DiversityNursing Blog

See How Nurses Are Doing Less Walking And More Caring

Posted by Pat Magrath

Thu, Feb 16, 2017 @ 11:11 AM

graduates-nursing-bsn.jpgEvery Nurse I know who works in a hospital, says they are amazed how much walking they do in their 12-hour shift. If you wear a Fitbit or another step tracking device, you know you walk miles during your shift. Here’s a story about a hospital that did a study to see where they could eliminate some steps for Nurses in the design of their new building.
 
The goal was to give Nurses more time to deliver the best patient care. If you have to walk all over the building to fulfill a medication order, perhaps there is a better way to do it with less steps. Maybe the applesauce or ginger ale could be located closer to where the medicine is dispensed. Please read on for some valuable information.

You don't know what you don't know until you know it.

That's the lesson leaders at ProMedica Toledo Hospital in Ohio learned during the design of its 615,000 square-foot patient tower set to 2019.

As part of the design process, the organization took part in research to identify and refine ways to improve nursing care and efficiencies, including distance traveled during a shift.

Architects from HKS, Inc., the firm designing the building, approached Alison Avendt, OT, MBA, vice president of operations, at ProMedica Toledo Hospital about doing the research.

"We have a building that we opened in 2008, so they wanted to look at how we were using the spaces [there], and get feedback from nursing on how it was working," Avendt says.

"That was really attractive to me because I heard we had issues with the building that we were in and there were many things that we wish we could have done better. I thought if we could do a good design diagnostic and learn something from that, it would really help guide our design work."

An Applesauce Moment
During two days of onsite observation, researchers shadowed ICU nurses and intermediate-level medical-surgical nurses. The researchers assessed the existing floor plan, used a parametric modeling tool, and created heat maps to provide a graphic representation of what a nurse's 12-hour shift looked like in terms of workflow and walking distances.

"One of the big [revelations] was around our whole process of medication passing," says Deana Sievert, RN, MSN, metro regional chief nursing officer and vice president for patient care services at ProMedica.

Observation revealed that a nurse reviewed the patient's medication administration record in the patient's room, walked to the supply room to get the medication from the Pyxis machine, and then often had to stop by the patient refrigerator to get something—like applesauce—to aid in the medication pass before walking back to the patient's room to administer the medication.

"It was something that was just so ingrained in our staff nurses' normal daily activities," Sievert says. "When they did the heat mapping it was like…'Wow. [There's a] big pinch point that we as staff nurses didn't really even realize was there.' "

Avendt says the researcher called this realization "the applesauce moment."

"Nurses are masterful at just making things work. There are a lot of things that the nurses knew were not value-added or were problematic, but they would just make it work," she says.

"It was really good to flesh out what those things were by observing because if you just ask[ed] them, the nurse would often not be able to verbalize what the problem was. But by seeing it, it came to light."

The architects used this information to design a unit that would cut down on walking time. Instead of a long corridor with a common area at one end, the unit was broken up into pods and supplies were located in multiple areas so nurses could get them from the location to which they were closest.

"We were able to take them from a three-mile journey on their shift to 1.5 miles. We cut in half the steps that they were taking," Avendt says.

After the tower opens, more research will be done to see how the design is affecting workflow.

"We've since learned that [field research] is not common for people to do. We paid a little bit of money to do that, but in the scheme of things it was well worth the investment," Avendt says.

"Everybody wants to give the nurse as much time as possible to be with the patient [and] try to take away the things that are not value-added in the nurse's day."

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Topics: efficiency, patient care, hospitals, Nurse burnout

Empathy: The Human Connection To Patient Care [VIDEO]

Posted by Pat Magrath

Fri, Oct 23, 2015 @ 10:22 AM

As Nurses, a big part of your job is empathy for your patients and their families. You’re so good at understanding what your patients are going through because you care and this I think, is primarily why you decided to become a Nurse – to help people and lend a sympathetic ear. You educate, show compassion, love and understanding every day. You are amazing! 

We came upon this touching video which reinforces that every one of us -- whether we’re a Nurse, a patient or patient’s family member -- has a personal life. Some days are better than others. It reminds us to be mindful of the people around us and their struggles. What are your thoughts about this video?

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Topics: patient care

Predicting The Top Medical Innovations For 2015

Posted by Erica Bettencourt

Mon, Nov 03, 2014 @ 11:05 AM

By Sara Cheshire

medical future resized 600

Can we predict the future of medicine? Although designer babies and a disease-free world may or may not come to pass, you can get a glimpse of the most promising and upcoming medical innovations each year, via the Cleveland Clinic.

The clinic's Top 10 Medical Innovations list, which has been an annual undertaking since 2007, contains treatments and technologies that are expected to significantly change patient care and save lives.

