6 Ways to Build Relationships with Patients

6 Ways to Build Relationships with Patients

New nurse graduates have a lot on their plate. With diploma in hand, they can barely shout a celebratory “woo hoo” before passing the NCLEX becomes the next focus. But this early time in your nursing career is an especially important time to begin laying the foundation of the kind of nurse you want to be.

Nursing students often say connecting with patients is what makes their long days worthwhile. No matter what population you will be working with, finding a way to bridge the gap and connect with patients makes your job easier and builds confidence and satisfaction for your patients.

Here are a few ways to start building relationships—whether they last for hours or years—it makes a difference.

1. Introduce Yourself

Your patients have medical professionals coming in and out of their rooms all day long. Don’t take it personally if they don’t remember your name or when you first came in or even what you need to do. Tell them your name and what you will be doing. Let them know how long you’ll be taking care of them.

2. Be Present

With all the hectic happenings in a healthcare setting, nurses have to have eyes and ears open to everything. Sometimes that means when you are with a patient, you aren’t 100 percent focused on them. Making the effort to bring your attention to the patient in front of you helps. “Be present in the moment,” advises Pamela Chally, Dean Emeritus, Brooks College of Health, University of North Florida. “Even something nonverbal does a lot for being present. It can be a touch or eye contact,” she says.

3. Keep Them Updated

Let your patients know what to expect. If you know they’ll have a CAT scan later in the day, let them know the approximate time. If that time changes, pass that information along. They might have questions about what’s going on and why they need certain tests or procedures. Let them know or, if you don’t know all the details, find out for them.

4. Spend Some Time

This is the most difficult piece because time is one thing nurses don’t have to spare. But making the most of your time with a patient can help overcome the quantity of the time you can offer. You can’t sit in the room and chat the afternoon away, but you can ask them about their outside life. Talk about the latest baseball game, their scrapbooking habit, or what they like about their job.

5. Learn About Them

If they have family in the room, try to learn a little about them and about your patient as well. Be mindful if a family doesn’t want to talk, but also listen for small details that aren’t volatile. Hobbies, favorite places, favorite foods, or upcoming events they are looking forward to are all great ways to connect and will help break the ice.

6. Have Patience

In addition to their professional skill and their calm demeanor, nurses’ patience is legendary. But having patience isn’t always easy, and when you have patients who are scared, in pain, or just not particularly pleasant, it can be downright difficult. Watch the nurses around you to see what coping techniques they have developed to deal when tempers flare in your setting. Do they deflect with questions? Do they ignore the situation and continue on calmly or do they address it directly? What does your manager recommend when you encounter a situation that’s not easy? And find your own way of bringing yourself back to a calm place when things get tough.

7. Make It Personal

With so many people to care for, it’s not going to be easy to remember small details about everyone. But if you can remember your patient is especially nervous about blood draws, has very particular food preferences or issues, or is more modest than most (or not!), you can be prepared for those situations. Showing that you care about them as a person will help build a mutual trust.

Building relationships with patients, no matter what setting you see them in, has a ripple effect. You’ll make their stay or visit more pleasant, but you’ll also feel more satisfaction from having connected with them, too. And if your patient trusts you and feels like you are advocating for their interests, they are more likely to listen to what you say and ask questions when they don’t understand something.

Building a relationship with a patient can lead them on a path to better health overall and a better quality of life—what nurse doesn’t want that?

Protecting Yourself from Tick Bites Is Critical

Protecting Yourself from Tick Bites Is Critical

Now that spring is upon most of the country, it’s a good time to refresh yourself about understanding tick-borne disease, learning how to protect yourself, and recognizing signs and symptoms of infections in yourself and in your patients.

Lyme disease gets most of the tick-borne disease headlines, but there are plenty of other illnesses caused by ticks that cause just as much misery and potentially life-changing harm.

Ticks tend to live in wooded areas and fields with tall grasses. The feed on blood, so small rodents like mice or larger animals like deer, moose, or human beings make perfect hosts for these bugs. Household pets that go outside are also known to bring ticks into your home where they can drop off on floors and furniture and attach to people. They will attach to their host and can remain attached for days, transmitting diseases along the way. According to the Centers for Disease Control and Prevention, some of the more well known tick-borne diseases include Lyme, bartonella, babesiosis, anaplasmosis, tularemia, and Rocky Mountain spotted fever.

