Staff Satisfaction Survey Research Articles

Evaluating the Efficiency and Staff Satisfaction of the Point-of-Care IV Activated System Versus Traditional Piggyback in Administering IV Antibiotics at a Saudi Tertiary Hospital.

This study aims to compare resource utilization and staff satisfaction between the point-of-care (POC) activated system and the traditional intravenous piggyback (PB) system in hospital pharmacy settings. Employing a pre-post quasi-experimental design from November 2019 to April 2020, the study assessed resource requirements for both the POC activated system and the traditional PB system. Additionally, a staff satisfaction survey was conducted, focusing on staff experiences related to the pharmacy preparation process and the subsequent activation of the system by nurses. The POC activated system required significantly fewer full-time equivalents (FTEs) per month compared to the PB system (0.36 ± 0.05 vs. 1.56 ± 0.07; p < 0.0001). Using POC in automated dispensing cabinets (ADCs) reduced medication administration time and returns (6.41% vs. 1.75%; p < 0.0001). The staff satisfaction survey revealed greater satisfaction with the POC activated system. A subsequent analysis showed the POC activated system had a low expiration rate of 0.1% and a cost of 39 Saudi riyal, while the traditional system had higher expiration rates and cost of 46,260 SR. The POC activated system reduced FTEs, decreased returned medications, and enhanced staff satisfaction compared to the PB system.

First Contact Physiotherapy: A 4-Year Service Evaluation of UK Primary Care Data.

The First Contact Physiotherapist (FCP) role offers patients direct access to musculoskeletal (MSK) specialists in primary care settings and is designed to reduce GP workload while providing high-quality care. Despite positive early evaluations of FCP services, there remains a need for up-to-date assessments of their impact. To evaluate the FCP model of care implemented in an NHS Primary Care Network (PCN) against pre-defined service objectives. A service evaluation was conducted using data from April 2020 to March 2024. Key performance indicators were based on national FCP evaluation criteria. Data included appointment utilisation, wait times, referral patterns, patient and staff satisfaction surveys, and audit results from clinical data. Over 4years, 12,185 patients were seen. Of these, 69% of patients were seen as true first contacts. The majority of patients (86.4%) were managed within primary care, with a referral rate of 8.5% to outpatient physiotherapy and 5.1% to orthopaedics. Patient satisfaction was high, with 82% rating their FCP experience as excellent or outstanding. The FCP service successfully met its objectives by reducing GP workload and providing effective care. However, there was an increase in outpatient physiotherapy referrals over the 4-year period. Staff satisfaction was generally positive, though some highlighted concerns about appointment duration and workload. This evaluation demonstrates that FCP services provide a viable solution for managing MSK conditions in primary care. Future research should explore the most effective MSK service delivery models and incorporate digital solutions for comprehensive outcome and experience measures.

Evaluation of a remote hybrid staffing model for investigational drug service pharmacists.

This project compared the time to complete investigational prescription drug order verification by investigational drug service (IDS) pharmacists in an onsite vs offsite (hybrid) staffing model, evaluating the impact of remote work on verification time. Parenteral IDS drug orders from August 2019 through June 2022 were analyzed. Electronic medical records were timestamped for each order, first verification, second verification, and medication administration. The project was divided into four 6-month time periods to allow for 2 independent comparisons of onsite vs hybrid staffing models. A survey was given retrospectively to IDS pharmacists for the last hybrid timeframe to assess work satisfaction and burnout. A total of 4,398 orders were evaluated. The time from order entry to first verification was 14 minutes (n = 1,248) during the first onsite time period compared to 13 minutes (n = 1,042) during the first hybrid period (P = 0.003). The time for order verification was similar between the second onsite and hybrid periods (12 minutes [n = 1,041] vs 10 minutes [n = 1,067], respectively; P < 0.0001). The staff satisfaction survey for the hybrid model showed high levels of job satisfaction and no self-reported burnout. The remote hybrid staffing model did not result in a meaningful change in the time from order placement to medication administration within the IDS pharmacy. Hybrid staffing also resulted in greater job satisfaction among IDS pharmacists. This study highlights the benefits of implementing remote work practices in the pharmacy practice setting.

