Executive vice president, Yale New Haven Health System, president and CEO, Bridgeport Hospital
What is nursing standardization?
YNHHS is working to provide the same standards of nursing practice across all of its delivery networks by taking a uniform approach to:
- patient- and family-centered care
- nursing research
- patient sitters and non-staff technology
- benchmarks and metrics
We will standardize nursing in these areas by implementing the policies, protocols and practices driven by the best evidence available to the nursing profession.
What was the catalyst for nursing standardization?
About three years ago, amid the uncertainty of healthcare reform, the chief nursing officers of our three delivery networks concluded that we needed to provide the best quality of care at the lowest possible cost while keeping our workforce strongly engaged. They wanted to adopt the best nursing practices from each delivery network as evidenced by measured outcomes. The Epic electronic health record further supported and strengthened the decision to standardize.
What is the nursing professional practice model and what role does it play in nursing standardization?
A professional practice model of nursing is a system — structure, process and values — that supports registered nurse governance over the delivery of nursing care. The YNHHS model, which was developed by staff nurses last year across all of our campuses, is just one of our objectives in standardizing nursing care. It is an important step in articulating the professional care provided by nurses to achieve the highest quality outcomes. It reflects how nurses collaborate, practice, communicate, develop professionally and integrate mission, vision, values and theories of nursing. It reflects the common foundation that all nurses share and supports their shared governance over how they deliver care and the environment in which care is provided.
The YNHHS Nursing Professional Practice Model includes a globe representing the diversity of YNHHS patients; stars representing the Virginia Henderson theory of nursing practice at Yale-New Haven Hospital; a heart representing the Jean Watson theory of human caring embraced by Bridgeport and Greenwich hospitals; and a patient- and-family-centered heart.
How will nursing standardization enhance the quality of care for patients?
Delivering care based on evidence-based best practices will enhance the quality of care provided to patients across YNNHS. Any time you reduce variation and waste, quality goes up and patient safety improves. It is no different than how we approach clinical practice standardization with our physicians. We identify best practices based on evidence and then build models of accountability and adherence.
What is the role of the staff nurse councils in nursing standardization?
The YNHHS and delivery network staff nurse councils have been an integral part of creating the professional practice model of nursing. They are a diverse, select group of nurses who have been chosen to represent all aspects of nursing practice across our hospitals.
Will nursing standardization support YNHHS in other ways?
Nursing standardization is a multi-faceted project. One facet involves a plan for system-wide research utilizing evidence-based practice. Other facets include initiatives to standardize general registered nurse orientation, safely decrease the number of patient falls while also decreasing the cost of patient-sitter utilization across the delivery networks through use of new technology, and standardize benchmarks and metrics in how we report data to the National Database of Nursing Quality Indicators (NDNQI). Implementation of these initiatives is fully under way.
What can staff nurses do to support/participate in nursing standardization efforts?
Staff nurses should become familiar with the education bulletin boards on nursing units that explain the new professional practice model and outline its four core components: professional development, quality and safety, a healing environment and professional excellence. Under each of these components are examples of how staff nurses can participate to fully support, own and embrace governing their practice of nursing at the bedside. We will discuss this more fully at systemwide staff meetings in the near future. Additionally, nurses will familiarize themselves with the individuals who represent their division/specialty on either the staff nurse council and/or the Shared Governance Council. This will help ensure that their voices are heard and they can actively participate in bringing ideas and opportunities forward.