CSI Summary
Available only to registered AACN.org users.
Project Topic:
Just Role With It
Hospital, City and State:
Seattle Veterans Affairs Medical Center, VA Puget Sound Healthcare System, Seattle, Washington
Unit:
5 East - Acute care medical surgical unit
6 West - Acute care medical telemetry unit specializing in cardiology and neurology
CSI Participants:
- Nhu-Ngoc Nguyen, BSN, RN
- Kathleen Shaner, BSN, RN
- Tyler Smith BSN, RN
Project Goals/Objectives:
- Improve RN comfort 40% by utilizing a pre-survey and post-survey after Rapid Response Role training
- Improve the AACN Healthy Work Environment Assessment Tool (HWEAT) standard score for True Collaboration 3.34 (somewhat healthy) to at least 4.00 (moderately healthy)
Project Outcomes:
- Improved RN comfort level 16%
- Improved HWEAT True Collaboration score from 3.34 (somewhat healthy) to 3.69 (somewhat healthy)
- Increased HWEAT aggregate score from 3.67 to 4.02 and all HWEAT standards
Project Overview:
After identifying that the rapid responses on our units were confusing, lacked clear and concise reports, and debriefing was not taking place, the CSI team decided to focus our project on the rapid response process. We also found that our HWEAT score for True Collaboration was only 3.34, which falls within the somewhat healthy range. This supported our decision to implement a plan to improve the rapid response process, improve nurse comfort level during a rapid response, and improve the care provided during a rapid response.
The CSI team met with various interdisciplinary healthcare team members such as respiratory therapy, STAT team, nursing education, acute care, and critical care providers. Next, we created a rapid response report tool, post rapid response debrief tool, and a rapid response RN roles poster as educational elements to utilize during our project kickoff. Our team provided education on these tools during our project kickoff. Afterward, a preclinical survey was released for staff to evaluate their baseline comfort levels.
Throughout the year, we provided in-services and incentives to encourage the use of the resources created to support the rapid response process. In addition to education, we also released a postclinical survey, and the results showed an average of a 16% increase in RN comfort level during the rapid response process. Our team also received positive feedback from the STAT team nurses and the hospitalists regarding the improved organization and efficiency of rapid responses on the units. Finally, our HWEAT score for True Collaboration increased to 3.69. The project had no direct fiscal impact; however, patient outcomes have improved by ensuring that patients are at the correct level of care.
Permission to Reuse Materials
The materials associated with this AACN Clinical Scene Investigator (CSI) Academy project are the property of the participating hospital noted above, not AACN. Requests to use content contained in the CSI team’s summary, presentation or toolkit should be directed to the hospital. We suggest reaching out to the hospital’s Communications, Marketing or Nursing Education department for assistance.
Disclaimer
The AACN CSI Academy program supports change projects based on quality improvement methods. Although CSI teams seek to ensure linkage between their project and clinical/fiscal outcomes, data cannot be solely attributed to the project and are estimations of impact.