Barriers and Enablers to Implementing a High-Dependency Care Model in Pediatric Care: A Preimplementation Study.

Abstract:

BACKGROUND:As the level of acuity of pediatric hospital admissions continues to increase, additional pressure is being placed on hospital resources and the nursing workforce. LOCAL PROBLEM:Currently, there is no formalized approach to care for high-acuity patients on our pediatric inpatient unit. METHODS:We used a qualitative descriptive design, guided by the Theoretical Domains Framework and Capability, Opportunity, Motivation-Behaviour (COM-B) model, to conduct focus groups and interviews with clinicians and administrators to identify potential barriers and enablers to implementing a high-dependency care (HDC) model. An HDC model focuses on the relationship between adequate nursing staff resources and patient acuity to improve patient health outcomes. RESULTS:Participants identified the need for clear guidelines and supportive physical structures to facilitate HDC implementation. Anticipated benefits included enhanced nursing confidence and family-centered care. CONCLUSIONS:Study findings highlight multilevel factors to consider prior to implementing an HDC model on a pediatric inpatient unit.

journal_name

J Nurs Care Qual

authors

Cassidy C,MacEachern L,Egar J,Best S,Foley L,Rowe ME,Curran J

doi

10.1097/NCQ.0000000000000398

subject

Has Abstract

pub_date

2019-10-01 00:00:00

pages

370-375

issue

4

eissn

1057-3631

issn

1550-5065

journal_volume

34

pub_type

杂志文章
  • The Nursing Outcomes Classification.

    abstract::The Nursing Outcomes Classification (NOC) is a comprehensive taxonomy of patient outcomes influenced by nursing care. Each outcome is stated as a variable concept measured on a five-point Likert scale and includes a definition, indicators, and references. The classification provides outcomes that can be used across th...

    journal_title:Journal of nursing care quality

    pub_type: 杂志文章,评审

    doi:10.1097/00001786-199806000-00005

    authors: Johnson M,Maas M

    更新日期:1998-06-01 00:00:00

  • Critical care nurses' perceptions of patient safety in Turkey.

    abstract::This study explored 150 critical care nurses' perceptions of patient safety standards in a selection of private, public, and university hospitals in Turkey. Quality management and patient safety programs were more prevalent in private hospitals. Private hospitals were also more likely to encourage reporting, have erro...

    journal_title:Journal of nursing care quality

    pub_type: 杂志文章

    doi:10.1097/01.NCQ.0000336677.56089.24

    authors: Badir A,Herdman EA

    更新日期:2008-10-01 00:00:00

  • Sepsis in Home Health Care: Screening, Education, and Rapid Triage.

    abstract:BACKGROUND:A majority of sepsis cases originate in the home and community. Home health clinicians play an important role in the early identification and timely treatment of sepsis. LOCAL PROBLEM:A home health care provider sought to prevent hospital readmissions due to sepsis by implementing a sepsis-screening protoco...

    journal_title:Journal of nursing care quality

    pub_type: 杂志文章

    doi:10.1097/NCQ.0000000000000525

    authors: Chimenti C,Sears G,McIntyre J

    更新日期:2020-10-19 00:00:00

  • Effect of an audit and feedback intervention on hospitalized oncology patients' perception of nurse practitioner care.

    abstract::Although patient satisfaction has been used traditionally as a measure of excellence, research has suggested that the perception of being well cared for is likely a more promising indicator of quality than satisfaction alone. Expectations, physical environment, communication, participation and involvement, technical c...

    journal_title:Journal of nursing care quality

    pub_type: 杂志文章

    doi:10.1097/NCQ.0b013e3181b7050d

    authors: Dulko D,Mooney K

    更新日期:2010-01-01 00:00:00

  • Using conformational positioning to reduce hospital-acquired pressure ulcers.

    abstract::Prevention of pressure ulcers is an ongoing concern. This article reports on the evaluation and usage of a new positioning device that adapts to the contours of the body and led to a decrease in the incidence of nosocomial pressure ulcers in a cardiothoracic intensive care unit. ...

    journal_title:Journal of nursing care quality

    pub_type: 杂志文章

    doi:10.1097/NCQ.0b013e3182a79ca9

    authors: Brennan MR,Laconti D,Gilchrist R

    更新日期:2014-04-01 00:00:00

  • Caring in action: the key to nursing service excellence.

    abstract::One of the key factors for organizational success is service excellence. Nursing service has been proved to be a pivotal factor in the overall patient satisfaction rating on hospital surveys. The article describes a service improvement implemented by one nursing service that improved patient satisfaction survey result...

    journal_title:Journal of nursing care quality

    pub_type: 杂志文章

    doi:10.1097/00001786-199610000-00011

    authors: Joiner GA

    更新日期:1996-10-01 00:00:00

  • Study of implementation of a guideline for brief alcohol intervention in primary care.

