American entrepreneur, author and motivational speaker Jim Rohn once said, “Ideas can be life-changing. Sometimes all you need to open the door is just one more good idea.”
For nurses at DeKalb Medical, that door has opened.
“Nurses have fabulous ideas every day. Someone will say, ‘You know it would be better, if we did this...,” but it rarely goes anywhere if nurses are just sitting around talking amongst themselves,” said Valerie Campbell, BSN, RN-BC, clinical coordinator and advanced charge nurse in the medical-surgical unit at DeKalb Medical’s Hillandale campus in Lithonia.
At DeKalb Medical’s Center for Nursing Practice, those ideas not only get shared, but implemented. Jan Gannon, vice president of patient care services and chief nursing officer, and Cathleen Wheatley, senior vice president and chief quality officer, started the center in 2008. In 2009, they initiated a delegate program, asking each hospital unit to select one nurse known for outstanding contributions to bedside nursing.
“It felt good to get that letter asking me to be a delegate, and I knew I needed to do a good job. It was a responsibility as well as an honor,” Campbell said.
The group of 20 delegates met for a year to find ways to improve patient care and safety throughout the hospital system.
“Each of us was asked to come up with an idea, initiate it in our unit and report back on whether it made a measurable difference,” she said.
Campbell wanted to change end-of-shift reporting to give nurses more visibility and to improve patient care.
“Previously, off-going and on-coming nurses sat at the computer to hand off patients,” she said. “Now we do it at the bedside. One nurse introduces the other and gives patients and their families a chance to ask questions.”
Bedside reporting helps nurses meet their patients faster and allows them to address care issues immediately.
“It takes about three minutes. The nurse leaving gets out faster, yet knows that her patient will be safer because the new nurse is better informed,” Campbell said. “On many levels, bedside reporting gives greater nursing satisfaction, and other units are looking to implement it.”
Regina Duncan, RN, ONC, who works the night shift in the oncology renal unit at the Decatur campus, came up with an idea she called the Village Project.
“Our patients often come from the emergency department. They’re very sick, with complications from chemotherapy, infections or in pain,” she said. “They have been waiting a long time to be seen.”
Duncan wanted to get those patients stabilized, comfortable and settled in for the night as soon as possible, but intake took two to three hours when one nurse performed that task.
“Now, instead of one nurse admitting the patient, anyone who is available on the floor comes to help,” she said. “One person checks meds, another starts an IV, someone else takes vital signs and enters information into the computer.
“We all have skills that we’re really good at. The wound care expert will attend to that and someone good at IVs will get that started. Now it takes us 20 to 30 minutes per admission.”
Not only has the Village Project improved morale for patients and their families, it has helped the staff build a team.
“I see a big difference in how we come to work. I never dread a terrible night anymore,” Duncan said. “Regardless of what they send us, I know we’ll be able to handle it together.”
She’s excited to see how contributing one simple idea can make an impact.
Now that the 2009 class of delegates for the Center for Nursing Practice has graduated, they will serve as fellows to the next group. Duncan is looking forward to mentoring the next delegate from her unit.
“I can’t wait to hear her ideas,” Duncan said. “This whole program will just keep growing and growing, and making this a better place to work.”
Leah Tollison, RN, CEN, who works in the emergency department at the Decatur campus, decided to address patient satisfaction.
“We scored lowest in keeping patients informed, so I came up with buttons that say, “Ask me because I care. We keep our patients informed,’ ” Tollison said.
She also wrote booklets with ideas on ways to keep patients better informed.
“Now, nurses write their names and direct phone numbers on the white board in the exam rooms and we also write, ‘What’s next,’ so that patients know exactly what they’re waiting on,” Tollison said.
By telling patients what’s going on and what to expect — even in the waiting room — less than 1 percent of them leave without seeing a provider. Tollison implemented the initiative in November and took a survey of patients in January. Seventy-five percent (up from 65 percent in November) said they were better informed.
“As nurses working for a large organization, we often feel like our ideas get drowned out, but at DeKalb I feel like nurses’ voices are valued and heard,” Tollison said. “We’re change agents. It’s been exciting working with this group to see ideas get implemented and things change.”
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