Welcome to the new department, Nursing Professional Development: Stories, Tips, and Techniques. I am excited about all the possibilities that lie ahead with that terrific new scope and promise.
Many people I meet have excellent stories, tips, and techniques they are willing to share with this journal. There is one consistent challenge I have found in asking people to share those in writing. Many people believe that they must write volumes of academic-style information to submit items for publication. This department benefits from quick, easy-to-replicate ideas and stories others can relate to and that are written in a conversational tone. I invite readers to accept the challenge to submit ideas in a writing style as if you were sharing them with a friend or colleague at work who could benefit from your experience.
Thanks to Dana Bush, MN, RN, Associate Professor, Cox College School of Nursing, Springfield, MO ([email protected]) who submitted this technique to remember the 12 cranial nerves while thinking about a visit to a coffee house:
The 12 Cranial Nerves and the Coffee House Visit
When you walk into this famous coffee house, you[horizontal ellipsis]
I. Smell the coffee aroma (olfactory)
II. Read the menu about 20 feet away (optic), then your
III. Pupils constrict as you look at items, such as the muffins, a bit closer (oculomotor)
IV. You look up at the sales person and down at your money as you pay (trochlear)
V. You clench your teeth and touch your face when they call out your drink order (trigeminal)
VI. You look side-to-side to see if anyone else has ordered the same drink (abducens)
VII. You smile because you realize this IS your drink (facial), then
VIII. You hear someone say "You can sit here; we are leaving." (auditory) As you sit
IX. You taste the sweet whipped cream on top of your drink (glossopharyngeal)
X. You say "Ahhh, this is good!" (vagus)
XI. You look at the person next to you because he heard you and frowned; then you shrug your shoulders (spinal accessory)
XII. When he looks away, you stick your tongue out at him (hypoglossal).
Thanks also to Nan Howland, BSN, RN, CPN; Andrea Platt, BSN, RN; and Lynn Crist, BSN, RN, ONC, all education consultants at St. Vincent Indianapolis Hospital, Indiana, who submitted a great idea on how to teach The Joint Commission's National Patient Safety Goals in orientation. These authors described their approach as follows:
Compliance with The Joint Commission 2008/2009 National Patient Safety Goals (NSPGs) is a primary initiative at St. Vincent Indianapolis Hospital and is supported by ongoing education. The consultants of the Education and Development Department identified the need to feature nine of the NSPGs established for hospitals (The Joint Commission, 2008) in nursing orientation.
The meaning and rationale of the NPSGs, woven throughout the nursing orientation presentations, were often lost within the multitude of facts, statistics, and policies. The overload of information affected some associates' ability to recognize and recall the NPSGs at the end of the week. The education consultants identified this barrier and developed a teaching tool to facilitate the learning process.
Over several weeks, analogies and/or rhymes were created and songs were identified to correlate the meaning of the NPSGs to the actual goal number. It was vital that the consultants be able to verbalize the intent of each goal prior to determining the method of presentation. Some goals seemed more obvious and easily lent themselves to rhymes or analogies while others were more challenging.
The end result was a multimodal presentation that includes an instructor-led discussion, handouts, and a teaching tool that contains all of the safety goals and the rhyme or analogy. Associates have found the session to be engaging, entertaining, and an effective method for relating each goal number to its meaning and how each is put into practice at St. Vincent.
THE NATIONAL PATIENT SAFETY GOAL TEACHING TOOL
The education consultants started with NPSG 1 which states "Improve the accuracy of patient identification using at least 2 [patient] identifiers when providing care, treatment, and services." Our analogy is, "The patient is always #1 with us." It is emphasized to the associates that each patient has only one name and one medical record number.
NPSG 2 states, "Improve the effectiveness of communication among caregivers." Our analogy is, "It takes 2 to communicate." A song was chosen to reinforce the association between the goal number and importance of effective communication. The chorus Symbol"It takes two baby[horizontal ellipsis]me and you!"Symbol (Stevenson & Moy, 1966) is sung to the associates by the facilitator of the presentation.
NPSG 3 states, "Improve the safety of using medications." Our analogy is to "Check three times for medication safety." In orientation, associates are reminded to check the physician's order, check the medication, and check the patient's identification prior to medication administration.
The next applicable NPSG for the acute care hospital is 7 "Reduce the risk of health care associated infections." Our rhyme is "Goal number seven, you might go to heaven-if you get an infection." Hand hygiene with soap and water or hand sanitizers upon entering and leaving patient rooms is emphasized with associates.
NPSG 8 states, "Accurately and completely reconcile medications across the continuum of care" was an easy play on pronunciation and spelling. Our analogy, "Goal number eight means to reconcili-eight!" is quickly echoed by the new associates. A brief discussion of responsibility in medication reconciliation at multiple points of care from admission to discharge is held. An in-depth discussion of the reconciliation process is presented in a medication-focused segment later in the week.
NSPG 9 states, "Reduce the risk of [patient] harm resulting from falls." Our rhyme is, "Goal number nine: don't fall on your behind." This rhyme is easy for learners to remember as evidenced by discussion in the Falls Risk Program presentation later in the day.
NPSG 13 states, "Encourage [patients'] active involvement in their own care as a [patient] safety strategy." The goal number was split for an effective rhyme: "One (1) & three (3) = Please involve me!" Examples of the importance in involving the patient and significant others in their care are presented.
NPSG 15 states, "The organization identifies safety risks inherent in its [patient] population." NPSG 15.01.01 identifies patients at risk for suicide. Our rhyme: "One (1) & five (5) = Help keep me alive!" This NPSG is addressed because the hospital treats patients with behavioral and/or emotional disorders.
NPSG 16 states, "Improve recognition and response to changes in a patient's condition." Our rhyme is, "One (1) & six (6) = My patient's getting sick." We share how the hospital has established a rapid response team which may be initiated by associates, patients, and/or families to assist in these identified situations.
RESULTS
The effectiveness of this innovative program was tested when mock surveyors challenged nursing associates with questions regarding the NPSGs. Surprisingly, new associates could articulate the safety goals more thoroughly than could seasoned associates. Surveyors reported that new associates stated that they recalled the analogies, rhymes, and/or songs associated with the goals presented in nursing orientation.
The education consultants were asked to present program content to executive nursing leadership. The teaching tool was well received and disseminated throughout the hospital as a learning opportunity for all bedside caregivers.
CONCLUSION
This program has been very successful and lends itself to be adapted as The Joint Commission makes changes to the NPSGs in the future. This approach is just one example of how the education and development department continues to make learning opportunities fun, memorable, and interactive for all associates.
REFERENCES