HCPro.com - Staff Development Weekly: Insight on Evidence-Based Practice in Education

From the desk of Adrianne E. Avillion, DEd, RN

Fri, 25 May 2012 14:24:00 GMT

Nursing association for simulation
Over the past few months, I have made a point of writing about various organizations and associations that I think would be useful resources for nursing professional development (NPD) specialists. A number of these are non-nursing or non-healthcare groups devoted to continuing education in the workplace. I encourage you to look at what our colleagues in other fields are doing since we can benefit from good education practices no matter the setting.

Today I would like to provide some information that a colleague wrote to me about concerning an association devoted to clinical nursing simulation. This is the International Nursing Association for Clinical Nursing Simulation and Learning (INACSL). Its website is www.inacsl.org. Its mission is to "promote research and disseminate evidence-based practice standards for clinical simulation methodologies and learning outcomes." The association holds an annual conference and provides networking opportunities for nurses who use simulation in their learning activities. Other benefits of membership include:

Clinical Simulation in Nursing Journal
Email listserv
Sample tools including policies
Teaching tips
Sample simulation scenarios
Equipment management

Check out the website to learn more about this association and broaden your perspective of simulation techniques.

SDW news brief: Patients’ perception of poor communication linked to safety

Fri, 25 May 2012 14:21:00 GMT

HealthGrades recently released the results of its annual survey of patient safety and patient satisfaction in U.S. hospitals, which also identifies the top-performing hospitals in those areas of hospital quality. HealthGrades recognized 263 hospitals out of 5,000 evaluated with the Patient Safety Excellence Award, and awarded the Outstanding Patient Experience Award to 332 hospitals out of 3,837 evaluated, with 47 hospitals receiving both awards. Healthgrades also examined the relationship between communication and patient safety by grouping hospitals according to patient satisfaction ratings and comparing the average patient safety scores for the three groups.

Healthgrades found that hospitals whose patients rated them in the bottom 10% with regard to how well the nursing staff communicated had, on average, 27% more patient safety events compared to the top-rated group. With relation to nursing communication, post-operative bloodstream infections were 77% higher in lowest-rated hospitals, and catheter-related infections were 58% higher in lowest-rated hospitals. The HealthGrades report stresses the importance of patient-provider communication to improve patient care.

View the HealthGrades report.

Source: Beckers Hospital Review

From the staff development bookshelf: Incidents of disruptive physician behavior

Fri, 25 May 2012 14:18:00 GMT

According to nurses, disruptive physician behavior most often occurs after they place phone calls to physicians, after they ask questions or seek clarification of physician orders, when physicians feel their orders were not carried out correctly or in a timely manner, when there are perceived delays in care, and when there are sudden changes in patient status (Rosenstein 2002).

Physicians believe the primary cause of their disruptive behavior is when their orders are not being carried out correctly or in a timely manner (Rosenstein 2002). Nurses depend on the actions of personnel in other departments; physicians often perceive a delay in medication administration or delivery of supplies as ineptitude on the part of the nurse. When studying the nurses' work, researchers found that nurses experience an average of 8.4 system interruptions per eight-hour shift (Tucker). Therefore, managers must follow up on delays or incorrect treatment. If they do not, physicians will be left to draw their own conclusions, which will most likely be that 'it was the nurse's fault'.

And there's always one thing in common with bad scenes: a tremendous amount of emotional charge. No one can solve a problem in the midst of so much hurt and anger.

The answer is to disengage-to physically remove yourself and others from the verbal abuse-and return to the issue at a later date.

Book excerpt adapted from Speak Your Truth: Proven Strategies for Effective Nurse-Physician Communication by Kathleen Bartholomew, RN, MN

Readers of Staff Development Weekly receive a 10% discount on this book! Just enter source code EB102930A at checkout. Click here to visit www.hcmarketplace.com

Website spotlight: How to improve your training program

Fri, 25 May 2012 14:13:00 GMT

Keep it simple, honest, fun, and interesting
HIPAA and HITECH have resulted in a whole new career for Tom Dumez, CHP. As human resources director at a records management company, Dumez's job in the last few years has taken a new direction-training others how to comply with HIPAA.

Dumez says he didn't know much about HIPAA when Congress enacted the HITECH Act in February 2009. However, the company he worked for, Kent Record Management in Grand Rapids, MI, realized someone had to find out about the HIPAA laws pretty quickly.

