Nursing Role In Program Design And Implementation

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Nursing Role In Program Design And Implementation

Nursing Role In Program Design And Implementation

In this Assignment, you will practice this type of leadership by advocating for a healthcare program. Equally as important, you will advocate for a collaborative role of the nurse in the design and implementation of this program. To do this, assume you are preparing to be interviewed by a professional organization/publication regarding your thoughts on the role of the nurse in the design and implementation of new healthcare programs.

To Prepare:

  • Review the Resources and reflect on your thinking regarding the role of the nurse in the design and implementation of new healthcare programs.
  • Select a healthcare program within your practice and consider the design and implementation of this program.
  • Reflect on advocacy efforts and the role of the nurse in relation to healthcare program design and implementation.
  • Review the User Guide for Uploading Media in your Blackboard Classroom by accessing the Kaltura Media Uploader on the Left Navigation Bar in preparation to record your narrated video or audio for this Assignment.

The Assignment: (2–3 pages)

In a 2- to 3-page paper, create an interview transcript of your responses to the following interview questions:

  • Tell us about a healthcare program, within your practice. What are the costs and projected outcomes of this program?
  • Who is your target population?
  • What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples?
  • What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you impact design?
  • What is the role of the nurse in healthcare program implementation? How does this role vary between design and implementation of healthcare programs? Can you provide examples?
  • Who are the members of a healthcare team that you believe are most needed to implement a program? Can you explain why?
Influence of nursing


“Unfortunately, nurses are not usually at the table,” Gregory explains, when facility design decisions are made. 
As result, project teams have been known to create designs that have negative impact on nursing care. 
While data show the value of nurses at the bedside, Gregory claims that the transition to totally decentralized nurse stations in many facilities has limited possibilities for nurses to collaborate with one another or mentor less-experienced colleagues. 
“While decentralized nurse stations on patient units are beneficial, they’ve been deployed in such way that the old centralized stations have been destroyed,” Redden adds. 
The workflow processes were not adequately examined to the point where we were able to achieve the greatest possible result from that design.”


Gregory believes that hybrid nursing station designs, which give space for collaborative work on the patient unit, are an improvement. 
“I believe that facilities have improved in positive way over time,” adds Redden. 
“And believe lot of that is due to nursing influence.” 
Nurses are being questioned more frequently. 
Nurses are employed by architecture firms all around the health-care industry. 
Nurses are being hired by hospitals to help in facility design.”


“I believe the times are changing,” Silverman says. 
Nurses are arriving at the table more quickly. 
The message is getting across, but at snail’s pace.”


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Nurses offer their opinions on health-care design.


Nurse satisfaction can be influenced by design.


Improving the efficiency of the hospital flow


Kathy Harper, R.N., EDAC, was Parkland Health Hospital System’s vice president of clinical coordination during the planning and construction of the system’s new 2.8 million-square-foot campus in Dallas. 
“Nurses appreciate the fact that there is more clinical input [on design] now than there was 15 or 20 years ago,” she says. 
“They’ve never had voice like this before.” 
Nurses, on the other hand, dislike the design process when they aren’t included, and their involvement varies per institution. 
“Nurses’ opinions are not taken into account in the industry as whole,” she claims.


“When nurses don’t have enough knowledge about the process and the budget,” Bonnie Sakallaris, R.N., vice president for Optimal Healing Environments at the Samueli Institute, health care research organization based in Alexandria, Va., says, “they feel like they have to accept less than optimal design decisions.” 
This does not happen if they are involved early on, and the project is much more likely to be completed on time and on budget.”


The hand-washing sink in each exam room was originally positioned such that clinicians would have to turn their backs on patients to use it, according to design drawings for cancer center project on which the Samueli Institute is consulting. 
“If you do it with your back to the patient, your Patient Experience of Care scores will be lower,” Sakallaris explains. 
The exam room arrangement may be changed at no additional cost because the plumbing design had not yet been finished. 
“It’s about recognizing when things may be modified without incurring additional costs.” 
“It makes difference,” Sakallaris says. 
“No one wants to be the one who causes project to be late or over budget. 
So, believe that nurses want to know — they want to understand the process, and then they want to be part of it.”


