Unit based concil/shared governance project ideas

[brownsc2]

What are some projects that your unit-based council has initiated or thought about initiating?

Also, I am trying to come up with some ideas for the bulletin board in the break room help, please!

[Rose_Queen, BSN, MSN, RN]

It may be helpful to know what specialty you work in. The work we do in my OR-based clinical council wouldn't apply to any other unit. You could look at how recommended practices and guidelines that your specialty organization may publish have changed as a way to get ideas as well.

[brownsc2]

Oops, I forgot. I work on a medical-surgical unit. Thanks!

[icuRNmaggie, BSN, RN]

I would suggest an initiative to increase efficiency and patient safety by requiring each department to use the encrypted hospital text page system rather than dumping their responsibilities on the bedside nurse and entering their own orders and interventions in the EMR.

Examples:

RT should notify the physician if a bronchodilator order has expired or if they have a critical ABG result and know how to enter their own orders.

The pharmacy should call the physician to clarify an order, not the nurse. Pharmacy needs to learn how to order the blood tests they need for dosage adjustments.

If a Radiology tech questions the appropriateness of an order or wants to d/c it, he or she needs to text page the ordering physician.

Consults are physician to physician. Always.

Abnormal EEG, CT, and MRI/MRA results should be called to the ordering physician, not the nurse.

Nutrition services should discuss the diet recommendations with the physician, not just leave a note in the chart, and they should also enter the prescribed diet in the EMR.

The lab should call critical values to the physician and document them in the EMR.

Speech Therapy needs to do more than hang a sign over the bed for a patient with dysphagia. Speech Therapy should enter the appropriate dysphagia diet and aspiration prevention interventions in the EMR.

Anesthesia providers need to learn how to enter PCA and epidural orders.

There should be an electronic footprint for services and interventions initiated by and billed for by ancillary therapeutic and ancillary diagnostic services.

The days of paper order sets and "I told the nurse to take care of it" are over.

Review your policies and procedures and request that they be updated to ensure appropriate communication between disciplines and 100% meaningful use of the EMR.

Ask to have the paper order sets removed from your units.

In other words, the nurse is not everyone's secretary. Each department should be responsible for their own orders.

[MunoRN, RN]

icuRNmaggie said:

I would suggest an initiative to increase efficiency and patient safety by requiring each department to use the encrypted hospital text page system rather than dumping their responsibilities on the bedside nurse and entering their own orders and interventions in the EMR.

Examples:

RT should notify the physician if a bronchodilator order has expired or if they have a critical ABG result and know how to enter their own orders.

The pharmacy should call the physician to clarify an order, not the nurse. Pharmacy needs to learn how to order the blood tests they need for dosage adjustments.

If a Radiology tech questions the appropriateness of an order or wants to d/c it, he or she needs to text page the ordering physician.

Consults are physician to physician. Always.

Abnormal EEG, CT, and MRI/MRA results should be called to the ordering physician, not the nurse.

Nutrition services should discuss the diet recommendations with the physician, not just leave a note in the chart, and they should also enter the prescribed diet in the EMR.

The lab should call critical values to the physician and document them in the EMR.

Speech Therapy needs to do more than hang a sign over the bed for a patient with dysphagia. Speech Therapy should enter the appropriate dysphagia diet and aspiration prevention interventions in the EMR.

Anesthesia providers need to learn how to enter PCA and epidural orders.

There should be an electronic footprint for services and interventions initiated by and billed for by ancillary therapeutic and ancillary diagnostic services.

The days of paper order sets and "I told the nurse to take care of it" are over.

Review your policies and procedures and request that they be updated to ensure appropriate communication between disciplines and 100% meaningful use of the EMR.

Ask to have the paper order sets removed from your units.

In other words, the nurse is not everyone's secretary. Each department should be responsible for their own orders.

Or get a U.C.

[icuRNmaggie, BSN, RN]

Compliance with Meaningful Use =more $$ for the hospital. I suggest you do a bulletin board on that.