1. Amy McLaughlin, BSN, RN, PCCN Heather Cable, RN Rutland Regional Medical Center 1

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3.  We work together on the Progressive Care Unit at Rutland Regional Medical Center (RRMC) in Rutland, Vermont.  Our patient population is varied and consists of Cardiac, Pulmonary, and high-acuity patients who do not require Intensive Care.  Our Unit’s Culture supports staff participation in various committees focused on patient safety and satisfaction.  The fast-paced environment, combined with high patient turnover and acuity, reinforces the need for Nurse-led interventions aimed at improving patient care and outcomes. 3

4.  We are members of the Progressive Care Unit (PCU) Patient Safety Team.  We began as the Medication Safety sub-Committee  Initial interest in the project focused on improving the Medication Administration process on PCU 4

5.  Our first step was a review of PCU medication administration data.  An informal Research Question was the result…  A Literature Review then followed…  …which helped guide us to our formal Research Question… 5

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7.  We had to decide:  What part of the Medication Process do we observe?  We decided we needed to observe the ENTIRE process, from beginning to end…  We needed to watch one Nurse, from the moment s/he entered the med room, until the final med was passed to that patient. 7

8. …Now where do we go from here? 8

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10.  One-Page Tool  Real Time  Second to second  Easy to Navigate 10

11.  First draft was an excel spreadsheet tool…  Busy  Smallest time increment in minutes  …back to the “drawing board”… 11

12.  Combined everything we needed:  One, attractive, easy-to-read page  Time-Stamped (Second-to-Second)  Easy to Individualize  “One Click is All You Need”!!  …And Here’s How It Looks… 12

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14. 14 7/9/2011 7:28:02 AM7:32:27 AM7:32:50 AM7:34:33 AM7:34:58 AM7:36:05 AM7:36:28 AM7:36:50 AM TASKSTRUE PHYSICIAN NURSE PATIENT TRUE 0:00:23 OTHER CLINICAL PROFESSIONAL TRUE 0:00:25 FAMILY PHARMACY/ OMNICELL COMPUTER TELEPHONE OTHER LNA CASE MANAGER RN SCANNER MED ADMIN PROCESS TRUE 0:08:48

15.  Over a period of one week in July, 2011, medication passes were observed on PCU from 7am to 11am.  A total of 67 passes were captured during Phase I of the Observation Process, using our tool. 15

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18. Implementation of Nurse-led Intervention Medication Room Etiquette “Respecting the Process” 18

19. How Will It Look? 19

20. Staff Pledge I pledge to follow proper medication administration practices to ensure the safety of my patients, myself, and my fellow health care professionals. How Did We Get Support? 20

21.  We will implement our intervention for four weeks, beginning this Monday, November 14 th.  We will then start Phase II of our Observation Study beginning the week of December 11 th.  Final Data Analysis following Data Collection. 21

22.  Will our Data support that our Intervention led to decreased interruptions?  Will our Intervention need an adjustment?  Might we go Hospital-Wide?  Might we Publish?  Perhaps other facilities will be able to use our Tool! 22

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