Nurse-Driven Fluid Responsiveness Evaluation in Patients With Septic Shock: A Quality Improvement Initiative.

Fluid responsiveness should be assessed in patients with septic shock because only 50% of patients are fluid responsive. Dynamic measures of fluid responsiveness, like pulse pressure variation measured after a passive leg raise maneuver, are recommended to guide fluid administration in patients with sepsis after initial fluid resuscitation. The purpose of the project was to evaluate outcomes after implementing a nurse-driven fluid responsiveness evaluation using passive leg raise and pulse pressure variation measurement in patients with septic shock. The project included 30 adult patients with septic shock in a 24-bed medical-surgical intensive care unit at a community hospital. A new nursing process was initiated for bedside fluid responsiveness evaluation (pulse pressure variation measurement after passive leg raise). Staff members received in-person individual training sessions. Preintervention and 20-week postintervention patient outcomes data were collected to estimate the project's impact on incidence of fluid overload and acute kidney injury, duration of mechanical ventilation, and intensive care unit length of stay. Preintervention and postintervention staff satisfaction surveys assessed nurses' perception of the project's value. Before intervention, 24 of 37 patients (65%) met criteria of fluid overload. The project resulted in a 28% decrease in the incidence of fluid overload. Staff satisfaction surveys revealed a significant increase in nurses' feelings of empowerment to positively affect patient outcomes; all nurses agreed that the new process was efficient. The results indicate that the project had a positive impact on patient outcomes and nurse autonomy.

Analysis of a Pharmacy Developed, Outpatient Lactation Consultant Initiated Domperidone Programme.

Domperidone is a commonly prescribed galactagogue used off-label for lactation insufficiency. Prescriber unfamiliarity or safety concerns can lead to therapeutic delay and potential early breastfeeding discontinuation. To facilitate access, the study site pharmacy department developed a Structured Administration and Supply Arrangement (SASA) for International Board-Certified Lactation Consultants (IBCLC) to screen and initiate domperidone using a checklist. To validate a domperidone screening tool via analysis of its use and compliance, together with a staff satisfaction survey. Records were extracted from the REDCap® database for women with documented domperidone supply between 06/05/2022 and 27/01/2023 and reviewed with medical records. A staff survey was distributed assessing compliance and attitudes towards the SASA. Records of supply revealed that 34% (17/50) of patients were referred to a physician, revealing a discrepancy between database documentation and checklists, as no referrals were documented. Overall staff satisfaction with the SASA was rated 4.6 out of 5. 77.7% (7/9) felt confident counselling and supplying domperidone with the SASA in place. 88.9% (8/9) felt confident using the checklist to identify the appropriateness of therapy and referral to a physician. The system in place allows the IBCLCs to initiate and supply domperidone in a timely manner to breastfeeding mothers with lactation insufficiency. The support tools, including domperidone SASA, REDCap® documentation database and the checklist domperidone as a Galactagogue Checklist, can be greatly appreciated by the LCs. Continued discussion with IBCLCs to refine and improve the SASA and associated education package will result in more consistent compliance.

Cancer Center Staff Satisfaction: Descriptive Results of a Canadian Study.

Caring for cancer patients is generally considered very rewarding work, but it can also be stressful and demanding. Therefore, it is important for oncology healthcare professionals to feel satisfied with their work environment in order to provide the best care possible. An ethics-approved 61-item staff satisfaction survey was developed in-house to gain insights regarding workplace satisfaction among all staff at The Ottawa Hospital Cancer Center. Descriptive statistics were used to analyze the responses. A total of 478 individuals completed the online survey, with 75.1% women, 23.2% men, and 1.7% preferring not to say. This represented the vast majority (>75%) of cancer center staff. The approximate breakdown according to healthcare professional type was as follows: 21% nurses, 20% radiation therapists, 18% physicians, 13% clerical staff, and 28% other types of staff. Almost all (97.4%) generally enjoyed their work, with 60% stating "very much" and 37.4% stating "a little bit", and 93.3% found working with cancer patients rewarding. The overall satisfaction level at work was high, with 30.1% reporting "very satisfied" and 54.2% "somewhat satisfied". However, in terms of their work being stressful, 18.6% stated it was "very much" and 62.1% "a little bit". Also, in terms of their workload, 61.3% stated it was "very busy" and 10% stated it was "excessively busy". The most enjoyable aspects of work were listed as interactions with colleagues, interactions with patients, and learning new things. The least enjoyable aspects of work were excessive workload, a perceived unsupportive work environment, and technology problems. Levels of satisfaction and stress at work varied according to role at the cancer center. Most cancer center staff seem to enjoy their work and find it rewarding. However, the work environment can be challenging and stressful. Areas for improvement include managing workloads, ensuring staff feel supported, and improving the user-friendliness of technology.