Most people can see the larger ticks, but they can get into areas that you won’t notice immediately – like your back, your feet, under your arms, or your scalp. But the ticks in the larval stage are nearly microscopic and are almost invisible unless you are searching for them. Even then, they are tough to see. And many ticks transmit a chemical that acts like an anesthetic, so your skin might not be irritated when they are biting you.

The first step in tick-borne illness is preventing yourself from ever getting it. That means treating your indoor/outdoor pets with tick medication that will both repel ticks from your animals and kill any that attach.

When you are outside, cover up with long pants tucked into socks and long sleeves if you are taking a hike or gardening. Use bug spray containing DEET to keep ticks off your exposed skin, but make sure you wash it off when you come in. And when you do come in from outside, head straight to the shower. Take your clothes off (from underwear to socks to coats) and pout them in plastic bags if you can’t get them right into the washing machine. Wash your clothes and then put everything in the dryer to kill off any ticks that might still be attached.

If you do notice a tick, pull it off with tweezers by grabbing the tick at the head and pulling hard enough to remove the whole tick. You want to make sure the head is not still burrowed into the skin. If that happens, you might need to get it removed (yet another bonus when you are working with nurses!). Wash the area and your hands and then apply an antibiotic and a bandage. Watch for signs of infection around the bite (or a Lyme-alert of a bulls-eye rash). Also pay attention to how you feel—any joint pain, fevers, flu-like symptoms, headaches—could signal a tick-borne illness.

Generally, treatment will consist of several weeks of antibiotics, but some people suffer longer-term issues. According to the Lyme Disease Association, there’s debate in the medical community, as some health practitioners believe Lyme is exceptionally difficult to diagnose and eradicate. Other believe the lingering symptoms some patients feel are related more to an autoimmune issue.

Either way, a tick-borne illness is miserable to deal with and your best course of action is prevention. You don’t have to avoid the outdoors, but take precautions and check yourself, your family members, and your pets when you all come in from the outside.

Working as a Transplant Nurse

Working as a Transplant Nurse

In honor of Transplant Nurses Day—April 19—we decided to ask a transplant nurse what it’s like to work in this part of the nursing field. Austin Timmons, BSN, RN, CNOR, an Operating Room Registered Nurse at Largo Medical Center in Largo, Florida. Took times to answers some questions for us. What follows is an edited version of our interview.

As a transplant nurse, what does your job entail? What do you do on a daily basis?

A transplant nurse’s job entails many criteria including patient education, clinical care, and patient safety as well as a wide array of interdisciplinary coordination within the hospital. Transplant nurses work closely with transplant physicians, pharmacists, the lab, anesthesia, Organ Procurement Organizations (OPOs), perfusionists, surgical scrub technicians, and other specialists to coordinate the best care possible for our patients.

As an Operating Room nurse specifically, I focus–along with other members of the OR team–on providing the most current standards of care to our patients in a safe and respectful manner. We handle setting up supplies for a transplant procedure, providing education for our patients, keeping the patients safe under anesthesia, handling donor organs, and eventually taking our patients safely to a recovery unit to begin their journey with their new organ.

Why did you choose this field of nursing?

I personally chose this field of nursing to help expand the transplant services within our community and to assist in offering the best care possible for the patients that we receive. We all work closely together and have our own roles to make the procedure come together as a whole. We have a growing presence in our community, and, as a healthcare team, we are proud to be a part of the transplant program.

What are the biggest challenges of your job?

One of the biggest challenges of my job includes seeing the patient immediately before surgery. This is always an emotional time for them, and as nurses, we are able to comfort and sympathize with them at the bedside before the procedure begins. We are constantly in close contact with family members during the procedure to keep them involved and are available for their support as well.

What are the greatest rewards?

