organizational overview structural empowerment · simulation short, small group inservices on unit...

Organizational Overview STRUCTURAL EMPOWERMENT

OO6 – The learner assessment of the continuing education needs for nurses at all levels and settings, and the related education implementation plan.

The Advocate BroMenn Medical Center Learning Needs Assessment was completed in June 2015 by inpatient and outpatient nurses in all levels of nursing across the organization.

Link to Exhibit OO6.1 Learning Needs Assessment Tool

Link to Exhibit OO6.2 Learning Needs Assessment Analysis

Link to Exhibit OO6.3 Learning Needs Education Implementation Plan

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OO6 Advocate BroMenn Medical Center 1

This survey was developed to assess the learning needs of the Advocate BroMenn and Eureka nurses ATALL LEVELS and THROUGHOUT THE ORGANIZATION. The information received from this survey will beaggregated and used to plan for professional development activities in the coming year.

Note: The questions with an asterisk (*) are required.

This survey should take around 10 minutes to complete, depending on your answers.

Purpose:

2015 Learning Needs Assessment

1

Exhibit OO6.1

General Information


1. Primary hospital you work at*

2. Choose your nursing role*

3. Choose your primary shift*

4. Choose your primary specialty area/ unit*

2

5. Choose your TOP 3 preferred methods of learning

Traditional Classroom (Lecture/Discussion)

Video

Webinar

Patient Case Study

Poster

Self-study

Online/Computerized

Social Media (e.g., YouTube, twitter, podcast)

Simulation

Short, small group inservices on unit

Hands on

Role Playing

Other (please specify)

6. Which method of communication do you prefer to learn about new educational programs? Selectyour TOP 3.

Central Education Calendar

Flyers

Advocate Email Address

Department Meetings

Shift Huddles

Website

ALEX/Healthstream


3

For your personal growth and/or development, SELECT 3 TOPICS below that are of interest to you.

If you do not see something that is of major interest/importance, use the "other" selection at the bottom toidentify additional topics.

The next few questions will allow you to describe what you would like to learn related to the 3 topics.

Clinical Practice


7. Clinical Practice Topics - Pick your top 3

12 Lead ECG Interpretation

Advanced Directives

Arrhythmia Interpretation

Asthma

Bariatric patients

Capnography

Cardiovascular procedures

Catheter Associated Urinary Tract Infections (CAUTI)

Central Line Acquired Blood Stream Infection (CLABSI)

Chest Pain/ Myocardial Infarction

Chest Tubes

Code Blue

Code Gray

COPD

De-escalating the angry patient/family

4

Diabetes

Drug/Alcohol Dependency

End of Life

Early signs of patient decline

Fall Prevention

Heart Failure

Hospital Acquired Pressure Ulcers (HAPU)

Insulin Pumps

Interpreting Lab Values

IV insertion skills

Neurosurgical procedures

Obstetric emergencies

Orthopedic procedures

Pain Management

Pancreatitis

Pneumonia

Rapid Response

Restraint Management

Safe Patient Handling

Sepsis

Stroke

Urological procedures

Venous Thromboembolism (VTE)

Ventilator Associated Pneumonia


5

8. Identify your first topic above & describe what you would like to learn related to this topic.

9. Identify your second topic above and describe what you would like ot learn related to this topic.

10. Identify your third topic above and describe what you would like to learn related to this topic.

6

Skills Day is being planned for the fall FOR BROMENN MED/SURG AND CRITICAL CARE Nurses. If youwork in one of these areas, please complete this section.

The following skills have already been identified to be a part of the education:* Performing a 12-lead ECG* In-house Code STEMI Review

Clinical Skills


11. For your unit/department, what additional skills do you think would be beneficial to review atskills day?

12. What patient care situations do you feel least confident with (diagnosis/procedures/treatments)?

13. Are there things you would like to review such as the new PCA, Meditech documentation, orinfrequently used equipment?

7

Managing department finances is integral in today's healthcare environment. Each one of us has aresponsibility to use resources wisely.

For the items listed below, please identify opportunities for your knowledge & skill growth and/ordevelopment.

Management of Department Finances


14. Department Finance & Productivity Management (Select those you are interested in learningmore about)

My role in unit finances

Organizational Impact

Capital Equipment Purchases

Understanding Budget Forms

Using the ADaPT (Advocate's Daily Productivity Tool)

ActionOI (Operational benchmarking database)


8

For the items listed below, please identify opportunities for your growth and/or development.

