Seriously...

[LouisVRN, RN]

So as part of a continuing process to improve patient satisfaction and fiscally beneficial as well we are implement a revised discharge plan (basically trying to get everyone to prepare for the patients discharge from arrival, anticipate any needs/barriers and get the correct departments on board in an effort to reduce a last minute scramble).

That being the case, we are trying to reinforce the need to do daily teaching with the patient daily regarding something...anythhing. We have a very simple, easy to use application that allows us to print pretty much anything you could think of that you'd want to educate the patient on (diet, procedure, test, medication, equipment). The staff has been educated to print the daily teaching sign give one copy to pt one copy to chart.

Because this discharge redesign is relatively new in implementation we have a specific team who has spent time daily on the units to offer assistance, answer questions.

So today during my audit, I found that 4/28 pts received daily education. SERIOUSLY?!? What do I have to do to get people on board with any changes?

I am so frustrated right now I could scream!

[Hoozdo, ADN]

So today during my audit, I found that 4/28 pts received daily education. SERIOUSLY?!? What do I have to do to get people on board with any changes?

I am so frustrated right now I could scream!

Well, do they have time to add one more arduous charting task? I know I don't.

[LouisVRN, RN]

Well, do they have time to add one more arduous charting task? I know I don't.

It has been an expectation for years that they do this, we are only now starting to enforce it because no one was doing it previously. It is an expectation of their job, they need to make time to do it, especially while their is a task force in place to help them.

ETA: And yes the majority of them, on the majority of the days have time to do it. I work the floor as well and have been doing it since I started.

[eriksoln, BSN, RN]

I was going to say our manager makes changes daily...........they go in one ear and out the other. People have told her, she has to include what we are going to stop doing in replacement with all these changes but she never does. So, the nurses prioritize and decide for themselves what to "be on board with" and what not to be.

Seriously? Yes.

I'd rather be on board with no pt. falls and pain managed than, well............w/e the flavor of the week obcession for management and administration is. Most days, safety and the most generic care is all there is time for.

[casi, ASN, RN]

Can you pre-print out information on commonly medications, tests, and conditions for your floor and stick them in a file so nurses can just grab and hand out?

I've found that since my floor switched to educational materials that have to be printed out by the nurse educational phamplets are being used a lot less. Why? I think it's a heck of a lot easier and faster to just grab a hand out from a file then dig around an online application. I'll also make the claim that I work with a lot of older nurses who aren't as comfortable with some of the computer applications which makes the process even slower.

[catshowlady]

I suspect we have the same application that you are using (Logicare?); if not, it sounds very similar. We are currently only expected to use it for discharge teaching, not the daily teaching that you mention.

Frankly, I find it time-consuming and very unfriendly to use. It took me over an hour last w/e to get a pt's discharge papers ready. Granted, I only discharge pts very rarely (I'm ICU), so I may not have as much practice as our med-surg nurses, but I'm far from computer illiterate. Takes way too long to sit there and generate all that stuff. Multiply by six or seven floor pts and.... well, I hope you get the idea. I know it doesn't sound like much ("It only takes 5 minutes!", right?). But multiply 5 minutes times 6 or 7, and you are looking for someone to carve 1/2 hour out of their day to print up all that stuff.

I would also say that the majority of pts will probably never look at handouts anyway. I have only seen the rare pt who actually reads the printed materials I do give them. I try my best to get through our educations packets for CHF, MI, COPD, and new-onset DM with these pts. I reinforce other education verbally with each pt. Many of them glaze over when I give them the most basic instruction on their meds when I pass meds!

So, if I can't get to everything I am supposed to do during my shift, I am going to prioritize keeping them clean, dry, ambulating/OOB, and doing IS, which I know will benefit them, over printing out a bunch of paper that isn't going to be used/of benefit.

JMO, take it for what you will.

:paw:

[CNL2B]

It's likely that this is JCAHO accreditation stuff. You are probably supposed to have been doing some form of patient education everyday anyway (I know we are.) So, somebody came up with a shiny new method of documenting education. Yay. I guess you get to use it.

[loriangel14, RN]

I never cease to be a amazed at what documentation they keep coming up with. My workplace has a new one - report received on a pt. We are supposed to chart time of report, who from, what professional designation, why there was a transfer of care, what was reported on, and how long it took. If you were busy or on break and someone else did something for your pt(e.g. toileted, turned, gave a med, gave a drink,helped with a meal) you have to fill out this documention EACH TIME. Needless to say most people choose not to participate.

[eriksoln, BSN, RN]

I never cease to be a amazed at what documentation they keep coming up with. My workplace has a new one - report received on a pt. We are supposed to chart time of report, who from, what professional designation, why there was a transfer of care, what was reported on, and how long it took. If you were busy or on break and someone else did something for your pt(e.g. toileted, turned, gave a med, gave a drink,helped with a meal) you have to fill out this documention EACH TIME. Needless to say most people choose not to participate.

Voicecare would solve a lot of this for you. Every report given on it it banked somewhere for............well, IDK the exact amt. of time but I've heard numbers as high as 3-5 years.

[Hoozdo, ADN]

I never cease to be a amazed at what documentation they keep coming up with. My workplace has a new one - report received on a pt. We are supposed to chart time of report, who from, what professional designation, why there was a transfer of care, what was reported on, and how long it took. If you were busy or on break and someone else did something for your pt(e.g. toileted, turned, gave a med, gave a drink,helped with a meal) you have to fill out this documention EACH TIME. Needless to say most people choose not to participate.

I also choose not to participate in that one. So far, I haven't been dinged for it.

I have also been thinking about not charting IV sites Q2hrs. Takes more time to

chart it than to assess them.

If I transfer someone, I make a quick nursing note.

Oh, how I miss charting by exception.

[RNperdiem, RN]

It is a wonder patients survived their hospital stay at all in the old days when the entire patient chart could fit on a clipboard. :)

This new requirement is not likely something staff nurses came up with themselves to improve patient care.

But you are put in the position of enforcer.

All you can do is remind them.

If this is an accreditation issue, tell the nurses.

What is in it for them? Losing accreditation might matter.

Myself, I mentally divide charting into 3 categories: essential( vital signs, assessments, lab values), semi-important, and fluff.

When I am busy, actual patient care comes as a higher priority to "fluff".

[mappers]

Have you asked them what to do?