As promised last week, we’ve added a free download from Kathleen Bartholomew’s Ending Nurse-to-Nurse Hostility, Second Edition, in honor of being the only book chosen by the American Nurses Association as a recommended bullying and horizontal hostility prevention tool.
To access the download site for a tool you can use to evaluate the health of your workplace as regards bullying, lateral violence, and other undesirable behaviors, click here.
To read last week’s story the ANA position statement on workplace violence and the nursing profession, click here.
Incidents reports are a pain to fill out, but vital for documenting what happened and for protecting yourself and your staff. This week, we’re republishing a popular post full of best practices, provided by Patricia A. Duclos-Miller, MS, RN, CNA, BC.
Yesterday we looked at the purpose of the incident report and the value of documenting facts as well as the patient’s responses to care in the nursing progress notes (see Incident Reports: Part One). Today we’ll look at eight risk reduction recommendations you should follow to limit the number of incidents you face. We’ll also give you a check list of tips for writing incident reports should adverse events occur. (I’ll make the checklist available as a PDF download in a few days, so check back for the link.)
RISK REDUCTION RECOMMENDATIONS FOR NURSE MANAGERS
- Be sure that everyone is clear as to who is managing the patient. This is especially critical in complicated cases with numerous consults. One of the major factors in adverse events is fragmentation or lack of clear communication between providers. Therefore, use the medical record as a communication tool for all providers and encourage your staff to read notes from other providers and disciplines.
- Be sure staff understand and utilize the chain of command when necessary. They are considered patient advocates and must speak on behalf of the patient to ensure quality patient care. Documentation of the chain of command process should be factual and blameless.
- Advise your staff never to create notes at home concerning the event. They should not discuss the event with other care providers without having someone from risk management present, unless the discussion is in a quality-review process or in the presence of the facility’s attorney.
- If an adverse event occurs, the staff must know that attention to patient needs is first and foremost. If a patient is injured, nursing and medical interventions take precedence over everything else.
- Follow the organization’s policy on medical-event disclosure. It is important that staff understand who is designated to inform the patient/family. Documentation should include who was present during the discussion, what information was discussed, and all of the patient/family responses.
- Ensure that the patient/family receives compassionate care and that everyone involved maintains a professional relationship.
- If an adverse event occurs, contact the risk manager. Discuss the case discretely, because conversations are not protected under a quality statute or attorney-client privilege, and therefore may be discoverable.
- Work with the risk manager. The risk manager can help you and your staff promote patient safety and proactive strategies to avoid injuries.
Incidents reports are a pain to fill out, but vital for documenting what happened and for protecting yourself and your staff. This week, we’re republishing installments of a popular post chock full of best practices, provided by Patricia A. Duclos-Miller, MS, RN, CNA, BC.
We work in high-stress, fast-paced environments. It is your responsibility as a member of the nursing management team to understand the importance of incident reports, to ensure that your staff completes them, and to investigate incidents to avoid any further occurrences. Your investigation will also provide possible defense if during your investigation you identify a system failure and take the necessary corrective action(s).
The purpose of the incident report is to refresh the memories of both the nurse manager/supervisor and the staff nurse. While the clinical record is patient-focused, the incident report is incident-focused. The benefit to you and your staff is [more]
Enjoy a FREE white paper on preceptor competency assessment and verification!
This white paper is compiled from the third edition of the groundbreaking book,
The Preceptor Program Builder, written by Diana Swihart, PhD, DMin, MSN, APN CS, RN-BC, and Solimar Figueroa, MHA, MSN, BSN, RN. It discusses and defines the competencies developed in preceptorships, explores the goals and essential elements of competency assessment and verification, and takes a close look at the categories of competencies and methods for assessing and verifying them within the context of the preceptor relationship.
Click here to download the white paper: Preceptor competency assessment and verification.
The Preceptor Program Builder provides professional development staff the keys to creating a successful preceptor program in the healthcare environment. Learn more here.
Click here to view our full range of nursing resources.
As promised in last week’s post, Try This: Build nursing team self-esteem, the exercise that Kathleen Bartholomew uses to encourage nurses’ self-esteem has been posted to our Tools Library.
To download the Hierarchy of Voice tool, click here.
Excerpted from Ending Nurse-to-Nurse Hostility, Second Edition, by Kathleen Bartholomew
Do you have an EBP story to share?
