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Strategies to Help Your Nurses Provide Safer Patient Care

By Lisa Mulcahy via Multibriefs

RNs are the backbone that makes every care team in your hospital run like clockwork. Yet these caregivers are often unsung heroes and heroines as well — they routinely work beyond their physical and emotional limits for the good of their patients, and do so without complaint.

As a hospital administrator, however, it's crucial to realize that the more essential support you provide your RNs with, the sharper they'll be when it comes to caring for every patient — improving health outcomes across the board. Employ these proven points to help your nurses accomplish their best work every day:

Re-evaluate staffing capacity.

A study published in the British Medical Journal (BMJ) found when nurses are in charge of six or fewer patients per shift, the overall mortality rate of these patients was 20 percent lower than it was for nurses caring for more than 10 patients in a shift.

Plan for adequate daily coverage to ensure that each of your nurses are covering the minimal number of beds at all times. Also, resist the temptation to schedule less skilled nurses to treat patients who aren't stable; this may lessen your RNs' workloads, but can put the vulnerable at more risk. Make sure RNs are assigned to the patients who need them most.

Give your RNs more daily downtime.

Research from the University of Eastern Finland reinforces the fact that hospitals should provide breaks of 11 hours or more between shifts.

When this occurs, nurses had more time to sleep — subsequently, their heart function improved, their blood pressure dropped, and the coped better with job demands the next day. Tweak your scheduling to allow for that essential extra hour or two.

Reduce key distractions.

Researchers from the University of Sydney looked at 4,271 incidents of nurses administering medication to patients — in about 53 percent of these cases, nurses were interrupted intentionally.

The result: only 19.8 percent of those patients received their meds without error. In contrast, when nurses were not distracted while giving meds, the risk of them making a mistake was only 2.3 percent.

How can you help curb unnecessary interruptions in a busy ward? Instruct other staff members to use a whiteboard for messages, and consider having your nurses wear "do not interrupt" vests while on drug rounds, the researchers suggest.

Listen to feedback.

Your nurses are a wealth of information about what works best — or doesn't work at all — on every floor of your hospital.

Establish a once-weekly lunch meeting in your nurses' break room, and ask them to share their concerns, complaints and suggestions with you. Ask them what they need to fulfill their care responsibilities optimally, and work to make changes and adjustments wherever appropriate and necessary.

Change ER protocol for the better.

A study from the American College of ER Physicians found that when measures allowing nurses to provide certain expanded treatment in emergency departments were implemented, patient health outcomes improved greatly, and time efficiency skyrocketed.

For instance, when nurses were allowed to supervise testing for chest pain, patients received a diagnosis in only 79 minutes; nurses caring more actively for patients with conditions like fever, hip fracture or pregnancy complaints reduced these patients' time in the ER by an average of four hours.

Always utilize your nurses' skills as actively as possible, and trust their judgment and knowledge as expansively as possible — the results will speak for themselves!

Lisa Mulcahy is an internationally established health writer whose credits include the Los Angeles Times. Redbook, Glamour, Elle, Cosmopolitan, Health, Good Housekeeping, Parade and Seventeen.


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