Nursing Committee Updates
In October, the Department of Nursing committee structure entered its second three-year term by welcoming new members and reviewing each committee’s purpose, goals and celebrating their accomplishments to date. Through the committee structure, the “voice of the nurse” continues to shape each committee’s work and the practice environment.
Informatics and Clinical Innovations Committee
The Informatics and Clinical Innovations Committee kicked off the new term welcoming eight new members. New and returning members were excited to begin the new term and are looking forward to continuing to advocate for practice to drive technology to assist the nurse at the bedside and promote patient and staff safety. Projects include:
BICS Order Entry Update: A new change with potassium sliding scale orders will be coming soon. In the current potassium scale orders, if a potassium level is less than 3.1, the physician is contacted to write for potassium replacement. With the new updated orders, the nurse will be able to give a one-time dose of potassium and then will need to call the physician for additional doses. To communicate this change the committee recommended that
An eMAR message display when the scales are updated in BICS;
An email be sent to all clinicians; and
A presentation be made at the Nurse Educator Meeting.
Feedback was given on the wording of the post-op antibiotic template to clarify the number of doses of antibiotics that the patient should receive.
Laboratory Communication Project: Feedback was given regarding four current workflows around collecting specimens and agreed that the workflows presented were accurate. Some of the new lab collection specimen features were reviewed with the committee. The most frequently added labs are troponin and magnesium. The committee suggested that a pop up box be given to the physician when they are ordering a panel which will ask if they would like these labs drawn.
Discharge Module Rewrite/Review: A new discharge module is being created to help streamline the discharge process in the computer. Committee members were asked to test the new discharge module for usability as well as provide feedback on the module. This will be a web-based application which will be available from the pod monitor. All disciplines will document on the same screen to prevent repetition and contradiction.
Alaris Pump Validation: Committee members validated changes in the Alaris pump drug library. Any drug that can be pushed will no longer be in the drug library.
If you have any questions/concerns regarding this committee or its projects, please contact co-chairs Heidi Smith Doucette, CNRN, or Carol Booth, MSN, RN, PCCN.
Standards Policies and Procedure Committee
The following highlights some of the policy changes that have occurred this fall.
Nurses working in the critical care units using propofol have long been aware that the tubing needs to be changed every 12 hours to reduce the chance of bacterial contamination in this lipid rich solution. In order to reduce the risk of central line infections, the clave should also be changed on this schedule to every 12 hours. This is likely a practice change for many. In addition, there are now 0 .5 micron filters to accommodate propofol infusion in those patients with patent foramen ovale, (PFO). Filters that are used for TPN are not large enough to ensure that propofol‘s molecular structure are not disrupted. These filters are purple in color and are available from Pharmacy. This will put us in compliance with the propofol DAG. Don’t forget to “scrub the hub!”
Policy MED-10 has been changed. This policy reflects the administration of aerosolized medication. HEPA filters will no longer be required. Precaution instructions will be included as the order templates are updated, as well as being flagged in EMAR (it may not yet available at time of this publication but is coming soon). Please see the DAG regarding aerosolized medications for further information, in addition to the policy.
When a patient returns after receiving a radiodiagnostic injection, a new information sheet will be placed in the front of the chart. The patient will be on radioactive precautions for 48 hours, which is the decay time of the materials used. On this sheet, the exact agent used along with its information will be identified by the department. Environmental Services is to be notified, and they will label the biohazardous waste containers and remove the trash and sharps when cleared by Health Physics. The labeling sign will come with the information sheet and can be taped to the receptacle. Contaminated linen should be retained in the patient room. Health Physics will collect the linen after 48 hours. The telephone number to reach them and other resources are on the information sheet. Of note, all bodily fluids, secretions and excretions can be disposed of in the usual way. A private room is not required. Guideline-12 contains this information.
As a result of the work of Cindy Jodoin, RN, and Elizabeth Ng, of Real Estate and Facilities, new signage regarding cell phone use will be placed over the next three months. This will reflect current information and has been approved by Biomedical Engineering.
