Specialty teams for pressure ulcers, weight loss, etc.

achot chavi · Jan 9, 2009

Does anyone:typing have specific teams for special quality assurance items such as pressure ulcer prevention, weight loss, falls, incontinence, etc? Who are the members and how do you make them work? What are the challenges and how do you keep the members motivated to do a good job?

yes we do, they are consistent of the ADON (me), dietitian, PT and of course the MD. We do weekly decubiti rounds and keep reports of all the pressure ulcers in the building, the dietitian and I sit once a month (we could sit every 2 weeks if we have a situation that warrants it but right now things are stable) with the weights, results of blood test ( esp albumin levels) and keep a monthly record of all the patients-

I coordinate statistics on the falls - every report is sent from the unit manager to the Med DIr then to the DON then to the CEO who all sign it and then to me and I keep statistics based on month, time of day, place , frequency, effectiveness of careplan etc. I give quarterly reports to the PT, unit manager, DON, MD, CEO and we decide a plan of care a the weekly multidisciplinary meetings.

My DON took on incontinence and she sits every other month on the toileting sheets etc. Yesterday she tells me that a continent pt just became incont- and we should give her diapers I had to ask her to sent the urine for testing and if it comes back normal to sent the pt to a urologist to see if novitropan can help her. So obviously we have to decide what to do about incont QA

I also keep monthly stats of foley (urine) catheters, gasto tubes, and stomas and check with the unit manager that they are infection free etc.

I am also inservice director so I build inservices based on problems

My DON is QA on Infection Control- gives 2 inservices a year on it- plus PRN, got posters for the walls, makes rounds (I think) weekly and sets up our isolation room.

Hope this helps

Oh about motivation? All the nurses are given opportunities to take insevices and classes to update their knowledge- most take advantage. If my nurses aren't motivated to do a good job, they are told to take a mini- vacation and freshen themselves up, the DON talks to them, reminds them of a few things and they do better, we give twice a year recognition to exemplary staff and letters of praise PRN to their personal file (they get a fancy copy of it). We leave notes of praise and try to compliment when we can. This really isn;t a problem by us, an unmotivated nurse usually gets herself in trouble at some point (doesn't do a dsg, or rounds, or report or a bld sugar,,,) and as a last resort is sent to the CEO for a talk-if that doesnt help- she is fired . (happened 4 times in the past 4 years)

gardie · Jan 9, 2009

Thank you achot chavi - you have been most helpful!

Gardie

CapeCodMermaid, RN · Jan 10, 2009

At one building we had a wound team...me and the OT. A weight team...me and the dietician. A falls team...me and the nurse manager from the floor the resident lives on....in other words, lots of special teams with basically the same person involved in all of them. Mostly movtivation to do a good job has to come from within, but I did make up silly awards such as the Golden Scale Award for the floor that got ALL the weights done or the Soft As A Baby's Behind award for the unit that had either the least number of pressure ulcers or the most improved ones.

gardie · Jan 10, 2009

I appreciate your input CapeCodMermaid....thanks.

Gardie

achot chavi · Jan 10, 2009

Love the Soft as a Babies Behind Award!!!:-)