scholarly journals Sustained Improvement in Antibiotic Stewardship in Acute Pancreatitis Mediated by Targeted Electronic Medical Record Based Communication-Lessons from a Quality Improvement Project

2020 ◽  
Vol 159 (2) ◽  
pp. e34
Author(s):  
Kevin Kline ◽  
Felippe O. Marcondes ◽  
Jorge N. Castillo ◽  
Ronald Samuel ◽  
Kevin Brown ◽  
...  
2020 ◽  
Vol 37 (3) ◽  
pp. 195-203
Author(s):  
Anna Evans ◽  
Mary Beth Vingelen ◽  
Candy Yu ◽  
Jennifer Baird ◽  
Paula Murray ◽  
...  

Purpose: Chemotherapy-induced nausea and vomiting (CINV) is a distressing, underrecognized effect of treatment that can occur in up to 80% of patients. The purpose of this quality improvement project was to evaluate the impact of implementation of a standardized nausea assessment tool, the Baxter Animated Retching Faces (BARF) scale, on nursing compliance with nausea assessment and the frequency and severity of patient-reported CINV for children with cancer. Method: The Plan-Do-Study-Act cycle was used to implement this practice change. With stakeholder support and hospital governance council approval, the BARF scale was introduced into the electronic medical record. Nurses were provided education about the assessment tool and were given badge buddy cards to prompt use of the tool, and workstation reminders were created. A root cause analysis was conducted to provide feedback for continuous quality improvement. Results: Retrospective, aggregate electronic medical record data from May 2018 to April 2019 were analyzed for assessment compliance, total number of admissions with vomiting episodes, and average BARF score. Over the 12-month implementation period, run charts demonstrated a shift in nursing practice with increased compliance in documented nausea assessments during the second 6-month period. There was not a significant decrease in patient-reported CINV. Conclusion: The use of standardized nausea assessments based on patient self-reporting can provide useful and consistent feedback for nurses and health care providers. This quality improvement project demonstrated increased compliance with nausea assessment documentation. Further studies are needed to demonstrate that improvements in nausea assessment may reduce the frequency and severity of CINV.


Author(s):  
Edgar R Miller ◽  
Haitham Alzahrani ◽  
Daniel Bregaglio ◽  
Jon Christensen ◽  
Sarah Palmer ◽  
...  

Abstract Background Low-cost, automated interventions that increase knowledge and skills around diet and lifestyle modifications are recommended for cardiovascular disease risk reduction. Methods We initiated a quality improvement program to assess the impact of a web-based diet and lifestyle intervention utilizing short animated videos in adults with high blood pressure (BP) at a primary care clinic in Saudi Arabia. We enrolled adults with elevated BP, not on BP medications, who were identified using the electronic medical record. We delivered a web-linked diet and lifestyle intervention using animated videos covering diet and lifestyle topics. Videos and reminders were sent weekly for five weeks. Outcomes were proportion who engaged in the program, returned for a repeat BP within 3-months, and change in BP. Results We enrolled 269 adult participants, with a mean (SD) age of 41.6 (12.4) years; 77% were male. At the conclusion of the pilot, we demonstrated a high level of engagement: overall, 69% of materials were viewed and 67% of patients returned for BP. Patients who returned, had a mean (SD) baseline systolic BP of 138.0 (7.2) mmHg and a large mean reduction in SBP from baseline: -10.5 mmHg (12.4; P<0.001). Conclusions In this quality improvement project, a video-assisted, web-based, diet and lifestyle intervention had a high participation rate and a high return rate for reassessment of BP. While these findings suggest that this low-cost, automated intervention may have a great potential as a scalable support tool, randomized trials are needed in order to document its effectiveness.


Sign in / Sign up

Export Citation Format

Share Document