Category: Clinical Corner

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Clinical Corner: Nurse Licensure Compact Changes

"Changes ahead" traffic sign

Prepare yourself for upcoming changes to the Nurse Licensure Compact as it transitions to the Enhanced Nurse Licensure Compact!

By Kora Behrens, Clinical Nurse Manager, Medical Solutions

Did you know the first and original Nurse Licensure Compact (NLC) was drafted way back in 1998? It was later signed into law in 2000 and 25 states have joined since.

Why have we waited so long to enhance and make the NLC better? Healthcare has changed dramatically since then and the nursing shortage only seems to increase as time goes on. The Bureau of Labor Statistics estimates there will be more than one million registered nurse openings by 2024 — twice the rate seen in previous shortages. The industry is way overdue on making changes to the NLC so that more nurses can cross state borders resulting in less open nursing positions. The National Council of State Boards of Nursing (NCSBN) has made this change a priority and with this change comes the Enhanced Nurse Licensure Compact (eNLC). Under the new eNLC, nurses will be able to provide care to patients in other eNLC states without having to obtain additional licenses.

As a Traveler, this is very important and impactful to the care that you provide — so listen up, because this may affect your license(s)!

Nurses who hold an original NLC multistate license will be grandfathered into the eNLC. The eNLC implementation date is currently set for January 19, 2018.

That said, it is important to know that while many of the original NLC states have passed legislation enabling them to be a part of the eNLC, not all of them have done so. Currently, there are four states — Colorado, Rhode Island, Wisconsin, and New Mexico — that were a part of the NLC but have not passed legislation to be a part of the eNLC.

There are also several states that were not previously part of the NLC that have passed legislation enabling them to become a part of the eNLC. These NEW states include Florida, Wyoming, Georgia, West Virginia, and Oklahoma.

Additionally, there are several states — Wisconsin, Massachusetts, Michigan, and New Jersey — which currently having pending eNLC legislation. At this time, it’s likely that Rhode Island will not pass legislation in time, and that Colorado and New Mexico will introduce emergency legislation to become part of the eNLC before the January 19, 2018 implementation date. Wisconsin is likely to pass legislation by December 2017, as well.

Now that you know which states are affected with these new changes, how does this effect you?

If you hold a compact license in a state that was in the NLC and is now a part of the eNLC as well, you do not have to do anything. The exception to this rule is if you obtained your perm state compact license on or after July 20, 2017. If this applies to you, then you will be required to meet the new eNLC requirements. Contact your state BON to learn more on what you need to do to meet guidelines.

If you are licensed in a state that was not a part of the original NLC and will become a part of the eNLC then on January 19, 2018, you will automatically have compact privileges in the new eNLC states.

If you are licensed in a state that is a current member of the NLC but will not be a member of the eNLC, then you will lose multistate privileges. However, you will still hold privileges in the states that were a part of the NLC. For example, if you have a multistate license in Rhode Island you will lose multistate privileges but will still hold the NLC compact license that would allow you compact privileges in Colorado, Wisconsin, and New Mexico — if they do not pass legislation to become part of the eNLC. You will need to obtain a single state license to travel in any other state. Some states do not have a process set up for this yet.

Travelers will then lose privileges to practice in the NLC states that have not become part of the eNLC as well. For example, someone who has compact privileges with their Iowa license will still have compact privileges in the eNLC states, however they will lose privileges to practice in Colorado, New Mexico, Wisconsin, and Rhode Island — again, if they do not pass legislation.

The biggest takeaway from these compact changes is the importance of awareness of your licenses and the actions to take moving forward! It’s crucial to stay up to date with any changes to the eNLC and to be proactive with your licenses in these pending states. If you have any questions, contact your Career Consultant or the Medical Solutions Clinical Team and we would be happy to assist you in this process.

We’ve also put together these handy FAQs on the NLC to eNLC transition and will be sure to add any changing or updated information to this page as the transition nears.

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Clinical Corner: Adaptability in Travel Nursing

Girl doing yoga

Adaptability and flexibility are key qualities for Travel Nurses!

By Kora Behrens, Clinical Nurse Manager, Medical Solutions

What is the key to success in Travel Nursing? This question is frequently asked when nurses or other healthcare professionals decide to embark on a contingency staffing career. Although there are many different qualities that make a Traveler successful, there is one trait that will directly impact your progress throughout your journey. The quality central to success is adaptability. Embracing change can be a challenge, however, if you become accustomed to this process you will possess a skill that is highly sought after by many potential employers.

