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The ECLIPSE Program Endowed Clinical Professor for Service and Education
at Saginaw Valley State University
Sally Decker, Jane Barnsteiner, Janalou Blecke
Dissemination of QSEN Competencies to faculty and community partners
• Use of concept maps
• Use of conferences
• Use of the overall competency framework in classes
• Use of TEAMSTEPS to focus on communication
Mapping
• Used first for overall QSEN outcome and later for KSA level
• QSEN used as a mapping column in the course concept map
Patient Centered Care: Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient’s preferences, values, and needs; knowledge QSEN Patient Centered Care (knowledge) 250 252 270 272 274 300 360 362 363 364 370 372 374 460 462 463 464 466 480 482 483 484 486
Analyze multiple dimensions of pt centered care: Pt/family/community preferences, values Coordination and integration of care information Information, communication and education Physical comfort and emotional support Involvement of family and friends Transition and continuity
Analyze how diverse cultural, ethnic, spiritual and social backgrounds function as sources of patient, family and community values
Analyze social, political, economic, and historical dimensions of patient care processes and the implications for pt centered care
Integrate knowledge of psychological, spiritual, social, developmental and physiological models of pain and suffering
Analyze ethical and legal implications of pt centered care – describe the limits and boundaries of therapeutic pt centered care
Analyze strategies that empower patient or families in all aspects of the health care process Analyze features of physical facilities that support or pose barriers for pt centered care Analyze reasons for common barriers to active involvement of patients and families in their own health care process
Integrate principles of effective communication with knowledge of quality and safety competencies Analyze principles of consensus building and conflict resolution Analyze advanced practice nursing roles in assuring coordination, integration and continuity of care Describe process of reflective practice
Map coordinates for courses • Phenomenon
• Metaparadigm
• Reference/Framework
• Content
• Topic and Assignment Focus
• NANDA Diagnostic Categories(Assessment & Diagnosis)
• NIC Intervention Categories (Planning Implementation)
• NOC Outcomes (Outcome Identification & Evaluation)
• Standards: AACN Essentials, QSEN, and ANA
Conferences
2009, 2010
And faculty invited to
present at other
conferences
Communication: TeamSTEPPS
• (Team Strategies and Tools to Enhance Performance and Patient Safety)
• TeamSTEPPS is a teamwork system designed for health care professionals that is:
A powerful solution to improve patient safety within your organization.
An evidence-based teamwork system to improve communication and teamwork skills among health care professionals.
Subscores
Team Stepps We Used
Role of the Endowed Clinical Professor to support QSEN dissemination
July 1, 2008 Dr Jane Barnsteiner was appointed as the Andersen/Lange Endowed Clinical Professor in Nursing. The broad goals were to:
• Provide leadership in dissemination of QSEN into the curriculum
• Develop and implement a series of learning collaboratives with faculty and clinical partners to improve quality and safety
Quality Improvement Projects
• Example: Glycemic Control
• Example: Alcohol Withdrawal
• Example: Communication (Silence Kills)
• Example: Teamwork/communication
• Example: Heart Failure
• Example: Remote Monitoring
Process
• Agencies wrote a one page proposal of a project
• For the selected agencies, teams were created to address the project and included a member of the SVSU faculty
• A model for improvement was identified (PDSA or Six Sigma)
• The aims of the project were identified (specific, measureable, actionable, relevant, timeframe)
Interest form for Eclipse project: (return to Sally Decker at SVSU)
Overall goal related to Quality and Safety that would be the focus of an Eclipse Team:
Overall Goal: To reduce readmission rates and length of stay for patients with heart
failure and Bay Medical Center
Intermediate Goal: To use Six Sigma methodology
Outcome:
Decrease readmission and length of stay
Timing of interest in working with a team on this project:
Current___x ___, in about one year_____, not able to forecast_______
Overall idea for what this project might look like at your agency:
Revise standing heart failure orders, integrated plan of care, improved education to
physicians, nurses and patients
Idea of who the participants might be:
Current team is lead by four Sigma Champions, nursing staff, mgt, Home Care,
physicians, pharmacist and case management
Name of agency __Bay Medical Center____________________________
Contact person __Sandy Garzell___________________________
(phone and email)____989-894-9510, sandy.garzell@bhsnet.org
Questions used: • What work has currently been done in your organization on
this topic?
• What hospital and nursing policies currently exist?
• Do you collect data related to this topic?
• What QI models are you using?
• Why is this a priority for the organization?
• What outcome is envisioned?
• Who are the stakeholders, team members and agency chairperson?
Project Goals (Established 7/29/08)
• Ultimate goal / Project Aim / Mission: To improve glycemic control of the MidMichigan
Health adult patient population
• Four Teams:
1. In-Patient
2. Peri-Operative
3. Home Care
4. Long Term Care • Each Team Established Specific Goals
ECLIPSE Project: Improved Glycemic Control
In-Patient: ●Clare ●Gladwin ●Gratiot ●Midland
Peri-Operative: ●Clare ●Gladwin ●Gratiot ●Midland
Home Care: ●Alma ●Bay City ●Clare
●Gladwin ●Gratiot ●Midland
Long Term Care: ●Gladwin Pines ●Stratford Village
Original Goals
• Implement RALS system at each affiliate
• System wide policy on hypoglycemia
• System wide use of same blood glucose record
• Implement system wide order sets
• Achieve 60% physician compliance
• Less than 5% incidence of hypoglycemia
• System wide nursing education
In-Patient Team Members
Chair – J. Foor MSN, RN
Gladwin – K. Kulick RD, CDE
Clare – D. Peckinpaugh BSN, RN, CDE
Midland – J. Ellison BSN, RN; C. Ahearn BSN, RN
Gratiot – S. Anderson BSN, RN
Coordinator – A. Frederick MSN, RN
SVSU – M. Graiver, MSN, RN, Associate Professor
4
5
6
7
8
9
10
Oct-08 Dec-08 Jan-09 Mar-09 Apr-09 Jun-09 Jul-09
Average = 8.3%
Average = 6.5%
Average = 6.8%
A1C
Target Range = 6.5 – 7%
Sliding Scale
in Use
No Sliding Scale
Norovirus
80% in Target
“Value added”
• Visibility as part of ECLIPSE
• Continual movement toward next visit by Dr Barnsteiner
• Involvement of SVSU faculty in the “real world” of agency
• Dr Barnsteiner – resource as to what “others” had done, cheerleader, help with clarification of aims and identification of measurements
Future Plans
Questions
Recommended