Posts from September, 2014

Nurse Retention: Culture of Safety Needed for Nurses Too

Written by LeAnn Thieman, CSP, September 30th, 2014

We read a lot about the culture of safety for patients, and it should also apply to nurses and other healthcare workers in order to increase nurse retention and retention of all healthcare workers. This group has consistently been ranked by the Bureau of Labor Statistics as having among the highest rates of workplace injury. Nurses are faced with many occupational hazards and health risks, including musculoskeletal injuries, needle sticks and radiation exposure.

warning signNew national standards for safe patient handling and mobility are an important tool for helping nurses and patients, said ANA’s Adam Sachs. “We can’t afford to lose nurses to preventable injuries at a time when more people are able to access healthcare services,” Sachs said.

To increase nurse retention and create healthy work environments visit SelfCare for HealthCare™. Contact me so we can customize this life-changing program for your employees.

Patient Care and Nurse Care: How Clothing Is Spreading Germs

Written by LeAnn Thieman, CSP, September 25th, 2014

A new dress code policy for doctors, nurses and other health care workers could keep dangerous germs from spreading among patients, an important piece to improve patient care and nurse care.

Short sleeves, bare forearms and white coats that are laundered at least once a week, if not more often, are the keys to keeping dangerous bacteria such as Staphylococcus aureus from clinging to a doctor’s wrist.

germsNew guidelines on hospital attire released by the Society for Healthcare Epidemiology of America, or SHEA, suggests that neckties are questionable and watches and rings should not be worn. It’s not clear what to do about name tags, lanyards, necklaces and cell phones, but when in doubt, it’s best to clean the offending items often or not wear them at all.

SHEA, determined to stop infections in hospitals and health care settings, reviewed dozens of studies that suggest grimy hospital garb might be responsible for spreading germs.

The direct link between the germs on health worker clothing and actual infections is unclear, said Dr. Gonzalo Bearman, a hospital epidemiologist with the Virginia Commonwealth University System and a member of the SHEA guidelines committee. But it makes sense that there would be a connection, he said.

SHEA members looked at studies that found a range of worrisome bugs, from Acinetobacter and Pseudomonas to Clostridium difficile on the sleeves, pockets and other sites of health care workers’ coats and scrubs. One study found that a third of doctors’ neckties grew Staph aureus in the lab. Several found that the germs were often resistant to the top drugs used to treat them.

SHEA members came up with the new guidelines which also call for sturdy, closed-toe, non-skid shoes. Clothes laundered at home must be washed with hot water and bleach.

The group is urging hospitals to adopt the new guidelines, or to pay greater attention to them if they’re already in place. They’re committed to more research to determine exactly how hospital garb spreads infection, in hopes of recommending a health worker wardrobe that’s safe.

To learn more about creating healthy work environments that improve patient care and nurse care, visit SelfCare for HealthCare™. Contact me to discuss how we can customize this powerful program for your staff.

Nurse Retention and Patient Safety: Decreasing Nurse Workloads Save Lives

Written by LeAnn Thieman, CSP, September 23rd, 2014

Patients who’ve undergone common surgical procedures are less likely to survive if they are treated in hospitals where nurses have heavier workloads and fewer have a bachelor’s degree, according to a new European study. These findings are important for facilities wanting to increase patient safety and nurse retention.

The findings, published in The Lancet, suggest that “a safe level of hospital nursing staff might help to reduce surgical mortality, and challenge the widely held view that nurses’ experience is more important than their education,” the study’s leader, Linda Aiken, a professor from the University of Pennsylvania School of Nursing.

Nurse Retention Researchers examined surveys of more than 26,500 nurses and reviewed the medical records of more than 420,000 patients 50 or older after they went home from the hospital following common surgical procedures, such as a joint replacement or gall bladder surgery. The researchers also considered the patients’ age, sex, type of surgery and whether they had any other medical conditions to assess their individual risk of death. After taking these factors into account, the study analyzed how the level of nurses’ education affected patient outcomes at 300 hospitals across nine European countries.