Do Organizational Values and Leadership Impact Staff Engagement, Wellbeing, and Patient Satisfaction?

Organizational culture has been shown to be an important characteristic that influences behaviors of groups and individuals within an organization. This study seeks to examine the relationships among various organizational values, staff engagement, staff wellbeing, and patient satisfaction in community hospitals. Organizational values and engagement data were retrieved from all-staff survey results from 387 clinical units at Mayo Clinic Health Systems. For patient satisfaction data, Press Ganey scores were matched with data for 17 outpatient units from the all-staff survey. Cluster analysis was used to create constructs from the staff satisfaction survey. Reliability was obtained using Cronbach's alpha. Structural equation modeling (SEM) was used to create the measurement model for prediction of constructs. Correlation was used to examine the relationship between culture and patient satisfaction. From the all-staff survey results, we identified nine constructs related to organizational cultural values, staff well-being, and employee engagement. We were able to determine a structural equation model for values and engagement that had an excellent fit. Staff's sense of fairness had a significant impact on how staff provide service excellence. Cultural values of excellence and innovation were positively correlated with large effect size in ten out of eleven patient satisfaction measurement domains and all were statistically significant. Values of excellence had a larger positive relationship with patient satisfaction than all other variables. How staff perceive the level of the organization's commitment to its values had impact on both staff engagement and wellbeing. This study also showed that the construct of wellbeing and patient satisfaction scores are not correlated. Staff will strive to provide excellent experience and good patient care regardless of their state of wellbeing.

Daily huddle best practice: An Evidence-Based guide.

Daily huddles positively influence staff satisfaction and perception; standardization of a daily huddle should be prioritized to benefit from its effects. The aim of this project initiative was to implement an evidence-based, standardized daily huddle on an inpatient medical-surgical oncology unit. A searchable question was developed, and the identified literature was critically appraised and synthesized for evidence-based recommendations. The recommendations for the structure and content of a daily huddle were implemented using a standardized format. Pre-implementation and post-implementation staff perception and satisfaction surveys yielded positive results. Improvements in effective communication and staff satisfaction were identified. An effective daily huddle is essential for communicating pertinent information that can affect workflows and patient safety, as well as promoting teamwork and staff satisfaction.

Impact of a perioperative pharmacist on completion rates for preoperative antibiotics

BackgroundEnsuring appropriate use of preoperative antibiotics and monitoring antibiotic administration timing are responsibilities a perioperative pharmacist may perform. Antibiotics requiring prolonged infusions such as vancomycin and fluoroquinolones should be administered within 120 min of the first surgical incision. These antibiotics require longer infusion times, so they may not be completed before the first surgical incision. Incomplete infusions may cause procedural delays and increase the risk of surgical infections. By implementing a perioperative pharmacist, we aim to increase the percentage of completed infusions of presurgical antibiotics that require prolonged administration times, which may decrease the incidence of postsurgical skin and soft tissue infections and urinary tract infections. MethodsThis retrospective cohort analysis compared the completion rates of prolonged infusion preoperative antibiotics between pre- and post-implementation of a perioperative pharmacist. Antibiotics of interest were those with infusion times of 60 min or greater which included vancomycin, ciprofloxacin, and levofloxacin. A survey was constructed to evaluate perioperative staff satisfaction with the Department of Pharmacy pre- and post-implementation of a perioperative pharmacist. ResultsAssessing presurgical antibiotic doses, 59.6% of vancomycin, ciprofloxacin, and levofloxacin were completely infused prior to the first surgical incision during the perioperative pharmacist pilot compared with 26.5% pre-implementation (p<0.001). A difference in the incidence of postsurgical skin and soft tissue infections and urinary tract infections within 30-days postoperatively was not detected. In the perioperative staff satisfaction survey, the statement: “a pharmacist in the perioperative setting improves patient care” was answered strongly agree or agree in 95% of respondents in the post-survey as compared to 71% in the pre-survey. Furthermore, 95% of the perioperative staff that completed the post-survey supported the continuation of a perioperative pharmacist role indefinitely. ConclusionImplementation of a perioperative pharmacist increased presurgical antibiotic prophylaxis infusion completion rates of vancomycin, ciprofloxacin, and levofloxacin and increased perioperative staff satisfaction with the Department of Pharmacy.

