Project Team: Project Team: Mary Ellen Murray, PH.D, Mary Ellen Murray, PH.D, RN RN Paula Jarzemsky, MS, RN Paula Jarzemsky, MS, RN Diana Girdley, MS, RN Diana Girdley, MS, RN Steve Douglas, MS, RN Steve Douglas, MS, RN Greetings From University of Greetings From University of Wisconsin Wisconsin
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Project Team: Mary Ellen Murray, PH.D, RN Paula Jarzemsky, MS, RN Diana Girdley, MS, RN Steve Douglas, MS, RN Greetings From University of Wisconsin.
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HOW WAS THIS HOW WAS THIS INNOVATION INNOVATION ACCOMPLISHED? ACCOMPLISHED?
Patient Safety Scan Patient Safety Scan
History of the Safety History of the Safety ScanScan
– Eaglewood retreat in October, 2007Eaglewood retreat in October, 2007– Motivated to change approach to clinical Motivated to change approach to clinical
teaching by incorporating an agenda of :teaching by incorporating an agenda of :
Safety & Patient Centered CareSafety & Patient Centered Care
Development of the Development of the ToolTool Checklist for students (who need Checklist for students (who need
structure and focus)structure and focus)
5 minute sit-down with patient as 5 minute sit-down with patient as an initiative for an initiative for – Therapeutic communicationTherapeutic communication– Identification of patient Identification of patient
goals/concernsgoals/concerns
The The Safety Safety
Scan Scan
Page 1Page 1
The The
Safety Safety
Scan Scan
Page 2Page 2
The The Safety Safety ScanScan Page 2 Page 2 (Cont’d)(Cont’d)
Implementation of the Implementation of the Safety Scan Safety Scan
Each student was to complete the Each student was to complete the form within the 1form within the 1stst 30 minutes on unit 30 minutes on unit
Safety issues identified were Safety issues identified were discussed in post-conferencediscussed in post-conference
Process established for reporting Process established for reporting staff/system errorsstaff/system errors
Forms were collected after each Forms were collected after each clinicalclinical
Safety AssessmentSafety Assessment
Majority of issues noted were environmentalMajority of issues noted were environmental
Other safety issues noted by students:Other safety issues noted by students:
– Hand gel not by doorHand gel not by door– Visitor doesn’t wear gown when patient on Visitor doesn’t wear gown when patient on
contact isolationcontact isolation– IV team started IV without using gloves or IV team started IV without using gloves or
communicating what they were doing.communicating what they were doing.– Wound care nurse failed to wash handsWound care nurse failed to wash hands– Med sheets and other notes left out for others to Med sheets and other notes left out for others to
readread
5 minute sit-down5 minute sit-down
What would you like to see happen What would you like to see happen today:today:
Home, bath/shower, pain Home, bath/shower, pain management, family visit, informationmanagement, family visit, information
““Soak feet and get up in a chair”Soak feet and get up in a chair” ““Win the lottery”Win the lottery” ““Watch the “Price is Right”Watch the “Price is Right”
5 minute sit-down5 minute sit-downIIs there anything that could s there anything that could have have made your hospital stay made your hospital stay better?better?
ExcellentExcellent Better pain control and Better pain control and
communicationcommunication ““Let me sleep in more – Let me sleep in more –
put a lock on the door”put a lock on the door” ““You couldn’t have done You couldn’t have done
better if you had rocked better if you had rocked me like a baby”me like a baby”
““A drink”A drink”
5 minute sit-down 5 minute sit-down What should nursing students What should nursing students know about being a patient in the know about being a patient in the hospital?hospital?
Be kind, allow control, it’s boring, have Be kind, allow control, it’s boring, have sense of humor, smile, respect privacysense of humor, smile, respect privacy
““It’s hard when staff are crabby”It’s hard when staff are crabby” ““I love this question. I wish more people I love this question. I wish more people
would ask it.”would ask it.” ““What a stupid question. I wish the sun What a stupid question. I wish the sun
would come out.”would come out.”
WHAT WERE THE WHAT WERE THE BIGGEST BIGGEST CHALLENGES?CHALLENGES?
Patient Safety Scan Patient Safety Scan
Student ChallengesStudent Challenges
Communication with Communication with patientspatients
Lack of role-modeling Lack of role-modeling from stafffrom staff
Time – (my Time – (my expectation)expectation)
Staff challengesStaff challenges Experienced staff were Experienced staff were
resistant to either utilize or resistant to either utilize or review the tool with studentsreview the tool with students
Surveys: Surveys: N=8 N=8
Anecdotal:Anecdotal:““We do this already “ – environmental We do this already “ – environmental
scanscan““I’m not prepared to deal with what I I’m not prepared to deal with what I
may hear” – 5 minute sit-downmay hear” – 5 minute sit-downNurse residents: “Can we get this in our Nurse residents: “Can we get this in our
orientation packet?”orientation packet?”
WHAT EVIDENCE OF WHAT EVIDENCE OF IMPACT IMPACT CAN BE SHARED? CAN BE SHARED?
Post-conference contentPost-conference content Student feedback – surveysStudent feedback – surveys Adoption for use by other practice pairsAdoption for use by other practice pairs
SUMMARY/CONCLUSIONSSUMMARY/CONCLUSIONS
WHAT WERE SOME IMPORTANT WHAT WERE SOME IMPORTANT THINGS LEARNED THIS YEAR? THINGS LEARNED THIS YEAR?
How is change implemented? How is change implemented?
Preparing for Preparing for Change: Change: The Pencil Metaphor The Pencil Metaphor
Used with permission and adapted Used with permission and adapted fromfrom
Jane H. Barnsteiner, PhD, RN, FAANJane H. Barnsteiner, PhD, RN, FAAN
October 13, 2007October 13, 2007
The pencil provided a The pencil provided a metaphor for the various metaphor for the various positions people assume positions people assume when asked to adapt to when asked to adapt to something new.something new.
Extending the Pencil Extending the Pencil MetaphorMetaphor
Sharp onesSharp ones
The wood The wood (“would”)(“would”)
Hangers-onHangers-on
Avoid the Blank PageAvoid the Blank Page
Allow for creativityAllow for creativity
Make use of existing Make use of existing resources resources
WHAT’S NEXT FOR WHAT’S NEXT FOR YOUR SCHOOL WITH YOUR SCHOOL WITH RESPECT RESPECT TO QSEN? TO QSEN?
University of WI - University of WI - MadisonMadison
Bringing ideas full Bringing ideas full circle circle
Pencil MetaphorPencil Metaphor
Dead woodDead wood
ErasersErasers
Reduce fear of Reduce fear of consequencesconsequences
DisseminationDissemination
The EndThe End
Or is it the Beginning?Or is it the Beginning?
The lead-ersThe lead-ers (Say led). (Say led).
These are the first to take on the These are the first to take on the technology, the early adopters who technology, the early adopters who usually document and usually document and enthusiastically enthusiastically share what they have tried--warts share what they have tried--warts and all. and all.
Students “Led” the Way Students “Led” the Way to Establish the Most to Establish the Most Effective Effective Clinical Partnership! Clinical Partnership!