Consistency of Nursing Directors, Nursing Supervisors, and Nursing Quality Specialists’ Perception about Nursing-Sensitive Indicators in Acute Care Settings

Introduction: Nursing-Sensitive Indicators (NSIs) is a critical concept for the advancement of the nursing profession. However, different managerial positions may have a different perspective on the appropriate NSIs that should be used in hospitals for the monitoring of nursing care quality. This study aims to find if there is a difference between three groups of nursing managerial positions on the appropriateness of NSIs for the monitoring of nursing care quality. Methods: Descriptive cross-sectional approach was employed to evaluate if there is a difference among the three managerial groups in their evaluation for the appropriateness of using a cluster of NSIs in acute care settings. The study was conducted in Jordan between February and March 2020. Result: The study participants were 60 nurses from different managerial positions. The mean scores of the participants were: directors of nursing (200.6), nursing supervisors (199.1), and nursing quality specialists (198.62). The findings revealed no statistical difference between the three groups of their evaluation of the appropriateness of the NSIs. Conclusion: Standardizing the nursing mangers perspectives of NSIs may advance utilization of the NSIs for the monitoring and reporting of nursing care quality. Implications for Nursing Management: Consistent understanding of the measures that can be used to monitor quality of nursing care can establish the foundation for quality measurement and quality improvement in acute care settings.

Analysis of the Effects of Preoperative Hepatic Artery Chemoembolization and Quality Nursing Intervention on the Perioperative Safety and Short-term Prognosis of Liver Transplantation in Patients with Hepatocellular Carcinoma

Objective: To investigate the effects of preoperative hepatic artery chemoembolization (TACE) and quality nursing interventions on the perioperative safety and short-term prognosis in patients with hepatocellular carcinoma undergoing liver transplantation. Methods: The study period spanned from January 2021 to December 2023, and 125 patients with hepatocellular carcinoma admitted to our hospital were selected, all of whom underwent liver transplantation. They were randomly divided into an observation group (n = 63) and a control group (n = 62). The patients in the control group did not undergo TACE before the operation, and the patients in the observation group underwent TACE and quality nursing intervention before the operation. The operation time, intraoperative blood loss, length of hospitalization, liver- free period, complication rate, short-term prognosis, and liver function indexes between the two groups were compared. Results: There was no significant difference in operation time, intraoperative blood loss, and length of hospitalization between the two groups (P < 0.05). The liver-free period of patients in the observation group was longer than that of the control group (P < 0.05). The two groups had no significant difference in the incidence of biliary complications, vascular complications, and postoperative infections (P > 0.05). The rate of immune reactive complications in the observation group was lower than that of the control group (P < 0.05). There was no significant difference in the perioperative mortality rate, 1-year postoperative survival rate, and 2-year postoperative survival rate (P > 0.05). The two groups had no significant difference in postoperative liver function indexes (P > 0.05). Conclusion: Preoperative TACE and high-quality nursing intervention in patients with hepatocellular carcinoma had no adverse effect on the perioperative safety and short-term prognosis, prolonged the liver-free time, and reduced the incidence of immune-reactive complications.

Application and Satisfaction Analysis of Humanized Quality Nursing Intervention in the Care of Patients with Critical Respiratory Failure

Objective:To implement humanized quality care in critical respiratory failure nursing,observe the effect,and analyze the satisfaction.Methods:80 patients with severe respiratory failure were divided into 40 cases per group(admitted from February 2022 to December 2023)by double-blind method,the control group performed routine care,and the observation group was given humanized quality care.Results:After the nursing care,two respiratory function indexes of the observation group were lower than those of the control group,and two pulmonary function indexes were higher than those of the control group(P<0.05);regarding the complication situation,the incidence rate of the observation group was lower(P<0.05);regarding the nursing care satisfaction situation,the observation group had a higher level of total satisfaction(P<0.05).Conclusion:The application of a humanized quality nursing intervention model in the care of critical respiratory failure can actively improve patients’respiratory status and lung function,reduce complications,and satisfy patients.

Explore the Practice and Application of Nursing Safety and Quality Management

Objective： Explore the practice and application of safety care management and quality management at work. Methods： Establish and improve the nursing management system, safety assurance and quality improvement through the development of clinical nursing assessment standards, supervision, inspection and evaluation of the hospital based nursing quality management to ensure the compliance of the basic quality indicators; raised the nursing quality,to improve with the basic pattern, we prefer both the long and short-term goals, implement and guide the nursing quality, to improve project implementation, quality management training and assessment. Results： Through the implementation of the management of nursing safety and nursing quality, hospital comprehensive nursing quality and service satisfaction has increased significantly. Conclusion： Implementation of nursing safety management and nursing quality management, which ensure the nursing quality of hospital-wide surveillance, improvement and implementation of nursing quality and service satisfaction improved to play a positive role in promoting. Through increased management, nursing quality management more standardized and institutionalized procedures, and enhanced the quality of nurses＇ awareness and sense of competition, play an enhanced role in the promotion of the service concept of ＂patient-centered＂, improve the nursing comprehensive quality, and create a safe and comfortable medical and rehabilitation environment.