Implementation of the 'PicNic' handover huddle: A quality improvement project to improve the transition of infants between paediatric and neonatal intensive care units.

Thorough handover and effective communication are crucial to the transfer of clinical information between different intensive care units. Following a sentinel patient safety event, an improvement project was initiated to reduce patient safety risks associated with the transfer of complex patients between the neonatal and paediatric intensive care. A handover tool was implemented over a 4-month period, guiding handover through means of a handover huddle. The tool ensured a full ISBAR (Introduction, Situation, Background, Assessment, Response) handover, with a specified attendance register. It acknowledged specific safety points inclusive of outstanding investigations, procedural history and medication transcription. Post implementation, huddle checklist sheets were audited for compliance and a staff satisfaction survey was conducted. Thirty-nine handovers took place during this trial period, of which 69% were captured in the huddle process. Senior medical and nursing staff attendance was greater than 95% throughout the process, and 100% of huddles attended to a full ISBAR handover. Sixty staff satisfaction survey responses were received, 90% of which identified the process to improve the safety of patient handover. Responses also identified safety issues such as discontinuity of medication transcription between the units, and inappropriate patient transfers occurring outside of working hours. Qualitative feedback highlighted how the tool improved interdepartmental educational and collaboration opportunities. The 'PicNic' huddle effectively facilitated a standardised handover between paediatric and neonatal intensive care. It also recognised the importance of interdepartmental collaboration and education surrounding culturally different clinical practices. Further improvement cycles continue to progress the tool and initiate a digital format for ongoing use.

Processes and Practices Improvement of Sample Receiving Counter at Government Clinical Laboratory in Sri Lanka

Improving efficiency of a clinical laboratory service should be a first priority in healthcare development of any country. It plays a significant role as it facilitates diagnosing and treating diseases and finally to discharge the patients faster. Therefore, the reliability and the accuracy of a clinical laboratory should be guaranteed through a sound sample management. The aim of this study was to improve the process and practices of sample management at a sample receiving counter of a selected government clinical laboratory in Sri Lanka. The study was an institution based interventional project. The research adopted mixed methods including a desk review, a checklist, focus group discussions and a staff satisfaction survey which was conducted among Medical Laboratory Technologists. Proportions, percentages and means were calculated for quantitative data and narrative analysis was done for the analysis of qualitative data. The results indicated that the incidences of missing samples and request forms and sample handling time have been significantly reduced at post intervention. Performance of the routine counter activities including proper documentation, updating the notice boards, monitoring temperatures of sample storing refrigerators and consideration of rejection criteria in accepting the samples were significantly improved after the intervention. Staff satisfaction on overall sample handling process and practices was significantly improved after the intervention except the current practice of sample data management and facility availability to carry out duties. The study recommends modifying the counter layout with adequate expansion. It also recognized the necessity of implementing a Laboratory Information Management System for whole laboratory operation.