To become someone who is adaptable you must learn to seek out opportunities for growth and development. Adaptable nurses and Travelers will challenge what they know to be right or correct and then mold that thinking into a new process or idea. By doing this they can investigate their habits to determine what leads to success and what does not. Examining their behaviors and processes will help them to make changes to what may or may not become the new normal and this directly reflects adaptability.

Another key characteristic of adaptability is being inventive and knowing what or who is available to you as a resource and asset. These resources can include other nurses, managers, physicians, ancillary staff, etc. Recognizing the individuals of your department that can assist you in adapting to a change in environment, policy, or process will help you to achieve the flexibility that is needed to be deemed an adaptable nurse. And never forget, your Career Consultant is always here for you as a very valuable resource as well!

Living in the moment is a mentality that’s prevalent in individuals who possess adaptability. What this translates to is the ability to take things one day at a time and to not focus on the what-ifs or what might happen. Being present in the moment allows nurses to stay centered on their job and avoid any complaints and bad attitudes. Nonetheless, adaptable nurses maintain the competency and capacity to look ahead. This pertains to discovering and uncovering opportunities for improvement.

The last few characteristics that define adaptability are acceptance and positivity. When it comes to positivity it is not just having a good attitude. It’s much more than that! Positivity is the ability to think positive about yourself and the situation. Taking a moment to breathe in a stressful situation will help to refocus your attention and energy and to shift your thoughts from anger, aggression, and frustration to patience, harmony, and confidence in your ability to handle the situation. This influence on your mind will advance to comprehensive control and long-term acceptance. Acceptance means that you do not place blame on others or seek out revenge when something goes awry. By accepting your part in the situation, you are taking responsibility and homing in on your ability to be adaptable.

Adaptability is important for Travel Nurses because it leads to success and it makes you more marketable to potential employers. The characteristics that I mentioned today will all help you as a nurse to achieve flexibility and to adapt to your surroundings. Travel Nurses that blend in will go unnoticed by other hospital staff because, to them, they are one of their own. This is the ultimate outcome to achieve when striving to become adaptable.

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Clinical Corner: Build a Strong Travel Nurse Resume

African woman with resume

Perfect your resume and take the Travel Nursing world by storm!

By Kora Behrens, Clinical Nurse Manager, Medical Solutions

Each interaction you have with others around you — whether social or professional — shapes the impression they have of you. A positive first impression typically leads to a better relationship, more opportunities, and better long-term outcomes. For obvious reasons, first impressions are extremely important when applying for a job or meeting someone for the first time. Translated into the Travel Nursing world, a positive first impression comes in the form of a well-structured, accomplished resume. A winning resume will get you noticed first for the best positions and can facilitate further development for your career and future.

So, how do you build a winning resume? The first step in becoming a champion resume builder is to present your value in terms of the objective. Paint a personalized picture of what you can offer and contribute. Include a narrative statement that outlines your goals, specialty area, level of experience, and expertise. Present a clear illustration of what you can contribute and why you would be the best fit for the position. Once you have put together your objective, you are ready to continue with the body of the resume.

There are several templates available to build a resume, but the secret is finding one that’s organized, clean, and detailed. Once you’ve chosen a template you are ready to continue with the other highlights of your resume. Adding in an expertise section will capture a brief account of your skills and it will make it easier for hiring managers to know what areas you’re an expert in. It may be helpful to include your certifications and qualifications in nursing in this section as well. Overall, this part of the resume should be a representation of your nursing skills and the diseases/illnesses that you are competent in.

To further highlight your competency in your resume, you should include a detailed description of your nursing experience. This should include what type of facilities you have worked at (acute, outpatient, long-term care), how long you worked there, the nurse to patient caseload, and the area or unit you specialized in. Additionally, while listing your past experiences, it is essential to list out patients that you cared for, the skills that you have performed, and the tasks that you were responsible for. The more details, the easier it is for employers to get an exact idea of your skill level and experience. It would also be relevant to provide information about your experience with electronic computer documentation, education, state licensure, etc. in this section to establish your qualifications.

