Staff RN Research Articles

Emergency: ED triage.

Margaret McMahon is an emergency clinical nurse specialist and staff RN at Atlantic City Medical Center, Pomona, NJ, and an ED pool RN at the Kennedy Memorial Hospital, Washington Township, NJ. Emergency is coordinated by Jeff Coto, MS, RN, CCNS:[email protected].

Cutting edge discussions of management, policy, and program issues in emergency care

Answer: At a recent national lecture directed to a nursing audience, a Joint Commission for Accreditation of Healthcare Organizations (JCAHO) surveyor discussed the new JCAHO requirement for a verification process. Effective January 1, 2004, a final verification process to confirm the correct patient, procedure, and site using active, not passive, communication must be undertaken before any invasive procedures are performed. According to the surveyor, ‘‘time out’’ is one acceptable verification process. This requirement will be scored at Standard PC.13.20 and EP9. One exception to this requirement is when the physician has a continuous attendance with the patient. The only other exception would be such an emergency that even the time out and/or marking would add more risk than benefit to the patient. The surveyor said that what has changed from the original draft of the standard is a requirement for site marking. Marking should focus on cases involving right/ left distinction, multiple structures (eg, fingers or toes), or multiple levels (eg, the spine). Organizations no longer are required to mark the site for other types of procedures, including mid-line sternotomies, cesarean sections, and interventional procedures for which the insertion site is not predetermined. When a JCAHO surveyor visits, he or she will interview leaders to determine the expectations and how the leaders know they are being met. In addition, they will interview physicians, nurses, and technicians involved in surgery/ procedures to determine how consistently this is done. This inquiry is being done, in part, because inspectors have found

Honoring the Values of Practice as a Retention Strategy

“My experience at the Personal Mastery retreat showed me how much the leadership in my organization values its nurses. Any organization that really supports this commitment to caring in these times of financial concerns is a place where I feel valued and want to stay.” —Roberta Mislivec, Staff RN

Developing Nutritional Services in Large Multi-office Home Health Agency

LEARNING OUTCOME: To explore the development of a nutrition intervention program for a Home Health Care agency.The purpose of this project was to develop nutritional screening and intervention in a multi office Home Health Care agency. This agency, an affiliate of North Mississippi Medical Center in Tupelo, MS, serves 3,500 patients in 13 counties from 11 different offices (1994 figures).This agency's professional staff consists of 240 total Registered Nurses and eight nurse clinicians.As a result of a 1994 staff survey, a need was identified for the services of a Registered Dietitian.The project was developed using the Performance Improvement concepts of Benchmark, Deliver, Evaluate and Improve. Some of the steps taken included: survey of nurses, development of screening and assessment tools, inservice training of Home Care staff, establishment of interdisciplinary nutrition team meetings, collection of nutritional outcomes, follow-up meetings with Teamworks, the Home Care Performance Improvement Team and developing communication and charting tools for this multi disciplinary team to use.As a result of this project, all NMMC Home Care patients are now screened for nutritional risk and those identified at risk are assessed by RD and an interdisciplinary nutrition care team. Recommendations are given to staff RN for implementation.Other nutritional services developed include: staff diet inservices, development of diet education materials and writing articles for Home Care Newsletter. Another result of the project was that the NMMC Home Care Agency realized the benefits of the RD as a team member. Budgeted consultant hours were increased from eight hours per week to 24 hours per week.

Compliance With Mandatory Continuing Education in Nursing: A Hospital-Based Study

The purpose of this study, which was conducted in a teaching hospital in northern New York, was to evaluate staff nurse and head nurse (HN) compliance with employer mandated continuing education (CE). The hospital's CE policy for nurses required all nursing employees to attend any six CE or inservice education programs per evaluation year. Staff nurse and HN sample groups were studied. The results revealed that 79% of the staff RN sample and 100% of the HN sample complied with employer requirements. The staff RNs attended an average of 13 programs per year, and the HNs averaged 16 programs per year. When comparing these averages to the actual number required, the assumption can be made that nurses attend CE programs for reasons other than complying with requirements.

Visitation in the CCU

PAT BRANNON, MSN, RN, CORN, is Clinical Nurse Specialist for Medical Cardiovascular Nursing, ALICE BRADY, RN, is Staff RN II, Coronary Care Unit and ANNETTE GAILEY, BN, RN, CCRN, is Staff RN I, Coronary Care Unit at Saint Joseph's Hospital in Atlanta, Georgia.

Characteristics of the nursing instructor which facilitate the process of becoming a nurse. Preliminary note

Our experience as nursing educator allows us to affirm that, as a general rule, there is a constant concern on that part of nursing teachers from the various schools and universities for the formation of the future professionals. Thus, with the purpose of improving the quality of teaching, these educations continually analyze and evaluate their programs, planning and implementing new or different theoretical and practical activities. However, notwithstanding that concern, we have observed that the professional behaviour of most of staff RN's, especially those recent graduated, does not reflect much of what was taught to them in nursing school. Often staff, nurses manifest dissatisfaction with their professional practice, although little or nothing seems to be done by them in order to change their professional reality and obtain self-achievement. Without any doubt, there are countless number of factors intervening and determining the above outlined situation, but, certainly one of them is the quality that these nurses attribute to the different learning situations experienced by them while students in their nursing programs. The person of the nursing instructor is always a relevant component in these situations. It is inquestionable that the nursing teacher, as any teacher, exerts a great influence upon the quality of the learning experiences of his students, as well as upon their lifes. By way of his attitude towards the educational process, particularly with respect to the subject of this process - the student - the teacher may, or may not, contribute in a consistent and significant way to the emotional maturation and to the personal and professional growth of this students, facilitating, therefore, the process by which these students become professionals. The lack of studies done in our midst on these fundamentals aspects of the nursing teaching - learning process, seems to indicate that, in general, nursing teacher confer a greater importance to the quality of teaching thin to the quality of learning. Concerned with these observations in a time which we consider critical for professional nursing in Brazil, we have been intensely motivated to identify the characteristics of the nursing teacher that enriches the student's learning experiences, and, consequently, facilitate to him the process of becoming a nurse.