Accuracy with new admissions!!

NurseExec · Oct 14, 2008

We use case studies to do admissions teaching. We spend an entire day of orientation on admissions and discharges. Then, they do both during their floor orientation. If they are having trouble after that, the unit manager goes through it with them one on one.

Once you have done all your education, it comes down to holding the staff accountable. The unit manager uses an audit tool to check all admissions the next day, and those go to me. Continued problems are dealt with on a individual basis (could be more education, coaching, etc).

CoffeeRTC, BSN, RN · Oct 14, 2008

by accurately, do you mean completed? If you provide them with the checklist, they should know what needs to be done and do it. Somethings may not get done on that shift, but then the next shift should pick it up.

Accountability is next.

achot chavi · Oct 14, 2008

I use professional videos to help my staff develop the skills they need to do a proper admission- including making the patient feel welcomed, help him adjust, etc.

I use personal example to show how to do an admission interview- even though we have a detailed adm history form etc.

The necessary paperwork is prepared in advance and there is a checklist of what needs to be done (EKG, bloodwork, ordering from pharmacy. ambulance- reimbursement slip etc)

I check all admissions within 24 hours and help write the first care plan.

If there are any problems- we have a very competitive SW who is happy to point out our omissions, mistakes and anything else we did wrong (G-d bless her)

As with any good facility we have a protocol detailing all this.

CapeCodMermaid, RN · Oct 15, 2008

You can show them all you want but until someone does an admission, it won't click what needs to be done. We have them oriented to the paper work but on their first 'real' admission, another nurse sits with them to go over the paper work one piece at a time. Does it take time? Is it frustrating for the 'old' nurse who could do 3 admits in the time it takes the new nurse to do one? Yes and yes but the pay off is a competent person who can do an admit. We also leave anything undone sticking out of the chart with the expectation that the next shift do it. They get till the next morning ..then someone whispers in their ears and tells them it is their job to make sure the whole admission is complete.

achot chavi · Oct 17, 2008

Nothing takes the place of good old fashioned experience and learning from your mistakes.

NurseKatie08, MSN · Oct 19, 2008

You can show them all you want but until someone does an admission, it won't click what needs to be done. We have them oriented to the paper work but on their first 'real' admission, another nurse sits with them to go over the paper work one piece at a time. Does it take time? Is it frustrating for the 'old' nurse who could do 3 admits in the time it takes the new nurse to do one? Yes and yes but the pay off is a competent person who can do an admit. We also leave anything undone sticking out of the chart with the expectation that the next shift do it. They get till the next morning ..then someone whispers in their ears and tells them it is their job to make sure the whole admission is complete.

This is exactly what was done in my orientation. I had a day with the unit coordinator, who walked me through all the paperwork....then I watched my preceptor do an admission, then they had me & another orientee come in one day especially to do admissions together (we work TCU so can get quite a few in a day at times) and then we followed the checklist & did them by ourselves--anytime there are any issues with the admission they are flagged & brought up so that they can be corrected. I have done probably 4-5 on my own by now, and it is getting easier every time. I work eves, so we get a lot of admissions, but typically they are anticipated, so the day nurse will try to do whatever little she can--put the person into the system as "waiting arrival", fill out a diet slip, or confirm orders if the person gets there before my shift, to make it easier on the eve shift. I definitely agree that the only way to learn is to do it yourself.