Friday, March 31, 2006

YSN Library April 3 - April 7

Here is the schedule for when I will be at YSN for this week.
Questions, comments, concerns? .... please email me

Monday 4/3
8:00- 5:00

Tuesday 4/4
See me in Medical Library for assistance - 737-2964
Class 12:00 - 1:00 RefWorks Basics

Wednesday 4/5
See me in Medical Library for assistance - 737-2964
Class: 7:00-8:00 PowerPoint Basics

Thursday 4/6
See me in Medical Library for assistance - 737-2964
Class: 4:00-5:00 EndNote Basics

Friday 4/7
8:30 - 1:00

Needlestick Injuries

In response to a rise in the number of needlestick injuries in its OR, Connecticut-based Hartford Hospital conducted a study to determine and better understand staff members’ perceived barriers to safety and discovered that communication problems with physicians and feelings of powerlessness among nursing staff were lead factors. The study, led by perioperative services nurse educator Andrea Hagstrom, prompted the formation of a staff-led safety committee and a physician-led initiative to gain practice change buy-in. The efforts have empowered nurses to enforce the new safety practices and improved the hospital’s needlestick injury rates.

Immediately following the passage of the Needlestick Safety and Prevention Act, Hartford Hospital updated its needlestick safety procedures and experienced a decrease in related injuries. However, needlestick injury rates began to worsen after the initial safety blitz, especially in the OR, where 33% of hospitalwide needlestick injuries occurred in the first quarter of 2004, compared with 25% in 2002. In a continued effort to reduce needlestick injuries, Hartford in 2004 implemented a hospitalwide campaign to promote a newer type of safety needle, including inservices on how to use it. However, physician compliance with the new policy was lower in the OR than in other areas of the hospital, and nurses “felt that surgeons were not aware that we were trying to implement a new practice,” Hagstrom said. As a result, Hagstrom decided to study staff perceptions to pinpoint the reasons for the problem. After gaining approval for the study from the hospital’s institutional review board and apprising hospital leaders of the project, Hagstrom gathered a group of five perioperative RNs and seven certified surgical technologists to participate in focus group discussions. During four one-hour sessions, Hagstrom asked participants to describe their risk of exposure to needlestick injuries in the OR, their power to implement practice changes to prevent needlestick injuries, and their perceived barriers to successful practice changes.

Barriers included:
  • inadequate horizontal and vertical communication,
  • powerlessness,
  • resistance to change,
  • intimidation,
  • inconsistencies in practice,
  • negative attitudes,
  • inexperience of medical and nursing staff members, and
  • time constraints.
In addition to forming the Sharps Safety Committee, Hagstrom has targeted physicians’ resistance to practice change with robust quantitative and qualitative reports to the OR’s leading physician group. Hagstrom noted that she did not gain much support when she first went to the group with needlestick injury data a year and a half ago. But she said she persisted “like a dog with a bone” to bring the compliance issue to the forefront of the physicians’ agenda. Once Hagstrom brought the results of her own research and an extensive literature search—including information from the Occupational Safety and Health Administration—the physicians heeded her call for change. The physicians group has since started needlestick safety education projects of its own, stressing the topic in mass communication to physicians and inviting Hagstrom to present more information almost quarterly. Because these efforts were “generated within their community,” OR surgeons have increased compliance with safety procedures, and sharps injuries in the OR have decreased, Hagstrom said. However, she noted that more research must be done to ascertain just how effective these efforts have been in addressing needlestick safety.

To see the full article:
Andrea M. Hagstrom (2006). Perceived Barriers to Implementation of a Successful Sharps Safety Program. AORN Journal. 83(2):391-397.

Thursday, March 30, 2006

AHRQ's Audio Series on Quality

AHRQ has posted two new audio special reports as part of the Healthcare411 series, called "Quality 101."

