What Do CQI Leaders Think about the Status of Quality Care?

Quality ImprovementWelcome back guest blogger, Anita Finkelman, author of Quality Improvement: A Guide for Integration in Nursing, for a new post in the Finding Your Way in Continuous Quality Improvement series.

On November 11 2016, the Institute for Healthcare Improvement (IHI) published an interview with a video of Donald Berwick, MD, who is one of our experts in quality care. The interview is entitled: To Me, Safety Fatigue Would Be Like Breathing Fatigue or Heart Beat Fatigue.

This is an important and interesting interview (text and video). I will highlight a few of the comments, but this video offers students the opportunity to hear an honest and direct appraisal of CQI—pluses and minuses. Students could be asked to view individually and the write up their comments, or it could be shown in the classroom followed by open discussion. Dr. Berwick has been a major leader in CQI for many years and for a short time served as Director of the Centers for Medicare and Medicaid Services. He led the development of the IHI for many years. This is a significant time to discuss quality care status with the potential of changes in ACA due to the new presidential election along with other potential changes that may occur. Some major quality improvement provisions are included in the ACA so one might wonder if they will be impacted, for example, establishment of the first national overall initiative on quality care, the National Quality Strategy, and the Patient-Outcomes Research Institute (PCORI). So we do need to be alert to changes, but also where are we now.

Some points Dr. Berwick makes to “entice you” to listen to the interview or read the text of the interview—there is much more said about each of these comments as well as other topics discussed.

  • Patient safety fatigue has become a problem. Just keep going from one CQI project to the next, with little systematic thought and focus is on getting it done to more on.
  • We need to build systems of safety.
  • We focused first on hospital care (for example, the original Institute of Medicine reports focused only on hospital care with two reports on public heath—though mostly examining education needs of healthcare professionals in public health). Now we need to expand to other types of settings—across the care continuum.
  • “The EHR (EMR) story is a good news, bad news story if I ever heard one.”
  • We need to practice informed anticipation.

About the text:

Quality Improvement: A Guide for Integration in Nursing serves as a comprehensive resource for teaching practicing nurses and nursing students about the importance of improving patient care and reducing errors through quality improvement.  The text focuses on the practical aspects of quality improvement and the nurse’s role in the process, while acknowledging the importance of an inter-professional approach.  In addition, it focuses on the current state of healthcare quality in the US, critical trends in preventing errors, data, analysis, and planning and implementing change to reach improvement. The author connects quality improvement to technology and the role of the patient while emphasizing the importance of engagement and nursing leadership. Learn more at our website.

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Review: Quick Reference for the Lactation Professional, Second Edition “provides excellent up-to-date information”

Quick Reference for the Lactation Professional, Second EditionGreat news to share– Quick Reference for the Lactation Professional, Second Edition by Judith Lauwers just received a 4-star review. According to Judy M. Comeaux, DNP, ARNP/PNP,CRNI, from the University of North Florida Brooks College of Health, writing for Doody’s Review Service,

“This book is well written, easy to read, and organized. [It] provides excellent up-to-date information related to breastfeeding and lactation support, not only for the novice but also for the expert.”

Quick Reference for the Lactation Professional, Second Edition is an easy-to-use resource for healthcare professionals working with breastfeeding women and their families. An invaluable tool for clinicians, educators, students, and interns, each chapter includes clinical management strategies, key clinical competencies, and tutorials that test comprehension and clinical application with short answer questions and counselling scenarios.

Completely updated and revised, the Second Edition incorporates inclusive language throughout to provide an equal and diverse approach to assisting breastfeeding families.

Find out more at our website.

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Review: Care of the Well Newborn “is a very useful reference”

Care of the Well NewbornAs the first text of its kind, Care of the Well Newborn by B.J. Snell and Sandra L Gardner focuses on care of the term newborn for the first month of life. In a new review, Sherita K. Etheridge, MSN, from the University of Alabama at Birmingham, writing for Doody’s Review Service calls it,

“…a very useful reference specific to newborns. It offers more detailed information for this population than most maternal-child books.”

Written by distinguished experts in the field, Care of the Well Newborn teaches students and professionals how and what to assess in the care of the nonverbal newborn, while also providing criteria for recognizing deviations from normal and strategies for managing complications that arise. It provides easily accessible information on evidence-based neonatal care that follows current guidelines, standards, and recommendations.

  • Explores physiology and pathophysiology, data collection, differential diagnosis, cultural considerations, and parental education
  • Ideal resource for both students and professionals
  • Each chapter includes multiple choice questions, case studies, or activities to facilitate critical thinking and learning

Learn more and preview a sample chapter at our website.

