Vol. 4 No. 7
July 2004
INSIDE
JCAHO
Read how one nurse leader
handled the JCAHO’s reliance
on nurses to describe patient
care during her facility’s recent
survey on p. 3.
Interdisciplinary care corner
Share this case study and staff
activity with your nurses to
develop more patient-focused
communication skills. Read more
on p. 4.
Nurse recruitment
Have a minimal recruiting
budget? Read about some
low-cost ways to recruit
nurses on p. 6.
Staff management
Looking for ways to get in
touch with your staff? Learn
how rounding can help
improve staff morale and
patient satisfaction on p. 8.
Quality initiatives
Transforming bedside care: Spark
innovation, excitement on your unit
Imagine this: During his hospital
stay for a routine surgery, a patient
sees pictures of his care team—including his nurse, physician, physical therapist, and nurses—on a
white board across the room. On
his bedside table he finds a small
notebook titled “Questions about My
Care,” suggesting good questions
to ask his doctor when she visits.
Such personal touches may seem
a far cry from standard hospital experiences, but these are real examples of changes being made to
patient care by a handful of pro-
gressive hospitals that are part of a
national initiative called Transforming Care at the Bedside (TCAB).
The program targets bedside care
on a standard hospital medical or
surgical unit and was launched in
July 2003 by the Institute of Healthcare Improvement (IHI) in partnership with The Robert Wood
Johnson Foundation (RWJF), a
healthcare philanthropy organization. The initiative aims to enhance
the quality of patient care and service, create more effective care
teams, improve patient and > p. 2
JCAHO
How JCAHO’s proposed Patient
Safety Goals will affect nurses
Three changes you need to know
Nurse-physician
communication
Help your nurses improve their
communications skills when
speaking with physicians
over the phone. Use the
communication “cheat sheet”
on p. 12.
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Three proposed revisions to the
JCAHO National Patient Safety Goals
that touch upon bar-coding requirements and drug safety could affect
nurses in 2005.
ing in place by 2007
• restrict IV preparation to the
pharmacy
• create a list of look-alike and
sound-alike drugs
The JCAHO released a proposed
draft of the 2005 National Patient
Safety Goals, which include three
goals for hospitals. The JCAHO board
of commissioners is expected to
vote on the proposals this summer.
If adopted, the goals will take
effect in January 2005.
Three major changes would require
hospitals to
• develop a plan to put bar cod-
Bar coding by 2007
The JCAHO would require hospitals
to have a bar-code system to identify patients and match them to their
medications by January 1, 2007.
Getting different
> p. 3
www.hcpro.com
Quality initiatives
Transforming care
< p. 1
staff satisfaction, and improve staff retention.
Field testing promising ideas
In fall 2003, IHI and RWJF chose three hospitals to test
the viability of the TCAB approach through a rapid
prototyping process. The sites included Seton Northwest Hospital in Austin, TX; UPMC Shadyside in Pittsburgh; and Kaiser Foundation Hospital in Roseville, CA.
After brainstorming with staff about ways to create
positive patient experiences, facilities began testing
their ideas on the units. Some of the most successful
prototype tests have been simple, commonsense
changes in how providers interact with patients.
At Kaiser Roseville Hospital, a successful test grew
out of an effort to help patients learn nurses’ names.
Chief Operating Officer Barbara Crawford’s team
decided to put up white boards in patients’ rooms to
write nurses’ names in large letters. Later they bought
a digital camera and took pictures of everyone on
the unit—physicians, nurses, aides, and respiratory
therapists.
They then attached photos to the white boards with
magnets and wrote staff members’ names and titles
underneath. “Patients can connect faces with names
and know who the people are coming in and out of
their rooms,” Crawford says.
A white board helped Seton Northwest Hospital turn
an inefficient scheduling process into a meaningful
shared system for managing nurses’ workloads. The
idea started with a desire to improve the admissions
scheduling process.
go from nurse to nurse every two hours, asking how
busy they were and making notes in a clipboard to
keep track. “It was a slow, one-on-one process of
portable cell phone calls around the unit,” says Viney.
“No one saw the information or could use it except
the scheduler.”
Viney says a TCAB unit nurse got an idea for using a
traffic light color rating scale to speed up the process
when she heard about a similar innovation at Luther
Midelfort–Mayo Health System in Eau Claire, WI.