The most important thing to feature in this section is a demonstration of your top performance. With each job that you present in the resume, make sure you include a narrative about how you went above and beyond your job duties including serving on committees, boards, and/or task forces. Listing out any accomplishments that you had on the job would also be important including any initiatives you were a part of, any health promotion campaigns or accreditation assistance, etc. The focus here is your confidence, competency, and contributions. It’s important to convey these qualities and to show what you can provide. By doing this, you will be able to make yourself more marketable in the Travel Nursing world, which gets increasingly competitive every day.

Upon completion of your flawless resume, you will be ready to apply for several nursing positions. Many nurses will be submitting resumes for various travel positions and the market is very competitive. Nonetheless, there is no cause for concern because you have set yourself apart from the rest. Your high-quality resume and the marketing approach you used in your resume will speak for itself. Before you know it, you will be on your way to an interview and job offer!

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Clinical Corner: Workplace Injuries & Workers’ Comp Process

Careful! Understanding the workers’ compensation process will help protect you as a Medical Solutions Traveler!

By Kora Behrens, Clinical Nurse Manager, Medical Solutions

Have you ever been injured on the job? Do you know about and understand workers’ compensation?

If you answered ‘no’ to either of these questions, consider yourself lucky. You never know how long it might be before you encounter a situation that requires you to know what to do in the event of a workplace injury. If you answered ‘yes’ you should still read this month’s Clinical Corner, so that you fully understand the workers’ comp process you’d need to follow if you’re injured on the job while working for Medical Solutions.

While we hope that you never experience any injury while taking care of your patients, if you do, here are some pointers to remember while traveling with us.

  1. The first step to remember when an injury occurs is to seek medical attention, if necessary. It is important to know where your hospital sends injured employees and travelers whether it be to the ER, urgent care, or employee health. For any needle sticks and/or blood or body fluid exposure, make sure you get blood drawn immediately from the patient you were exposed to and yourself if necessary. It will be your responsibility to be your own patient advocate in a situation as such, so make sure this blood drawn is done as soon as possible. It is also important that YOU are the one following up on the blood results with the hospital in case of a serious exposure.
  2. The next step in the process is to notify your career consultant (recruiter) and to have someone from Medical Solutions complete an incident report. If at any time, you are injured on the job you must report this to Medical Solutions and must be done within 24 hours of the injury or incident and Medical Solutions will need to know as much detail as possible to file the report and workers’ compensation claim. This step is important because billing will not be covered until the report is made with Medical Solutions.
  3. If you are off work for any amount of time due to the injury you must notify your career consultant. We will need copies of any restrictions you received because of the injury or treatment AS WELL AS a release saying that you are okay to return to work. This is required prior to returning to any work.
  4. Once you have spoken with someone from Medical Solutions about the details surrounding your injury, we will file the workers’ compensation claim with Sedgwick Claims Management Services. Once this is filed, you will receive an email that contains your claim number, contact information for Sedgwick, and instructions on how to register online to track your claim. Once you have received that claim number you should be able to view the status of your claim and any other information regarding the claim through Via One Express. You can register with Via One Express through claimlookup.com. Using this website and dashboard will allow you to upload any files associated with your claim or case, including bills which will allow for quicker payment. You can and should also communicate any billing items or questions about benefits to your claim adjuster through Sedgwick.

Please Note: If the injury occurs in Ohio, North Dakota, Washington, or Wyoming the injury still needs to be reported to Medical Solutions BUT you will need to follow hospital protocol for further information on the workers’ compensation process.

Knowing the proper process involved with workers’ compensation claims is very important to providing coverage to our Travelers as well as ensuring their health is managed and they are taken care of. The number one, most important important thing to remember if any workplace injury occurs is to communicate with Medical Solutions and your Career Consultant right away. No matter what the injury or the severity, Medical Solutions needs to be aware of what happened and that all starts with knowing the process and communicating overall!

 

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Clinical Corner: Hospital Safety

By Kora Behrens, Clinical Nurse Manager, Medical Solutions

Did you know that hospitals are one of the most hazardous places to work? Every day nurses are exposed to many health risks which makes them prone to illnesses, infections, injuries, and diseases.

It’s especially timely to discuss safety in nursing because June is National Safety Month. The concept of safety in the workplace is an essential component to providing quality nursing care. Additionally, healthcare staff and nurses must be aware of safety practices outside of patient care as well. It’s imperative that all healthcare workers know how to limit their exposure and minimize any risks that may be involved with the job.

The wide range of hazards on the job include sharps injuries, exposure to chemicals and hazardous drugs, back injuries, latex allergies, violence, and stress.