Application Value of Evidence-Based Nursing in the Perioperative Care of Ankle Fracture Patients

Objective:To analyze the value of applying evidence-based nursing in the perioperative care of patients with ankle fractures and propose corresponding measures to improve the quality of patient care.Methods:The study started in May 2022 and was terminated in March 2023.During this period,50 patients with ankle fractures treated by our hospital were selected as research subjects.They were divided into a control group and a research group.The control group had 25 patients who received routine care,and the research group had 25 who received evidence-based care.The nursing effects of the two groups were observed and compared.Results:The pain scores,quality of life,incidence of adverse reactions,and nursing satisfaction of patients in the research group were all significantly better than those in the control group(P<0.05).Conclusion:Evidence-based nursing can effectively improve the quality of care,reduce the risk of adverse reactions,and promote patient recovery,so it is suitable for clinical implementation.

Analysis of the Effect of Quality Control Circle on the Central Sterile Supply Department

Objective:To analyze the effect of quality control circle on the central sterile supply department(CSSD).Methods:The control group and the observation group each consisted of 180 instruments received by the sterilization supply center from January to March 2023 and 11 CSSD staff.The control group underwent routine management while quality control circle was implemented in the observation group.The quality of work,disinfection and sterilization qualification rates,disinfection and sterilization of various instruments,cleaning indicators,and management satisfaction of both groups were compared.Results:The observation group scored higher in terms of work quality,the qualification rate of disinfection and sterilization in each link,the disinfection and sterilization of instruments,and cleaning indicators compared to the control group.Besides,the management satisfaction of the observation group was higher than that of the control group(P<0.05).Conclusion:A quality control circle ensures the quality of work,improves the cleaning,disinfection,and sterilization of instruments of the CSSD,and improves the management satisfaction of the CSSD staff.

The Influence of Nursing Safety Management on the Quality of Hemopurification Nursing

Objective:To study the influence of nursing safety management on the quality of hemopurification nursing.Methods:Fifty-six patients who underwent hemopurification in our hospital from October 2019 to October 2020 were selected and randomly divided into research group(n=28)and control group(n=28),control group patients adopt routine nursing mode,research group patient take nursing safety management mode.Then compare the nursing quality score,the occurrence of adverse events and nursing satisfaction of patients in the two groups after different nursing modes.Results:The service attitude,doctor-patient relationship,medical environment and professional skill scores of the research group were significantly higher than those of the control group(P<0.05),the incidence of adverse events in the research group was significantly lower than that of the control group(P<0.05),and the satisfaction of the patients in the research group was significantly higher than that of the control group(P<0.05).Conclusion:The application of nursing safety management in hemopurification can effectively improve the quality of nursing,reduce the occurrence of adverse events,and improve the patient's nursing satisfaction,the effect is significant and suitable for promotion.

Clinical nursing visual health education pathway for patients with perianal abscess

Objective:To investigate the effect of a clinical nursing pathway and visual health education on patients with perianal abscesses was the objective of this study.Methods:Eighty patients with perianal abscesses undergoing in-patient surgical treatment(blinded for review)between December 2019 and November 2020 were divided randomly and evenly into a control group and an experimental group.The control group received routine nursing care,and the experimental group received visual health education nursing care.Digital pain scores,patient satisfaction scores,nursing quality scores,and scores measuring knowledge of perianal abscess disease for the two groups before and after nursing care were compared and analyzed.Results:The experimental group had visual analog scale(VAS)scores significantly lower than those of the control group(P<0.05).For total nursing satisfaction,the experimental group demonstrated a higher satisfaction rate(P<0.05).Clinical nursing quality scores were significantly higher in the experimental group than those in the control group(P<0.05).The perianal abscess disease-related knowledge scores after intervention were significantly higher in the experimental group than those in the control group(P<0.01).Conclusions:Visual health education nursing can help patients better understand and deal with perianal abscess disease.

Optimization of emergency nursing process for the rescue of patients with chest pain in the emergency department

Background The occurrence factors of emergency chest pain are relatively complex,and the progression of the condition is fast.Within a short period of time,the condition can worsen significantly,resulting in a higher mortality rate.Therefore,conducting proactive and effective emergency rescue work within a short period of time can significantly improve the success rate of patient resuscitation.Therefore,this study will focus on exploring the research on optimizing the emergency nursing process for the rescue effectiveness of emergency chest pain patients.Methods 82 patients with emergency chest pain admitted to our hospital from January 2022 to January 2023 were selected as the subjects of this study.They were evenly divided into observation group and control group by random number table method,with 41 cases in each group.The control group was given routine nursing,and the observation group was given optimized emergency nursing process.The rescue effect,rescue efficiency,adverse events and nursing quality of the two groups were compared.Results The success rate of rescue was 100.00%in the observation group and 90.24%in the control group,which was significantly higher than that of the control group(P<0.05).The duration of rescue,emergency stay time and hospitalization time in the observation group was lower than that in the control group(P<0.05).The proportion of patients with shock,arrhythmia and heart failure was 0.00%in the observation group,which was lower than the 9.76%in the control group(P<0.05),and the nursing quality scores of emergency order and basic nursing in the observation group were higher than those in the control group(P<0.05).Conclusionss Optimized emergency nursing process can improve the rescue success rate of patients with chest pain in the emergency department,improve the rescue work efficiency,speed up the treatment of patients,and significantly reduce adverse events,which is worthy of popularization and application.

