Our city was significantly impacted by the initial COVID-19 outbreak in the United States. We describe how members of our Quality and Safety team were able to leverage skills in relational ...coordination and process improvement to respond to rapidly changing needs in a flexible and effective way.
A daily management system (DMS) can be used to implement continuous quality improvement and advance employee engagement. It can empower staff to identify problems in the care environment that impact ...quality or workflow and to address them on a daily basis. Through DMS, improvement becomes the work of everyone, every day. The authors of this 2-part series describe their work to develop a DMS. Part 1 describes the background and organizing framework of the program.
A daily management system (DMS) can be used to implement continuous quality improvement and advance employee engagement. It can empower staff to identify problems in the care environment that impact ...quality or work flow and to address them on a daily basis. Through a DMS, improvement becomes the work of everyone, every day. The authors of this 2-part series describe their work to develop a DMS. Part 2 describes the implementation and outcomes of the program.
We relate a case history that involved the therapeutic sharing of self with an elderly patient. The potential usefulness of this kind of intervention is discussed in light of the literature on ...self-disclosure and the use of self in clinical practice. We discuss how these concepts might relate to other welldescribed phenomena in geriatric nursing, including reminiscence, life review, loneliness, and storytelling. Recommendations for use in clinical practice and for qualitative studies are given. (Geriatr Nurs 1998; 19: 34-7.)
As the healthcare environment changes, systems that have served hospitals well for many years no longer meet the current needs of patients, families, and communities. This is particularly true with ...regard to health education. The authors describe an innovative learning center that offers comprehensive health education services and programs designed to empower consumers with the information and skills needed to maintain health or recover from illness or injury.
Postural or orthostatic vital signs, although frequently used in many clinical settings to aid in the diagnosis of fluid volume disturbance, can be a source of confusion. Practitioners often have ...questions about how to perform the test and may be uncertain about what results mean in various clinical situations. Some of this confusion is reflected in the literature, where studies on normal orthostatic responses seem to contradict clinically used parameters of "normal," and where very few studies appear on evaluating unusual responses as indicators of patients' fluid volume status. A review of existing literature is presented, in which relevant data are reviewed in terms of their impact on the use of this clinical sign. Recommendations regarding the use of the orthostatic test are given.
The authors describe how an interdisciplinary team used skills in communication and collaboration to improve patient care on a busy surgical service. A major goal was to establish and maintain ...continuity of care in the face of decreasing lengths of stay and increasing patient acuity. The authors share their insight about designing and supporting a successful interdisciplinary patient care team and discuss how their experiences relate to concepts such as case management and career development.
Patient-controlled analgesia is an innovative method of pain control that is being used with increasing frequency in postoperative patients. Besides affording patients a sense of control over their ...pain, the method seems to offer superior pain relief with less sedation compared with traditional methods. Nurses report that valuable patient care time is saved when complicated negotiations among nurses, patients, and physicians regarding pain management are eliminated, and tasks such as signing out and preparing analgesic injections are no longer necessary. A review of the method is presented.