Advocate Experience (Safety, Quality, Service)


15. Safety Topics (select those you would like to learn more about)

Advocate's Safety Strategic Plan

Harm Classification/ Identifying a Serious Safety Event

Principles of High Reliability

Safety Event Reporting


16. Quality Topics (Select those which you would like to learn more about)

Performance Improvement Process (PDSA)

How To Turn Data Into Information

Behavioral-based Interviewing


9

17. Service Topics (Select those which you would like to learn more about)

How to pull reports from Press Ganey

HCAHPS/ Press Ganey Survey Tools


10

For the items listed below, identify opportunities for your growth and/or development.

DNV/ISO 9001 Requirements


18. DNV/ISO 9001 Topics (Select those which you would like to learn more about)

General Overview of ISO 9001

Document Control Requirements

How to Navigate the Advocate Document System

Non-conforming Product Requirements

Control of Records

QMS Audits

How to Manage a Corrective Action Plan


11

For the items listed below, identify opportunities for your growth and/or development.

General Professional Development Topics


12

19. General Professional Development Topics (Select those which you would like to learn moreabout)

Application Process for Continuing Educatoin Hours (e.g., ONA)

Behavior-based Interviewing Skills

Certification Review/ Prep Courses

Clinical Coaching

Computer Training (please specify below)

Conflict Resolution

Corrective Action

Creating a Professional Portfolio

Critical Thinking

Crucial Conversations

Cultural Diversity

Evidence Based Practice

Front Line Leader Development

Journal Clubs

Membership to Professional Organizations

Nursing Research

Performing a Lit Search

Running a Meeting (e.g., agendas, minutes, prep)

Shared Governance

STEPs (Success Through Excellence in Practice)

Supervision and Delegation related to Assistive Personnel

Time Management


20. For the Professional Development Topics, decribe what you would like to learn about eachtopic.

13

21. Additional Comments:

14

Thank you so much for taking the time to take this assessment!!!


15

Advocate BroMenn Medical Center 2015 Learning Needs Assessment Analysis

1

Exhibit OO6.2

Participation Rate & Dates of Survey

Completed by 249 nurses at Advocate BroMennMedical Center, a 60% response rate.

The Learning Needs Assessment was completed June 4, 2015 through June 18, 2015

2

Participant Nursing Roles

1

615 1

211

30

125

16

32

Participants in the 2015 ABMC Learning Needs Assessment

CNO Director Manager CNS/APN Charge Nurse

Nurse Clinician IV Nurse Clinician III Nurse Clinician II Nurse Clinician I Other

3

Shift Worked

37

85

33

3

67

2220

2015 Learning Needs Assessment - Shift Worked

7am-3pm 7am-7pm 8am-4:30pm 3pm-11pm

7pm-7am 11am-11pm Registry Other

4

Unit Participation

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

6W Surgical

Cardiology/ Cardiac Rehab

Care Mgmt

CDI

Clinical Education

Clinical Informatics

Critical Care

CVCU

ED

Float Pool/ Registry

Inpatient Rehab

Magnet

Mental Health

MOSU

MBU

Nursing Leadership

Nursing Operations

OR

PACU

PAT

PCU

Peds/ Infusion

QRM

Radiology

SDS

Specialty

WHC

2015 Learning Needs Assessment Unit Participation 5

Preferred Method of Learning

0 10 20 30 40 50 60 70 80 90 100 110 120

Other

Poster

Social Media

Role playing

Webinar

Video

Pt Case Study

Sm group inservices

Self Study

Simulation

Traditional Classroom

Online/ Computerized

Hands on

2014 Learning Needs Assessment Preferred Method of Learning6

Preferred Method of Communication

0 30 60 90 120 150 180 210

Other

Central Education Calendar

Website

Shift huddles

Flyers

ALEX/ Healthstream

Dept meetings

Advocate email address

2015 Learning Needs AssessmentPreferred method of communication for learning opportunities

7

Top 3 Clinical Topics Identified

0 5 10 15 20 25 30 35 40 45 50 55

AsthmaPneumonia

Fall PreventionHAPU

PancreatitisVAP

CLABSICAUTI

Insulin PumpsUrological procedures

Bariatric patientsChest Pain/ MI

Code GrayCOPD

Restraint MgmtHeart Failure

Orthopedic proceduresVTE

Drug/ Alcohol dependencyChest tubes

Safe Patient HandlingIV Insertion skills

StrokeRapid Response

End of LifeAdvanced Directives

Cardio- vascular proceduresCapnography

Code BlueNeuro- surgical procedures

Early signs of patient declineDiabetes

Arrhythmia interpretationOtherSepsis

De- escalating the angry pt/ familyPain Mgmt

12 Lead ECG InterpretationObstetric Emergencies

Interpreting Lab Values

2015 Learning Needs Assessment - Top 3 Clinical Topics

8

Clinical Topic CommentsManagement of Emergent Clinical Situations Code Blue

Code Simulation (6)- include code-like situations i.e. decompensated SVT, sequence of events, practicing the different roles

