2.50
Hdl Handle:
http://hdl.handle.net/10755/163862
Category:
Abstract
Type:
Presentation
Title:
Reinstating Nursing Orders: A CNS Initiative
Author(s):
Gralton, Karen S.
Author Details:
Karen S. Gralton, MSN, RN, Children's Hospital of Wisconsin, Milwaukee, Wisconsin, USA, email: nacnsorg@nacns.org
Abstract:
Problem: The documentation system for the model of nursing care did not clearly incorporate all components of the nursing care plan; specifically, nursing orders. Purpose: 1) To utilize the current computerized system to write individualized nursing orders for each patient/family, and 2) To increase consistency of care and communication among nurses. Significance/Justification: Individualized nursing orders are important because they address the uniqueness of the patient/family, as well as their responses to illness and hospitalization. Although the expected outcomes are identified upon admission and regularly updated, the computerized order entry system for writing nursing orders was not being utilized by staff nurses. This frequently resulted in each bedside nurse making decisions related to nursing care, which were not always consistent with previous nurses, and thereby, creating the potential to leave families confused by the lack of consistency and communication by nursing staff. Practice Innovation/Methods: Utilizing the present computerized order entry system, the CNS collaborated with a nursing clinical informatic specialist, to identify how nurses could enter individualized nursing orders for their patients and families. By expanding the existing nursing section (used by physicians to write nursing orders) with additional categories, nurses were able to enter their specific orders with comments. To assist the nursing staff with the development and writing of nursing orders, the CNS provided an in-service and individual consultation. Outcomes: Presently, all patients now have general nursing orders related to nursing assessment and standard nursing care. Approximately, 50% of the patients also have individualized nursing orders that describe specific nursing care activities. The individualized nursing orders provide consistency of care among nurses and their practice. Since many of the staff nurses have an assignment of four to five patients, the nursing orders decrease the time necessary to communicate the nursing plan of care during shift report. Subsequently, this decreased the amount of overtime paid to nurses because they were leaving on time. In an effort to spread the effects of this project house wide, oral presentations were given to each unit based clinical practice committee, who were considered key stakeholders in changing practice. Four of the seven patient units write nursing orders, and some units have written nursing order sets for specific diagnoses. Interpretation/Conclusion: Developing a method to write nursing orders using the present computerized system, enable staff nurses to communicate more effectively and efficiently, as well as increase the consistency of nursing care for their patients and families. This resulted in both increased family and nurse satisfaction. Implications for Practice: As technology increases, nurses need to re-evaluate how to utilize new systems to plan and deliver quality nursing care, and the CNS must be at the forefront leading the way.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2004
Conference Name:
2004 NACNS Conference, Renaissance in CNS Practice: Transforming Nursing in the 21st Century
Conference Host:
NACNS - National Association of Clinical Nurse Specialists
Conference Location:
San Antonio, Texas, USA
Description:
Conference theme: Renaissance in CNS Practice: Transforming Nursing in the 21st Century, held on March 11 to 13, 2004 in San Antonio, Texas, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleReinstating Nursing Orders: A CNS Initiativeen_GB
dc.contributor.authorGralton, Karen S.en_US
dc.author.detailsKaren S. Gralton, MSN, RN, Children's Hospital of Wisconsin, Milwaukee, Wisconsin, USA, email: nacnsorg@nacns.orgen_US
dc.identifier.urihttp://hdl.handle.net/10755/163862-
dc.description.abstractProblem: The documentation system for the model of nursing care did not clearly incorporate all components of the nursing care plan; specifically, nursing orders. Purpose: 1) To utilize the current computerized system to write individualized nursing orders for each patient/family, and 2) To increase consistency of care and communication among nurses. Significance/Justification: Individualized nursing orders are important because they address the uniqueness of the patient/family, as well as their responses to illness and hospitalization. Although the expected outcomes are identified upon admission and regularly updated, the computerized order entry system for writing nursing orders was not being utilized by staff nurses. This frequently resulted in each bedside nurse making decisions related to nursing care, which were not always consistent with previous nurses, and thereby, creating the potential to leave families confused by the lack of consistency and communication by nursing staff. Practice Innovation/Methods: Utilizing the present computerized order entry system, the CNS collaborated with a nursing clinical informatic specialist, to identify how nurses could enter individualized nursing orders for their patients and families. By expanding the existing nursing section (used by physicians to write nursing orders) with additional categories, nurses were able to enter their specific orders with comments. To assist the nursing staff with the development and writing of nursing orders, the CNS provided an in-service and individual consultation. Outcomes: Presently, all patients now have general nursing orders related to nursing assessment and standard nursing care. Approximately, 50% of the patients also have individualized nursing orders that describe specific nursing care activities. The individualized nursing orders provide consistency of care among nurses and their practice. Since many of the staff nurses have an assignment of four to five patients, the nursing orders decrease the time necessary to communicate the nursing plan of care during shift report. Subsequently, this decreased the amount of overtime paid to nurses because they were leaving on time. In an effort to spread the effects of this project house wide, oral presentations were given to each unit based clinical practice committee, who were considered key stakeholders in changing practice. Four of the seven patient units write nursing orders, and some units have written nursing order sets for specific diagnoses. Interpretation/Conclusion: Developing a method to write nursing orders using the present computerized system, enable staff nurses to communicate more effectively and efficiently, as well as increase the consistency of nursing care for their patients and families. This resulted in both increased family and nurse satisfaction. Implications for Practice: As technology increases, nurses need to re-evaluate how to utilize new systems to plan and deliver quality nursing care, and the CNS must be at the forefront leading the way.en_GB
dc.date.available2011-10-27T11:40:31Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:40:31Z-
dc.conference.date2004en_US
dc.conference.name2004 NACNS Conference, Renaissance in CNS Practice: Transforming Nursing in the 21st Centuryen_US
dc.conference.hostNACNS - National Association of Clinical Nurse Specialistsen_US
dc.conference.locationSan Antonio, Texas, USAen_US
dc.descriptionConference theme: Renaissance in CNS Practice: Transforming Nursing in the 21st Century, held on March 11 to 13, 2004 in San Antonio, Texas, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en_US
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