Improving Nursing Practice

[Raaa]

If you were a Nurse Manager, what suggestions do you have to improve nursing practice?

If you were a Nursing Director, what suggestions do you have to improve nursing practice?

[Wuzzie]

You first!

[Raaa]

I need ideas since I am having these questions for job interview

[Wuzzie]

Well the interviewer is more interested in what you think than what strangers on the internet do so why don't we start with that.

[JadedCPN, BSN, RN]

2 hours ago, Raaa said:

I need ideas since I am having these questions for job interview

Assuming you are applying for a Nurse Manager/Director position, it seems extremely important that you should be able to answer this basic question on your own and with your own idea. We could definitely help refine it though.

[Golden_RN, MSN]

Of course, I don't know what type of unit/environment this is, but I'd first start with a needs assessment to find out what the nursing staff is lacking in terms of training/education. Then you could take that information and collaborate with your unit managers/clinical educators to develop a plan for education based on evidence based practice and facility policy/procedure. I would include audits or other way to test the outcome. The key is collaboration between management, educators and front line staff.

[myoglobin, ASN, BSN, MSN]

Well these answers are pretty much guaranteed to not get you a job. But here are my ideas:

a. Almost every hospital would benefit from a nursing union to help ensure due process and fairness. Nurses work better when they don't fear capricious actions on the part of management and know that they have some basic representation.

b. Adequate staffing ratios as defined by the California nursing ratio laws.

c. Adequate help in terms of unit secretaries and CNA help. Also lift teams to help reduce injuries and improve patient safety, and reduce bedsores.

d. Any new form, process, or intervention should be put before a nursing review peer group. Introducing a new form means getting rid of an old form. Remember time spent on charting and forms is time away from the patient.

e. Hot food should be available on nights. Unit visitation rules need to be consistently enforced and nurses should be backed up when they enforce visitation policy even if the family complains. Just stick with these in your interviews and you will never get hired again.

[Golden_RN, MSN]

1 minute ago, myoglobin said:

Well these answers are pretty much guaranteed to not get you a job. But here are my ideas:

a. Almost every hospital would benefit from a nursing union to help ensure due process and fairness. Nurses work better when they don't fear capricious actions on the part of management and know that they have some basic representation.

b. Adequate staffing ratios as defined by the California nursing ratio laws.

c. Adequate help in terms of unit secretaries and CNA help. Also lift teams to help reduce injuries and improve patient safety, and reduce bedsores.

d. Any new form, process, or intervention should be put before a nursing review peer group. Introducing a new form means getting rid of an old form. Remember time spent on charting and forms is time away from the patient.

e. Hot food should be available on nights. Unit visitation rules need to be consistently enforced and nurses should be backed up when they enforce visitation policy even if the family complains. Just stick with these in your interviews and you will never get hired again.

While all great ideas in an ideal world, the nurse manager does not have the power to make MOST of these changes by him/herself (unions, ratios, etc.). In an interview, I would stick to solutions that I can actually follow through on in that particular department or facility.

In my previous comment above, I was referring to improving nursing practice in a particular unit, but maybe the question is more universal. There are just a million ways to go with the answer.

[K+MgSO4, BSN]

Part of me is alarmed that you have not up any suggestions yourself and relying on the strangers on the internet forum for advice.

However I will throw you a few suggestions.

Review your dept clinical incidents and see what the trends are.

Review the audit data you have to see where improvement is needed but drill down into the reasons why it is not being completed.

Review complaints data

Complete an LNA(learning needs analysis) with your staff, and a separate one with your leadership team about what their leadership gaps are (have them complete the general LNA as well as they deserve to learn as well).

Look at why people are leaving the dept.

Audit all of your equipment and supplies. Look into what supplies are not needed and replace with the things the staff are looking for e.g. my team wanted warming blankets on the shelf and the machine, spoke to a colleague who works in peri op as a manager and she gave me the rep name and boom a meeting a week later it was all sorted.

Review every single item of equipment that the staff use. If it is broken see can it be fixed, if you can order new do it or ask your boss for the funds to replace/ upgrade it orask your hospital foundation for money - you may need to give up booze for a dry July or get on a bike for a cycleathon. Keep your staff in the loop with this.

Keep your staff in the loop - I do a weekly newsletter that goes to their work email and a hard copy to the folder in the breakroom with all other memos and information.

Critically look at all the garbage on your walls I looked in the drug room the other day. It is tiny and the flipping pharmacy dept had 6 - SIX!! copies of the same poster in a tiny room, all out of data about a drug shortage that ended 3 months prior but they hadn't removed. That amount of noise means that nothing on the walls is looked at as it is all background babble