Ask staff to help choose new devices
Would you rather use a new device that you helped to select or one that was selected without your input?
Involvement of front-line workers in evaluation and selection of new devices is the best way to ensure success, says Karen Daley, RN, MPH, president of the Canton-based Massachusetts Nurses Association. The reverse is also true, she says: "Lack of involvement by staff is the greatest barrier to success in this effort."
If purchasing decisions are made by someone in an office picking from a product catalogue, and decisions are made based on cost and not on effectiveness or experience, the process of gaining buy-in by your staff will not be successful, says Daley. "Even worse, injuries are unlikely to continue," she stresses.
Introducing a new way of doing things is always difficult, especially in an ED where things tend to change from moment to moment, says Vicki Cadwell, RN, MS, CEN, CCRN, MICN, the ED educator at St. Jude Medical Center in Fullerton, CA.
"If the ED staff has been involved in the evaluation of new equipment, the process will be easier," she adds. "It is important for staff to feel their participation is important and that the change will have a positive effect on their safety and their practice."
However, if the device that is selected by the facility is not the one that the staff preferred, there might be a reluctance to accept the new device, notes Cadwell. "In this case, you’ll need to do a lot of individual or small group inservicing," she says.
Focus on the positive aspects of the device, especially with the reluctant staff, she advises. "I would also make sure I was seen using the device myself whenever I was on the unit assisting in patient care," adds Cadwell.
Here are effective ways to involve staff in the evaluation process:
• Offer a prize.
Cadwell offers staff a "prize drawing" from among the names of those who turned in evaluation questionnaires. Prizes can be anything, she says. "You might give out bandage scissors, stethoscope covers, food, meal tickets, movie tickets," Cadwell suggests.
• Use a good evaluation form.
Questionnaires should address ease of use for the nurse, ease of disposal, safety, comfort for the patient, quality, and durability, says Cadwell. "There should be ample room for comments," she adds. "Even though comments are difficult to collate, the individual thoughts behind them are important."
Emphasize that if staff don’t provide input, they may have to work with a device that they may not like, advises Cadwell.
• Contact staff members individually.
Many nurses welcome the chance to increase their safety, but others might be reluctant to switch products and see the needleless system as a burden, notes Pierce. In these cases, individual contact by management, an educator, or clinical nurse specialist is helpful, says Cadwell. "Thank-yous, whether in person or written, for their participation are important and are appreciated," she adds.
• Be clear about objectives.
For a trial or switch to be successful, the people involved need to know the goal, advises Darlene Matsuoka, RN, BSN, CEN, CCRN, ED clinical nurse educator at Harborview Medical Center in Seattle. "For example, the goal may be trying several products and deciding on one, or trying a single product the hospital is considering a switch to," she says.
A recent switch to a different IV product was hampered by a misunderstanding of the nature of the trial, says Matsuoka. "The word trial’ implies there is temporary usage of a product for purposes of evaluation," she explains. "Nurses thought they could stay with the previous product because they liked that better."
If there is no choice involved and a switch to another product needs to occur, make that clear from the beginning so that nurses don’t become resistant, notes Matsuoka.
• Encourage ED staff to participate on hospital committees to evaluate products.
A 1999 directive from the Washington DC-based Occupational Safety and Health Administration requires you to involve employees who will be using the new devices in the selection and evaluation process, says Daley.
Encourage ED staff who use the devices to participate in the hospital safety committee, says Daley. "This needs to be supported by management," she says. "For example, provide nursing staff coverage to allow nurses on the committee to attend meetings."
At Harborview, a hospitalwide product evaluation committee makes decisions about which products will be tried, with a representative from the ED. All new products must go through the committee first, says Matsuoka. "Then decisions are made to put the product into use right away, to switch products, or to hold off," she says.
Sources
For more information about involving ED staff with product evaluation, contact: Darlene Matsuoka, RN, BSN, CEN, CCRN, Harborview Medical Center, Emergency Department, Mail Stop 359875, 325 Ninth Ave., Seattle, WA 98104. Telephone: (206) 731-2646. Fax: (206) 731-8671. E-mail: [email protected].
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