Thursday, March 15, 2012

Staff Development Weekly: Insight on Evidence-Based Practice in Education - March 16, 2012

Staff Development Weekly: Insight on Evidence-Based Practice in Education  | HCPro

In this issue - March 16, 2012

  1. From the desk of Adrianne E. Avillion, DEd, RN

  2. SDW news brief: Patient satisfaction scores increase when clinicians sit

  3. From the staff development bookshelf: Anticipated goals of implementing a just culture

  4. Website spotlight: At the forefront of transitional care culture change: Meadowlark Hills’ Therapy Suite

  5. Live program: Time-saving tips for nursing professional development

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Staff Development Weekly: Insight on Evidence-Based Practice in Education
March 16, 2012
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Welcome to this week's issue of Staff Development Weekly. Visit HCPro's Nursing home page at

From the desk of Adrianne E. Avillion, DEd, RN

Editor's note: This feature is written by nursing professional development expert Adrianne E. Avillion, DEd, RN. Each week, Adrianne writes about an important issue in the area of professional development or answers reader questions. If you have a question for Adrianne, e-mail her at

Nursing professional development's role in reducing the incidence of adverse occurrences

Falls and medication errors are a common source of concern and dismay among all healthcare professionals. Nursing professional development (NPD) specialists are often called upon to create education strategies to help reduce the incidence of commonly occurring adverse events such as falls and medication errors.  How can we creatively offer education that helps to decrease the incidence of adverse events?

First of all we need to avoid the typical approach, such as reviewing the eight rights of medication administration or listing safety measures such as making sure the call light is within reach of patients to avoid falls. These things are not bad, but nurses will either be bored or insulted by such commonplace approaches.

We need to think creatively. How about visual illustrations? Draw a picture of a patient area with about 10 to 15 safety violations and post it wherever learners are most likely to see it (e.g., bulletin boards, computer screens, hospital newsletter) Offer a prize (e.g., free lunch or dinner in the cafeteria) for the first 10 nurses, or others as appropriate, who correctly identify the violations. Making a contest with a reward attached generates discussion and stimulates interest.

Similarly, write a scenario involving a medication error. Ask nurses to respond by identifying at what point(s) the error could have been prevented. Include a variety of points such as the order being transcribed incorrectly, mislabeling at the pharmacy, failure to check two patient identifiers, etc. Or ask the nursing staff to come up with a creative scenario about error prevention. Come up with guidelines and make it a contest with members of the education council or other groups acting as judges.

The preceding ideas incorporate fun, which is particularly important to generation Y nurses. However, errors are certainly serious. Is information about error rates and their impact shared with staff nurses? Do they know the scope of the problem within your organization? Do they know the impact? Sadly, many nurses are only given statistics such as the number of medication errors, but not the impact on length of stay, stress on staff, and/or monetary costs. How can we expect nurses to truly become involved in error prevention if they don't know what's going on? One of the best ways to reduce risk is to share with nurses the impact of adverse occurrences and how their actions either contribute to or negate patient outcomes.

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SDW news brief: Patient satisfaction scores increase when clinicians sit

Patients perceived that a clinician spent more time at their bedside and reported higher levels of satisfaction when clinicians sat down rather than stood during conversations, according to a study conducted by Jennifer Moran, RN, BSN, CNRN, clinical nurse educator at the University of Kansas Hospital. Moran studied Paul Arnold, MD, a practitioner whose patients consistently perceived him to be rushed and whose patient satisfaction scores were low, as he consulted his patients in both a standing and a sitting position. Patients believed Arnold spent as much as 15 minutes more at the bedside when sitting than when standing, even though he spent the same amount of time with patients in both instances.

Patients reported feeling as though they had the clinician's full attention when he was sitting, and noted that the clinician seemed more open and relaxed. Moran speculates that sitting has a calming effect, and plans to repeat the study with nurse practitioners rather than physicians. The study concluded that patient perceptions are significantly altered by small details such as sitting rather than standing.
Source: The Kansas City Nursing News

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From the staff development bookshelf: Anticipated goals of implementing a just culture

No matter how much planning and communicating is done to prepare for a change in culture, folks will still be leery and mistrustful until they actually see the new, more positive attitude in action. To that end, setting goals that have been developed collaboratively by leadership and staff is essential to the successful transition toward implementation of a just culture.