“[The coordinator] put at the top of her clipboard the
check-in times—8 a.m., 10 a.m., noon, and 2 p.m.—
and on the left side she wrote the nurses’ names.
When she talked to them, she asked them to rate
themselves: red for ‘I’m swamped, I can’t take another patient,’ yellow for ‘I’m almost there, just give me
another hour,’ and green for ‘I’m ready for a new
patient.’ ”
Soon, the nurse replaced the clipboard with a
white board in a central location on the unit and
bought red, yellow, and green magnets to communicate the rankings. The board caught on right away,
and is being adopted by other units in the hospital,
says Viney.
“This went from a bubble in someone’s head to
implementation in four days and for about five dollars,” says Viney. “There really isn’t any new information involved—we were already asking nurses how
busy they were during a shift. But it feels so different for the staff: It’s empowering.”
“The TCAB floor is a very busy 64-bed unit that gets
15–20 admissions a day,” says Mary Viney, Seton
Northwest’s director of patient care. The unit can be inundated with requests to take in new patients, but it relied on an ineffective process to manage this, she adds.
The new system is enhancing productivity in subtle
ways. “Once the information became visible, there was
a real sense of teamwork. Everyone could see who
was swamped. And people started being proactive,
pitching in to help get someone ‘out of the red,’ ”
says Viney.
The staff person in charge of bed placement used to
Source: IHI, www.qualityhealthcare.org.
Page 2
© 2004 HCPro, Inc.
Strategies for Nurse Managers—July 2004
www.hcpro.com
JCAHO
Patient Safety Goals
< p. 1
departments on the same page is one challenge to
starting a bar-code system, says Priti Merchant,
PharmD, clinical pharmacy coordinator at Warren
Hospital in Phillipsburg, NJ. Hospitals would need to
educate pharmacy staff about bar-coding drugs and
teach nurses how to use scanners. The hospital would
also need to print patient-identification wristbands
with bar codes.
nursing staff would not have to worry about mixing
them without pharmacists available.
Monitor look-alike and sound-alike drugs
Under this proposed goal requirement, hospitals
would have to maintain a list of look-alike and
sound-alike drugs they use. They would also have to
take steps to prevent staff from selecting the wrong
drug by mistake.
Prepare IVs in pharmacy only
One proposed goal would restrict IV-drug preparation to the pharmacy. Pharmacies could opt to use
commercially premixed IV fluids in place of or in
addition to preparing fluids in the pharmacy.
Premixed medications tend to cost more, but they
could help hospitals without 24-hour coverage, says
Kasey Thompson, PharmD, from the American
Society of Health System Pharmacists. IV fluids
would be available in floor stock after hours, and
Although Deaconess Hospital in Oklahoma City
does not have a list of look-alike and sound-alike
drugs, Risk Manager Tim O’Kelley, RN, says it makes
sense to create one, as there might be confusion
about drugs with names such as Cardizem and
Cardizem CD, which both treat chest pain but have
different dosage requirements, he says.
Source: Hospital Pharmacy Regulation Report,
May 2004, HCPro, Inc.
JCAHO
Nurses now more responsible for describing
patient care during a JCAHO survey
JCAHO surveyors now prefer to talk to nurses rather
than managers because they are on the front lines of
patient care, says Mary Jaco, RN, MSN, nursing
director of inpatient services at Shriners Hospital for
Children in Galveston, TX.
Jaco’s facility underwent a three-day survey in February. A nurse surveyor toured the hospital and,
rather than meet with hospital leaders, the surveyor
preferred to chat with frontline staff, patients, and
their families, says Jaco.
Jaco had heard about the new focus prior to survey,
but she didn’t realize how heavily the surveyor would
rely on the nursing staff to paint the full picture of
Strategies for Nurse Managers—July 2004
patient care.
Jaco says that while the surveyor was speaking to one
nurse, she asked about the nutritional screening process. This was no problem, as this is a direct nursing
role. However, the surveyor then asked about the dietician’s role, which a nurse may not necessarily know.
“The nurse is now seen as the center point person
for the patient in the eyes of the JCAHO,” she says.
“So the nursing staff must be aware of what all the
other departments are doing.”
Source: Adapted from Briefings on JCAHO, June
2004, HCPro, Inc.
© 2004 HCPro, Inc.
