Practicum Powerpoint Presentation 2014.1

Information about Practicum Powerpoint Presentation 2014.1

Published on July 13, 2014

Author: jjmpgh



PowerPoint Presentation: 1 Implementation of Bedside Report between Post-Anesthesia Care Unit and Inpatient Orthopedic Unit Staff Nurses using Facetime Overview: JCAHO Patient Safety Goal 2E “ improve the effectiveness and communication among caregivers: managing hand-off communications with particular attention to ensuring the opportunity for asking and responding to questions ” 13 “ encourage patients ’ active involvement in their own care as a patient safety strategy Bedside Nurse Report builds Teamwork Ownership Accountability Patient safety Patient satisfaction Overview 2 Magee’s Values: We use the acronym IRISE: I- Integrity R- Respect I- Innovation S- Service E- Excellence Magee ’ s Values 3 Magee’s Mission/Vision: Mission: The mission of Magee-Womens Hospital nursing and Patient Care Services is to lead and nurture excellence in care for our patients, their families, and each other Vision: Magee-Womens Hospital nursing and Patient Care Services inspire nurses in a respectful, compassionate environment to use their talents to deliver the best nursing care. By utilizing an interprofessional approach, in collaboration with strong mentoring and innovative thinking, we cultivate an enriched learning environment Magee ’ s Mission/Vision 4 Project Outcomes: Successful implementation of bedside nurse report via Facetime from PACU to surgical inpatient unit Improve Nurse Communication Improve Nurse Accountability Improve Patient Safety Improve Nursing Morale between Pacu and surgical inpatient unit. Project Outcomes 5 Why we changed to Bedside Nurse Report: Evidence Based Practice- Literature review on bedside shift report Nurse accountability Nurse Morale/ Relationships (mentor from experienced to less experienced RN , PACU) Patient involvement in own health/education Patient assured correct information is passed along Patient satisfaction Improve relationships outside based unit Why we changed to Bedside Nurse Report 6 Overview: Pascal Safety Survey Result : Overview: Pascal Safety Survey Result 7 Nursing staff is concerned about patient report/safety 75% nurses agreed that “ shift changes are problematic ” 50% felt “ important patient care information is often lost during shift changes ” Background: Implemented Bedside Nurse Report on 4100 unit in Sept 2012 Implemented Bedside Nurse Report in Med/Surg settings in 2013 Eliminated VoiceCare (taped patient report) within the nursing unit How do we roll out Bedside Nurse Report between nursing unit transfers? Background 8 Pre-Initiative: What ’ s next? Report from Pacu to 4100 unit Previous practice: Voicecare or Taped report Challenges with Voicecare Patient ’ s are unable to participate in their plan of care Patient ’ s are unable to ask questions Receiving nurse is unable to ask questions Receiving nurse is unable to see patient Wall between nurses from Pacu and 4100 unit. Patient safety was compromised due to lack of communication. Pre-Initiative 9 Project Team: Unit Director for 4100 unit Unit Director for PACU Clinicians for 4100 unit Clinicians for PACU IT lead IT specialist Clinical education specialist Med/Surg PCS director Risk Manager Project Team 10 Goals: Goals 11 Follow Hcahp ’ s satisfaction scores, maintain 90 th percentile on Nurse Communication Maintain 100% for patient satisfaction via the inpatient unit daily discharge satisfaction score Reduce falls Reduce number of conditions at change of shift Use Facetime bedside nurse report 100% of the time Improve in the yearly NDNQI scores Using Nursing Management Theory: Peplau ’ s Theory: Theory involves concepts such as communication techniques, assessment, definition of problems and goals, direction, and role clarification. According to Peplau ’ s theory The nurse encounters the patient The nurse observes Interprets what he or she observes Then decides what needs to be done Voicecare did not promote Peplau ’ s Theory Bedside Nurse Report/Facetime Report does promote Peplau ’ s Theory Using Nursing Management Theory 12 Leadership Style: Transformational Leadership Style: Transformational leader is one who commits people to action, who converts followers into leaders, and who may convert leaders into agents of change Empowering frontline staff Take Ownership of the initiative Everyone has a VOICE Why it is important to do Show achievements Work as a group to correct failures Leadership Style 13 Use Plan.Do.Check.Act (PDCA) Methodology: The Plan Completed Pascal Safety Survey (nurses voiced patient safety concerns on handing off report between nurses Develop Bedside Nurse Report committee within 4100 unit Develop Facetime committee, including IT, PACU staff, Unit Directors, & Risk Researched