Nursing Committee Updates
Informatics and Clinical Innovations Committee
The Informatics and Clinical Innovations Committee has been focusing on a number of projects to improve clinical technologies to support the clinical nurse at the bedside. Projects include:
Omnicell Changes: pharmacy demonstrated to the group a new option in the omnicell for medication retrieval. The new option allows for scheduled meds to match the “to do” list of meds. The alphabetical/stock med option would still be available. The new Baxter System of dispensing antibiotics (vs. the advantage system that we have previously used) is currently being trialed in both the intermediate and ICU areas.
Alaris Validation: the informatics committe reviewed and validated the newest version of the Alaris Drug Library. The new version was deployed in September.
Discharge Rewrite Module Project: a new Web-based discharge module is being created. Discharge contingencies were presented to the informatics committe for feedback. Clear defined discharge contingency parameters were supported by the group.
BWH Responding Clinician Project: Partners IS gathered feedback from the committee as to how to educate RNs about the “RC” column informatics committe on the pod monitor. This system was successfully implemented at MGH and provides accurate, up-to-date information as to who is the responding clinician for a particular patient. A system that accurately provides which clinician is covering a patient is essential in order to support the critical test result notification system within the Lab Order Communication Project.
Phase II Lab Order Communication Project: The committee provided feedback on the current workflow for specimen collection occurring on the patient care units. The information provided by the committee was needed to begin the design of a new lab system that will eliminate paper lab requisitions.
Patient Education TV Project: The patient education video system is a new, interactive, education video system where the nurse can assign videos for the patient to watch to be better informed about their disease process. The content has been validated by BWH nurse experts. This system provides the clinical nurse with another teaching tool to assist with patient education. It was piloted on Shapiro 9West and 10 East/West. Enhancements to the system have been made based on recommendations from the clinical nurses on the pilot units.
Acute Care Documentation Project (ACD): See page 8.
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.
Quality Safety and Care Improvement Committee
The Quality, Safety and Care Improvement Committee continues to focus on promoting hand hygiene throughout the Department of Nursing. This past year, under the leadership of Colleen Zidik, MBA, BSN, RN, quality program manager, the department improved hand hygiene compliance rates for nurses to 90 percent from 81 percent in 2008, and PCA hand hygiene compliance rates improved from 80 percent to 86 percent.
This is a great achievement for the department and for the committee. The committee reviewed and approved the Hand Hygiene team’s plan for 2010 that will focus on sustainability and address off-shift needs. The committee also discussed skin assessment, plans of care, pressure ulcer care and prevention issues. This discussion led to insight into the need for detailed plans of care for these patients, and the communication of these plans during handoff reporting. The committee recommended two units pilot a process in December to help establish a centralized system for the communication of pressure ulcer safety reporting. The goal is to establish a process for communicating when a safety report was filed through handoff reporting and a tagging system. All skin recommendations from the committee were shared with the skin team lead, Lucy Feild, PhD, RN, quality program manager.
Standards, Policies and Procedures Committee
This fall’s agendas have been exceptionally packed with policies and procedures that go across all specialty areas. We hope that the “New to You..Time to Review” e-mails have been a helpful tool in keeping up. As always give it a quick scan and hone in on the policies that affect your practice.
A new Joint Commission requirement affects all nurses. For all Nursing notes: date at the top and again on the signature line along with the time. The correct patient name and medical record number must be stamped (preferably), or written or typed on the front and back of all pages.
Guide-06 contains information regarding timing subcutaneous insulin administration. Definitions for nutritional, correctional and basal insulin are given. Also information to help with common clinical issues like delays in patient’s eating, tube feedings and TPN can be accessed in this guideline. Concurrent with this is MED-15 which gives instruction on the use of the new Innolet regular insulin pen. Only regular insulin will be available in a vial. Nursing vigilance must be maintained for this High Alert/High Risk Medication.
Tracheotomy and PEG Tube Insertion Conducted in the ICU Guidelines are important for those of you in ICU settings that may assist in these procedures. Anesthesia must be booked; additional information for all members of the care team is provided. Found in the Administrative and Medical Staff Manual, this policy can be accessed via PikeNotes.
The Patient Communication sheet has been revised specifically to address restraint use and chemotherapy concerns. Please continue to utilize this sheet to ensure safety for your patients.
Questions, concerns or comments related to policies and procedures can be directed to the SPP co-chairs, Cindy Jodoin, MHA, BSN, RN, and Sharon Swan, BSN, RN, CRN, via partners e-mail
Nursing Practice Committee
The Nursing Practice Committee celebrated its first year as a committee in November. Mairead Hickey, PhD, RN, chief nursing officer and senior VP for Patient Care Services, and Trish Gibbons,RN, DNSc, associate chief nurse and Nursing Co-Coordinating Committee tri-chair, attended the meeting. Members described both their learning and accomplishments. The characteristics of excellent practice and how they appear at different stages of development have framed the ongoing discussions of the committee. Committee members have provided feedback on the prevalence of excellent practice at BWH. They have identified what supports are necessary for preserving and extending excellent practice. They are also advising the Department of Nursing about how to prepare for this work.
If you have any questions, contact committee co-chairs Mary Beth Mondello, CNRN, and Alice O’Brien, MS, RN.
Patient and Family Education Committee
The committee has been redesigning and updating the patient and family education Web site on BWHPikeNotes.org to make it user friendly, easy to access and the main resource for nurses on teaching materials for patients and families. We encourage you to access the site and become familiar with what’s available. The site is available for Partners PC Start menu > Partners Applications > Clinical References > BWH Patient Education or on BWHPikenotes.org in the Patient and Family Care section.
There you will find Krames on demand, Care Notes, diabetes information, chemotherapy teaching sheets, printable BWH brochures, teaching sheets on tubes and drains, infection control fact sheets and more. Send any suggestions and feedback to co-chairs Deb Moody, BSN, RN, and Cindy Loring, RNC, CNS.