RSSArchive for March, 2012

Transparency…are we there yet?

Apparently not. Public reporting of surgical site infections is required in only eight states. That fact was brought to light by a new Johns Hopkins University report, which calls for more reporting. Lead author of the report, Martin Makary, MD, notes that patients still have little information when choosing hospitals.

Personally, I think the bigger issue is that public reporting gives hospitals, from the top down, a real push to do better. I think Makary does too:

“Nothing motivates hospitals to improve quality and listen to their front line staff like public reporting,” he says. “In order for the consumer to interpret publicly reported SSI rates, it is imperative that the data be collected and reported in a standardized manner,” he and his co-authors wrote.

I would have to agree. Surgical site infections not only result in 8,000 deaths a year in the U.S., they occur in 4% to 25% of patients who undergo major surgical procedures, and their cost to the healthcare system is about $10 billion annually (these stats are mentioned in the report and come from other studies).

Makary calls out state hospital associations for not supporting public reporting. What do you think? Is public reporting the way to change hospital culture?

Source: HealthLeaders Media

Editor’s note: This blog post originally appeared on the Patient Safety Monitor Blog.

Board membership and the role of nurses in healthcare decision making

Nurses hold leadership roles in healthcare organizations, yet nurses are not perceived as leaders in healthcare decision making, according to an article in the March issue of American Journal of Nursing (AJN). The article investigates the lack of nurse representation on hospital boards, drawing data from a 2010 American Hospital Association survey of more than 1,000 hospital boards that found that only 6% of board members were nurses, compared to a 20% board membership comprised of physicians. The Institute of Medicine urged healthcare decision makers to include nursing representation on boards and management teams in its report, The Future of Nursing: Leading Change, Advancing Health, but nurses must also take initiative in developing their own skills and acquiring the competencies necessary for leadership, according to the AJN article.

What are some of the essential capabilities of board members? According to the article, nurses already possess several: personal skills, professionalism, and collaboration. Other qualities, such as an understanding of business, finance, and human resources, can be developed over time with the help of continuing education. The article also profiles several nurses who serve as board members and who share the personal traits and professional competencies that are crucial to their success.

As a nurse leader, it is important for you to establish not only your capability in managing your staff, but also your ability to contribute to the development of your organization and the services it provides. Continue to demonstrate and enhance the skills and knowledge you bring to the board, and encourage your fellow nurses to do the same. Serving as a member of the board can be a rewarding and instructive experience.

Share your thoughts: Does your board have sufficient nurse representation? Would you want to take on a more active role in leadership and decision making as a member of the board? Leave a comment below!

Room for improvement remains in preventing sharps injuries

Although there has been substantial progress in reducing needlestick injuries in U.S. healthcare settings since the Needlestick Safety and Prevention Act (NSPA) of 2000, there is still room for improvement, according to a statement released by the International Healthcare Worker Safety Center and endorsed by the American Nurses Association. Data collected from both the EPINet Sharps Injury Surveillance research group in Virginia and the Massachusetts Sharps Injury Surveillance System in recent years shows that nurses sustain approximately 35% of total sharps injuries, while workers such as housekeepers, administrative staff, and clinicians sustain 30% of sharps injuries. The most common settings for injuries are patient rooms and surgical settings, according to the statement.

The statement also identifies five key areas for progress in reducing sharps injuries in healthcare workers: improving sharps safety in surgical settings, understanding and reducing exposure risks in non-hospital settings such as clinics and home healthcare, involving frontline healthcare workers in the selection of safety devices, addressing gaps in safety devices, and enhancing education and training. Each improvement area includes statistical information and recommendations for action.

This statement serves as a pertinent reminder that laws alone cannot guarantee a safe and injury-free work environment. You must continue to educate your staff on safe practices when using and disposing of needles, and remind them of the hazards involved with sharps injuries, including exposure to bloodborne viruses. You must also act as an advocate for the selection of safer devices to further prevent the risk of injury; you and the members of your staff should have be able to voice opinions on which sharp devices best suit your needs.

Weigh in below: what has your organization done to reduce rates of needlestick injuries? How do you work to establish a culture of safety with regard to sharps injuries?

Facebook photos lead to jail time for nursing assistant

How would you respond to disturbing images or posts by an employee on Facebook? The Regency Pacific Nursing and Rehab Center in Portland, OR, did not like the pictures posted on Facebook by nursing assistant Nai Mai Chao, and fired her following a conviction of invasion of privacy. Images of elderly or disabled patients using bed pans and the contents of the bed pans, dating back to April 2011, appeared on Chao’s Facebook wall; Chao admitted to posting the photos but denied taking them. In addition to losing her job, the 26 year old nursing assistant spent eight days in jail, surrendered her nursing certificate, has been ordered to write a lengthy apology to a patient, and is forbidden from working at any job caring for children or the elderly in the next two years.

Social networking sites can be wonderful tools for nurses looking to connect with others in their profession or stay informed with the latest news about nursing. However, these sites also blur the line between one’s personal and professional lives, and people tend to forget that they are sharing pictures, information, and comments not only with their friends but also with the rest of the online world. There’s a good chance the majority of your staff participates in some form of social media, and addressing appropriate and inappropriate uses for these sites is crucial to prevent not only outrageous incidents like the one involving Chao, but also more innocent-seeming posts that still put patient privacy in jeopardy.

Talk with your nurses about privacy policies and how Facebook posts about their jobs or their patients can lead to trouble, no matter how innocuous the information may seem. Remind your nurses that although they may utilize the maximum privacy settings to prevent information or photos from spreading, their Facebook friends could still “share” content with their own networks and reach unintended audiences. Develop and enforce a social media policy that clearly states what is considered inappropriate use and outlines the consequences of violating the policy. As social media permeates all aspects of personal and professional spheres, taking these actions and being proactive about Facebook and social media use is a must for nurse leaders.

What are your policies on social media? How do you address concerns about privacy when it comes to Facebook and other sites? Leave us a comment and let us know your thoughts!

Can you head off nurse burnout by hosting a nursing salon?

Communication is a key part of the nursing profession, and successful nurses must effectively communicate and collaborate with colleagues to ensure a high level of quality and patient care. While much has been written about the necessity of communication between nurses on the job, there is not an abundance of information or research regarding the frequency and the potential benefits of nurse socialization outside of the workplace.

A recent poll on asked nurses how often they spent time with fellow nurses outside of working hours. Of the respondents, 46% reported that they rarely spent time with their colleagues, and 23% said they never spent time with other nurses from their unit when not working.  Most of the remaining respondents (29%) indicated that they occasionally spent time with fellow nurses, while only 2% spent non-working hours with other nurses on a weekly basis.

Meeting with other nurses outside of the hospital could provide opportunities for nurses to talk about issues and concerns regarding their profession and potentially relieve feelings of burnout. It might give nurses a chance to vent about work-related frustrations or help them rediscover the reasons they chose to become nurses. This is the theory behind nursing salons, which have been gaining popularity in many areas; these events provide a casual atmosphere in which nurses can connect with one another and share their thoughts.

While it does not need to be an official or mandatory event, inviting the nurses in your unit to come together outside of their shifts could promote conversation and foster improved relationships among colleagues. It would also let nurses connect with you and express themselves in an informal, non-threatening environment.

Would you consider hosting a nursing salon or a get-together for the members of your unit? Do you think such an event could be beneficial? Share your thoughts in the comment section!