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Creating Partnerships in Practice
In the Healthcare Setting
Kathie Poplar RN-BC, MSN February 2015
Partnership Outline
Immediate ResourcesInformationBarriers to PracticeOpportunities for growthThe Bigger Picture
Who Are Your Resources ?
PreceptorCharge Nurse
EducatorHouse
Supervisor
LNA
More Resources!
DiabetesTherapy
NutritionWound Team
RespiratoryRapid
Response Team
Risk Manager
Directors
Transport
Wound Team
Academic Affiliation
Physicians
IS
Building Relationships
As important as building clinical skills
Fosters a positive work Environment
Safe patient careTeam partnerships for
shared care & efficiency
Teamwork
Where to Find Information
Nursing PoliciesMedication Resources
(Lexicomp)Reputable Online ResourcesPatient Education MaterialsAncillary DepartmentsBringing forth foundational
information and following up with preceptor
Barriers Encountered
Time pressures with patient care needs
Resistance to change with culture
Lack of knowledge about new trends or current practice
Technical issuesLack of knowledge for policies(Patient Safety Solutions, 2007)
Value of Asking Questions
Find a resource at the beginning of the shift so they know to be there
for you
Not asking puts you &
your patient in danger
You are not expected to know it all
Preceptors are concernedwhen new nurses do not
ask questions
Constructive CriticismListen to what your preceptor is
telling youAnticipate constructive feedbackDon’t be afraid to admit that you
do not know somethingDon’t argue with your preceptorListen
Follow up with Clinical Manager or Educator if you have a personality clash with your preceptor.
Adopt Caring Behaviors
♥ See possibilities in solutions♥ Respect and value co-workers♥ Do what ever it takes to do the “Right
thing”♥ Follow through on commitments♥ Seek to understand the other person’s
point of view♥ Avoid making assumptions♥ Seek to understand other people’s roles• (Koloroutis, 2004)
Healthy Team Relationships
♣ Establish trusting relationships through competency & character
♣ Treat others with mutual respect regardless of their role
♣ Trading weekends and work shifts♣ How does your work ethic impact
the team♣ Consistent and visible support so
people know they can count on you♣ Open and honest communication(Koloroutis, 2004)
Partnerships with LNAs Treat LNAs with respect! Patient centered care – Walk away from
old notions of “my” role vs “their "role. How can “we” work better together to
take care of “our” patient How do you transition from old role of
LNA to new role of RN delegation Bringing value and respect to our
members of team Relationships built on trust bring staff
satisfaction & quality patient care Patient care such as “toileting” does not
belong only to LNA
Nurse-Physician Communication
► Joint Commission Patient Safety Goal #2 is to Improve the effectiveness of communication among caregivers
►TORB – Clarification of Orders(VORB taken only in emergencies)
►Teamwork and good communication is imperative for safe patient care
►Decreased mortality►Decrease cost of patient care► Increased job satisfaction and overall work
relationships(2012 National Patient Safety Goals)(Hughes & Fitzpatrick, 2010)
Magnet Journey◙ Getting involved in a committee helps to
network within the organization◙ Fosters understanding of how other
departments function◙ Building the bedside nurse as leaders◙ Grooms you as an expert resource within
your own department◙ Presents an opportunity to make a
difference◙ Unit Practice Councils provide a forum for
the nurse to raise their voice◙ Understanding organizational initiatives(Sanborn, 2006)
Shared Governance Committees
Unit Practice Council
Diabetes Team
Professional Recognition
Program
Magnet
Ed & Prof Development
Evidence Based Practice
Skin-Wound Assessment
Team
EPAC
Building Your Network• Linked In• NHNA/ANA or professional
organization • Work towards specialty certification• Attend conferences• Again…get involved in shared
governance• Volunteer activities• Legislative forums• Academic Affiliations• Social Network systems
Professional Growth & Development
• Nursing is a profession…..not just a job
• Full completion of orientation• Participation in Shared
Governance Committees• Precepting• Charge• Unit based Involvement
Governing Bodies
• CMS: Centers for Medicare & Medicaid
• The Joint Commission– Reimbursement– Setting standards of Practice– Open Reporting– Accreditation– Core Measures: heart failure,
CAUTI, VAP, Pressure Ulcer prevention, Stroke …….
Core Measures• Conditions impacting morbidity
and mortality• Represent National Health
priorities• Conditions that drive up
healthcare costs• Require involvement of the
healthcare team• Building of electronic health
records for communication
Health Network Systems
• Community Based Programs– Urgent Care– Volunteer Organizations– Paramedics– Health Clinics– Patient Education
Accountable Care Organizations (ACO) Doctors, hospitals, and home healthcare
providers that network for the provision of high quality care for Medicare patients
Share financial and medical responsibilities Coordinate care Goal targeted for chronic illness Avoiding duplication of resource Focus on prevention and meeting benchmarks Reduction of costs High performers can pocket more of the costs Projected savings Medicare $940 million/4years G5 example
Embarking on Your Nursing Journey
References• Centers for Medicare and Medicaid Serivces(2013).
Recommended Core Measures. Retrieved from: www.cms.gov/Regulations-and-Guidelines/Incentive Programs/ Recommended_Core_Set.html
• Centers for Medicare and Medicaid Services ((2015). Accountable Care Organizations. Retrieved from: www.cms.gov/Medicare/Medicaid-Fee-for-Service-Payment/ACO/index.html
• Kaiser Health News (2015). FAQ on ACOs: Accountable Care Organizations, Explained. Retrieved From: kaiserhealthnews. org/news/aco-accountable-care-organization-faq/
• Koloroutis, M. (2004). Relationship Based Care: A Model for Transforming Practice. Minneapolis, MN: Creative Health Management
• Hughes, B. & Fitzpatrick, J. J. (2010). Nurse-physician collaboration in an acute care community hospital. Journal of Interprofessional Care,November 2010; 24(6): 625–632
• The Joint Commission (2012). 2012 National Patient Safety Goals. From: http://www.jointcommission.org/2012_npsgs_slides/
• World Health Organization (2007). Communication during patient hand overs. Patient Safety Solutions, 1 (3).
• Sanborn, M. (2006). You don’t need a title to be a leader. New York: Crown Business.