Jul 09

Work Study

I saw somewhere that the work study program might be making a comeback. Any truth to that? Details?

Ron Smith, RN

We are in process working with David Marshall and our external partner Catalyst Learning to install a similar kind of work study program to meet our employee’s needs. There are two sub-programs, “School at Work®” (SAW) and “Expanding Your Career and Healthcare Opportunities®” (ECHO) described below. Our expected rollout timeline is in the fall with centralized joint-communications from Dr. Marshall, Dr. McKinley and Dr. Barrett.

1.  School at Work® (SAW) is the premier career development system for entry-level workers in healthcare. Over six months, SAW’s blended-learning instructional model helps students refresh essential skills and gain an understanding of healthcare-specific subjects. Students develop a customized Career and Learning Plan to guide advancement after SAW completion. SAW students possess the potential to advance into higher level positions but need a bridge to help them take the next step in the development process. The typical student is 25-50 years old and has a high school diploma or GED. Course length – 6 months

2.  Expanding Your Career and Healthcare Opportunities® (ECHO) is a forward-thinking tool that taps into the potential of mid-level employees and puts them on a nursing, clinical or management pathway. ECHO utilizes a blended-learning delivery model that provides a healthcare-specific curriculum with an emphasis on critical thinking and advanced communications. The objective is to help students hone their knowledge and develop the confidence needed to enroll in degree or certification programs. Students develop a customized Career and Learning Plan to guide advancement after ECHO completion. Course length – 3 months

Zenglo Chen, Ph.D.

Director, Talent and Organizational Development

Human Resources

Jul 09

Administrating Antibiotics

What is UTMB’s policy for administering antibiotics that require a trough level to be drawn. Do you draw the level and wait for the results before giving the medication or do you draw the level and give the medication leaving the MD make the necessary adjustments afterwards? If there is a policy, what how can I find it? Thanks

Alison Vuy, RN

There is no UTMB policy statement that is specific to administering antibiotics that require trough dose testing. When it comes to antibiotic dosing, there is essentially a therapeutic window that we are shooting for. The trough level is drawn once the drug reaches steady state concentration in the blood which takes approx. 3-4 doses. In order for the lab result to represent a true trough, the trough specimen must be drawn immediately prior to giving the next dose (without waiting). If administration is delayed in order to wait for the result, the blood concentration has continued to fall during this wait and the resulted “trough” no longer represents the lowest concentration in the blood. This could mean that patients are under-dosed related to an inaccurate trough representation. When a change in the dose is required, providers typically make the adjustment beginning with the following dose (the 2nd dose given since the trough specimen was obtained). The Antimicrobial Committee at UTMB supports the practice of immediately administering the antibiotic after the trough specimen has been obtained, without the lab result yet in hand.

Amber Clayton, MBA, BSN, RN

Project Development and Support Manager

Oct 10

Scrubs

I heard a rumor that there is an ongoing patient/staff survey, in regards to black scrubs that nurses wear, and the result wasn’t all favorable. If this is true, would we be changing colored scrubs again? And would UTMB pay for it this time?

Teresita Tan, RN

The rumor is false. In December of 2011, 604 nurses voted for their preference of scrub colors. The majority voted for black with 41% of the vote. In June 2012, the new dress code policy went into effect. Currently there are no plans to change the scrub color for the nurses or PCTs. The Retention Council is in the process of revising the current policy for the Health Unit Coordinators only. There are no changes to the nurses or PCT’s dress code. The policy will now add Caribbean Blue polo shirts to the HUC uniform due to the fact that the only shirts we had available for HUC were long or 3/4 sleeve shirts. Once the policy gets approved, we will then add the option for the HUC polo shirt. Polo shirts are not being bought for current HUCs who have already been supplied with uniforms. If they chose to buy the Caribbean Blue polo shirt, it must have the logo and will be an out of pocket expense to them.

The Retention Council

Sep 04

Starbucks

Is there any way the Starbucks can stay open until about 7PM or 8PM for the night shift employees?

Nickie Fielder, RN

This was something we experimented with prior to its closure for the concourse project. The volume of service was not sufficient at that time.

Since reopening, we are seeing the sales drop after 4PM to about an average of six customers from 4 to 4:30PM, and two customers from 4:30 to 5PM.

Once the temperatures get colder, we may try to pilot a 7PM closing for a few weeks and see if volume is available. If so we could keep it open.

Allen Pemberton

Director, Food and Nutrition Services

Jun 24

Shared Leadership Meetings

Can managers attend unit shared leadership meetings? What is the best practice on when/how often they should attend if this is allowed?

Deatra Delcambre, RN

Shared leadership is about creating an environment that promotes professional growth, transforming the nurse from follower to leader resulting in quality patient and family centered health care. It nurtures the values of collaboration, trust and mutual respect among nurses.