Obviously, the primary goal for any organization, regardless of culture, is to provide safe, high-quality care-this goal should be at the top of the list. However, there should be additional goals that address specifically what the organization wants to achieve by implementing a new, fairer way to look at medical events. The following are some examples for such goals:

  • Every person affiliated with the organization in some way is cognizant and aware of the fact that healthcare is a risky business. Every person understands that there are inherent risks to the provision of care and that, on occasion, there will be mistakes made.
  • Every staff member understands that although occasional mistakes will be made, staff should continuously work to identify and control or manage hazards or potential hazards. In fact, in a just culture, folks are actually always looking for ways in which an error could occur so that proactive efforts can be made to prevent errors from happening.
  • It is clearly understood that willful or intentional violations of policy or protocol will absolutely not be tolerated.
  • Employees and leadership clearly understand and agree on what is acceptable and unacceptable behavior.
  • Employees are encouraged to proactively report anything thought to pose a potential safety hazard.
  • When hazards or adverse medical events are reported, they are analyzed using an objective method of evaluating why the event occurred. Identified patterns and trends are reviewed and shared with staff and actions are taken to address them.
  • Hazards and medical errors, and actions to control them, are tracked and reported regularly at all levels of the organization.
  • Employees, volunteers, contracted individuals, and medical staff are all encouraged to develop and apply their own skills and knowledge to enhance organizational safety. In this case, it's okay to use those critical thinking skills and consider thinking outside the box to achieve the organization's goals.
  • Staff and management feel free to communicate openly and frequently concerning safety hazards, medical errors, potentially compensable events, etc.
  • Lessons learned should be discussed openly and regularly following an event occurrence so that leadership and staff can share with others what not to do in the future and also to prevent recurrence of a similar event.
  • Feedback regarding reporting and adverse events is provided. Staff are interested in hearing whenever an adverse event is reported and appreciate knowing what the outcome of any adverse event, including what actions were taken to address why the event occurred, if there was anything they could have done differently to avert the event's occurrence, etc.

Book excerpt adapted from Creating a Just Culture: A Nurse Leader's Guide by Vivian B. Miller, BA, CPHQ, LHRM, CPHRM, FASHRM.

Readers of
Staff Development Weekly receive a 10% discount on this book! Just enter source code EB102930A at checkout. Click here to visit

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Website spotlight: At the forefront of transitional care culture change: Meadowlark Hills’ Therapy Suite

In October 2011, Meadowlark Hills (MLH) opened the doors to a new wing within its transitional care household: the Bramlage House Therapy Suite. As the most recent addition to the MLH campus in Manhattan, KS, the suite is having a tremendous impact on resident rehabilitation and quality of care.

Designed for the practice of occupational therapy exercises for patients in transition from skilled care to a home environment, the therapy suite offers a functioning kitchen, dining room, bathroom, laundry area, mock bedroom, and even a small store with products on shelves and shopping carts.

"Instead of working on traditional therapy equipment using traditional therapy modalities, we use the actual things people will use when they get home," says Willie Novotny, president and CEO of MLH. "So instead of working on lower body balance and upper body dexterity, we will actually have the resident practice doing dishes and loading the dishwasher, or getting pots out of the cabinet, putting them on the stove, and mixing ingredients."

Before transitioning to the therapy suite, patients undergo an intensive therapy process similar to what is provided at any traditional rehabilitative setting, Novotny says. Once a certain level of functioning is reached, patients split their rehabilitation time between physical therapy and the occupational components of the therapy suite. MLH has carefully considered each aspect of a patient's length of stay.

To read the rest of this FREE article, click here.

Editor's note: To read more articles like this, visit the
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Live program: Time-saving tips for nursing professional development

Join Adrianne E. Avillion, DEd, RN, and Barb Brunt, MA, MN, RN-BC, NE-BC, for a live program on March 30, 2012, where they will share best practices and new approaches for delivering orientation, competency assessment, evidence-based practice, and engaging resistant learners.

The 90-minute webcast will help you conquer four of the biggest challenges in nursing education. From competency assessment to orientation to evidence-based practice, you'll receive timely tips and proven methods that will help you to provide nursing professional development services that are both effective and practical.

Click here to learn more about the program

Readers of Staff Development Weekly receive a 10% discount on this webcast! Just enter source code EB102930A at checkout. Click here to visit

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Katrina Gravel
Staff Development Weekly: Insight on Evidence-Based Practice in Education

Volume 11 Issue 11
ISSN# 1543?7361

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