Nursing surveillance and immediate jeopardy in Veteran Health Administration community living centers unannounced survey program 2018 to 2019.

BACKGROUND: The VA Community Living Center (CLC) Unannounced Survey Program aims to assess standards of care set by the government to protect residents. PURPOSE: To describe patterns of practice failures in nursing surveillance causing or having potential to cause immediate jeopardy, as defined by the Centers for Medicare and Medicaid Services. METHODS: Using CLC survey data consisting of 200 statements of deficiency (SODs) for 2018 to 2019, we collected a SOD sample (n = 20) of immediate jeopardy events. They were described using descriptive statistics and discourse content analysis. FINDINGS: We identified clinical events, their duration, work shift, and nursing skill mix for each SOD. Most to least common themes about failures in nursing surveillance were acquisition/transfer of information; decision-making; and early recognition of problems. DISCUSSION: Our analysis of nursing surveillance failures in CLC immediate jeopardy SODs provides insight into opportunities for registered nurses and the nursing skill mix to reduce avoidable harms.

Nursing journal clubs and the clinical nurse specialist.

PURPOSE/OBJECTIVES: The purpose of this article was to describe the clinical nurse specialist's role in developing and implementing a journal club. Tools for critiquing clinical and research articles with an application of each are provided. BACKGROUND: The journal club provides a forum through which nurses maintain their knowledge base about clinically relevant topics and developments in their specific clinical discipline, analyze and synthesize the relevant scientific literature as evidence, and engage in informal discussions about evidence-based and best practices. RATIONALE: The value of journal clubs includes nursing staff education, review of and support for evidence-based practice, promotion of nursing research, and fostering of organization-wide nursing practice changes. DESCRIPTION: The process for establishing a journal club and suggested appraisal tools are discussed. In addition, strategies for overcoming barriers to the implementation of a journal club are outlined. Suggested article review questions and a reporting format for clinical and research articles are provided with examples from 2 articles. Finally, a glossary of terms commonly used by research scientists and manuscript writers are listed and additional resources provided. OUTCOME/CONCLUSION: The clinical nurse specialist's role in developing and implementing a journal club will be facilitated through the use of this article. IMPLICATIONS: Enhanced nursing staff education, evidence-based practice, organization-wide nursing practice changes, and nursing research may be conducted following the implementation of a nursing journal club.

The NICHE geriatric resource nurse model: improving the care of older adults with Alzheimer's disease and other dementias.

There are an estimated 5.3 million Americans with Alzheimer's disease, and as the population ages, that number is expected to reach 7.7 million by the year 2030. Older adults with Alzheimer's and other dementias are 3.1 times more likely to have a hospital stay than those without the condition. The Nurses Improving Care to Healthsystem Elders (NICHE) geriatric resource nurse (GRN) model is a proven framework to prepare acute care hospital registered nurses to care for this special population of older adults. This article addresses the NICHE/GRN model and its implementation at Palomar Pomerado Health.