Improving Supply Procurement on Nursing Units
New York-Presbyterian Hospital Columbia Presbyterian Medical Center
The Capstone team worked with a leadership team at New York-Presbyterian Hospital Columbia Presbyterian Medical Center to develop a process for improving the procurement of supplies on two adult inpatient oncology nursing units, one medical and one surgical. This project was triggered by a time and motion study done in 2006, which showed that nurses are spending significant time away from the bedside to obtain supplies needed for routine or more specialized care. To better assess the needs of the nurses, the team conducted surveys and focus groups with nursing staff. An evaluation of the flow of supplies both from the central supply source to the unit and from the unit supply area to the point of care was undertaken. The team initiated an evidence-based approach and considered limits in modifications to the patient unit. The results can be utilized by the hospital to transfer time spent on obtaining supplies to providing direct bedside care.
Patient Acuity Systems
New York-Presbyterian Morgan Stanley Children's Hospital
The Capstone team formulated two research questions to assess the extent to which the New York-Presbyterian Hospital (NYPH) was utilizing evidence-based nursing sensitive patient acuity measures to manage nurse staffing: what are the current NYPH practices and how would a patient acuity system (at no significant extra cost) improve staffing decisions and patient care at NYPH? The Capstone team identified the current practices on two similar medical-surgical units in the NYPH system. Through a series of interviews and an evidence-based literature review, the team identified criteria to evaluate relevant patient acuity systems in the marketplace. Based on the findings, the Capstone team recommended next steps for the NYPH system with regard to acuity-based staffing.
Streamlining the NYPH Restraint Data Monitoring Process
New York-Presbyterian Hospital Department of nursing
New York-Presbyterian Hospital (NYPH) Department of Nursing is committed to the provision of safe, quality care to its diverse patient population. The vision of the Department of Nursing is to be one of the nation's leaders in nursing best practices; quality, safety and outcomes; research; education; and service excellence. The Capstone team was entrusted to develop a streamlined monitoring process for patient restraint that is efficient, reliable, compliant with regulatory agency requirements, and replicable. The Capstone team reviewed current manual process flow of patient restraint monitoring, hard copies of monitoring tools, and performed an extensive literature review. Nursing Quality Assurance Governing Council members, Patient Care Directors of pilot units, front line staff, Nursing Informatics, clients, and individuals from peer organizations were interviewed to better understand the scope of the project. The information was mapped out, researched, analyzed and a report of initial findings was submitted to the client as a point of reference for NYPH as it moves toward building a more efficient and accurate quality monitoring process. The team's recommendation will provide a hand-off to the client that presents a streamlined process, which includes data mining, timelines, and milestones. The recommendation also defines clear ownership and accountability of the specific campus-based Nursing Quality Assurance Governing Council that can be consistently and equally applied to other quality initiatives.
Introducing the Allen Pavilion Nurses to Community Outreach
New York-Presbyterian Allen Pavilion
New York-Presbyterian Hospital (NYPH) is committed to serving the vast array of neighborhoods comprising its service area and recognizes the importance of preserving a local community focus. The Department of Nursing plans for its nurses to have a strong community presence through volunteerism. The Capstone team identified current community outreach efforts at NYPH by conducting surveys and interviews with internal and external stakeholders and identified a local community school as an institution requesting a partnership with a health care facility. The final report includes recommendations to achieve a community outreach program, responding to the community's needs and the Allen Pavilion nurses. In addition, a communication strategy is outlined to better market community programs and increase participation of Allen Pavilion nurses.
Improving Supply Procurement on Nursing Units
New York-Presbyterian Weill Cornell Medical Center
For years, nurses have struggled with balancing bedside service, direct patient care, teaching, and an array of other daily tasks. Several studies have shown that nurses can spend seventeen percent or more of their shift administering medications, which can be equal to or greater than the amount of time they are able to devote to patient teaching and other interventions. New York-Presbyterian Weill Cornell Medical Center requested the Capstone team to observe the medication administration process on several medical-surgical units, identify the barriers that impede a safe and efficient medication administration process and present opportunities for improvement. The recommendations are being developed through observation data analysis, focus group discussions with nurses working on the units studied, and evidence extracted from literature reviews. The recommendations presented to the nursing leadership of New York-Presbyterian Weill Cornell Medical Center will identify opportunities to remove barriers that currently prevent nurses from spending quality time at the bedside.