Evidence Based Nursing articles Discussed in Staff Meetings Develop Facetime Policy Develop Process Map Focused on one initiative during this period Use Plan.Do.Check.Act (PDCA) Methodology 14 Use Plan.Do.Check.Act (PDCA) Methodology: Do Educate nursing staff on Ipad/Facetime functions Educate nursing staff on process map Educate nursing staff on policy and procedure Shadow reporting process Continue with Facetime committee, discuss achievements and failures Continue to test procedure Checklist for issues during the do phase to bring back to the committee Time trials Use Plan.Do.Check.Act (PDCA) Methodology 15 PACU/Med-Surg Facetime Process Map: PACU/Med-Surg Facetime Process Map 16 Patient is assigned a room via bedboard Charge RN assigns patient to a RN PACU calls Floor ( huc ) to provide 15 minute IPAD report Warning Huc tells PACU RN which IPAD to call HUC notifies floor RN that report will take place in 15 mins and provides appropriate IPAD to RN Is floor RN available for report? Report is given via facetime on IPAD Floor/Charge RN returns IPAD to HUC Patient is transferred to unit immediately following report via escort Escort provides Huc with chart upon arrival to unit Huc informs PCT/RN of patient arrival HUC informs Charge RN or PNCC that report will take place in 15 mins and provides appropriate IPAD NO YES Use Plan.Do.Check.Act (PDCA) Methodology: Check Schedule Staff meeting to discuss process with frontline nursing staff Interview patient ’ s and get their point of view Discuss results of time trials Meet with Facetime committee and discuss achievements and failures, problem solve. Keep nursing staff engaged/ownership Do not be afraid to change the procedure (trial and error) Use Plan.Do.Check.Act (PDCA) Methodology 17 Use Plan.Do.Check.Act (PDCA) Methodology: Act Keep repeating the cycle to improve initiative (Facetime report) Monitor changes you made to see improvement or not Keep following up with nursing staff and patients to get their input Monitor goals Use Plan.Do.Check.Act (PDCA) Methodology 18 Timeline: Timeline 19 FACETIMING BEDSIDE NURSE REPORT INITIATIVE TIMELINE Started bedside nurse report on inpatient unit in Sept 2012 Successful implementation of bedside nurse report on inpatient unit Sept 2013 First project meeting on how to spread bedside nurse report on patients who transfer from unit to unit, Dec 2013. Facetime born Awarded Beckwith Grant for Facetiming bedside nurse report. $5000 for purchase of IPADS. Jan 2014 Started trial of facetiming bedside nurse report from PACU to inpatient surgical unit. April 2014 2 months into facetiming bedside nurse report from PACU to inpatient care unit. Using PDCA model to continuously improve and problem solve. July 2014 Spread Facetiming bedside nurse report from PACU to inpatient oncology unit, starting Sept 2014 Financial Impact of Facetime initiative: Hours spent in committee meetings Hours spent in frontline education Hours spent in technology problem solving Equipment charges Salaries for committee meetings, education, & problem solving = $4855.00 Equipment charges 6 Ipads = $3600.00 Ipad covers= $480.00 Ipad stands= $100.00 Headphones= $200.00 TOTAL COSTS= $9235.00 Financial Impact of Facetime initiative 20 Financial Reimbursement: Applied for Beckwith Institute Frontline Innovation Program grant Nicholas and Dotty Beckwith helped fund the grant due to the care that Mrs. Beckwith received as a patient at UPMC In 2012, the Beckwiths donated 5 million dollars to the program and UPMC matched their donation Facetime initiative was granted $5000.00 from the Beckwith Institute Frontline Innovation Program to help roll out for patient safety. Thus total costs after the grant = $4235.00 Financial Reimbursement 21 Hcahps/Falls Timeline:   Jan-Sept 2012 Sept-Dec 2012 Jan-Mar 2013 Apr-June 2013 July-Sept 2013 Oct-Dec 2013 Current Apr-Now 2014   (379 responded) (159 responded) (112 responded) (117 responded) (134 responded) (130 resonded) (108 Responded) Communication with Nurses 80 81 87 83 87 86 92                 Rn's treat with courtesy/respect 85 88 91 89 90 91 95                 Rn's listen carefully to you 74 73 85 79 84 84 90                 Rn's explain in way you understand 81 82 86 82 87 82 92                 Pain 74 74 82 76 76 83 78                 Communication regarding Meds 66 67 63 67 67 77 69                 Falls 32 12 6 6 5 4 4                 Hcahps/Falls Timeline 22 Start Bedside Nurse Report 9/17/2012 Start Factime report with PACU 1/27/14 Future: Spread of Facetime Report Other Magee Inpatient Units MD offices Nursing Homes Outlying Hospitals Future 23 Bedside Nurse Report Accountability Patient Safety Evidence Based Practice Questions?: Questions? References: References 25 References: References 26

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