Taking Action Against Clinician Burnout Through Reducing the Documentation Burden With an Operating Room Supply Scanning Approach

Documenting surgical supply items in the operating room can be a burdensome task for circulating nurses because of manual input within the electronic medical record. This can lead to documentation fatigue and contribute to nursing burnout. The aim of this quality improvement project was to design and implement a supply item scanning process and evaluate the effect on intraoperative documentation completion time, room turnover time, picklist documentation accuracy, nurse satisfaction, and burnout. The sample included nine acute care hospitals throughout the United States, with 189 total circulating nurses and 31 718 procedures occurring during the study timeframe of 8 months. Results indicated that nurses were able to complete documentation on average 37.33 minutes sooner, and the operating room turnover time decreased by 1.88 minutes. Although nurses reported that their perceived picklist documentation accuracy did not improve, and the presence of new scanning technology did not influence their hospital employment decision, subjective feedback was mostly positive, with most responses citing the helpfulness of scanning for documentation. This study shows that an interdisciplinary team can effectively work to optimize documentation efficiency and performance improvement using a scanning intervention. Lessons learned through this process can translate into optimizations elsewhere in the electronic medical record.

Using Teaching Videos to Improve Nursing Students' Self-Efficacy in Managing Patient Aggression

BACKGROUND

Nursing students experience patient aggression due to their age and lack of experience. Academic institutions can implement strategies to prepare students to manage aggression.

METHOD

One-hundred forty-eight undergraduate nursing students in a baccalaureate nursing program participated in this quality improvement initiative. Baseline and postintervention perceived self-efficacy (PSE) data were gathered using the Self-Efficacy in Patient Centeredness Questionnaire-27. Students viewed two educational videos and underwent debriefing.

RESULTS

Overall PSE scores increased significantly (p < .01) from baseline (M = 76.44, SD = 13.00) to postintervention (M = 91.66, SD = 11.97). PSE in the subscales exploring the patient's perspective, sharing information and power, and dealing with communication challenges increased significantly (p < .01) from pre- to postintervention.

CONCLUSION

PSE in caring for patients exhibiting aggressive behavior increased after nursing students were taught behaviors to use and how to manage their own biases to avoid provoking patients to respond aggressively. [J Nurs Educ. 2023;62(7):423-426.].

Use of the Modified Early Warning Score by Medical-Surgical Nurses to Initiate the Rapid Response Team: Impact on Patient Outcomes

BACKGROUND

Cardiac arrests are often preceded by several hours of physiological deterioration that may go undetected.

LOCAL PROBLEM

Cardiac arrests frequently occurred on medical-surgical units without prior rapid response team intervention.

METHODS

A pre/postintervention design was used to evaluate a protocol to guide the use of the Modified Early Warning Score (MEWS) by medical-surgical nurses to escalate the care of deteriorating adult patients.

INTERVENTIONS

Following staff education, the MEWS protocol was implemented across 8 medical-surgical units.

RESULTS

There was a significant increase in patients experiencing a rapid response prior to a cardiac arrest after implementing the MEWS protocol ( P < .0001).

CONCLUSION

Implementing a consistent review of MEWS values allows medical-surgical nurses to initiate assistance from a rapid response team that may prevent an inpatient cardiac arrest.

Development and Implementation of a Real-Time Inpatient Palliative Care Screening Process to Promote Earlier Palliative Care Referrals

Despite the previous development of criteria for palliative screening tools, there remains a lack of validated and practical screening processes for the general hospitalized patient population for everyday clinical use. This quality improvement project's aim was to implement a practical institution-based adult inpatient palliative care screening tool embedded into the electronic medical record with an automated alert process to assist in identifying patients earlier within hospital admission. The project used a preimplementation and postimplementation design and followed the Plan-Do-Study-Act process to measure the effectiveness of the tool and alert process in decreasing time from admission to palliative care referral and impact on referring patterns. During the project period, 1851 palliative care referrals were completed, and minimal difference (0.6%) was noted in the average time from admission to referral preimplementation and postimplementation ( P = .939). There was a 3.7% increase in referrals postimplementation and a shift in referring service patterns ( P = .321). Although the expected outcome of earlier palliative referrals during admissions was not met, the development and implementation of the tool and alert process is a step toward the creation of a standard practical tool for the general hospitalized patient population.

Nurse Leader Preparation for Disasters: A Cross-sectional Survey

OBJECTIVE

The aim of this study was to evaluate nurse leader confidence in emergency management and disaster preparedness.

BACKGROUND

There is a dearth of evidence in the literature regarding the preparation of nurse leaders to manage emergencies and disasters. Research suggests significant gaps in nurse leader confidence across roles and in structured education that prepares nurse leaders across the spectrum of experience to manage in a crisis.

METHODS

An exploratory, cross-sectional survey included a sample of 432 RNs who are members of the Northwest Organization for Nurse Leaders.

RESULTS

Results indicate significant variance in nurse leader confidence across roles, experience, and previous disaster-related education. Positive associations regarding nurse leaders' confidence in managing disasters exist with more advanced positions, advanced education, and structured training.

CONCLUSIONS

Nursing leaders lack consistent education that prepares them for emergency and disaster management. Nurse leaders across all levels would benefit from formal education in these areas.

