Medication errors are common and harm hospitalized patients. The authors designed and implemented an automated system to complement an existing computerized order entry system by detecting the administration of excessive doses of medication to adult in-patients with renal insufficiency. Its impact, in combination with feedback to prescribers, was evaluated in 3 participating nursing units and compared with the remainder of a tertiary care academic medical center. The baseline rate of excessive dosing was 23.2% of administered medications requiring adjustment for renal insufficiency given to patients with renal impairment on the participating units and 23.6% in the rest of the hospital. The rate fell to 17.3% with nurse feedback and 16.8% with pharmacist feedback in the participating units (P<.05 for each, relative to baseline). The rates of excessive dosing for the same time periods were 26.1% and 24.8% in the rest of the hospital. Automated detection and routine feedback can reduce the rate of excessive administration of medication in hospitalized adults with renal insufficiency.
The purpose of this study is to investigate the relationships among critical care nurses' attitudes, subjective norms, perceived behavioral control, and intentions to provide culturally congruent care to Arab Muslims. The provision of culturally congruent care is contingent on understanding nurses' motivational influences for providing culture care. Significant relationships among critical care nurses' behavioral beliefs, normative beliefs, control beliefs, intentions, and demographic variables supported the need for culture-specific debriefing sessions, underscored the importance of collaborative practice and interdisciplinary learning models, and established an evidence-based foundation for the design of culturally informed approaches to nursing education and service.
The purpose of this performance improvement project was to design, implement and evaluate an interprofessional education initiative intended to improve surgical team efficiency, communication and work satisfaction. The development of interprofessional perioperative accountable care teams in three surgical specialties, cardiothoracic, neurosurgery and orthopedics, demonstrated a reduction in turnover time, increased staff, patient and surgeon satisfaction, and increased operating room (OR) revenue generated by the surgical specialties within one year of implementation.
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