IVT-33 reflects the potential use of intraosseous devices for access during codes. This equipment will now be on the code carts and the code leader will decide to use this if vascular access is unable to be obtained or inadequate. Code team members will need to review this policy.
Please direct questions, concerns or suggestions to co-chairs Cindy Jodoin, RN, or Sharon Swan, RN.
Nursing Practice Committee
The Nursing Practice Committee has continued to discuss and refine the Supports and Conditions for Excellent Practice they initially identified in 2009. These supports and conditions are organized under five main areas: nurse director, supportive colleagues, culture of learning, resources and strategies and conditions. The committee has paid particular attention to continuity of the nurse-patient relationship as one important and foundational strategy/condition for patients and families to feel known and cared for and for nurses to develop in their own practice. Continuity of nursing care promotes knowing the patient/family and knowing the patient is essential for the development of excellent practice. The committee has discussed the definition of continuity and how to describe what continuity looks like when in place. Committee members share examples and stories of the current state of continuity in their areas and the challenges and benefits to maintaining continuity.
An overarching goal of the committee is to preserve and extend the excellent practice that is present at BWH (i.e., the characteristics of excellent practice) so that every patient, family and nurse shares in the benefits that continuity provides. Committee members regularly share how they communicate to their colleagues the work of the committee and how the work has influenced their practice and the practice environment.
If you have any questions, contact committee co-chairs Mary Beth Mondello, CNRN, MSN,NP-C; and Alice O’Brien, MS, RN.
Quality Safety and Care Improvement Committee
The Quality, Safety and Care Improvement Committee entered the start of its fourth year with a transition meeting welcoming new members. This year, the QSCI committee welcomes Martha Doherty, RN, nurse educator for Labor and Delivery, into the role of committee co-chair alongside returning co-chair Stephanie Capello, RN, 15CD staff nurse. Mary Antonelli, RN, had moved into the committee’s advisor role. The QSCI committee continues its work to improve patient-family centered care, quality and safety while providing input into the department’s quality program plan. One of the committee’s primary charges includes identifying department-wide systems and processes in need of improvement to advance nursing practices and patient/family outcomes. The QSCI committee welcomes its new members and appreciates the contributions of its retiring members as it continues to use the voice of the nurse to influence and shape the nursing practice. The QSCI committee meets the second Tuesday of every month from 3:30 to 5:30 p.m. Please direct any concerns to co-chairs Martha Doherty, RN, or Stephanie Capello, RN.
Patient and Family Education Committee
The Patient and Family Education Committee welcomed 13 new members for the second term, including an additional seven staff nurses to increase the voice of the nurse from more clinical areas. After an orientation to the work of the committee, new members became immediately involved by enthusiastically participating in discussions, offering new ideas and confirming the direction of the committee’s current work.
In October, new members participated in their first project as the Patient and Family Education Committee embarked on a communication campaign as a result of feedback that many staff nurses are still unaware of the Patient Education website and all of its great resources. Donning “Push My Button” pins, committee members spread the word about the Patient Education website in each of their respective areas. Their efforts resulted in an upward trend in website usage in October. Additional website communication strategies will include messages on the electronic boards over the next few months and ensuring new nurses receive information about patient education resources during orientation. Get to know the Patient and Family Education committee member in your area and ask often about the committee’s work.
For more information, contact co-chairs Cindy Loring, RN, and Deb Moody, RN.
