Standardize, Engage, and Collaborate: An Initiative to Reduce Community Acquired Central Line Blood Stream Infections Across the Continuum of Care.

BACKGROUND: Community acquired blood stream infections (CA-CLABSI) are a major source of morbidity and mortality for pediatric patients. Many organizations discharge pediatric patients to home health agencies to care for central lines. To reduce the incidence of CA-CLABSIs requires a concentrated effort between hospitals and home health agencies. It is important for home health agencies to be accountable for the care and maintenance they provide to patients with central lines. Local Problem: At a large children's hospital, CA-CLABSI metrics and collaboration with home health agencies to reduce CACLABSI events lacked organizational standardization. METHODS: An organizational committee was formed to establish standards of care for CA-CLABSI follow-up and reduction. RESULTS: As a result of the committee's work, several best practices resulted including the creation of a CA-CLABSI resource booklet; a screening tool to identify contributing risks associated with a CA-CLABSI, and increased awareness of CA-CLABSIs. Since implementation of these best practices, the organization has seen a 30% reduction in the number of CA-CLABSIs. Standardization of CA-CLABSI efforts and proactive surveillance of central line care may lead to decreases in the number of CA-CLABSI events. Collaboration between service lines may identify siloed best practices that can be implemented organizationally that may have a large impact.

Orienting and Onboarding Clinical Nurse Specialists: A Process Improvement Project.

PURPOSE: Clinical nurse specialists (CNSs) have a unique advanced practice role. This article describes a process useful in establishing a comprehensive orientation and onboarding program for a newly hired CNS. DESCRIPTION: The project team used the National Association of Clinical Nurse Specialists core competencies as a guide to construct a process for effectively onboarding and orienting newly hired CNSs. Standardized documents were created for the orientation process including a competency checklist, needs assessment template, and professional evaluation goals. In addition, other documents were revised to streamline the orientation process. OUTCOME: Standardizing the onboarding and orientation process has demonstrated favorable results. As of 2016, 3 CNSs have successfully been oriented and onboarded using the new process. CONCLUSION: Unique healthcare roles require special focus when onboarding and orienting into a healthcare system. The use of the National Association of Clinical Nurse Specialists core competencies guided the project in establishing a successful orientation and onboarding process for newly hired CNSs.

Ensuring Safe Transfer of Pediatric Patients: A Quality Improvement Project to Standardize Handoff Communication.

BACKGROUND: During a single hospital stay, a patient's care is transferred several times between health care clinicians requiring multiple handoffs. Nurses often voice concerns about feeling unsafe when receiving patients from other areas. AIMS: The aims of the intradepartmental quality improvement project were to identify the safest way to transfer care of pediatric patients and to improve bedside nurses' knowledge on conducting an evidence based practice project. METHODS: Guided by clinical nurse specialists, nurses from various departments worked together and reviewed the literature regarding safe transfers, timing, and handoff communication. RESULTS: Findings from this quality improvement project led to creation and implementation of a system wide handoff tool. Use of the handoff tool decreased medication errors and improved nursing satisfaction. CONCLUSIONS: Partnering with bedside nursing staff to research and apply system wide quality improvements can increase knowledge and understanding of evidence based practice as well as quality of patient care.

Perceptions of the influence of social media and therapeutic relationships on nurses: a systematic review protocol of qualitative evidence.

REVIEW QUESTION/OBJECTIVE: The objective of the review is to explore the perceptions of the influence social media has on professional boundaries and therapeutic relationships between nurses and their patients and families.