As a director of nursing, I found the December 2012 article, “Incivility and the Nurse Leader” by Donna Ostrofsky, MSN, RN, CNOR, extremely fitting as the roles nurses encompass continue to evolve, and more so with healthcare reform. With these evolving roles, nurse leaders must be cognizant of not only healthcare operations, but also their role in organizational culture. Both organizational culture and professional practice behavior facilitate civility, which is essential for safe patient care in stressful environments.
Although the study had a small sample size, data collected from the interviews identified that the nurse managers felt a lack of support in addressing such behavior. This is unfortunate because nursing leadership must have the courage and confidence to address these issues head on and advocate for themselves and their colleagues. In addition, the study was unable to deliver adequate information on the source of incivility. Nonetheless, this is a beginning to further identify measures to combat incivility and educate colleagues about its indirect impact on patient safety.
How to reduce CLABSIS
As an experienced nurse leader who's passionate about reducing harm and risk to our patients, the May 2013 article, “Can An Education Program Reduce CLABSIs?” by Glenn H. Raup, PhD, RN, CNL; Joyce Putnam, DNP, RN, ACNP-BC, CCRN; and Kathy Cantu, MSN, RN, CEN, NEA-BC, caught my attention. After reading this article, I began thinking about our current practice to reduce CLABSIs in my practice environment.
My department needed a great deal of help with the reduction of CLABSIs. We implemented insertion bundles and standardized maintenance of central lines through our policy and procedures council, provided education to our staff, and promoted 100% adherence to hand hygiene. However, we weren't able to accomplish complete success. Our infection prevention team ventured on to current literature to investigate what could be done toward the reduction of CLABSIs. They found that alcohol impregnated caps had the greatest potential of reducing CLABSIs.
As the article points out, a multidisciplinary approach is recommended to create a culture of patient safety. Inclusive education was provided to ensure that all disciplines knew the objective and were informed of their duty to help reduce CLABSI rates throughout the hospital. It's time for us to embrace research and evidence-based practice. Traditional methods aren't yielding the results that we need and simply reinforcing education hasn't yielded positive outcomes. Is it time to try something new?