Review of the process (4) Case studies, include what could be done differently, what could have been done

to prevent them (2)

Review of Crash Cart contents (2) Review of the responsibilities of the team members (2) How to document a Code

Summary of medications for cardiac arrhythmias New technology for Codes – i.e. chest compression hardware How the determination is made to stop resuscitation efforts

Operating Room – Mock Code (different process than the rest of the hospital); review of roles (2)

9

Clinical Topic CommentsManagement of Emergent Clinical Situations

Early Signs of Patient Decline Assessment findings for patient’s in the early stages of decline (8)- include

respiratory & neurological changes

Interventions to take when early signs are detected (3)- include treatment based upon policy vs experience, utilization of Rapid Response

Utilizing EBP to identify these patients in the EMR; Use of early warning systems for detection

Case Studies (2)

Rapid Response Review of Protocol/Policy/Process (6) – include new hypotensive response,

roles/responsibilities

Pediatric Simulation

Operating Room Process Review

10

Clinical Topic Comments Neurology

Stroke Using the EMR to assist in care for Stroke patients Detailed neurological assessment (3) Initial treatment with onset of symptoms

Inpatient Care – include traditional medications & progression of care Newest research & statistics on how to improve times

Code Gray Simulation Code Gray Process (2) – include how it is handled, roles/responsibilities, documentation

Other Parkinson’s Treatment

11

Clinical Topic Comments Neurosurgery Neurosurgery Procedures

Specifics about the types of procedures & what is done in the OR (11) – include what is documented in the record & what it means, anatomy for spine cases, what is new & associated nursing care, new technology

Pre-operative teaching needs/expectations – so patient is prepared for discharge

Expected outcomes & recovery process (3) – include physician preference for patient care

Immediate postoperative care for craniotomy patients

Pain Management

Would like to be able to see some procedures

12

Clinical Topic Comments Cardiovascular

Chest Pain/ MI Overview of treatment when patient is admitted Nursing assessment & when to notify the physician (2) – include vital sign changes Differentiating cardiac/GI/deferred pain Newest research & statistics on how to improve times

Cardiovascular Procedures Overview of current procedures (9) – include documentation in the record, indications

& why one procedure is chosen over another How to best explain the procedures to patients/ provide education (2) Review of order sets (2) Post-operative care (2)– include symptoms that are common & expected,

complication assessment findings New developments in the treatment of coronary artery disease Non-invasive procedures Would like to be able to watch some cath lab procedures

13

Clinical Topic Comments Cardiovascular (Cont’d) 12 Lead ECG Interpretation

Beyond the basics (3) – include identifying ischemic changes & which vessel is affected

Review of 12 lead ECG interpretations/ case studies (5) – include determination of ST depression/elevation, interpreting non-acute abnormal EKGs

How to perform a 12 lead ECG

When to notify a physician

Arrhythmia Interpretation A Review/Refresher (12)

Life-Threatening dysrhythmias and appropriate action

Treatment of arrhythmias (2)

Bundle branch blocks, pacemakers single/dual chamber

14

Clinical Topic Comments Cardiovascular (Cont’d)

Heart Failure Preload & Afterload Advanced information including medications New treatments

Coding options

Other Care of the Open Heart Patient – including immediate post-op recovery,

ventilator, hemodynamics, IV drips, etc

Detailed Pacemaker Inservice/Course – including the various types of pacers & AICDs now available with illustrations of how to ensure they are firing properly

New cardiac meds

15

Clinical Topic CommentsWorkplace Safety De-escalating the angry patient/family

Comments noted from all areas of the hospital Area of interest noted by Nurse Clinicians, Charge Nurses, Managers, Directors & the CNE Recognition of early signs that a patient may escalate to try to prevent it (2) How to handle a situation with an angry patient and/or family member (13) – include how to

redirect the individual, tactics to remove one’s self from the situation, how to minimize drama for others in the area, when to call security and/or the physician, how to set limits while maintaining patient dignity, identifying manipulative behaviors, how to turn the situation into a positive for patient & self