HITECH made Kent and other similar companies that handle PHI for covered entities (CE) into business associates (BA) that were now directly subject to certain HIPAA rules.
Since he handled compliance at Kent Record Management, Dumez was assigned the responsibility of learning about HIPAA and how to comply with laws the company was previously only required by contract to comply with.

To read the rest of this FREE article, click here.

Editor's note: To read more articles like this, visit the Reading Room, part of www.StrategiesForNurseManagers.com.

From the desk of Adrianne E. Avillion, DEd, RN

Fri, 18 May 2012 14:13:00 GMT

American Society for Training and Development (ASTD): Many of you are familiar with ASTD, but even if you are familiar with ASTD you may not be a member or may not have looked at its website lately. ASTD is the world's largest professional association dedicated to the training and development field. Its journal, Training, is a truly excellent resource. The organization offers education events, numerous publications, and access to a wide network of colleagues. Access ASTD at www.astd.org.
Health Care Education Association (HCEA): The HCEA is a "multi-disciplinary professional organization of health care educators that creates resources, instruction, & communications for both staff and clients." HCEA membership represents educators from across the continuum of care in a variety of healthcare settings. Access HCEA at www.hcea-info.org
The American Association for Adult and Continuing Education (AAACE): The AAACE's mission is to "provide leadership for the field of adult and continuing education by expanding opportunities for adult growth and development; unifying adult educators; fostering the development and dissemination of theory, research, information, and best practices, promoting identify and standards for the profession, and advocating relevant public policy and social change initiatives." AAACE offers numerous publications, research information, and education events. Access AAACE at www.aaace.org.

Even if membership is not something you want to pursue, it can be helpful to regularly take a look at the information on these websites. It's always a good idea to keep abreast of what is going on in the world of continuing education and training. This helps us to broaden our perspectives and avoid becoming ingrained in the way things have always been done within our various organizations.

SDW news brief: New California RNs struggle to find work

Fri, 18 May 2012 14:11:00 GMT

A recent survey conducted by the California Institute for Nursing and Healthcare found that 43% of nearly 1,500 newly licensed registered nurses (RN) in California did not have a nursing job within 18 months of graduating. Of the nurses who were not working at the time of the survey, 92% noted that they were told they lacked the necessary experience, and 80% indicated that they would be willing to participate in an unpaid internship to gain that experience. Additionally, 54% of the nurses not working were told that no jobs were available, and 42% were told that a bachelor's degree was preferred or required.

Last November, a state forecast reported on what appears to be a surplus of RNs in California, and predicted that the trend would continue if RN graduations remained at existing levels and older nurses continued delaying retirement. However, the forecast also cautioned that a shortage could occur if graduations decline as potential RN students are discouraged by a lack of job prospects.

Source: Mercury News

From the staff development bookshelf: Diagnosing CAUTI

Fri, 18 May 2012 14:06:00 GMT

A catheter-associated urinary tract infection (CAUTI) is diagnosed only when signs and symptoms of an infection coexist with evidence of bacteriuria (> 100,000 colony-forming units per ml [CFU/ml] and a host response to the presence of bacteriuria [diagnosed on urinalysis as pyuria]). Asymptomatic bacteriuria is not routinely treated in the catheterized patient, regardless of whether it occurs in the critical care unit, inpatient hospital unit, or long-term care facility.

Treatment should not occur even when asymptomatic bacteriuria coexists with pyuria. Patients with indwelling urinary catheters typically develop pyuria because of the inflammation associated with the presence of the catheter itself. Asymptomatic bacteriuria is treated only in highly selected cases, such as patients undergoing certain abdominopelvic or urologic procedures, or selected immunocompromised patients.

Signs and symptoms of a CAUTI include the presence of two or more of the following:

Fever (> 2.0?F or > 1.1?C)
Flank, abdominal, or suprapubic tenderness
Change in urine character
Hematuria
Sudden change in mental or functional status (CMS 2008)

Book excerpt adapted from Catheter-Associated Urinary Tract Infections: Evidence-Based Best Practices for Nurses by Mikel L. Gray, PhD, CUNP, CCCN, FAANP, FAAN.

