Nurses' Knowledge of and Confidence in Perioperative Skills for Emergency Cesarean Birth.

OBJECTIVE: To assess if nurses' perioperative knowledge of and confidence in perioperative skills for emergency cesarean birth improved after didactic learning and high-fidelity simulation. DESIGN: Descriptive, one-group pretest and posttest design. SETTING/LOCAL PROBLEM: Level 3 labor and birth unit that averages 3,000 births per year. At the site, there were no current evidence-based programs specifically focused on perioperative skills sustainment of the maternity nursing professional. PARTICIPANTS: Registered nurses on a labor and birth unit with at least 1 year of experience completed an online educational course and simulation activity. INTERVENTIONS/MEASUREMENTS: Participants were given pretests and posttests to assess knowledge and confidence in emergency cesarean birth perioperative skills. Observations of nurses' pretest and posttest interventions in cesarean births were made to assess changes in competency. Chart reviews were completed to assess changes in decision-to-incision time before and after the intervention. RESULTS: Nurses reported greater confidence and knowledge during emergency cesarean birth after participating in the interventions. Other results included decreased decision-to-incision times. None of these results held statistical significance. CONCLUSION: This project highlights the need for evidence-based, standardized perioperative maternity education across labor and birth nursing practice.

An Essential Clinical Dataset Intervention for Nursing Documentation of a Pediatric Admission History Database.

PURPOSE: The purpose of this study was to improve nursing documentation efficiencies and satisfaction of a pediatric admission history workflow. Secondary aims determined if defining essential data elements was associated with decreased pediatric admission history documentation time, increased dataset completion rate, and increased satisfaction. DESIGN AND METHODS: A quasi-experimental between-group difference comparison was conducted for a nurse-led quality improvement study that included implementation of a pediatric essential clinical dataset (ECD) tool for pre/post-intervention analysis of nursing admission history documentation time, dataset completion rate, and satisfaction. A survey was administered to nurses pre- and post-intervention to compare documentation satisfaction. RESULTS: Nursing admission history documentation time decreased by 1 min 31 s and the number of clicks decreased 38%. Dataset utilization increased 8% indicating improved nursing documentation of essential questions within a pediatric admission history form. Nursing documentation satisfaction with the pediatric admission history form was minimally impacted by the pediatric ECD study intervention. CONCLUSIONS: Defining what is essential for nurses to document positively influenced nursing documentation time, dataset completion rate, and satisfaction. PRACTICE IMPLICATIONS: The study contributed to EHR content standardization, optimization, and documentation efficiencies for nurses within a pediatric organization with implications for clinical and informatics collaboration to create real-world evidence, leveraging an intervention that decreased documentation burden and increased time for children and families.

The effect of an active shooter response intervention on hospital employees' response knowledge, perceived program usefulness, and perceived organizational preparedness.

Active shooter events occur frequently across the United States in a variety of locations, including health care facilities. Hospital health care worker response to an active shooter event may mean the difference in life or death for self or others. There is little research on how hospitals prepare nonmanagers to respond to active shooter events. We conducted a study to explore differences in knowledge, perceived organizational preparedness, and program utility following participation in an active shooter response program. Self-efficacy, personal characteristics, and professional characteristics were also explored. Program evaluation was conducted via a one-group pretest/posttest design. There was a significant increase in knowledge and perceived organizational preparedness postintervention. Trait-level self-efficacy did not have a significant effect on retained knowledge and perceived organizational preparedness. The current study is the first known to evaluate the efficacy of an active shooter response program for nonmanagers within an inpatient health care facility. Findings from this study may inform risk managers on how to educate employees on what to expect and how to react should an active shooter event occur.

Barriers to the Use of Assistive Devices in Patient Handling.

Work-related musculoskeletal disorders (WMSD) are a major safety concern in today's health care environment due to the manual lifting of patients with higher acuity levels and obesity. Nurses move patients multiple times each day, incurring cumulative stress and trauma resulting in chronic pain and potential injury. The purpose of this study was to assess barriers to the use of assistive devices in safe patient handling and mobility (SPHM) that contribute to WMSD in health care workers. Interpersonal, situational, organizational, and environmental influences have both direct and indirect effects on workers' commitment to use, or their actual likelihood of using, assistive devices. This study confirmed that time constraints contribute to fewer instances of assistive device use. Comprehensive ergonomic programs are needed to promote staff and patient safety. By providing safe environments for health care workers who engage in patient handling and mobility, the risk of injury can be significantly reduced.