While the goal of professional nursing programs is to ensure that students have a basic level of competency to care for older adults in a variety of care settings, the greatest challenge is to garner students' enthusiasm about caring for older adults in nursing homes. To increase and strengthen the professional nursing workforce in nursing homes, schools of nursing must ensure that students have appropriately placed, well-designed, and innovative clinical experiences in nursing homes with faculty who are knowledgeable about the nursing home environment and the professional nursing care needs of its residents. Four factors identified as keys to success in developing exemplary clinical experiences for students in nursing homes include: (a) nursing homes with positive reputations and providing quality care, (b) faculty knowledgeable and enthused about nursing homes, (c) committed partnerships between schools of nursing and nursing homes, and (d) creative and innovative clinical teaching strategies.
Interdisciplinary rounds are a new care coordination strategy in several healthcare settings. This article describes the process used by clinical nurse specialists in one institution to broaden existing discharge planning rounds to interdisciplinary rounds. In addition, a survey queried advanced practice nurse subscribers to two listserves, the ANPACC and CNS-L, to determine how other institutions conducted interdisciplinary rounds, including structure, membership, and leadership. As a result of the changed focus in rounds, the target institution noted greater participation by all disciplines in achieving patient and family outcomes, increased early recognition of patients at risk, and improved communication among members of the healthcare team. These findings were supported by participants in the Internet survey. It was determined that interdisciplinary rounds are a valuable mechanism for improved patient outcomes and increased staff professionalism.
Health care organizations today are being challenged to deliver care that is cost-effective, satisfying to patients, and based on quality outcomes. Urgency created by inadequate bed capacity as well as financial opportunity prompted United Hospital's Birth Center to launch care improvement activities aimed at assessing appropriateness of antepartal length of stay. Collaboration between all members of the health care team enabled a steering committee to implement evidence-based provider practice guidelines targeting variance around preterm labor management. Other multidisciplinary strategies implemented include a home care prescreening process, case management, and establishment of a peer review process. Within the 1-year care improvement process, the Birth Center successfully decreased the length of stay for preterm labor patients from 6.9 days to 5.3 days. This article describes one institution's efforts to improve care by implementing guidelines for the inpatient management of preterm labor.
INTRODUCTION:We sought to externally validate Gimovsky et al.'s prediction model for spontaneous vaginal delivery (SVD) in the second stage (https://www.pushprescriber.com [PUSH MODEL]) prior to using it for a quality improvement (QI) intervention at our hospital.
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