1 st Things 1 st ….and hurry up!
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Transcript of 1 st Things 1 st ….and hurry up!
1st Things 1st ….and hurry up!
Managing Patient Care
RANC Objectives Apply principles of priority setting to
patient care situations. Apply time management strategies to the
reality of delivering effective nursing care. Relate time management strategies to
enhance personal productivity.
Why prioritize? Identifies relevance & /or significance Increases quality care
Allows for delegation & collaboration Enhances preventative care
Promotes time management Increases productivity Not a linear activity
variables occur simultaneous actions (multitasking) is a must
Elements of Managing Pt Care Competency (Box 21-1) Facility/Unit Vision Model of Care Organizational Structures Leadership Decision-Making Skills Knowledge Base & Con’t Educ Communication Teamwork!
On Your Mark… Know yourself!
Strengths & limitations Increase knowledge
Holistic care Specialization Evidence-based practice Strive for excellence
Sharpen critical thinking skills Practice hands-on skills Communicate effectively Team-player (aka “collaboration”)
…Get Set… Assessment 1st
Focused vs complete assmnt Thoroughness
Developing rapport Critical thinking
Making clinical judgments Affects decision-making
Nursing process Know your limitations & ask for help
…Go!!! Anticipate pt needs look for cues
verbal/nonverbal, history info, meds, environment, etc Involve the pt Priority setting
High life-threatening (“MUST do”)
Intermediate Non-emergent (“SHOULD do”)
Low Related to other needs (“Nice to do”)
Note condition changes Time availability
Length of stay, interruptions, etc
Start with the ABC’s! 1st priority sustain life & safety Physiological needs usually 1st unless
psychosocial need Physiological:
Airway Breathing Circulation
Psychosocial: Anxiety Fear Depression Ineffective coping
Maslow’s Hierarchy of Needs
▪ Physiological 1st
▪ Safety 2nd
*See p48, 71-72
Prioritizing on the “same” level Most urgent 1st
If the airway isn’t clear the oxygen won’t get to the lungs to be circulated to the tissues!
If the need to void is more urgent than the need to eat
If rest is more important than sex!
Acute vs. Chronic problems LOC change: acute confusion vs
Alzheimer’s Surgery-related pain vs. arthritic pain Immobility post-op vs. anxiety
Patient Preference prn Motivation to participate Perception of event Value system of the patient (not the nurse!) Advocacy prn Family/Significant Other involvement Right to refuse care
Informed consent *Nurses are responsible to act in the best
interest of the client
Case Study A 16-yr-old male pt was involved in a MVA
and was ejected from the car. Initial assmnt reveals a patent airway, response to painful stim, laceration (L) thigh covered with drsg, contusions to (L) flank.
Prioritize these interventions: Immobilize head and neck Assess LOC & Neuro deficits Assess (L) thigh & Apply clean pressure drsg Call parents for consent to Tx Insert Foley catheter
Managing Time Time analysis/assessment
How do you usually spend your time? When are you most efficient?
Time frame Organized method of planning
Principle of time mngmt “Organize & execute around priorities”
(Covey, 1989, p149) ADOPIE (Nrsg Process)
Avoid “Pitfalls” along the way: Procrastination, easiest thing done 1st,
distractions, 1st seen=1st done, socialization overload, failure to differentiate priorities, or accepting someone else’s priorities!
Time Management Tips ID important aspects/ needs ID barriers to completion Prioritize needs Develop reasonable time frames Delegate appropriate tasks Avoid the need to be perfect Evaluate your efforts & note areas to be
improved
Lipe, S. K. & Beasley, S. (2004) Critical thinking in nursing: A cognitive skills workbook
Managing to Find the Time! Organize priorities after shift report
Nursing Process Make lists & cross off items as you go SET GOALS
“A goal without a deadline is a dream” Judith Brumm, RN, CNOR
THINK ahead-be prepared! “If you don’t spend time using your brain, you’ll
spend time using your feet!” (E. Heim, ) Plan time for documentation
Personal Time Management
Nursing Spectrum: Student Corner http://www.nursingspectrum.com/Student
sCorner/StudentFeatures/TimeSide.htmStudent website
http://caring4you.net/tests.html
Finally….
The End
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