On the other side of the coin, the greatest reward as a transplant nurse in the operating room is seeing the patients after the procedure is complete–witnessing their joy and appreciation for this gift of life. For example, after one of our kidney transplant recipients had been brought to the Intensive Care Unit and woke up, the patient began to cry out of joy when they saw they were making their own urine for the first time in over a year. Knowing that our team has played an integral part in such a big milestone for their health is a great feeling.

What would you say to someone considering this type of nursing work?

To someone considering this type of work I would say, “Go for it!” It is a rewarding experience and allows you to work with many different departments and specialties, all of which have one common goal in mind. I believe compassion, attention to detail, organization, highly developed communication skills, and transplant-specific education are needed for this type of nursing work.

Is there anything I haven’t asked you about being a transplant nurse that is important for people to know?

One other thing that I would add is the involvement with our local population. The Transplant Institute of Florida at Largo Medical Center works with Life Link and other organizations to support community-centered events and education regarding donation and transplantation. These events help to strengthen our presence and help reach out to people in need.

Celebrate Transplant Nurses Day on April 19

Celebrate Transplant Nurses Day on April 19

The International Transplant Nurses Society sponsors the Transplant Nurses Day on April 19 this year, and the organization offers some great tips and suggestions for celebrating the day.

Transplant nurses specialize in the care of people who are undergoing or have had transplant surgery of solid organs. Since 2006, the ITNS has helped honor nurses who are committed to this branch of nursing by recognizing their efforts and their skill on the third Wednesday of every April.

The transplant nurses on staff work with a distinct population and help patients through all phases of care. They are there to help both the sickest patients awaiting transplant surgery and the healthy live donors, and assist during the procedures. Transplant nurses also work closely with patients and their families post-surgery to ensure everything goes as smoothly as possible and to monitor for any complications such as organ rejection.

During this year’s Transplant Nurses Day, take a few tips from the ITNS and shower your transplant nurses with some extra love. Like with many other holidays to celebrate a specific field of nursing, the celebration to honor a group is what makes it special.

A luncheon or a gathering with cake and coffee is always a nice break in the day and a good way to say thanks. This is a great time to call out some nurses who have gone above and beyond their job duties and give them a small gift like a gift card to a local shop or coffee store they love. Personal thank you notes are also always appreciated.

In keeping with the ITNS mission, spreading education about transplant nurses and what they do is important. Invite local and state legislators to come hear a presentation in the near future about this profession. If you’re a transplant nurse, see if your team will take the time to make a presentation to a local school or library to teach others about what you do.

If transplant nursing sounds like something you would like to do, you’ll need to obtain your RN and then gain experience in critical care and surgical units. You need to be certified with a Transplant Nurses Certification through the American Board for Transplant Certification. As the field is so fast-paced, keeping up with the latest cutting-edge research and outcomes will become part of your job duties.

Say thank you to your transplant nurses on Transplant Nurses Day, and if you’re a transplant nurse, take the time today to honor all you do and the patients you help.

How to Handle Working Swing Shifts

How to Handle Working Swing Shifts

Working as a nurse can really take a toll on your body. While many nurses work either all day work or all night work, there are others who work both day and night shifts, and that can be really tough.

We asked some experts for tips on how to make the switch and keep yourself healthy while working swing shifts.

Carrie Silvers, RN, MSN, a professor of nursing at the University of Arizona gave these tips:

On switching days to nights: Stay up later the night before you switch, and sleep in as late as possible. I used to find it hard to nap during the day, anticipating my shift. Schedule early family dinners and bath times for the kids on work nights.

On switching nights to days: A couple of ways I switched included not going to bed right away when I got home in the morning. I was able to see my kids, and make them breakfast. I’d sleep a shorter period of time so that I could go to bed that night and get a good night’s sleep. This also allowed me to be awake when they got home from school, help with homework, dinner, sports, and bedtime stories.

On eating healthy: Eat a balanced and healthy diet full of fresh fruit and vegetables with an increase in lean protein intake. Increasing protein will help with stamina and staying awake. Pack healthy snacks and a meal to take to work. Avoid high fat and fried foods while at work. Limit caffeine intake to early in your shift, and to only a couple of servings. Working during the day I would avoid caffeinated beverages after noon, and on night shift after midnight.

