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Liptrott SJ, Saliquni A, Giau L, Pecora R, Cimino C, Lo Piccolo A, Palermo A, Vidovic B, Cheda E, Imhof S, Tolotti A, Guastamacchia I, Cavatorti S. Nurse performed bladder ultrasound: a clinical quality improvement initiative. Contemp Nurse 2024:1-17. [PMID: 39321322 DOI: 10.1080/10376178.2024.2406350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 09/13/2024] [Indexed: 09/27/2024]
Abstract
Background: Bladder ultrasound (BUS) provides an accurate measurement of post-void residual (PVR) volume and bladder assessment. Access to BUS is dependent on practitioner availability with delays resulting in poor symptom management, delayed discharge and dissatisfaction. Developing nursing practice to perform BUS can address these patient's needs.Aims: Through a quality improvement initiative the aims were (1) to develop theoretical knowledge and practical competence of nurses to perform BUS, (2) to evaluate nursing activity in relation to BUS, (3) to evaluate stakeholders perceptions of the initiative.Methods: Based on the Deming Plan-Do-Study-Act (PDSA) cycle, an interprofessional team was created and a theoretical/practical based education program was devised. Activity in relation to the nurse-performed BUS was collected and analysed descriptively. Stakeholder perceptions were evaluated via patient and physician questionnaires subject to descriptive analysis and a focus group with nurses analysed descriptively.Results: The team developed a training program to perform BUS, certifying 11 nurses. Investigation of nursing activity related to BUS (n = 202) showed its use for PVR evaluation, and symptom and catheter assessment. It aided decision-making and nurse-physician communication. Stakeholders were satisfied with the initiative. Patients (n = 30) felt nurses were competent, clearly explaining the procedure, results and inspiring confidence. Physicians (n = 2) saw BUS as enhancing efficiency and care quality, while nurses (n = 7) felt this new skill enhanced nursing care providing a more holistic approach. Team reflection on the results of the evaluation confirmed BUS utility and activity, while nurses requested continuing education and a post-certification refresher course.Conclusion: Through reflection on clinical practice areas for improvement to enhance patient care were identified by the nursing team. Application of the PDSA cycle provided a structured approach to guide the quality improvement initiative. Improvements in nursing care and patient care processes have been observed and this has been a positive experience for stakeholders.
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Affiliation(s)
- Sarah Jayne Liptrott
- Ospedale Regionale Bellinzona e Valli, Ente Ospedaliero Cantonale, via A. Gallino 12, 6500, Bellinzona, Switzerland
| | - Anduena Saliquni
- Ospedale Regionale Bellinzona e Valli, Ente Ospedaliero Cantonale, via A. Gallino 12, 6500, Bellinzona, Switzerland
| | - Letizia Giau
- Ospedale Regionale Bellinzona e Valli, Ente Ospedaliero Cantonale, via A. Gallino 12, 6500, Bellinzona, Switzerland
| | - Rosario Pecora
- Ospedale Regionale Bellinzona e Valli, Ente Ospedaliero Cantonale, via A. Gallino 12, 6500, Bellinzona, Switzerland
| | - Carmelo Cimino
- Ospedale Regionale Bellinzona e Valli, Ente Ospedaliero Cantonale, via A. Gallino 12, 6500, Bellinzona, Switzerland
| | - Antonio Lo Piccolo
- Ospedale Regionale Bellinzona e Valli, Ente Ospedaliero Cantonale, via A. Gallino 12, 6500, Bellinzona, Switzerland
| | - Antonio Palermo
- Ospedale Regionale Bellinzona e Valli, Ente Ospedaliero Cantonale, via A. Gallino 12, 6500, Bellinzona, Switzerland
| | - Branislav Vidovic
- Ospedale Regionale Bellinzona e Valli, Ente Ospedaliero Cantonale, via A. Gallino 12, 6500, Bellinzona, Switzerland
| | - Eveline Cheda
- Ospedale Regionale Bellinzona e Valli, Ente Ospedaliero Cantonale, via A. Gallino 12, 6500, Bellinzona, Switzerland
| | - Sally Imhof
- Ospedale Regionale Bellinzona e Valli, Ente Ospedaliero Cantonale, via A. Gallino 12, 6500, Bellinzona, Switzerland
| | - Angela Tolotti
- Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, via A. Gallino 12, 6500, Bellinzona, Switzerland
| | | | - Shaila Cavatorti
- Ospedale Regionale Bellinzona e Valli, Ente Ospedaliero Cantonale, via A. Gallino 12, 6500, Bellinzona, Switzerland
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Greene MT, Linder KA, Fowler KE, Saint S. Influenza Vaccination Requirements for Health Care Personnel in US Hospitals. JAMA Netw Open 2024; 7:e2416861. [PMID: 38869903 DOI: 10.1001/jamanetworkopen.2024.16861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/14/2024] Open
Abstract
This survey study assesses changes from 2017 to 2021 in self-reported annual influenza vaccination among workers in nonfederal and Veterans Affairs hospitals.
