Karen Gabel Speroni

Comparison of occlusion rates by flushing solutions for peripherally inserted central catheters with positive pressure Luer-activated devices.

In this prospective, randomized study of 102 subjects with single-lumen peripherally inserted central catheters with positive pressure Luer-activated devices, 2 flushing solution groups were compared for their effect on occlusion rates. Of the 50 subjects randomly assigned to the normal saline group, 3 (6%) experienced occlusions, all of whom were elderly women. There were no occlusions in the 52 subjects randomly assigned to the heparinized saline group. Although the occlusion rate findings were not statistically significant, the charges associated with replacing a PICC because of occlusion are economically relevant. The annualized savings attributable to heparinized saline use are

Evaluating the Effectiveness of the Kids Living Fit™Program: A Comparative Study

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BSN completion barriers, challenges, incentives, and strategies.

After-school programs can be implemented by school nurses to facilitate healthy lifestyle choices in children with the goal of decreasing obesity. Kids Living Fit™(KLF), an after-school program designed by community hospital nurses, was implemented in elementary schools and focused on best lifestyle choices regarding foods consumed and activities chosen for children in grades 2 through 5. Study measures included comparison of body mass index (BMI) percentiles for age and gender and waist circumference between two self-selected groups composing a total sample size of 185 participants: the KLF intervention group (n =80) and the no-intervention/ contrast group (n =105). The 12-week intervention included a weekly fitness program and monthly dietitian presentations. Participants completed food and activity diaries and wore pedometers. In pairwise comparisons, the KLF group had a significant decrease in BMI percentile between baseline and follow-up (−2.3%) compared with the contrast group. The KLF group also demonstrated a smaller increase in waist circumference than the contrast group.

Patients' Perceptions of Patient Care Providers With Tattoos and/or Body Piercings

OBJECTIVE: The objectives of this study were to explore RN perceptions regarding barriers/challenges and incentives/supports for BSN completion and identify recommendations to increase RN BSN completion. BACKGROUND: The Institute of Medicine’s 2011 The Future of Nursing report recommended the proportion of RNs with a BSN increase to 80% by 2020. METHOD: This qualitative study included 41 RNs who participated in 1 of 6 focus groups based on their BSN completion status. RESULTS: Primary themes were sacrifices, barriers/challenges, incentives/supports, value, how to begin, and pressure. Primary BSN completion barriers/challenges were work-life balance and economic issues. Incentives/supports identified were financial compensation, assistance from employer and academic institution, and encouragement from family. Institutional strategies recommended for increasing BSN completion rates were improved access to education and financial support facilitated by collaboration between hospitals and academic institutions. CONCLUSIONS: Exploring RN barriers/challenges and incentives/supports for BSN completion can lead to implementation of institutional strategies, such as tuition reimbursement and academic collaboration.

Workplace bullying: the effectiveness of a workplace program.

Objective: This study evaluated patients’ perceptions of patient care providers with visible tattoos and/or body piercings. Background: As tattooing and body piercing are increasingly popular, research that informs nursing administrators regarding policies on patient care providers having visible tattoos and body piercings is warranted. Methods: A total of 150 hospitalized adult patients compared pictures of male and female patient care providers in uniform with and without tattoos and/or nonearlobe body piercings. Results: Patient care providers with visible tattoos and/or body piercings were not perceived by patients in this study as more caring, confident, reliable, attentive, cooperative, professional, efficient, or approachable than nontattooed or nonpierced providers. Tattooed female providers were perceived as less professional than male providers with similar tattoos. Female providers with piercings were perceived as less confident, professional, efficient, and approachable than nonpierced female providers. Conclusions: Nursing administrators should develop and/or evaluate policies regarding patient care providers with visible tattoos and/or body piercings.

Evaluating Use of Flash Sterilization in the OR With Regard to Postoperative Infections

Workplace bullying can not only cost thousands of dollars to replace an affected nurse, but also have detrimental economic effects on health care organizations. Occupational health nurses can provide leadership in preventing or eliminating workplace bullying. This pilot study determined that attendance at a cognitive rehearsal program decreased workplace bullying. The study used an Internet-based survey administered 6 months after nurses completed the 2-hour cognitive rehearsal program. Half of the nurses reported witnessing bullying behaviors since attending the program; 70% of the nurses reported changing their own behaviors following the course; and 40% of the nurses reported a decrease in bullying behaviors during the past 6 months. Although 70% of the nurses believed they could intervene in bullying situations, only 16% reported they responded to bullying at the time of occurrence. This study illuminates the need to continue searching for other effective methods to prevent and manage workplace bullying.

Effect of Nurses Living Fit™ exercise and nutrition intervention on body mass index in nurses.

This article describes a quality improvement project that examined postoperative infection rates for 100 surgical procedures in which a total of 121 flash sterilizations were performed and determined the costs of treating the postoperative infections compared to the cost of purchasing additional instruments. The post operative infection rate on physical examination was 3%, and the overall cost of diagnosing and treating the postoperative infections was found to be lower than the cost of purchasing additional instruments. To minimize use of flash sterilization, the hospital has added additional surgical instrument inventory and expanded flash sterilization education requirements for staff members.

Evaluation of a Pilot Hospital-Based Community Program Implementing Fitness and Nutrition Education for Overweight Children

Objective: The hospital-based Nurses Living Fit (NLF) intervention was implemented by nurses to determine its effect on decreasing body mass index (BMI) in nurse participants. Background: Although there are limited data on obesity rates of nurses working in the United States, more than half are estimated to be overweight or obese. Methods: The NLF intervention included exercise (12 weekly sessions), yoga and nutrition (4 monthly sessions), and diary completion (exercise/yoga, food/water consumption, and sleep), addressing healthy lifestyle principles. Results: NLF participants experienced a greater mean reduction in BMI and waist circumference inches. Ninety-three percent of NLF participants recommended the NLF program. Conclusions: Provision of an evidence-based program such as NLF facilitates nurse education on healthy lifestyle principles.

A Randomized Double-blind Study Comparing Intradermal Anesthetic Tolerability, Efficacy, and Cost-effectiveness of Lidocaine, Buffered Lidocaine, and Bacteriostatic Normal Saline for Peripheral Intravenous Insertion

PURPOSE Evaluate the effect of the Kids Living Fit hospital-based intervention on body mass index (BMI) percentile, adjusted for age (months) and gender in children ages 8-12 years with BMI percentiles > or = 85. DESIGN AND METHODS Twelve weekly exercise sessions and three nutrition presentations were held. Nurses recorded BMI and waist circumference at baseline, week 12, and week 24. Participants completed food and activity diaries. RESULTS Of the 32 participants enrolled, 16 completed all outcome measures and experienced a decrease in average BMI, BMI percentile, and waist circumference between baseline and weeks 12 and 24. PRACTICE IMPLICATIONS Hospitals can offer exercise and nutrition programs to decrease childhood obesity in their communities.

A 2-tier study of direct care providers assessing the effectiveness of the red rule education project and precipitating factors surrounding red rule violations.

In this double-blind study, 256 surgical patients meeting eligibility criteria were randomized in a 1:1:1 ratio to 1 of the 3 intradermal injection groups prior to intravenous (IV) line insertion (Group 1 = 1% lidocaine, Group 2 = 1% buffered lidocaine, and Group 3 = bacteriostatic normal saline with a benzyl alcohol preservative). The most tolerable solution, as measured by the average level of pain from an intradermal insertion, was buffered lidocaine (Group 2). The most efficacious, as measured by average level of pain at IV cannulation, were Groups 1 and 2. Group 3 was the most cost-effective.