To be considered, each innovation must have a good chance of being available to the public in the upcoming year, says Dr. Michael Roizen, chief wellness officer at the Cleveland Clinic and chairman of the committee that decides the list. The committee must also expect it to have a significant impact on a large part of the population.

The process starts with a panel of Cleveland Clinic physicians and scientists who submit their ideas. These suggestions, which Roizen said totaled about 700 for the 2015 list, are then narrowed down and voted on by 40 physicians in a variety of health fields.

Here's what they selected for 2015:

1. Mobile stroke unit

Videoconferencing has made its way into ambulances, specifically for treating stroke victims on the go. Hospital stroke neurologists can interpret symptoms via a broadband video link and instruct an onboard paramedic, critical care nurse and CT technologist on treatment. This new technology should improve the speed of medical care, which is important as strokes quickly damage and kill brain cells.

2. Dengue fever vaccine

The World Health Organization reports that about half of the world's population is now at risk for dengue fever, which up until now was preventable only by avoiding mosquito bites. The disease is a leading cause of death and illness in children in some countries. A new vaccine has been developed and tested, and is expected to be available in 2015.

3. Painless blood testing

For those who hate large needles, a nearly painless way to sample blood will be a welcome relief. Plus, it will be cheaper and provide faster results than today's blood test. The new technology takes blood from your fingertip, and the Cleveland Clinic reports that over 100 tests can be performed on just one drop of blood.

4. New way to lower cholesterol

New self-injectable drugs called PCSK9 inhibitors have shown to be very effective in lowering cholesterol. These drugs may prove to be helpful for people with high LDL cholesterol who don't have good results with statins. The FDA is expected to approve the first PCSK9 in 2015.

5 ways to lower cholesterol

5. Cancer drug that doesn't harm healthy tissue

Although chemotherapy can save lives, it can be hard on the body and attack healthy cells as well as cancerous ones. A welcome breakthrough in the world of cancer treatment, antibody-drug conjugates can deliver targeted treatment without damaging healthy tissue.

6. Immune booster for cancer patients

Immune checkpoint inhibitors have been shown to prevent cancer cells from "hiding" from the immune system, allowing the body to more effectively fight these abnormal cells. Combined with chemotherapy and radiation treatment, the drugs have shown significant, long-term cancer remissions for patients with metastatic melanoma, one of the most deadly forms of cancer.

7. Wireless cardiac pacemaker

Until this point, wires have been a necessary component in pacemakers. A new wireless pacemaker about the size of a vitamin can now be implanted in the heart without surgery. Its lithium-ion battery is estimated to last about seven years.

8. New medications for idiopathic pulmonary fibrosis

Idiopathic pulmonary fibrosis is a life-threatening disease that causes scarring in the lungs, leading to breathing difficulties and a shortage of oxygen in the brain and other organs. Life expectancy is only three to five years after diagnosis, but those numbers may change now that the FDA has approved two experimental drugs that slow the disease: pirfenidone and nintedanib.

9. Single-dose radiation therapy for breast cancer

The National Cancer Institute estimates that 40,000 women in the United States will die from breast cancer in 2014. The Cleveland Clinic cites multiple chemotherapy appointments, sometimes requiring the patient to travel long distances, as a hindrance to successful treatment. Intraoperative radiation therapy is a new solution. It treats a breast cancer tumor during surgery in a single dose, reducing time and cost spent on treatment.

10. New drug for heart failure

About 5.1 million people in the United States suffer from heart failure, according to the National Heart, Lung and Blood Institute. It is managed with a combination of drugs, but a new drug, angiotensin-receptor neprilysin inhibitor, has been granted fast-track status by the FDA because of its ability to cut the risk of dying from heart failure more effectively than current treatments.

For more information on the annual medical innovations list, including descriptions and videos, download the "Innovations" app or visit the website. A "where is it now" feature also includes updates on innovations that made the top 10 list in prior years.

"We look in past to see what we voted on to improve the process," Roizen said. "With one exception, we've been pretty good."

Source: www.cnn.com

Topics: technology, healthcare, health care, future, medical, cancer, vaccine, patient care, medicine, testing, treatments, innovations, diseases

Nurse Entrepreneurs Put Problem-solving Skills to Work

Posted by Alycia Sullivan

Mon, Dec 16, 2013 @ 12:10 PM

By Megan Murdock Krischke

“The nurses I work with are the smartest, funniest people I know. Our work causes us to problem-solve and to think critically about everything, and that leads us to coming up with solutions in every aspect of our lives.  It just fits that we would be inventors,” remarked Stacey Tatroe, RN, BSN, inventor of RN I.D. Scrubs.

Nurse entrepreneur Sarah Mott encourages other nurse inventors to bring products to market.

