At left, Adeluisa De Guzman, RN, listens during an impromptu education session.
Have a question on the weekend? Who are you going to call? Nurses at the Robert Wood Johnson University Hospital in New Brunswick, N.J., reach out to one of the clinical nurse specialists/educators in the Clinical Assistance and Professional Education program, known as CAPE.
“This is a good way for us to learn about new procedures or policies and about what is going on in the hospital,” said Adeluisa De Guzman, RN, BSN, CCRN, a staff nurse in the surgical ICU. “It increases our awareness and our compliance.”
Kathy Zavotsky, RN, MS, CCRN, CEN, ACNS-BC, director of nursing research, advanced clinical practice, education, and a team of about 25 CNS/educators came up with the idea for a weekend education program. The hospital approved their proposal for a six-month pilot in 2008. When CAPE received a good response, the hospital expanded it throughout the 600-bed facility.
CNS/educators had provided supervisory support on weekends, such as staffing sick calls and providing administrative consents, but when staff nurses frequently asked them clinical education questions, they saw an opportunity to restructure the role.
Nursing supervisors and directors now handle all administrative duties, and the CNS/educators picked up responsibility for responding to codes, falls and clinical consultations, while providing less formal educational opportunities.
“Nursing care is a seven-day-a-week process; it is not just weekends,” said Kathy Easter, RN, CCRN, Magnet program director at the hospital. “Our clinical nurse specialists and educators saw that need, planned, implemented and continually evaluate the process to make it better.”
CNS/educators come up with an annual training plan based on staff nurses suggestions, but it is subject to change based on hospital needs. If they cannot cover the material for everyone one weekend, another member of the team will pick it up the next weekend.
A crash cart review, complete with prizes for finding the correct equipment in a training cart, and EKG rhythm strip reviews are staff nurse favorites.
“Its beneficial for us to get more familiar with the code cart and makes us more comfortable,” De Guzman said.
Some weekends the CNS/educators may focus on new policies and procedures.
They will help nurses with the procedure at the bedside and walk them through the decision-making associated with a new protocol, such as removing a Foley catheter based on criteria established by medical staff.
“We spend a lot of time chatting about it and feel they get it when we bring it to their unit at the bedside,” Zavotsky said.
The CNS/educators touch base with new hires and answer questions and talk to nurses about professional development and what it will take to move up the clinical ladder.
“It serves as an adjunct,” Zavotsky said. “We find folks are able to run through the competencies a little bit quicker because we are giving them all around better education when they are on the unit and not as stressed.”
De Guzman said she appreciates not having to leave the unit to attend formal education programs.
“Its a very casual environment and not intimidating,” she said. “The staff can converse with the educator, ask questions and tell them suggestions.”
“When the staff tells us something, we listen,” Zavotsky said. Those suggestions have resulted in modifications to the policy or to the documentation screen in the electronic medical record.
Easter credits the CAPE program with helping the hospital improve its outcomes, with reductions in falls, catheter-associated urinary tract infections, pressure ulcers and central-line bloodstream infections.
“The program has elevated the amount of communication and education throughout the organization,” Easter said. “In the end, our patients benefit, our families benefit and our staff benefits. The staff [nurses] are happier and more satisfied, and that leads to patient and family satisfaction. And those together lead to overall quality. “
Debra Anscombe Wood, RN, is a freelance writer.