Readers of Staff Development Weekly receive a 10% discount on this book! Just enter source code EB102930A at checkout. Click here to visit www.hcmarketplace.com.

Website spotlight: Nurses harness patient engagement tools to educate and empower patients

Fri, 18 May 2012 13:53:00 GMT

By Gary Kolbeck, President of LodgeNet Healthcare

Until recently, patients at the four hospitals operated by NorthShore University HealthSystem (NorthShore) in Chicago's northern suburbs were given standard printed educational material about their medical condition or scheduled surgery. It was clear to nurses, however, that some of their patients did not read or understand the information. Recognizing that this knowledge is essential for patients to become active participants in their own care and achieve the best possible clinical outcome, the nursing staff did their best to identify and fill in the gaps, but they recognized it wasn't an ideal situation. This led the health system to implement a new patient engagement solution across its four hospitals that is designed to improve nursing efficiency, communication, clinical outcomes, and overall patient satisfaction. The program helps patients:

Become involved in their medical care during and after their hospital stay
Feel more in control of their situation
Optimize their hospital experience

Improving learning and retention

When patients are admitted, they often are worried, frightened, nervous, emotional, or stunned, especially after learning they have a serious medical condition. Not surprisingly, they often have difficulty grasping important medical information and recommendations. To overcome these problems, NorthShore wanted a patient engagement solution that could capture patients' attention and then educate, empower, and encourage them to become actively involved in their care.

The health system purchased an interactive television system that allows nurses to prescribe videos that patients can view on their in-room TVs, which helps introduce them to the facility and their personal care team, as well provides them with safety information. Patients can watch specially selected videos about their condition and post-discharge treatment regimen. Patients can watch the videos as often as they want, whenever they like, and they are encouraged to ask their nurses and healthcare providers questions, which improves comprehension and retention.

To read the rest of this FREE article, click here.

Editor's note: To read more articles like this, visit the Reading Room, part of www.StrategiesForNurseManagers.com.

Nurses Week: Contest to win a free webcast on preventing CAUTIs!

Fri, 11 May 2012 18:57:00 GMT

We're marking the last day of HCPro's Nurses Week celebration with a fun nursing quiz! Entrants who answer all questions correctly will be entered into a drawing for a chance to win a free seat to HCPro's webcast on evidence-based methods to prevent catheter-associated urinary tract infections (CAUTI). The lucky winners will be able to bring their colleagues from nursing, quality, and other disciplines together to learn about best practices for keeping patients safe.

The live webcast will be presented on May 30, 2012, and features Mikel Gray, PhD, PNP, FNP, CUNP CCCN, FAANP, FAAN, and Brian Koll, MD, FACP, FIDSA. Winners will also receive the webcast-on-demand so they may share the training with others in their facility. Click here to learn more about the webcast.

To enter the contest, email your answers to the following questions to Rebecca Hendren at rhendren@hcpro.com.

When was Florence Nightingale's famous Notes on Nursing first published?
What percentage of RNs in the United States are male?
What day marks the beginning of Nurses Week every year, and what is the day recognized as?
What is the significance of May 12?
What year did Florence Nightingale establish her nursing school at St. Thomas' Hospital in London?
When was the American Nurses Association founded?

Entries must be received by May 18, 2012.

From the desk of Adrianne E. Avillion, DEd, RN

Fri, 11 May 2012 18:54:00 GMT

The Society for Simulation in Healthcare (SSH): The mission of SSH is to lead "facilitating excellence in (multi-specialty) healthcare education, practice, and research through simulation modalities." SSH was established in January, 2004 and has a membership of more than 3,000. It sponsors education conferences and events, posts news briefs, offers a career center, and publishes a newsletter and bi-monthly journal, Simulation in Healthcare. Access the society's web site at https://ssih.org.
The Society for Modeling & Simulation International (SCS): SCS, an international society, was established in 1952 dedicated to advancing the use of modeling and simulation to solve real-world problems. The SCS has a database of education resources and publishes several journals and newsletters. It also has a digital library. The SCS membership represents a variety of professions from industry, academia, and government. Access the SCS at www.scs.org/home.

SDW news brief: Deceleration in healthcare job growth

Fri, 11 May 2012 18:52:00 GMT

Healthcare sector job growth is slowing, according to April job figures from the U.S. Bureau of Labor Statistics (BLS). Despite this deceleration, the healthcare sector created 19,000 jobs in April, nearly a sixth of the new jobs created in the economy last month. The deceleration reflects a slowing job growth across the overall economy.

