Decreasing Falls By Improving RN To CNA Communication and Collaboration

Project Topic:

RN to CNA Communication Tool

Hospital, City and State:

Methodist Jennie Edmundson Hospital, Council Bluffs, Iowa

Unit:

• 4H Ortho/Neuro

CSI Participants:

• Lora Justesen, BSN, RN
• Ryann Portch, RN
• Staci Wuestwald, BSN, RN

Project Goals/Objectives:

1. Improve Healthy Work Environment Assessment Tool (HWEAT) survey Skilled Communication and True Collaboration scores greater than or equal to 4.5 (healthy work environment survey1 was 3.53)
2. Decrease staff disengagement Oldenburg Burnout Inventory (OLBI)2 to less than or equal to 20 (OLBI2 scored 22.1)
3. Decrease fall rates 20% (originally 24)
4. Decrease accumulative staff overshift time 15% (originally was 286 hours)

Project Outcomes:

1. Decreased HWEAT Skilled Communication and True Collaboration scores 3.53 to 3.45
2. Decreased Oldenburg Burnout Inventory (OLBI) disengagement score 22.1 to 21.4 and risk for exhaustion 23.4 to 21.4
3. Increased fall rates 24 to 28
4. Increased accumulative staff overshift time 286 to 631 hours
5. An unintentional outcome included decreased length of stay 98.91 to 86.45

Project Overview:

We created a standardized RN to certified nursing assistant (CNA) communication tool to improve staff communication and collaboration and help ensure quality involvement and care of patients. There is an area on the handoff tool for dual signoff for RNs and CNAs, and also an area for notes on forms for any other pertinent information related to patient care. Our patient volume and acuity increased after kickoff, which contributed to a increase in falls and increase in overtime. However, there was a decrease in length of stay during this period as noted in our outcomes. Sustainability efforts include incorporating the handoff report as an electronic document.