EP8EO
Interprofessional Care EP8EO
- Provide one example, with supporting evidence, of an improved patient outcome associated with an interprofessional education activity led or co-led by a nurse (exclusive of the CNO).
- Outcome data must be in the form of a graph and a data table.
Example: Spine Basics Class Increases Nurses’ Knowledge regarding Spine Patients
Problem
From July 2017 to June 2018, the nurses on the Greenwich Hospital Surgery Unit treated more than 300 patients who had undergone a variety of spinal procedures including kyphoplasties, laminectomies, discectomies and spinal fusions. With the wide variety of neurosurgeries performed, 11 new nurses on the unit and a recent incident involving a patient at risk for autonomic dysfunction, an interprofessional team came together and identified the need for additional nursing education on the Surgery Unit.
This team, now called the Spine Basics Steering Committee, created a survey to administer to the Surgery clinical nurses in June 2018. The survey showed that 31% of nurses felt under-prepared in treating and mobilizing patients who have undergone spinal procedures. Specifically, the nurses expressed a need for more education on the anatomy and physiology of the spine, surgical procedures, “red flags” and complications to watch for postoperatively, pharmacological and non-pharmacological pain management, and safe mobilization of these patients.
The Surgery Unit’s Press Ganey patient satisfaction scores confirmed that the unit needed to focus on nurses’ knowledge regarding this patient population. The unit’s score for the question, “Skill of the nurses” was low in June 2018, at 79.2%; this is the percent of patients who responded “always” to this Press Ganey question.
Goal Statement
Improve the Surgery Unit score for the patient satisfaction question, “Skill of the nurses.”
Participants
Spine Basics Steering Committee
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Name/Credentials |
Discipline |
Title/Role |
Department |
Ann Nardi, DPT, PT |
Physical Therapy |
Coordinator of the Spinal Fusion Program; Co-lead |
Surgery |
Peggy Lennon, MSN, RN, NE-BC |
Nursing |
Program Director; |
Surgical Services |
Kasey Connor, BSN, RN |
Nursing |
Clinical Nurse |
Surgery |
Carol Ann Doherty, BSN, CRN |
Nursing |
Nurse Manager |
Surgery |
Sheila Finn, MS, CRN |
Nursing |
Clinical Coordinator |
Surgery |
Barbara Flanagan, MSN, RN, CNL |
Nursing |
Education Specialist |
Education Department |
Georgeann Torina, PA-C, RD |
Physician Assistant |
Physician Assistant |
Surgery |
Margarita Temprosa, BS, PT |
Physical Therapist |
Physical Therapist |
Physical Medicine |
Description of the Intervention
July 2018
Peggy Lennon, MSN, RN, NE-BC, Surgery Services Director, and Annie Nardi, PT, Spinal Infusion Program Coordinator, conducted a survey of the Surgery nurses to determine need for an education class. Based on the survey results and the low Press Ganey score for “Skill of the nurses,” Lennon and Nardi worked with the Spine Basics Steering Committee to develop an education class to increase Surgery Unit clinical nurses’ knowledge and confidence in providing care for patients who have spinal procedures.
Lennon and Nardi led the committee in identifying clinical experts (a clinical nurse, physician assistant and physical therapist) to lead the class.
August 2018
The Spine Basics Steering Committee developed the teaching plan for the Spine Basics Class. Surgery Clinical Nurse Kasey Connor, BSN, RN; Physician Assistant Georgeann Torina, PA-C, RD; and Physical Therapist Margarita Temprosa, BS, PT combined their expertise and knowledge and used evidence-based practice to create the education class:
- Torina took the lead on the component of the anatomy and physiology of the spine and common surgical procedures performed at Greenwich Hospital.
- Connor took the lead on the nursing examination skills, postoperative complications and pain management strategies.
- Temprosa took the lead on the spinal precautions and hands-on teaching regarding safe mobilization and proper patient handling techniques.
The class leaders created a PowerPoint presentation and handouts for the class, the purpose of which was to educate nurses on the skills needed to treat and educate their patients on appropriate pain management techniques, potential for and prevention of complications, and the importance of mobility.
September 2018
The speakers conducted a mock teaching class to ensure a clear and concise presentation of the content and skills.
October-December 2018
The Spine Basics Class was offered four times over three months to the nursing staff on the Surgery Unit. The mandatory class was offered on different days and times to provide flexibility and ensure all clinical nurses and nursing assistants could attend. All nurses and nursing assistants on the Surgical Unit completed the class.
Outcomes
Lennon and Nardi led the interprofessional Spine Basics Steering Committee to improve patient outcomes on Surgery Unit. Following the completion of the educational activity, the Surgery Unit’s patient satisfaction score for “Skill of the nurses” increased to 92.9% in January 2019, 100% in February 2019 and 90% in March 2019.
Evidence EP8EO-1, Greenwich Hospital Surgery Unit Press Ganey Question:
Skill of the Nurses
Following completion of the Spine Basics Class, the Steering Committee surveyed the nursing staff attendees on their knowledge and confidence in treating patients who have undergone spinal procedures. Immediately following the class, over 99% of the nursing staff felt confident in their skills and knowledge. This confidence was maintained one month and two months after completing the class, with confidence over 99% and 94%, respectively.