Nurses play on level field with clinical guidelines
July 1, 1997 2 minutes read
Nurses play on level field with clinical guidelines
Improving documentation is still a struggle for many home care companies. But an Illinois agency found that improving it could be as simple as buying clinical practice guidelines.
"What we were finding is the staff had some good habits, and some had bad habits; there wasn’t any level playing field in documentation," recalls Deborah Parra, RN, MHRM, administrator of Anrex Health Care of Melrose Park, IL.
Anrex started to use Clinical Practice Guidelines by Mosby of Chicago more than a year ago so that all the nurses could assess patients from the same starting point. "Nurses with two years of experience tend to overemphasize some clinical symptoms, whereas more experienced nurses would take it in stride and not make such a big deal of it," Parra says.
By using the guidelines, the assessments became more consistent, she adds.
The guidelines describe different symptoms and clarify each stage of severity. Then they explain what type of intervention should be done at each stage.
Parra educated nurses on how to use the guidelines by first starting with a standard overview and giving staff a chance to look at the new tools.
"Then we told them how to incorporate this with the patient," Parra says. "It took four months before everyone was up to speed. We were teaching this weekly for at least an hour and sometimes longer."
One of the most common concerns nurses had was what would happen if two nurses visited a patient and they saw different things. Parra says they worried that would mean one nurse was wrong and the other correct. But when they began to use the guidelines, they discovered that this wasn’t a problem after all. "They realized after a while that you could have more than one person look at the patient, and generally, they’d see the same picture."
Another advantage was that newer nurses built up more confidence with the new tool because they could include everything they thought was important in observing the patient on the documentation. All they had to do is put it in the right framework, Parra says.
The best benefit, Parra says, was that the agency did very well soon after that when it was surveyed by the Joint Commission on Accreditation of Healthcare Organizations of Oakbrook Terrace, IL.
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