Brigham and Women’s Faulkner Hospital’s Department of Nursing was well represented at the Organization of Nurse Leaders (ONL) for Massachusetts, Rhode Island, New Hampshire and Connecticut Fall Quarterly Meeting in Norwood. During the conference, nurses from both 7 South and the Weiner Center for Preoperative Evaluation had poster presentations during the exhibit session.
7 South’s Interim Nurse Director Mary Anne Barry, MBA, BSN, RN, along with Program Manager of Informatics for Nursing/Patient Care Services Paula Wolski, MSN, RN, CCRN, presented their work titled “Implementation of Plan of Care Documentation.” The project outlined the steps that 7 South has taken to improve documentation against the patient centered plan of care.
“The idea of a formal plan of care was new to the inpatient registered nurse with the implementation of Partners eCare (our new electronic health record),” explains Wolski. “Documentation had been inconsistent and this made chart review more difficult within the medical record. The 7 South staff chose the template and problems to focus on. Education was provided in the form of a tip sheet and a formal grand rounds presentation. The results revealed that plan of care documentation improved from 23 to 96 percent.”
Wolski and Barry both felt that attending the ONL Fall Quarterly Meeting allowed them to share their work with other facilities that may be having the same issues. “Visitors were engaged and asked great questions regarding the process we undertook. The next step of the project is to include the patient engagement perspective to see how involved patients feel they are in planning their care. It is very empowering to know that the work you are part of is making a difference in patient care and easing the documentation load of staff on your unit,” says Wolski.
From the Weiner Center for Preoperative Evaluation, staff nurses Betsy Kasper, RN, and Judy Shelton, RN, presented their work titled “Identifying Patients at Risk for Sleep Apnea through Preoperative Screening Using the Stop Bang Tool.”
Obstructive sleep apnea (OSA) is known to contribute significantly to perioperative complications, particularly when it is undiagnosed and untreated. After the transition to Partners eCare it was noted by nurses in the Weiner Center for Preoperative Evaluation that an area to assess and document OSA was not available in the new system. The Unit Based Council decided to take on the issue as an Evidence-Based Project with the goal of improving and standardizing the identification, assessment, education and safety of patients and decreasing practice variance among nurses through education.
The results of the project have been very positive. Education of clinicians and identification of patients at risk for OSA showed statistically significant improvement after the project began. Even using a strict cut-off for a positive screening, results increased from 11.02 percent before screening began to 21.7 percent at the first monthly audit.
For Kasper and Shelton, attending the ONL Fall Quarterly Meeting was energizing experience. “This was a positive and supportive experience,” says Kasper. “We were able to share the good work we have done with leaders in other facilities.”
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