For nurses just getting started with evidence-based practice, the steps between deciding on an area to research and implementing a plan for improvement can be overwhelming. Identifying sources of qualified research, interpreting the results, translating procedures from theory to practice… It’s complicated, to say the least.
I’m looking for a few brave souls who would be willing to share what I’m calling “EBP notes from the field.” If you’ve gone through the process from start to finish, would you be willing to share your story? I see these as 1-2 pages looking into the decision making process, the research you chose, the steps you took to get buy-in from management. What did you learn in the process? How did you implement your research? Have you been able to measure the results?
I’d like to include a few of these stories in an upcoming book project: a simple EBP guide for working professionals. It will be very practical, straightforward, and [more]
Hierarchy of Voice
Excerpted from Ending Nurse-to-Nurse Hostility, Second Edition, by Kathleen Bartholomew
Try the following exercise that I often use to encourage nurses’ self-esteem. I call it a “hierarchy of voice” because each step results in greater empowerment. Addressing specific behaviors that are a challenge to a nurse stimulates meaningful conversations about that individual’s stumbling blocks to empowerment and self-esteem.
In performance evaluations, share the following list and ask team members to pick 10 meaningful actions that they would like to [more]
Listening, validating and asking for a commitment
From Team-Building Handbook: Accountability Strategies for Nurses, by Eileen Lavin Dohmann, RN, MBA, NEA-BC
When working with a group, I assume that people are rational and logical.
So, if I want them to do something, I just need to explain it and they’ll do it. When I don’t get the results I am seeking, I tend to think “Oh, I must not be explaining it well. Let me try it again.”
It’s taken me a long time to realize that what I was hearing as “not understanding me” was often someone’s polite way of telling me no. So, now when I find myself explaining the same thing to someone for the third time, I stop and ask the person what he or she is hearing me request. If I can validate that the person is hearing me correctly, I ask for the commitment: yes or no.
Validating… and asking for a yes or no
We can hold ourselves accountable, but holding other people accountable can be much more difficult. Consider this nurse-physician scenario and ask yourself [more]
I’ve posted in the past on accountability strategies, communication techniques, and building team relationships, all of which can improve the workplace. Recently I ran across the term “positive pushback”—easy to remember thanks to those alliterative “p” words—and felt that the technique might be helpful in those potential conflict situations that arise from time to time.
The promise of positive pushback is that you can communicate your concerns in an unequivocally strong and clear manner that doesn’t damage your professional relationships. No yelling and certainly no retreating to an unassertive approach.
According to Susanne Gaddis, the Communications Doctor:
A “positive pushback” is the ability to deliver an appropriately assertive response to a potentially negative and/or harmful situation. A positive pushback is executed by looking someone straight in the eye, and saying with an even, non-stressed tone what you want or need. (If you want to be really assertive include the word “I,” such as “I really need for you to stop and review this now…”)
What resources do you need to use positive pushback? Self-esteem, self-confidence, and an ability to convey urgency without “emoting” your emotions. I highly recommend that you read this blog post from Susanne Gaddis, to see if this is a tool that you can add to your collection. As with all the “soft skills,” practice makes perfect.
If you try the techniques, please post a comment here to let us know how it worked out for you!
With thanks to Susanne Gaddis, PhD, CSP and CEO of The Communications Doctor, is an acknowledged communications expert who has taught the art of effective and positive communication since 1989.
There is a connection between nurses’ feelings about
their work environments and nursing quality and safety
Rebecca Hendren recently posted about a June 2015 Healthleaders magazine article focusing on steps organizations are taking to measure and improve nursing staff satisfaction. For anyone who hasn’t yet read it, I just want to share my favorite quote from the article. In it, Linda Aiken, PhD, a nursing workforce researcher and director of the Center for Health Outcomes and Policy Research (U. Penn) is quoted as saying that
Nursing “is the single biggest factor
in how patients rate their hospitals”
Do you agree with this statement? Have you seen the impact of improvements in nursing staff satisfaction on care quality, outcomes, and patient ratings? What tools or strategies have you used to improve staff retention and satisfaction? Please leave a comment sharing your experiences with your fellow nurse leaders.
For more details on the kinds of nursing staff surveys conducted by organizations that have received designation as ANCC Magnet Recognition Program® hospitals as well as those that have not, plus the source of the headline quote (which no one would dispute!), click here to go to the HealthLeaders article.