The study authors found that each additional patient added to a nurse’s workload increased the odds of surgical patients dying within 30 days of surgery by 7 percent. On the other hand, the findings revealed that a 10 percent increase in the proportion of nurses with a bachelor’s degree was linked to a 7 percent drop in patients’ risk of death.

The study also revealed that nurse workload and education levels varied greatly from one country to the next. The researchers suggested that there would be a nearly 30 percent reduction in the risk of death after surgery in hospitals where nurses care for an average of six patients instead of eight, and the proportion of nurses with bachelor’s degrees is at least 60 percent.

“Our findings emphasize the risk to patients that could emerge in response to nurse staffing cuts under recent austerity measures, and suggest that an increased emphasis on bachelor’s education for nurses could reduce hospital deaths,” Aiken said.

Research proves we need more nurses. To learn proven strategies for nurse retention, nurse recruitment and how to improve patient safety, visit Let’s talk today about how I can partner with your facility!

Life Balance: Encourage Exercise, Take the Stairs

Written by LeAnn Thieman, CSP, September 18th, 2014

Better access to stairs in office buildings and reminding people to use them encourages workers to get more exercise and improve life balance, a new study suggests. This has already proven to increase physical activity in places like subway stations and shopping malls.

The report also offers evidence that natural light in stairwells is important, according to a statement from the New York City Department of Health and Mental Hygiene.

The health department’s Bureau of Chronic Disease Prevention and Tobacco Control conducted the study, which only included city employees.

life balance - walk stairs“Adults spend a large portion of their life in their workplace, and having access to and incorporating physical activity into one’s day can have a positive impact on health,” the department’s statement read.

Ryan Richard Ruff, director of the Research & Evaluation Unit at the health department, led the study. He and his coauthors analyzed assessments of 14 New York City buildings alongside physical activity surveys of their 1,300 total employees.

Small signs were placed at elevator call buttons and stairway entrances reminding employees to “burn calories, not electricity” by using the stairs. These prompts included information about the benefits of taking the stairs, on personal health and the environment.

Employees were about three times more likely to use stairs in buildings with stair prompts. More than half of participants said they climbed at least one flight of stairs at work per day.

Stairwells that had natural lighting and were visible from lobby entrances were also more frequently used than darker or more distant ones.

People working on higher floors were less likely to take the stairs. The authors suggest encouraging employees to take the stairs for at least part of the journey and take the elevator the rest of the way.

“These types of actions are necessary as today nearly 60 percent of NYC adults and 40 percent of school children are overweight or obese,” according to the health department statement. “Regular physical activity and healthy eating are key factors in addressing the epidemic, and the scientific evidence now tells us that creating environments that support people in the behavior changes they are trying to make helps people to be successful at accomplishing these healthier behaviors.”

Get tips to increase exercise, healthy habits at work and life balance at SelfCare for HealthCare™. Contact me today to talk about implementing a work life balance program at your organization.

Nurse Retention: Thirty Percent of Hospital Nurses Feel Bullied at Work

Written by LeAnn Thieman, CSP, September 16th, 2014

Thirty percent of nurses working in hospitals say they feel bullied at work, according to a recent Jackson Healthcare survey – an alarming statistic for nurse retention.

Nurses feel bullied by a variety of people, including senior management (13%), fellow nurses being cliquey or rude (11%), nursing administration and leaders (5%) and physicians (5%).

Nurse BullyingBullying has a significant negative effect on job satisfaction for nurses, according to the survey. Nurses who feel bullied are more likely to say their profession has taken a turn for the worse. They are also more likely to admit to feeling isolated and waste time on tasks others could do.

Maintaining a positive workplace environment in hospitals not only fosters better job satisfaction, but it also improves nurses’ performance and subsequently, patient outcomes.

To learn how to create supportive, non-bullying environments that increase nurse retention and patient satisfaction, visit SelfCare for HealthCare™ and contact me today to discuss your facility’s needs.

