were used to mark neutral at points on the subject's head, sternum, and pelvis. The subject was tilted 45 degrees left and right with movement measured in inches. Comfort level was measured before and after. Paired t-tests were used to detect differences in movement. RESULTS: No statistical difference in movement was found between devices for the head; however, there was statistically significant greater movement on the padded litter for the sternum and pelvis. CONCLUSION: The padded litter did not immobilize as tightly as the long board although the effect of the differences was small.

A comparative study of a happiness intervention in medical-surgical nurses.

An intervention study evaluating the impact of journaling on nurse happiness was conducted with 91 medical-surgical nurses. No differences in general happiness, percentage of time happy, and gratitude were detected among groups although journaling was qualitatively described as meaningful.