Shared governance continues to grow in the nursing profession. From improving recruitment and retention to competing for Magnet designation, any facility seeking to give its nurses a sense of control over the care they provide is going to present this opportunity.
As far as Mylene Perez James, BSN, RN, OCN, is concerned, shared governance is essential to instilling quality care during a time when patients become labeled as "informed consumers" more often, seemingly with each passing day.
"Most people know that if they're going to run a successful institution for their patients, those working at the bedside have to make an influence," said James, the oncology educator at DeKalb Medical Center, Decatur, GA.
She should know. As the co-chairperson of DeKalb's 4200 Partnership Council, a group of 11 staff members that is tasked with maintaining quality care throughout the facility, James and fellow co-chair Jacqueline Atkinson, RN, OCN, lead an innovative bunch that has successfully identified and formulated policies and procedures using evidence-based practice, and has implemented changes in nursing practice and education to facility staff.
The group, comprised of eight RNs, an LPN, a patient-care technician and an operations-support associate, is also the winner of ADVANCE's 2010 Best Nursing Team award, as decided by a panel of independent nursing judges.
Nominated by James, the council's mission is to promote professional growth of staff and enhance the quality of patient care through effective collaboration among Dekalb Medical partners. Since its inception, the council has launched a number of initiatives that have led to improved patient care at the hospital, generated more camaraderie amongst staff and increased patient-satisfaction scores, James said. Most projects are piloted on the oncology units (where all nurses from the council are staffed) before being rolled out to the med/surg units and the rest of the facility, as desired.
Policies & Procedures
Most recently, the oncology unit enacted its "Village" project as a means of enhancing patient experiences from the point of admission and information-sharing while encouraging positive attitudes in hopes that patients will feel welcomed into a more smoothly operated, less-stressed environment.
Through this initiative, conceived by clinical coordinator Regina Duncan, RN, OCN, patient admissions are expedited more efficiently as a group effort, James said. Following the adage that it "takes a village to raise a child," each member on staff plays a role in the admissions process so patients can get into beds as quickly as possible. Arriving patients are escorted to their rooms by nurses who individually handle particular responsibilities as opposed to one nurse and a technician having to complete everything, as was the previous standard.
"It was taking up to 3 hours to complete an admission at times, because nurses were often busy doing other tasks and, sometimes, having little time to concentrate on completing the admission," James said. "And if you've ever been a patient who's been admitted at night, you know you're always tired because there's no telling how long you've been up all day. Admissions now take between 30 and 45 minutes under the new process, and a lot of other units have embraced this idea and are looking to implement it."
The council is also known around the facility for being a trendsetter with clinical projects. Some of these highlights include establishing a unit-specific orientation manual that serves as a model for orientation training on all med/surg floors; launching a falls project that has studied response times of staff members responding to calls; creating a series of annual skills competencies that has helped the hospital standardize numerous practices; and authoring multiple care-planning initiatives such as an oral-care policy for oncology patients, an intraperitoneal chemotherapy policy, a bleeding precautions and thrombocytopenia policy, and various protocols within the special oncology unit.
Furthermore, the group is credited with initiating a survey that addresses staff's educational needs, devising an educational calendar that details the year's continuing education sessions, penning the welcome brochure given to all patients and creating a "community board" that's used to inform visitors and families.
Another recent evidenced-based study by council members also led the special oncology unit to discontinue use of booties as part of its neutropenic precautions because they did not show evidence of reduced infections - a move that's reportedly saving the hospital $14,000 per year.
While the partnership council clearly was enacted for more important reasons, James said the attention the group has been getting for their winning entry has been well-received.
"Everyone is very excited," she said. "This is well-deserved, and we're not taking it lightly - it's a big deal. The team is just very happy and really feels appreciated. We'd be doing this regardless of the award, but it is nice to be recognized for the work that we're doing."
Praise at the facility has come in abundance.
"It's an exceptional accomplishment, and very much deserved," said Cathleen Wheatley, MS, RN, senior vice president, chief quality officer.
Jan Gannon, MSN, RN, vice president of patient care services and chief nursing officer, describes the team as "truly dedicated."
"They represent us so well, and we appreciate all that they do every day," she said. "This is a tremendous accomplishment."
To share the achievement with the facility, James said a celebration was being planned amongst staff and administration.
"It's a good feeling to know that the work you're doing makes a difference," she told ADVANCE. "It's reaffirmation that we're doing what's right. We didn't start this group to win an award, but we do want to share the good things that we're doing with others in hopes that people will be able to do some of the same things, because all of us in healthcare have the same goal of wanting to give good, quality care."