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Nursing project to improve care at bedside

Local team of nurses at Riverwood Healthcare on board

 Riverwood Healthcare Center is one of 22 Minnesota hospitals participating in an 18-month project to improve care at patients’ bedsides through nurse-led innovations.

 “Transforming Care at the Bedside” (TCAB) works to empower nurses and other bedside caregivers to suggest, test, and implement potential solutions to problems.

 “We are excited to participate in this initiative to improve quality of care for hospital patients,” says Kristine Layne, chief nursing officer at Riverwood Healthcare Center. “As highly trained professionals who spend the most time with patients and their families, nurses play a central role in ensuring the quality and safety of hospital care. They are well-suited to help lead efforts to improve clinical outcomes for patients and overall patient satisfaction with their hospital stay.”

 The Riverwood team of registered nurses includes team leader Jody Ennis, Dawn Ahonen, Joanna Brenny, and Traci Moreland.

 This is the second TCAB project to be hosted in Minnesota. The first cohort of 23 hospitals started in 2010 and will complete their work this February. In addition, three other Minnesota hospital teams are participating in national TCAB training, bringing the total to 50 teams in Minnesota.

 The goals of this initiative are 1) to improve the quality and safety of patient care and reduce disparities in care; 2) to increase the vitality and retention of nurses and frontline staff; 3) to engage and improve the patient’s and family members’ experience of care; and 4) to improve the effectiveness of the entire care team.

 TCAB is part of a national Aligning Forces for Quality initiative funded by the Robert Wood Johnson Foundation. The overall Minnesota effort is led by Minnesota Community Measurement, which partners with the Minnesota Hospital Association (MHA) to organize and coordinate TCAB.

 This initiative has demonstrated impressive results in Minnesota and nationwide. Thus far, one or more Minnesota participants have reported: half as many falls; half as many medication variances, or wrong medication time/dosages; increasing the number of patients triaged upon arrival to the emergency room from 58 percent in August 2010 to 98 percent in March 2011; and increased patient satisfaction scores.

 Generally, before hospitals implement TCAB, nurses spend not quite one-third of their time at the bedside. After putting TCAB into place, some teams have been able to raise that figure to 60 percent. Minnesota TCAB teams do not yet have data measuring how much time nurses spend at the bedside, but many teams estimate they have improved by 20 percent to 30 percent.

 In addition, one team decreased the time nurses spent admitting a new patient to their unit from an average of three hours to an average of one hour. Nurses have significantly decreased the amount of steps they take during shifts, as measured by pedometers. Teams have reported decreases from 20 percent to 45 percent. Many teams did so by moving supplies closer to the bedside, which reduces time spent looking for and gathering appropriate supplies. The improvement allows nurses to have more time at the bedside with their patients.

 The program also aims to increase retention of nurses and front-line staff; improve the patient’s experience and improve the effectiveness of the entire care team. Participating nurses will share their successes and lessons learned with other hospitals across the country.

 “At Riverwood, our newly designed inpatient area will support the Transforming Care at the Bedside quality initiative by putting nurses closer to hospital patients,” Layne adds. “When our new inpatient rooms open in the spring, we’ll have nurse viewing stations located between every two single hospital patient rooms. This will enable nurses to spend more time monitoring patient care and preventing falls.”

For more information on this initiative to improve healthcare quality, contact Rachel Jokela, Minnesota Hospital Association patient safety and quality coordinator, at (651) 659-1404, or go to www.forces4quality.org

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