Safety First

June is National Safety Month, but hospital safety has many benefits year-round!

Through numerous encounters with patients with varying conditions, nurses become more prone to infectious agents like bacteria, fungi, viruses, and parasites. This type of exposure makes nurses and healthcare staff more prone to diseases such as HIV/AIDS, Hepatitis, Ebola, Influenza, MRSA, Tuberculosis, SARS, and MERS.

Healthcare workers and patients can sometimes be unprotected from chemical hazards as well. These hazards include several different anesthetic gases, aerosolized medications, chemotherapy medications, cleaning, disinfecting, and sanitizing agents, medical supplies and instruments, and fixative chemicals used for tissue specimens.

In addition to the infectious and chemical hazards, healthcare workers must also avoid damaging effects from the physical demands of the job. Injuries can occur frequently and they are often related to patient handling that involves heavy lifting and awkward body positions.

Lastly, the threat of violence and stress is equally as important to safety. Many healthcare workers experience physical and emotional stress which can contribute to health problems. This also has an impact on patient care and it can contribute to errors, patient falls, and other unfortunate outcomes.

The impact that these hazards can have on nurses and patients can be deadly and devastating, so it’s extremely important this month and every day of the year to improve safety and minimize any risks involved. The following suggestions will help nurses advocate for safety and make progress with their quality of work and patient care:

  • The first thing that every nurse and healthcare worker should do is to promote and support anyone and everyone who is an advocate for safety. A culture of this nature encourages everyone to be open and honest — plus it allows for learning from mistakes and transparency with any errors. Nurses that work in a safety-conscious culture will be more empowered to speak up when something is unsafe and they don’t have to fear any potential repercussions.
  • Another strategy for safety includes effective communication. By collaborating with each other and communicating appropriately, nurses will be able to provide better hand-offs and more detailed information on their patients. Implementing hourly rounding will help to communicate with patients on bathing, bathroom, or other health needs and this can eliminate fall risks and other health hazards for all parties.
  • Following protocol and policy as well as nursing standards of practice is essential to safety. Safety mechanisms are built into these policies and standards so it becomes extremely important to follow each step involved. Initiating fall precautions and turning patients should not be skipped or ignored and resources should be implemented for safe patient handling, transfer, etc. Harm and human error increase with each missed care for every patient. Time management and ancillary staff are important to executing all safety initiatives and protocols designed for risk depreciation.
  • Patient engagement is another factor that can contribute to maintaining safety. This includes active listening to the patient’s concerns and goals with their care. This will help everyone to stay informed about the needs and desires of the plan of care and it will help to communicate any risks for injury or threats to safety. Another added benefit to patient engagement and open communication is patient education. This provides an opportunity for the nurse to identify gaps in knowledge, but also for the patient to become educated on their health risks. For example, if a patient has a true understanding of their health and disease process they may be less likely to get out of bed without assistance as this would be a risk for injury from falling. The educated patient is a satisfied, protected, and confident patient.
  • The most important part of safety in nursing is learning from past incidents and other near misses. Many nurses will say that the mistakes they have made in the past were defining moments in their career that taught them great lessons. When an error occurs, it is important to review the events of the situation to understand why it happened. A root cause analysis is a strategy that is useful for identifying the cause of the problem in a safety situation. Some may refer to this as a debriefing of sorts as well which can be help immediately following a safety incident. This debriefing is done immediately following the incident so that details of what happened are not forgotten. Healthcare staff and nurses should be encouraged to immerse themselves in safety leader positions, officers, and management teams. Becoming an advocate for safety starts with taking on the role of someone who can hold others accountable.

Let us focus this month and beyond on minimizing risk and maximizing safety in all healthcare settings and segments!

 

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Clinical Corner: The Year of the Healthy Nurse

By Kora Behrens, Clinical Nurse Manager, Medical Solutions

May is a wonderful time to celebrate. Trees are budding, flowers are blooming, and the sun is shining. Most importantly, each May we spend a whole week celebrating nurses and the impact they have on their patients and healthcare. Nurses Week, celebrated each year May 6-12, provides a great opportunity to honor all the nurses who advocate for their patients, speak up for safety, and give of themselves daily to the patients they care for.