Figures from the BLS indicate that the healthcare sector employed more than 14.2 million people in April. Of those jobs, 4.8 million were in hospitals and 6.2 million were in ambulatory services. Healthcare has created more than 116,000 jobs in 2012.

Source: HealthLeaders Media

From the staff development bookshelf: Importance of managing reporting

Fri, 11 May 2012 18:49:00 GMT

When an organization begins to look at incident reporting, it often has to reconcile two divergent opinions. Quality and risk management staff want to know about everything that is happening throughout the organization. Because of their thirst for knowledge, they want to see more reports. But often there is another camp-sometimes the board of directors or the senior leadership-that associates an increasing number of reports with declining performance. Have you ever heard a board member exclaim, "I hope we don't see that number of falls reported next month"? He or she is looking at reporting in a completely different fashion-in the board member's mind, fewer reports is the preferable direction. An effective Problem Identification and Resolution (PIR) process needs to effectively communicate that reporting is a good thing and strongly encourage it.

Monitoring your reporting flow is important for several reasons:

If your reporting volume is too low, you may be missing important issues
A low reporting volume also means you lose stability and can't confidently use the reporting process to indicate improvements or declines in performance
If your reports are not effectively sampling the entire organization, you may have blind spots

Book excerpt adapted from Occurrence Reporting: Building a Robust Problem Identification and Resolution Process by Kenneth Rohde.

Readers of Staff Development Weekly receive a 10% discount on this book! Just enter source code EB102930A at checkout. Click here to visit www.hcmarketplace.com.

Website spotlight: Nurses shining exception to public’s dim view of healthcare

Fri, 11 May 2012 18:44:00 GMT

Alexandra Wilson Pecci, for HealthLeaders Media, May 1, 2012

Americans are having a hard time paying for their prescription drugs. They're not confident in their ability to afford health insurance. They don't trust pharmaceutical companies. They think Medicare needs an overhaul, but don't want to be the ones to foot the bill. And they think that doctors and hospitals should be paid based on quality and results, rather than the volume of care they provide.

A lot of people are pretty down on healthcare in this country. In fact, in a Gallup poll last summer the healthcare industry ranked near the bottom in terms of popularity, right around real estate and energy. Only the federal government earned a lower standing. A recent Rasmussen poll found that only 6% of likely U.S. voters think the performance of Congress is good or excellent.

But there's one bright spot, a group of people for whom warm feelings never seem to wane, despite the chilly climate around them.

That bright spot is nursing, which the Gallup Poll consistently ranks as the most honest and ethical profession. In fact, the latest poll shows that 84% of respondents think nurses are high or very high on the ethics and honesty scale.

To read the rest of this FREE article, click here.

Editor's note: To read more articles like this, visit the Reading Room, part of www.StrategiesForNurseManagers.com.

HCPro celebrates National Nurses Week!

Fri, 04 May 2012 19:27:00 GMT

May 6 through May 12 marks the celebration of National Nurses Week, an annual event to recognize the contributions of nurses throughout the country. In honor of Nurses Week, HCPro will feature a different special offer each day, including discounts, giveaways, and contests.

The celebrations begin on Monday when HCPro is pleased to offer a free white paper on the Image of Nursing-plus free CE credit. Visit The Leader's Lounge on Monday to receive the white paper.

Every day next week, there will be a special Nurses Week promotion. Watch out for discounts on a variety of nursing products, contests with prizes, and more during Nurses Week. Visit The Leader's Lounge blog each day of Nurses Week to learn about the newest offer!

From the desk of Adrianne E. Avillion, DEd, RN

Fri, 04 May 2012 18:26:00 GMT

Editor's note: This feature is written by nursing professional development expert Adrianne E. Avillion, DEd, RN. Each week, Adrianne writes about an important issue in the area of professional development or answers reader questions. If you have a question for Adrianne, e-mail her at adrianne1@comcast.net.