Life Balance: Reduce Stress for Adults and Teens

Written by LeAnn Thieman, CSP, September 11th, 2014

Teens across the USA are feeling high levels of stress that negatively affects every aspect of their lives, a new national survey suggests. This means that teens need to be taught life balance tools to help combat the stress.

More than a quarter (27%) say they experience “extreme stress” during the school year, and 13% in the summer. And 34% expect stress to increase in the coming year.

life balance - teen stressStressors range from school to friends, work and family. And teens aren’t always using healthy methods to cope, reports the latest Stress in America survey from the Washington, D.C.-based American Psychological Association.

Findings on more than 1,000 teens and almost 2,000 adults suggest that unhealthy behaviors associated with stress may start early and continue through adulthood. With 21% of adults reporting “extreme” stress levels, the survey says that with teens “mirroring adults’ high-stress lives” they are “potentially setting themselves up for a future of chronic stress and chronic illness.”

The report warns that teens are at risk of a variety of physical and emotional illnesses and potentially shorter lifespans than their elders if they don’t act to “reverse their current trajectory of chronic illness, poor health and shorter lifespans.”

“Our study this year gives us a window in looking at how early these patterns might begin,” says clinical psychologist Norman Anderson, the association’s CEO. “The patterns of stress we see in adults seem to be occurring as early as the adolescent years — stress-related behaviors such as lack of sleep, lack of exercise, poor eating habits in response to stress.”

Teens’ average stress level was 5.8 out of 10 during the school year and 4.6 in August. Adults reported average levels of 5.1 in August.

As a result of stress, 40% of teens report feeling irritable or angry; 36% nervous or anxious. A third say stress makes them feel overwhelmed, depressed or sad. Teen girls are more stressed than boys, just as women nationally are more stressed than men.

The report says stress appears to be affecting teens’ performance in all aspects of life:

• 59% report that managing their time to balance all activities is a somewhat or very significant stressor;

• 40% say they neglected responsibilities at home because of stress; 21% say they neglected work or school because of stress;

• 32% say they experience headaches because of stress; 26% report changes in sleeping habits;

• 26% report snapping at or being short with classmates or teammates when under stress.

I’ve often said that we adults are always role modeling, whether we want to be or not. To learn symptom of stress and how to increase life balance for yourself and your children, visit SelfCare for HealthCare™.

Work Life Balance: How Does Exercise Affect Your Sleep?

Written by LeAnn Thieman, CSP, September 9th, 2014

Researchers found that people who exercise in the evening sleep as well as those who aren’t active in the hours before bed. People who work out in the morning report getting the best sleep, on average, which is something to consider when finding your work life balance.

Some sleep recommendations suggest avoiding exercise prior to bed, but evidence to the contrary suggests that individuals need not avoid exercise at night.

work life balance - night exerciseResearchers analyzed responses collected from 1,000 adults participating in the 2013 National Sleep Foundation Sleep in America Poll. The telephone- and web-based questionnaire asked participants how well they felt they slept, how long they slept each night, how much time it took them to fall asleep, and whether they felt refreshed waking in the morning.

The poll also asked participants about their exercise habits and whether they worked out regularly. If so, were they active in the morning, afternoon or evening? (within four hours of going to sleep).

People who exercised vigorously in the morning were 88% more likely to report good sleep than non-exercisers and 44% less likely to say they woke up feeling unrefreshed.

Moderate-intensity morning exercisers were 53% more likely to say they slept well overall, compared to people who didn’t exercise.

Although the National Sleep Foundation’s sleep hygiene recommendations don’t preclude pre-bedtime workouts, they do advise sticking to relaxing exercises, such as yoga, in the evening hours. Some doctors advise against evening workouts.

But this research gives us fewer excuses to avoid exercise and more reasons to increase work life balance with exercise! To learn how to care for your body, mind and spirit visit SelfCare for HealthCare™. Let’s talk today about how to customize this program for your staff. Contact me today!