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Review praises the “unique” Perianesthesia Nursing Care: A Bedside Guide for Safe Recovery, Second Edition

Perianesthesia Nursing Care, Second EditionThe good reviews are already coming in for Perianesthesia Nursing Care: A Bedside Guide for Safe Recovery, Second Edition by Daphne Stannard and Dina A. Krenzischek. In a new review, Linda K. Connelly, PhD, MSH, ARNP, CNOR, from the University of North Florida Brooks College of Health, writes for Doody’s Review Service that,

“This book is unique in its focus on nurses caring for perianesthesia patients across all venues where nursing care is delivered. The question-answer format makes it easy to read…”

Perianesthesia Nursing Care: A Bedside Guide for Safe Recovery, Second Edition is an essential reference for clinicians caring for perianesthesia patients in a variety of situations, such as in a preop and postanesthesia care unit (PACU), an intensive care unit (ICU), a procedural recovery area, or on a labor and delivery unit. Ideal for perianesthesia nursing orientation and perioperative cross-training programs, it is also a valuable tool for nursing students preparing to sit for the Certified Post Anesthesia Nurse (CPAN) and Certified Ambulatory Perianesthesia Nurse (CAPA) certification examinations.

  • Contributions from leading experts
  • Addresses common clinical issues, population-specific knowledge, and surgery-specific knowledge
  • New chapter on trauma, an increased emphasis on non-OR areas, and an extended focus on pediatric patients

Would you like to learn more? Just visit our website.

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5-Star Review for Breastfeeding and Human Lactation, Enhanced Fifth Edition

Breastfeeding and Human Lactation, Enhanced Fifth EditionBusy lactation consultants rely on the latest clinical techniques and research findings in Breastfeeding and Human Lactation, Enhanced Fifth Edition by Karen Wambach and Jan Riordan. In a recent 5-star review, Judy M. Comeaux, DNP, ARNP/PNP, CRNI, from the University of North Florida Brooks College of Health, writing for Doody’s Review Service raves that it,

“… presents up-to-date information…and is well written and organized, making it easy to read. The focus on evidence-based information and clinical practice supports current recommendations by the healthcare community.”

Thoroughly updated and revised with current research, references, and photos, Breastfeeding and Human Lactation, Enhanced Fifth Edition contains a clear clinical focus with more than 2,000 research studies supporting the clinical recommendations found in the text.

  • Topics include placing breastfeeding in its historical context, workplace-related issues, anatomical and biological imperatives of lactation, the prenatal and perinatal periods and concerns during the postpartum period, the mother’s health, and sociocultural issues
  • Contributions from the foremost experts in the field
  • Excellent resource to prepare for certification and practice as an International Board Certified Lactation Consultant (IBCLC)

Visit our website to learn more and preview a sample chapter.

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2017 Nursing Catalog Now Available

2017 nursing catalog cropWe can’t wait for you to see all we have in store for 2017. Our just released 2017 Nursing catalog features the latest and greatest Jones & Bartlett Learning Nursing titles and digital products.

“We pride ourselves on providing content that spans all levels and specialties. In the last ten years, we have expanded our products to offer more resources for undergraduate students, including in-depth ancillary packages, while simultaneously becoming the leading provider of doctoral-level nursing education material. We have maintained a focus on cultivating our professional development resources for nurse educators, staying ahead of trending educational methodologies, while continuing to expand our practical references for bedside nurses charged with doing more with less. We have made exciting new strides in women’s health and midwifery, areas near and dear to our hearts, while furthering our use of technology to provide more robust learning experiences and reference tools for all customers.” – Amanda Martin, Executive Editor, Jones & Bartlett Learning

The 2017 Nursing catalog features:

  • New product offerings for Nursing Informatics, Nursing Education, Pathophysiology, Leadership, Nurse Practitioners, Women’s Health, and more
  • New Undergraduate and Graduate Online Course offerings
  • New Custom Learning Solutions offerings for Nursing
  • Which conferences we’ll be attending in 2017

What are you waiting for? Download your copy of the 2017 Nursing catalog today.

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Finding Your Way in Continuous Quality Improvement

Quality ImprovementPlease welcome guest blogger, Anita Finkelman, author of Quality Improvement: A Guide for Integration in Nursing, for a new series on quality improvement.

