Nurse Empowerment

On the CUSP: Stop BSI

Learning Objectives

• To understand the importance of nurse empowerment

• To consider the regulatory and accreditation mandates for nursing leadership

• To learn strategies to help empower nurses

CUSP/CLABSI:What We Know

• Change involves technical challenges– Evidence– Measurement– Analysis

• Change involves adaptive challenges– How to engage nurses, physicians, executives– Competing priorities– Organization hierarchies– How to hardwire practice changes

Improve Patient Safety Culture: Create Trust

• Caring– Keep patients as your North Star– Commit that preventable harm is not tenable– Tell your own Josie Story

• Competent– Learn from mistakes – Implement teamwork tools (CUSP)

Ensure Patients Reliably Receive Evidence

Pronovost: Health Services Research 2006

  Senior TeamStaffleaders leaders

EngageHow does this make the world a better place?

Educate What do we need to do?

ExecuteWhat keeps me from doing it?How can we do it with my resources and culture?

Evaluate How do we know we improved safety?

Nurse Empowerment

Keep Patient as North Star – Harm is not tenable

• Decision to speak up– Must feel competent – Must feel it is safe– Must feel it will work

• Transparency when harm occurs– At patient level– At provider level– At organization level

Strategies for Nurse Empowerment

• Policy Level– Code of conduct– Require nurses to assist with central line placement

• Make certain supportive structures are in place

– Require adherence to insertion checklist– Policy to deal with disruptive behavior– Require that bedside nurse attend rounds– Managers need to support best practice; hold nurses

accountable and respond to poor practice

Strategies for Nurse Empowerment

• Practice Level– Licensure– Nurse Practice Act– Magnet Nursing– Collaborative Practice Models• Infection Preventionists• Attending Physicians

Strategies for Nurse Empowerment

• Performance Level–Orientation/Skill Building–Annual Competency Assessment–Clinical ladder – leadership recognition

Strategies for Nurse Empowerment

• Use tools to practice nurse empowerment in safe space

– Nurses participate in staff safety assessment

– Nurses participate in HSOPS (culture survey)

– Daily Goals with nurse read back

– Learn from Defects

– Participate in M&M

• Address disruptive behavior quickly

Strategies for Nurse Empowerment

• In conflict, keep focus on patient as North Star

• Remind staff that teams make wise decisions with diverse and independent input– Do not play person down

Action Plan

• Project leaders meet with CUSP/CLABSI team

• Discuss what policies can be put in place to enhance nurse empowerment

• Create strategy to involve beside nurses in this project: use the 4Es

• Discuss what tools you can use to enhance nurse empowerment