Journal clubs for nursing professional development specialists
Journal clubs have long been used as a way to help nurses learn. Presenting information about treatment advances, nursing care, and other relevant topics facilitates not only learning but helps nurses to polish their presentation skills as they discuss and debate the merits of various healthcare developments. A journal club for nursing professional development (NPD) specialists is another way to help busy professionals learn about advances in their particular specialty. I suggest that an NPD journal club focus on NPD topics, rather than clinical ones. That is not to imply that clinical topics are not important to us. However, there are so many options already available for clinical discussions. I think that it is extremely important to take time to focus on the specialty of NPD, something we often fail to do.

I would also suggest that an NPD journal club should include resources pertaining to continuing education and training that are not healthcare related. We are so ingrained in healthcare that we sometimes forget that our colleagues in the business world and academia, for example, face many of the same dilemmas we do. An excellent resource is the journal Training, a publication of the American Society for Training and Development (www.astd.org). The Society for Modeling & Simulation International is another resource, an international organization with members representing industry, government, and academia (http://www.scs.org/home). This society publishes several journals that could serve as an impetus for NPD journal club meetings.

A virtual journal club has the advantage of being able to network with other NPD specialists outside of your organization. Consider establishing such a journal club. Most NPD departments are not very large and expanding NPD journal club membership also expands the number of persons available to review resources and lead discussions. Start your own NPD journal club soon and be sure to include resources from business, industry, government, and academia!

SDW news brief: Another walkout for California nurses

Fri, 04 May 2012 18:23:00 GMT

This past week, members of the California Nurses Association staged their third strike in seven months over ongoing contract negations. Thousands of nurses from Sutter Health-managed hospitals in the San Francisco area gathered to protest a proposed increase in healthcare payments. A spokesman for the California Nurses Union claims that Sutter Health has lied to employees and made claims in print that negotiators later denied in a meeting with union representatives.

Hospital services continued to run without interruption, not only because not all of the nurses went on strike but also because Sutter brought in contract nurses to maintain a full staff. Hospital representatives from multiple Sutter hospitals reported 30-50% of nurses crossing picket lines to report for work.

Source: Bay City News

From the staff development bookshelf: Defining accountability and responsibility in nursing

Fri, 04 May 2012 18:17:00 GMT

Before you can work toward achieving accountability, you need to ensure that you understand what is meant by the term and the way in which we will be using it in this book. We frequently hear the terms responsibility and accountability used interchangeably, but they do not mean the same thing.

If you look up dictionary definitions, you'll find the following explanations:

Accountability:
- Responsible for something
- Capable of being explained
Responsibility:
- Being accountable for something
- Authority to make decisions independently

These definitions are not much help. So, let's consider alternative definitions. A powerful distinction can exist between accountability and responsibility.

An effective way to distinguish them is as follows:

Accountability = A commitment to others to deliver and account for a result by a given date
Responsibility = An authority over people to have them respond to one's direction

Accountability is about the results to be delivered. A result is a desired situation that can be described. It is measurable, observable, and time-limited, such as "I will have the operating room reorganized by Friday."

Responsibility is about things that will respond to you. Think of responsibility as what is included in a job description. Your job responsibilities include the things you need to do to perform your job, including staffing, budgeting, and so on

It turns out that accountability and responsibility appear in different ways depending on the role you fill. You will encounter accountability and responsibility at work in two ways: through your organizational roles and your interpersonal interactions. You can use these distinctions to better see the game you are playing at any moment in time-and win that game!

Book excerpt adapted from Accountability in Nursing: Six Strategies to Build and Maintain a Culture of Commitment by Eileen Dohmann, RN, BSM, MBA, NEA-BC.

Readers of Staff Development Weekly receive a 10% discount on this book! Just enter source code EB102930A at checkout. Click here to visit www.hcmarketplace.com.

Website spotlight: Avoiding overuse of tests to prevent harm, eliminate waste, and reduce costs

Fri, 04 May 2012 18:12:00 GMT

The Joint Commission recently proposed a new National Patient Safety Goal (NPSG) to take effect January 1, 2013, addressing overuse of treatments, tests, and procedures in order to reduce the risk of patient harm. The idea is that if evidence shows no benefit to an unnecessary test, treatment, or procedure, you are exposing a patient only to potential harm by performing it.

The proposed goal would require hospitals to implement a program to address the issue by selecting a test or treatment to focus on, evaluating and monitoring it, and implementing methods to decrease any overuse found along the way.