Factors Influencing Job Satisfaction of Nurses in Cardiac Center, Hail, KSA

Background: The present healthcare organizational landscape is experiencing a myriad of issues that have resulted in more and more nurses quitting. Job satisfaction is defined as the employees' feelings and behaviors towards their job. The healthcare system of Saudi Arabia is composed of considerable numbers of expatriate nurses from different countries, bringing about diversity. Compared to the past data, there has been an increment in the rate of nurses quitting, meaning a reduction in job satisfaction. This study determines the factors influencing job satisfaction among nurses working in Cardiac Center Hail in Saudi Arabia. Methods: The study utilized a retrospective study based on prospective data collection focusing on the nursing staff's responses to the staff satisfaction survey in Cardiac Center Hail (CCH). The convenience sampling technique of data collection was adopted since it is incredibly prompt, economical, fast, less sophisticated, and easy to research. This method is random and hence eliminates bias in the research. The data collection process utilized inclusion criteria to ensure high quality and reliable data s obtained. Results: It can be observed the job satisfaction in the Cardiac Center Hail is average since the highest percentage of job satisfaction scores ranges between being average and very good for most of the influencing factors. The most dissatisfying factor in the institution was the food supply, followed by the communication system, transportation, and working hours. Conclusion: This information is critical for utilization by policymaking in developing long-term sustainable strategies for promoting a higher retention rate of nurses through offering favorable conditions to promote health care quality deliverance. . Improvements include allocating allowances, reducing the workload on the nurses by maintaining the required shift time, compensate on overtime, improve the communication system, food should be properly cooked, fresh, and balanced, reduce congestion in accommodation &amp; provide appropriate accessories, and establish proper and reliable transport system.

Evaluation of staff satisfaction after the implementation of a daily goals sheet in the routine work of an oral outpatient department and its influence on work efficiency

BackgroundIn March 2021, the supervision group of our hospital inspected the daily work of the outpatient department in the branch and found many problems in the process, such as an excessive number of daily check-up forms, nurses’ confusion regarding the daily check-up process, and the omission of daily check-up items. Therefore, focusing on these problem, our hospital established a quality improvement team to conduct a status survey and perform this study. This study evaluated the feasibility, availability and sustainability of using a daily goals sheet in the routine work of a stomatological outpatient department and investigated the satisfaction of the nursing staff with the sheet.MethodsAfter determining the theme of this study through the status survey, 60 nurses were randomly selected and divided into an experimental group and a control group by a random grouping method. Then, the study was divided into two stages: Applying the PDCA cycle method and following the MECE (Mad Exclusive, Collectively Exhaustive) principle to design, manufacture and apply the daily goals sheet. After the expert group performed Stage one, an analysis of work efficiency and routine omissions and a staff satisfaction survey were carried out. The results of the groups either using the daily goals sheet (n = 30) or not (n = 30) were analysed and compared.ResultsThe average work time of the daily goals sheet group was 15.20 ± 1.70 min, and that of the nondaily goals sheet group was 25.30 ± 2.70 min (P < 0.001). The omission rate was 0% in the daily goals sheet group and 16.67% in the nondaily goals sheet group. Staff satisfaction with the use of the daily goals sheet was high.ConclusionThe daily goals sheet can make routine work more efficient and convenient in a stomatological outpatient department. It is recommended for use in stomatological outpatient departments or hospitals.

The Importance of Mediator Training in Applied Behavior Analysis

The mediator training is an important procedure of the applied behavior analysis. By providing an appropriate training to the mediator, the trainer can enhance the likelihood that the trainee will implement the intervention plan accurately. The purpose of this study was to operate mediator training to an instructor therapist to implement mand training to a 5-year old girl with autism spectrum disorder. Through this study we had to follow all the necessary steps of the mediator training and to collect data, through the behavior fidelity checklist and the staff satisfaction survey. The results demonstrated that the mediator implemented the steps accurately and she was also satisfied from the overall training that she received. Moreover, the interobserver agreement for the treatment fidelity, between the comparison of trainers and trainee&amp;rsquo;s checklist, demonstrated exact agreement of the implementation of the intervention.

Healthcare-worker-associated outbreak of Panton–Valentine-leukocidin-producing meticillin-sensitive Staphylococcus aureus in a large neonatal unit in London: successful targeted suppression therapy following failure of mass suppression therapy

