Paper
Friday, July 11, 2008
Using Technology to Blend Different Levels of Care: A Leadership Strategy to Create an Evidence-Based Nursing Environment
Alma Degracia Cabading, RN, MBA, CCRN, Director Transplant Unit, The Methodist Hospital, Houston, TX, USA, Nena M. Bonuel, MSN, RN, CCRN, Center for Professional Excellence, The Methodist Hospital, Houston, TX, USA, Mary L. Shepherd, RN, MS, CNAA, Center for Professional Excellence NB1-087, The Methodist Hospital, Houston, TX, USA, and Karen L. Burger, RN, PhD, Graduate level class facilitator, University of Phoenix, Phoenix, AZ, USA.
| Learning Objective #1: learn leadership strategies to improve patient and nursing outcomes. |
| Learning Objective #2: learn about the acuity adaptable phenomena. |
In today's healthcare market, healthcare costs continue to rise while reimbursements fall. Nursing leaders must be innovative and resourceful in order to be competitive in the current healthcare arena. By combining the different levels of care, one can create an environment conducive to produce quality care, nursing, and administrative outcomes. The essence of leadership practice theory is to have a desired goal and creative actions to achieve that goal. The nursing leader on the multi-organ transplant unit created an evidenced-based nursing environment by adding technology at the bedside that supported the acuity-adaptable concept. During the patient's hospital stay, they could expect to transfer to various units having different levels of care. A visionary nurse leader developed protocols and trained nurses allowing the patient to remain in the same room beginning with their pre-operative care through in-patient admission to discharge, thereby minimizing care interruptions and positively impacting patient and nursing satisfaction, which are at an all time high.
By creating this new high-acuity unit transplant program, the nursing leader was able to secure a higher labor budget, which allowed the unit to titrate the nurse to patient ratio relative to the patient's acuity level, while adapting the nurse's skill and higher technology room to meet the patients' needs. By employing technology and combining different levels of care such as ambulatory pre-operative care, surgical intensive care unit, intermediate care, and acute medical-surgical floor to produce superior patient outcomes, the unit observed decreased patient falls, medication errors with harm, and average decrease of 2.2 days length of stay and the associated costs and increased patient satisfaction with nursing care and nursing satisfaction with autonomy. This is not just innovative, but a breakthrough in nursing practice.