Transcript Amy McLaughlin, BSN, RN, PCCN Heather Cable, RN 1
Amy McLaughlin, BSN, RN, PCCN Heather Cable, RN Rutland Regional Medical Center 1
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We work together on the Progressive Care Unit at Rutland Regional Medical Center (RRMC) in Rutland, Vermont.
Our patient population is varied and consists of Cardiac, Pulmonary, and high-acuity patients who do not require Intensive Care.
Our Unit’s Culture supports staff participation in various committees focused on patient safety and satisfaction.
The fast-paced environment, combined with high patient turnover and acuity, reinforces the need for Nurse-led interventions aimed at improving patient care and outcomes.
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We are members of the Progressive Care Unit (PCU) Patient Safety Team.
We began as the Medication Safety sub-Committee Initial interest in the project focused on improving the Medication Administration process on PCU 4
Our first step was a review of PCU medication administration data.
An informal Research Question was the result… A Literature Review then followed… …which helped guide us to our formal Research Question… 5
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We had to decide:
What part of the Medication Process do we observe?
We decided we needed to observe the ENTIRE process, from beginning to end… We needed to watch one Nurse, from the moment s/he entered the med room, until the final med was passed to that patient.
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One-Page Tool
Real Time
Second to second
Easy to Navigate
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First draft was an excel spreadsheet tool… Busy Smallest time increment in minutes …back to the “drawing board”… 11
Combined everything we needed:
One, attractive, easy-to-read page Time-Stamped (Second-to-Second) Easy to Individualize “One Click is All You Need”!!
…And Here’s How It Looks…
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7/9/2011 7/9/2011 7/9/2011 7/9/2011 7/9/2011 7/9/2011 7/9/2011 7/9/2011 7:28:02 AM 7:32:27 AM 7:32:50 AM 7:34:33 AM 7:34:58 AM 7:36:05 AM 7:36:28 AM 7:36:50 AM
TASKS
PHYSICIAN NURSE PATIENT OTHER CLINICAL PROFESSIONAL FAMILY PHARMACY/ OMNICELL COMPUTER TELEPHONE OTHER LNA CASE MANAGER RN SCANNER
MED ADMIN PROCESS TRUE
TRUE
TRUE
TRUE
TRUE
TRUE
TRUE TRUE
0:00:23 0:00:23 0:00:25
Over a period of one week in July, 2011, medication passes were observed on PCU from 7am to 11am. A total of 67 passes were captured during Phase I of the Observation Process, using our tool.
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50 40 70 60 10 0 30 20 23 42 65 21
Total # Interruptions 67 Observed Med Administrations
14 24 9 2 1 23 14 6 16
80 70 60 10 0 30 20 50 40 75 38 49 45
Average Interruption Elasped Time
34 48 59 32 47 34 43 23 17
Implementation of Nurse-led Intervention Medication Room Etiquette “Respecting the Process”
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How Will It Look?
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How Did We Get Support?
Staff Pledge
I pledge to follow proper medication administration practices to ensure the safety of my patients, myself , and my fellow health care professionals.
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We will implement our intervention for four weeks, beginning this Monday, November 14 th .
We will then start Phase II of our Observation Study beginning the week of December 11 th .
Final Data Analysis following Data Collection.
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Will our Data support that our Intervention led to decreased interruptions?
Will our Intervention need an adjustment?
Might we go Hospital-Wide?
Might we Publish?
Perhaps other facilities will be able to use our Tool!
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