© 2009 on the cusp: stop bsi nurse empowerment

© 2009

On the CUSP: STOP BSIOn the CUSP: STOP BSINurse EmpowermentNurse Empowerment

© 2009

Learning ObjectivesLearning Objectives

• To understand the importance of nurse empowerment

• To learn strategies to help empower nurses

© 2009

What Have We Learned So Far?What Have We Learned So Far?

• Work involves technical problems– Evidence– Measurement

• Adaptive problems– Engagement of nurses, physicians, leaders– CUSP– Daily goals– Competing priorities

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Improving ICU CultureImproving ICU Cultureby Creating Trustby Creating Trust

• Caring

– Keep Patients your North Star

– Preventable harm is not tenable

– Tell your own Josie Story

• Competent

– Learn from mistakes and implement teamwork tools (CUSP)

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Ensure Patients ReliablyEnsure Patients ReliablyReceive EvidenceReceive Evidence

Pronovost: Health Services Research 2006

  Senior TeamStaff

leaders leaders

Engage How does this make the world a better place?

Educate What do we need to do?

ExecuteWhat keeps me from doing it?How can we do it with my resources and culture?

Evaluate How do we know we improved safety?

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Nurse EmpowermentNurse Empowerment

• Keep Patient as north star

• Decision to speak up– Must feel competent – Must feel it is safe– Must feel it will work

• Policy level (code of conduct) – Helpful if enforced

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Strategies for Strategies for Nurse EmpowermentNurse Empowerment

• Policy Level

– Code of conduct

– Require nurses to assist with central line

placement

– Require adherence to checklist

– Policy to deal with disruptive behavior

– Require that bedside nurse attend rounds

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• Use tools to practice nurse empowerment in safe space– Nurse attends rounds– Daily Goals with nurse read back– Learning from Defect

• Address disruptive behavior quickly

Strategies for Strategies for Nurse EmpowermentNurse Empowerment

© 2009

• In conflict, keep focus on patient as north star

• Remind staff that teams make wise decisions with diverse and independent input– Do not play man down

Strategies for Strategies for Nurse EmpowermentNurse Empowerment

© 2009

Action PlanAction Plan

• Meet with ICU team

• Discuss what policies can be put in place to enhance nurse empowerment

• Create strategy to involve beside nurses in this project use the 4Es

• Discuss what tools you can use to enhance nurse empowerment