Page 3
www.hcpro.com
Interdisciplinary care corner
Use patient-focused statements
to better communicate across disciplines
Without clear, consistent communication across disciplines, your facility’s interdisciplinary approach to
patient care is doomed to fail.
Sharing assessment findings, identifying patient problems and goals, and prioritizing these problems and
goals cannot be successfully accomplished without
effective written and verbal communication across all
disciplines.
Question: In documenting the care of a patient,
the nurse describes the patient’s problems with
phrases such as “alteration in fluid volume deficit,”
“alteration in respiratory status,” and “ineffective
coping.”
What is wrong with how these problems are stated,
and how could they be restated to promote a better
interdisciplinary understanding of the patient’s
needs?
Answer: The problem statements have to reflect
your patient. If they do not, they reflect the particular discipline that authored them, and suddenly the
problems become that discipline’s problems. As a
result, the other disciplines involved in that patient’s
care often cannot understand what is communicated.
Your problem statements should be patient-focused. For
example, write “No money to buy medications,” “does
not understand how to change dressing,” or “unable
to get out of bed without two people assisting.”
Staff activity: Read the active record of a patient
receiving care from members of a care team who
represent different disciplines. Write a list of words
or phrases used in the record that are unclear. Then
share this list with the nurses and other healthcare
professionals on the care team.
are unclear and share the results with other nurses
on the unit.
Have team members from different disciplines try
the same exercise with the same chart, and then
discuss substitute words and phrases that would be
more useful to build a common language for future
documentation.
Source: Adapted from Working in Interdisciplinary
Teams to Improve Patient Care: A Staff Training
Handbook, HCPro, Inc.
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Try to find a better translation for the phrases that
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Strategies for Nurse Managers—July 2004
www.hcpro.com
Patient safety
In a high-alert medication pinch? Create
a double-check system
Get nurses on your staff to understand the importance of having a colleague double-check high-alert
medications before giving them to patients.
Creating a PINCH high-alert medication list to tell
nurses which orders they need to double-check
before they administer drugs is one way to get the
point across.
Many hospitals have created versions of a PINCH list
to help nurses remember high-alert medications.
Robin Keyack, RPh, assistant vice president of
pharmacy services for Virtua Health, a four-hospital
system in New Jersey, says her organization’s list
stands for the following:
Strategies for
Nurse Managers
reader survey
In your last issue of Strategies for Nurse
Managers, we included a reader survey but
inadvertently neglected to include a selfaddressed stamped envelope.
We apologize for this oversight. We have since
sent the survey, with an envelope, to you via
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Again, we apologize for any inconvenience or
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look forward to receiving your valuable feedback, which will help us tailor Strategies for
Nurse Managers to best meet your needs as a
nurse leader.
Strategies for Nurse Managers—July 2004
•
•
•
•
•
•
Patient-controlled analgesia
Potassium challenges
Insulin drips
Narcotic drips
Chemotherapy
Heparin drips
When nurses administer a drug from this list, another nurse must double-check the order, Keyack says.
Nurses must double-check the medication and the
order at four different stages, including when
•
•
•
•
they hang the IV bag
they change the IV bag
the medication administration rate changes
the patient is transferred to another unit
Source: Hospital Pharmacy Regulation Report,
April 2004, HCPro, Inc.
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Call customer service at 800/650-6787 to register.
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Recruitment
Have a minimal recruiting budget? Find more
nurses with these inexpensive tips
Do you need to recruit nurses but have only a minimal budget? Try these low-cost suggestions:
1. Top-performer referrals. Ask your top nurses individually to increase their referrals to five
a month. Ask them to refer their “mentees,”
friends, and former colleagues.
2. References of candidates. When checking the
references of candidates who look exceptionally
promising, ask them, “Is there anyone else you
would recommend?”
3. First day of new hires. Ask all new hires on
their first day whether they know any other
high-quality nurses at their former facility. Ask
them to help you recruit any of these targeted
individuals.
4. Job descriptions. Rewrite your job descriptions to resemble marketing pieces. Identify
the features that excite your current employees and include these perks in your job
descriptions.
5. “Find you again” profile. Ask your current
nurses how you would find them again. Ask
them what healthcare and social events they
attend, what magazines and journals they read,
etc. Use this information to identify the sources
that are the most likely to produce results.