On exercise: I used to exercise before work because it helped me to wake up and get my blood circulating. Even a walk or 30-minute exercise videos work.

On staying hydrated: Drink a lot of water. At least 8 glasses/shift. You’ll feel hydrated, less tired, and your body will thank you.

Nicole Thomas, RN, MSN, CCM, founder of Nicole Thomas, Inc and Going Beyond the Chart, has been a nurse for more than 11 years and worked many swing shifts. Here are some of her tips for working swing shifts:

Get a calendar and get organized. By working swing shifts, it is very easy to forget other obligations including medical appointments, family functions, meetings, etc. for yourself and your family. You must get organized, and you can do that by getting a planner that you can write in or simply use google calendar which is free and has a mobile app which is amazing.

Do things you enjoy doing. While it’s important to rest, you have to have fun and enjoy life. Working shift work oftentimes limits you being able to enjoy events, family functions, etc. so you must make time to do the things you like. If you don’t, you can feel like you are missing out on living a fulfilling life. Have a balance.

April Is National Minority Health Month: See How You Can Help

April Is National Minority Health Month: See How You Can Help

My first experience with “minority health” came during my Master of Public Health degree program. I served as a member of the speakers’ committee for the annual Minority Health Conference at the University of North Carolina at Chapel Hill.

We sought to raise awareness about issues related to health disparities and how to take collaborative action across different professions. Our participants included academic scholars, researchers, public health practitioners, community leaders, human rights advocates and policy makers.

We often hear the terms “health disparities,” “health inequities” and “social determinants” as they relate to populations, locally, nationally and globally. So let’s start with a few basic definitions:

Health Equity

Health equity means achieving the highest level of health for all people. It requires valuing every human being equally with continuous efforts to address avoidable social and economic inequalities, historical and contemporary injustices. Health equity also seeks the elimination of health and healthcare disparities.

Health Disparities

Health disparities are defined as a particular type of health difference that is closely linked with one’s social or economic status. Health disparities negatively affect groups of people who have experienced greater social and/or economic obstacles to health due to characteristics historically linked to discrimination or exclusion. These characteristics include but are not limited to:

  • Racial or ethnic group
  • Religion
  • Socioeconomic status
  • Gender
  • Age
  • Mental health
  • Physical disability
  • Sexual orientation
  • Geographic location

Social Determinants of Health

Social determinants of health refers to environmental conditions in which people are born, live, work and play that affect a wide array of health and quality-of-life outcomes and risks.

Ways to Observe National Minority Health Month

There are several easy ways to participate in National Minority Health Month. This year’s theme is “Bridging Health Equity across Communities.” During April, consider doing the following activities:

Stay Informed

  • Learn more about your own family’s medical history and keep a good record of your health conditions and treatment plans.
  • Read, watch or listen to local news about emerging health conditions in your community.
  • Obtain details about culturally and linguistically appropriate services.

Get Involved

  • Attend a local event.
  • Join community-based organizations or a local health department task force on minority health.
  • Use and share the resources from reputable organizations.

Get Connected

  • Use social media groups that engage in discussions about minority health and help spread the word.
  • Sign up for OMH newsletters to receive email updates on Office of Minority Health and health disparities issues.
  • Contact the Department of Health and Human Services if you have questions about National Minority Health Month.

Public Health Involving Minorities Is a Global Concern

National Minority Health Month recognizes health disparities in the United States, but coping with public health issues involving minorities remains both a local and a global problem. Fortunately, there are local public health events that address issues disproportionately affecting minorities, such as the Houston Heart Failure Management Conference, Save a Life and the Adult Congenital Heart Symposium.

In addition, international organizations have addressed global public health issues affecting minorities. The national ministries of health in the African region, the Centers for Disease Control and Prevention, and the World Health Organization/African Region are evaluating Ebola outbreak response capabilities, which have been strengthened through my collaboration.

The best way to teach more consumers about public health – and especially the health of minority groups – is through education. Staying informed, getting involved and getting connected are powerful ways to raise awareness and learn about the health problems affecting minorities.