Hospitals may select a treatment, procedure, or test based on a risk assessment of their clinical services using evidence-based literature on the potential harm of a specific test to patients; or they may select a treatment, procedure, or test from a list in the proposed NPSG that is relevant to their services.

The list provided by The Joint Commission reflects growing attention to the safety and quality problems that unnecessary use of certain tests, treatments, or procedures can cause, and research has documented that overuse occurs with significant frequency in the United States. Should hospitals choose to select a test from the list provided by The Joint Commission, they will have to choose one of the following, relevant to the hospital's services:

Early induction of labor in women at less than 39 weeks of gestation
Insertion of tympanostomy tubes in children with otitis media and bilateral effusions of less than 60 days and without other symptoms
Packed red blood cell transfusions in patients with hemoglobin of 12 grams or more
Coronary stenting or balloon angioplasty for coronary stenosis of 40% or less
CT scans for emergency department patients complaining of abdominal pain

To read the rest of this FREE article, click here.

Editor's note: To read more articles like this, visit the Reading Room, part of www.StrategiesForNurseManagers.com.

From the desk of Adrianne E. Avillion, DEd, RN

Fri, 27 Apr 2012 15:00:00 GMT

Make exercise a part of your life. If you really can't make use of those exercise DVDs sitting in a pile next to your DVD player, or walk on that treadmill lurking in your basement, perhaps you could:
- Park as far away as safely possible from the employee entrance at work, the entrance to the mall, grocery store, etc., instead of looking for the closest space. Those extra steps really add up and will help promote fitness and, if needed, weight loss.
- Investigate membership at a no frills gym. You can avoid the expense of a gym that has a swimming pool, formal classes, juice bar, etc. by joining a relatively inexpensive gym that concentrates on letting you be yourself and exercise at your own pace. Planet Fitness is a chain that comes to mind. For just a few dollars a month you have 24-hour access (on weekdays, on weekends the hours may be more limited) to treadmills, stationary bicycles, and weights. You may come and go as you please.
- Find some type of exercise that you really like and have ready access to. Walking, swimming, hiking, dancing, try whatever works for you! Check out the continuing education calendars from local school districts. These are great resources for all kinds of fun exercise options at reasonable prices.
- Find someone to exercise with. Many people need someone to help motivate them to exercise.
- Think about commandeering your children's Wii video game console. Some of those games provide a terrific workout.
Check with your human resource department about benefits you may not even be aware of. You may have access to discounts for various exercise facilities just because you are an employee at a particular organization. You may be able to secure a spa discount for a facial, massage, etc. Take time to pamper yourself. Check out local community college programs such as those training beauticians, cosmetologists, massage therapists, etc. These programs frequently offer discounts because services are provided by students.
Make time to enjoy an activity that has nothing whatsoever to do with work. For example, how about listening to an audio book as you commute to work or carpool the kids from one activity to another. Check with your local craft stores and find out about classes and group activities that are just plain fun.
Avoid or reduce your caffeine intake. Caffeine in large enough quantities can add to your stress, elevate your blood pressure, and increase your heart rate.
Stop smoking. This is tough. Consult with your physician and/or your employee health department for support and advice.
Pack a snack of fresh fruit or vegetable sticks for a break at work. This will help avoid the sugary snacks so readily available at most work places.
Finally, take time, even if it's just 10 minutes a day to do absolutely nothing. Relax for those few minutes and don't think about anything except recharging your energy.

SDW news brief: New law in Virginia encourages healthcare teams

Fri, 27 Apr 2012 14:57:00 GMT

The Medical Society of Virginia and the Virginia Council of Nurse Practitioners teamed up to create a new law aimed at promoting team-based care and greater collaboration between nurse practitioners (NP) and physicians. The law allows physicians to partner with six NPs, and enables NPs to work in different locations apart from their team to serve a wider patient population. Previous laws required NPs to work under direct supervision of a physician at the same location, and limited the number of NPs a physician could partner with to four. Supporters of the new law feel it offers greater flexibility and will improve patient care.

The American Academy of Nurse Practitioners opposes the new law, citing concerns that the law links a nurse practitioners' ability to obtain a license with being a part of a healthcare team under the leadership of a physician. The organization also notes that the language of the law stresses physician-led teams rather than collaborative team-based care.

Source: American Medical News