6. Almost qualified. Take another look at the
finalists from previous hiring efforts and see
whether they are more qualified now and you
are willing to give them a second look.
7. Boomerangs. Call nurses who left your facility
and ask them whether they would like to return.
Also ask them to be referral sources.
8. Any authors on staff? Have your best nurses
Page 6
© 2004 HCPro, Inc.
written articles in nursing journals? Has your
facility been written about for your best practices? The publicity is an excellent referral
tool.
9. Bring a friend to work day. Hold an invited open house at your site and encourage
your nurses to bring their fellow nursing
friends.
10. Hold a contest. Challenge your nursing staff to
spend a month identifying the best nurses within the region. Make it a friendly competition
(with a prize) and encourage each nurse to
scour their e-mails, and address books for the
names of potential hires.
11. Sell sheet. Attach a “sales sheet” to your application that highlights the best practices and features of your facility.
12. Chat rooms. Have your best nurses frequent
nursing-related Internet chat rooms and list
servers. Ask them to answer tough questions to
build your facility’s image and brand as a great
place to work.
13. Trade fairs. Ask your best nurses attend and
speak at trade fairs and industry conferences.
Having these nurses discuss their best practices
is an excellent recruiting tool.
14. Employee referral program (ERP). The most
effective recruiting tool of all is the ERP. Revisit
your facility’s program and help reenergize its
marketing program. Consider holding a raffle for
an enticing prize for all those that made referrals
during the quarter.
Source: “Recruiting Nurses (With No Recruiting Budget)” by Dr. John Sullivan, www.drjohnsullivan.com.
Adapted with permission.
Strategies for Nurse Managers—July 2004
www.hcpro.com
Training
Cultural diversity training: Enhance your staff
orientation to improve patient care and satisfaction
Educating staff on respecting patients’ cultural differences not only complies with a JCAHO requirement;
it also significantly improves patient satisfaction and
helps your nurses provide better patient care.
day of orientation, says Fagan. Any new managers,
supervisors, or directors have to meet with Fagan
during their first six months for a more detailed explanation of the diversity council and its goals.
JCAHO’s standard HR.2.10 says facilities must include cultural diversity and sensitivity training as
part of their employee orientation program.
Cultural competency is one of the topics addressed
during nursing orientations. A culturally competent
nurse is able to adapt the hospital’s policies and
practices to function effectively in a cross-cultural
setting, says Fagan. Respecting differences is crucial
to achieving cultural competency, she adds.
For staff at BryanLGH Hospital in Lincoln, NE, cultural diversity is a way of life. Lincoln is the fifth
largest city for refugee resettlement in the United
States, and approximately 40 languages are spoken
in the city’s public schools, says Helen AbdaliSoosan Fagan, the hospital’s diversity coordinator.
It’s not easy to include more content to any orientation program. However, role-play, discussion, and
distance learning techniques can all be used to provide basic information.
Staff at BryanLGH saw diversity training as an opportunity. Their commitment to diversity would help
recruit and retain employees, provide better patient
care, and involve the hospital more in the community. The hospital created a strategic plan for diversity, including the creation of Fagan’s position and a
diversity council to help meet these goals.
Allow time for face-to-face discussion as well. Include
information about how cultural differences manifest
themselves in patients, visitors, and colleagues.
Source: Adapted from Briefings on JCAHO, November 2003, and HCPro’s newly published book, A
Practical Guide to Staff Development: Tools and
Techniques for Effective Education by Adrianne E.
Avillion, DEd, RN. For more information on both
products, visit www.hcmarketplace.com.
One strategy was to enforce ongoing training. When
new employees start working at BryanLGH, they review the hospital’s diversity initiative during the first
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Strategies for Nurse Managers—July 2004
© 2004 HCPro, Inc.
Page 7
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Staff management
Nurse leader rounding crucial to employee satisfaction
Nurse rounding is one of the best ways for nurse
leaders to win the respect of their staff and lead the
entire unit toward improved customer service.
Quint Studer, CEO of the Studer Group, a consulting
firm that helps guide organizations through major
changes, has identified nurse manager rounding as
one of the most important tools that contribute to
employee and patient satisfaction.
to connect the dots on why they don’t have the item
in question without blaming administration.