    abstract::Application of research findings to clinical care has been advocated to improve quality of care and patient outcomes. This article discusses a method to evaluate the translation of research findings in support of evidence-based care. An exemplar of a brief intervention in primary care for high-risk drinkers is used. ...

    journal_title:Journal of nursing care quality

    pub_type: 杂志文章

    doi:10.1097/NCQ.0b013e3181ace2bc

    authors: Hyman Z,Crosby F

    更新日期:2010-01-01 00:00:00

  • Implementing outcome facilitation teams in an integrated system.

    abstract::Coordination of patient care is the goal; the structure to promote the multidisciplinary plan of care is the unit-based outcome facilitation team. The focus of the team is the outcome achievement for the day, which could include patient education, therapies, or discharge planning. ...

    journal_title:Journal of nursing care quality

    pub_type: 杂志文章

    doi:10.1097/00001786-199902000-00008

    authors: Schifalacqua M

    更新日期:1999-02-01 00:00:00

  • Unannounced JCAHO survey.

    abstract::In general, the unannounced JCAHO survey is a more positive and patient-focused process than surveys in the past. Staff are able to demonstrate and explain what they actually do in their job on a day-to-day basis rather than stating policies. In the continuous survey-readiness process, there is less emphasis on docume...

    journal_title:Journal of nursing care quality

    pub_type: 杂志文章

    doi:10.1097/00001786-200501000-00002

    authors: Comeau E,Lowry D

    更新日期:2005-01-01 00:00:00

  • Clinical Nurse Leader Knowledge Production to Quality Improvement in a Seamless Trajectory: A Participatory Research Approach.

    abstract:BACKGROUND:Health systems are actively implementing Clinical Nurse Leader (CNL)-integrated care delivery across the United States. PROBLEM:However, the CNL model is a complex health care intervention, making it difficult to generate evidence of effectiveness using traditional research frameworks. APPROACH:Participato...

    journal_title:Journal of nursing care quality

    pub_type: 杂志文章

    doi:10.1097/NCQ.0000000000000386

    authors: Bender M,Spiva L,Patrick S,Meffert S,Moton L,Clarke S,Mathis K,Leclerc L,Knotts K,Mount A

    更新日期:2019-10-01 00:00:00

  • Structural empowerment, Magnet hospital characteristics, and patient safety culture: making the link.

    abstract::Nurse managers are seeking ways to improve patient safety in their organizations. At the same time, they struggle to address nurse recruitment and retention concerns by focusing on the quality of nurses' work environment. This exploratory study tested a theoretical model, linking the quality of the nursing practice en...

    journal_title:Journal of nursing care quality

    pub_type: 杂志文章

    doi:10.1097/00001786-200604000-00007

    authors: Armstrong KJ,Laschinger H

    更新日期:2006-04-01 00:00:00

  • Falls prevention at Mayo Clinic Rochester: a path to quality care.

    abstract::Falls prevention is a complex problem. Following in the footsteps of an earlier fall prevention team, the Safe Landings Fall Prevention Team used many strategies for implementing a fall prevention/reduction program. The tactics we used to prevent falls combined with the adoption of a fall assessment risk model are sha...

    journal_title:Journal of nursing care quality

    pub_type: 杂志文章

    doi:10.1097/01.NCQ.0000263103.13934.9b

    authors: Sulla SJ,McMyler E

    更新日期:2007-04-01 00:00:00

  • Gender differences for Rapid After Bypass Back Into Telemetry tract following cardiac surgery.

    abstract::The Rapid After Bypass Back Into Telemetry program is based on a simple clinical algorithm to predict same-day transfer of patients to the cardiac telemetry unit following cardiac surgery. This program proved to be an excellent predictor for decreased postoperative complications, shorter intensive care unit and hospit...

    journal_title:Journal of nursing care quality

    pub_type: 杂志文章

    doi:10.1097/00001786-200607000-00014

    authors: Halpin LS,Gilliam P,Barnett SD,Ad N

    更新日期:2006-07-01 00:00:00

  • Cardiac health: relationships among hostility, spirituality, and health risk.

    abstract::This study examined hostility, spirituality, and indices of health risk among 100 young, primarily males of Hispanic background. Over half of the subjects were prehypertensive or hypertensive; one third had at least 2 objective risk factors for cardiac disease; and younger participants had lower spirituality scores an...

    journal_title:Journal of nursing care quality

    pub_type: 杂志文章

    doi:10.1097/00001786-200501000-00013

    authors: Sethness R,Rauschhuber M,Etnyre A,Gilliland I,Lowry J,Jones ME

    更新日期:2005-01-01 00:00:00

  • The development of patient safety in Turkey: constraints and limitations.