Communication techniques (7) -include how to communicate that you are their advocate & will do your best to obtain the best outcome for their situation

Post-escalation care needs Law enforcement responsibilities for patients they bring to the facility

Safe Patient Handling Review of safety devices to use in moving patients – include body mechanics (4) – include how to

prevent caregiver back pain related to patient repositioning How the EMR assists Accountability of all disciplines

16

Clinical Topics CommentsAdvanced Directives/ End-of-Life Advanced Directives

Review of the basics (10) – include why it is important, the various complexities about them, identifying the differences between surrogacy, guardianship, POA-HC, POA-property, Living Wills, Wills and what is appropriate for healthcare, what options are out there & how to have a conversation

What to do on the off-shifts if a patient has a decreased LOC & DNR/DNI information is needed

POLST form (2) – include how to fill it out with the patient, how to talk to patients & families about choices

When the paperwork is utilized during hospitalization

Advanced care planning process conversations

Mental Health Advanced Directives

End-of-Life Area of interest noted by Nurse Clinicians, Charge Nurses, Managers, & Directors

Beginning signs of end-of-life

Best practices in wholistic care of patients at end-of-life, spiritual, emotional, psychosocial, pathophysiology, support of family, roles of interdisciplinary and community supports (3)

ABMC’s hospital care/processes for patients/families at end-of-life (2)

Palliative Care options

How to discuss end-of-life choices with patients & families (3) – including withholding or withdrawing care

Ethics related to end-of-life (2) – include how to manage patients with poor prognosis, limited resources, patient/family not accepting of end of life scenario but have no discharge options, prolonging life without hope of recovery, information to give to families related to ethics of prolonged TF/TPN

How to help comfort families

17

Clinical Topic CommentsPain Management Pain Management

New pain management techniques, pharmacological & non-pharmacological (6)-include management for different diseases

Alternatives to or in conjunction with pain medication (6) Pain assessment and differentiating types of pain

Principles of pain management Different pain medications (4) - include how they work & dosage limits Conversion of pain medications for one route to another ie oral to IV (2)

Pain management at end-of-lfe Management of patients with perceived drug seeking behaviors Managing chronic pain (2) – including treatment with frequent admissions

Patient education materials C-section – post-operative pain management Regional block options

18

Clinical Topic CommentsNurse Sensitive Indicators HAPU

Prevention of sheering during transport & transferring patients – to be shared with Rad techs & transporters

Risk & incident reduction

CLABSI Prevention

Central Line Policy related to care – include when & how to use tpA, how to draw off line

CAUTI Prevention

Benefits of foley vs straight cath

OB specific CAUTI rates

Fall Prevention Risk & incident reduction

Fall prevention for patients not yet identified as a fall risk

19

Clinical Topic CommentsLab Interpretation Lab Value Interpretation

Comments noted from all areas of the hospital Overview of understanding of lab values (18) – include how to assess lab values in light of the patient’s

condition & signs & symptoms, what to watch for in terms of trends & abnormal values, standard labs, who to call with abnormal values

CBC with differential (2) Renal labs (2)- including UA, importance of GFR Liver function tests (2) Viral vs Bacterial shifts Values associated with infected wounds Obstetric related values (4)- including normal values in pregnancy, postpartum & newborn, abnormal

values HELLP syndrome (2) Pediatric related values ABGs (2)

Other Fluid & electrolyte balance

20

Clinical Topic CommentsPotential Healthcare Acquired Conditions

VTE Occurrence in different disease entities, how to recognize & reduce risk, management

of IV lines with current or previous VTE, how medications work, integrating different management techniques into care of the patient, evaluation of effectiveness, communication techniques in dealing with VTE concerns with patient/family/staff/physicians, what does EBP as well as nursing research information indicate in this area

Prevention (4) – including new prevention medications and best practices

Current treatment

Pros & cons of prophylaxis after neurosurgical & orthopedic procedures

VAP Refresher

21

Clinical Topic CommentsDisease Specific Diabetes

Review & update on current management (11) – include the newest medications and dietary plans