Training indicators and quantitative criteria for emergency nurse specialists

Objective： By constructing a training system of quality evaluation standards for emergency nurse specialist（ENS）, we can ensure smooth operations and quality training for ENS.Methods： First, the frame structure of indicators was designed on the basis of system theory and the balanced scorecard method. Meanwhile, corresponding quantitative standard indicators were compiled through literature analysis and a review of training characteristics. Next, screening indicators were collected through consultation with experts and statistical calculations. The indicators weight coefficient was calculated using the analytic hierarchy process（AHP）. Finally, indicators were validated in two groups of nurses in two different training courses.Results：（1） We created a three-level indicator system： level-Ⅰ dimensions have 4 indicators, while level-Ⅱ dimensions and level-Ⅲ dimensions have 13 and 34 indicators, respectively;（2） The coefficient of expert＇s judgment is 0.840, familiarity is 0.914 and authority is 0.877, and the three rounds of coordination coefficient are 0.456, 0.553 and 0.715, respectively;（3） There are at least 56 indicators in alternative quantitative standards; and（4） The alpha reliability value of the indicator system in the two training course had no significant difference（P 〉 0.05）. The same result was observed when examining two groups of nurses in one training course（P 〉 0.05）.Conclusions： This study established a training system of quality evaluation standards for emergency nurse specialists that is objective, reliable, easy to operate and representative according to scientific selection and verification. This system can therefore provide a basis for quality evaluation and targeted improvement for ENS training in addition to promoting health.

The effect of the quality of vital sign recording on clinical decision making in a regional acute care trauma ward

Purpose： Recording vital signs is important in the hospital setting and the quality of this documentation influences clinical decision making. The Modified Early Warning Score （MEWS） uses vital signs to categorise the severity of a patient＇s physiological derangement and illustrates the clinical impact of vital signs in detecting patient deterioration and making management decisions. This descriptive study measured the quality of vital sign recordings in an acute care trauma setting, and used the MEWS to determine the impact the documentation quality had on the detection of physiological derangements and thus, clinical decision making. Methods： Vital signs recorded by the nursing staff of all trauma patients in the acute care trauma wards at a regional hospital in South Africa were collected from January 2013 to February 2013. Investigator- measured values taken within 2 hours of the routine observations and baseline patient information were also recorded. A MEWS for each patient was calculated from the routine and investigator-measured observations. Basic descriptive statistics were performed using EXCEL Results： The details of lgl newly admitted patients were collected. Completion of recordings was 81% for heart rate, 88~; for respiratory rate, 98~; for blood pressure, 92% for temperature and 41~ for GCS. The recorded heart rate was positively correlated with the investigator＇s measurement （Pearson＇s correlation coefficient of 0.76）; while the respiratory rate did not correlate （Pearson＇s correlation coefficient of 0.02）. In 59~ of patients the recorded respiratory rate （RR） was exactly 20 breaths per minute and 27~ had a recorded RR of exactly 15. Seven percent of patients had aberrant Glasgow Coma Scale readings above the maximum value of 15. The average MEWS was 2 for both the recorded （MEWS（R）） and investigator （MEWS（1）） vitals, with the range of MEWS（R） 0-7 and MEWS（1） 0-9. Analysis showed 59% of the MEWS（R） underestimated the physiological derangement （scores were lower than the MEWS（1））; 80%; of patients had a MEWS（R） requiring 4 hourly checks which was only completed in 2%;; 86% of patients had a MEWS（R） of less than three （i.e. not necessitating escalation of care）, but 33% of these showed a MEWS（1） greater than three （i.e. actually necessitating escalation of care）. Conclusion： Documentation of vital signs aids management decisions, indicating the physiological derangement of a patient and dictating treatment. This study showed that there was a poor quality of vital sign recording in this acute care trauma setting, which led to underestimation of patients＇ physi- ological derangement and an inability to detect deteriorating patients. The MEWS could be a powerful tool to empower nurses to become involved in the diagnosis and detection of deteriorating patients, as well as providing a framework to communicate the severity of derangement between health workers. However, it requires a number of strategies to improve the quality of vital sign recording, including continuing education, increasing the numbers of competent staff and administrative changes in vital sign charts.