    abstract::Patient safety is a complex multifaceted issue linked with quality management. Evidence reveals that nurses are pivotal to the success of quality management and patient safety initiatives. There are many studies about patient safety in developed countries, but less is known about nursing care and patient safety in dev...

    journal_title:Journal of nursing care quality

    pub_type: 杂志文章

    doi:10.1097/NCQ.0b013e3181a55872

    authors: Badir A

    更新日期:2009-10-01 00:00:00

  • Clinical paths for cardiac surgery patients: a multidisciplinary approach to quality improvement outcomes.

    abstract::Implementation of clinical paths has resulted in a successful multidisciplinary approach for monitoring quality improvement outcomes in a select group of cardiovascular patients. This article defines clinical paths and explains their development, implementation, and evaluation. It also discusses how variances (which a...

    journal_title:Journal of nursing care quality

    pub_type: 杂志文章

    doi:10.1097/00001786-199404000-00006

    authors: Rudisill PT,Phillips M,Payne CM

    更新日期:1994-04-01 00:00:00

  • Using hospital information systems to manage outcomes.

    abstract::This article discusses techniques used at Staten Island University Hospital to help automate manual data collection for performance improvement reports and outcomes analysis. If data must be collected manually, it is time to take a look at information available in your hospital's information system. ...

    journal_title:Journal of nursing care quality

    pub_type: 杂志文章

    doi:10.1097/00001786-199808000-00008

    authors: Johnson DI,Mooney K,DiStefano M,Sullivan M,Haber D,Kalriess G

    更新日期:1998-08-01 00:00:00

  • The interdepartmental ticket (IT) factor: enhancing communication to improve quality.

    abstract::This article presents the implementation and 1-year evaluation of a staff nurse-driven initiative addressing a Joint Commission patient safety imperative to improve the consistency of handoff communication. An interdepartmental ticket was developed and implemented through a planned process. The interdepartmental ticke...

    journal_title:Journal of nursing care quality

    pub_type: 杂志文章

    doi:10.1097/NCQ.0b013e31824f0e3b

    authors: Roberts M,Putnam J,Raup GH

    更新日期:2012-07-01 00:00:00

  • A Roadmap for Practice-Based Evidence: Validation of the Hester Davis Fall Risk Scale.

    abstract:BACKGROUND:To ensure successful integration and implementation of evidence into practice, validation of measures and interventions should be performed in the population and setting in which they will be used. PURPOSE:This article provides a method for evaluating the predictive performance of a risk tool using the Hest...

    journal_title:Journal of nursing care quality

    pub_type: 杂志文章

    doi:10.1097/NCQ.0000000000000503

    authors: Kaiser J,Wills N,Reilly T,Pratt J,Tumbleson V,Niemeyer M,Mindling G

    更新日期:2020-07-10 00:00:00

  • Higher Quality of Care and Patient Safety Associated With Better NICU Work Environments.

    abstract::The objective of this study was to investigate the associations between the neonatal intensive care unit (NICU) work environment, quality of care, safety, and patient outcomes. A secondary analysis was conducted of responses of 1247 NICU staff nurses in 171 hospitals to a large nurse survey. Better work environments w...

    journal_title:Journal of nursing care quality

    pub_type: 杂志文章

    doi:10.1097/NCQ.0000000000000146

    authors: Lake ET,Hallowell SG,Kutney-Lee A,Hatfield LA,Del Guidice M,Boxer BA,Ellis LN,Verica L,Aiken LH

    更新日期:2016-01-01 00:00:00

  • Nurses' perceptions of and factors promoting patient safety culture in Turkey.

    abstract::This descriptive and cross-sectional study included 561 nurses in hospitals located in Istanbul, Turkey. The Patient Safety Questionnaire was used for data collection. The type of hospital and the amount of education nurses obtained about patient safety and quality improvement were positively associated with patient s...

    journal_title:Journal of nursing care quality

    pub_type: 杂志文章

    doi:10.1097/NCQ.0b013e31828b1a81

    authors: Turkmen E,Baykal U,Intepeler SS,Altuntas S

    更新日期:2013-10-01 00:00:00

  • Incorporating bedside report into nursing handoff: evaluation of change in practice.

    abstract::Nursing shift report on the medical-surgical units of a large teaching hospital was modified from a recorded report to a blend of both recorded and bedside components. Comparisons between baseline and postimplementation data indicated increased patient satisfaction and nurse perception of accountability and patient in...

    journal_title:Journal of nursing care quality

    pub_type: 杂志文章

    doi:10.1097/NCQ.0b013e31827a4795

    authors: Sand-Jecklin K,Sherman J

    更新日期:2013-04-01 00:00:00

  • STABLE: an acronym for managing the observation-status patient.