Nursing Students Gain Valuable Skills in Remote Areas

Nursing Students Gain Valuable Skills in Remote Areas

In hopes of gaining a breadth of experience, many nursing students immediately look for a job in a hospital setting upon graduation. But Judy Liesveld, associate professor at the University of New Mexico’s College of Nursing, encourages students to look past the typical offerings.

Working on a “Nurse Education, Practice, Quality and Retention-Bachelor of Science in Nursing Practicum” grant from the U.S. Department of Health and Human Services, Liesveld runs a program in which selected nursing students from the University of New Mexico and San Juan College in Farmington, New Mexico, work twice a year (once in fall and once in early spring) in the Chinle Indian Health Service Unit on very rural Navajo Nation Reservation located in Arizona, three hours outside of Albuquerque.

In their two-week stay on the reservation, the students are immersed in an unfamiliar culture and with medically underserved people who need healthcare that runs the gamut from minor to serious. Students who want to return are able to complete a senior capstone in the following term.

When they are in this setting, they are in a very rural setting where it’s a totally different culture with a vulnerable population,” she says. “This totally helps to expand their world view. This is a robust, rich experience for them.”

And the experience the nursing students get in a short time rivals intense clinical experience in a larger healthcare setting, she says. Liesveld should know—her first job out of nursing school was working in Chinle Health Services.

The Chinle clinicals, as they are called, bring students through things like the emergency department, obstetrics, urgent care, and pediatrics. There are primary care clinics that the students participate in as well as home visits where many residents live without running water or heat in extremely remote areas where dirt roads are common. Even in living conditions that aren’t what they are used to, students see the human bonds that make the community what it is, Liesveld says. They see an incredibly close family structure and a culture that is powerful and strong.

The nursing students give presentations on health topics to different populations increasing both their presentation capabilities and their understanding of the different needs throughout a community.

They presented at a senior center on smokeless tobacco and at a middle school on self esteem,” she says. Through the presentations, the nursing students interacted with people and felt like they were making a difference.

The hope is students will love the experience and will work in rural settings,” says Liesveld. But if they never work in a rural setting again, she says the experience they gain on the reservation is one they will never forget and one that will offer them skills they will use throughout their careers.

They learn they have to be resourceful and they learn how to think on their feet,” says Liesveld. Students quickly develop authentic rapport with the residents and they use nursing skills they might not have a chance to use in other places. “It changes their world,” she says.

If they stay in the region, they are likely to work with a Native American population, so the exposure to their culture will give them a cultural competency that can only be gained by such an immersive experience.

And the ripple effect of what they have learned can lead to advocacy as well. Students begin to think about health policy on a national level and what that means for the country as a whole and these rural pockets of communities that exist across the nation.

When there is that kind of meshing of skills, understanding, and cultural exposure, nursing students, wherever they land after graduation, will have a broad view that will benefit them and their patients.

 

The Role of the Nurse in Preventing Opioid Abuse

The Role of the Nurse in Preventing Opioid Abuse

Overdose deaths related to prescription opioids have quadrupled since 1999, according to the Centers for Disease Control and Prevention (CDC), which has made it a topic of dinner conversation as well as a top priority in health care. Nurses can play an important role in reducing these deaths, as well as addiction problems, through their assessments and monitoring of patients. But it’s also important for nurses to be well aware of steps they can take to help protect themselves from possible legal action stemming from opioids.

Scope of the Problem

The depth and breadth of prescription opioid abuse is far reaching. In 2014, almost 2 million people in the United States abused or were dependent on prescription opioids. At least half of all opioid overdose deaths involve a prescription opioid. Every day, more than 1,000 people are treated in emergency departments for misusing prescription opioids.

The most common drugs associated with prescription opioid overdose deaths are methadone, oxycodone, and hydrocodone. According to the CDC, prescription opioid overdose rates between 1999 and 2014 were highest among people aged 25 to 54.

Role of the Nurse

A 2016 study published in the Journal of the American Medical Association (JAMA) by Baker and colleagues notes that there is significant variability in the amount of opioids prescribed, and the most commonly dispensed opioid was hydrocodone (78%), followed by oxycodone (15.4%). Interestingly, a 2015 study in the American Journal of Preventive Medicine reported a decrease in the rate of prescribing opioids (-5.7%), perhaps indicating that more health care providers are becoming aware of the addiction issue.