Fellow nurse entrepreneur Sarah Mott, RN, agrees. “My colleagues and I were always making little inventions to provide patient care--like things to elevate a leg or to make an IV work. But we weren’t thinking about these as inventions. That is why I wanted to encourage other nurses to pursue their inventions and to bring their products to market.”

Mott has recently started her own company, Nurse Born. Her vision is to market products created by nurses that are inspired by practical experience.

“I want to encourage nurses to think about the needs of their colleagues and patients and then to pursue their ideas,” said Mott. “As the company grow, I would like to hire nurses who, because of an injury, can no longer tolerate long hours on the floor.”

Mott’s own work-related injury is part of the story of how she became a nurse inventor and a business owner.

“It has been a very long road. It started when I was working as a staff nurse on a post-op ortho floor. My neck was bothering me and I was uncomfortable with the stethoscope hanging on my neck. It also bothered me to keep an item that carried so many germs so close to my face. I was looking for an alternative way to carry it and I couldn’t find anything, and I thought someone should invent something,” she explained.

A few months later, her injury had progressed to the point that she had to take some time off work. At home and bored, she started experimenting with household items to create a stethoscope clip. Once she assembled a workable clip, she began pursuing a patent and was accepted into a free program where a local university student helped her apply for it. An engineer acquaintance of hers was willing to create a prototype.

Nurse Born's Stethoscope Holster is the company's first product by a nurse inventor.

In due time, her Stethoscope Holster became a reality, and is now the first product to be marketed through Nurse Born.

Mott says her biggest challenge so far is just getting the word out about her product.

“My experience as a nurse has helped me in my new career as an entrepreneur. I learned to be more confident and to trust my own judgment,” she stated. “Nursing helps you develop good instincts about people because you are constantly interacting with different kinds of people and personalities.”

Along the path of bringing her product to market, Mott was mentored by members of a local small business association as well as other nurse inventors she found through online research. She would love to provide that same kind of support to other nurse inventors and encourages them to contact her.

Tatroe is one of the inventors who mentored Mott.

Tatroe works as an ER nurse at Wellstar Health Systems in Atlanta, Ga., and fell into the role of nurse entrepreneur through a different route.

After working as an LPN for six years, she had completed her RN licensure and wanted to celebrate.

“For work that day, I hand-made scrubs that said RN and wore a sash and a crown!” she said. “What was so interesting was that colleagues I had worked with for years were surprised to find out that I wasn’t already an RN. Even though our licensure is written on our IDs, clearly no one was reading that. But they saw it when it was written on my scrubs.”

“It is frustrating for patients when they don’t know who is walking into your room.  Some hospitals use a color-coding system, and that can be helpful for the staff, but the code often remains unclear to patients, family members and providers who don’t work at the facility. I.D. Scrubs communicate to the patient, ‘I am your nurse. I am the one who is here to take care of you and answer your questions.’”

Nurse entrepreneur Stacey Tatroe models her RN I.D. Scrubs.Tatroe pursued a patent and contacted her favorite scrub manufacturer, Cherokee Uniforms, to pitch her idea. They are now marketing her line as RN I.D. Scrubs.

Tatroe agrees with Mott that marketing can be the most challenging part of inventing a product and getting it off the ground.

“Every time I am at a trade show or show another nurse these scrubs, they love them and they ‘get it’ immediately. The challenge is getting the word out and letting nurses know that I.D. Scrubs are available,” she remarked. “I hope we will be able to expand the line to include IDs for all scrub-wearing clinicians and staff.”

Tatroe urges other nurses to pursue their ideas.

“Go for it!” she said. “You will never know unless you try. Think of all the innovations in history--what if those inventors hadn’t given it a go? You have to put yourself out there and work for it. Nothing comes easy or free.”

Source: TravelNursing.com

Topics: improvement, entrepreneur, ideas, invent, nurses, patient care

Experience Sets You Apart when It Comes to Quality Nursing Care

Posted by Alycia Sullivan

Mon, Jun 10, 2013 @ 03:49 PM

patient care, nursing careAs a health care giver, you have a responsibility to ensure that they have adequate knowledge in order to provide competent nursing care. Malcolm Gladwell wrote about “rapid cognition,” or our innate sense of “knowing” in his 2005 book, “Blink.” If you haven’t read it, I highly recommend it; it is a fascinating read for all nurses. Of it, Gladwell says:

“You could also say that it’s a book about intuition, except that I don’t like that word. In fact, it never appears in ‘Blink.’ Intuition strikes me as a concept we use to describe emotional reactions, gut feelings -- thoughts and impressions that don’t seem entirely rational. But I think that what goes on in that first two seconds is perfectly rational. It’s thinking -- it’s just thinking that moves a little faster and operates a little more mysteriously than the kind of deliberate, conscious decision-making that we usually associate with ‘thinking.’ In ‘Blink’ I’m trying to understand those two seconds. What is going on inside our heads when we engage in rapid cognition? When are snap judgments good and when are they not? What kinds of things can we do to make our powers of rapid cognition better?”

