The Elephant In The Room and Evidenced Based Practice

Posted

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac. Has 30 years experience.

Our directors are very fond of saying "evidenced based practice" when telling us what to do..like hourly rounding, bedside report, safety huddles, etc. etc. I usually have no problem with any of this. I'm a "go with the flow" type of person.

Next up is a mandatory report sheet we have to use to give bedside report, in the SBAR format. Again, I'll go with the flow and I helped create one for our floor and sent it for approval (but they lost it and it's not saved..doh). A director was talking to our unit about it, siting "we're modeling ourselves after the airline industry that greatly improved safety over the years. Hospitals have the worst safety record of all industries. Evidences shows lack of communication is one of the things that cause mistakes and evidence shows this SBAR report will help with that."

Me: "I have one word to say: ratios. Evidence based practice over and over shows this improves safety and outcomes".

They want it all...safety, great customer service scores, high profit, but don't address the one elephant in the room.

amoLucia

Specializes in retired LTC. 7,495 Posts

I hadn't even finished your post without having thought : STAFFING!!!

Why is it so obvious to us, but not them?!? Maybe selective 'elephant blindness'? :bag:

ProgressiveActivist, BSN, RN

Specializes in ICU. Has 20 years experience. 670 Posts

Your manager is being disingenuous. What you do about it is up to you.

kalevra, BSN, RN

Specializes in ED, Telemetry,Hospice, ICU, Supervisor. Has 5 years experience. 530 Posts

Healthcare is centered on the patient especially in terms of morbidity, mortality and patient satisfaction. Communication breakdown is a common area in the workplace that can result in a lot of conflict and breakdown. I can understand their want to standardize the report/hand-off process in order to make communication more efficient.

EBP help guide nursing practice in a way to maximize the client experience in the healthcare setting. As a profession, it is important to work together an communicate our needs is an efficient manner so we can improve patient care throughout the healthcare continuum.

RN., MSN, DNP, RN

Specializes in Perianesthesia. Has 31 years experience. 995 Posts

Do you work in a MAGNET hospital, (or one trying for Magnet), btw, Tweety?

This sounds a lot like a MAGNET-Journey "checklist".

Been there,done that, ASN, RN

Has 33 years experience. 6,764 Posts

Healthcare is centered on the patient especially in terms of morbidity, mortality and patient satisfaction. Communication breakdown is a common area in the workplace that can result in a lot of conflict and breakdown. I can understand their want to standardize the report/hand-off process in order to make communication more efficient.

EBP help guide nursing practice in a way to maximize the client experience in the healthcare setting. As a profession, it is important to work together an communicate our needs is an efficient manner so we can improve patient care throughout the healthcare continuum.

Clearly, you are one of "them" . As a profession, we need to "communicate our needs" for better staffing ratios and less paperwork.

Been there,done that, ASN, RN

Has 33 years experience. 6,764 Posts

Our directors are very fond of saying "evidenced based practice" when telling us what to do..like hourly rounding, bedside report, safety huddles, etc. etc. I usually have no problem with any of this. I'm a "go with the flow" type of person.

Next up is a mandatory report sheet we have to use to give bedside report, in the SBAR format. Again, I'll go with the flow and I helped create one for our floor and sent it for approval (but they lost it and it's not saved..doh). A director was talking to our unit about it, siting "we're modeling ourselves after the airline industry that greatly improved safety over the years. Hospitals have the worst safety record of all industries. Evidences shows lack of communication is one of the things that cause mistakes and evidence shows this SBAR report will help with that."

Me: "I have one word to say: ratios. Evidence based practice over and over shows this improves safety and outcomes".

They want it all...safety, great customer service scores, high profit, but don't address the one elephant in the room.

Did you address the elephant ? What are your ratios?

Tweety, BSN, RN

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac. Has 30 years experience. 30,505 Posts

Healthcare is centered on the patient especially in terms of morbidity, mortality and patient satisfaction. Communication breakdown is a common area in the workplace that can result in a lot of conflict and breakdown. I can understand their want to standardize the report/hand-off process in order to make communication more efficient.

EBP help guide nursing practice in a way to maximize the client experience in the healthcare setting. As a profession, it is important to work together an communicate our needs is an efficient manner so we can improve patient care throughout the healthcare continuum.

Totally agree and I didn't want to minimize the importance of effective communication and the evidenced based practice that good communication results in good outcomes. I'm frustrated by their commitment to patient safety while missing the evidenced based practice on staffing ratios.

Tweety, BSN, RN

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac. Has 30 years experience. 30,505 Posts

Do you work in a MAGNET hospital, (or one trying for Magnet), btw, Tweety?

This sounds a lot like a MAGNET-Journey "checklist".

We had Magnet status, but lost it because we showed no growth or improvement in areas. I love where I work, and I think we provide high quality care to best of our ability with what we have. But we can do better with better ratios. In my opinion.

Tweety, BSN, RN

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac. Has 30 years experience. 30,505 Posts

Did you address the elephant ? What are your ratios?

I'm a staff nurse on med-surg and our ratios go from 5:1 to 7:1. If you're asking have I personally addressed the elephant by making demands, refusing assignments and organizing staff protest, no I haven't. I'm an introvert and not the activist type. I suppose as is suggested in a prior post, I'm part of the problem because I put up with it and have not right to complain. Others don't and hit the road, but it seems to be the standard in this area.

In many meetings, many times I've addressed the issue with managers and directors.

My post is the irony of people promoting evidenced based practice and moving towards that direction in pretty much every area but one.

Horseshoe, BSN, RN

5,879 Posts

They want it all...safety, great customer service scores, high profit, but don't address the one elephant in the room.

But apparently neither did you, which is partly why that great beast continues to sit pretty.

Tweety, BSN, RN

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac. Has 30 years experience. 30,505 Posts

But apparently neither did you, which is partly why that great beast continues to sit pretty.

I'm not sure what you mean by saying I didn't address it because I did bring it up.

Me: "I have one word to say: ratios. Evidence based practice over and over shows this improves safety and outcomes".

I was ignored because they said they weren't talking about that topic, but the new hand off report.

Will I organize a protest, refuse assignments, quit for a better job, contact labor unions, march to the capital. No.

I do understand I'm part of the problem by whining about it and putting up with it.