Screen Patients

Nurses are well positioned to detect patients with substance misuse. One simple screening tool is the National Institute on Drug Abuse (NIDA) Quick Screen. If a substance use disorder is suspected, the nurse should remain nonjudgmental while referring patients for further evaluation and treatment, so they receive the care they need.

One model for follow-up of possible substance abuse is Screening, Brief Intervention, and Referral to Treatment (SBIRT) from the Substance Abuse and Mental Health Services Administration. SBIRT is a method for ensuring that people with substance use disorders and those at risk for developing these disorders receive the help they need.

Assess the Patient Carefully

Pain medication should be matched to the individual patient’s needs. This begins with a detailed history, including a list of currently prescribed and past medications. Ask about a history of substance use or substance use disorders in the patient and the patient’s family. If opioids are being considered, assess the patient’s psychiatric status.

A physical exam should also be completed, keeping in mind signs and symptoms of possible substance abuse such as advanced periodontitis, traumatic lesions, and poor oral hygiene. If patients are already being managed for chronic pain, the nurse should consult with the appropriate provider.

Apply Evidence-Based Pain Management

To provide optimal patient care, as well as to protect themselves from legal action, nurses should practice evidence-based pain management. That includes considering non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, as first-line pain medication.

NSAIDs have been shown to be at least as effective (if not more so) than opioids for managing pain, particularly in combination with acetaminophen. Before patients begin taking NSAIDs, verify that they are not taking other anticoagulants, including aspirin, and check for hepatic or renal impairment.

Nurses should complete continuing education courses in pain management, and document they did so, which can provide evidence of their knowledge in event of legal action.

Educate Patients

Nurses have an opportunity to educate patients about the role of pain medication in their care. This education should include pain medication options and the reasons why non-opioids are preferred.

Verbal and written instructions after the procedure need to contain name of drug, dosage, adverse effects, how long the drug should be taken, and how to store it. Results from a 2016 survey published in JAMA Internal Medicine found that more than half (61%) of those no long taking opioid medication keep it for future use, so patients need to be told to dispose of unused drugs and how to do so. Patients can search for places that collect controlled substance drugs through the Drug Enforcement Administration at www.deadiversion.usdoj.gov.

The same survey found that about 20% shared the opioid with another person, so education material should mention not to do this. Nurses should also discuss the perils of driving or undertaking complex tasks while taking an opioid. Document in the patient’s health record that this information was provided and the patient acknowledged receipt and understanding. An office visit can also provide the opportunity for nurses to address opioid abuse on a larger scale.

Refer Patients as Indicated

Nurses need to closely monitor patient use of controlled drugs to avoid overdependence or potential addiction, and refer chronic pain patients to a pain management center or specialist. Be sure to document the referral in the patient’s health record. Nurses also should consider referral for patients who seek opioids beyond when they are likely to be needed.

Pain Medications Cautions

Below are some considerations for the use of pain medication in patients:

  • Use non-steroidal anti-inflammatory drugs (NSAIDs) as the first option. Consider a selective NSAID to avoid increased risk of bleeding. Know that using acetaminophen in combination with NSAID may have a synergistic effect in pain relief. (Do not exceed 3,000 mg/day in adults.)
  • Provide patient education.
  • Document patient communications, education, and referrals in the health record.

Protecting Patients and Nurses

Nurses who assess and monitor patients for treatment of pain are encouraged to be mindful of and have respect for their inherent abuse potential. Doing so helps protect patients from harm and nurses from potential liability.


Disclaimer: This article is provided for general informational purposes only and is not intended to provide individualized business, risk management, or legal advice. It is not intended to be a substitute for any professional standards, guidelines or workplace policies related to the subject matter.

