Committee Updates
Quality Safety and Care Improvement
The QSCI committee reviewed the various injury severity levels currently available when completing a safety report. The committee’s feedback will be used to propose standardization of severity levels within the RL safety reporting system. Results of this work will be clearer injury category selections and a more accurate description of the event outcome.
The committee also reviewed the results from a VRE reduction project, which included hand hygiene as a major intervention. As a spin off of this project, the committee has taken on hand hygiene as a focus and will be identifying core elements to support development of a departmental program.
Please share thoughts and ideas with QSCI co-chairs Stephanie Capello, RN, or Mary Antonelli, RN.
Standards Policies and Procedures
This committee wants to make sure staff are aware of changes in some policies that have resulted in practice changes.
IV Therapy policies have been reviewed and updated. The change throughout most of these policies is the 10-second scrub. All needle-less connectors, caps and Y sites now require a 10 second scrub prior to accessing. This practice reflects current evidence in the literature connecting the 10-second scrub to a reduction in central line and blood stream related infections. Unit based educators will provide specific information, as well as IV Therapy alerts. So remember: “Scrub the Hub!”
Another across-the-board change involves the Alaris Pumps. When delivering a secondary medication, add 5 percent to the volume to account for overfill by the manufacturer. There is great variability in volumes added by the manufacturers, so this is a way to help ensure that all of the ordered medication is delivered and to decrease variability when measuring drug levels. So if you are hanging a 50cc bag, add 5cc; a 100 cc bag would require 10 cc., etc.
When writing your synthesis note you may abbreviate the title by writing N.S.N for Nursing Synthesis Note. This is accepted for documentation. In addition, comment codes are no longer required for the glucometer since they were updated.
Remember to read, “New to You; Policies to Review” information sent by e-mail. These include up-to-date policy information than can affect your practice.
Any ideas, questions or comments can be directed to Sharon Swan, RN, or Cindy Jodoin, RN, as committee co-chairs or to any member of the committee.
Nursing Informatics and Clinical Innovations
This committee provided feedback and recommendations for several projects.
One projects is a new Rehabilitation Services documentation system, which will enable therapists to improve their documentation and streamline processes. Representatives from this project attended a meeting and solicited feedback from the committee on how best to access the new inpatient OT/PT evaluations.
Nursing order sets, in which nurses can order services such as Social Work, Nutrition, smoking cessation and Chaplaincy without a doctor’s order, are being explored. The committee contributed to the list of potential areas to which Nursing Order sets might apply.
To meet new regulations and to prevent electronic prescriptions from being altered, tamper proof prescription paper will be implemented on all inpatient units sometime this fall. The committee made recommendations on how best to implement this change on the units.
Please share thoughts and ideas with committee co-hairs, Carol Booth, RN, and Heidi Smith, RN.
Patient and Family Education
The Patient and Family Education Committee has been focusing on the new television system that is now available to all BWH patients and families. The committee in June reviewed, evaluated and edited slide show materials that patients can view in their rooms. The slides consist of general hospital information as well in information on the Kessler Library, Dana-Farber Cancer Institute resources and patient and family resources that are available.
The committee also has been brainstorming to identify desired content that will be available in the future on the patient and family Web site. The site will make patient and family education readily accessible to all patients and families.
Other areas of focus include how to best document smoking cessation teaching and instructions on patient discharges to rehab and other facilities and hospital-wide diabetes teaching and education. We are looking for the best way to educate patients early in their stay about diabetes, checking glucose levels and insulin administration. Co-chairs Cindy Loring, RN, and Deb Moody, RN, appreciate any suggestions.