Types of Insulin & methods to give (2) Review of DKA & Insulin drips

Inpatient care Best practices in patient/family education (3) – include promotion of healthy lifestyle to

improve outcomes, managing medications, and nutrition Diabetes in pregnancy

Overview (4) – include effects on the fetus & infant once delivered

Documentation & coding options

Insulin Pumps Overview (3) – include how they work & key points about managing them Inpatient care

22

Clinical Topic CommentsDisease Specific (cont’d) Pancreatitis

Pathophysiology & treatment

Coding options

Sepsis Prevention & early identification (4)

Pathophysiology (4)– including associated lab studies

Management/ treatment of the patient (9) – including new treatment plans/guidelines & data

ED management regarding testing & fluid resusciation

Simulation

23

Clinical Topic CommentsDisease Specific (cont’d) Drug/Alcohol Dependency

Withdrawal symptoms & treatment (5) – including medications that help with withdrawal, withdrawal from a variety of substances, complications related to withdrawal

Benzodiazepine withdrawal

Overdose treatment

How to manage substance abuse (2) – include strategies for working with patients & families

Management of drug abuse with pregnancy

24

Clinical Topic CommentsDisease Specific (cont’d) COPD

Update on current trends & practice (2) Use of CPAP & BiPAP

Asthma Basic information related to medications Pediatric asthma exacerbation

Other Carboxyhemoblobinemia – recognition and appropriate intervention Hypothermia refresher & simulation – include night staff Liver failure, Cirrhosis, Hepatitis, Physiology of ascites, etc Methyl blue (Accidental inhalation of Hurricaine spray)- Signs & symptoms, how to treat, etc Migraines – prevention & treatment Renal failure Ulcerative colitis – pathophysiology & treatment

25

Clinical Topic CommentsSurgical Procedures Orthopedic Procedures

Overview of the types of procedures (3) – including documentation/abbreviations, step-by-step what happens in surgery, what’s new in joint replacements

EBP/Standardization of Care

Position & Equipment

Improving patient education process

Urological Procedures New innovations

Other Bowel resection nursing care

26

Clinical Topic CommentsMother-Baby Obstetric Emergencies

Management of Obstetric Emergencies (16) – include policy review, signs & symptoms and associate pathophysiology, associated labs, treatment including medications (common doses & side effects) Shoulder dystocia (2) (more frequent)

OB hemorrhage (3) (more frequent)

Amniotic fluid embolism (2)

Shock, HTN, Eclampsia, seizures

Antepartum, Intrapartum, Postpartum (2)

High risk pregnancies & emergencies associated with them (4) – including uterine involution, placenta abruption, cord prolapse, preterm labor, uterine rupture, pre-eclampsia, mag sulfate, blood transfusions, HELLP syndrome

Teamwork

Simulation

27

Clinical Topic CommentsMother-Baby (cont’d) Other

Infant/preemie related education (2) – including normal newborn findings

Caring for late preterm infant (2) –including review of systems, normal findings, abnormal findings including labs & significance

Neonatal cardiac complications ie tetralogy of fallot and nursing management/stabilization

EBP at delivery – delayed cord clamping, skin-to-skin in OR, non-separation of mom & baby

Opioid treatment of pregnant women for chronic pain & how to prevent this. Neonatal abstinence syndrome in newborns of these women & how to regularly assess for this. Alternatives for chronic pain control.

Postpartum assessment- normal & abnormal findings, common labs, complications

Intermediate level fetal monitoring class onsite.

Experienced staff need AWOHHN class in IUPC insertion & use of ultrasound

28

Clinical Topic CommentsPediatrics

Other Pediatric emergencies (2)- including mock codes & trauma

29

Clinical Topic Comments Equipment/Skills Capnography

Troubleshooting waveform problems Indications/use & how to monitor (5) – including how to accurately read & relate

findings to patients, what to look for in patients who have impending problems, how different lung diseases affect readings, basic interpretations and adverse values, ABMC process & expected parameters/responses

Why CO2 is often better than PaO2 readings to determine patient status

Intermediate to advanced skills Utilization for C-sections, more indepth review

Restraint Management Review of the Restraint Policy/Procedure (2) Types of restraints & regulatory requirements Information regarding documentation & when to notify people (2)

Methods to minimize use of/length of restraints (2) – include when to remove restraints

