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Nursing tips of the week

A communication tool for education and clinical updates

Martin, Layla San MSN, MHA, BSN, RN, CPN, HCAP

doi: 10.1097/01.NURSE.0000585948.51158.f3

Electronic flyers as an educational tool

Layla San Martin is a nursing quality outcomes coordinator and the nursing lead for regulatory and accreditation adherence in the Department of Nursing Science, Professional Practice, and Quality at Children's National Health System in Washington, D.C.

The author has disclosed no financial relationships related to this article.



COMMUNICATION IS critical in the delivery of new information in healthcare. Due to the intensity of high-impact information being exchanged, healthcare systems are recognized as complex.1 Nurses receive new information daily regarding updates on policies, procedures, practice changes, and regulatory requirements, which should be absorbed and consistently reflected in practice. This article describes a new approach to communicating and reinforcing practice points with a weekly electronic flyer, titled Nursing Tips of the Week (NTOTW), designed to educate the nursing staff by highlighting a focused topic every week.

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Keeping up with change

The pace of change in healthcare policies, procedures, and clinical practices can impact patient care and safety. Errors in care contribute to unhealthy work environments and may decrease nurse retention rates.2 Communication deficiencies regarding required documentation in a healthcare system may even put a nurse's professional license in jeopardy.3

Although many organizational frameworks are available for developing updates to policies, procedures, and clinical practices, no standardized messaging or delivery method effectively communicates this information.2,4,5 Despite a plethora of electronic communication tools, including emails, flyers, posters, unit huddles, and staff meetings, nothing guarantees the receipt of crucial information.2 As a result, nurses may not be aware of the most current, institution-approved, and practice-affecting policies.

Nursing and organizational readiness for change depends on communication strategies initiated by nursing leaders.5-8 Given the volume, intensity, and frequency of the complex information routinely exchanged in healthcare systems, an effective communication tool for system leaders is a priority. Creating a communication tool that can reach nurses quickly and easily, hold their attention, and keep them awaiting the next update may seem like an impossible challenge.

A common, simple method of communicating information to healthcare professionals on a large scale is through electronic notifications such as email. Email communication allows leaders to share high-value information rapidly with large groups, but the daily volume of messages can desensitize nurses to the information being shared. How can healthcare organizations take full advantage of the large-scale ability to share information rapidly through electronic notifications while also making messages memorable and demonstrable?

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The author's healthcare system consists of multiple sites in geographically distinct states, including a central freestanding pediatric hospital, two EDs, multiple primary care clinics and ambulatory surgery centers, and partnering physician offices. Keeping the nursing staff abreast of changes in policies, procedures, and clinical practices as they provide care in each of these locations requires electronic communication to disseminate information and education.

To provide these updates, the weekly one-page NTOTW flyer was created and delivered via email. By communicating information in a creative and visually stimulating manner, the newsletter engaged readers by making new knowledge memorable and reinforcing standards of care.

The NTOTW flyer served to educate the nursing staff by detailing a focused topic every week. Topics covered a range of subjects, including pain management, fall risk assessment, device rotation to prevent pressure injuries, and patient food storage. Content was chosen according to recent regulatory findings, new processes for care, and any updates on organizational policies and procedures. The flyer also included screenshots and hyperlinks to detailed information from the organizational intranet and facility policies and procedures. The information was disseminated in a variety of formats and templates, including bullet points, poetry and anecdotes, songs, and humorous memes to add familiarity and humor to the educational materials. One especially creative flyer likened the progression of diaper dermatitis to a strengthening hurricane.

Efforts were made to theme each flyer to generate interest depending on the season or any well-known current events within the local, national, or global community. These included annual sporting events, seasonal topics, movies, holidays, and any activities going on within the organization or community. For example, the Fall Assessment and Prevention flyer had an autumn theme and was decorated with colorful leaves (see NTOTW: Fall assessment and prevention).

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Success was measured based on outcome data in the form of monthly audits to track regulatory and safety requirements in a respective area of healthcare. These included pain reassessment, patient falls, and head circumference measurements.

After a NTOTW flyer focused on pain reassessment was widely disseminated, compliance in this area increased by 14% in 1 month. Similarly, head circumference measurement compliance increased by 25% following the dissemination of topic-specific NTOTW flyers. In 1 month, patient fall events across clinical areas in the main hospital campus decreased by 31%, and these continued to decrease by 50% for 2 more months.

The findings were continuously audited for sustained compliance. Consistent monitoring helped to identify areas that may have seen decreased rates, but specific areas of noncompliance may require more focus. In these cases, a flyer with the same information and content would be distributed with a different presentation to reinforce education. For example, themes, backgrounds, or pictures might be changed to reflect current events.

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In the last 2 years, the NTOTW flyers have become a popular tool for disseminating information and educating the healthcare staff. The tool has received more than 150 positive comments via verbal and written correspondence, suggesting its acceptance as a communication method for system and practice-level updates. It also received an interorganizational award for its creativity and ability to captivate staff to promote safety. The flyers have become an accepted communication platform for both the division of nursing and other multidisciplinary teams and departments within the organization.

Several groups from multiple disciplines, including infection control, risk management, engineering, compliance, laboratory, and pharmacy, have requested the dissemination of their updates through this method. Additionally, other clinicians have requested to receive information in this format. In the past year, a NTOTW flyer has been created more than 12 times at the request of a multidisciplinary team within the organization.

These requests, combined with the overall positive response, indicate a general consensus among the staff to continue this communication tool and style. Successful adoption and adaptation has been demonstrated with similar email informational flyers following the same format as the NTOTW flyers. These have been disseminated to clinical staff and received similarly positive feedback, suggesting that the tool may be transferrable to other topics, education, or situations.

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Tips for success

Although increased clinical compliance rates cannot be solely attributed to the dissemination of the NTOTW flyer, these tips support and reinforce ongoing initiatives to improve compliance and increase regulatory and safety standards. Formatting email content to include facts, a familiar context, and humor has demonstrated a formula for successful electronic communication and staff education.

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