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Initial Competency Tool to Assist Preceptors in the Documentation of New RN Competency
No full textHealth organizations rely on Registered Nurse (RN) preceptors to train and evaluate new RN’s competence. A competency tool guides and documents a new RN’s competency to adequately perform the skills needed for their position. This DNP project utilized preceptor input to optimize the competency tool to improve the preceptor’s ease of use, clear expectations for each competency, and improved the preceptor-to-preceptor handoff. This quality improvement project involved surveying RN preceptors for their perception of the initial competency tool throughout its development and after implementation. Preceptors reported a dramatically improved preceptor perception of the initial competency tool. Survey results showed an increase in perceived ability to accurately document a new RN’s competence, ease in transitioning a new hire RN from one preceptor to the next, and a clear understanding of what is expected for each competency
A Review of Bleeding Risk with Impella-Supported High-Risk Percutaneous Coronary Intervention
Get PDFComplex, high-risk percutaneous coronary intervention (HR-PCI) is increasingly being performed, often with mechanical circulatory support (MCS), though to date, there are limited randomised data on the efficacy of MCS for HR-PCI. The majority of MCS is provided by intra-aortic balloon pumps, but increasingly Impella® (Abiomed, Danvers, MA, USA) heart pumps are being used. While the Impella pumps provide greater increases in cardiac output, these devices require large bore access, which has been associated with an increased risk of bleeding and vascular complications. Decisions regarding the use of Impella are often based on risk–benefit considerations, with Impella-related bleeding risk being a major factor that can impact decisions for planned use. While bleeding risk related to large bore access is a concern, published data on the risk have been quite variable. Thus, the goal of this article is to provide a comprehensive review of reports describing bleeding and vascular complications for Impella-supported HR-PCI
Implementation of Proper Lead Selection Based on ECG Practice Standards in Hospitalized Patients
Get PDFEnsure adult patients in a 36 bed Telemetry Unit and 14 bed Cardiac Intensive Care Unit (CICU) with the diagnosis of STEMI and NSTEMI are being monitored in the appropriate leads to detect acute or silent ischemia and arrhythmias.https://digitalcommons.centracare.com/nursing_posters/1109/thumbnail.jp
Implementation of a Chemotherapy Guideline: A Quality Improvement Project to Standardize the Chemotherapy Delivery Process
Get PDFAdjusting chemotherapy rates is one gap in chemotherapy practice that evokes inconsistency. The purpose of this project was to implement a standardized guideline for staff to utilize in adjusting rates of chemotherapy medications.https://digitalcommons.centracare.com/nursing_posters/1108/thumbnail.jp
Retrospective Study of Warfarin Use in the CentraCare Family Health Clinic
Get PDFIntroduction: Warfarin is FDA approved for a variety of indications Recommended INR goal ranges can vary depending on indication Appropriate warfarin management is necessary for safety and efficacy of the medication Since November 2019, warfarin has been managed by the ambulatory pharmacist in the Family Health Clinic
Purpose: To further understand the patterns of use of warfarin within the CentraCare Family Health Clinic Specifically, determine the prevalence of warfarin indications and corresponding INR goals.https://digitalcommons.centracare.com/pharmacy_posters/1005/thumbnail.jp
Evaluation of Heparin-Induced Thrombocytopenia Antibody Laboratory Use and Anticoagulation Prescribing Patterns
Get PDFIntroduction Heparin-induced thrombocytopenia (HIT) is a rare adverse reaction Calculating a 4T score prior to ordering a heparin-PF4 immunoassay is recommended. For a score \u3c 4, HIT probability is low and an assay is not advised If high suspicion of HIT (4T greater than or equal to 4), an assay should be ordered, all heparin products discontinued, and a non-heparin anticoagulant initiated.
Purpose Determine if heparin immunoassay ordering was indicted according to retrospective 4T score Assess anticoagulation prescribing depending on the result of the assay Serve as a pre-group for a planned perverse post-HIT order set implementation analysishttps://digitalcommons.centracare.com/pharmacy_posters/1007/thumbnail.jp
St. Cloud Hospital Hand Hygiene Achievers
Get PDFDevelop and adopt a culture change to increase hand hygiene compliance across all St. Cloud Hospital (SCH) inpatient and outpatient departments Hand hygiene is the best method to prevent the spread of infection (CDC, 2017). Historical data for SCH indicated below desired goal of 95% compliance with hand hygiene practices and continued identification of hospital associated infections. Employee engagement best achieved through promoting culture of safety supporting hand hygiene best practices (Piras et al., 2018). Educating staff on the WHO 5 Moments of Hand Hygiene, developing monitoring process for assessing opportunities to complete moments of hand hygiene, and providing detailed feedback can enhance results and improve culture (Haas, 2014). All staff survey identified best sources of performance feedback comes from peers and direct leadership.https://digitalcommons.centracare.com/nursing_posters/1115/thumbnail.jp
Deep Tissue Injuries
Get PDFPurpose Statement from Poster: Recognize and identify Deep Tissue Injuries Ability to describe and define Deep Tissue Injuries Increase awareness of Deep Tissue Injuries in order to promote early identification and treatmenthttps://digitalcommons.centracare.com/nursing_posters/1106/thumbnail.jp
Expansion of Medication Therapy Management Services to Rural Sites for Patients with an Employer-Sponsored Health Plan
Get PDFPrevious literature supports that pharmaceutical care provider in the ambulatory care setting can improve clinical, economic, and humanistic outcomes for recipients, and when utilized in employer-provided health plans can lead to reduced spending on healthcare costs by employers. A large health system in central Minnesota offers an Employee Medication Therapy Management (MTM) benefit that offers further financial incentives to meet with an MTM Pharmacist for a comprehensive review of one’s medications. Currently, this program is underutilized due to both lack of awareness of the program and geographic for employees in the wester region of the health system. This project sought to increase the utilization of the Employee MTM program and advocate for ambulatory pharmacy services across the far reaches of the health system
Reduced Frequency Monitoring Post-Stoke Treatment
Get PDFIn 2020, the nation was faced with a pandemic that quickly depleted health care resources. Standards of care were reviewed to identify opportunities to reduce the burden on healthcare resources. One of the standards of care that was reviewed nationally and locally at the St. Cloud Hospital (SCH), was the postalteplase/ thrombectomy patient placement and monitoring.
The standard of care for the placement and monitoring of post-alteplase patients was established during the 1996 NINDS trial and has not been studied since. Very minimal literature is available on the standard of care for patient placement and monitoring post-thrombectomy.https://digitalcommons.centracare.com/nursing_posters/1114/thumbnail.jp