Bold Voices - August 2017 - 17

AT THE BEDSIDE

Survival Rates Higher During
Joint Commission Surveys
A significant decrease
in 30-day mortality
for admissions was
noted during survey
weeks compared to
non-survey weeks.

P

atients admitted to hospitals during Joint Commission surveys have better 30-day
survival than those admitted three weeks before or after.
"Patient Mortality During Unannounced Accreditation Surveys at US Hospitals,"
in JAMA Internal Medicine, finds that improved survival rates during unannounced survey
periods are particularly noticeable at major teaching hospitals.
Seeking to determine whether heightened vigilance affects the quality and safety of inpatient care, the study examined Medicare admissions at 1,984 survey hospitals from 2008 to
2012, focusing on the period from three weeks before to three weeks after the surveys. The
observational study involved 244,787 admissions during surveys and 1.46 million admissions during non-survey weeks, with similar patient characteristics, reason for admission
and in-hospital procedures for both groups.
A significant decrease in 30-day mortality for admissions was noted during survey weeks (7.03 percent)
compared to non-survey weeks (7.21 percent). "Observed mortality reductions were largest in major teaching hospitals, where mortality fell from 6.41 percent to 5.93 percent during survey weeks," the study adds. There were no
significant differences in admission volume, length of stay or secondary outcomes.
Commenting in The Hospital Leader, the official blog of the Society of Hospital Medicine, Tracy Cardin, a nurse
practitioner in the Section of Hospital Medicine at the University of Chicago, says the results suggest hospitals
should consider "which aspects of normal day-to-day activities changed the most during survey weeks," with the
goal of consistently repeating behaviors that increased patient safety. It might be difficult to maintain this type of
elevated awareness environment every day, she adds.
However, Cardin states, this study makes "me think more about some of the day-to-day details and how I can be
more cognizant of them when directing care of my very sick inpatients."

Effect of Rudeness
on Pediatric Team
Performance
Rudeness can increase
medical errors and
decrease collaboration.

S

imulated workshops indicate rudeness can have
negative consequences, including
increased medical errors and less
collaboration.
"Rudeness and Medical Team
Performance," in Pediatrics, discusses
the effects of a rude parent on the
performance of 39 neonatal ICU
teams caring for newborns in simulation sessions.
In each workshop, two teams were
exposed to either rude comments

©Pixabay

from a patient's mother that were
unrelated to medical performance or
were in a control condition with neutral
comments. Two additional teams
were randomized to receive rudeness
with either preventive (cognitive bias
modification - CBM) or therapeutic
(narrative) intervention.
Rudeness had adverse consequences on diagnostic and intervention
parameters and team processes, as
measured by two independent judges

using questionnaires. Rudeness
resulted in a mean therapeutic score
of 3.81 compared to 4.31 in controls
and a mean teamwork score of 4.04
compared to 4.43 in controls.
"Exposure to rudeness debilitated
the very collaborative mechanisms
recognized as essential for patient
care and safety," the study notes.
CBM "mitigated most of these
adverse effects of rudeness, but the
postexposure narrative intervention
had no significant effect."
As a result, the study recommends preventive interventions
such as CBM. Such interventions
"may offer a means to mitigate the
adverse consequences of behaviors that, unfortunately, cannot be
prevented."
REFERENCE: Riskin A, Erez A, Foulk TA, et al.
Rudeness and medical team performance. Pediatrics.
2017;139(2).

17
AACN BOLD VOICES AUGUST 2017

REFERENCE: Barnett ML, Olenski AR, Jena AB. Patient mortality during unannounced accreditation surveys at US hospitals. JAMA Intern Med. 2017;177(5):693-700.


http://www.jamanetwork.com/journals/jamainternalmedicine/article-abstract/2610103 http://blogs.hospitalmedicine.org/Blog/16677-2/ http://pediatrics.aappublications.org/content/early/2017/01/06/peds.2016-2305?sso=1&sso_redirect_count=4&nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3A%20No%20local%20token&nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token http://pediatrics.aappublications.org/content/early/2017/01/06/peds.2016-2305?sso=1&sso_redirect_count=4&nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3A%20No%20local%20token&nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token

Table of Contents for the Digital Edition of Bold Voices - August 2017

Another Angle
Pres Note Front Teaser
Masthead
New Online Toolkit Shows Crucial Roles of Nurses in Serious Illness Communication
Oct. 31 Deadline to Apply for AACN Research Grants
PCCN or CCRN: Which Certification Is Right for You?
Failed Resuscitations May Increase Stress for Nurses
Updated Cardiac Nursing Course and CMC Review Course Online
New Behavior-Based Pain Assessment Tool
Hospital Rooftop Is a Hive of Activity
Former ICU Nurse Collects 100K Objects for Medical Mosaic
Interventions Reduce Wrong-Patient Orders in NICUs
Increasing Acceptance of Pediatric Telemedicine
The Privilege of Nursing
Effects of Dexmedetomidine
Seizure Risk Much Higher for Sepsis Survivors
Studies Provide Insights Into Reducing Opioid Use
Short-Term Oral Corticosteroids Increase Risk of Adverse Effects
Hospital Staff Becoming Product Innovators
Addressing Barriers to APRN Practice
Survival Rates Higher During Joint Commission Surveys
Effect of Rudeness on Pediatric Team Performance
Glasgow Coma Scale Stands the Test of Time
ECRI Introduces Patient Identification Tools
Reducing Risk Factors in Pediatric Delirium
Bundle Compliance Increases Survival, Reduces Delirium
Fostering Resilience in Healthcare Professionals Who Are Also Moms
Members: Enhance Your Career With an AACN Scholarship
In Our Journals
Transitions
President’s Note
Bold Voices - August 2017 - Cover1
Bold Voices - August 2017 - Cover2
Bold Voices - August 2017 - Pres Note Front Teaser
Bold Voices - August 2017 - Masthead
Bold Voices - August 2017 - Oct. 31 Deadline to Apply for AACN Research Grants
Bold Voices - August 2017 - PCCN or CCRN: Which Certification Is Right for You?
Bold Voices - August 2017 - 7
Bold Voices - August 2017 - Updated Cardiac Nursing Course and CMC Review Course Online
Bold Voices - August 2017 - New Behavior-Based Pain Assessment Tool
Bold Voices - August 2017 - Former ICU Nurse Collects 100K Objects for Medical Mosaic
Bold Voices - August 2017 - Increasing Acceptance of Pediatric Telemedicine
Bold Voices - August 2017 - The Privilege of Nursing
Bold Voices - August 2017 - 13
Bold Voices - August 2017 - Seizure Risk Much Higher for Sepsis Survivors
Bold Voices - August 2017 - Short-Term Oral Corticosteroids Increase Risk of Adverse Effects
Bold Voices - August 2017 - Addressing Barriers to APRN Practice
Bold Voices - August 2017 - Effect of Rudeness on Pediatric Team Performance
Bold Voices - August 2017 - ECRI Introduces Patient Identification Tools
Bold Voices - August 2017 - Bundle Compliance Increases Survival, Reduces Delirium
Bold Voices - August 2017 - Members: Enhance Your Career With an AACN Scholarship
Bold Voices - August 2017 - Transitions
Bold Voices - August 2017 - President’s Note
Bold Voices - August 2017 - Cover3
Bold Voices - August 2017 - Cover4
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