Analysis of Age-Friendly Cancer Care Readiness

OBJECTIVES

Cancer care attuned to meeting the needs of older adults is imperative to ensure that they receive appropriate levels of treatment in accordance with their goals of care. Achieving age-friendly systems and geriatric-competent workforces require rethinking current models of cancer care delivery. This article reports on a descriptive study on the readiness of U.S. cancer programs to provide age-friendly cancer care.

SAMPLE & SETTING

A survey was sent to 567 ambulatory oncology leaders in the United States. Of the 81 respondents, 61 answered all questions.

METHODS & VARIABLES

The authors developed and administered an online survey assessing cancer programs' age-friendly cancer care practices and readiness. Survey questions were based on the elements of the 4Ms framework. Results were analyzed using frequencies and percentages for categorically measured survey items and measures of central tendency for continuously scaled survey items.

RESULTS

67% of respondents reported that their program could deliver age-friendly cancer care within five years. Respondents less frequently indicated that they employed specific 4Ms elements.

IMPLICATIONS FOR NURSING

The results of this study suggest gaps in readiness to implement age-friendly cancer care. Recommendations to improve readiness include increasing awareness, expanding workforce preparation, and improving cancer program leadership engagement.

Connecting Nursing Students and Older Adults: An Intergenerational Service-Learning Experience

BACKGROUND

Aging populations have an increased need for health care services. Nursing students are often introduced to care of older adults through a clinical experience in a skilled nursing facility, which can negatively bias a student's attitudes toward this population.

PURPOSE

The purpose of this quality improvement project was to improve the attitudes of undergraduate nursing students toward older adults.

METHOD

Students (N = 104) completed a minimum of 5 visits with an independent community-dwelling older adult. Student attitudes toward older adults were measured before and after the experience using the Polizzi Refined Aging Semantic Differential Scale. Student and older adult participants responded to satisfaction surveys.

RESULTS

Statistical and clinically significant improvements in student attitudes were noted after the service-learning intervention.

CONCLUSIONS

Nurse educators can impact the way nursing students view the older adult population by including intergenerational service-learning experiences in the curriculum.

Cancer Nursing's Potential to Reduce the Growing Burden of Cancer Across the World

Cancer is the first or second leading cause of premature death (i.e., at ages 30-69 years) in 134 of 183 countries, and it ranks third or fourth in an additional 45 countries. An estimated 18.1 million new cancer cases and 9.6 million cancer-related deaths occurred worldwide in 2018. The incidence of cancer globally is expected to exceed 27 million new cancer cases per year by 2040 in part due to the aging of the population and greater susceptibility to aging-related diseases such as cancer. This estimated increase in cancer incidence will occur in all countries, but the predicted increase will be proportionately greatest in low and medium countries. Cancer is also a disease associated with significant morbidity. It is estimated that the total annual economic cost of cancer in 2010 was US$1.16 trillion per year.

Leveraging the Power of Board Leadership in Professional Nursing Organizations

Nurses who aspire to lead a professional nursing organization can significantly influence the future of the nursing profession. This article describes 4 essential responsibilities required in a board leadership position as identified by a group of nurse leaders who have each served as the board president of a national or international professional nursing organization.

A Framework for Integrating Oncology Palliative Care in Doctor of Nursing Practice (DNP) Education

Doctor of Nursing Practice (DNP) faculty play a critical role in preparing students to meet the complex needs of the nation as the number of cancer rates and survivors rise (National Cancer Institute, 2018) and as an unprecedented number of older Americans enter into the healthcare system with complicated comorbidities (Whitehead, 2016). Palliative care has dramatically expanded over the past decade and has been increasingly accepted as a standard of care for people with cancer and other serious, chronic, or life-limiting illnesses. Advanced practice registered nurses (APRNs) are recognized as important providers of palliative care (Walling et al., 2017). A 2-day course was held with support from the National Cancer Institute to enhance integration of palliative oncology care into DNP curriculum. The course participants (N = 183), consisting of DNP faculty or deans, practicing DNP clinicians, and students, received detailed annotated slides, case studies, and suggested activities to increase student engagement with the learning process. Course content was developed and delivered by palliative care experts and DNP faculty skilled in curriculum design. Participants were required to develop goals on how to enhance their school's DNP curriculum with the course content. They provided updates regarding their progress at integrating the content into their school's curriculum at 6, 12, and 18 months post course. Results demonstrated an increase in incorporating oncology palliative care in DNP scholarly projects and clinical opportunities. Challenges to inclusion of this content in DNP curricula included lack of: perceived time in curriculum; faculty educated in palliative care; and available clinical sites.

Camp Raising Spirits: An Oncology Nursing Society Chapter Leadership Success Story

Oncology Nursing Society (ONS) members share a unique passion for the people they serve and frequently commit to projects that make a difference. Camp Raising Spirits, a weekend retreat for adults with cancer, has made a difference in southwestern Pennsylvania for hundreds of people with cancer and their caregivers for 24 consecutive years. This article will describe how an ONS chapter capitalized on the leadership attributes of partnership, creativity, and commitment to sustain an important community service program. 
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