Project Team: Mary Ellen Murray, PH.D, RN Paula Jarzemsky, MS, RN Diana Girdley, MS, RN Steve Douglas, MS, RN Greetings From University of Wisconsin

Project Team: Mary Ellen Murray, PH.D, RN Paula Jarzemsky, MS, RN Diana Girdley, MS, RN Steve Douglas, MS, RN

Project Team: Mary Ellen Murray, PH.D, RN Paula Jarzemsky, MS, RN Diana Girdley, MS, RN Steve Douglas, MS, RN

UNIVERSITY OF WISCONSIN-MADISON UNIVERSITY OF WISCONSIN-MADISON Project Team: Mary Ellen Murray, PH.D, RN Paula Jarzemsky, MS, RN Diana Girdley, MS, RN Steve Douglas, MS, RN

Partnership with Practice Partnership with Practice Identification of participants Identification of participants 3 formal meetings 3 formal meetings (Jan, Mar, May) (Jan, Mar, May) –Overview of QSEN / invited proposals –Opportunity to work on projects –Project summaries / Abstracts One outcome: One outcome: Patient Safety Tool Patient Safety Tool

HOW WAS THIS INNOVATION ACCOMPLISHED? Patient Safety Scan Patient Safety Scan

History of the Safety Scan History of the Safety Scan –Eaglewood retreat in October, 2007 –Motivated to change approach to clinical teaching by incorporating an agenda of : Safety & Patient Centered Care Safety & Patient Centered Care

Development of the Tool Checklist for students (who need structure and focus) Checklist for students (who need structure and focus) 5 minute sit-down with patient as an initiative for 5 minute sit-down with patient as an initiative for –Therapeutic communication –Identification of patient goals/concerns

The Safety Scan Page 1

The Safety Scan Page 2

The The Safety Safety Scan Scan Page 2 Page 2 (Cont’d) (Cont’d)

Implementation of the Safety Scan Each student was to complete the form within the 1 st 30 minutes on unit Each student was to complete the form within the 1 st 30 minutes on unit Safety issues identified were discussed in post-conference Safety issues identified were discussed in post-conference Process established for reporting staff/system errors Process established for reporting staff/system errors Forms were collected after each clinical Forms were collected after each clinical

Safety Assessment Safety Assessment Majority of issues noted were environmental Majority of issues noted were environmental Other safety issues noted by students: Other safety issues noted by students: –Hand gel not by door –Visitor doesn’t wear gown when patient on contact isolation –IV team started IV without using gloves or communicating what they were doing. –Wound care nurse failed to wash hands –Med sheets and other notes left out for others to read

5 minute sit-down What would you like to see happen today: 5 minute sit-down What would you like to see happen today: Home, bath/shower, pain management, family visit, information Home, bath/shower, pain management, family visit, information “Soak feet and get up in a chair” “Soak feet and get up in a chair” “Win the lottery” “Win the lottery” “Watch the “Price is Right” “Watch the “Price is Right”

5 minute sit-down I s there anything that could have made your hospital stay better? 5 minute sit-down I s there anything that could have made your hospital stay better? Excellent Excellent Better pain control and communication Better pain control and communication “Let me sleep in more – put a lock on the door” “Let me sleep in more – put a lock on the door” “You couldn’t have done better if you had rocked me like a baby” “You couldn’t have done better if you had rocked me like a baby” “A drink” “A drink”

5 minute sit-down What should nursing students know about being a patient in the hospital? 5 minute sit-down What should nursing students know about being a patient in the hospital? Be kind, allow control, it’s boring, have sense of humor, smile, respect privacy Be kind, allow control, it’s boring, have sense of humor, smile, respect privacy “It’s hard when staff are crabby” “It’s hard when staff are crabby” “I love this question. I wish more people would ask it.” “I love this question. I wish more people would ask it.” “What a stupid question. I wish the sun would come out.” “What a stupid question. I wish the sun would come out.”

WHAT WERE THE BIGGEST CHALLENGES? WHAT WERE THE BIGGEST CHALLENGES? Patient Safety Scan Patient Safety Scan

Student Challenges Communication with patients Communication with patients Lack of role-modeling from staff Lack of role-modeling from staff Time – (my expectation) Time – (my expectation)

Staff challenges Experienced staff were resistant to either utilize or review the tool with students Experienced staff were resistant to either utilize or review the tool with students Surveys: N=8 Anecdotal: “We do this already “ – environmental scan “I’m not prepared to deal with what I may hear” – 5 minute sit-down Nurse residents: “Can we get this in our orientation packet?”

WHAT EVIDENCE OF IMPACT CAN BE SHARED? Patient Safety Scan Patient Safety Scan

Impact Student empowerment/raised consciousness Student empowerment/raised consciousness Post-conference content Post-conference content Student feedback – surveys Student feedback – surveys Adoption for use by other practice pairs Adoption for use by other practice pairs

SUMMARY/CONCLUSIONS WHAT WERE SOME IMPORTANT THINGS LEARNED THIS YEAR? How is change implemented? SUMMARY/CONCLUSIONS WHAT WERE SOME IMPORTANT THINGS LEARNED THIS YEAR? How is change implemented?

Preparing for Change: The Pencil Metaphor Preparing for Change: The Pencil Metaphor Used with permission and adapted from Jane H. Barnsteiner, PhD, RN, FAAN October 13, 2007

The pencil provided a metaphor for the various positions people assume when asked to adapt to something new.

Extending the Pencil Metaphor Extending the Pencil Metaphor Sharp ones Sharp ones The wood (“would”) The wood (“would”) Hangers-on Hangers-on

Avoid the Blank Page Avoid the Blank Page

Allow for creativity Allow for creativity

Make use of existing resources

WHAT’S NEXT FOR YOUR SCHOOL WITH RESPECT TO QSEN? University of WI - Madison University of WI - Madison

Bringing ideas full circle

Pencil Metaphor Dead wood Dead wood Erasers Erasers

Reduce fear of consequences

Dissemination Dissemination

The End The End Or is it the Beginning? Or is it the Beginning?

The lead-ers (Say led). These are the first to take on the technology, the early adopters who usually document and enthusiastically share what they have tried--warts and all. The lead-ers (Say led). These are the first to take on the technology, the early adopters who usually document and enthusiastically share what they have tried--warts and all.

Students “Led” the Way to Establish the Most Effective Clinical Partnership! Students “Led” the Way to Establish the Most Effective Clinical Partnership!