    abstract::Ever rising patient acuity, new nursing staff practitioners, and cumbersome documentation processes potentially impact quality of care. Nurse managers are challenged to utilize creative strategies to minimize risk potential and improve patient outcomes. One 36-bed medical/ surgical/telemetry unit focused on improving ...

    journal_title:Journal of nursing care quality

    pub_type: 杂志文章

    doi:10.1097/00001786-200304000-00007

    authors: Horak D,Hollabaugh S,Duffy T

    更新日期:2003-04-01 00:00:00

  • Quality of life after participation in a rural phase II cardiac rehabilitation program.

    abstract::The purpose of this study was to explore the effectiveness of a cardiac rehabilitation program (phase II) in improving participants' quality of life (QOL). Existing data collected previously by a not-for-profit rural community hospital using the SF-36 tool were analyzed. The secondary data consisted of precardiac and ...

    journal_title:Journal of nursing care quality

    pub_type: 杂志文章

    doi:10.1097/00001786-200601000-00012

    authors: Aude T,Hill PD,Anderson MA

    更新日期:2006-01-01 00:00:00

  • Implementing a clinical practice guideline to manage postpartum urinary retention.

    abstract::Postpartum urinary retention is a common condition in obstetric units. A Clinical Practice Guideline was implemented in a high-risk obstetrical unit to decrease variance of clinical practice, rate of postpartum urinary retention, and number of urinary catheterizations and increase awareness of this common condition. G...

    journal_title:Journal of nursing care quality

    pub_type: 杂志文章

    doi:10.1097/NCQ.0000000000000087

    authors: Stanley AY,Conner BT

    更新日期:2015-04-01 00:00:00

  • Using Palliative Care Nurses in a Supportive Care Program to Reduce Hospital Utilization for Patients With Multiple Chronic Conditions.

    abstract:BACKGROUND:Health care organizations are designing comprehensive care programs to reduce hospital utilization by high-risk patients with multiple chronic illnesses. LOCAL PROBLEM:A community hospital recognized patients with multiple chronic conditions had higher rates of inpatient stays and emergency department (ED) ...

    journal_title:Journal of nursing care quality

    pub_type: 杂志文章

    doi:10.1097/NCQ.0000000000000482

    authors: Allen A,Frederick L,Hovey SL

    更新日期:2021-01-01 00:00:00

  • Project SITUP: An Interdisciplinary Quality Improvement Initiative to Reduce Aspiration Pneumonia.

    abstract::The purpose of this quality improvement initiative was to improve oropharyngeal dysphagia screening and reduce aspiration pneumonia rates on 3 inpatient hospital medical units. Guided by a Plan-Do-Study-Act methodology, an interdisciplinary health team developed and implemented a systematic process for oropharyngeal d...

    journal_title:Journal of nursing care quality

    pub_type: 杂志文章

    doi:10.1097/NCQ.0000000000000285

    authors: OʼMalley MB,Trotta RL,Rohrbach J,Ahya V,Bradway C

    更新日期:2018-04-01 00:00:00

  • Using baseline data to improve care of the patient with type 2 diabetes mellitus.

    abstract::Diabetes mellitus affects approximately 16 million people in the United States. Despite the publication of multiple guidelines, the delivery of care has not substantially changed. This article describes a program at Advocate Health Care to improve the delivery of care to individuals with Type 2 diabetes mellitus in an...

    journal_title:Journal of nursing care quality

    pub_type: 杂志文章

    doi:10.1097/00001786-199908000-00002

    authors: Ludwig-Beymer P,Arndt DM

    更新日期:1999-08-01 00:00:00

  • The consumer's role in quality: partnering for quality outcomes.

    abstract::Partnering with the patient in the planning and delivery of care to achieve high-quality outcomes is a goal shared by health care providers. The achievement of a full partnership with the patient often varies based on the communication skills of individual nurses. To provide more consistency, Patient Standards of Care...

    journal_title:Journal of nursing care quality

    pub_type: 杂志文章

    doi:10.1097/00001786-199501000-00010

    authors: Cramer D,Tucker SM

    更新日期:1995-01-01 00:00:00

  • Improving patient outcomes in a dialysis unit: an integrated approach to CQI.

    abstract::Continuous quality improvement (CQI), staff education, and patient education are essential, interrelated components of nursing practice that share the common goal of improved patient outcomes. The nurses of the Nashville Veterans' Administration Medical Center dialysis unit effectively combined these activities to imp...

    journal_title:Journal of nursing care quality

    pub_type: 杂志文章

    doi:10.1097/00001786-199410000-00007

    authors: Heard K

    更新日期:1994-10-01 00:00:00