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Affiliation(s)
- M Todd Greene
- Veterans Affairs (VA) Ann Arbor Healthcare System, Ann Arbor, Michigan
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor
- VA/University of Michigan Patient Safety Enhancement Program, Ann Arbor
| | - Kathleen A Linder
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor
- Infectious Disease Section, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
| | - Karen E Fowler
- Veterans Affairs (VA) Ann Arbor Healthcare System, Ann Arbor, Michigan
- VA/University of Michigan Patient Safety Enhancement Program, Ann Arbor
| | - Sanjay Saint
- Veterans Affairs (VA) Ann Arbor Healthcare System, Ann Arbor, Michigan
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor
- VA/University of Michigan Patient Safety Enhancement Program, Ann Arbor
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Collier KM, Greene MT, Gilmartin HM, Fowler KE, Saint S. The role of spirituality, religiosity, and self-care on infection preventionist well-being: Results from a national survey in the United States. Am J Infect Control 2024; 52:726-730. [PMID: 38122935 DOI: 10.1016/j.ajic.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The degree to which religiosity, spirituality, and self-care practices can improve well-being among infection preventionists is not well understood. METHODS We surveyed infection preventionists from a random sample of United States hospitals in 2021. Multivariable logistic regression models were used to examine the associations between measures of spirituality, religiosity, and self-care and well-being. RESULTS Our response rate was 47% (415/881). A total of 49% of respondents reported burnout, 17% reported increased feelings of uncaring, and 69% would choose to become an infection preventionist again. Most respondents found importance in spiritual well-being (88%), religious beliefs (82%), and self-care practices (87%). Spiritual well-being was associated with increased odds of choosing to become an infection preventionist again (odds ratio = 2.32, 95% confidence interval = 1.19-4.53, P = .01). DISCUSSION Our national survey provides evidence that spiritual importance is associated with career satisfaction among infection preventionists. Our findings contribute to a general body of evidence suggesting spiritual importance may translate to higher flourishing and well-being via serving a higher purpose. CONCLUSIONS Promoting spiritual well-being may positively influence career satisfaction and overall well-being among infection preventionists.
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Affiliation(s)
- Kristin M Collier
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI.
