Emergency Department Nurse Leader Rounding: A Clinical Intervention and Quality Initiative

2.50
Hdl Handle:
http://hdl.handle.net/10755/162688
Type:
Presentation
Title:
Emergency Department Nurse Leader Rounding: A Clinical Intervention and Quality Initiative
Abstract:
Emergency Department Nurse Leader Rounding: A Clinical Intervention and Quality Initiative
Conference Sponsor:Emergency Nurses Association
Conference Year:2008
Author:Damian, Frances J., MS, RN, CNAA
P.I. Institution Name:Children's Hospital, Boston
Title:Director of Nursing/Patient Services, Emergency Services
Contact Address:, Boston, MA, 02152-, USA
Co-Authors:Mary Fallon Smith, MS, RN, CCM; Erika Penney, MSN, RN, CPNP, CCM
Purpose: Improve communication of information to families and intervene when appropriate. Results of the ED Patient/Family satisfaction survey showed an opportunity for improvement communicating the plan of care and explaining the process of care at frequent intervals. Additionally, families who voiced concerns about their visit often did not know their child?s RN or MD for a variety of reasons. Leader rounding with patients/families helps identify unmet needs of individuals and affords the leader the opportunity to meet expressed needs.

Design: Based on Quint Studer's work, Hardwiring Excellence, a five-item structured interview was created for nurse leaders to use during rounding. Questions were designed to elicit information on the important aspects of communication to families during ED care. This information included identifying who their nurse and doctor was, ensuring their pain is being controlled, explaining what they were waiting for, and determining if they had any other needs or concerns. Responses and interventions were recorded and analyzed.

Setting: Urban, Level I Pediatric Trauma Center, teaching facility, with 52,000 annual visits.

Participants: Patients/families in ED exam rooms. Nurse leaders participating included RN Director, case managers and designated senior nurses.

Methods: Convenience sample of patients /families determined the population. The visit was made by a nurse leader at various times of the day or evening Monday through Friday. Families were asked the questions from the interview form. Leaders intervened immediately if the family indicated or the leader recognized a need. Feedback and information was given to the Nurse and/or MD caring for the child when indicated.

Results: 87.25% knew who their MD was, 87 % knew who their RN was, 78.88% reported pain controlled, 93.5% knew why they were waiting, 46.25% had questions or concerns needing intervention. Of the families needing help the following was provided: comfort interventions 35%, communication facilitation 35%, intervention to get care 7%, received care from leader 4%, leader advocacy 5% and referral needs 1%.

Recommendations: Based on analysis of leader rounds findings, three recommendations were identified: Implement ongoing training of staff regarding what to communicate and how frequently to update patients/families; Embed key phrases into conversations with families, such as "I have time if you have questions" and share themes of expressed needs/concerns of families to staff as well as compliments and aspects of care that are perceived positively. *Studer, Q.(2003) Hardwiring Excellence. Florida: Fire Starter Publishing
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleEmergency Department Nurse Leader Rounding: A Clinical Intervention and Quality Initiativeen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162688-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Emergency Department Nurse Leader Rounding: A Clinical Intervention and Quality Initiative</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2008</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Damian, Frances J., MS, RN, CNAA</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Children's Hospital, Boston</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Director of Nursing/Patient Services, Emergency Services</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">, Boston, MA, 02152-, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">fran.damian@childrens.harvard.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Mary Fallon Smith, MS, RN, CCM; Erika Penney, MSN, RN, CPNP, CCM</td></tr><tr><td colspan="2" class="item-abstract">Purpose: Improve communication of information to families and intervene when appropriate. Results of the ED Patient/Family satisfaction survey showed an opportunity for improvement communicating the plan of care and explaining the process of care at frequent intervals. Additionally, families who voiced concerns about their visit often did not know their child?s RN or MD for a variety of reasons. Leader rounding with patients/families helps identify unmet needs of individuals and affords the leader the opportunity to meet expressed needs. <br/><br/>Design: Based on Quint Studer's work, Hardwiring Excellence, a five-item structured interview was created for nurse leaders to use during rounding. Questions were designed to elicit information on the important aspects of communication to families during ED care. This information included identifying who their nurse and doctor was, ensuring their pain is being controlled, explaining what they were waiting for, and determining if they had any other needs or concerns. Responses and interventions were recorded and analyzed. <br/><br/>Setting: Urban, Level I Pediatric Trauma Center, teaching facility, with 52,000 annual visits.<br/><br/>Participants: Patients/families in ED exam rooms. Nurse leaders participating included RN Director, case managers and designated senior nurses.<br/><br/>Methods: Convenience sample of patients /families determined the population. The visit was made by a nurse leader at various times of the day or evening Monday through Friday. Families were asked the questions from the interview form. Leaders intervened immediately if the family indicated or the leader recognized a need. Feedback and information was given to the Nurse and/or MD caring for the child when indicated. <br/><br/>Results: 87.25% knew who their MD was, 87 % knew who their RN was, 78.88% reported pain controlled, 93.5% knew why they were waiting, 46.25% had questions or concerns needing intervention. Of the families needing help the following was provided: comfort interventions 35%, communication facilitation 35%, intervention to get care 7%, received care from leader 4%, leader advocacy 5% and referral needs 1%.<br/><br/>Recommendations: Based on analysis of leader rounds findings, three recommendations were identified: Implement ongoing training of staff regarding what to communicate and how frequently to update patients/families; Embed key phrases into conversations with families, such as &quot;I have time if you have questions&quot; and share themes of expressed needs/concerns of families to staff as well as compliments and aspects of care that are perceived positively. *Studer, Q.(2003) Hardwiring Excellence. Florida: Fire Starter Publishing</td></tr></table>en_GB
dc.date.available2011-10-27T10:32:28Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:32:28Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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