Here Are Excerpts from Our Magnet Documentation That Speaks to Nursing And
--- Original Message ---
Here are excerpts from our Magnet documentation that speaks to nursing and
technology. Please let me know if we can be of further assistance!
Sincerely Linda Knodel
Force 1.7 BM__Toc114986017Provide specific examples of ways nurses at all
levels have identified and advocated for additional nursing resources to
support unit goals.
SAMC nurses participate in nearly 70 committees throughout the medical
center, all of which endeavor to improve patient care. Nursing involvement
specifically influences technology development, service line implementation,
and professional role delineation throughout the hospital. The following
examples show how nurses advocated for technology improvement in the
Intensive Care Unit (ICU), development of a new bariatric service line, and
evolving the role of advanced practice nurses in the Emergency Trauma Center
(ETC).
In their continuous efforts to expedite documentation while increasing time
spent at the bedside, the Intensive Care Unit recently evaluated a
transition to computerized charting. As part of their evaluation, they
reviewed the processes involved in charting, their goals for improvement,
the cost to implement computerization, how well the computerized instrument
would interface with existing patient information systems, and how adoption
of the technology would directly impact patient and financial outcomes.
An ad-hoc group of ICU staff nurses, management, and Nursing Informatics
addressed the above questions by evaluating the current documentation
system, as well as identifying prospective solutions. The group surveyed
staff, evaluated performance data, and identified both problems and
solutions that could form the decision criteria for future product
selection.
The nurses' involvement included:
* Choosing between computer and paper documentation
* Identifying a preference for an exception-based charting system
* Participating in a site visit to another facility utilizing the
preferred clinical documentation system
* Choosing physician - nurse partners
* Making necessary screen changes with an ad-hoc group of Telemetry
nurses
* Setting up a working timeline with a 'go-live' date
* Establishing ongoing communication to involved participants, as
well as training staff and physicians
* Identifying necessary house-wide documentation changes that
influence all patient computerized charting
* Forwarding recommended house-wide changes to the Administrative
Council for approval
* Choosing capital equipment such as laptops and laptop carts, and
recommending hardware placement within ICU rooms
* Involving the ICU clinical education in system education for the
staff
As part of the normal quality improvement and goal reporting processes,
nurses were also involved in patient trending, quality improvement analysis,
and cost accounting changes resulting from this project. Retrospective
analysis of the project indicates that it has improved documentation and
staff satisfaction within the ICU.
BM__Toc115075621BM__Toc1150764846.24 Provide evidence that
research consultants are actively involved in shaping nursing research
infrastructure, capacity, and mentorship.
As an informal practice, Ms. Knodel sends copies of articles with side notes
and questions from recent journals to the various shared governance councils
for their review. In March 2005 Linda forwarded a reference published in
the December 2004 issue of Hospitals and Health Networks journal entitled:
"Evidence-Based Medicine." Members of the NQRC reviewed the article prior
to the meeting, then reviewed and discussed the implications of this article
to their current practice. The article encouraged using established
unit-based information technology to address or follow performance
improvement issues.
Given that SAMC already uses a strong information technology system, the
NQRC noted how well the medical center already uses computerized data
collection in studies. They also noted ways in which technology could be
used in new and innovative ways. For instance, SAMC tracks all restraint
usage to ensure appropriately low utilization rates. Because the ETC
currently utilizes a paper charting system to document restraints, they have
not been able to evaluate when these rare but occasional restraint usage
episodes occur. After reading this article, the NQRC Evidence-Based
Practice Restraint Team consisting of Bev Jacobs, RN, Rehab, Patricia
Bullinger, RN, ETC, and Joni Tweeten, RN, Medical/Oncology devised an idea
to utilize the pharmacy Accudose system to assist in tracking restraint
usage. They locked the ETC restraint box and placed the key in the Accudose
system in the ETC. If restraints have to be utilized, the nurse documents
the patient name within Accudose in order to obtain the restraint box key.
The QI representative can then query the pharmacy Accudose system for a list
of any patients who may have been placed in restraints for the previous
month.
BM__Toc11516355112.1. Provide examples to illustrate how
the CNO has influenced organizational decision-making and strategic
planning.
The CNO's visionary leadership extends to her quest for cutting-edge
technology and information systems, particularly the need for systems
providing operational analysis processes and intradepartmental connectivity
for improved patient care. The CNO drove information system development for
two significant initiatives: Simulus (Simulated Nursing Education
Information Systems) and Bedside Nursing computer systems. St. Alexius
Division of Nursing implemented bedside computer charting systems in the
1990s when only approximately 1% of hospitals in the nation had bedside
computers. The Division of Nursing was the first division in the
organization to utilize monthly dashboards for unit and divisional based
operations reporting. Again, Ms. Knodel drove the vision for this
activity.[1][1] Ms. Knodel was also the catalyst for developing the shared
governance system which has been in place at St. Alexius Medical Center
since the early 1990s.
Linda Knodel, MHA, MSN, RN, CNA, BC, FACHE
Senior Executive Vice President/CNO
Administration
St. Alexius Medical Center
900 East Broadway Avenue, PO Box 5510
Bismarck, ND 58506-5510
701-530-7601
email: <mailto:>
<mailto:> St. Alexius Medical Center-The First Magnet
TM Hospital in North Dakota