With all the time and effort spent on patient care, it’s easy for nurses to ignore and neglect their own health and wellbeing because their patients will forever be their number one priority. This presents a huge challenge for nurses to overcome! Nurse health is significant not only for each individual nurse’s good, but also because a nurse’s health has a direct impact on patient outcomes and the overall quality of care.

The increasing emphasis on safeguarding the health of nurses was the American Nurses Association (ANA) Nurses Week focus this year. The ANA dedicated 2017 as the “Year of the Healthy Nurse” with the tagline “Balance Your Life for a Healthier You.”

In keeping with this theme is the launch of Healthy Nurse, Healthy Nation (HNHN). This effort targets HNHN’s five fundamental indicators for wellness: rest, nutrition, physical activity, quality of life, and safety. Nurses are the face of our healthcare system, therefore focusing on their wellbeing has become important to delivering quality care to all patients and communities. To improve the wellbeing of our nurses we must first examine what their health struggles are.

Nurses are working longer hours and shifts, most often without breaks or moments to regroup. These long shifts make it difficult to get the adequate sleep and rest they need. Additionally, it becomes a challenge to eat healthy when nutritious foods are not easily accessible or cost effective. Lastly, working as a nurse is demanding on the mind and the body. It’s become increasingly difficult to avoid workplace violence and bodily injury while on the job. With such hurdles to navigate, it’s no wonder that the U.S. Bureau of Labor Statistics reports that nurses have the fourth highest rate of injuries and illnesses resulting in days away from work, when compared to all other occupations.

So, how do we focus on helping nurses to get healthier? The first step is getting involved. For example, spread the word to others on how to become more active, hold educational lunch hours to talk about eating healthy, and cater in meals from healthy places to eat. It starts with one person putting in the effort and eventually it becomes an active lifestyle and part of the culture within your facility and/or department. Making the commitment is the first step.

Establishing relationships with community partners in an effort to initiate healthier lifestyles expands the movement even further. Nursing schools, state nursing associations, healthcare organizations, consumer organizations, local businesses, and other organizations can all get involved to make an impact and enhance the health of nurses in their area.

Even though Nurses Week 2017 has come and gone, it’s important that we remember this year’s focus on keeping nurses healthy. Step outside of your comfort zone and make a change to your lifestyle. Reach out to your colleagues and friends to lend a hand in taking that first step in making a change. Encourage each other and work together for an improved and healthier nurse force.

Click here to learn more about The Year of the Healthy Nurse.

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Clinical Corner: Handling Conflict in the Workplace

Two knight on a chessboard. Confrontation.

Face Off: Learn to keep your cool and handle conflict in the workplace!

By Kora Behrens, Clinical Nurse Manager, Medical Solutions

Shellie clocks in for her shift. She gathers her things and heads out to the nurse’s station to find the nurse that she needs to get report from. Shellie gets report from the nurse and is then approached by the charge nurse about an admit that will be coming to the unit shortly. The charge nurse orders Shellie to take the new admit even though she already has a full patient load. The other nurses don’t have nearly as many patients to care for and Shellie feels like the patient assignment is unfair. She asks the charge nurse why she is getting this admit when everyone else clearly has a lighter patient load. The charge nurse proceeds to engage in an argument with Shellie and, rather than argue, she just accepts the assignment and carries on. Shellie can’t help but feel uneasy throughout the entire morning with the tension that is present between her and the charge nurse.

Has this ever happened to you? My guess is that you’re shaking your head yes! Scenarios that play out like this are very common in the workplace. Healthcare staff come in all shapes and sizes, and they each bring different attitudes, personalities, perspectives, beliefs, etc. to the workplace — which makes it difficult to avoid disagreements and struggles throughout the workday. Understanding why conflict occurs and how to resolve it will help you to maintain quality in the care that’s provided within your unit and facility. Furthermore, this will help to improve the morale of the staff and the overall work environment.

Here are some important steps you can take to handle conflict effectively in the work environment:MAKE UP

Talk with the person who is directly involved in the conflict.

The first step in eliminating any tension and conflict is to engage in open and honest communication. Arrange a time and place that is convenient and appropriate, preferably a quiet area that’s away from distractions, patients, and other staff. The conversation that you engage in doesn’t need to last long; it is purely an opportunity for each party to present their perspective and thoughts on the situation.

Focus on the specific behavior or event that was most bothersome and be clear about the details.

Present the problem to the other party to make sure they are aware of the focus of conversation. Be specific about what actions or words bothered you and why they bothered you. Allow the other party to present their point of view and actively listen to what their feelings and thoughts are.

