Almost everything you needed to know you learned in nursing school!
In nursing school, we learned hand washing is the single most effective way to prevent infection. I learned this over thirty years ago and today's best evidence still reinforces this fact. Yet, studies also show that on average, health care providers wash around 34 % of the time. How about you? Are you in the hand washing group?
Along these same lines, wearing gloves when performing invasive procedures protects patients and health care providers from infection. This summer, my daughter was treated for community acquired MRSA, and the person drawing blood cultures had the finger punched out of his glove! I asked him about it, and, of course I blew my cover when he asked me if I was a nurse. What we do makes the difference for our patients, our families and ourselves. Our patients watch what we do, and our actions make a big impact.
I could not have imagined that after all this time, patient positioning would still be so important. Despite all the high tech treatments we have available to us, elevating the head of the bed still prevents ventilator associated pneumonia. Turning patients every two hours still prevents pressure ulcers and getting individuals up post operatively still prevents deep vein thrombosis and pneumonia. Now we measure these nurse sensitive indicators and they tell us we are vital to our patient's recovery.
Talk about full circle, the evidence on ventilator associated pneumonia has helped us understand that brushing patient's teeth has a significant positive impact, and that other old stand by treatments--toothettes and lemon glycerine swabs--are not only ineffective but actually detrimental!
The Five Rights
Even today, with all the measures we have implemented to keep patients safe, violation of the five rights is still at the root of most errors. Okay, I concede, some of you are teaching six rights, good for you! If we could get the five rights down, it would be a big first step. Checking the wrist band, validating identity using a second identifier and cross-checking each medication can stop most errors. With central lines and PCA pumps we now have faster, more invasive ways to inflict harm. Cross checks are essential to ensure medication safety.
It's fall--flu shot time. In 2005, less than 43 % of all nurses got an influenza vaccine. This one act can help protect you, your family and patients from one source of infectious disease. With very few exceptions, every individual should be immunized for influenza, and older adults should all be immunized against pneumococcal pneumonia. The extra time it takes to administer these life saving vaccines are one more thing you do to keep your patients safe.
Now I do know we have learned a few things over the past thirty years. Evidence has busted some tried and true nursing techniques--stripping chest tubes, tracheal lavage, heat lamps and orange juice with sugar to name a few. We know that it's good to keep blood sugars under 150, most patients do not get addicted to pain medication, and IV dressings can be changed once a week.
The decisions we make every day regarding the care we provide our patients is critical. Nurses are the difference between recovery and complication. Some patients may not be cognizant of the vital role we play, others are keenly aware of every action. In fact, keeping our patients informed of the little things we are doing to keep them safe should be a part of the ongoing dialogue we have with them.
As nurses, we are in a unique position to make a difference for our patients. The mounting evidence of our value to the health care system should be a source of pride, and that it's the little things we do (or don't do) that make the difference. It's what happens at the bedside day in and day out; our collective actions that promote recovery.
We just completed a very successful Oklahoma Nurses Association annual convention. Plans are already underway for next year. Our association is getting ready to celebrate our one hundredth anniversary. Oklahoma nurses are a unique group. Our forbearers formed a nurses association during the very first year of statehood. We are in the process of planning our celebration, and we have an energetic planning group. If you would like to be involved, call the ONA office. This is one party you do not want to miss!
Our keynote speaker, Kathleen Bartholomew gave an excellent overview of the issue of horizontal hostility and the deleterious effects this phenomena has on nurses, patients, our organizations and our profession. The Oklahoma Nurses Association House of Delegates approved a resolution promoting healthy work environments.
New Board Members
I am very pleased to introduce the new ONA Board of Directors--President-Elect: Christine Weigel, Vice President: Kimberly Anderson, Secretary-Treasurer: Linda Lyons Coyle, Practice Director: Angie Kamermayer, Education Director: Patti Muller-Smith, Political Affairs Director: Barbara Smith, Disaster Response Director; Keith Reed; and Region Presidents and Representatives: Lucille Cox (Region 1), Jennifer Warren (Region 2 President) Cindy Lyons (Region 2 Representative), Diana Mashburn (Region 3 President), Karen Scott (Region 3 Representative) Kay Farrell (Region 4), and Joe Catalano (Region 6). Please join me in welcoming them and thanking them for their dedication!
Region 1: President: Darlene Barnard York
Region 2: President: Lynn Caskey
Region 3: Sharon Patrick
Region 4: President: Kay Farrell
Region 5: Vacant
Region 6: President: Joseph Catalano
Region 7: President: Trish Engel
by Karen Tomajan, ONA President