This risk management information was provided by Nurses Service Organization (NSO), the nation’s largest provider of nurses’ professional liability insurance coverage for over 650,000 nurses since 1976. INS endorses the individual professional liability insurance policy administered through NSO and underwritten by American Casualty Company of Reading, Pennsylvania, a CNA company. Reproduction without permission of the publisher is prohibited. For questions, send an e-mail to [email protected] or call 1-800-247-1500.

American Workers Feel Jitters Over Taking Paid Family Leave

American Workers Feel Jitters Over Taking Paid Family Leave

A new study on paid family and medical leave by the Pew Research Center shows American workers want access to paid time off for family or medical events. But even if they have access, many workers don’t a;ways feel secure to take the leave.

 

On the whole, Americans appreciate paid time off after a child is born or is adopted, if they have a medical issue that requires time off, or if they need time to care for an ill family member. But many study respondents disagreed on who should absorb the cost and just how reliable the system was.

 

Despite many calls to elevate the United States’ paid leave policy to that of other countries, respondents were divided over if the government should mandate access to paid leave. Only 51 percent thought that the government should mandate time off in those circumstances while the remaining 48 percent thought employers should be able to decide whether or not to offer employees that benefit.

 

In general, most people believe that paid family and medical leave is beneficial, with 82 percent believing the benefit should be available to new moms and 69 percent believing new dads should have the option. And if the government mandates the policy, 73 percent said they believed it should be available to both mothers and fathers (only 26 percent thought it should be for new moms only).

 

The United States stacks up woefully behind many other countries in offering paid parental leave to workers who have just had a child or adopted a child. According to another Pew study, the United States ranks last out of 41 countries in paid leave policy.

 

But industries are taking notice. Many respondents, while acknowledging that paid family leave was more beneficial to families and individuals than to businesses, said they thought offering the benefit would attract more quality works and also help retain them.

 

No matter where you work, according to a Henry J. Kaiser Family Foundation study, larger firms tend to offer more access to paid family and medical leave. But the Pew study asserts that many workers don’t take the time even if they are able to for reasons ranging from fear of losing their job to overwhelming job demands.

 

Those in lower income brackets were much less likely to receive or take paid family leave. Nearly one-third of those with household incomes of $30,000 or less said they were unable to take leave within the past two years although they wanted to, while only 14 percent of those with households of income above that level reported the same.

 

The study reveals that American workers, while they might support this leave, aren’t always able to, don’t always have access to it, or feel there might be career repercussions if they take the leave.

 

What do you think about paid family or medical leave for American workers?

A Team Approach to Health IT Implementation

A Team Approach to Health IT Implementation

Hospitals have dedicated tremendous resources to create an integrated clinical environment that results in better patient care and outcomes, reduces readmissions, and increases hospital utilization, in hopes of reducing the overall cost of health care.

Unfortunately, health IT projects either fall short of business and clinical goals or are completely abandoned at an astonishing rate. Studies vary, but failure-rate estimates range from 35% to 75%.

Overrun budgets and functionality problems are often cited as the primary culprits of doomed implementations. However, the failure to include direct-care clinical staff—including nurses—in the evaluation, implementation, and training of new technology should not be overlooked.

It’s easy to consider a new hardware or software solution and imagine its transformative potential. Health care trade shows brim with thousands of devices, enterprise systems, and software applications marketed as painless solutions for any clinical challenge facing a hospital or care unit. But a poorly implemented system that did not evaluate the impact to the clinical workflow can just as easily exacerbate inefficiencies and reduce the overall quality of patient care.

Equipment that doesn’t work properly or causes needless redundancies in daily tasks is enormously frustrating. The lack of sufficient training and vendor support increases the chances of mistakes or encourages direct-care staff to either work around a new solution or outright revolt at go-live.

A Shared Vision

Many of the doomsday scenarios associated with technology adoption and implementation can be mitigated with adequate planning, training, and collaboration. By listening to, engaging with, and educating front-line staff, hospitals can dramatically increase their chances of success with technology adoption.

For example, consider medical devices with alarm capabilities. Nursing staff are charged with the proper setting of the alarms and the prompt response when any of the devices send an alert. As the presence of alarm equipment continues to grow, nurses find their workflow and ability to engage with patients disrupted as they chase down hundreds of (often non-actionable) alarms. Without proper education and implementation of alarm devices, it’s all too easy to imagine clinical staff arbitrarily adjusting alarm settings—or even turning them off entirely.

