12:24pm Friday 20 October 2017

Nurses connect the dots between data and better patient care

New nurses Maria Laylo and Zeinab Yusuf lead a five-minute Soarian education session with nurse Anna Solala. (Photo by Yuri Markarov)

New nurses Maria Laylo and Zeinab Yusuf lead a five-minute Soarian education session with nurse Anna Solala

“I had never done research or quality improvement before, so I volunteered,” said Laylo. “It looked like a good opportunity for a new nurse like me to learn and make a change in our unit.”

The Knowledge Translation of Performance Data for Frontline Nurses and Leaders Project (known as PERFORM KT) connects front-line nurses with research mentors and provides monthly education sessions. With this support and some dedicated backfill time, nurses analyze and use their unit’s performance data to identify and plan improvements to care.

Laylo, Zeinab Yusuf (also a new nurse) and their mentor found an important gap in the unit’s documentation: although their own patient surveys showed that nurses were performing pain assessments appropriately, that work wasn’t showing up in Soarian. Laylo and Yusuf designed five-minute Soarian education sessions to take place whenever colleagues had a spare moment at the nursing station. They’ve seen a big jump in documentation of pain since then.

In Gastro/General Surgery, nurses Stephanie MacDonald and Beharta Bregasi joined the program to look at their unit’s data on falls. They discovered that 65 per cent happened between midnight and 7 a.m. MacDonald and Bregasi introduced “intentional rounding” on the night shift, using a standard script. This means that every night on their unit, a team of one nurse and one clinical assistant visit patients hourly to offer assistance with activities such as toileting and remind patients to ask for help.

    PERFORM KT is a research study funded by the Ontario Ministry of Health and Long-Term Care and led by Dr. Lianne Jeffs, St. Michael’s Volunteer Association chair in nursing research and director of nursing/clinical research. Several Ontario hospitals are participating in the program.

Joanne Bennett, a clinical leader/manager on the unit, said the strength of MacDonald and Bregasi’s approach was in their consultation and collaboration with their peers.

“It took many, many iterations of the rounding sheet and process to get it right,” said Bennett. “But it meant they had front-line buy in from the beginning; everyone agrees that their process is doable and equitable. Stephanie and Beharta led the initiative themselves, and engaged champions to help them.”

Through the program, Respirology nurses Jessie Kar Yan Chiu and Michelle Ng discovered that their unit’s patient satisfaction scores for pain management were low. They developed an in-service education session for their peers.

“It makes sense for a bedside nurse to be doing this kind of research,” said Ng. “We have the perspective on patient care, and we are tuned into issues facing our unit’s nurses.”

About St. Michael’s Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.


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