30

Clinical Topic CommentsEquipment/Skills IV Insertion Skills

Review of products, techniques, & policy Ultrasound guided IV insertion in classroom, using video & simulation Opportunity to perform/practice skill (6) Difficult stick practice (4) – including practice on dehydrated patients with an 18 guage needle,

how to prevent blown/infiltrated IVs, tips/tricks, new techniques EBP, as well as nursing research information on insertion, complications & their preventions, ways

to improve skills

Chest Tubes General review (3) – include care of the patient & how to read output Placement (2) – include how to set up including any physician specific requirements

Other Advanced IV care (2) – include Swan-Ganz, art lines, dialysis catheters, Swan set-up IABP – better understanding of the numbers (parameters) & troubleshooting Ventilator management – patient care

31

Clinical Topic CommentsSpecial Care Needs Bariatric Patients

Review of specific care needs for this population (6) – include ventilator management, surgical risks, hospital & post-acute hospital considerations, wound care considerations, communication techniques (how to discuss weight issues respectfully & truthfully)

Other Foreign language i.e. Spanish learning software to be able to communicate with

patients better

Helping patients & families effectively deal with poor prognosis or grief ie new cancer diagnosis/ miscarriage, etc

Wound related topics (2) – Current updates & management, infection prevention & management

Herbal medicine – what nurses should know

32

What additional skills do you think would be beneficial to review at skills day? 12 lead EKG interpretation 12 lead EKG performing – including how to load information into the machine Acute Rehab Admission Criteria/ FIM documentation Advanced directives Administration of blood & blood products and use of the warmer & rapid infuser (2) A-lines (8)- include set-up, maintenance, monitoring BiPAP (2) Capnography (4)- include set-up & interpretation Cardiology information, basic Chemotherapy precautions (2) Chest tube (12) – include equipment, maintenance, emergent insertion Code Blue (4) – include responsibilities Code Gray (7) – include standing stroke orders, verification of NIHSS, others (PT & Techs) Code STEMI, inhouse (2)

33

What additional skills do you think would be beneficial to review at skills day? (cont’d) CRRT (4) DVT prevention Echos – how to understand them Epidural/spinal anesthesia – care of the patient Ethical Dilemma Protocols Fall Risk/Prevention (2) Foley catheter care Hypothermia (5) IABP (5) IVs

Central line care (7) – include PICC line, mediport & dressing changes, blood draws from central lines & mediport, treating of occluded ports

IV insertion Mid-line care

34

What additional skills do you think would be beneficial to review at skills day? (cont’d) Lab Review, basic Lumbar drains (3) Menu education (for the new menus) Microfilament testing Nephrostomy tubes Neuro assessment (3) Neurosurgical procedures & care(2) OB protocol for patients in the ED > 20 weeks OB Unit specific

OB emergencies – including hemorrhage OB intrauterine resuscitation OB Pitocin management OB RN attended delivery OB shoulder dystocia drills

Oncological emergencies review

35

What additional skills do you think would be beneficial to review at skills day? (cont’d)

Open Heart care – including review, insulin orders Order set knowledge Oxygen therapy Pacemakers, temporary PAN discharges to nursing home Palliative care Patient positioning PCA (2) Pressor usage Procedures – general information regarding what is done for our primary ortho &

neuro cases Rapid Infuser Rapid Response (8) – include responsibilities, simulation, how to escalate

concerns, when to call & not call Restraints (4) - including application, documentation, sign-off

36

What additional skills do you think would be beneficial to review at skills day? (cont’d)

Safe patient handing (3) – including the aggressive patient, update on assist devices, transfer devices

Sedation in the ED

Sepsis (4) – including timelines & early identification of patient decline

Swan-Ganz (2)

Ventilators (4) – including the standard of care

Ventriculostomy (4) – including set-ups

Withdrawal – include benzodiazepine, opiate

37

What patient care situations do you feel least confident with (diagnosis/procedures/ treatments)? Alaris pump

Aline (3) – including set-up & care

Ambiguous symptoms

Bedside procedures (3) – including both routine & emergent (chest tube placement, ventrics, etc)

Behavioral Health

Cancer treatment

Capnography (2)– including how to care for patient & alter care based upon trends

Cardiac arrhythmias

Cardiac medications

Cardiac Procedures

Cardiac related topics (4) – including complications, unexpected cardiac events, decline in patient condition, NSTEMI, elevated troponins

38

What patient care situations do you feel least confident with (diagnosis/procedures/ treatments)? (cont’d)

Central lines (3) – including care, blood draws, PICCs

Chest pain r/o

Chest tubes (6) – including insertion

Code blue (5) – including roles

Code blue on MH

Code Gray (3)