A Beginning: Our Blog

Welcome to the blog Finding your Way in Continuous Quality Improvement! I am going to refer to “quality improvement” as CQI (continuous quality improvement). Upfront, let’s recognize that not only is healthcare a mixed up, changing area but so is CQI—and a new area. I like to use Alice in Wonderland as a background setting to set my mind around the topic of CQI. Why Alice? It actually is not an uncommon source used in leadership and management, but it has implications for CQI, too.

Alice in Wonderland provides a window into a world that is confusing, often viewed as nonsense; where language and terminology are not clear. There is lack of clarity as to who characters are and what they do. They change, and time is not always based on reality. One of the main characters, the Red Queen, makes it clear that you cannot expect to improve if you allow the status quo to continue. Alice, the main character, struggles in this world to find her way, as if in a maze, not knowing where to go or what her destination may be. Alice is full of questions as she tries to make Wonderland clearer to herself and engage others in Wonderland. She does discover that to be shown something improves her understanding. “What is the use of a book,” thought Alice, “without pictures and conversation.” Alice also comments on change, “How puzzling all these changes are! I’m never sure what I’m going to be, from one minute to another.”

So here we are at the beginning—working on making CQI clearer for us and for our students. We want to prepare our students for the real world, as confusing as it might be. We want them to be practicing nurses who engage in CQI.  I will attack various topics for us to consider as we facilitate effective learning and hopefully effective practice and quality care. A dialogue improves our understanding.

What, Another Medication Error?

Medication errors happen every day—and there is much variety in the types and circumstances. Why do we start here? Nurses administer medications. Learning how to do this safely is probably the most critical early learning activity for nursing students. As students get into the clinical area more and more issues come out about medication—increasing risk. What can we do about this?

Getting to Some Solutions

We are busy as faculty. Developing teaching-learning materials take time. As we well know, we sometimes tend to reinvent the wheel or feel we have to start from scratch. I am here to tell you we have a wealth of resources available to us—AND I am sure sharing with colleagues would also go a long way to expedite this prep work and lead to more effective learning.

To begin we must keep at the forefront, at all times, that health care has moved away from the Blame Environment. We know what this is—you make a medication error, and you are blamed with little consideration given to all of the many, many factors that might have led to that error in the system and with individuals. This blog posting is not directed at this major change in error response to a Culture of Safety, but it is important to remember it so that we know this is an overall perspective of errors that now impacts the learning experience.

There are many resources available to us from government resources and through other organizations. I want to begin by highlighting several and what how you might use them.

An Ongoing Update in Medication Administration

We begin with a great resource from the Institute for Safe Medication Practices (ISMP) (http://ismp.org/). This website is rich with resources for us. It not only provides resources but also an update on FDA alerts. For example, here is a list of the tools it features:

  • Special Error Alerts
  • High Alert Medications
  • Confused Drug Name List
  • Error-Prone Abbreviations List
  • Names with Tall Man Letters—to avoid errors with look-alike drugs

Check out the tools on the main website at http://ismp.org/.

An important option on this website: Sign-up for the free Nurse Advise-ERR. This electronic newsletter provides you with resources for effective facilitation of learning about medication administration.

What can you do with these resources? They can be used to provide examples and guidelines that you can incorporate in the cases you develop for students that might be used for individual assignments or team assignments. It is critical to incorporate this type of information in simulation as students engage in learning about medications and administration of medications. Even after they learn about the basics of incorporating them in complex simulation experiences we must remind students that learning about medications and administration of medications is an ongoing process. Students can also be directed to the ISMP website and asked to describe how they might use this information source. These resources are important to us as they reflect current concerns about medications based on evidence from practice and research.

Another resource is the Agency for Healthcare Research and Quality, Patient Safety Network (AHRQ, PSNet). Its Patient Safety Primers offer resources on patient safety, including medication administration, for example, https://psnet.ahrq.gov/primers/primer/23.

Also, when you open the home page at https://psnet.ahrq.gov/ you find a list of current references that are highlighted and abstracts are provided. The topics cover the areas of patient safety, and thus some often relate to medication administration and medications.

This ends our blog for now. What do you do to engage students in the critical need to provide safe and effective medications? How might you use some of these resources to update or change your teaching-learning strategies?

About the text:

Quality Improvement: A Guide for Integration in Nursing serves as a comprehensive resource for teaching practicing nurses and nursing students about the importance of improving patient care and reducing errors through quality improvement.  The text focuses on the practical aspects of quality improvement and the nurse’s role in the process, while acknowledging the importance of an inter-professional approach.  In addition, it focuses on the current state of healthcare quality in the US, critical trends in preventing errors, data, analysis, and planning and implementing change to reach improvement. The author connects quality improvement to technology and the role of the patient while emphasizing the importance of engagement and nursing leadership. Learn more at our website.

