The Nursing Practice Councils facilitate multidisciplinary collaboration on patient care standards and integrate the activities of committees and councils to achieve best practice goals. Following are some highlights of their activities.
Click on the links below for additional information on specific Crozer-Keystone hospitals.
Crozer-Chester Medical Center/Springfield Hospital
Delaware County Memorial Hospital
System-wide Nursing Practice Manual
Taylor Hospital
Crozer-Chester Medical Center/Springfield Hospital
Laying Early Foundation for the Magnet Journey
Crozer’s council leadership includes, left to right, Marianne Kupchick, RN, MSN, CCRN, Deborah Kenney, RN, Katie Eppehimer, RN, BSN, CCRN, and Kathy Miller, RN, BSN.
When Crozer's Nurse Practice Council was established 15 years ago, it was the only nurse-driven committee available to the hospital with representation from each nursing unit/department. The council addressed a broad range of issues involving the nursing work environment. As it evolved over time, the council’s focus shifted solely to practice issues faced daily by the nurses and the hospital. More recently David Bullen, RN, MSN, CCRN, CAN, NE-BC, and SueAnne Machemer, RN, led council members in researching the concept of shared governance, sharing their findings with all nursing units and the hospital.
Ultimately, the Practice Council’s efforts led to the formation of other key councils: Quality, Education, Executive and Unit Based Councils. Many nurses who were members of the original Practice Council accepted leadership positions in Crozer’s newer councils, which have benefited from their knowledge and experience. Kathy Miller, RN, BSN, and Marianne Kupchick, RN, MSN, CCRN, now serve as co-chairs of the Education Council. Katherine Eppehimer, RN, BSN, CCRN, is chair of the Quality Council. Kathy Poole, RN, BSN, CCRN, and Deborah Kenney, RN, currently co-chair the Practice Council.
During the past year, the Practice Council has brought about important changes, including a new critical lab value form and a new pain medicine kardex. In collaboration with clinical areas such as Pharmacy, Laboratory and Radiology, the council recommended new policies for safer transporting, addressing the acuity of patients, and better orientation to the unit.
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Delaware County Memorial Hospital
Nursing Practice Manual Focus Changed to Nursing Diagnoses
Rose Young, RN, and Kathy Layton, RN, MSN.
Over the past 18 months, the DCMH Nurse Practice Council, under the leadership of Rose Young, RN, and Kathy Layton, RN, MSN, has converted their Clinical Practice Guidelines, which were based on medical diagnoses, to Practice Guidelines that are based on nursing diagnoses. These Practice Guidelines came from Taylor Hospital. The DCMH Nurse Practice Council then looked at each guideline and updated the guidelines to reflect current evidence-based practice.
The updated Practice Guidelines were finalized and then distributed after staff education took place. By adopting the Practice Guidelines that were already being utilized at Taylor Hospital and Crozer Chester Medical Center, all facilities are now heading toward the ultimate goal of standardizing nursing practice system-wide.
The DCMH Practice Council assisted in the implementation and education of the following policy/protocol changes and updates:
- High Risk Medication Policy – second signature for subcutaneous insulin dose of 12 units or greater.
- Surveillance cultures for MRSA.
- Foley catheter surveillance cultures and CAUTI initiatives initiated.
- Low beds for non-compliant patients at a high risk of falling.
- “Time-Out” protocol for all invasive procedures.
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Developing a System-wide Nursing Practice Manual
An ad hoc work group has been established from the nurse practice council chairs and co-chairs, nurse manager liaisons and a CKHS nursing director to develop one standardized Nursing Practice Manual to be used by all Crozer-Keystone hospitals. A system-wide manual will enhance patient safety by ensuring that all CKHS nurses provide care according to the same guidelines, which are based on current best practices, at all system hospitals. This is especially important for the Crozer-Keystone Supplemental Staffing nurses who provide care at every hospital. System-wide Specialty Nursing Practice Manuals will also be developed. The new manuals will be available online at the Crozer-Keystone Intranet site. The project is expected to be completed in 2009.
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Taylor Hospital
Reducing Falls
Han Young Park, RN, MSN, and Cynthia Miller, RN.
Taylor’s Nurse Practice Council (NPC) was concerned with the hospital’s high rate of falls compared to national benchmarks, despite a new fall risk assessment instituted two years prior. The council developed a performance plan that included reviewing charts/incident reports for common characteristics of patients that fell at Taylor and listing all possible causes for patient falls. After determining that the majority of patients fell while ambulating and/or had repeat falls, council members developed a standard of care based on research of current best practices in the literature.
Under the leadership of Han Young Park, RN, MSN, and Cynthia Miller, RN, co-chairs of Taylor’s NPC, a post fall flowchart was developed with a post test for educational purposes. Working in collaboration with Taylor’s Education and Quality Councils, the Nurse Practice Council rolled out the new standard this year. NPC will continue to monitor Taylor’s fall rate in FY 2009 to assess whether these performance initiatives have helped to decrease falls.
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