New Knowledge, Innovations and Improvements
New Knowledge, Innovations and Improvements enhance our professional practice and improve our outcomes. Nurses are active in research and adopt evidence-based practices (EBP) to deliver quality care. Innovation is promoted, and daily, we look for new ways to improve our nursing care delivery.
In 2023, nurses improved the patient experience and enhanced professional practice by:
- Adopting evidence-based practices to implement a Health Literacy program that addresses one of the top social determinants of health.
- Improving health equity by removing language barriers through the adoption of on-demand interpretation via bedside hand-held devices.
- Modifying an Emergency Department role to provide support to staff and offer more efficient patient care.
Health literacy champions help peers educate patients and families
Evidence suggests implementing health literacy strategies can increase patient understanding and decrease Emergency Department visits and re-hospitalizations. However, health care professionals often fail to employ health literacy techniques.
To combat some of these issues, an institutional review board-approved implementation science study titled “Communicate to CARE” (Clear communication, Achieve understanding with teach-back, Receptive to our patient family needs, Empathetic care delivery) was completed in the Ear, Nose and Throat clinic. Health literacy champions emerged as keys to improving the ways clinicians help patients understand their health and how to care for themselves through better clinician adoption of health literacy practices. This led to a second IRB-approved study titled “Implementing Health Literacy Practices in Pediatric Ambulatory Care: A Mixed Methods Study Using the iPARIHS Framework,” which implemented more health literacy champions.
Nurses in this role are embedded in individual clinics to influence the team and help improve the ways they communicate with patients and families, ultimately helping families navigate the complex health system more easily and making health information easier for patients and families to understand. This is especially important as social determinants of health (SDOH) data shows health literacy is among patients’ and families’ top needs.
Since launching in April 2023, the health literacy study:
- Trained 26 health literacy champions across 16 clinics
- Trained 216 team members in health literacy practices
- Formed a health literacy learning community
Nurses involved in these studies have disseminated findings through publications and at professional conferences across the country.
On-demand interpreters remove language barriers for nurses
Nurses recognized the challenges posed by language barriers in patient care and facilitated the addition of the On-Demand Interpretation (ODI) to the Rover, a hand-held, bedside device used in care delivery.
The resource was added to the Rover through an EBP project to enhance seamless communication, remove barriers to interpretation services and consider updated and evidence-based measures for interpretation services. Nurses identified the challenge, reviewed the literature, identified barriers and collaborated with Language Services and other key stakeholders to integrate ODI into practice.
ODI contributes to health equity, a key priority at Children’s Health. The service gives fair and equal access to interpretation and alleviates language barriers so nurses can communicate well with our diverse patient population. The innovative addition of ODI to Rovers also exemplifies the unwavering commitment of nurses to prioritize patient well-being in every aspect of their practice.
Plano Emergency Department improves processes with flex nurse
Emergency Department leaders in Plano improved the patient and team member experience with a new flex nurse role.
Leaders identified the need to adjust the role and responsibilities of the nurse assigned as the second triage nurse. Charge nurses utilize the flex nurse role as a resource to the department by providing support to staff and offering more efficient care to patients. Clinical nurses on a triage committee defined this role and outlined the expectations.
The flex nurse:
- Assists with initial triage.
- Completes primary assessments and suicide ideation screening and initiates standing delegation orders (physician-prepared, written instructions that address specific patient needs).
- Temporarily acts as a resource to other areas based on departmental needs.
The process improvements contributed to:
- A 6.2% improvement in the left-without-being-seen (LWBS) rate from 2022 to 2023.
- A 47-minute reduction in door-to-provider time.
- A 2023 year-end RN turnover rate reduction of 9.3%.
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