Higher Quality of Care and Patient Safety Associated With Better NICU Work Environments.

The objective of this study was to investigate the associations between the neonatal intensive care unit (NICU) work environment, quality of care, safety, and patient outcomes. A secondary analysis was conducted of responses of 1247 NICU staff nurses in 171 hospitals to a large nurse survey. Better work environments were associated with lower odds of nurses reporting poor quality, safety, and outcomes. Improving the work environment may be a promising strategy to achieve safer settings for at-risk newborns.

Impact of canine-assisted ambulation on hospitalized chronic heart failure patients' ambulation outcomes and satisfaction: a pilot study.

BACKGROUND AND RESEARCH OBJECTIVE: Chronic heart failure (HF) is a prevalent and costly disease process. Early ambulation has been shown to have a positive impact on patient outcomes and length of stay. Animal-assisted therapy is a novel modality that has shown to be a safe and effective adjunct to a number of traditional treatment plans. This study sought to synergistically combine ambulation and animal-assisted therapy by using canine-assisted ambulation (CAA) to improve the ambulation outcomes of HF patients. SUBJECTS AND METHODS: Sixty-nine hospitalized patients with a primary diagnosis of HF were approached to ambulate with a restorative aide. After recording their initial response, they were given the opportunity to participate in CAA (walking with a therapy dog). Initial ambulation refusal rate was compared with a historical population of 537 HF patients. Distance ambulated was recorded using a pedometer and compared with a randomly selected, 64-patient sample from the historical HF patient population, stratified by day of hospital stay. Patient satisfaction was assessed through a 5-item Likert scale survey. RESULTS AND CONCLUSION: The 537-patient historical HF population had an ambulation refusal rate of 28%. When offered the chance to participate in CAA, only 7.2% of the study population refused ambulation (P = .0002). Of the 69-patient study sample, 13 initially refused ambulation then agreed when offered CAA (P = .0009). Distance ambulated increased from 120.2 steps in a randomly selected, stratified historical sample to 235.07 in the CAA study sample (P < .0001). Patients unanimously agreed that they enjoyed CAA and would like to participate in CAA again. Canine-assisted ambulation is a safe and effective adjunct to an early ambulation program for HF patients. Canine-assisted ambulation may decrease hospital length of stay and thereby decrease the costs of HF care. Additional research involving CAA's application to other disease processes in various settings is warranted.

In-house consulting helps disseminate EBP.

Using a business model, administrators ata Pennsylvania hospital established a consulting service to incorporate evidence-based practice into projects and policies.

Can society take God's place--a reflection on Nursing's Social Policy.

TOPIC: This article is an opinion on the strength of and issues related to applying nursing's social contract. PURPOSE: The purpose of this article is to promote discussion on the implications, use, and knowledge of nursing's social contract in a volatile healthcare environment. SOURCE(S) OF INFORMATION: This article is based on the author's opinions and Nursing's Social Policy Statement (2nd ed.) (ANA, 2003). CONCLUSION: Nurses today need to understand the history and current implications of nursing's social contract to meet society's expectations of the nursing profession.