Evaluating Sepsis Bundle Compliance as a Predictor for Patient Outcomes at a Community Hospital: A Retrospective Study.

BACKGROUND: Clinicians are encouraged to use the Centers for Medicare & Medicaid Services early management bundle for severe sepsis and septic shock (SEP-1); however, it is unclear whether this process measure improves patient outcomes. PURPOSE: The purpose of this study was to evaluate whether compliance with the SEP-1 bundle is a predictor of hospital mortality, length of stay (LOS), and intensive care unit LOS at a suburban community hospital. METHODS: A retrospective observational study was conducted. RESULTS: A total of 577 patients were included in the analysis. Compliance with the SEP-1 bundle was not a significant predictor for patient outcomes. CONCLUSIONS: SEP-1 compliance may not equate with quality of health care. Efforts to comply with SEP-1 may help organizations develop systems and structures that improve patient outcomes. Health care leaders should evaluate strategies beyond SEP-1 compliance to ensure continuous improvement of outcomes for patients experiencing sepsis.

Nurses' Perceptions of Caring at Work: Mixed-Methods Study, Quantitative Report.

OBJECTIVES: Study objectives were to explore nurses' perceptions of self-care, co-worker, and leader caring within healthcare work environments and assess reliability of 3 Watson Caritas Scores. BACKGROUND: Assessing caring in an organization where Watson's Theory of Human Caring guides nursing practice offers insight into the professional practice environment. METHOD: This study reports quantitative data from mixed-methods descriptive, cross-sectional survey of 1307 RNs at a large healthcare system. RESULTS: Mean scores were self = 5.46, co-worker = 5.39, and leader score = 5.53, and median scores were >5.6 (range, 1-7). All scales had a positive and significant correlation to likelihood to recommend the organization, with the largest being feeling cared for by leaders. Internal reliability of the 3 scales was ≥0.9. CONCLUSION: Nurse perceptions of caring may influence the organization's reputation. Assessing the perception of caring among nursing staff after the introduction and enculturation of this framework is needed. Results support psychometric value for 3 Watson Caritas Scores.

Trio Rounding: Perceptions of Acute Inpatient Rehabilitation Nurses and Physicians.

PURPOSE: The purpose of this study was to explore the process, benefits, and challenges of patient-centered Trio rounding in acute inpatient rehabilitation from the perspectives of nurses and physicians. DESIGN: A descriptive qualitative design was used in this study. METHODS: Focus group interviews (FGIs) involving 27 nurses and physicians were thematically analyzed using Dedoose. A descriptive survey of rounding practices was conducted. FINDINGS: Five primary themes were identified: (1) interprofessional team collaboration; (2) patient safety and quality of care; (3) communication, education, and patient/family partnering; (4) synchronicity of workflow; and (5) participants' recommendation to develop rehabilitation Trio rounding standard process. Themes were consistent with Picker's patient-centered care principles. Findings from a survey on current rounding practice done prior to the FGI reinforced participants' discussion on challenges in conducting patient-centered Trio rounding. CONCLUSIONS: Trio rounding in acute inpatient rehabilitation is a complex process challenged by asynchronous workflow and patients' therapy schedules. Nurses and physicians reported benefits outweighed challenges for Trio rounding in acute rehabilitation. CLINICAL RELEVANCE: The study provided valuable recommendations to develop acute inpatient rehabilitation Trio rounding standard process.

A Nurse-Led Implementation Science Specialist Program.

ABSTRACT: A well-known challenge in health care is integrating evidence into practice. Implementation science (IS) is a growing field that promotes the sustainable application of evidence-based practice (EBP) to clinical care. Health care organizations have an opportunity to support sustainable change by creating robust IS infrastructures that engage nurses in the clinical environment. Integrating IS into a nursing shared governance model is an ideal vehicle to empower direct care nurses to sustain EBP. Importantly, an IS infrastructure may also promote nurse retention and increase interdisciplinary collaboration. This article, the first in a series on applying IS, describes how a multisite health care organization developed a systemwide nurse-led IS Specialist program within a shared governance model.

Traumatic brain injury in children: acute care management.

The care of the pediatric patient with a severe traumatic brain injury (TBI) is an all-encompassing nursing challenge. Nursing vigilance is required to maintain a physiological balance that protects the injured brain. From the time a child and family first enter the hospital, they are met with the risk of potential death and an uncertain future. The family is subjected to an influx of complex medical and nursing terminology and interventions. Nurses need to understand the complexities of TBI and the modalities of treatment, as well as provide patients and families with support throughout all phases of care.