Within professional nursing, we call this concept “tacit knowledge.” It is not easily shared through lectures or books, but it comes with experience and knowing through repetitive, almost unaware situations and critical thinking. I explicitly learned about tacit knowledge (what an oxymoron) in my undergraduate nursing studies. However, I actually learned tacit knowledge while working with patients alongside more experienced nurses.

I picked it up from colleagues such as the night shift nurse, a LVN with 30 years of experience, who walked back to the desk after assessing a certain patient she’d cared for during the last three days saying, “I’m going to keep my eye on Mr. Second-Door-on-the-Left. I can’t put my finger on it, but I’m going to watch him.” As the oh-so-terribly-young charge nurse, I’d walk in and assess him, too, especially because I knew he was scheduled for discharge some time the next day. Not seeing what my colleague saw nor anything in the chart to cause alarm, I brushed it off only to think, What the…???, as we called a code in the wee hours of the morning -- in between patient rounds because my colleague increased her routine patient checks, “just because.” Similar situations have happened to me numerous times, and I have learned to trust members of the nursing community when they sense something going awry with a patient.

Tacit knowledge is one way to improve patient care, though it’s hard to explain when you know it as well as when you learn it. What a mysterious and fascinating concept and feeling.

Source: NurseTogether

Topics: quality, health care, patient care, improve, nursing care

VCU dentists and nurse practitioners collaborate on patient care

Posted by Alycia Sullivan

Sat, Apr 20, 2013 @ 03:49 PM

Dominiquea Rosario sees a dentist regularly for debilitating jaw pain, but at her last two dental appointments at Virginia Commonwealth University she also saw a nurse practitioner who checked her blood sugar and blood pressure.

In a new practice model, dentists and nurse practitioners at VCU are teaming up to see patients together, with goals of increasing access to care, better understanding the connection between oral health issues and disease elsewhere in the body and lowering health care costs.

“It’s a new model … so that you can have sort of one-stop shopping,” said Nancy Langston, professor and dean of the VCU School of Nursing.

“Dentistry has always been about health promotion and disease prevention. Nurse practitioners have been about early recognition, risk reduction and health promotion. We are putting them in the same environment to see if we can truly matter in reducing risk and increasing health promotion,” Langston said.

The new VCU Neighborhood Partners Practice is being provided primarily to patients enrolled in VCU’s Virginia Premier Health Plan, a managed care plan for Medicaid enrollees.

The combined practice is located in the oral medicine suite in the Wood Memorial Building on the MCV campus.

“We’ve found when we have been looking at the literature that a lot of patients who visit the dentist haven’t seen a primary care provider in about three or four years,” explained nurse practitioner Judith Parker-Falzoi.

“There are a lot of chronic health problems that come up in the course of a dental exam that can impede the progression of their dental treatment plan,” she said.

The combined practice project is modeled after a New York University partnership in which dentists and nurse practitioners work together. VCU nursing professor Debra Lyon, chairwoman of VCU’s Department of Family and Community Health Nursing, is overseeing the VCU project.

The dental visit is the entry point.

“We are using the well-established, prevention-oriented delivery system of dentistry to see if we can harness that to apply to other disease,” said David C. Sarrett, dean of the VCU School of Dentistry. “So that patients who are coming for dental care, and if they also have other chronic issues, we can encourage them or facilitate them to pay some attention to those other things.”

At Rosario’s visit to the combined practice Tuesday, she saw dentist Bhavik Desai, an assistant professor of oral medicine and temporomandibular joint disorder, about the jaw pain and then went down the hall to see Parker-Falzoi, the nurse practitioner.

Parker-Falzoi checked her overall health, Rosario said. One item that did get red-flagged this time was her fasting blood glucose level. It came back a little high.

“I didn’t know I might have diabetes,” Rosario said later. “I had gestational diabetes a couple of years back when I was pregnant with my son,” said Rosario, whose children are ages 2, 3 and 4.

“And I was feeling … where I was craving salt, a lot of water and using the bathroom a lot.”

Rosario is scheduled for a follow-up visit with her regular primary care doctor next week.

Langston said the combined practice also promotes a more holistic look at health in training.

“Another piece of this is teaching nurses to do better assessments of the oral cavity and teaching our dental students and future practitioners to look more holistically at the human being in their chair and not just the mouth. So we will be doing some cross education,” she said.

Source: Times Dispatch

Topics: nurse practitioners, patient care, NP, dentists, collaboration

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