© 2009 on the cusp: stop bsi nurse empowerment christine a. goeschel rn mpa mps scd (candidate)...
TRANSCRIPT
© 2009
On the CUSP: STOP BSIOn the CUSP: STOP BSINurse EmpowermentNurse Empowerment
Christine A. Goeschel RN MPA MPS ScD (candidate)
Tennessee Center for Patient Safety
December 2, 2009
© 2009
Learning ObjectivesLearning Objectives
• To understand the importance of nurse empowerment• To consider the regulatory and accreditation mandates
for nursing leadership• To learn strategies to help empower nurses
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CUSP/CLABSI:CUSP/CLABSI:What We KnowWhat We Know
• Change involves technical challenges– Evidence– Measurement– Analysis
• Change involves adaptive challenges– How to Engage nurses, physicians, executives– Competing priorities– Organization hierarchies– How to hardwire practice changes
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Improve Patient Safety Improve Patient Safety Culture: Create TrustCulture: Create Trust
• Caring
– Keep Patients your North Star
– Commit that preventable harm is not tenable
– Tell your own Josie Story
• Competent
– Learn from mistakes
– Implement teamwork tools (CUSP)
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Ensure Patients ReliablyEnsure Patients ReliablyReceive EvidenceReceive Evidence
Pronovost: Health Services Research 2006
Senior TeamStaff
leaders leaders
Engage How does this make the world a better place?
Educate What do we need to do?
ExecuteWhat keeps me from doing it?How can we do it with my resources and culture?
Evaluate How do we know we improved safety?
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Nurse EmpowermentNurse Empowerment
Keep patient as north star ~ Harm is not tenable
• Decision to speak up– Must feel competent – Must feel it is safe– Must feel it will work
• Transparency when harm occurs– At patient level– At provider level– At organization level
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Strategies for Nurse Empowerment
• Policy Level
– Code of conduct
– Require nurses to assist with central line
placement
– Require adherence to checklist
– Policy to deal with disruptive behavior
– Require that bedside nurse attend rounds
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Strategies for Nurse Empowerment
• Practice Level
– Licensure
– Nurse Practice Act
– Magnet Nursing
– Collaborative Practice Models
• Infection Preventionists
• Attending Physicians
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Strategies for Nurse Empowerment
• Performance Level
– Orientation /Skill Building
– Annual Competency Assessment
– Clinical ladder ~ leadership recognition
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• Use tools to practice nurse empowerment in safe space– Nurse participates in patient rounds– Daily Goals with nurse read back– Learn from Defects– Participate in M&M
• Address disruptive behavior quickly
Strategies for Strategies for Nurse EmpowermentNurse Empowerment
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• In conflict, keep focus on patient as north star
• Remind staff that teams make wise decisions with diverse and independent input– Do not play man down
Strategies for Strategies for Nurse EmpowermentNurse Empowerment
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Action PlanAction Plan
• Project leaders meet with CUSP/CLABSI team
• Discuss what policies can be put in place to enhance nurse empowerment
• Create strategy to involve beside nurses in this project : use the 4Es
• Discuss what tools you can use to enhance nurse empowerment