"planned change" in healthcare

[oreo84]

Hi everyone!

I'm doing a project for school in which we have to pick an area of healthcare... related to patient care, organizational structure, or unit functioning and determine a solution to the problem. We have to explain how we will solve that problem. I'm trying to think of an idea that is backed up by evidence based research. I was wondering if anyone could think of any ideas - especially those of you that work in hospitals already? Maybe you have seen something that drives you crazy that could be fixed??

I've thought about the whole debate of 12 hour shift vs 8 hour shift... but research to back that up goes both ways. At my current clinical we wear hospital scrubs instead of wearing our school scrubs and I looked up to see if that improved infection rates, and those studies don't show much of a difference either. The example in class was something as simple as implementing a new way to remind employees to wash their hands.

If anyone can think of any ideas please let me know! I'm trying to get past this "brainstorming" stage.

Thanks!

[Daytonite, BSN, RN]

policies and procedures are always good to go after for review and change. often the policy and procedure book doesn't get a regular review. procedures come and go with the times. often new equipment gets purchased for use but the official policy or procedures don't get changed to reflect it. you'll see people kind of doing their own thing with the new equipment. stuff to look at: iv pumps, any kind of equipment that gets attached to a patient and plugged into a wall socket, the hospital bed itself. another thing you might do is find out who is on the qa (qi) committee and ask them what they have been looking at recently and see what kind of ideas you can get from them. those kinds of committees are the ones that find the things that need changing. what they do is target a policy or procedure and then do a study (assessment) as to whether or not the staff is compliant in following it. you are going to find the nursing process staring you in the face in just about everything you do and not just with writing a care plan. when i was on nursing qa (qi) committees we looked at things like foley care, hand washing, sterile dressing changes, the fire policy, narcotic sign out, dirty utility room neatness (we had a real problem with this at one place that i worked), and holiday work rotations (another bees nest).

remember the steps of the nursing process which is a problem solving method and definitely applies here:

1. assessment
   
2. problem determination
   
3. plan for change
   
4. implementation of the plan
   
5. evaluation of the plan