| | - M Todd Greene
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI; VA Ann Arbor Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI
| | - Heather M Gilmartin
- Department of Health Systems, Management and Policy, University of Colorado, School of Public Health, Aurora, CO, USA; Denver/Seattle Center of Innovation for Veteran-Centered and Value Driven Care, Veterans Health Administration Eastern Colorado Healthcare System, Aurora, CO
| | - Karen E Fowler
- VA Ann Arbor Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI
| | - Sanjay Saint
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI; VA Ann Arbor Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI
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Pisney L, Camplese L, Greene MT, Saint S, Fowler KE, Chopra V. Practices to prevent central line-associated bloodstream infection: A 2021 survey of infection preventionists in US hospitals. Infect Control Hosp Epidemiol 2024:1-5. [PMID: 38654493 DOI: 10.1017/ice.2024.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
OBJECTIVE To determine prevalence of technical and behavioral interventions aimed at preventing central line-associated bloodstream infection (CLABSI) following the COVID19 pandemic. DESIGN Cross-sectional survey. SETTING US acute care hospitals. PARTICIPANTS Infection preventionists at participating hospitals. METHODS Surveys were sent to infection preventionists from a national random sample of 881 US acute care hospitals. Questions covered use of technical interventions to prevent CLABSI (eg, alcohol-containing chlorhexidine gluconate [CHG] for skin antisepsis, use of coated catheters), socio-adaptive interventions (eg, feedback of CLABSI rates, use of appropriateness criteria), and leadership support for CLABSI prevention. RESULTS Survey response rate was 47% (415/881). Technical interventions such as maximal sterile barriers (99%) or CHG-impregnated dressings (92%) were highly prevalent, but routine use of CHG bathing was less common (68% indicated regular use in intensive care unit [ICU] vs 18% in non-ICU settings). Although 97% of respondents indicated use of systems to monitor CLABSI, feedback to providers on CLABSI events was reported by 89%. Only 53% of respondents indicated regular use of tools to determine appropriateness of central venous catheters (CVC). Three-quarters of respondents indicated their hospital assessed CVC necessity daily, but only 23% reported strategies to reduce routine blood cultures. CLABSI prevention was extremely important to hospital leadership at 82% of responding hospitals. CONCLUSIONS Most US hospitals continue to use evidence-based methods to prevent CLABSI as recommended by leading organizations. Opportunities to focus on socio-adaptive interventions such as feedback of infection rates, use of appropriateness criteria for CVC placement, and improving the "culture of pan-culturing" remain.
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Affiliation(s)
- Larissa Pisney
- The Division of Infectious Diseases, Department of Medicine, University of Colorado Anschutz, Aurora, CO, USA
- University of Colorado Health System, Aurora, CO, USA
| | - Lisa Camplese
- University of Colorado Health System, Aurora, CO, USA
| | - M Todd Greene
- VA/UM Patient Safety Enhancement Program, Ann Arbor, MI, USA
- Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Division of Hospital Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Sanjay Saint
- VA/UM Patient Safety Enhancement Program, Ann Arbor, MI, USA
- Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Division of Hospital Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Karen E Fowler
- VA/UM Patient Safety Enhancement Program, Ann Arbor, MI, USA
- Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Vineet Chopra
- Division of Hospital Medicine, Department of Medicine, University of Colorado Anschutz, Aurora, CO, USA
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Scruggs-Wodkowski E, Greene MT, Saint S, Fowler KE, Linder KA, Krein SL. Comparing practices to prevent infectious diseases transmission among Veterans Affairs and Nonveterans Affairs hospitals: Results from a national survey in the United States. Am J Infect Control 2024; 52:495-497. [PMID: 37944756 DOI: 10.1016/j.ajic.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/27/2023] [Accepted: 10/29/2023] [Indexed: 11/12/2023]
Abstract
Our national cross-sectional survey of United States hospitals found greater implementation of contact precautions for multidrug-resistant organisms and a higher percentage reporting the use of supplemental no-touch disinfection devices among Veterans Affairs (VA) versus non-VA hospitals. Nationally coordinated infection prevention initiatives within the VA could account for these practice differences.
