January 2013: 7C Staff Meeting

Wins & Managing Up

•   7C has a new vein light, it is the same light that the NNICU has.  Thanks to Amelia for writing a grant!
• Lindsay Amerman was accepted into graduate school!

Staffing Update

·         Erin O’Donnell: our new educator, she has former RN experience in the PICU at MUSC and the PICU at CHOP.

·         Julianne Walsh: new RN, she has approximately 3years experience in peds.  Her most recent position was at a Children’s Hospital in San Diego, CA.  She’ll be orienting with Kate Siegfried for approximately 8 weeks.

·         Liza Hoover resigned – she is travelling to France and Syria.  Liza plans to return to MUSC as a Meduflex RN in the future.

Education Update

·         New 2013 Competency Model- Donna Wright: The Medical Center is moving to a new competency model where everyone identifies an area that needs to be reviewed each year instead of just doing the same competencies year after year.

o   A competency worksheet will be placed in everyone’s mailbox and staff will have one month to complete the assessment.  The worksheet will highlight: things that I know, things that are problematic, etc.  Competencies and problem areas can be identified as High, Medium or Low.  The other piece will be that competencies can now be done in different formats – possibly a demonstration or showing charting documentation. 

·         Please remember to be detail-oriented when filling out the competency worksheet.

o   A group of 2 or 3 people interested in working on the competencies would be helpful – this could be a good RN III project.

o   Competencies will start to be due on a fiscal year basis: July 1 – June 30 and will be handed to staff at the beginning of the year.  Nurses will be held accountable for doing their own competencies within that year.  HR is deciding how to monitor and handle competencies in the new format, there may be disciplinary action if competencies are not done within the year.

o   PCT competencies will also be included in the new model.

o   The amount of competencies will be reduced and limited to 6 – 10 annually.  More instructions will go out when assessment has been distributed.

·         The PICU and 7C now have a Pediatric Critical Care blog.  An email containing the link was sent out by Melinda on January 14, 2013.  The blog will be posted as a “favorite” on all computers on the unit.  The blog will be used to post pictures, post updates easily, survey monkeys, needs assessments, etc. 

o   Blog has been created to cut back on emails. 

o   Expectation: check the blog at least once a week.

o   A search gadget has been posted on the blog, this will enable staff to type in a keyword and find a blog that was posted in the past on a particular subject. 

o   Comments are able to posted on the blog – always post your name if you comment on the blog.

o   Reminder – the blog is NOT a protected MUSC site, please do not violate patient confidentiality and HIPAA.

 

 Patient Satisfaction

·         Lisa McCormick and Kate Santos Seay are on the patient satisfaction committee.  Please let them know if you have any ideas to help improve patient satisfaction – we need to work on our hourly rounding.  Remember to let families know at discharge that they may receive a patient satisfaction survey.  Last quarter the 7C was in the 99^th percentile.  We received 12 surveys back – we need 30 surveys returned to receive the Patient Satisfaction banner.

Cost Savings

·         Heron Human Resources Action Plan: Heron is a consulting group that MUSC has partnered with to help find cost saving measures within the organization.  With recent healthcare changes, the hospital has to plan to operate with 57 million dollars in cuts each year in revenue for the next 5 – 7 years.  Current changes that will affect the staff are:

o   Decreasing the WOW shift differential. WOW differential will decrease from $10/hour to $7/hour.  This will provide the hospital with approximately 900 thousand dollars in savings.

o   PTO changes: this will not affect employees on 7C, only employees who were here prior to 2001 and are on the “plan A” program, these employees will accumulate less PTO.  Employees who started after 2001 will not be affected by this change.  The savings for PTO accrual changes will be approximately $1.9 million annually.

o   Evening Differential: will go away from 3p – 7p.  For day shift people, this will mean about a decrease of approximately $50/paycheck or $1300/annually.

·         The Medical Center has a new CEO, Dr. Pat Cawley.  He has been our Executive Medical Director.  Our interim CEO is Kester Freeman.  Mr. Freeman and Dr. Cawley will work together on reorganizing the organization and work on implementing a Management Savings Plan.  Staff will be updated of changes as soon as we know.

·         7C made it to the Rumor Mill on the MUSC Intranet – 7C is NOT going to change, this is a rumor that went around at Christmas.

·         Timeclock:  Please remember to not clock in early and clock out on time! 

·         If you’re a charge nurse, please try to pair 1:2 assignments together.  Also, be mindful of RNs who float from another unit, it’s not appropriate to give them a 1:2 patient – be mindful of the type of patient(s) that they receive. 