Involving direct-care staff is critical to the success of any new technology. How will this new technology impact how nurses deliver patient care? What adjustments in workflow and practice need to be made—at go-live and beyond? Starting with these questions fosters buy-in from the staff who will be utilizing this equipment. If end-users are not involved in the selection, adoption, and implementation of a technology, then the likelihood that they will become owners of that product is significantly lower.

Environmental and Workflow Assessments

Hospitals each have their own unique characteristics, culture, and needs. Identifying and documenting those attributes are critical to any successful health IT implementation. To achieve measurable progress in health IT adoption requires that hospitals identify and support internal champions in all relevant departments.

For hospitals and health systems, especially those that are breaking ground on new technology integration, the first step is an assessment of needs and potential impact to workflow. The formidable task list that comes with any technology implementation requires the input and expertise of a project team, which ideally, should be comprised of leadership from myriad stakeholders, including IT networking, facilities, patient safety experts, educators, informatics nurses, laboratory staff, pharmacists, electrical engineers, biomedical engineers, quality improvement specialists, vendors, and direct-care clinical staff . This team will be responsible for every phase of deployment—evaluation, acquisition, rollout, implementation, and transition to live operations. They will determine the hospital’s objectives and integration goals, as well as vendor evaluations, business and clinical requirements, risk management concerns, patient safety goals, and costs.

The project team will also be charged with identifying the departments or units the integration will first impact. Big bang, enterprise integrations are not unprecedented, but a phased roll out in a single department or set of departments with the highest acuity, such as the surgical suite, allows more time and space for assessments, lessons learned, and best practices, which can be applied as the integration spreads to the rest of the enterprise.

One aspect of integration that is often overlooked is the value of clinical workflow, which can vary among hospitals and individual units. Workflow should not be minimized because it will largely define how data is collected, how it is displayed, and what is displayed. Hospitals should incorporate clinical workflow as quickly and as early as possible in the process.

Designating a nursing champion—or super-user—at the outset allows other nurses and direct-care clinical staff to receive information, training, and support during all phases of adoption. These super-users would be working closely with the interdisciplinary team assembled for the implementation project.

Vendor Partnerships

Health IT implementations can be expensive, complex, involve dozens of stakeholders, and are often up against aggressive deadlines. Technology can also be disruptive and bring new uncertainties to the entire organization. However, the quality of the relationship with the vendor supplying the solution can make a huge difference.

Any hospital or health system has business and clinical needs and cultures that make them different from other organizations. A partner with deep knowledge of the unique aspects of your organization not only will help you avoid common mistakes, but also keep you focused on detailed integration points and workflows.

A partner that knows your organization also helps other vendors get acclimated, provides guidance, and ensures everyone stays accountable. A positive and fruitful collaboration allows hospitals to establish benchmarks and ensure that configurations and interoperability are optimized and seamless.

An excellent vendor also acts as a consultant and educator, making hospital staff comfortable with new technology and uncovering strategies for optimizing workflow. The importance of evaluating the vendor as much as the product they are delivering cannot be stressed enough. Vendors that lack expertise, training capabilities and clear steps toward go-live and beyond are critical red flags.

Can the vendor explain their process? Can they share metrics? Do they offer continued training and support after the implementation is complete? Answers to these questions will give your project team keen insights into the potential challenges of a technology implementation.

If your vendor supplies references, ask their customers specifically about their specific challenges and the vendor resolved them. Setbacks are a natural part of any implementation, but the true difference maker is determining the level of support and collaboration provided to overcome it.

A team approach to health IT doesn’t guarantee that technology adoption and implementation will be a success—but it will significantly increase its chances of sustainability. Today’s nurses have neither the desire nor the option to be passive consumers of health care technology. The seamless integration of technology requires that direct-care clinical staff have influence in the design and testing of equipment and applications. Involving end-users in the early stages of system analysis and design specifications can lead to better adoption of new technology, as well as identifying how current technology can be adapted for greater user acceptance.