Process Improvement and Change Project

LouisVRN, RN · Apr 5, 2011

Can anyone give me some ideas or example of a Process Improvement or Change that they have PERSONALLY been involved with? Was it hard to bring about the change? How did you get the idea that something needed to be changed or improved on? Thanks!

Oh yeah. Well one thing that we recently changed on our unit was reviewing the chart with the oncoming/offgoing nurse at shift change because things were being missed and it was leading to a lot of medication errors, as well as doctor's not being called until super late (doctor wrote to be called with 8pm labs - not passed on in report, noticed at 0200 when doing chart check, and doctor then being called and ****** at 0230, and a lot of unnecessary doctors calls for clarification of orders written by another doctor, which could have been avoided had there been proper communication by the nurses.) The first step for me, was getting the manager/supervisor on board so they could support me when I told the staff that this was mandatory (as in if you choose not to do this, you choose not to work here). This was actually fairly easy by showing how many of the incident reports were directly tied to improper handoff communication. The staff was also made aware of a few of these critical incidents that had shocking patient outcomes that had happened on our floor, to prove, yes it has happened here. It's always hard to bring about change, but you need to be able to hold people accountable. For us we sign the chart, both nurses, when we review it. Basically as offgoing nurse you are signing you gave oncoming nurse chance to ask and answer any questions and for oncoming nurse to acknowledge being aware of the orders. Does this completely eliminate critical patient information not being conveyed, no way. But it has most definitely been a positive change. Do people still ***** that it takes an extra minute? Sure, but it beats the half an hour you would have spent calling the doctor, writing the incident report, etc.

classicdame, MSN, EdD · Apr 5, 2011

about 2 years ago we recognized that there were complaints from nursing that isolation kits were not getting re-filled with PPE. Inf. Control turned the job over to a tech who rounds daily and refills, plus checks every sharps box. Also, isolation kits are now pre-stocked with info for patient education. This makes it easier to nurses to do education.