·         Melinda is working on having a position approved to have someone at the desk from 3p – 11p. 

·         Lauren Mercede and Kelly Grommersch created a new assignment sheet for 7C.  This will be rolled out in the near future – please remember – DO NOT scratch through a patient’s name.

Magnet Update

·         Heron Human Resources Action Plan: Heron is a consulting group that MUSC has partnered with to help find cost saving measures within the organization.  With recent healthcare changes, the hospital has to plan to operate with 57 million dollars in cuts each year in revenue for the next 5 – 7 years.  Current changes that will affect the staff are:

o   Decreasing the WOW shift differential. WOW differential will decrease from $10/hour to $7/hour.  This will provide the hospital with approximately 900 thousand dollars in savings.

o   PTO changes: this will not affect employees on 7C, only employees who were here prior to 2001 and are on the “plan A” program, these employees will accumulate less PTO.  Employees who started after 2001 will not be affected by this change.  The savings for PTO accrual changes will be approximately $1.9 million annually.

o   Evening Differential: will go away from 3p – 7p.  For day shift people, this will mean about a decrease of approximately $50/paycheck or $1300/annually.

·         The Medical Center has a new CEO, Dr. Pat Cawley.  He has been our Executive Medical Director.  Our interim CEO is Kester Freeman.  Mr. Freeman and Dr. Cawley will work together on reorganizing the organization and work on implementing a Management Savings Plan.  Staff will be updated of changes as soon as we know.

·         7C made it to the Rumor Mill on the MUSC Intranet – 7C is NOT going to change, this is a rumor that went around at Christmas.

·         Timeclock:  Please remember to not clock in early and clock out on time! 

·         If you’re a charge nurse, please try to pair 1:2 assignments together.  Also, be mindful of RNs who float from another unit, it’s not appropriate to give them a 1:2 patient – be mindful of the type of patient(s) that they receive. 

·         Melinda is working on having a position approved to have someone at the desk from 3p – 11p. 

·         Lauren Mercede and Kelly Grommersch created a new assignment sheet for 7C.  This will be rolled out in the near future – please remember – DO NOT scratch through a patient’s name.

Quality/Culture of Safety

·         High Reliability Organizations (HRO) – {specifics to be posted on blog}

o   Preoccupation with failure

o   Reluctance to simplify interpretations

o   Sensitivity to operations

o   Commitment to resilience

o   Deference to expertise

·         Safety Rounds Follow up:

o   Trach needs assessment results: about 75-85% of the staff completed the survey.  The general consensus: almost all nurses know about trachs.  Most people feel comfortable taking care of trach patients, however, there are a lot of discrepancies on trach care at the bedside, trach changes, etc.   An audit on trach care was completed, 100% of items needed for trachs at the bedside was not there for any of the audits.

§  Erin created a trach care checklist – this will be posted in a visible location, possibly on the walleroos.

·         A trach sheet for patients may be adopted in the PICU – information on this checklist would be: “my trach size is,” “my backup size is,” etc.

·         Make sure to have all safety equipment at the bedside when caring for a trach patient.

·         A resource notebook may also be created with information on 10 – 12 of the month common types of patients that 7C had admitted.

o   A Study Drug Resource Binder has been created.  It was found that the drug is being administered in many different, incorrect ways.  The binder will provide information on how to correctly administer the drug. 

§  Kate Santos and Lisa McCormick will be checking off all nurses on how to correctly administer the drug – this will be the February competency. 

§  7C nurses will be taking these drug study patients, not any other unit.

·         Chest tube: Peds surgery residents have been ask for adult pleurovacs – they are using the wrong language.  They are referring to the Atrium Dry Chest Tube System – you can get this item from Central Supply.

·         IV bag and tubing changes:

o   Hang new bag after 24 hours for any dextrose or anything coming from pharmacy. 

o   Premixed bags not containing Dextrose can be hung for 72 hours. 

o   med line – 72 hours

o   TPN – 24 hours

o   Good rule of thumb: anything white needs to be changed every 12 hours

·         Pediatric Assessment: A family was recently concerned about the care their child received from a nurse.  The patient’s diapers were not being changed frequently.  Remember that diaper changes are a part of the assessment. 

o   Make sure to document any diaper rashes – esp. wounds and pressure sores.

Staff Recognition

Employee of the Quarter: Jessie Green, PCT, she was nominated by multiple people for her great patient care.

Open Forum

·         The 2 year anniversary of 7C’s opening day is on February 14, 2013. 

Staff meetings will be moved to quarterly and all staff meeting minutes will be posted on the blog within a one week turnaround.

The next meeting will take place on  April 22^nd & 24^th