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Transforming Care at the Bedside (TCAB)

Transforming Care at the Bedside (TCAB) . Partnership between Robert Wood Johnson Foundation and Institute of Healthcare Improvement with the American Organization of Nurse Executives to focus on: Quality and safety of patient care Vitality and retention of nurses

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Transforming Care at the Bedside (TCAB)

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  1. Transforming Care at the Bedside (TCAB) • Partnership between Robert Wood Johnson Foundation and Institute of Healthcare Improvement with the American Organization of Nurse Executives to focus on: • Quality and safety of patient care • Vitality and retention of nurses • Patient and family members’ experience of care • The effectiveness of the entire team • Confidential: Quality Improvement Material

  2. Shared Governance with Magnet Forces: Force 1- Quality of Nursing Leadership Force 3- Management Style Force 6- Quality of Care Force 7- Quality Improvement Force 8- Consultation and Resources Force 11- Nurses as Teachers Force 12- Image of Nursing Force 13- Interdisciplinary Relationships Force 14- Professional Development • Confidential: Quality Improvement Material

  3. Aim Improve nursing satisfaction greater than 80% during initial assessment and medication administration by decreasing the amount of non- emergent interruptions. • Confidential: Quality Improvement Material

  4. Cycle 1Plan and Do • Develop Guidelines • Create poster to educate staff and MDs • Define non-emergent interruptions to be “Issues and information that does not require nursing judgment” • Define focus time to be “a 1 hour window between 0800-0900 & 2000-2100” (2008 National Patient Safety Goals Manual, Requirement 3) • Educate Service Coordinators (SC) about importance of detailed messages for nurses • Educate SC relaying mode of travel to ancillary departments • Study • Confidential: Quality Improvement Material

  5. Nursing Satisfaction After Cycle 1 • Confidential: Quality Improvement Material

  6. Cycle 2Plan and Do • Discuss Barriers: • Medical team not familiar w/ “Focus Time” • Day Limitations: Transportation mode phone calls and family phone calls • Night Limitations: Family at bedside w/ questions wanting to see RN before they left, no ice/water for medication administration and many admits • Confidential: Quality Improvement Material

  7. Cycle 2Plan and Do • Implementations: • Educate patients, families and friends about focus time with unit brochure • Educate staff to document patient mode of transportation in Epic • Educate ancillary units how to utilize EPIC • Create visual awareness: stop light • Develop Predki Model: have pitcher of ice water on med cart available for med administration • Met w/ IT to change system wide issue and have all ancillaries able to view “mode of travel” • Confidential: Quality Improvement Material

  8. Nursing Perception Regarding Phone Calls After Cycle 2 • Confidential: Quality Improvement Material

  9. Cycle 3Plan and Do • Discuss barriers • Ancillary departments calling for patient status information such as • Any changes in condition • NPO maintained • Medication given • Patients asking same types of questions from RN about procedures and pt education information on intranet is outpatient specific. Confidential: Quality Improvement Material

  10. Cycle 3Plan and Do • Implementations: • Met with ancillary departments collaboratively revise pt education information sheets to be inpatient friendly • Continue to: • Educate staff to document patient mode of transportation in Epic • Educate ancillary units how to utilize EPIC • Provide visual awareness • Study sustainability of RN satisfaction • Confidential: Quality Improvement Material

  11. Nursing Satisfaction After Cycle 3 • Confidential: Quality Improvement Material

  12. Next Steps • Collaborate with ancillary departments to revise pt education information sheets • Continue to survey nursing satisfaction of “Focus Time” • Review reports of medication dispensing errors and study effects of Focus Time • Share success story nationally, April 2009 • Spread process to other units • Celebrate success • Confidential: Quality Improvement Material

  13. Team Members Stacy Hubert RN, MS Theresa Pavone RN, MSN Mary Morrow PhD Michelle Ragasa RN, BSN Daphne Bobo RN Sarah Born RN, BSN Sabrina Ensign RN Sima Patel RN, BSN Laura Rodriguez RN Becky Savastano RN, BSN The entire 3 NESW nursing unit You too can be…TCABLE • Confidential: Quality Improvement Material

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