Transcript Project Report - Lean Sigma

On the CUSP: STOP BSI
Nurse Empowerment
© 2009
Learning Objectives
• To understand the importance of nurse empowerment
• To learn strategies to help empower nurses
© 2009
What Have We Learned So Far?
• Work involves technical problems
– Evidence
– Measurement
• Adaptive problems
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Engagement of nurses, physicians, leaders
CUSP
Daily goals
Competing priorities
© 2009
Improving ICU Culture
by Creating Trust
• Caring
– Keep Patients your North Star
– Preventable harm is not tenable
– Tell your own Josie Story
• Competent
– Learn from mistakes and implement teamwork tools (CUSP)
© 2009
Ensure Patients Reliably
Receive Evidence
Senior
leaders
Team
leaders
Staff
Engage
How does this make the world a better place?
Educate
What do we need to do?
Execute
What keeps me from doing it?
How can we do it with my resources and
culture?
Evaluate
How do we know we improved safety?
Pronovost: Health Services Research 2006
© 2009
Nurse Empowerment
• Keep Patient as north star
• Decision to speak up
– Must feel competent
– Must feel it is safe
– Must feel it will work
• Policy level (code of conduct)
– Helpful if enforced
© 2009
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
© 2009
Strategies for
Nurse Empowerment
• Use tools to practice nurse empowerment in
safe space
– Nurse attends rounds
– Daily Goals with nurse read back
– Learning from Defect
• Address disruptive behavior quickly
© 2009
Strategies for
Nurse Empowerment
• 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
© 2009
Action Plan
• Meet with ICU 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
© 2009