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Jones & Bartlett Learning Wins Six AJN 2016 Book of the Year Awards

BOTY-seal-2016-GoldWe are so proud to share that we have garnered six prestigious 2016 AJN Book of the Year Awards. Representing the best in nursing publishing, the awards recognize the most valuable texts published between August 2015 and August 2016. Jones & Bartlett Learning recipients include:

Awarded first place: Pharmacology for Women’s Health, Second Edition by Mary C. Brucker and Tekoa L. King in the Maternal-Child Health category

Awarded second place: Clinical Nursing Calculations by Susan Sienkiewicz and Jennifer F. Palmunen in the Medical-Surgical Nursing category and Transition from Clinician to Educator: A Practical Approach by Maria C. Fressola and G. Elaine Patterson in the Nursing Education/Continuing Education/ Professional Development category

Awarded third place: Breastfeeding Management for the Clinician: Using the Evidence, Fourth Edition by Marsha Walker in the Maternal-Child Health category, Leadership for Evidence-Based Innovation in Nursing and Health Professions by Sandra Davidson, Daniel Weberg, Tim Porter-O’Grady, and Kathy Malloch in the Nursing Education/Continuing Education/ Professional Development category, and Advanced Nursing Research: From Theory to Practice, Second Edition by Ruth M. Tappen in the Nursing Research category

Read the full press release.

“Jones & Bartlett Learning is quite humbled by the outcome of the AJN 2016 Book of the Year Awards. We are so honored to have been provided distinction for six of our publications in the areas of Maternal-Child Health, Medical-Surgical Nursing, Nursing Education & Professional Development, and Nursing Research. To be grouped among the best in nursing publishing in these subject areas is a testament to the hard work and dedication of our authors and our publishing team. Receiving these prestigious awards not only confirms the value of our work, but also provides inspiration for future contributions to the field. Many thanks to the American Journal of Nursing for their continued support of publishing in nursing.” – Amanda Martin, Executive Editor, Jones & Bartlett Learning

Pharmacology for Women’s Health, Second EditionPharmacology for Women’s Health, Second Edition is a unique text that discusses pharmacology as it specifically relates to women’s health. Completely updated and revised to reflect the changing field of pharmacology, it includes new pharmacological agents for common conditions, changes in indications, the use of vaccines, updated guidelines from the CDC for treatment of sexually transmitted infections, and the effects of the Affordable Care Act.

Clinical Nursing CalculationsClinical Nursing Calculations is an essential text for teaching dosage calculation to undergraduate nursing students. Using the CASE approach, a step-by-step method for performing dosage calculations, it features all three methods for calculation side-by-side, making it tremendously helpful for students who struggle with math or need a refresher. It covers key topic areas, such as mathematics overview, principles of medication administration, basic dosage and intravenous calculations, and advanced calculations.

Transition from Clinician to EducatorAs the population continues to age and retire, the shortage of qualified nurse educators continues to grow. Simultaneously, student demand is also increasing. In order to address this current and future need, organizations are looking toward practicing clinicians to fill the gap. Transition from Clinician to Educator: A Practical Approach is a hands-on guide to prepare future educators who are entering the world of education.

Breastfeeding Management for the Clinician, Fourth EditionBreastfeeding Management for the Clinician: Using the Evidence, Fourth Edition is an essential and practical reference guide for clinicians. Using a research-based approach, it includes literature reviews while covering incidence, etiology, risk factors, prevention, prognosis and implications, interventions, expected outcomes, care plans, and clinical algorithms. The Fourth Edition provides a new discussion of the vitally important newborn gut microbiome.

Leadership for Evidence-Based Innovation in Nursing and Health Professions Written by healthcare leaders for current and future innovation leaders, Leadership for Evidence-Based Innovation in Nursing and Health Professions addresses the current and emerging issues facing healthcare leaders and practitioners who lead evidence-based innovation. A truly unique text, it systematically addresses innovation and evidence from the perspectives of both a leader and a practitioner within the context of health care.

Advanced Nursing Research, Second EditionAdvanced Nursing Research: From Theory to Practice, Second Edition is an ideal graduate-level text for teaching students how to prepare research proposals and carry out research studies using a practical approach. With a greater emphasis on the connection to evidence-based practice, quality improvement, and the use of aggregate data, the text features a reality-based approach to the actual conduct of research. It also reflects current practice and thinking about research while integrating qualitative and quantitative methods, including emerging mixed methods.

