Full Answer Section

• Proposed Nursing Care Delivery Model: Team Nursing
  • Rationale: Team nursing offers a balance between cost-effectiveness and quality care. It allows for a more efficient use of nursing staff while maintaining patient safety.
  • Structure:
    • A team leader (RN) will coordinate care for a group of patients.
    • The team will include other RNs, LPNs/LVNs, and nursing assistants (NAs), each with specific roles and responsibilities.
    • Assignments will be based on patient needs and staff competencies.
  • Implementation:
    • Develop clear roles and responsibilities for each team member.
    • Provide comprehensive training on team communication, delegation, and coordination.
    • Implement a standardized care planning process.
    • Establish regular team meetings for communication and collaboration.
    • Carefully consider the ratio of RNs, LPNs, and NAs for each team.
• Cost Savings:
  • Reduced overtime through more efficient staffing.
  • Optimized use of LPNs/LVNs and NAs for tasks within their scope of practice.
  • Decreased length of stay through improved care coordination.

2. Addressing Joint Commission National Patient Safety Goals:

• Chosen Goals:

  • NPSG.07.01: Reduce the risk of healthcare-associated infections (HAIs).
  • NPSG.03.06: Improve medication safety.

• Strategies for Improvement:

  • NPSG.07.01: Reduce the risk of healthcare-associated infections (HAIs).
    • Team Nursing Role:
      • Team leaders will ensure adherence to hand hygiene and infection control protocols.
      • NAs will be responsible for environmental cleaning and disinfection.
      • All team members will participate in infection surveillance and reporting.
    • Specific Interventions:
      • Implement standardized hand hygiene protocols and provide regular training.
      • Enhance environmental cleaning and disinfection practices.
      • Improve catheter and central line maintenance.
      • Implement a robust infection surveillance system.
      • Increase staff education related to infection control.
  • NPSG.03.06: Improve medication safety.
    • Team Nursing Role:
      • RNs will be responsible for medication administration and patient education.
      • Team leaders will ensure accurate medication reconciliation and documentation.
      • All team members will participate in medication safety huddles.
    • Specific Interventions:
      • Implement barcode medication administration.
      • Enhance medication reconciliation processes.
      • Provide regular medication safety education for staff and patients.
      • Implement a “double-check” system for high-risk medications.
      • Improve communication during patient handoffs regarding medications.

3. Implementation Plan and Timeline:

• Phase 1 (Weeks 1-2):
  • Conduct staff training on team nursing and the chosen patient safety goals.
  • Develop standardized care plans and protocols.
  • Establish team structures and assignments.
• Phase 2 (Weeks 3-12):
  • Implement the team nursing model and new patient safety interventions.
  • Conduct regular team meetings and performance evaluations.
  • Monitor key performance indicators (KPIs) related to cost, patient outcomes, and safety goals.
• Phase 3 (Weeks 13-24):
  • Evaluate the effectiveness of the new model and interventions.
  • Make necessary adjustments and refinements.
  • Prepare for the Joint Commission revisit.
• KPIs:
  • HAI rates.
  • Medication errors.
  • Length of stay.
  • Nurse satisfaction.
  • Patient satisfaction.
  • Cost per patient day.

4. Communication and Stakeholder Engagement:

• Transparency: Communicate the need for change and the rationale behind the new model to all staff.
• Collaboration: Involve staff in the planning and implementation process.
• Feedback: Establish channels for ongoing feedback and address concerns promptly.
• Board and Stakeholder Reports: Provide regular updates on progress and outcomes.

5. Technology and Resources:

• Leverage electronic health records (EHRs) for efficient communication and documentation.
• Utilize technology for medication administration and infection control.
• Ensure adequate staffing and resources to support the new model.

This plan addresses the financial sustainability concerns while prioritizing patient safety and quality care. By implementing team nursing and focusing on the chosen patient safety goals, Ocracoke Regional Healthcare System can achieve improved outcomes and prepare for a successful Joint Commission revisit.