Nurse Recruitment: Affordable Care Act Demands More Advanced Practice Nurses

Written by LeAnn Thieman, CSP, September 4th, 2014

With the Affordable Care Act there could be an additional 32 million to 38 million people covered with health insurance. Raising the bar for nurse recruitment is necessary as advanced practice nurses will be needed to care for them. Most registered nurses have an associate’s or, increasingly, a bachelor’s degree. But as the face of medicine changes, nursing is changing too, with many getting master’s degrees as advanced practice nurses to be able to order tests and prescribe medicines.

A growing number are going on to a Doctor of Nursing Practice, acquiring the skills not only to offer direct care to patients, but to assist in management and program development, and incorporating findings from new research. It typically takes 13 years from the time research is done to the time the findings are applied to change patient practices. Part of the training in getting a DNP is designed to help shrink thaNurse Educationt lag time.

As healthcare professionals try to curb costs while improving outcomes, they increasingly look at the whole patient, including family situation and lifestyle, trying to prevent problems, not just treat them. The Affordable Care Act is accelerating that development, pushing the market into creating a continuum of care. Advanced nursing degrees fit well into that theory because nursing has always been about the person and not just the illness, considering the physical, psychological, social, financial and even spiritual concerns.

Entry level nursing programs still require a lot of classroom time and clinical work, but the advanced degrees can increasingly be done with a mix of online and clinical practice, some requiring little or no class time.

Advance practice nurses specialize in one of four areas: Nurse practitioners, clinical nurse specialists, nurse anesthetists, or nurse midwives.

More nurses will be needed to meet this demand. To learn the most effective strategies for nurse recruitment and nurse retention, visit SelfCare for HealthCare™. Contact me today to schedule a complimentary consultation about your facility’s needs.

Nurse Retention and Nurse Retention: Improving Patient Care and Outcomes

Written by LeAnn Thieman, CSP, September 2nd, 2014

Both the quality and quantity of nurses on a hospital staff have significant influence on whether the patient will survive, even after simple surgery, according to a large new study. This underlines the fact that effective nurse retention and nurse recruitment are necessary to create the best patient care.

Researchers found the proportion of staff nurses with a bachelor’s degree and the number of patients each nurse had to care for could add up to a difference of 30% or more in mortality rates for inpatients.

“If you go to a hospital in a developed country like the U.S. or UK, you think you’d get equal care, but that’s really not the case,” said the study’s lead author, Linda Aiken, a professor of nursing and director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania in Philadelphia.

Aiken and her team found that for every 10 percent increase in the number of staff nurses with a bachelors degree, there was a 7 percent lower risk of patient death within a month of being admitted to the hospital. On the other hand, boosting a nurse’s workload by one patient increased the likelihood of an inpatient dying within 30 days of admission by 7 percent.

nurses and patient careTheir study used medical data on more than 422,000 patients over the age of 50, collected between 2007 and 2009 as part of RN4CAST, an effort funded by the European Commission to gather information about the nursing workforce from 488 hospitals in 12 European countries. The patients had undergone common surgeries, such as an appendectomy, knee replacements, or gallbladder removal, which are not linked to a high risk of death but still require a stay in the hospital afterwards. The research team also took into account the patients’ preexisting health problems.

Surveys of more than 26,000 nurses working in the hospitals were also part of RN4CAST, and measured the professional nurses’ education levels, along with the usual number of patients each nurse was expected to take care of during his or her shift.

The difference in patient deaths between nurses with and without a bachelors degree likely stems from the nurses’ abilities to think critically and discuss patient care freely with other hospital staff, such as physicians, Aiken said.

The results are particularly relevant as hospitals and policymakers look to decrease costs – sometimes by cutting nursing staff. Such decisions may be short-sighted and threaten patient safety down the road.

To learn more ways to improve patient care and outcome and increase nurse retention and nurse recruitment efforts, visit SelfCare for HealthCare™. Contact me today to customize this powerful program that improves the overall health of your facility.