We would like to thank AJN for this outstanding honor!

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Technology – A Disruptor and Catalyst for Change

Leadership for Evidence-Based Innovation in Nursing and Health Professions Welcome back guest blogger, Daniel Weberg, co-author of Leadership for Evidence-Based Innovation in Nursing and Health Professions for a new post on technology.

Although difficult, unraveling the care process across the healthcare system is necessary in order to identify specific areas where technology can enable care for the future and meet the triple aim.  Healthcare systems that scrutinize this process can incorporate technology to decrease cost, improve patient experience, and improve overall population health. To affect change, leaders must be able to lead through ambiguity in order to see the patterns that signal change.  Technology is a disruptor and it can motivate teams to create novel solutions to long held problems like those in the Triple Aim.  The key for any leader is to understand how technology fits in.  It’s seldom the only solution but rather a facilitator and catalyst to systemic change.

Decrease Cost:

  • Improved efficiency by facilitating fewer steps to complete needed care, such as reducing hunting and gathering tasks using real time location technology which allows for time to be spent on care rather than non-value added tasks.
  • Improved decision making through better data. Data analytics and real time decision-making support tools allow frontline care givers to access the right information at the right time for the right care thus optimizing system utilization and caregiver effort.
  • Improved coordination of care through better connections among the care team allows patients to transition through the system seamlessly reducing time, unnecessary testing, and improved patient outcomes.

Improve Patient Experience:

  • Informing the patient and family about their care journey through interactive patient care systems that put the patient at the center of their care and allows for better participation in care options.
  • Intelligent routing of patient requests shifts non-nursing tasks, such as changing the room temperature and ordering lunch, to more appropriate care team members thus improving request follow-through and outcomes.
  • Personalizing care through facilitating patient reported information such as pain level through interactive systems not only when a caregiver rounds on the patient.

Improve Population Health:

  • Social networks that reach beyond the four walls of care and into the patient’s home and everyday life.
  • Remote monitoring that allows care givers to assess and intervene when patterns of vital signs, lab values, and activity indicate the need for outreach when the patient is not in the clinic.
  • Linking hospital care to home care through longitudinal plans of care and shared data from inpatient settings to outpatient follow-up care.

The five categories of technologies described here address multiple areas of improvement:

The five categories of technologies described in this report address multiple areas of improvement

About the text:

Written by healthcare leaders for current and future innovation leaders, Leadership for Evidence-Based Innovation in Nursing and Health Professions addresses the current and emerging issues facing healthcare leaders and practitioners who lead evidence-based innovation. A truly unique text, it systematically addresses innovation and evidence from the perspectives of both a leader and a practitioner within the context of health care.

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Review: 2017 Nurse’s Drug Handbook “is excellent”

2017 Nurse's Drug HandbookTerrific news to share– the recently published 2017 Nurse’s Drug Handbook just received a 4-star review. According to Carol E. Agana, MNSc, RNP, APRN, from the University of Arkansas, writing for Doody’s Review Service,

“As a reference, this one is excellent and it also serves the purpose of a textbook. What differentiates [it] from other drug references are the nursing considerations and patient teaching points.”

Jones & Bartlett Learning 2017 Nurse’s Drug Handbook is the most up-to-date, practical, and easy-to-use nursing drug reference. Updated annually, it provides accurate and timely facts on hundreds of drugs from A-Z. Written in a no-nonsense style that speaks your language in terms you use every day, it offers concise and consistently formatted drug entries organized alphabetically.

The 2017 Nurse’s Drug Handbook also includes:

  • Index of all generic, trade, and alternate drug names
  • Chemical and therapeutic classes, FDA pregnancy risk category, and controlled substance schedule
  • Indications and dosages, as well as route, onset, peak, and duration information
  • Incompatibilities and contraindications
  • Interactions with drugs, food, and activities
  • Adverse reactions
  • Nursing considerations, including key teaching points for patients
  • Mechanism-of-action illustrations
  • Warnings and precautions

New drug entries include alirocumab, brexpiprazole, cangrelor, cariprazine, edoxaban, eluxadoline, evolocumab, flibanserin, idarucizumab, ivabradine, and mepolizumab. Updates to the appendices include parenteral insulin preparations, selected ophthalmic drugs, selected topical drugs, selected antivirals, selected antineoplastic drugs, and interferons.

Take 2017 Nurse’s Drug Handbook wherever you go with an affordably priced app for Android, iPhone, and iPad. Try the app free for 30 days!

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