These are interviews with AHRQ Director Carolyn M. Clancy, M.D., on such topics as "Understanding Health Care Quality," "Questions to Ask Before Surgery," and "How to Get the Most out of a Visit with Your Health Care Professional."

The latest are "Next Steps After Diagnosis," based on the consumer booklet on this topic, and "What is Patient Safety," produced for Patient Safety Awareness Week held early in March.

Each audio is about 15 minutes long. Transcripts also are also available from the site.

Wednesday, March 29, 2006

Guideline: Evaluation of Syncope

For the latest guideline on evaluating syncope:

AHA/ACCF Scientific Statement on the evaluation of syncope: from the American Heart Association Councils on Clinical Cardiology, Cardiovascular Nursing, Cardiovascular Disease in the Young, and Stroke, and the Quality of Care and Outcomes Research Interdisciplinary Working Group; and the American College of Cardiology Foundation: in collaboration with the Heart Rhythm Society: endorsed by the American Autonomic Society. Circulation 2006 Jan 17;113(2):316-27.

Tuesday, March 28, 2006

U.S. Surgeon General's Family History Initiative

This web-based tool helps users organize family history information and then print it out for presentation to their family doctor. In addition, the tool helps users save their family history information to their own computer and even share family history information with other family members.

To see the tool go to the Health and Human Services webpage:
My Family Health Portrait Download

Monday, March 27, 2006

'Critical Path' Projects Aim to Advance Product Innovation

As part of its Critical Path initiative, FDA has released a list of 76 high-priority research projects designed to modernize and advance medical product development. The program aims to bring medical innovations to patients faster and at a lower cost. As part of the initiative, FDA and the Critical Path Institute have formed a consortium with five drug companies to share information that will help predict the safety of new treatments before they are tested in humans.

Friday, March 24, 2006

YSN Library March 27 - March 31

Here is the schedule for when I will be at YSN for this week.
Questions, comments, concerns? .... please email me

Monday 3/27

Tuesday 3/28
See me in Medical Library for assistance - 737-2964
Class 12:00 - 1:00 RefWorks Basics

Wednesday 3/29
10:30 - 5:00
Class: 7:00-8:00 PowerPoint Basics

Thursday 3/30
See me in Medical Library for assistance - 737-2964
Class: 4:00-5:00 EndNote Basics

Friday 3/31
8:30 - 5:00

Social Insurance

"Americans have been urged for several decades to view Social Security and Medicare as political relics--both unaffordable and unfair in light of contemporary demographic and fiscal circumstances and the practices of modern financial markets and modern medicine. Proposals abound for "modernizing" both systems to emphasize choice, competition, and individual ownership. This paper contends that critics of Social Security and Medicare have misanalyzed the problems of both programs and are urging misdirected reforms. The critics, we argue, are often wrong factually and sometimes confused conceptually. More fundamentally, these critiques and proposals are either ignorant of or hostile to the fundamental logic of social insurance."

To see the full article:
Marmor TR, Mashaw JL. (2006) Understanding Social Insurance: Fairness, Affordability, And The 'Modernization' Of Social Security And Medicare. Health Aff (Millwood). Mar 21; [Epub ahead of print] PMID: 16551642

Monday, March 20, 2006

New look Blog

A technical glitch hit my old blog, and whenever I posted a new blog, the posting would not show up. Enjoy the new look!

Here is the link to the old blog should you wish to revisit any information on it.

Janene's Blog

Friday, March 17, 2006

YSN Library March 20 - March 24

Here is the schedule for when I will be at YSN for this week.
Questions, comments, concerns? .... please email me

Monday 3/20

Tuesday 3/21

Wednesday 3/22
1:30 - 5:00
Class: 4:00-5:00 EndNote Basics

Thursday 3/23
See me in Medical Library for assistance - 737-2964
Class: 5:00-6:00 RRS & Blogs
Class 7:00 - 8:00 RefWorks Basics

Friday 3/24
8:30 - 5:00