The Impact of the Advanced Practice Nurse-led Critical Care Rounds on the Knowledge of ICU Nurses
The Impact of the Advanced Practice Nurse-led Critical Care Rounds on the Knowledge of ICU Nurses Ms CHUA Cindy Hsu Fung Advanced Practice Nurse Natio...
The Impact of the Advanced Practice Nurse-led Critical Care Rounds on the Knowledge of ICU Nurses Ms CHUA Cindy Hsu Fung Advanced Practice Nurse National University Hospital, SINGAPORE 22 November 2013
Research Clinical Care Education
Outline • Describe the development of the critical care round • Identify initiatives to ensure sustainability of the critical care round • Evaluate the advanced practice nurse (APN)’s input on enriching the nurses’ knowledge
Background • Grand rounds are traditionally medical which are well recognized internationally and exist widely • Nursing Grand Rounds existed way back to 1980s • Based on Benner’s (1984) theoretical framework of skills acquisition – using 5 different levels from novice to expert • Studies have shown that the use of NGRs are means of continuing education and professional advancement
In general, its purpose…… Educate Engage the interprofessional team
Support undergraduate and post-graduate education
Grand Round Science and Medicine
Business Socialise
Exciting Happenings – Remodeling of Main Building
Background
• 1,068-bedded tertiary hospital and major referral center • 5 Intensive Care Units – 84 beds
• 2 High Dependency Units – 35 beds
Critical Care Round - Aims • To promote and demonstrate excellence in nursing • Provide opportunities for nurses to learn or expand their clinical knowledge base of practice • Provide the nurses a forum to share clinical expertise and the best of the nursing practice • Decrease staff isolation and promote professional development
Critical Care Round - Determinant
Achieve 50% of the AM shift nursing staff
Evolution
Pre-CCR Survey
2010
Inaugural CCR (Once every 2 months)
2011
Post-CCR Survey
2012
CCR (Monthly)
2013
Methodology • WHO – Nurse leaders, i.e. NM; NC; NE; APN – Registered nurses – Assistant nurses
• WHAT – Research studies, practice problems, issues and/or methodologies – Clinical case presentation of diagnoses or diseases – Best practices on selected interventions or care practices – Conference updates/HMDP experiences
Methodology • WHEN – 2nd Thursday of the month
• WHERE – Presentations held at Seminar Room (Hospital)
• HOW – PDF announcement emailed/provided to all nurse leaders for posting (1-2 weeks before)
Topics Presented FY2011 - 2013 Topics (2011)
Topics (2012)
Topics (2013)
Advancing Clinical Nursing
ICU Delirium and Assessment
Basic Clinical Microbiology I
Facts about HIV
Case Discussion: Acute Myocardial Infarction
Therapeutic Hypothermia after Cardiac Arrest: A Nursing Perspective
Tracheostomy Care at a Glance
Case Discussion: Sepsis & Septic Shock
USA Learning Experience: HMDP
Daily Goal Setting: The Nursing Role
Case Discussion: Subarachnoid Hemorrhage
Increasing the Chances of Obtaining Consent from Deceased Organ Donor
Role of Brain Death Coordinator
CRRT Conference 2012 Updates (San Diego)
Palliative & End-of-Life in Acute Care Settings
Role of a Transplant Coordinator
Heart Failure Workshop 2012 Updates (Singapore)
Singapore Trauma Conference Updates 2013 (TTSH)
Case Discussion: Community Acquired Pneumonia
Singapore Trauma Conference 2012 Updates (TTSH)
2nd Singapore-ANZICS Intensive Care Forum Updates 2013
National Teaching Institute (NTI) & Critical Care Exposition 2012 Updates (Orlando)
Results • Provides 1/5 of the continuing education hours granted yearly to the nurses • Provides education and networking for student nurses • Comments: “CCRs are beneficial with a good blend of theoretical and practical knowledge” “More case study discussions & pharmacological topics”
Results • Overall CCR survey average rating: – FY2011: 3.6 – FY2012: 3.8 (based on 4-point Likert Scale)
Evaluation of Nurses’ Knowledge
How did it sustain? • Frequency - Bi-monthly -> Monthly - 1 hour/session
• Publicity • •
CCR schedule with fixed date sent to all nurse leaders (beginning of the year) HMS reminders sent to all nurse leaders (actual day)
• Topics • •
More clinical and case study discussions by APNs PPT slides are uploaded to NHG Blackboard eLearning system 1 week after live presentation
Moving Forward • Increase participation from bedside clinical nurses • Engage other healthcare professionals, i.e. Doctors, Pharmacists, etc. • Peers and self evaluation of performance • Possible uploading of live presentation on eLearning system on top of the PPT slides