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Affiliation(s)
- Elizabeth Scruggs-Wodkowski
- Department of Internal Medicine, Division of Infectious Diseases, University of Michigan Medical School, Ann Arbor, MI; Center for Clinical Management Research, VA/UM Patient Safety Enhancement Program, Ann Arbor, MI; Department of Internal Medicine, Infectious Diseases Section, LTC Charles S Kettles VA Medical Center, Ann Arbor, MI.
| | - M Todd Greene
- Center for Clinical Management Research, Veterans Affairs (VA) Ann Arbor Healthcare System, Ann Arbor, MI; Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI; Center for Clinical Management Research, VA/UM Patient Safety Enhancement Program, Ann Arbor, MI
| | - Sanjay Saint
- Center for Clinical Management Research, Veterans Affairs (VA) Ann Arbor Healthcare System, Ann Arbor, MI; Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI; Center for Clinical Management Research, VA/UM Patient Safety Enhancement Program, Ann Arbor, MI
| | - Karen E Fowler
- Center for Clinical Management Research, Veterans Affairs (VA) Ann Arbor Healthcare System, Ann Arbor, MI; Center for Clinical Management Research, VA/UM Patient Safety Enhancement Program, Ann Arbor, MI
| | - Kathleen A Linder
- Department of Internal Medicine, Division of Infectious Diseases, University of Michigan Medical School, Ann Arbor, MI; Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI; Center for Clinical Management Research, VA/UM Patient Safety Enhancement Program, Ann Arbor, MI; Department of Internal Medicine, Infectious Diseases Section, LTC Charles S Kettles VA Medical Center, Ann Arbor, MI
| | - Sarah L Krein
- Center for Clinical Management Research, Veterans Affairs (VA) Ann Arbor Healthcare System, Ann Arbor, MI; Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI; Center for Clinical Management Research, VA/UM Patient Safety Enhancement Program, Ann Arbor, MI
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Apisarnthanarak A, Greene MT, Collier KM, Kasatpibal N, Fowler KE, Saint S. The influence of spirituality, religiosity, and self-care on well-being among Thai infection preventionists during the COVID-19 pandemic. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2024; 4:e26. [PMID: 38415096 PMCID: PMC10897717 DOI: 10.1017/ash.2023.510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 02/29/2024]
Abstract
In a national survey of lead infection preventionists in Thai hospitals, spiritual and religious importance were associated with increased odds of career satisfaction. Cultivating environments for spiritual, religious, and self-care practices within the clinical setting may help facilitate emotional well-being-and prevent burnout-among Thai healthcare workers.
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Affiliation(s)
- Anucha Apisarnthanarak
- Division of Infectious Diseases, Thammasart University Hospital, Khlong Luang, Pratum Thani, Thailand
| | - M. Todd Greene
- VA Ann Arbor Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Kristin M. Collier
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Nongyao Kasatpibal
- Division of Nursing Science, Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand
- Epidemiology Research Center of Infectious Disease (ERCID), Chiang Mai University, Chiang Mai, Thailand
| | - Karen E. Fowler
- VA Ann Arbor Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Sanjay Saint
- VA Ann Arbor Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
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Greene MT, Borg MA, Schwaber MJ, Najjar-Debbiny R, Apisarnthanarak A, Saint S. Perceptions of organizational culture among infection preventionists in Israel, the United States, and Thailand: Results from national infection prevention surveys. Am J Infect Control 2024; 52:246-248. [PMID: 37625548 DOI: 10.1016/j.ajic.2023.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023]
Abstract
In national surveys of infection preventionists in Israel (n = 15), the United States (n = 415), and Thailand (n = 100), we found that views of organizational culture track well with these countries' cultural dimension scores of power distance and individualism. Our findings highlight the importance of considering cultural dimensions when implementing infection prevention efforts.
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Affiliation(s)
- M Todd Greene
- VA Ann Arbor Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA; Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA; VA/UM Patient Safety Enhancement Program, Ann Arbor, MI.
| | - Michael A Borg
- Department of Infection Prevention and Control, Mater Dei Hospital, Malta; Department of Pathology, University of Malta, Msida, Malta
| | - Mitchell J Schwaber
- National Center for Infection Control, Israel Ministry of Health, Tel Aviv, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ronza Najjar-Debbiny
- Infection Prevention and Control Unit, Lady Davis Carmel Medical Center, Haifa, Israel; Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | | | - Sanjay Saint
- VA Ann Arbor Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA; Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA; VA/UM Patient Safety Enhancement Program, Ann Arbor, MI
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