Managers should also reward and recognize staff
during rounding. Ask questions or make observations to assess whether staff perform in the manner
you are trying to achieve, and then specifically recognize those who demonstrate the desired behavior.
The key is rewarding and recognizing behavior that
is repeated.
When nurse managers make rounds, their goals are to
• fix and monitor systems
• ensure that goals were accomplished
• model desired behavior
• talk to individuals in the department and update
information
Studer recommends that nurse managers set aside
time each day for rounding. For example, you may
want to begin meetings after 10 a.m., with the
understanding that the time spent before 10 a.m. is
spent rounding in work areas.
Managers should have a key question to ask staff,
such as, “Do you have what you need to do your job
today?” If staff need something, this is an opportunity
Source: Adapted from the HCPro book Handling Difficult Patients: A Nurse Manager’s Guide, by Richard A.
Bryan, BSN, RN, CCM, and Linda Childers.
Leadership tips
Trust: The key to effective management
Fewer than half of employees surveyed trusted the
leaders of their organization, according to a study
recently conducted by a human resources consulting
firm based in Chicago.
Remember these six effective ways for leaders to
build trust within their staff:
1. Invoke the law of reciprocity. To receive trust,
you have to give it first.
2. Ensure that your word is always as good as gold.
Team members should never have to secondguess anything leaders tell them.
3. Hold everyone accountable. Team members need
to be held accountable for their actions. One way
to do this is to have them commit to this powerful axiom: “If it’s to be, it’s up to me!”
4. Establish boundaries. Trust works when people
Page 8
© 2004 HCPro, Inc.
know they can count on each other to do a certain thing a certain way. Leaders must discipline
themselves to expect that their team members are
going to operate within those boundaries.
5. Walk your talk. Trust will only come alive if leaders reinforce their words with actions. Leaders
must be the role model for everything they want
to happen on their team.
6. Practice high-touch. There simply is no shortcut
to developing trust with another human being. It
can’t be done via the Internet, voice mail, faxes,
or other electronic media. It requires personal
contact.
Source: Don’t Oil the Squeaky Wheel and 19 Other
Contrarian Ways to Improve Your Leadership Effectiveness, by Wolfe Rinke. McGraw-Hill, New York,
2004. Adapted with permission.
Strategies for Nurse Managers—July 2004
www.hcpro.com
Preceptorship
Choose wisely when selecting a nurse preceptor
The success of your preceptorship program is highly
dependent on the selection and training of qualified
preceptors. That’s why it’s important to clearly establish the selection criteria.
Here are some suggested criteria that your preceptor
candidate should demonstrate:
• Expresses desire to serve in the role of preceptor
• Has education commensurate with the preceptor
role (e.g., bachelor’s degree, critical-care certificate, etc.)
• Is employed on the nursing unit; assigned for at
least two years
• Has no negative evaluative performance criteria in
the past year
• Has all unit competencies/annual education
requirements up to date
• Serves on a professional practice committee
• Has no planned extended vacation periods during
the preceptorship period
• Possesses a clear understanding of his or her
duties and acts as a role model for professional
nursing practices
• Is able to apply nursing theory in the workplace
An application process that involves a checklist
approach to the above criteria will ensure that you
select only the most qualified preceptors.
In addition to unit preceptors, also consider identifying assistant preceptors who may fill in when the
preceptor has other obligations or in the case that he
or she has an unexpected illness or absence.
The following are some possible incentives:
• Hourly wage differential during the preceptorship
period
• Fixed bonus pay at the end of the preceptorship
period
• Reimbursement for attending a regional continuing education program
• Reimbursing tuition costs for courses taken
toward a degree
• Preceptor/preceptee recognition meal
• Article in the institution newsletter
• Cross appointment (e.g., adjunct professor position) with the academic institution providing
nursing students to the program
Positive reinforcement is critical if the preceptor is to
continue in this expanded and demanding role.
Decision time
To make a decision from among the preceptor program applicants, review the characteristics that an
ideal nursing preceptor possesses:
• Knowledge—of the policies, procedures, rules,
regulations, and care practices of the institution.
• Skill—at performing the technical aspects of
the position. The ability to model excellence in
nursing practice and not taking short cuts ensures that the preceptor is respected by the
preceptee.
• Ability—to integrate knowledge and skill into
daily interactions in the healthcare environment.