Identify what you agree on and the issues that may be conflicting.

After each party has had a chance to present their perspective it is important to summarize the points of agreement and disagreement. Assess the situation to determine if the other person understands your point of view and then try to understand where they are coming from. Empathy is a huge factor within this step of dissolving conflict. If each party can see the perspective of the other, then common ground is easier to obtain.

Develop an action plan to work on reducing and avoiding any future conflicts.

The focus here should be obtaining harmony and minimizing any discord in the future. Striving for a better understanding of everyone in the unit will help to determine the course of action with any future conflicts. For Travelers specifically, this may be difficult because they do not have a lot of time to establish who they are to their peers and they have limited time to understand everyone around them. This is a challenge that can sometimes be difficult to achieve. To seek successful communication, Travelers should be open, honest, approachable, friendly, sociable, communicative, and warm to the others around them. In addition to these qualities, one should set the standard up front that they are open to discussing conflicts and clearing up any misunderstandings.

Follow through, model effective conflict management, and strive to build on successes.

Effective conflict management depends on continually striving to address conflicts quickly and appropriately. It becomes increasingly important for all nurses to engage in the correct conflict resolution techniques so that others can learn and model these behaviors. Establishing that standard right away will help to minimize future conflicts, thus future successes will be easier to achieve and celebrate.

Often in healthcare, there are many things that are out of our control. As nurses, we all care about our patients and their outcomes. If we let conflict progress it will affect our patients and the overall quality of care will suffer. As a result, the nursing field should maintain focus on controlling the issue of conflict when, most often, it is unnecessary and can be easily resolved.

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Clinical Corner: Joint Commission Sentinel Event Alert 57 — Role of Leadership in Safety Culture

Safety First

The Joint Commission’s Sentinel Event Alert 57 concerns the importance of adequate leadership to safety in healthcare facilities.

Hospital leadership has the crucial responsibility of protecting the safety of patients, staff, and visitors. That’s the inspiration behind The Joint Commission’s Sentinel Event Alert 57, which aims to help establish and improve safety culture in health care.

The Joint Commission periodically — though somewhat rarely — releases Sentinel Event Alerts about issues they find to be of concern.

This recent alert was spurred by the finding that within The Joint Commission’s Sentinel Event Database that “leadership’s failure to create an effective safety culture is a contributing factor to many types of adverse events — from wrong site surgery to delays in treatment.”

Additionally, Sentinel Event Alert 57 gives a few examples of adverse events that can be caused by inadequate leadership, including:

  • Insufficient support of patient safety event reporting
  • Lack of feedback or response to staff and others who report safety vulnerabilities
  • Allowing intimidation of staff who report events
  • Refusing to consistently prioritize and implement safety recommendations
  • Not addressing staff burnout

Whew — that’s a lot to address! Thankfully, as far as staff burnout goes, Travel Nursing can be of help when it comes to that issue. So, if you’re a Travel Nurse: Thank you — you are part of the solution!

Joint Commission Sentinel Event Alert 57The Joint Commission defines a “Safety Culture” as follows: “Safety culture is the sum of what an organization is and does in the pursuit of safety. The Patient Safety Systems (PS) chapter of The Joint Commission accreditation manuals defines safety culture as the product of individual and group beliefs, values, attitudes, perceptions, competencies, and patterns of behavior that determine the organization’s commitment to quality and patient safety.”

The Sentinel Event Alert 57 details these 11 steps that health care leaders can implement in order to properly address safety culture:

  1. Transparent, non-punitive approaches to reporting and learning from adverse events, close calls and unsafe conditions.
  2. Clear, risk-based processes for recognizing and separating human error and error arising from poorly designed systems from unsafe or reckless actions.
  3. Adoption of appropriate behaviors and championing efforts to eradicate intimidating behaviors.
  4. Establishment, enforcement and communication of all policies that support safety culture and the reporting of adverse events, close calls and unsafe conditions.
  5. Recognition of care team members who report adverse events, close calls and unsafe conditions or who have suggestions for safety improvements.
  6. Establishment of an organizational baseline measure on safety culture performance.
  7. Assessment of safety culture survey results from across the organization to find opportunities for improvement.
  8. Development and implementation of unit-based quality and safety improvement initiatives in response to information gained from safety assessments and/or surveys.
  9. Implementation of safety culture team training into quality improvement projects.
  10. Proactive assessment of system (such as medication management and electronic health records) strengths and vulnerabilities, and prioritizing them for enhancement or improvement.
  11. Organizational reassessment of safety culture every 18 to 24 months to review progress and sustain improvement.

