Developing a Unit Profile Dashboard to Inform Nursing Care Delivery Based on Unique Needs of Patients.

Nurse leaders need real-time, accurate data to design care delivery models and make decisions that reflect the patient populations they serve. To support nurse leader practice and optimize patient care, we developed a unit profile dashboard to describe the unique characteristics of patient populations cared for on each clinical unit at our hospital. In this article, we describe dashboard development, challenges, use cases, and plans for data analytics to further advance nursing practice.

Strategies for Success in Regulatory Readiness.

This article describes the formation of a Regulatory Advisory Council to address regulatory preparedness. The council used quality improvement methods to address data and findings from previous mock surveys and created 2 categories of work, an environment of care and clinical standards group, with checklists and work streams to improve organizational success with regulatory readiness.

Hypocalcemia and Massive Blood Transfusions: A Pilot Study in a Level I Trauma Center.

Trauma is a leading cause of death in the United States, and uncontrolled hemorrhage is often the primary cause of mortality. Massive transfusions provide lifesaving treatment for the bleeding trauma patient; yet, this is not a benign intervention. Calcium levels can be significantly decreased with rapidly transfused blood products due to the citrate preservative that is added. Citrate binds to the patient's endogenous calcium when blood products are administered, rendering calcium inactive. As a result, undesirable physiological effects can occur. Although there is a plethora of evidence reporting the negative effects of hypocalcemia during resuscitation, the research for standardization of calcium monitoring and replacement during a massive transfusion event is less robust. Consequently, monitoring and replacement of this vital electrolyte are often overlooked. Trauma department employees at an urban academic hospital were given a pretest to assess their knowledge of calcium monitoring and replacement during a massive transfusion. On the basis of test results and a need for staff education, a short, animated video was designed and distributed for viewing. Following the educational video, a posttest was administered and yielded higher scores when compared with the pretest (p = .001). Lack of knowledge and national standards may be root causes for hypocalcemia. Educational interventions such as innovative, brief videos can be effective for enhancing staff members' knowledge and improving patient care.

A Transparent Tracking System for Competency-Based Orientation: One Children's Hospital Transport Unit Experience.

When nurses are hired for positions that require lengthy, highly specialized in-house orientation, their failure to complete orientation on time can lead to staffing shortages. In this article, we report the use of a transparent tracking system to monitor nurses' progress through a competency-based orientation program. By monitoring progress and detecting lapses, immediate remediation can be offered to those who need it, and staffing shortages thereby are avoided.

Checklists for New Graduates.

Even highly trained new nurses can feel overwhelmed when starting a new job. A professional development tool, the First Things First Checklist, described in this article, can help new nurses structure their day and prioritize their tasks. This checklist approach can help mitigate stress, structure the day, and promote optimal patient care. J Contin Educ Nurs. 2017;48(11):494-495.

The Preparation-Practice Gap: An Integrative Literature Review.

BACKGROUND: The purpose of this integrative literature review was to evaluate and synthesize the evidence regarding the existence, extent, and significance of a preparation-practice gap-namely, the deficits in knowledge and skills that novice nurses may demonstrate on entry into the clinical setting and the identified best practices to narrow this gap. METHOD: An integrative literature review was performed. RESULTS: A final set of 50 articles were included in the review. Three main themes permeate the evidence: a preparation-practice gap exists; this gap is costly; and closing the preparation-practice gap will likely rely on changes in undergraduate education and on-the-job remediation (i.e., nurse residency or preceptor programs). CONCLUSIONS: The preparation-practice gap is a challenge that has faced the nursing profession for years. Efforts to close this gap can be justified on the hopes of decreasing turnover (and its attendant costs), boosting morale of novice nurses and their preceptors, decreasing stress among the novice nurses, and improving patient safety.