Capital Health nurses use grant money to improve care across the district

Friday, May 9, 2014 - 12:27pm

The Nursing Strategy Advisory Committee sets aside a portion of the continuing education monies allotted by the Department of Health and Wellness each year to fund the Improving Nursing Practice Grants. These grants are intended to fund short-term initiatives that will promote innovation in nursing and clinical practice by enhancing quality improvement and patient care, fostering a spirit of inquiry, advancing clinical practice and building practice leadership capacity in staff at all levels. The grants involve the broader interprofessional team to help foster collaborative relationships.

Here are this year’s recipients from Capital Health.

“Integrating Motivational Interviewing into Practice - Supporting Change Behaviour” - Submitted by Jane Hughes, Clinical Nurse Educator, Mental Health - This project was created for the benefit of the Acute Care Mental Health Inpatient nurses to provide knowledge, help build skill development and to gain confidence with integrating the Motivational Interviewing approach using the Tidal Model philosophy and principles into practice. The initial workshops have been attended by nursing staff from direct care roles and nurse educators. The workshops are open to interprofessional designations and have been attended by recreation therapists and social workers as well.  

“Medicine Basics: A pocket guide for nurses” - Submitted by Jennifer Hyson, Clinical Nurse Educator, Medical Teaching Unit - Five staff nurses who work on medical units at the Halifax Infirmary and their clinical nurse educators developed a pocket guide for medicine nurses. The five staff nurses were paid for a day to research and develop the content of the pocket guide. The guide serves as a quick reference for standards of care, unit routines and procedures, equipment set up, risk assessments and communication tips and tools. The pocket guide will be given to all new and existing nursing staff of the medicine units.

“Improving Discharge Education in the Emergency Department” - Submitted by Heather Peddle-Bolivar, Clinical Nurse Educator, DGH Emergency Department - With the fund received from this grant, a group of seven RNs met to review the current ED patient education pamphlets. The pamphlets were revised to ensure that the content was up to date and met best practice criteria. The group also assessed the list of topics covered and determined the gaps. From this list, four new pamphlets were developed. These pamphlets will be linked to the electronic tracking system in the ED to make accessing the pamphlets easier. The current ED documentation tool was revised to include a more comprehensive section for documenting discharge education.

“Neurosurgery Education Project” - Submitted by Debra White, Clinical Nurse Educator, Neurosurgery - The neurosurgery unit is a complex acute care floor, with patients who often experience a life altering outcome as result of their admission. This complexity offers many challenges for patients, families and staff.  In 2013, there was a very high staff turnover which created a new set of challenges. Many nurses were new graduates, who along with adapting to life as a nurse, were asked to have a wide knowledge of nursing care related least 30 different diagnoses. There were very few print/teaching resources available to them to help with learning/understanding. The internet is a great resource but not a feasible option with this population and internet availability.

This project fits under the category of innovating health and learning. We needed to support nurses and in doing so help our families understand and cope. We purchased several laminated teaching aids and books/models. We held a four-hour education session for 19 staff on some of the basics of the top case diagnosis they will see (spinal cord injury and basic neurology). Evaluations of the education piece were very positive. The print material has arrived and the newly formed practice council will be consulted about rollout plans.

“The Four C’s of Leadership Synopsis” - Submitted by Helena MacKinnon, Clinical Nurse Educator, Medicine/Ortho - Eight charge nurses from medicine and orthopaedic units attended a full day charge nurse leadership workshop on January 28. The content of the day was based on a formal “charge nurse education needs” survey that was conducted prior to the day. Topics covered included leadership, coaching and capacity building, conflict and communication and nutrition on the go. At the end of the day each charge nurse was presented a copy of the book, “Crucial Conversations - Tools for talking when stakes are high” by Kerry Patterson, Joseph Grenny, Rom McMillan, All Switzler.