Staphylococcus aureus is a leading cause of healthcare-associated infection, and outbreaks have been associated with neonatal units and colonization of healthcare workers. To describe an outbreak of Panton-Valentine-leukocidin-producing meticillin-sensitive Staphylococcus aureus (PVL-MSSA) in a neonatal intensive care unit. Multi-disciplinary outbreak control investigation. Over a period of 16 months, seven neonates were identified as positive for PVL-MSSA. Isolates were identified in blood cultures (two patients), nasopharyngeal aspirate (one patient) and rectal screening swabs (four patients). Epidemiological and whole-genome sequencing data suggested a long-term carrier as the most likely source. Despite two rounds of mass suppression therapy of staff, using chlorhexidine initially followed by octenidine-based regimens, positive patients continued to be identified. Staff screening subsequently identified one healthcare worker colonized with the outbreak strain of PVL-MSSA who underwent enhanced screening and further suppression therapy. No further cases have been identified to date. Compliance with mass suppression therapy was >95% and a post-administration staff satisfaction survey showed that the majority of staff agreed with the steps taken, with low rates of adverse reactions. S.aureus outbreaks are commonly associated with colonization of healthcare workers, and are challenging to manage within environments such as neonatal units. This study highlights the utility of whole-genome sequencing in identifying and mapping an outbreak. It is recommended that targeted staff screening should be considered early in similar outbreaks. In this setting, mass suppression therapy was not an effective strategy despite a high level of staff engagement and compliance.

Evaluating the Efficacy of an Evidence-Based Charge Nurse Professional Development Activity at a Highly Complex Veterans Affairs Medical Center.

Incompetent charge nurses negatively impact quality patient care. An analysis of a charge nurse professional development activity intervention included pre- and posttests, an activity curriculum evaluation, and staff satisfaction surveys. Posttest scores improved significantly (t = 60, p = .001). All participants rated the professional development activity as highly appropriate and beneficial to their nursing practice.

Expanding Video Consultation Services at Pace and Scale in Scotland During the COVID-19 Pandemic: National Mixed Methods Case Study.

BackgroundScotland—a country of 5.5 million people—has a rugged geography with many outlying islands, creating access challenges for many citizens. The government has long sought to mitigate these through a range of measures including an ambitious technology-enabled care program. A strategy to develop a nationwide video consultation service began in 2017. Our mixed methods evaluation was commissioned in mid-2019 and extended to cover the pandemic response in 2020.ObjectiveTo draw lessons from a national evaluation of the introduction, spread, and scale-up of Scotland’s video consultation services both before and during the pandemic.MethodsData sources comprised 223 interviews (with patients, staff, technology providers, and policymakers), 60 hours of ethnographic observation (including in-person visits to remote settings), patient and staff satisfaction surveys (n=20,349), professional and public engagement questionnaires (n=5400), uptake statistics, and local and national documents. Fieldwork during the pandemic was of necessity conducted remotely. Data were analyzed thematically and theorized using the Planning and Evaluating Remote Consultation Services (PERCS) framework which considers multiple influences interacting dynamically and unfolding over time.ResultsBy the time the pandemic hit, there had been considerable investment in material and technological infrastructure, staff training, and professional and public engagement. Scotland was thus uniquely well placed to expand its video consultation services at pace and scale. Within 4 months (March-June 2020), the number of video consultations increased from about 330 to 17,000 per week nationally. While not everything went smoothly, video was used for a much wider range of clinical problems, vastly extending the prepandemic focus on outpatient monitoring of chronic stable conditions. The technology was generally considered dependable and easy to use. In most cases (14,677/18,817, 78%), patients reported no technical problems during their postconsultation survey. Health care organizations’ general innovativeness and digital maturity had a strong bearing on their ability to introduce, routinize, and expand video consultation services.ConclusionsThe national-level groundwork before the pandemic allowed many services to rapidly extend the use of video consultations during the pandemic, supported by a strong strategic vision, a well-resourced quality improvement model, dependable technology, and multiple opportunities for staff to try out the video option. Scotland provides an important national case study from which other countries may learn.

Sentiment classification for employees reviews using regression vector- stochastic gradient descent classifier (RV-SGDC).

