On the CUSP: STOP BSI Nurse Empowerment

1. On the CUSP: STOP BSINurse Empowerment

3. Learning Objectives • To understand the importance of nurse empowerment • To learn strategies to help empower nurses

4. What Have We Learned So Far? • Work involves technical problems • Evidence • Measurement • Adaptive problems • Engagement of nurses, physicians, leaders • CUSP • Daily goals • Competing priorities

5. Improving ICU Cultureby Creating Trust • Caring • Keep Patients your North Star • Preventable harm is not tenable • Tell your own Josie Story • Competent • Learn from mistakes and implement teamwork tools (CUSP)

6. Ensure Patients ReliablyReceive Evidence Pronovost: Health Services Research 2006

7. Nurse Empowerment • Keep Patient as north star • Decision to speak up • Must feel competent • Must feel it is safe • Must feel it will work • Policy level (code of conduct) • Helpful if enforced

8. Strategies for Nurse Empowerment • Policy Level • Code of conduct • Require nurses to assist with central line placement • Require adherence to checklist • Policy to deal with disruptive behavior • Require that bedside nurse attend rounds

9. Strategies for Nurse Empowerment • Use tools to practice nurse empowerment in safe space • Nurse attends rounds • Daily Goals with nurse read back • Learning from Defect • Address disruptive behavior quickly

10. Strategies for Nurse Empowerment • In conflict, keep focus on patient as north star • Remind staff that teams make wise decisions with diverse and independent input • Do not play man down

11. Action Plan • Meet with ICU team • Discuss what policies can be put in place to enhance nurse empowerment • Create strategy to involve beside nurses in this project use the 4Es • Discuss what tools you can use to enhance nurse empowerment