Nurses who are pioneers


Despite the hurdles, Joyce M. Durham, R.N., AIA, senior partner and executive vice president for health care management and consulting firm Global Health Services Network in Farmington, Mich., notes that nurses have been responsible for some recent disruptive developments in health care design. 
Celeste Phillips, R.N., pioneered single-occupancy maternity rooms for labor, delivery, recovery, and postpartum care, according to Durham; Cecelia Kirvin, MSN, R.N., NE-BC, devised the design of private rooms for neonatal intensive care units (ICUs); and Anne Hendrich, MSN, R.N., led the design of the acuity-adaptable patient room, according to Durham.


In nutshell, nurses are uniquely prepared to contribute constructively to facility projects.


• By doing so, nursing processes can be improved while also avoiding unnecessary project expenditures.


• Nurses are becoming important members of the design team as result of these advantages.


Nurses were involved in the Parkland hospital project from the beginning, according to Harper. 
Gay Chabot, R.N., program director and clinical liaison on the initiative, is now retired after 25 years at Parkland. 
Nursing representatives at all levels — aides, technicians, clerks, staff nurses, managers, and other supervisors — contributed to design mock-ups, which ranged from cardboard duplicates of health care rooms to fully fitted-out replicas, according to her. 
“It was critical to our project’s success,” Chabot explains.


Based on this feedback, the project team decided to discard roughly half of the equipment and much of the cabinetry that had been planned for the hospital’s ten trauma rooms, saving the project several million dollars, according to Chabot.


The patient room headwalls, which have medical gas and electrical plugs on both sides of the bed, were also designed with input from nurses. 
The outlets are as high from the ground as the code allows. 
Nurses don’t have to bend over or crawl under bed to plug in or unhook equipment, and many persons, such as nurse and respiratory therapist, can care for patient at the same time without crowding or feeding line over the bed. 
According to Chabot, the design “simply made more sense.” 
“Steps equal time, and time equals money.” 
If you can save few steps in the long term, you’ll be more efficient.”


Nurses also assisted in deciding where bedside computers would be placed in Parkland’s patient rooms. 
They looked at number of wall-mounted, adjustable monitor arms before settling on one that reaches almost to the patient and flips sideways, allowing caregiver to chart without turning away from the patient and family. 
“That was another important aspect of nursing,” Chabot explains.


Nurses also assisted in the layout of computer monitors in the surgical department’s scheduling section. 
“It’s like traffic control,” Harper says of running 27 operating rooms at the same time. 
“I think they did fantastic job of laying things out based on what they anticipated their needs to be.”


The project team at Akron (Ohio) Children’s Hospital was completely involved with the Lean principle of incorporating front-line personnel into problem-solving talks, according to Evans. 
Nurses were among those requested to help create full-scale departmental mock-ups of the emergency department, ambulatory surgical department, and newborn intensive care unit. 
According to Evans, the architects were able to reconfigure the ambulatory surgical prep/post-anesthesia care unit three times in one day as consequence of staff feedback; they also reduced the ED square footage by 11%, saving more than $1 million. 
According to Evans, the design of the ED triage room was revised multiple times to increase patient safety and throughput.


Nurses at the University of Texas MD Anderson Cancer Center in Houston were polled regarding the design of inpatient units on the first five floors of an eight-story patient tower in order to improve the design for the remaining three floors, which were previously shelled for future use. 
MD Anderson spent nearly three years examining how the design worked for nurses on all shifts, according to Redden, who was the center’s director of clinical operations development. 
Interviews, surveys, and work shadowing were among the methods used to acquire data.


The final three levels’ design, which is now in progress, involves various revisions based on this information. 
According to Redden, improvements include the removal of pass-through nursing servers that were deemed too noisy for storing supplies in the patient room, the installation of extra work space for allied health professionals on the unit, and more storage for patients’ personal goods in the patient room. 
In addition, the patient bathroom was redesigned.
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