The Nursing Practice Roadshow: A tool for improving nursing practice by reducing potential failure to rescue as a result of oversedation from opioids

2.50
Hdl Handle:
http://hdl.handle.net/10755/203268
Type:
Presentation
Title:
The Nursing Practice Roadshow: A tool for improving nursing practice by reducing potential failure to rescue as a result of oversedation from opioids
Abstract:
(Summer Institute) Problem: Failure to rescue is a devastating problem that can occur anywhere in the acute care population. When RRT data was analyzed more closely it was noted that there were a significant number of RRTs as a result of over-sedation from opioids in the acute care areas. Evidence: The RRT is a well-established methodology known to have a significant impact on improving outcomes in the acute care hospital setting. The general purpose of an RRT is to reduce cardiopulmonary arrests by early recognition of significant signs and symptoms to get needed help and resources to a failing patient bedside. Our RRT has experienced considerable success since it was implemented. Each RRT is tracked in detail and reported to a formal committee monthly by the critical care nurse manager. The committee reviews all rapid responses and cardiopulmonary arrests. Strategy: The clinical nurse specialist (CNS) for the acute care and critical care areas was consulted by the manager to develop a plan to reduce the number of events. The CNS worked with the acute care team and a plan for improving nursing practice and patient care was developed. Implementation was carried out at the Nursing Practice Roadshow events which were established by the CNS to bring needed practice changes to bedside nurses. Attendance at these events by acute care nursing staff is mandatory. Practice Change: Several changes in nursing practice are reported by nursing staff. Nurses state they have a greater comfort level with managing patients’ pain and a better knowledge level of the agents that they are using to manage pain. They also state they have an increased awareness of the issues associated with co-administration of agents that may be given with opioids that can affect respiratory drive. Results: Through education and communication with front line acute care nursing staff using our Nursing Practice Roadshow events we experienced a significant reduction in our number of patients that required rescue from respiratory depression that was a result of opioid administration. Since the implementation of the Nursing Practice Roadshow events, RRTs as a result of opioid over-sedation have been reduced dramatically. Patient pain satisfaction scores were also reviewed and remained consistent despite changes in practice. Evaluation: The Nursing Practice Roadshow events have been successful in providing staff with the information they need to guide their practice when caring for patients that require opioids. Recommendations: RRT data is very valuable and should be analyzed closely for trends that indicate a need for practice improvements. Clinical Nurse Specialists are advanced practice nurses able to directly impact clinical outcomes. They are an integral part of improving processes that directly impact patient safety. Lessons Learned: The Nursing Practice Roadshow format is a method that can be used to implement needed changes in a consistent manner for groups of nursing staff. Changes require the use of a team approach and the CNS is uniquely positioned to help orchestrate needed practice changes that affect patient outcomes. Bibliography: Bader, MK., Neal, B., Johnson, L., Pyle, K., Brewer, J., Luna, M…. Ritter, M (2009). Rescue me: saving the vulnerable non--ICU patient population. Joint Commission Journal on Quality & Patient Safety. 35(4), 199-205. Bennett, T. & Duffy, M. (2007). The role of the clinical nurse specialist in the implementation of a rapid response team; Clinical Nurse Specialist, 32(2), 103. Jolley, J., Bendyk, H., Holaday, B., Lombardozzi, K.A.K. & Harmon, C. (2007). Rapid response teams: do they make a difference? Dimensions of Critical Care Nursing. 26(6), 253-262. Leach, L.S., Mayo, A. & O'Rourke, M. (2010). How RNs rescue patients: a qualitative study of RNs' perceived involvement in rapid response teams. Quality & Safety in Health Care. 19(5), e13. Linck, J., Wilson, J., Rock, S. & Henderson, S. (2006). Successfully launching a rapid response team by using quantitative data to prove efficacy and dispel misconceptions. American Journal of Critical Care. 15(3), 329. Mailey, J., Digiovine, B., Baillod, D., Gnam, G., Jordan, J., Rubinfeld, I. & DelGorno, J, (2006). Reducing hospital standardized mortality rate with early interventions. J of Trauma Nursing, 13(4), 178-182. Scott, S.S. & Elliott, S. (2009). Implementation of a rapid response team: a success story. Critical Care Nurse. 29(3), 66-76. [© Academic Center for Evidence-Based Practice, 2011. http://www.acestar.uthscsa.edu]
Keywords:
Tool; Opioids
Repository Posting Date:
16-Jan-2012
Date of Publication:
3-Jan-2012
Sponsors:
UTHSCSA Summer Institute

