PURPOSE: The goal of this Nursing Procedural Reference is to enable community hospital critical care nurses to maintain proficiency in low volume procedures.
METHODS: The Nursing Procedural Reference (nicknamed “The Help Book”) was initiated with a limited number(6)of entries. Following unanimous positive feedback from ICU staff, the reference book grew into two four inch binders containing 35 reference sections. Digital pictures taken of actual procedure setups and the necessary equipment lists were placed into power point slides with only the necessary pieces of written text added to maximize the ease of use and understanding.
RESULTS: As the Clinical Educator of the ICU I was frequently called to the bedside to assist in the setup for many of these low volume procedures. The nursing staff often felt they had insufficient experience in the setup and understanding of these procedures. Along with continued education and competence verification, this reference has made it possible for staff to become independent when asked to set up for procedures such as bedside EEG monitoring, Bispectral Index monitoring, Intra-abdominal pressure monitoring and Esophageal Doppler monitoring, etc. This has been extremely important for the evening and night shifts, when backup resources and limited. Experienced ICU nurses (n=14) evaluated this reference, and found the following: extremely useful (93%), excellent learning guide 86%), and extremely easy to follow (93%). The overall result has been an increase in staff self confidence and competence in many areas of their critical care practice.
CONCLUSION: The rates of certain procedures at community hospital ICU's can be low and occur sporadically. The development of an ICU procedural quick reference manual, which is image driven with limited written text, is an extremely useful resource to the ICU staff nurse.
CLINICAL IMPLICATIONS: It is difficult to maintain nursing proficiency in the setup and monitoring for low volume procedures. The development of a similar reference manual at other community hospital ICU's can help maintain nursing competence and therefore improve patient care.
DISCLOSURE: Nancy Meszaros, No Financial Disclosure Information; No Product/Research Disclosure Information