Click here to see The Joint Commission’s infographic on 11 Tenets of a Safety Culture.

You can view the entire publication here.

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Clinical Corner: Pain Assessment and Management

Pain Management

Pain assessment is crucial to providing quality patient care, but not every patient judges their pain equally!

By Chris Vinton, Medical Solutions Quality Assurance Specialist

Patient pain can be one of the more difficult aspects to manage when it comes to complete patient care. Pain can’t be measured or objectively found, and it is often reported by patients based on how they have experienced pain in the past. Other times, patients have no experiential basis for rating or conveying the pain they are experiencing.

As with just about everything in the nursing field, pain assessment and management will differ depending on the unit and the hospital. The most common way to assess pain is the numerical measurement scale. Patients rate on a scale from 1-10, but this does have its issues. Patients may come in for an ear ache and they may rate the pain as a 10. To the patient, this may be the worst pain he or she has ever been in, but their condition might not require some of the more serious pain meds. Hospitals do have their own protocol in place on what pain medicine to use and, as always, ask your supervisor if your patient’s pain has not been alleviated after administering medicine.

Pain rating scale chartThe 1-10 scale is just a baseline for a patient’s pain. To get a full view of the patient’s pain, there are several things nurses can do — such as observing the patient’s behavior. A patient’s facial expressions may be anything from clenching of teeth or a grimace. They could favor a certain body part or try to protect it with their arms. The pain could cause the patient to experience disorientation or withdraw socially. Use your best judgement when observing for pain and if you aren’t entirely sure, get some guidance from your supervisor.

Pain assessment skills are essential to nurses when it comes to providing quality patient care. Doctors may assist you in pain assessment and will provide the medication for pain management, but ultimately nurses know their patients the best. Your judgement on your patient’s pain is crucial to complete patient care. Your judgements can help alleviate a patient’s pain or even save a patient’s life.

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Clinical Corner: Travel Nurse Guide to CEU Sites

Nurse continuing education units

Don’t let CEUs give you the blues! Check out these five great CEU sites — including one that’s free for Medical Solutions Travelers

By Chris Vinton, Medical Solutions Quality Assurance Specialist

Continuing Education Units (CEUs) — you know them and you probably don’t love them. CEU requirements vary from state to state, though most states require nurses qualify a certain amount of CEU hours every year. Because this affects so many of our Travel Nurses, I tried to find the best CEU websites and the most up to date information for state CEU requirements.

There are literally hundreds of CEU websites that I found while researching this blog. Some of them are great and some of them are a little suspect, in my opinion. That’s why it’s so crucial to understand which CEU sites are legit and offer good information and solid CEUs. After my sleepless nights of thorough research and asking our internal Clinical Nurse Managers which websites they typically use for CEUs, I came up with this handy list featuring the five best websites with both free and paid CEUs.

Nurse.com

This website features a few free CEUs and a staggering amount of paid CEUs. They also have a subscription service where you pay $50 a year for unlimited access to all their nursing CEUs. The website also features up to date information on state requirements for CEUs.

ANA.org

When I asked our internal nurses for their preferences, the ANA was the most mentioned CEU website. The site has a handy feature where you can search all of their CEUs by subject, format, and price. It makes finding specific CEUs very easy!

CEUfast.com

CEUfast features quite a few free CEUS. It is also nice because it does not require you to sign up on the website, I accidently got into a course about ABG interpretation after clicking around a bit. They also offer a subscription service for only $30 a year.

WesternSchools.com

I particularly like this website. It organizes CEUs by state and shows you the most popular CEUs by state as well. I couldn’t find any free CEUs on this site, however. It also shows the state requirements for CEUs for each state, which is very helpful!

MyFreeCE.com

This is purely a subscription-based CEU website. For only $30 dollars you get access to a plethora of CEUs. The best thing about MyFreeCE.com is that Medical Solutions will pay for a whole year subscription while you’re working for us! So they are truly free CEUs!

CEUs are a great way to increase your knowledge base about the healthcare field. So don’t be afraid to take some courses that are outside your skillset! CEUs are just one of the many ways to improve yourself as a nurse.

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