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleThe Nursing Practice Roadshow: A tool for improving nursing practice by reducing potential failure to rescue as a result of oversedation from opioidsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/203268-
dc.description.abstract(Summer Institute) Problem: Failure to rescue is a devastating problem that can occur anywhere in the acute care population. When RRT data was analyzed more closely it was noted that there were a significant number of RRTs as a result of over-sedation from opioids in the acute care areas. Evidence: The RRT is a well-established methodology known to have a significant impact on improving outcomes in the acute care hospital setting. The general purpose of an RRT is to reduce cardiopulmonary arrests by early recognition of significant signs and symptoms to get needed help and resources to a failing patient bedside. Our RRT has experienced considerable success since it was implemented. Each RRT is tracked in detail and reported to a formal committee monthly by the critical care nurse manager. The committee reviews all rapid responses and cardiopulmonary arrests. Strategy: The clinical nurse specialist (CNS) for the acute care and critical care areas was consulted by the manager to develop a plan to reduce the number of events. The CNS worked with the acute care team and a plan for improving nursing practice and patient care was developed. Implementation was carried out at the Nursing Practice Roadshow events which were established by the CNS to bring needed practice changes to bedside nurses. Attendance at these events by acute care nursing staff is mandatory. Practice Change: Several changes in nursing practice are reported by nursing staff. Nurses state they have a greater comfort level with managing patients’ pain and a better knowledge level of the agents that they are using to manage pain. They also state they have an increased awareness of the issues associated with co-administration of agents that may be given with opioids that can affect respiratory drive. Results: Through education and communication with front line acute care nursing staff using our Nursing Practice Roadshow events we experienced a significant reduction in our number of patients that required rescue from respiratory depression that was a result of opioid administration. Since the implementation of the Nursing Practice Roadshow events, RRTs as a result of opioid over-sedation have been reduced dramatically. Patient pain satisfaction scores were also reviewed and remained consistent despite changes in practice. Evaluation: The Nursing Practice Roadshow events have been successful in providing staff with the information they need to guide their practice when caring for patients that require opioids. Recommendations: RRT data is very valuable and should be analyzed closely for trends that indicate a need for practice improvements. Clinical Nurse Specialists are advanced practice nurses able to directly impact clinical outcomes. They are an integral part of improving processes that directly impact patient safety. Lessons Learned: The Nursing Practice Roadshow format is a method that can be used to implement needed changes in a consistent manner for groups of nursing staff. Changes require the use of a team approach and the CNS is uniquely positioned to help orchestrate needed practice changes that affect patient outcomes. Bibliography: Bader, MK., Neal, B., Johnson, L., Pyle, K., Brewer, J., Luna, M…. Ritter, M (2009). Rescue me: saving the vulnerable non--ICU patient population. Joint Commission Journal on Quality & Patient Safety. 35(4), 199-205. Bennett, T. & Duffy, M. (2007). The role of the clinical nurse specialist in the implementation of a rapid response team; Clinical Nurse Specialist, 32(2), 103. Jolley, J., Bendyk, H., Holaday, B., Lombardozzi, K.A.K. & Harmon, C. (2007). Rapid response teams: do they make a difference? Dimensions of Critical Care Nursing. 26(6), 253-262. Leach, L.S., Mayo, A. & O'Rourke, M. (2010). How RNs rescue patients: a qualitative study of RNs' perceived involvement in rapid response teams. Quality & Safety in Health Care. 19(5), e13. Linck, J., Wilson, J., Rock, S. & Henderson, S. (2006). Successfully launching a rapid response team by using quantitative data to prove efficacy and dispel misconceptions. American Journal of Critical Care. 15(3), 329. Mailey, J., Digiovine, B., Baillod, D., Gnam, G., Jordan, J., Rubinfeld, I. & DelGorno, J, (2006). Reducing hospital standardized mortality rate with early interventions. J of Trauma Nursing, 13(4), 178-182. Scott, S.S. & Elliott, S. (2009). Implementation of a rapid response team: a success story. Critical Care Nurse. 29(3), 66-76. [© Academic Center for Evidence-Based Practice, 2011. http://www.acestar.uthscsa.edu]en_GB
dc.subjectToolen_GB
dc.subjectOpioidsen_GB
dc.date.available2012-01-16T11:06:53Z-
dc.date.issued2012-01-03en_GB
dc.date.accessioned2012-01-16T11:06:53Z-
dc.description.sponsorshipUTHSCSA Summer Instituteen_GB
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