Bold Voices - March 2013 - (Page 29)

AT THE BEDSIDE Checklists May Reduce Venous Thromboembolism Requiring physicians to methodically mark a simple checklist may decrease preventable thromboembolism prophylaxis events in trauma patients, says a study in the Archives of Surgery. Venous thromboembolism (VTE) is responsible for the hospitalization of 250,000 Americans per year and poses a life-threatening risk if not treated properly. Although clinical practice guidelines assist in managing these cases, clinicians may encounter a variation of VTE that is not well documented. The study sought to assess the effectiveness of mandatory support tools that send the physician through prompts and replies with the appropriate prophylaxis. Reports have already shown that the checklists have improved compliance with VTE prophylaxis guidelines and made VTE events 36 percent less likely overall, the study adds. “Improved Prophylaxis and Decreased Rates of Preventable Harm With the Use of a Mandatory Computerized Clinical Decision Support Tool for Prophylaxis for Venous Thromboembolism in Trauma” compared VTE at Johns Hopkins’ DVT rate fell from 2.3 level 1 trauma percent to 0.3 percent. center before the computerized checklist was added to the order entry system. Although factors such as length of stay didn’t change, medical recordkeeping jumped from 3 percent with paper health records to 98 percent with the electronic system. The VTE event rate also declined from 3 percent to 1.3 percent. And the rate of deep vein thrombosis fell even more — from 2.3 percent at baseline to 0.3 percent. VA Hospitals Achieve Surprising Decline in Readmission and Mortality A study of 129 acute care VA hospitals finds that shorter hospital stays don’t increase readmission rates or lead to more deaths, according to research at Iowa City VA Medical Center. “Associations Between Reduced Hospital Length of Stay (LOS) and 30-Day Readmission Rate and Mortality: 14-Year Experience in 129 Veterans Affairs Hospitals,” in Annals of Internal Medicine, shows that while LOS decreased 27 percent over 14 years, or 2 percent annually, the Could private VA hospitals achieved hospitals achieve surprising declines of 16 percent in the same results? readmissions and 3 percent in mortality. Researchers attributed the results to “better coordination between hospital and outpatient services, as well as the use of hospitalists.” “What we found was that they both went down simultaneously, lead researcher and hospitalist Peter Kaboli says in a related article in HealthDay. “We can improve efficiency and at the same time improve 30-day readmission rates.” Researchers are uncertain, however, whether the same results could be seen at private hospitals. They suggest future work should examine whether a tipping point exists for LOS reduction and hospital readmission. That point is suggested in two studies at the University of Maryland’s Robert H. Smith School of Business, College Park, that conclude revenue-driven surgery and poor planning drive some surgical patients home before they are healthy enough, the university reports. The studies show a correlation between readmission rates and hospital occupancy at time of discharge. Join Us Online 24/7 Dare to become an active participant in AACN’s online communities. Contribute Facebook comments and posts to facebook.com/aacnface and facebook.com/ntiface. And tweets to twitter.com/aacnme and twitter.com/ntiaacnme. New for NTI 2013: NTI Network, the online community, where you can check the program schedule, sign up for free ticketed events and connect with like-minded colleagues before, during and after the NTI’s Boston experience. Read more on page 32. AACN BOLD VOICES MARCH 2013 29 http://archsurg.jamanetwork.com/article.aspx?articleid=1380449 http://www.annals.org/article.aspx?articleid=1485308 http://www.annals.org/article.aspx?articleid=1485308 http://www.annals.org/article.aspx?articleid=1485308 http://www.annals.org/article.aspx?articleid=1485308 http://health.usnews.com/health-news/news/articles/2012/12/17/shorter-hospital-stays-dont-compromise-care-study-finds http://newsdesk.umd.edu/universitynews/release.cfm?ArticleID=2687 http://newsdesk.umd.edu/universitynews/release.cfm?ArticleID=2687 http://www.facebook.com/aacnface http://www.facebook.com/aacnface http://www.facebook.com/ntiface http://www.twitter.com/aacnme http://www.twitter.com/ntiaacnme

Table of Contents for the Digital Edition of Bold Voices - March 2013

Front/Digital Edition Viewing Guide
Another Angle
Design an NTI Just for You
New Guidelines Set Practice Framework for Tele-ICU NursingPractice
New Methods Increase Speed of Sepsis Diagnosis
High Blood Pressure Can Injure the Brain of Young Adults
Recurrent Hypoglycemia May Not Impair Long-Term Development of Preterm Infants
Superstorm Sandy Hospital Evacuation Decisions Questioned
New STEMI Guidelines Focus on Symptom Recognition, Ease of Use
Early Communication About Resuscitation Improves EOL Quality
Vote Now for AACN Board, Nominating Committee Members
Simple Measures Reduce Pneumonia
Fresh Blood in the ICU
Meeting Veterans’ Healthcare Needs
In Our Journals
Checklists May Reduce Venous Thromboembolism
Certification Capsules
Chapter Leadership Workshop @NTI 2013
Wear Your NTI Pride on May 20
Dare To
Back

Bold Voices - March 2013

http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201911
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201910
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201909
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201908
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201907
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201906
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201905
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201904
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201903
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201902
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201901
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201812
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201811
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201810
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
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201804
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201803
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201802
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201801
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201712
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201711
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201710
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201709
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201708
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201707
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201706
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201705
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201704
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201703
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201702
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201701
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201612
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201611
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201610
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201609
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201608
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201607
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201606
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201605
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201604
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201603
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201602
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201601
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201512
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201511
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201510
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201509
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201508
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201507
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201506
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201505
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201504
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201503
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201502
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201501
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201412
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201411
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201410
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201409
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201408
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201407
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201406
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201405
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201404
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201403
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201402
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201401
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201312
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201311
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201310
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201309
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201308
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201307
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201306
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201305
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201304
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201303
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201302
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201301
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201212
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201211
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201210
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201209
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201208
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201207
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201206
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201205
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201204
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201203
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201202
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201201
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201112
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201111
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201110
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201109
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201108
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201107
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201106
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201105
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201104
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201103
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201102
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201101
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201012
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201011
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201010
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201009
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201008
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201007
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201006
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201005
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201004
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201003
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201002
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_201001
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_200912
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_200911
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_200910
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_200909
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_200908
http://www.nxtbook.com/nxtbooks/aacn/boldvoices_200907
http://www.nxtbookMEDIA.com