Reporting Relationships & Communication
Nursing Strategic Plan & Quality
Professional Development
Shared Decision-Making
Quality improvement & Outcomes
100
How do you communicate with your Manager? Director? Your CNO? Your CNE?
Manager: daily rounds, MOX, email, staff meetings, office hours Director: rounds, MOX mail, email, staff meetings, office hours CNO: rounds, email, CNO luncheon, CNO presentations CNE: rounds, CNE presentations, TriHealth Nursing News (TNN) on SourceNet (LinkNet)
100
How do nurses participate in the Nursing Strategic Plan creation/review process?
Staff RNs participate in the nursing retreat, along with nurse leaders. At this time the strategic plan is updated
100
How do you incorporate peer feedback into your annual goal setting process?
Peer feedback is included in annual appraisal. Goals are derived in part from that feedback Peer feedback is in large part the entirety of the Peer 360 process, where mid-year goals are made
100
How are your unit’s SLC and SLC leader supported?
Meeting time is respected, paid, and not limited by manager Meals are provided by department Department SLC chair meets routinely with manager and director Shared Leadership membership varies throughout the year. As of publication it is: Treaundra Pope, RN Chair Jane Gockenbach, RN Jenn Heffron, RN Nakisha Jacobs, RN Pat Patton, RN Erica Selby, RN Kristi Sutherland, RN Lindsay Rawlings, RN
100
How do you give input to your management team to improve patient care and the work environment?
Staff Meetings Rounds Face-to-face Email and Mox Mail Charge RN meetings Educator during lunch/dinner relief shifts SLC chair to management team
200
Describe a time or situation in which you were supported by senior nursing leadership (Manager, Director, CNO, or CNE).
Security needs in the ED – led to longer hours for officers, locked down department, portable buttons Additional staffing and lunch/dinner staffing in response to requests Resources in response to requests: Ensuring adequate daily staffing in the department Manager is on unit prior to end of night shift many days
200
How are Strategic Priorities from the plan incorporated into unit goals?
Goals for SLC, capital budget, staffing, research are aligned with the strategic priorities For example, focus on Evidence Based Practice (EBP) led to uniform changes and bedside report, Focused on TriHealth wide practices: Suicide risk assessment is an example of TriHealth-wide assessment document EMTALA process and transfer form developed with all ED sites working together
200
What type of support is available for managers and staff for nursing specialty certification?
Payment, pre-payment of certification. Payment of specialty association dues often included
200
How are annual SLC goals created?
By committee, presented to ED director
200
What has been done on your unit in the past two years to improve patient safety?
Increased security officer hours Added patient aides (sitters) Enhanced RN staffing Decreased LOS in department leading to less time in waiting room
300
How are quality data/outcomes and trends communicated?
Agenda item at each staff meeting
300
How do you partner with other disciplines to provide patient care? Describe a recent example (past two years).
The Shared Leadership Committee (SLC) is in the process of hosting representatives from each inpatient unit for a lunch and learn. The purpose is to exchange information and to enhance relationships. To date the 11th floor, 15AB, and 14CD have met with our SLC. All newly hired RNs shadow in L&D triage for 4 hours. This came about from an interdisciplinary team of RNs from L&D and the ED.
300
How are you involved with professional nursing organizations (i.e. ENA, ANA)?
ENA developed current 5 level triage classification used at all TriHealth EDs (ESI triage) ENA staffing benchmarks are used to assist in developing staffing ratios at all TriHealth EDs ANA standards of care used as reference in all TriHealth EDs
300
How does management help facilitate the SLC meeting process (i.e. – unit staffing, meeting room, funds, etc)?
Encourages participation in the SLC Acknowledges the importance of the SLC Funds computer (laptop) and software for SLC Funds office supplies, meals, and other needs Provides meeting rooms for the SLC
300
What has been done on your unit in the past two years to improve staff safety?
Increased security officer hours Added portable panic buttons Added closed quick triage area with bullet-resistant glass Locked down the department, including squad doors Increased outside lighting Developed a code word Trained 100% of staff in de-escalation
400
How are the results of the biennial NDNQI RN Satisfaction Survey discussed & actions planned?
Staff meetings
400
How is interdisciplinary conflict addressed? Describe a recent example
There is a process in place for conflict management. The ED Process Team is an excellent venue for interdisciplinary issue discussion and resolution. A recent example is delayed radiology testing. The process was reviewed and reworked at several ED Process Team meetings with ED RNs, physicians, and Radiology Techs/Radiology managers in attendance.
400
How do you share information from professional nursing organizations with staff?
Departmental journal club Department staff meetings MOX mail SLC meetings
400
How do you stay abreast of the work of the Nursing Council & Committees? How do you share this information with staff?
From members of Councils such as: Ginny Mclaren – Management Council Paula Horner – Practice Council Christina Caldwell – Education Council Jim Owen – Leadership Council Other Councils include: Quality and Research From members of Committees such as: Melissa Gayle – Recognition and Retention Committee Julia Mahoney – Skin Care Committee, Pain Resource Committee Other committees and teams that everyone is involved in include: Chart and hand washing audits – Lots of people Quality team – Gail Tyson & Julie Mahoney Hazmat team – Melissa Taylor, Michele Simms, & Michael Mullen Journal Club, (two, one nursing and one social!) – Lots of people Professional Excellence Rep – Melissa Wolford
400
How do you know that nurses on your unit are giving good patient care?
Chart audits by staff RNs, manager QI process, trending Rounding by charge RNs, manager Trending safety events
500
How is the Nursing Strategic Plan and unit goals discussed with unit staff?
Staff meetings – strategic plan and updates are presented at department staff meetings
500
Describe a recent (past two years) quality improvement initiative on your unit.
Physician Triage – adding an RN, physician, ED tech, and lab tech to a formal 6-bed triage area has led to a reduction in potentially sick patients leaving the department without treatment. Length of stay has been significantly reduced, meaning patients will see a doctor quicker and begin diagnosis and treatment.
500
What type of continuing education opportunities are available for RNs at TriHealth?
LEARN has assigned CE modules plus hundreds of key-word searchable CE and non CE training modules Two to three RNs are sent to national conferences (usually ENA) each year, then bring back timely info RNs are sent to local conferences throughout the year Conferences/seminars are offered and sponsored by TriHealth throughout the year ACLS/PALS/HAZMAT Journal Club Educator Board Annual cardiac EMS/RN offering
500
How do nurses in your area participate in scheduling decisions?
Requests made before the cutoff date are accepted Trades are allowed unless resulting in overtime Vacations are taken by seniority first week through all staff, then second week. No RNs were denied a first week vacation in the past 10 years No RNs were denied a second week vacation in the past 6 years Scheduling grid reviewed annually at staff meeting and with department representative at the GSH staffing committee. Scheduling policies reviewed/revised by the SLC every three years or more often if needed
500
Describe a recent (past two years) RN Satisfaction Survey action plan item that was completed on your unit.
2009 NDNQI RN satisfaction survey issue: Perception of Quality of Care on Unit: Action plan included 1.) Revamping Triage – 4/2011 added quick triage. 2.) Slow full registration – 9/2010 changed to quick registration. 3.) Progressive Care inadequately staffed – 9/2010 changed staffing ratio for Progressive. 4.) Need Standards of Care – 12/2012 standards completed.
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