Bold Voices - May 2012 - (Page 7) AT THE BEDSIDE Patients at End of ICU Rounds Receive Less Face Time interruptions accounted for another 11.5 minutes. “We’ve just begun to look at this issue,” study leader Laura Jones of Emory University, Atlanta, tells MedPage Today. “Our findings were unexpected because we hypothesized that the time spent with each patient would not change significantly Interruptions accounted for during At this point, we really rounds. 21.5 minutes during rounds don’t know whether spending less time with patients has clinon 12 CTICU patients. ical significance.” However, resource distribution The number of patient visits during during rounds could have a substantial the study averaged 6.4, and round impact on the efficiency and effectiveduration averaged 117.9 minutes. ness of rounds and, potentially, the Interruptions accounted for about quality of care, she adds in the article. 10 minutes per session, while social preliminary study published by the Society of Critical Care Medicine, Mount Prospect, Ill., finds that clinical staff spent significantly less time with ICU patients at the end of rounds than at the beginning. The implications of this declining face time — including the impact on patient outcomes — remain unclear. “Last Patients Finish Last: End of Round Time Compression During CT ICU Clinical Rounds,” in Critical Care Medicine, notes the time decreased by about one minute per patient as clinical staff made rounds in a 12-bed cardiothoracic ICU. Comparison of the first four and last four patients seen on rounds produced a statistically significant difference in the time spent with physicians and other participants. A Jones says future phases of the study will attempt to address the unknowns. Researchers plan to make audio recordings of rounds and gather more information about the patients and decision-making processes involved in determining the order of patient visits. Four Meds Cause Two-Thirds of Emergency Hospitalizations in Seniors Four anticoagulants and diabetes medications cause two-thirds of the estimated 100,000 annual emergency hospitalizations for Americans 65 and older due to adverse drug events, a November 2011 study reports. “Emergency Hospitalizations for Adverse Drug Events in Older Focused safety initiatives Americans,” a New England Journal of Medicine study of 58 hospitals from 2007 to 2009, indicates warfarin caused 33 percent of the hospion a few medicines can talizations. It also cites oral antiplatelet medications, insulins and oral improve elder care. hypoglycemic agents as major contributors and encourages clinicians to focus on medication management for patients. “These data suggest that focusing safety initiatives on a few medicines that commonly cause serious, measurable harms can improve care for many older Americans,” lead author Daniel Budnitz, director of the Centers for Disease Control and Prevention’s Medication Safety Program, says in a related Medscape article. “Doctors and patients should continue to use these medications but remember to work together to safely manage them.” The problem is particularly acute for patients 80 and older, who make up 48 percent of the cases. Of the estimated 100,000 emergency hospitalizations for seniors each year, two-thirds are due to unintentional overdoses. AACN BOLD VOICES MAY 2012 7 http://www.emory.edu/home/index.html http://journals.lww.com/ccmjournal/Citation/2011/12001/638__Last_Patients_Finish_Last__End_of_Round_Time.594.aspx http://journals.lww.com/ccmjournal/Citation/2011/12001/638__Last_Patients_Finish_Last__End_of_Round_Time.594.aspx http://www.medpagetoday.com/MeetingCoverage/SCCM/31096 http://journals.lww.com/ccmjournal/Citation/2011/12001/638__Last_Patients_Finish_Last__End_of_Round_Time.594.aspx http://www.nejm.org/doi/full/10.1056/NEJMsa1103053 http://www.nejm.org/doi/full/10.1056/NEJMsa1103053 http://blogs.cdc.gov/safehealthcare/?page_id=1110 http://www.cdc.gov/medicationsafety/ http://www.cdc.gov/medicationsafety/ http://www.medscape.org/viewarticle/754612?src=cmemp Table of Contents for the Digital Edition of Bold Voices - May 2012 Front/Digital Edition Viewing Guide Another Angle AACN Boards and Contact Information Your NTI Checklist AACN, Case Western Reserve University Announce Innovative DNP, PhD Collaboration Patients at End of ICU Rounds Receive Less Face Time Medical Panel Members Have Conflicts of Interest Adverse Events Unreported Penn Nursing Study: Nurse Burnout a Worldwide Problem Low-Cost Changes to Nurses' Work Environment Also Benefit Patients Hospital Workers Reluctant to Report Medical Errors Flame of Excellence Awards Circle of Excellence Awards UTI Prevention Lower Priority Than Other HAIs Children at Higher Risk for Infection in Intensive Care Cameras, Feedback: Effective Tools to Enforce Hand Washing In Our Journals More Coronary Events Associated With Dabigatran Certification Capsules Publishing-related Events at NTI Stay Connected at NTI Letters From the President Back Bold Voices - May 2012 http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201809 http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201808 http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201807 http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201806 http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201805 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