Last week, I enjoyed a visit to an amazing facility – Hillcrest Baptist Medical Center in Waco, Texas. I bonded with Jamie immediately (so what if we are both directionally challenged!) and found many new nursing friends. I shared my thoughts on professionalism and accountability with staff from many areas and departments. When it comes down to it, there is only one common theme – each individual can and must make a difference every day to achieve excellence at the bedside.
One of the examples we discussed involved “bedside report,” the most recent innovation in patient hand-offs leading to quality improvements. Here’s how the story unfolds:
- The nurses in the ICU decide that the best way to prevent skin breakdown or pressure ulcers is to conduct a “four-eyed assessment” during the bedside hand-off each shift. EVERY time!
- But what happens if it is busy, or someone is tired, or we don’t remember to do it? Is that such a big deal? I mean, what are the odds that missing the assessment just once will result in an adverse event for the patient? (A single pressure ulcer costs $43,1801 in additional care, which the facility will no longer receive.)
- Who’s responsible to assure that the things that matter get done? Should an advanced practice nurse or wound specialist be reminding RNs what is needed? What does it really mean to be the professional nurse responsible for coordination of care?
I believe that every nurse needs to understand their accountability and take responsibility to be their best, do their best and expect the same from others. And to do that, executive leaders should support the Chief Nursing Officer to provide the tools – supplies, equipment and technology – to support nurses to be their best. Communication is key, and smartphones might seem expensive on the front end, but using them to improve communication, coordinate care, and maybe even remind the team about skin assessments or patient positioning, might be an added benefit as we head into this new healthcare reality. I’m just saying….
Hines, P.A., & Yu, K.M. (2009). The changing reimbursement landscape: Nurses’ role in quality and operational excellence. Nursing Economic$, 27(1), 1-7.