Nurses become quality, safety investigators
Quality and safety can be improved by providing special training to nurses and then making them the bedside champion for best practices, says Liz Carlton, RN, MSN, CCRN, director of quality, safety, and regulatory compliance at the University of Kansas Hospital (KUMED) in Kansas City, KS.
Carlton and her colleagues designed the hospital's Quality Safety Investigator program (QSI), with a designated QSI nurse on each unit.
"The goal was to improve quality and safety right at the bedside, the most direct contact we ever have with the patient," Carlton says. "We wanted the nurses to really own that safe, quality-based patient care."
Currently, there are 39 QSI nurses. Each nurse participating in the program is given dedicated time to focus on safety and quality initiatives specific to their unit, Carlton says. The nurses attend a monthly two-hour meeting, all paid time. The QSI nurses also undergo special training on topics such as medication safety, handoffs, and hand hygiene.
"We known that nurses don't receive a lot of training in quality issues as part of their nurse education, so we teach them some of the key concepts and techniques, such as the plan-do-check-act cycle and the difference between quality assurance and quality improvement," Carlton says. "We also spend a bit of time in the curriculum talking about having critical conversations. It may be difficult for a younger nurse to talk to a more seasoned nurse about doing the bedside safety check, for instance, so we go through some of those scenarios."
Must agree to be active
Not just anyone can become a QSI nurse, Carlton says. Nurses must go through an application process, and if selected, must sign a contract promising to actively participate. The nurse's manager also must sign a contract pledging to support the QSI nurse and encourage him or her to be active in the program.
"We didn't want anyone forced to do this, so we sent out a notice that asked if they wanted to help others understand and use information to improve quality of care for their patients," she says. "There are people out there who are dedicated to this kind of work, if you just ask them to participate."
Each QSI is paired with a mentor who can help them advance their skills in quality assurance. The QSI is seen as a leader on their unit and is considered part of the leadership team with the nurse manager, practice council representative, unit coordinator, and unit educator.
"Once they become a QSI nurse, they are responsible for helping their colleagues and peers on their unit understand the quality initiatives or create their own that are specific to the unit, and to really be the quality champion for that unit," she says.
There are perks to being a QSI nurse. In addition to receiving the tools necessary to promote quality and safety on their units, they get to wear distinct scrub tops and can go to outside conferences for training. Those benefits can encourage other nurses to join the QSI program, Carlton says.
The results are encouraging after one year of the program. Hand hygiene rates have improved significantly, and pre- and post-testing of the QSI nurses on quality issues shows a much greater understanding, Carlton says.
"We're beginning to see changes in communications patterns, which is kind of hard to track, but it is one of the more important improvements," Carlton says.
Source
Liz Carlton, RN, MSN, CCRN, Director of Quality, Safety, and Regulatory Compliance, University of Kansas Hospital, Kansas City, KS. Telephone: (913) 588-5428. E-mail: [email protected].
Quality and safety can be improved by providing special training to nurses and then making them the bedside champion for best practices, says Liz Carlton, RN, MSN, CCRN, director of quality, safety, and regulatory compliance at the University of Kansas Hospital (KUMED) in Kansas City, KS.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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