“Advancing Practice in Mental Health” - Submitted by Suzanne MacDonald-Gilby, Clinical Nurse Educator, Tri-Facilities - Effective management of mental health emergencies is an important area in the field of mental illness. Mental health awareness can be enhances by way of improved communication, focused mental health assessments and utilizing key components from the mental health program. This has increased nursing knowledge when these patients present to emergency department or are admitted to the unit. Our education exceeded staff expectations with knowledge gained on mental health issues. Over 30 staff from the tri-facilities attended the day and evaluations indicated a highly successful day. Topics included “The Word on the Street”, a presentation done by local RCMP members on current and rising trends in street drugs, and how these street drugs can affect and individual’s behavior.  We also had a presentation from a member of the community who has lived with bipolar disease since age 40. This presentation enlightened those who attended. Presentations on completing an accurate assessment of the mental health patient in crisis as well as using MOCHA, DOS and MMSE in practice proved to be beneficial to the group. Highlight of the day was the presence of Sound Beings. “Sound therapy is a new exciting field with the potential to completely shift our health care paradigms…and is boundless in its potential ramifications. Sound can redress imbalances on every level of physiologic functioning and can play a positive role in the treatment of virtually any medical disorder”

“Generating a Brighter Future in Rural Health Care” - Submitted by Suzanne MacDonald-Gilby, Clinical Nurse Educator, Tri-Facilities and Diana Rossong, Nurse Practitioner, Tri-Facilities - Our goal to develop is to develop a six-week program for students within the Tri-Facility family of schools. Initial development of the outline and development of presentations were completed along with letters sent to the high schools and phone calls to both principles and guidance counselors were made requesting time to meet with the students. Positive response was received from the high school leadership. To date information on rural nursing has been delivered to career fairs at the college level which proved to be very successful in showcasing rural health care. The program is ongoing with the high schools and we anticipate a very successful outcome.

“Stabilizing the Unstable Patient” - Submitted by Jackie Frew, Clinical Nurse Educator, 4.1/7.1 Halifax Infirmary - This six-hour education day focused on increasing 4.1 and 4.2 nursing staff knowledge of basic stabilization principles and discussed techniques to effectively handle a situation when a patient becomes unstable. Presentations were given on basic stabilization principles, the respiratory therapist roll in an unstable patient, common cardiopulmonary events and the roll of a staff nurse during a Code Blue. Participants were able to demonstrate how to use SBAR in order to clearly convey patient information. A case study was reviewed and a hands-on cardiac arrest simulation was demonstrated. Over all feedback from participants was positive.

“Standardizing Emergency Cardiac Care Protocols for Cardiovascular Surgery Patients: A Simulated Learning Experience” - Submitted by Jackie Frew, Clinical Nurse Educator, 4.1/7.1 Halifax Infirmary and Lindsay Pottinger, Clinical Nurse Educator, CCU/Cardiology IMCU - On Thursday, February 13, 24 staff from 5.1 CVICU and 7.1 attended one of two, 2.5hr education sessions to learn, practice through simulation and reflect on the European Resuscitation Council (ERC) evidence based protocols for emergency resuscitation of the cardiovascular surgery patient. Physician support provided by the cardiovascular surgery department started our sessions with a thorough review of the ERC cardiac arrest protocols and how this protocol is envisioned to be implemented in 5.1 and 7.1 at CDHA. Three case based scenarios were presented through simulation and hands on participation by all in attendance. The scenarios were developed to give a realistic experience on 5.1, 7.1 IMCU and 7.1. The newly learned protocols and roles were practiced in a group setting. Physician and nurse educator feedback was provided during the simulation. This provided the opportunity for reflection on current practice, barriers for implementation of the protocols unit wide and clarification. Engagement of the participants was excellent and plans for expanding the education to the remaining interdisciplinary team was put forth. Feedback was positive and it was identified that the simulation experience enhanced their learning and understanding of the protocols. We were able to accomplish our goals to promote innovation and advance clinical practice by providing staff with knowledge of evidence based protocols aimed at improving care for the client population they provide care for.

“Improving Care of Elderly Patients in the ED” - Submitted by Heather Peddle-Bolivar, Clinical Nurse Educator, DGH Emergency Department - For this grant, a group of six staff RNs and CTAs met to review literature and best practice for caring for elderly patients. From this review, we developed a new rounding process for elderly and frail patients in the ED. Intentional Rounding consists of assessing the four Ps (pain, position, personal care, possessions) hourly. As well, the staff member informs the patient of the goals of rounding and ensures they are aware when the staff member will return. The Rounding is documented on a flow sheet that was developed by the committee members. We also surveyed patients prior to implementing the tool to determine assess how we were doing with managing their care before the rounding and will be completing a post-implementation survey in the near future. To roll out the initiative, we held an education day that reviewed physiological changes in elderly patients with a focus on dementia/delirium, pharmacological causes of delirium as well as reviewed the concept of rounding and documentation requirements.