They gave us
kinda of an overview of how to change things,
how to start small and kinda gave the power
to us, to the staff nurses, and we are the ones with the patients, with the doctors,
with the families
day to day.
Our status board is probably one of the first projects that we came up with, just
trying to help out the nurses, make them
feel more empowered to take control of their day. It consists of a red, yellow, green
board.
Every two hours either the charge nurse or the desk clerk calls the nurse and asks
what color are you?
Green meaning I'm good, everything is going fine, I'm
doing alright right, yellow meaning well, I've got some things to do and I'll be okay
in about an hour.
Red means I'm swamped, I've got the patient with chest pains
the doctors rounding, writing up the orders, I have patients being transferred,
I'm swamped and I need help.
What is your color, honey? One time on this side
you get a whole team of nurses that was red, a whole team of nurses over here that was
green.
I looked up onto the board and saw that and said let's go help Diana's team.
A whole pack of them came over here and just said what can we do to help,
on their own, just helping each other. Still gives me chills
to tell that story.
One thing that we found is to try to
identify patients who are at risk for falls, most of our beds have bed
alarms on them and patient's wear ruby red socks. If someone is seen wandering out in the
hallway with these ruby red socks on
we know they are a fall risk, we know to go and intervene and guide them back to
their room.
On our TCAB unit we have
a whiteboard and it's a dry erase board that's in the patient room
where we identify who the nurses is and who the clinic assistant is.
The biggest place on the board is for the question
what is the most important thing I can do for you today
and the patients are floored they just can't believe it
they love that. I love that.
Multi-disciplinary round is kind of
a project I've been working on and I've been very close with.
We pick one or two patients that are real complex and we get together a little
team.
There've been times that we brought the families into ot and they really enjoy it
because they feel that they are heard and they're telling their story in their
wishes for their
family member. What we can do in putting all these heads together
is to try and make things better for the patients in order to get them
discharged.
Hi, this is Annie on four, I need a CRT in 455.
With a critical response team, if a nurse is feeling that
just something is not going right with the patient they can call in critical
response which is an ICU nurse that will come up
and assess the patient and a respiratory therapist. Its two new eyes looking at a
problem.
The role of the express admit nurse has
given the autonomy of that marriage to have more time to take care of that
patient that came in.
Their goal is to take care of that patient and get that patient settled and
processed through the system. They don't have any other patients that they're
tending to at the time.
OK, let's go to ICU.
Now with the TCAB unit and the changes that we've
made
we spend over sixty percent of our time
at the patient's bedside or in what we call value-added
care. We have clarification of what's going on,
we have time with the patient. You develop a better relationship with them
they feel like they're listened to. They feel like
they have a say. We started TCAB here
and when it was time to cutback and
simplify my life the obvious choice would have been to
fall out at med-surge but there was no way.
But there was no way that I would leave here.
It's too exciting and it was too ground breaking and empowering
so I actually chose the job that paid the least amount of money
but gave me the most satisfaction. I've been a nurse for years and years and years
and this is nothing like anything I've ever seen.
You are so welcome, I'll come back and see you in a minute.