Nursing Committee Updates
Standards, Policy and Procedures
This committee is happy to be hearing from bedside nurses and has responded to their questions and inquires. Recently, several staff expressed difficulty in finding policies. To find a policy: Click on the Start Menu, scroll to utilities and click on BWHPikeNotes. On the PikeNotes, click on the “Policies” tab in the main navigation banner that runs horizontally across the top of every page.
The most effective and fastest way to find a specific policy is to use the “Search” function in the center of the Policies page. Enter key words here, like you would on any Web search engine, and click on the “Search All Policies” button. This search button filters results so that only policies appear in the search results. These results will include Nursing and all other related policies.
You can also search the entire site from any PikeNotes page by using the search box at the top right-hand corner. Whether you search via the Policies function or the entire site, you can refine your search results by clicking on the tabs above your results which are labeled PikeNotes, Policies or Forms. To learn more about searching for content on PikeNotes, follow the “PikeNotes search tips” link on the results page.
To find Nursing policies, you can also scroll through the left-hand navigation bar in the Policies section. Simply click on Nursing, and you can choose from the Clinical Practice Manual and others. There will be multiple sections. For example, policies related to blood will be under BLD, medications under MED, etc. You may also select alphabetically. There is also a guidelines section that may contain the information you need. Don’t forget to skim the “New to You, Time to Review” email for policies and changes that may affect your practice.
In the recent e-mail you may have noticed the list of IV drugs approved for “push” administration. This is a reminder to utilize this method (a Joint Commission Standard) in order to avoid mixing drugs. The language in MED 01 (currently being updated) will state “All IV admixtures must be prepared by the Pharmacy Department except in urgent life threatening situations in which a delay could harm the patient or if the Pharmacy Department has deemed the stability of the medication too short to mix in the Pharmacy.” You will notice in the coming weeks more pre-mixed medications from Pharmacy to support this practice. You will be hearing much more on this from clinical educators. You can access the DAGs and IV Push list the same way as the Nursing policies from Pike Notes but select “Pharmacy.” Also in the MED section, (MED-15), is an updated policy on administering Insulin and Insulin Analogs.
Skin and wound care has also been updated. Now comprehensive, the policy contains seven procedures on patient assessment, techniques and care products most suited to different kinds of wounds. Please utilize this very user-friendly resource, listed as INT. 21. Also updated is INT 26, which gives guidelines for bariatric bed selection.
Questions, concerns or comments related to policies and procedures can be directed to the SPP co-chairs, Cindy Jodoin, MHA, BSN, RN, and Sharon Swan, BSN, RN, CRN, via partners e-mail.
Quality Safety and Care Improvement Committee
This committee continues the discussion around pressure ulcer care and prevention and recently completed a two-week pilot that focused on a process for communicating pressure ulcer safety reporting.
The aim was to establish a system that identified the completion of safety reports through handoff communication and a tagging system. The pilot was completed on two units in December. The committee is still reviewing staff feedback for further recommendations and improvement of the process. The committee has also provided input and recommendations on how to achieve best practice with pressure ulcer documentation and staging. Members continue to review and provide input into the Quality Department’s proposed Lean Performance Project headed by Quality Program Directors Lucy Feild, PhD, RN, and Mary Antonelli, MPH, RN. This project is focused on improving and standardizing wound documentation with plans to trial on Tower 3BC in March.
Other committee work has included recommendations on improving the communication of patient fall risk when patients are traveling off unit for tests or procedures, review of patient education sheets for MRSA, VRE, C-diff, and resistant gram negative infections and feedback on communication sheet documentation for patient travel and the sticker documentation of patient/family education related to infection.
If you have questions, contact committee co-chairs Stephanie Capello, RN, and Mary Antonelli, MSN, RN.
Patient and Family Education Committee
This committee’s 2010 goals consist of expanding the educational content on the Patient and Family Education Web site. The committee asks all clinical nurses to contact the co-chairs if they are currently using teaching materials that they can not find on the Web site. The information will then be added. Another goal is to organize and set guidelines for the Web site. The ultimate goal is to increase Web site usage. This committee has recently served as a resource in updating the infectious disease handouts and the process nurses follow to utilize and deliver these handouts to the patient. The committee also responded to feedback from nurses when they said they wanted easier access to the Web site. The Web site will soon be available on the resource button on eMAR screen. The committee is eager to make the Web site as user friendly and accurate as possible.
If you have any questions, contact committee co-chairs Cindy Loring, RNC, CNS, and Deb Moody, BSN, RN.
Informatics and Clinical Innovations Committee
The focus of this committee’s work continues to be on projects to improve clinical technologies that will assist the clinical nurse at the bedside. Projects include:
eMAR Enhancements: To improve communication of eMAR application changes to staff, a BWH eMAR Sharepoint site is being created. The committee gave feedback on the set up of the site including e-mailing snapshots of the updates as well as a link to the Sharepoint site with the complete update/announcement so as not to clog up nurses’ e-mail. Other enhancements include: administration history will incorporate dose number, med overview sorting-alphabetically/by category, heparin nomogram and signing off orders that were documented on paper in eMAR.
New Hardware Committee: A new clinical computing hardware committee has been created in preparation for Acute Care Documentation (ACD) pilot.
ACD Update: The group has been providing validation of nurses’ current workflow as well as future state processes. Topics have included bed confirmation, information flow, lag times, telemetry information flow and forms (such as the Braden scale etc.)
If you have any questions/concerns regarding this committee or its projects, please contact co-chairs Heidi Smith Doucette, CNRN, or Carol Booth, MSN, RN.
Nursing Practice Committee
The committee has been focusing on identifying the supports and conditions necessary for excellent practice to develop. Five themes have emerged: Nursing Leadership, Supportive Colleagues, Culture of Learning, Resources and Conditions/Strategies.
The committee identified the critical role of the nurse director in supporting practice development. The desirable behaviors and characteristics of this role were discussed. The committee agreed that supportive colleagues demonstrate accountability to their peers and to the unit. A culture of learning was described with emphasis on understanding the stages of practice development and developing strategies that support the developmental needs of staff. The committee has discussed the value of having access to resources for developing staff and the importance of having resources available throughout the shifts. Several other strategies/conditions have been identified. A strategy currently under discussion is continuity of care as a way to promote knowing the patient.
If you have any questions, contact committee co-chairs Mary Beth Mondello, CNRN, and Alice O’Brien, MS, RN.