Nursing Committee Updates
Quality, Safety and Care Improvement Committee
The committee has provided feedback on many new initiatives impacting nursing care. The first was on the administration of oral medication. Currently there is no distinction between Intravenous, Intramuscular and oral syringes, which can lead to safety issues in administration. Anne Bane, MS, RN, nursing director for Clinical Systems Innovations, presented a new oral syringe product that is orange in color and asked committee members for advice on the sizes of syringes needed for oral medication administration. The committee provided feedback on this product, which will be available to use with oral medication administration in the fall. Please look for the broadcast.
Ann Furey, MBA, BSN, RN, and Beth Baldwin, BSN, RN, shared with the committee the Shapiro 9/10 Patient Education - Automatic Video Assignment pilot. The goal is to ensure patients receive safety education and assist with documentation of the Joint Commission's patient education requirements. There will be more to come on this initiative before it is rolled out to all units. The upcoming changes to the Warfarin patient education process were also discussed. Discharge instruction will be incorporated into the Patient Discharged Instruction sheets, and the patient educational booklets will have all the educational elements to be reviewed and checked with the patient when completed.
The Nursing Dashboard, which is being set up on patient care units this summer, was presented by Mary Swenson, RN. In September, the quality data will be posted for all staff to see. A contest to name the nursing dashboard has been underway, and the person who submits the winning name will receive a pizza party for their area. The name selected will be announced in September.
If you have any quality issues you would like feedback on, please submit an agenda item to Marty Doherty, RN, co-chair, QSCI.
The Practice Committee had the opportunity to hear from Sharon Levine, BSN, RN, clinical nurse in the CCU, committee member and 2009 Essence of Nursing Award recipient, about her participation at a meeting in Boston with Susan Hassmiller, PhD, RN, FAAN, from the Robert Wood Johnson Foundation. Dr. Hassmiller presented the report from the Institute of Medicine, "Future of Nursing: Leading Change, Advancing Health." One of the recommendations for the future of nursing was about transforming education. Members participated in a discussion and acknowledged that there is a need for more integrated learning, and that encouraging and assisting nurses to continue life long learning is a role of the Department of Nursing.
Committee members continue to develop knowledge about the stages of practice development. Karen Legere, BSN, RN, committee member and 2011 Essence of Nursing recipient, presented her narrative at the June and August meetings. Committee members asked many questions to gain a fuller understanding of this patient and family situation and the expertise required to care for them. Legere's narrative provided a point of reference as members learn and share aspects of practice of the expert nurse.
If you have questions, contact committee co-chairs, Suzanne Fernandes, RN, and Alice O'Brien, MS, RN.
Standards, Policies and Procedures Committee
The Standards, Policies and Procedures Committee compromised of nurses in a variety of roles throughout BWH meet monthly to review current nursing policies. Sometimes there are minor updates to the policies, and at other times the changes are more important. Significant changes in these policies are communicated to nursing staff with the "New to You" email.
Discussions have occurred around the formatting of policies in the Clinical Practice Manual and assuring that the information is accessible to appropriate nurses. The decision was made to change the heading of ICU to Critical Care. This change would encompass areas that have nurses performing critical care in a non-ICU setting such as the Emergency Department and other specialty areas.
The Controlled Substance Policies MED-02 was recently reviewed in regards to transdermal patches. The following language was added to this policy to ensure safe disposal of transdermal controlled substances: "Transdermal patches must be immediately folded in half, the adhesive side of the patch against itself, then immediately flushed down a toilet. Only after these steps are taken should a new patch be placed upon the patient. The used patch should never be placed temporarily on a bedside table or stuck to a bed rail while applying a new patch. Flushing must be witnessed by a second professional authorized to witness controlled substance waste. Waste must be recorded in the Omnicell using Waste Medication Function. The amount of waste recorded in the Omnicell should be the strength of the patch and the waste reason entered is ‘Used Patch.'"
If you have questions, comments or concerns please email co-chairs Cindy Jodoin, RN, and Diane Miller, RN.
Patient and Family Education
The Patient and Family Education Committee is excited to announce that our Palliative Care Resource button is now ready to access on the Patient Education website. This button will lead you to great resources which include symptoms management, end of life care resources and hospice information. Please check it out.
We had the opportunity to meet with Infection Control to discuss our current infection control practices and patient education, as well as view a video we are considering for MRSA education for our patients.
We are also working on reviewing our current documentation process in preparation for a smooth transition to patient education documentation in EPIC.
Please contact committee co-chairs Katie Fillipon, RN, or Deb Moody, RN, with suggestions.
The Informatics and Clinical Innovations Committee
The Informatics and Clinical Innovations Committee continues to advocate for clinical systems projects to support the work of the nurse at the bedside and promote patient and staff safety.
The committee received a presentation from Biomed highlighting the practical use of its new website. Through the website, nurses can search for equipment, find links to the clinical practice policy manual, the operator's manual with an overview of the item and the manufacturer's website. Safety alerts are also available, as well as a section to "ask Biomed" questions.
The committee discussed and provided feedback regarding the Alaris pump (wireless download/transmission of information, soon to be made updates to the drug library, and a relook at some of the parameters to enhance programming compliance). The need to re-educate nursing regarding the importance of infusing certain antibiotics (such as Ceftaz) over three hours was also discussed. With programming issues, please e-mail BWHSSmartpumpLibraryChanges@partners.org.
The committee provided feedback regarding safety and ergonomic use of computer stands for future use. The group was instructed on some of the changes that would be occurring with the implementation of Windows 7. The icon indicating that the scanner is associated will disappear, and an audible beep will be the only indicator of association. Faster login times should also occur, and signing back in will also be faster.
Committee co-chairs Heidi Smith-Doucette, RN, and Gary Zina, RN, are available for questions.