HI to all, How do you handle non-compliant Rn's regarding parked tubing, no cap, wrong caps, wrong dressings, dressings not change, use of non-aseptic technique. We are going through a tough time and need advice or tips on how to get the message across. We have in-serviced, messaged, and more inservice, posters, etc. with minimal effect! Any Help would be GREATLY appreciated. TY Andrea
Sounds like you need to go through a Progressive Disciplne action. Once you have brought their non-compliance to their attention and provided inservice education then the next steps need to be verbal counselling, written counselling and more agressive actions such as suspension if needed. If you allow this continue you might be liable for a malpractice action and that can be costly in more ways then just money.
Marvin Siegel RN CRNI
Director of Clinical Services
Town Total Health
NY, NY
Marvin is correct about the liability in a potential lawsuit and lawsuits involving infections are increasing. I would also direct you to Allegheny General, which I think would be close to you. They have an exceellent model. I served on an APIC with Dr. Jerry Granato from that hospital who described their competency program. When I asked him what they do for those staff members who do not comply, he said they are told "do it our way or you do not work here any longer"!! I would also investigate why they are not compliant with policies and procedures. Are the p&p ambiguous? What is their workloads like? Do they get mixed messages from management? I have just finished reading Dr. Peter Pronovost book - Safe Patienrts, Smart Hospitals. I truly believe he is right on target with the work on the culture of an organization. A culture of safety for both patients and healthcare workers is what must be present. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Yes, I agree with both. Now that the IC people are involved, we hope to get more response. We are going to institute a red flag system hopefully, where we will flag the line or site involved, give a written notice to the rn, manager and IC. We are also going to give talks at staff meeting to let them know this is starting, I have been trying to get this accomplished since February! Hopefully it will be up and running soon. I am going to read that book Lynn and maybe suggest it to the managers of the units we are having trouble with! Ty very much andrea
dsnyrn
Infection preventionist definitely needs to be involved, but the staff nurses must own the process. IPs can not prevent infection, only the people with their hands on the catheters can. That message has to be loud and clear. Also, do not use high level statistics. When you have a patient that is infected, bring it home to the staff with the actual numbers of patients. Nurses do not relate to 0.53 events per 1000 catheter days, but they sure do know that they have caused 3 BSIs on our unit this month. A little healthy competition between nursing units in a race to see which can get to the least number can also be a good thing. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
The nurses should be held accountable. Many instances of noncompliance come not from lack of knowledge but of simple failure to be compliant. Until we hold them accountable for their actions it will not change. I certainly would change my behavior if I had to explain to my supervisor why I failed to follow a protocol that I knew I was supposed to follow.