CRRT (3)

Diabetes

Direct admits

Documentation

eAccess

EKG (2) – including how to perform

39


Encephalopathy

End-of-life (2)

Fetal demise

Heart Failure

Hemodialysis

Hemorrhage management

Hypothermia (2)

ICP insertion in the ED

IV starts (3) – including hard patients, use of ultrasound

Labs

Mobilab

40


Neuro

Neuro procedures (2)

Newborn umbilical cath

OB emergencies

OB precipitous deliveries

Oncology

Ortho procedures (2) – including post op care

Pacemakers (2) – including problems ie failure to capture

PCAs

Phlebotomy

Procedures (2) – including specific doctor preferences

41

What patient care situations do you feel least confident with (diagnosis/procedures/ treatments)? (cont’d) Pulmonary medications

Pulmonary procedures

Rapid incisor in an emergent situation

Rapid patient decline

Respiratory distress/failure (2)

Restraint (2) – including documentation

Sedation (2) – including paperwork

Sepsis (3)

STEMI

Stroke (4) – including assessment, paperwork

Telemetry reading

42


Thoracentesis

Trachs

tPA administration (2)

Tube care – all & nephrostomy

Urology – TURPs

Vascular procedures

43

Are there things you would like to review such as the new PCA, Meditech documentation, or infrequently used equipment? All of the above (3) A-lines Bed/seat alarms Bedside handoff Capnography (7) – including all the different tubing & how the PCA & Mindray monitors

are different Central lines/ PICC lines Ceiling life equipment on MOSU Chest tubes (3), including set-up CO/CI monitor CPOE review Crash cart (2) ED cardiac monitors – beyond the basics, hints on extras they can do Fluid warmer Hypothermia machine

44

Are there things you would like to review such as the new PCA, Meditech documentation, or infrequently used equipment? (cont’d) IABP (2) Infant delivery care Infrequently used equipment (5) Insulin pumps Lifevests Med reconciliation (3) Meditech documentation (19) – including how to document an existing PICC & Latex

allergy, scenarios that may be difficult, documenting medications, using AST information in the computer, recalling pt’s previous visit, fall documentation, a resource book for reference, how to find information, how to document, sedation documentation, what HAS to be documented for each patient, downtime process, how to clean up MARs

Mobilab (2) New blood transfusion New defibrillators New Pacemakers New PCAs (15)

45

Are there things you would like to review such as the new PCA, Meditech documentation, or infrequently used equipment? (cont’d)

Pneumatic tourniquet

Portable LVADs

Rapid infuser (3)

Restraints – including documentation & procedures

Temporary pacemaker

Ventrics – including off CSF samples

46

Unit Finance & Productivity Management

103

55

50

45

40

3412

Number of Nursing Associates interested in Learning More:

Role in unit finances Using ADaPT

Organizational impact Capital equipment purchases

Budget forms Action OI

Other

47

Unit Finance & Productivity Management My role in unit finances & Organizational Impact – predominant interest

area of Nurse Clinicians & Charge Nurses

Using the daily ADAPT productivity & Use of budget forms– area of interest for Charge Nurses & Managers

Action number one requested area of interest by nursing leaders, including the CNE, Directors, and Managers

Capital Equipment Purchases noted as interest by Directors & Managers

48

Safety Topics49

Safety Topics

Harm Classification – broadest level of interest, including CNE, Directors, Managers, APN, Charge Nurses, & Nurse Clinicians

Safety Event Reporting & Advocate’s Safety Strategic Plan - interest of Nurse Clinicians & Charge Nurses

Principles of High Reliability highest safety topic for Nursing Directors and Managers (10); also an area of interest for Charge Nurses & Nurse Clinicians

50

Quality Topics51

Quality Topics

All 3 topics areas of interest across the ABMC levels of nursing

Behavioral-based interviewing – Directors, Managers, APN, Charge Nurses & Nurse Clinicians interested

PDSA – Directors, Managers, Charge Nurses & Nurse Clinicians interested

How to turn data into information – CNE, Directors, Managers, Charge Nurses & Nurse Clinicians interested

52

Service Topics53

Service Topics

HCAHPS/Press Ganey survey tools – area of interest for CNE, Directors, Managers, Charge Nurses and Nurse Clinicians

How to pull Press Ganey reports – Directors, Managers, Charge Nurses, and some Nurse Clinicians

54

DNV/ISO 9001 Topics55

DNV/ISO 9001 Topics

Highest levels of interest: General Overview – identified as an area of interest for Directors, Managers,

Charge Nurses & Nurse Clinicians

How to navigate the Advocate Document System – Managers, Charge Nurses & Nurse Clinicians interested

How to manage a corrective action plan – area of interest for Managers, APN, & Charge Nurses

QMS Audits – Managers, Charge Nurses & Nurse Clinicians indicated interest

56

General Professional Development Topics

57

General Professional Development Topics Topic interest spread across all levels of ABMC nursing. No predominant

themes for any particular group of nurses.