The membership of unit shared leadership per the professional practice plan: nurses working within the same or similar types of patient population or areas of the healthcare continuum. One of the goals of unit shared leadership is to collaborate with the interdisciplinary team to develop, implement and evaluate process improvements to improve patient outcomes.

Review of the Magnet® listserv discusses managers participation as dependent on the culture of the unit, and/or the agenda topic lending itself to manager involvement for decision making. So, there is no definitive answer to the question asked. You need to consider the individual unit goals and current professional practice environment on the unit. Thank you for your question and if I can help in anyway, please let me know.

Barbara Bonificio, MS, RN-BC

Director, Nursing Excellence

May 24

Rounds Report

Is there any way that we can get the patient’s attending service back on the rounds reports? Thanks

Allison Vuy, RN

The Connect implementation changed how Epic understood the treatment team, and the security for who should be able to see it didn’t get corrected for everyone. This is a perfect example of how things can be missed when such a large project is implemented.

This should be corrected now; if you still can’t see the treatment team, please send me an email with your name and the unit you were logged into.

In addition to posting a comment to the blog or sending an email to me when you find something like this that needs to be corrected, you can also use the “Suggestion Box” within Epic. This should be a button on the top bar, and pressing it will allow you to send information like this to the build team.

Suggestion Box

You won’t receive an immediate response, so it isn’t useful for correcting an issue impacting patient care. It is perfect for notifying the Epic team that something like this needs to be corrected.

Thank you for the input on improving Epic, it is always appreciated.

Tim Hilt, MSN, RN-BC

Manager, Project Development and Support

Mar 05

CCAP

If CCAP is being utilized for EBP, why are the nurses the only ones in the hospital that are doing it? The OT, RT, NNPs, etc. aren’t required to do it.

Lavelva Madden, RN

Thank you for the question. You are correct, it is EBP and most every hospital with a career ladder requires some self-reported documentation(portfolios, writing exemplars, points systems, etc.). We want every nurse to be successful in reporting their work contributions and providing us a overview of what they do to contribute. We want to fairly evaluate each employee and assure that a NC III, IV or V is an NCIII, IV or V meeting the same criteria with a similar (not exact) level of effort and contribution. This is a standard expectation nationally for professional nursing. The method is accomplished in different ways – CCAP is our way.

Patient care services and the nursing department are responsible for nursing practice and as such started with RNs. The next group is nursing directors, managers, educators, PCFs and educators (the leadership group). That process is underway in the early stages and set for pilot in 2014 and implementation in 2015. At some point other job descriptions may take a similar approach but leadership for those areas will make those decisions about when and how that is accomplished.

Patricia Davis, DNP, RN-BC, NEA-BC, CNL

Director, Nursing Practice & Professional Advancement

Feb 25

CCAP

Can you tell me if the roster sign-in sheets used for unit meetings, inservices, etc. can be used for CCAP and if so where?

Diane Siecko, RN

Regular attendance at departmental staff meetings alone is not awarded CCAP points. Presenting at the staff meeting is awarded points. Regular membership on shared leadership councils is awarded points – attendance is supported by the sign-in sheets but the award is for serving and engaging. Rosters only serve as evidence of attendance to something – education, training, committee, etc. Submitting rosters alone is not points awardable. We would suggest recording the dates attended with whatever activity you participated in on the appropriate form – most often form A.

Patricia Davis, DNP, RN-BC, NEA-BC, CNL

Director, Nursing Practice & Professional Advancement

Jan 29

Dress Code

Can we wear red scrub tops on Feb. 1st?

Deyna Williams-Walker, RN

February 1st is not a designated holiday for out of dress code. You may wear a red coordinating top under your black scrub top. The Nurse Manager may designate specific days for the unit to be out of dress code. Please refer to Policy 2.8 Dress Code and Professional Appearance.

Retention Council

Jan 28

PP19E Community Service

Does this include ANY kind of community service or only nursing related such doing health screenings, health education. For instance, will volunteering at The Grand as an usher or volunteering at the church count?

Elvia Gomez, RN

PP19E community service is very broad. The things that are limited like blood administration are because they might create a bartering or pay back scenario, …”this thing for that thing”. Volunteering in the community does include things outside of health care. Volunteering at the Grand, for church, scouting, Dickens on the Strand, community sponsored clean-ups, helping with school initiatives or school events, tutoring reading, etc., all counts as community service hours. When you do these things those around you often know that you are a UTMB RN – you represent the profession. ANA expects we represent the profession in the community.

Patricia Davis, DNP, RN-BC, NEA-BC, CNL

Director, Nursing Practice & Professional Advancement

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