Davidson, Carolyn L, PhD, RN, CCRN, FNP-BC

Holleran, Kim, BSN, RN, CMSRN

Jordan, Kim, MHA, BSN, RN, NE-BC

Peter, Debra, MSN, RN-BC

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksPatient Care Services / NursingFrom B17 Bomber to Bedside: Using a BundleMethodology to Enhance QualityKim Jordan MHA, BSN, RN, NE-BCLehigh Valley Health Network, Marie.Jordan@lvhn.orgCarolyn L. Davidson PhD, RN, CCRN, FNP-BCLehigh Valley Health Network, Carolyn_L.Davidson@lvhn.orgDebra Peter MSN, RN-BCLehigh Valley Health Network, Debra.Peter@lvhn.orgKim Holleran BSN, RN, CMSRNLehigh Valley Health NetworkFollow this and additional works at: http://scholarlyworks.lvhn.org/patient-care-services-nursingPart of the Nursing CommonsPublished In/Presented AtPeter, D. (2010, November). From B17 Bomber to Bedside: Using a Bundle Methodology to Enhance Quality. Poster Presented at: TheUniversity of Pennsylvania Patient Safety Conference, Philadelphia, PA.Jordan, K. Davidson, C. L. (2011, April). From B17 Bomber to Bedside: Using a Bundle Methodology to Enhance Quality. PosterPresented at: The American Organization of Nurse Executives, San Diego, CA.Davidson, C. L. (2011, March). From B17 Bomber to Bedside: Using a Bundle Methodology to Enhance Quality. Poster Presented at: TheEastern Nursing Research Society, Philadelphia, PA.Davidson, C. L. (2011, January). From B17 Bomber to Bedside: Using a Bundle Methodology to Enhance Quality. Poster Presented at: TheNational Database of Nursing Quality Indicators, Miami, FL.Holleran, K. (2011, September). From B17 Bomber to Bedside: Using a Bundle Methodology to Enhance Quality. Poster Presented at: TheAcademy of Medical Surgical Nurses Annual Convention, Boston, MA.Davidson, C. L. (2011, March). B17 Bomber to Bedside: Using a Bundle Methodology to Enhance Quality. Presented at: Eastern NursingResearch Society, Philadelphia, PA. (Oral presentation)B17 Bomber to Bedside: Using a Bundle Methodology to Enhance QualityLehigh Valley Health Network, Allentown, PennsylvaniaAim:•		Promote	patient	SAFETY;•		Optimize	QUALITY;•		Successfully	PREPARE	for	upcoming	regulatory	agency	visits.Project Design:•		Formed	a	workgroup	of	stakeholders	from	the	medical-surgical	division,	inclusive	of	unit	educators	and	the	nursing	quality	administrator•		Focused	on	‘How	to	improve	quality	outcomes?’•		Performed	an	extensive	literature	review	-	addressing	topics	such	as	‘use	of	a	checklist	for	improvement	of	processes,	quality	improvement	strategies,	staff	engagement,	the	role	of	the	advance	practical	nurse	in	promoting	quality.’•		Developed	a	‘Quality	Bundle	of	Care©’	checklist	to	address	priorities	of	care,	compliance	with	network	processes	and	quality	issues,	including:	 	 	 -	 	FALL	and	PRESSURE	ULCER	prevention,	MEDICATION	safety,	CATHETER-ASSOCIATED	URINARY	TRACT	INFECTION	prevention,	RESTRAINT	reduction,	PAIN	management,	The	Joint	Commission	National	Patient	Safety	Goals,	high	risk/low	volume	skills	and	problem	prone	issues	•	Communicated	expectations	to	unit	staff	of	the	new	processResults:Representatives	of	the	medical-surgical	division	at	Lehigh	Valley	Health	Network	were	charged	to	design	a	process	that	would	actively	engage	and	empower	staff	in	quality	issues	to:Background:Healthcare’s	current	dynamics	and	evolving	national	and	state	regulations	are	driving	safer	and	more	effective	patient	care.		Recognizing	the	challenges	nurses	face	daily	to	provide	and	document	the	most	optimal	care	possible,	a	process	was	explored	to	enhance	staff	performance	and	improve	overall	outcomes.					Method:•		Checklist	methodology	and	efficacy	informed	and	guided	the	process	(Berenholtz,	2004;	Gwande,	2009)•		Review	individual	patient’s	plan	of	care	utilizing	the	‘Quality	Bundle	of	Care’	checklist•		Coach	staff	during	the	review	on	topics	r/t	quality	improvement,	such	as:	 	 	 -	 	High	risk	for	skin	breakdown:	Have	we	tried	an	alternative	pressure	reducing	surface?		Have	we	collaborated	with	the	dietitian?		Are	we	using	specialty	skin	products?	Have	we	determined	and	documented	a	skin	risk	score	daily	and	updated	the	plan	of	care?	 	 	 -	 	High	risk	for	falls:	Have	we	considered	the	low	bed?		Have	we	appropriately	identified	the	patient	at	risk	for	falls	using	unit	prompters?	Have	we	determined	and	documented	a	fall	score	daily	and	updated	the	plan	of	care?	 	 	 -	 	Actively	dying:	Have	we	considered	additional	supportive	resources	for	the	family	who	is	present?		Have	we	considered	the	bereavement	cart?	 	 	 -	 	Indwelling	urinary	catheter:	Have	we	collaborated	with	the	physician	to	determine	the	ongoing	necessity	of	the	indwelling	catheter?		Have	we	implemented	and	documented	the	urinary	catheter	bundle?•		Collate	data	every	2	weeks	for	units	to	review,	discuss	and	action	plan,	as	necessary		•		Conduct	medical-surgical	division	Quality	Retreats	bi-annually	to	discuss	data,	trends,	and	action	plansSignificance to Nursing:A	structure	driven	by	unit-based	clinical	leaders	promotes	staff	engagement	in	quality	outcomes.		The	combination	of	a	transformational	leader,	standardized	tool,	formal	process	and	feedback	of	results	in	real-time	contributed	positively	to	quality	outcomes	and	improved	safety	for	our	patients.		In	addition,	the	tool	can	be	used	by	any	clinician	(unit	council	member,	management	team)	as	a	self	or	peer	review.		Marie K. Jordan, MHA, BSN, RN, NE-BC; Carolyn Davidson, PhD, RN, CCRN, FNP-BC: Patient Care Specialists - Medical-Surgical DivisionReferences:1	 	Berenholtz,	S.M.,	Pronovost,	R.J.,	Lifsett,	P.A.,	Hobson,	D.,	Earsing,	K.	et	al.	(2004).	Eliminating	catheter	related	bloodstream	infections	in	the	ICU.	Critical Care Medicine, 32(10),	2014-2020.2	 	Gwande,	A.	(2009).	The	checklist	manifesto:	How	to	get	things	right.	New	York:	Metropolitan	Books.

From B17 Bomber to Bedside: Using a Bundle Methodology to Enhance Quality

https://scholarlyworks.lvhn.org/cgi/viewcontent.cgi?article=1032&context=patient-care-services-nursing

From B17 Bomber to Bedside: Using a Bundle Methodology to Enhance Quality

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