• Good attitude—to be willing to use that knowledge, skill, and ability all the time.
Incentives
Attracting quality nurses who will take on the additional responsibilities that come with preceptorship
may require offering some incentives.
Researchers have found that the amount of recognition and reward given to a preceptor directly reflects
the value that healthcare institutions place on nursing clinical excellence and new nurse retention.
Strategies for Nurse Managers—July 2004
Also, ensure that your candidate is organized, resourceful, can adapt easily to change, can identify
learning opportunities, and can communicate clearly
by making and receiving constructive comments.
Source: Nurse Preceptor Program Builder: Tools for a
Successful Preceptor Program, by Brian Rogers, RN,
BSc, CCRN, DHA, EMT-HP. HCPro, Inc.
© 2004 HCPro, Inc.
Page 9
www.hcpro.com
Nursing shortage
Analyzing the shortage: Low number of RNs
linked to increase in adverse events
A compilation of nurse staff analyses showed that
hospitals with fewer nurses have higher rates of poor
patient outcomes. The group of six studies funded
by the Agency for Healthcare Research and Quality
(AHRQ) found that hospitals with nurse staffing problems and fewer RNs than LPNs were more likely to
have outcomes such as pneumonia, shock, cardiac
arrest, and urinary tract infections (UTIs).
The studies classified these adverse patient outcomes
as “nursing sensitive.” For example, researchers found
a considerable link between staffing levels and rates of
pneumonia among patients. Researchers believe the
link exists because of the significant responsibility RNs
have for surgical patients’ respiratory care. Researchers found that when the number of RNs increased
by 10%, the chance that a patient would contract
pneumonia decreased by 10%.
Nurse educational levels were also a factor in poor
patient outcomes. Patients in hospitals with more
RNs had lower rates of UTIs, pneumonia, shock, and
upper gastrointestinal bleeding. They also had shorter lengths of stay than patients in hospitals with
fewer RNs on staff.
Although hospitals may worry that hiring more RNs
will impact the facility’s finances, the study says differently. A 1% increase in full-time RNs increased a
facility’s operating expenses by 0.25%, but did not
affect the institution’s profit margins.
Several nurse-staffing bills are currently pending
across the country, including national legislation proposed by Representative Lois Capps (D-CA), an RN
and co-chair of the House of Representatives Nursing Caucus.
Source: Hospital Nurse Staffing and Quality of Care,
AHRQ.
Analyze staffing data and find patterns to alleviate low staff levels
Most facilities know they need more nurses on
staff—the difficulty is finding and retaining nurses
during this nursing shortage.
Laura Harrington, RN, CPHQ, practice director
of external peer review and credentialing for the
Greeley Company in Marblehead, MA, says one
solution is to strategically plan on pursuing magnet status—a proven way to attract quality nurses
to your facility.
A more short-term solution is to analyze your
staffing data and see where the problems lie in
retaining nurses on your unit. “If you don’t know
what you’re doing wrong, you can’t solve the
problem,” says Harrington. Create a database to
track staff levels, or purchase a staffing tool that
Page 10
© 2004 HCPro, Inc.
has a spreadsheet component.
If your unit has had an adverse event, Harrington
advises looking at the big picture and identifying
patterns related to staffing. “When something goes
wrong people don’t think it happened because of
a staffing issue,” says Harrington.
Nurses are often called on to perform procedures
they may not be adequately trained to do. Harrington suggests cross-training your nurses so if they
are pulled into a situation that isn’t their specialty,
they can easily fill in and provide quality care. “Use
their skill level to drive where they should be
cross-trained,” says Harrington. For example, a critical-care nurse would benefit from cross-training in
the ED rather than in pediatrics, she says.
Strategies for Nurse Managers—July 2004
www.hcpro.com
Technology
Take the first step
toward improving your
computer literacy
Have you made technology
a top priority in your unit?
If not, why? In many cases,
someone holds the department back from adopting
new technology because
he or she is not confident in
his or her own computer literacy, said Bill G. Felkey, MS, associate professor of
pharmacy care systems at Auburn (AL) University.
Felkey suggests nurse leaders who aren’t confident
in their own computer skills start by understanding
how to use Internet search engines. Felkey advises
going to Google (www.google.com), clicking on the
link to basic search tips, and then moving on to the
advanced tips.
