Knowledge and barriers related to food insecurity screening in healthcare settings.

OBJECTIVE: Assess healthcare professionals' knowledge, referral practices, readiness, and barriers for food insecurity policy and practice implementation in Johnson County, Kansas. DESIGN: An expert panel of regional anti-hunger advocates was convened to identify critical domains for instrument development. SAMPLE: The questionnaire was disseminated via REDCap to approximately 2800 healthcare professionals. MEASUREMENTS: The questionnaire was composed of 32 items related to demographics, general knowledge, referral knowledge, current practices, perceived challenges, and perceived advantages. RESULTS: Social Workers' knowledge regarding food insecurity and referral was statistically greater (p = .0001 and p = .0001, respectively) than other professional groups. By department, Primary Care and Care Coordination's knowledge regarding food insecurity and referral was statistically greater (p = .008 and p = .0001, respectively) than Ancillary Care. Ninety-eight percent of respondents reported that food insecurity should be addressed in healthcare. Evaluation of the unique perspectives and needs related to food insecurity and perceived barriers of the healthcare providers serving the local population will guide an organization in building an implementation plan targeting the unique needs of the organization. POLICY IMPLICATIONS: As the need for food insecurity services grow during the coronavirus pandemic, this work can help build the foundation for better communication and awareness between healthcare, government, and community programs.

Achieving Disease-Specific Care Joint Commission Certification: The Impact of Clinical Nurse Specialist Practice.

PURPOSE: The aims of this study are to describe a program to achieve disease-specific care (DSC) certification from The Joint Commission and highlight the value of the advanced practice nurse in the certification outcome. DESCRIPTION OF PROGRAM: The expertise in clinical practice, performance improvement, and leadership skills demonstrated by the clinical nurse specialist (CNS) can be instrumental in building a strong foundation for a DSC certification program. As an organization prepares for a DSC on-site review, the CNS can guide the program stakeholders in identifying gaps in care, developing action plans to meet certification standards, and preparing team members for the DSC on-site review. OUTCOME: At this Midwestern, 504-bed facility, The Joint Commission DSC certifications were achieved in 5 separate categories: diabetes, stroke, sepsis, total hip replacement, and total knee replacement. CONCLUSION: By influencing a certain patient population throughout the organization, population-focused CNSs are in a unique role to lead an interprofessional team or serve as an expert consultant in pursuing DSC certification from The Joint Commission.

CE: Original Research: Identifying Hospitalized Patients at Risk for Harm: A Comparison of Nurse Perceptions vs. Electronic Risk Assessment Tool Scores.

: Objective: In many hospitals, nurse-led "safety huddles" are used to relay patient safety information, although whether this effectively identifies patients at risk for harm has not been determined. New electronic risk assessment tools are designed to identify patients at risk for harm during hospitalization, based on specific markers in the electronic health record. This study sought to compare the results of both methods. The findings may help to enhance decision making at the level of care delivery. METHODS: A nonexperimental correlational study was conducted over a three-week period in 2015 in a large metropolitan acute care community hospital. Nurses on three units-a medical-surgical unit, a progressive care unit, and an orthopedic unit-constituted the convenience sample. Designated safety huddle leaders collected data using the daily census sheet to record the nurses' perceived risk of harm for each patient and the reason for risk concern. Separately, designated advanced practice nurses collected the electronic risk assessment tool's reports from the same units. Data were paired as they were entered into the database and analyzed to determine correlation. Perceptions of harm from the nurses, recorded as yes or no responses, were compared with the electronic tool's identification of high risk or moderate-to-low risk. RESULTS: In 746 data pairs, differences between the nurses' harm risk perceptions and the electronic tool's harm risk reports were statistically significant, supporting our prediction that there would be no correlation. The most significant difference was seen in instances when a nurse identified a patient as being at higher risk than the electronic tool did, often citing behavioral or psychosocial issues as the reason for concern. CONCLUSIONS: Nurses perceived harm risk differently than the electronic tool did. In situations when the electronic tool cited risk and the nurse perceived no risk, the risks were currently being addressed in the plan of care. In situations when the nurse perceived higher risk than the electronic tool did, the nurse often cited behavioral or psychosocial issues (which frequently lacked defined data points in the electronic health record and thus were not available to the tool). Changes in data mining algorithms must incorporate and weight the impact of psychosocial and behavioral elements together with other risk factors in order to provide meaningful practice recommendations.