Priscilla Merryman, RN, MSN, MBA, NE-BC, is the type of nurse who can see the cup as half-full and half-empty at the same time. She not only has an eye for systems that are not working well, but also ideas for how to improve these systems and the potential benefits to patients and caregivers.
By initiating change, I get to see nurses who are happier in their roles and outcomes that are better for patients, says Merryman, director of medicine service at University of North Carolina Healthcare System.Priscilla Merryman, RN
One of Merrymans innovations was implementing a nursing protocol to remove a Foley catheter without a physicians order. She knew catheters often were placed on admission, but in some cases the catheters were not needed at all or could be removed earlier. She hoped the new protocol would reduce the number of catheter-related UTIs. She conducted a study to determine appropriate reasons for using a catheter, and these reasons are listed in the new protocol.
If one of the reasons isnt present in a patient, then the nurse can remove the catheter and notify the physician, Merryman says.
The new protocol gives nurses more autonomy and has resulted in roughly a 50% decrease in catheter-related UTIs.
Merryman also created a new lift team in an effort to reduce the number of work-related injuries caused by lifting patients. She gathered a group of nursing assistants who would be trained to lift complex patients, such as those who were morbidly obese or suffered from co-morbidities. These mobility technicians work 12-hour shifts and are on call throughout the day. They now get about 45 calls a day.
Merryman also was aware of a high turnover rate among nursing assistants, so she tackled this problem by implementing a new clinical support technician role, which expands the responsibilities of nursing assistants.
In addition, she worked with the hospital to establish a program to sponsor 15 nursing assistants to complete a 160-hour Nursing Assistant II course at a community college.
The program has been so successful that the nursing assistant turnover rate has dropped dramatically. The rate was as high as 16% before the program, compared to 0% for nursing assistants working in the new roles.
The biggest challenge to innovation within an organization is opening minds to the possibility and value of change, Merryman says. But it is really rewarding when people work together to implement something new and then see it working successfully.