Using an Old/New Educational Methodology Resulting in Quality of Practice and Patient Safety

Saturday, April 5, 2014: 1:30 PM

M. Anne Longo, PhD, MBA, RN-BC, NEA-BC
Center for Professional Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH

The educational session provides the participant with the knowledge to plan a large scale educational program using a new twist on an old theory. The example is standardizing care in order to reduce variation in practice. Participants will be provided with step by step strategy using an instructional design model and complete their own example.

In 2007, the Center for Medicare/Medicaid chose to no longer pay for certain hospital acquired conditions (events of harm) including:  pressure ulcer stages III and IV; falls and trauma; surgical site infections; vascular-catheter associated infection;  and catheter-associated urinary tract infection.

For one hospital, 79% of FY 13 Events of Harm were a result of Catheter Associated Blood Stream Infections, Catheter Associated Urinary Tract Infection, Ventilator Associated Pneumonia, and Pressure Ulcers (all known as Prevention Standards).  Assessment of the situation included chart review, patient interview, staff interview, and direct observation revealing a variation in practices.

Based upon W. Edward Deming’s theories of continuous improvement, the Toyota job instruction method was used to design a class where both RNs/RTs validated their skill and knowledge of 4 events that can cause a patient serious harm. The 4 hour class included a rotation of 6 stations with trainer scripts, aids, equipment all insured each trainer provided a consistent message and each participant provided a return demonstration of the skill. Online pre-work was followed by support using the hospital’s online procedure manual.

Kirkpatrick’s level 4 evaluations were conducted to gauge the participants: reaction, learning, changes in behavior and if there were results in terms of the level of Never Events. The 3 domains of learning were assessed/evaluated via a pre/post knowledge survey, post observations of skill at the point of care, continued tracking of the events of harm, and the cost of the education.

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