Lewin's Change Theory - A three-step process: unfreezing; moving or change; refreezing
- unfreezing; recognizing a change is needed, change needs to be
... [Show More] done d/t safety issue or other concerns
- freezing: change done by motivating, educating, implementing based on showing nurses what is happening isn't the best/show them why they need to change, benefits of change, how they are going to change - makes them more likely to change
- refreezing
change is difficult so explain why you need to change and once in place, solidify the practice so they keep doing it
PDSA model of quality improvement - Plan, do, study, act
- Plan - identifying there is a problem
- Do - testing and potential solution, testing b/c you aren't sure it's the right solution so do it on a small scale/small test study
- Study - research and analyzing whether or not if it is effective
- Act - implementing change and deciding if we should keep the intervention and if it's meeting the requirements/should we use it
- Continuous model*
- Keep looking at it to see if there are any changes needed and keep evaluating it
- Once you find the right solution you can adapt change based on what you have found as good
spreadsheet for nursing - - columns and rows
Nursing Primary Use:
- Calculation
- Recalculate for a change in a reference cell (cell in a formula)
- Trending
Nursing Concerns
- Quality Tracking
- Medication Errors
- Patient falls
- Hospital Acquired Infections
- Length of stay
- Time & attendance
- Financial /budget mgm
- Some statistics
line graphs for nursing - Line graph - displaying data over time and looking at a trend; evaluating over time and looks at consistency
pie chart - Pie chart - percentages, can't look at measured quality outcome over time, time isn't measured by a pie chart
rule based error - good rule applied in the wrong situation
EHR vs. PHR - EHR - organizational use
PHR - personal use
CDSS, CPOE and how they are utilized - CDSS - Clinical Decision Support Systems:
- databases that help support and enhance knowledge of nurses to enhance decisions and make healthcare decisions
- like Lexicomp
- gives prompts and reminders to help with implementation of evidence-based practice and can show drug interactions
CPOE - computerized provider order entry
- physicians are primary users
- easy to maintain, online prescribing for doctors
software, programs, & hardware - software - application within the computer [Show Less]