ABSTRACT
BACKGROUND: Implementation of the professional nurse advocate (PNA) role and the Advocating and Educating for QUality ImProvement model (A-EQUIP) in nursing is relatively new. The model aims to build personal and professional resilience, enhance the quality of care and support preparedness for appraisal and professional revalidation. AIM: To describe the implementation of the PNA role in a combined acute and community trust in England. METHODS: A quality implementation framework was used to appraise and represent locally derived strategic activities for successful implementation of the role in an acute and community hospital in England. The content of this framework was derived from a synthesis of 25 implementation frameworks focusing on important elements understood to represent quality implementation. FINDINGS: The article identifies strengths and weaknesses to implementation and ways to sustain early implementation success. CONCLUSION: Using a quality implementation framework can provide a clear path for the successful implementation of the professional nurse advocate role. Professional nurse advocates should be supported to develop a culture of effective supervision within their organisation.
Subject(s)
Quality Improvement , Humans , EnglandABSTRACT
Background: The association between the nurse-to-patient ratio and patient outcomes has been extensively investigated. Real time location systems have the potential capability of measuring the actual amount of bedside contact patients receive. Aims: This study aimed to determine the feasibility and accuracy of real time location systems as a measure of the amount of contact time that nurses spent in the patients' bed space. Methods: An exploratory, observational, feasibility study was designed to compare the accuracy of data collection between manual observation performed by a researcher and real time location systems data capture capability. Four nurses participated in the study, which took place in 2019 on two hospital wards. They were observed by a researcher while carrying out their work activities for a total of 230 minutes. The amount of time the nurses spent in the patients' bed space was recorded in 10-minute blocks of time and the real time location systems data were extracted for the same nurse at the time of observation. Data were then analysed for the level of agreement between the observed and the real time location systems measured data, descriptively and graphically using a kernel density and a scatter plot. Results: The difference (in minutes) between researcher observed and real time location systems measured data for the 23, 10-minute observation blocks ranged from zero (complete agreement) to 5 minutes. The mean difference between the researcher observed and real time location systems time in the patients' bed space was one minute (10% of the time). On average, real time location systems measured time in the bed space was longer than the researcher observed time. Conclusions: There were good levels of agreement between researcher observation and real time location systems data of the time nurses spend at the bedside. This study confirms that it is feasible to use real time location systems as an accurate measure of the amount of time nurses spend at the patients' bedside.
ABSTRACT
BACKGROUND The healthcare environment is recognized as a source for healthcare-acquired infection. Because cleaning practices are often erratic and always intermittent, we hypothesize that continuously antimicrobial surfaces offer superior control of surface bioburden. OBJECTIVE To evaluate the impact of a photocatalytic antimicrobial coating at near-patient, high-touch sites in a hospital ward. SETTING The study took place in 2 acute-care wards in a large acute-care hospital. METHODS A titanium dioxide-based photocatalytic coating was sprayed onto 6 surfaces in a 4-bed bay in a ward and compared under normal illumination against the same surfaces in an untreated ward: right and left bed rails, bed control, bedside locker, overbed table, and bed footboard. Using standardized methods, the overall microbial burden and presence of an indicator pathogen (Staphylococcus aureus) were assessed biweekly for 12 weeks. RESULTS Treated surfaces demonstrated significantly lower microbial burden than control sites, and the difference increased between treated and untreated surfaces during the study. Hygiene failures (>2.5 colony-forming units [CFU]/cm2) increased 2.6% per day for control surfaces (odds ratio [OR], 1.026; 95% confidence interval [CI], 1.009-1.043; P=.003) but declined 2.5% per day for treated surfaces (OR, 0.95; 95% CI, 0.925-0.977; P<.001). We detected no significant difference between coated and control surfaces regarding S. aureus contamination. CONCLUSION Photocatalytic coatings reduced the bioburden of high-risk surfaces in the healthcare environment. Treated surfaces became steadily cleaner, while untreated surfaces accumulated bioburden. This evaluation encourages a larger-scale investigation to ascertain whether the observed environmental amelioration has an effect on healthcare-acquired infection. Infect Control Hosp Epidemiol 2018;39:398-404.