Also download NetMeeting software from Microsoft
and learn how to connect with other nurse leaders
over the Web. These first steps will help you get a
handle on what new technology has to offer you,
your staff, and your patients.
Source: Adapted from “High Tech = High Touch:
Integrating Information Systems and Other Technologies that Transform the Point of Care,” presented by
Felkey during the American Organization of Nurse
Executives’ 2004 Annual Meeting in Phoenix.
Questions? Comments? Ideas?
Contact Associate Editor Rebecca Delaney
Telephone:
E-mail:
781/639-1388,
Ext. 3157
rdelaney@hcpro.com
Strategies for Nurse Managers—July 2004
Tech tip: Spice up your
next speech to leadership
If you have to make a speech to senior leadership and you are worried about how to organize
your PowerPoint presentation, Bill G. Felkey,
MS, associate professor of pharmacy care systems
at Auburn (AL) University, has some advice:
Go to Google (www.google.com) and click the
image search tab. Type in the topic of your presentation, and Google will return hundreds of
photos you can add—with proper attribution—
to your slide show. Next, click on the “Advanced
search” link, enter your subject, and instruct
Google to return only files in Microsoft PowerPoint format (.ppt). You can check out how
other people around the globe chose to address
the subject.
Source: Adapted from “High Tech = High Touch:
Integrating Information Systems and Other Technologies that Transform the Point of Care,” presented by Felkey during the American Organization
of Nurse Executives’ 2004 Annual Meeting in
Phoenix.
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© 2004 HCPro, Inc.
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Nurse-physician communication
Improve nurse-physician phone communication
New nurses may have trouble quickly and efficiently
communicating with physicians over the phone.
Instead of flipping though charts and wasting both
their and the physicians’ time, nurses at Zeeland
(MI) Community Hospital use a laminated “cheat
sheet” attached to their ID badges that guides them
through eight steps to communicating effectively.
“We noticed that, especially for new RNs, it was
sometimes difficult to communicate with physicians
over the phone. That’s where a breakdown usually
occurred,” says Sandy Nelson, BS, RN, nursing
practice educator at Zeeland Community Hospital.
“Our new nurses really appreciate the cards.”
Take the following eight steps when contacting
physicians:
1. Gather patient information (i.e., review progress
notes, have chart in hand with most recent vital
signs and diagnostic tests).
2. Collaborate with another nurse or the patient
care manager if you’re not sure whether the call
is necessary.
3. Call the correct physician.
4. Introduce yourself (i.e., state your name, title,
hospital, and department).
5. Briefly state your business (e.g., state the patient’s
name, diagnosis, and issue). Ask whether the physician is familiar with the patient and let him or her
know who the patient’s primary-care provider is.
6. Be prepared to take orders. Recite orders back,
spelling drug names and checking dosage and
route.
7. Inform the physician if you want him or her to
come in and ask for estimated arrival time.
8. Document the call and expedite orders.
We want to hear from you
Strategies for Nurse Managers
Editorial Advisory Board
Shelley Cohen, RN, BS, CEN
President
Health Resources Unlimited
Hohenwald, TN
Bob Nelson, PhD
President
Nelson Motivation, Inc.
San Diego, CA
Sue Fitzsimons
Senior Vice President
Patient Services
Yale-New Haven Hospital
New Haven, CT
Tim Porter-O’Grady, EdD, RN, CS, CNAA, FAAN
Senior Partner
Tim Porter-O’Grady Associates, Inc.
Otto, North Carolina
David Moon
Executive Vice President
Modern Management, Inc.
Lake Bluff, IL
Dennis Sherrod, EdD, RN
Forsyth Medical Center Distinguished
Chair of Recruitment and Retention
Winston-Salem State University
Winston-Salem, North Carolina
For news and story ideas:
Contact Associate Editor Rebecca Delaney
• Phone: 781/639-1872, Ext. 3157
• Mail: 200 Hoods Lane, Marblehead, MA 01945
• E-mail: rdelaney@hcpro.com
• Fax: 781/639-2982
Publisher/Vice President: Suzanne Perney
Group publisher: Kathryn Levesque
Online resources:
• Web site: www.hcpro.com
• Access to past issues: www.hcpro.com/onlinepubs
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Page 12
© 2004 HCPro, Inc.
Strategies for Nurse Managers—July 2004