Nursing Committee Members for 2011
Informatics and Clinical Innovations: Katherine Andrews, RN; Anne Bane, RN; Sarah Bifulco, RN; Carol Booth, RN; Gina Cappelleti, RN; Lisa Caravaggio, RN; Robert Cullerton, RN; Ann Marie Curran, RN; Kristin Dexter, RN; Heidi Doucette, RN; Anne Marie Doyle, RN; Jennifer Eaton, RN; Marian Fitzgerald, RN; Denise Goldsmith, RN; Brenda Griffin, RN; Caitlin Guerrero, RN; Eric Hahn, RN; Richard Henlotter, RN; Carol Luppi, RN; Lisa Masiello-Schmedlin; James McCarthy, RN; Eileen McMahon Bowen, RN; Laura Mcphilemy, RN; Andrew Meyers, RN; Amy Nelson, RN; Ann O’Dea, RN; Regina Pepin, RN; Carol Prone; Heather Rurak RN; Leslie Sabatino, RN; Lauren Selvitella, RN; John Solman, RN; Escel Stanghellini, RN; Maureen Tapper, RN; Bill Theisson, RN; Joan Wallace, RN; Bernadette White, RN; Gary Zina, RN
Patient and Family Education: Beth Baldwin, RN; Kristin Bartucca; Carol Bellinghausen, RN; Jeanne Berk, RN; Lynn Blech; Valerie Jean Bragg, RN; Lauren Brent, RN; Adriana Cecchini, RN; Diana Cuypers, RN; Jane Davies, RN; Petrona Forbes, RN; Ann Furey, RN; Yolanda Harmuth, RN; Mary Anne Kenyon; Sherilyn Levy, RN; Cindy Loring, RN; Lorraine MacDonald, RN; Muffie Martin, RN; Deb Moody, RN; JoAnn Morey, RN; Joan Morgan, RN; Karen Morse Gallager, RN; Amy Perchard, RN; Cindy Shore-Wadness; Rachel Slate, RN; Sandy Torrisi, RN; September Wallingford, RN; Brianna Welenc, RN; Jayne Wheeler, RN; Aliesha Wisdom, RN; Colleen West, RN
Nursing Practice: Peggy Bernazzani, RN; Kristine Carlo, RN; Laura Cavagnaro, RN; Petra Clark, RN; Ellen Clemence, RN; Carol Corbett, RN; Liz Doane, RN; Joan Dorr, RN; Andrea Edmands, RN; Mary Lou Etheredge, RN; Lucy Feild, RN; Suzanne Fernandes, RN; Katie Fillipon, RN; Chris Flanagan, RN; Patricia Frazier, RN; Nina Johnson, RN; Sharon Levine, RN; Ellen Liston, RN; Heather MacDougall, RN, Julie McCarthy, RN; Susan McDonald, RN; Marsha Milone, RN; Mary Beth Mondello, RN; Kerry Noonan, RN; Kelli O’Brien, RN; Alice O’Brien, RN; Jennifer Palermo, RN Corinne Cyr Pryor, RN; Matt Quin, RN; Karen Reilly, RN; Suzanne Silvernail, RN; Elyssa Towers, RN; Noreen Valentine, RN; Nori Ann Vincitorio, RN; Rosemary Wickman, RN; Ronna Zaremski, RN
Quality, Saftey and Care Improvement: Mary Antonelli, RN; Ellen Bergeron, RN; Sharon Bouyer-Ferullo, RN; Heidi Braun Lally, RN; Casey Burnett, RN; Stephanie Capello, RN; Sophia Chambers, RN; Michelle Delprete, RN; Martha Doherty, RN; Joanne Hall, RN; Jessica Lachapelle, RN; Kathleen Leone, RN; Katie O’Connell, RN; Michaelle Renard, RN;Anne Marie Reynolds-Lynch, RN; Tina Steele, RN; Sarah Thompson, RN; Kristen Toczylowski, RN; Paula Trabucco, RN; Cheryl Ventola, RN
Standards, Policy and Procedures: Barbara Bauman, RN; Diane Cambell, RN; Marie Courtney, RN; Jane Daisy, RN; Kathy Davis, RN; Joan Deary, RN; Patricia Green, RN; Brenda Griffin, RN; Cindy Jodoin, RN; Yaeko Karantonis, RN;Jennifer Klein, RN; Carole Kubiak, RN; Rhonda Martin, RN; Alexandra Mclean, RN; Diane Miller, RN; Diane Miller, RN; Justin Precourt, RN; Mary Reynolds ,RN; Sharon Swan, RN; Lauren Willard, RN