Fundamentals - Leadership, part 4: Efficient Nursing Practice, Critical Paths
by Meris Shuwarger December 08, 2022 Updated: August 09, 2023 4 min read
- 0:00 What to Expect from Efficient Nursing Practice, Critical Paths
- 0:25 Best Practices for Efficiency
- 3:24 Critical Pathways
- 4:20 Quiz Time!
Hi, I'm Meris. And in this video, I'm going to be covering some best practices for nursing efficiency. I'm going to be following along using the leadership section of our Fundamentals Flashcard deck. And if you have this flashcard deck, I would encourage you to go ahead and pull out these cards and follow along with me. All right, let's get started.
So first up, let's talk about some ways to be efficient in delivering care as a nurse. As you can see, we got a nice bulleted list here for you along with some bold red text. So let's get into it.
Efficient nursing practice. A lot of this is going to be common sense, but in case you have never worked in medicine before or you've never worked as a nurse before, let's go over it. So you need to identify and prioritize the tasks for your patients at the beginning of the shift. So for instance, when I get report as an ER nurse, I might be thinking about who needs scans still? Who needs a timed blood draw? Are there any kinds of important things that I need to prioritize in my delivery of care? I should also cluster patient care. So for instance, if I'm going to go see a patient and I'm going to do my initial assessment and all of that kind of good stuff after taking over report from the outgoing nurse, I might also look and see, are there any medications due? Any labs I need to draw? Is there any stuff that I can do in this one trip into the patient's room? Because first of all, it's going to help me to be more efficient. It's also going to help decrease that kind of interruption and bothering of my patient and allow them to rest and things of that nature. So see if you can cluster care. And even if it's something where you want to bring somebody with you, like maybe you're a floor nurse and you need to do your assessment, give your meds, and your patient needs a bath. And so maybe you could say to your UAP, "Hey, could you come with me and we can do all of this at the same time?"
Complete tasks for one patient before moving on to the next. This is good practice in situations where you have fully stable patients. So what that means is if I'm doing my initial assessments and passing morning meds, I'm going to do all of that good stuff. I'm gonna get my patient all tucked in and taken care of before I move on to doing something for the next patient. The one caveat to this is, of course, if my other patient is unstable, if something happens, if there's a change in their status, I need to stop what I'm doing to go see that patient. But in general, do all the tasks for one before you move on to another.
Delegate tasks when appropriate, we've talked about that in a previous video. Go, check it out.
Complete charting as soon as possible following that intervention. So don't wait until the end of your shift to chart. And this is so important for a number of reasons. The first being you're not going to remember at the end of the shift every single thing you need to chart, right? It's just not possible. You're not going to remember. People who are caring for that patient as well aren't going to be able to see your assessments, your interventions, and everything in real time. And then legally speaking, you want to cover yourself by charting in real time as much as possible so that I can say, "At this moment, this is what I observe and I'm charting it in real time," meaning I'm not going back in time to chart something. Because it would be very easy for that to not hold up as strongly in the court of law. So I always try to chart in real time when possible. Sometimes you're not going to be able to. Sometimes things are going to be crazy and hectic and chaotic, but chart that stuff as soon as possible following whatever it is.
So now let's talk about critical pathways. This is something that you'll learn about in nursing school. But a critical path is essentially what's the hold-up? What is the hang-up? What is the thing that's going to get in the way of our patient being healthy, well, discharged, whatever it may be? So for instance, we say here that this is a multidisciplinary care plan, which details the essential steps to care for patients with a common diagnosis. And the whole goal is to improve your efficiency and to decrease the length of stay for your patients. So what's the critical path for the patient with a CHF exacerbation, having fluid in their lungs? It's going to be X, Y, Z to get them breathing better and able to ambulate around the unit so that they can go home. That is what the critical path is.
All right. Are you ready for some quiz questions? Because I know I am. When should the nurse chart an intervention? As soon as possible following that intervention. Do not wait until the end of the shift.
That is it. I hope you learned something. Please leave me a comment if you have a great way to remember something. I definitely want to hear it. I know that other people do too. Thanks so much and happy studying.
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