58

ABMC 2015-16 Learning Needs Assessment and Plan

Topic Source

Search Term (if

electronic) Schedule CNE Director Manager

Charge

Nurse

Clinical

RN APN

Interpreting Lab Values Healthstream Laboratory Anytime x x x

Obstetrical Emergencies

OB: OB skills days

(11/15)

ED: TBD

(Topics also available

in Healthstream) Obstetric

Healthstream-

anytime x x

12 Lead EKG Interpretation

Dr. Ghandi

presentation

(Video available on

Healthstream) 25-Jan-16 x x x

Pain Management Healthstream Pain Anytime x x x

De-escalating the angry

patient/family

Managing the

Aggressive Person

Training

Monthly--see

Education

Calendar x x x x x x

Sepsis Healthstream Sepsis Anytime x x x x

Arrhythmia Interpretation

class--6 times per year

Semi Monthly--

see Education

Calendar x x

Diabetes and Insulin Pumps March 2016 Nurse

Quarterly

March/April-see

Education

Calendar x x x x x

Early signs of patient

decline. (Rapid Response

and Codes) Healthstream rapid response Anytime x x x

Neuro-surgical proceduresHealthstream neuro Anytime x

Safe Patient Handling2016 System Initiative TBD x x x x x

Audience

Exhibit OO6.3 Advocate BroMenn Medical Center 1


Restraint Management

Managing the

Aggressive Person

class. Also will be

included in 2016 Skills

Days

Monthly--see

Education

Calendar. See

Skills Days

schedule. x x x x

Chest Pain/MIHealthstream, Nurse

Residency Chest Pain

Healthstream--

Anytime Nurse

Residency-TBD x x x x

Finance:

Unit Finance and

Productivity ManagementHealthstream finance Anytime x x x x x x

Role in Unit Finances Healthstream finance Anytime x x x x x x

Using ADaPT Intranet self learning

tools adapt Anytime x x x x

Quality:

Patient SafetyHigh Reliability

Training

Scheduled unit

rollouts: fall

2015 through

2017 x x x x x x

Performance Improvement

Process (PDSA)Healthstream PDSA Anytime x x x x x x

Behavioral Based

InterviewingIntranet self learning

tools

behavioral based

interview Anytime x x x x x x

Service Topics:

HCAHPS/Press Ganey Survey

Tools

Intranet self learning

tools

Press Ganey

Resources Anytime x x x x x x

How to Pull Reports from

Press Ganey


tools

Press Ganey

Resources Anytime x x x x

DNV/ISO 9001:Intranet self learning

tools DNV Anytime x x x x x x



General Overview of ISO

9001

Completed August

2015 x x x x x x

How to Navigate the

Advocate Document SystemSkills Days (Aug 2015

and 2016)

Skills Days

schedule x x x x x x

How to Manage a Corrective

Action Plan


tools DNV Anytime x x x x

QMS AuditsIntranet self learning

tools DNV Anytime x x x x

Non-Conforming Product

Requirements


tools DNV Anytime x x x x x x

Document Control

Requirements Done 2/2016 x x x x x x

Control of Records Done 2/2016 x x x x x x

General Professional

Development Topics Most

Requested Include:

Certification Review/ Prep

CoursesHealthstream

Search for the

name of the

certification Anytime x x x x x x

Conflict Resolution

Coach Class, MAP

MAP- Monthly--

see Education

Calendar

Coach class--see

calendar x x x x x x

Evidence Based Practice

Research Committee

Contact

Committee Chair x x x x x x

Clinical CoachingCoach Class

See Education

Calendar x x x x x x

Nursing Research

Research Committee

Contact

Committee Chair x x x x x x

STEPS(Success through

Excellence in Practice) Quarterly class

See Education

Calendar x x x x


organizational overview structural empowerment · simulation short, small group inservices on unit...

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