Handwashing practices are persistently suboptimal among healthcare professionals and are also stubbornly resistant to change. The purpose of this quasi-experimental intervention trial was to assess the impact of an intervention to change organizational culture on frequency of staff handwashing (as measured by counting devices inserted into soap dispensers on four critical care units) and nosocomial infections associated with methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). All staff in one of two hospitals in the mid-Atlantic region received an intervention with multiple components designed to change organizational culture; the second hospital served as a comparison. Over a period of 8 months, 860,567 soap dispensings were recorded, with significant improvements in the study hospital after 6 months of follow-up. Rates of MRSA were not significantly different between the two hospitals, but rates of VRE were significantly reduced in the intervention hospital during implementation.
Programme participants reported increased capacity to perform their professional roles as a result of their having participated in this programme. More capacity building activities are needed to further enable nursing professionals to meet the demands for health care around the world.
The imperatives of the Affordable Care Act to reduce 30-day readmissions present challenges and opportunities for nurse administrators. The literature suggests success in reducing readmissions through enhancing patient-centered discharge processes, focusing on medication reconciliation, improving coordination with community-based providers, and effective patient self-management of their disease and treatment. Evidence-based interventions addressing low health literacy, when used with all patients, hold promise to promote understanding and self-management. Strategies addressing low health literacy aimed at reducing 30-day readmissions are identified and discussed.
Concerns about stubbornly persistent high rates both of error-related patient injuries and of occupational injuries among healthcare workers have generated intense exploration of etiologies, interventions, and the role of underlying safety culture. Much of this work has centered on the role of physicians and nurses in health care, and suggests common issues related to safety culture. However, the role of front-line health care workers, such as nursing assistants, ward clerks, environmental service workers, food workers and transportation workers, among others, has not been explored sufficiently. This article provides the background for a workshop held in Washington, D.C., to identify gaps and opportunities for integrating front-line hospital workers into safety efforts. It provides a brief review of available information, the results of a series of focus groups of front-line workers from a single urban hospital addressing the question, and a series of framing questions for the workshop itself.
Previous work on the relationship between worker safety and patient safety has focused on nurses and physicians. 1 Safety climate and nurses' working conditions predict both patient injuries and nurse injuries, supporting the premise that these outcomes may be linked. 2 Less attention has been paid to other members of the health care team, including nursing assistants, orderlies, aides, food service workers, janitors and other environmental service workers, ward clerks, and others. (We use the term health care workers [HCWs] to include frontline hospital workers rather than "support personnel" or other terms that may unintentionally exclude them.) Engaging frontline HCWs in developing, implementing, and evaluating interventions to improve safety may improve patient as well as worker outcomes.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.