The satisfaction of employees is very important for any organization to make sufficient progress in production and to achieve its goals. Organizations try to keep their employees satisfied by making their policies according to employees’ demands which help to create a good environment for the collective. For this reason, it is beneficial for organizations to perform staff satisfaction surveys to be analyzed, allowing them to gauge the levels of satisfaction among employees. Sentiment analysis is an approach that can assist in this regard as it categorizes sentiments of reviews into positive and negative results. In this study, we perform experiments for the world’s big six companies and classify their employees’ reviews based on their sentiments. For this, we proposed an approach using lexicon-based and machine learning based techniques. Firstly, we extracted the sentiments of employees from text reviews and labeled the dataset as positive and negative using TextBlob. Then we proposed a hybrid/voting model named Regression Vector-Stochastic Gradient Descent Classifier (RV-SGDC) for sentiment classification. RV-SGDC is a combination of logistic regression, support vector machines, and stochastic gradient descent. We combined these models under a majority voting criteria. We also used other machine learning models in the performance comparison of RV-SGDC. Further, three feature extraction techniques: term frequency-inverse document frequency (TF-IDF), bag of words, and global vectors are used to train learning models. We evaluated the performance of all models in terms of accuracy, precision, recall, and F1 score. The results revealed that RV-SGDC outperforms with a 0.97 accuracy score using the TF-IDF feature due to its hybrid architecture.

Implementation of a Nurse-Driven Pediatric Bowel Management Algorithm: A Quality Improvement Project

BackgroundIn September 2018, a staff survey on a 16-bed pediatric neuro-rehab care unit (RCU) revealed nurses felt their care was limited with few resources available to treat patients experiencing constipation. Based on guidelines published by the North American and European Societies for Pediatric Gastroenterology, Hepatology, and Nutrition, an evidence-based algorithm was implemented in the RCU. AimsThe aims of this project were to reduce the need for invasive constipation treatment and to improve nurse satisfaction. MethodsAn evidence-based interventional quality improvement project, based on the Plan-Do-Study-Act (PDSA) method, was initiated by RCU's clinical nurse leader. To measure impact on patients, use of invasive treatment was tracked in the electronic medical record. To measure impact on staff, a staff satisfaction survey was completed pre- and post- project implementation. ResultsThere was a statistically significant reduction in average rates of invasive medication administration between pre-intervention (M = 2.23, SD = 0.77) and post-intervention (M = 0.79, SD = 0.52; t (7) = 3.38, p = 0.01). A Wilcoxon Signed Rank Test revealed a statistically significant improvement in post-intervention nurse satisfaction for having tools and resources (z = −5.196, p < 0.001). ConclusionsThe findings of this quality improvement project showed that nurse-driven protocols based on current evidence can improve the prevention and treatment of constipation by reducing the need for invasive constipation treatment and improve nurse satisfaction.

Reduction of aggressive and violent behavior toward behavioral health unit staff and other patients: a best practice implementation project.

The current project aimed to implement evidence-based recommendations for the management of inpatient aggressive and violent behaviors in four behavioral health units (BHUs) in a mental healthcare area within an academic medical center. Patient violence against healthcare workers is a global concern, particularly in mental health care. All employees who work in inpatient psychiatric environments are at higher risk for targeted violence than are other healthcare workers. For healthcare organizations and staff, violent episodes involving patients can bring about medical expenses, potential legal expenditure, sick leave and a high turnover rate. The hospital at which this project was implemented had been experiencing a steady increase in violence and aggressive behavior. The project used the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice audit tool for promoting practice change in four BHUs. A baseline retrospective audit of 10 electronic health records from four BHUs assessed compliance with best practice regarding violent episodes. The Getting Research into Practice tool was used to identify barriers and develop an evidence-based educational strategy for 70 BHU staff aimed to improve compliance with best practice for managing aggression and violence. Staff education compliance was assessed via hospital education department records. A pre and postimplementation staff satisfaction survey assessed perceptions about education, confidence and unit safety. The baseline audit indicated that one of the three criteria had 0% compliance. Following implementation of an educational strategy using mock codes for BHU staff, there was 96% improvement in compliance for the BHU staff education audit criterion. Staff de-escalated patients in 83% of the episodes postimplementation. There was a slight decrease (9.1%) in the rate of violence across all four inpatient BHUs. Staff satisfaction survey findings did not show a statistically significant difference. Enhanced evidence-based education and mock codes resulted in BHU staff competence and confidence in managing aggressive and/or violent patients. Early signs of a decrease in the violence rate and improvement in the efficient use of de-escalation will be sustained with on-going yearly education, quarterly mock codes and future audits. This project was limited by its small size and short timeframe (21 weeks), making results not generalizable.