A Team Approach to Improving Tissue Management.

Tissue implant management can be labor intensive because of multiple storage locations and cumbersome tracking systems. The purpose of this quality improvement (QI) project was to enhance patient safety and nursing satisfaction by upgrading our tissue-management facility and processes. We created a centralized storage room for tissue implants and staffed this room during all shifts. Tissue management was executed using tracking software and transportation devices that supported tissue receipt, storage, disposition, documentation, and reporting. Our project resulted in our full compliance with tissue implant requirements from the US Food and Drug Administration (FDA) and The Joint Commission. We also reduced our documentation error rate from 3% to less than 1%, and decreased the tissue-expiration rate by 1.1%. Tissues are now delivered to ORs, which allows RNs to focus on patient care rather than retrieval of implants. Monitoring of the tissue inventory has improved, resulting in the reduction of tissue wastage.

Surviving OR computerization.

In 2007, a steering committee at West Virginia University Hospitals, Morgantown, began a three-year, accelerated design, computer implementation project to institute an automated perioperative record. The process included budgeting, selecting a vendor, designing and building the system, educating perioperative staff members, implementing the system, and re-evaluating the system for upgrades. Important steps in designing and building the system included mapping patient care and documentation processes, assessing software and hardware needs, and creating a new preference card system and surgical scheduling system. Staff members were educated to use the new computer applications via contests, inservice programs, hands-on learning modules, and a preimplementation rehearsal. Role-based security ensures that staff members are granted access to the computer applications they need to perform the work defined by their scope of practice. Planning ensures that the computer system will be maintained and enhanced over time.

Evaluation of a program to increase evidence-based practice change.

OBJECTIVE: The study evaluated a nursing research program designed to achieve systematic evidence-based practice change. Specifically, change in nurse attitudes about use of research and research conduct, practice change projects, and nurse participation in research-related activities were evaluated. BACKGROUND: Evidence indicates that successful evidence-based practice change in an organization requires senior leadership support and a systematic program for practice change. Evaluation of program effectiveness provides evidence about opportunities for further improvement. METHODS: Quantitative evaluation used a pretest-posttest design. The site was an academic medical center in rural West Virginia. Participants were registered nurses from all inpatients units, perioperative services, and emergency departments. Surveys used Alcock et al's Staff Nurses and Research Activities scale. Descriptive evaluation included the number of nurses who attended the workshop, practice change projects, scholarly products disseminated, and outcome of a Magnet review. RESULTS: First, knowledge about the availability of support services increased between 1999 and 2002 and was associated with higher attitude scores about research and research utilization. Second, registered nurses who reported participating in research-related activities had more positive scores on all attitudes than registered nurses who reported not participating. CONCLUSIONS: Nurse leaders may improve participation and attitudes about research and research utilization by internally marketing the support available for research-related activities.