Accomplishments 

Since entering the BSN completion program,  I've had a whirlwind of a year.  

• November 2013-I became the Clinical Leader for the Burn Center at Shands hospital. 
• Being a clinical leader means that I am now obligated to attain my Master's in nursing.  I have until December 2016 to complete this. I will also have to acquire a nursing certification.  I'm going back and forth between CCRN and a wound care certification.  
• I've joined the hospital's Scope of Practice Council. 
• The Burn Center has engaged in an evidenced based research project to find out the Modified Early Warning System Sepsis Recognition score that is useful in determining impending sepsis in the burn population. I created and presented the poster for this project at the hospital's Quality Conference. We are past the early stages and are applying for IRB approval this week.

Nursing Leadership and Management

     My experience working within a team to complete a Quality Improvement project was certainly a learning experience.  Although the team was very excited about our project-improving post discharge cleaning processes to reduce hospital acquired infections, different personalities was our challenge. It was funny that we’d all just taken a conflict resolution style inventory, and sure enough, the group project proved to reveal those styles. I was proud that although we didn’t always agree, the group was civil and compromising and able to easily come to consensus that worked for the project outcomes and goals. 

Ultimately, the project presentations proved that not only our team, but all of the teams were incredibly competent.  The projects were quite professional and the presentations were interesting and it was apparent that the nurses in this program have grown in confidence, curiosity, and empowerment by developing their professional practice. I left the presentation day potluck very proud of the group as well as feeling as if I’m already reaping the benefits of obtaining my BSN. 

     The weekly reading by Staffileno & Carlson (2010) emphasizes that nurse managers need to encourage this same sort of curiosity and ability to engage in and understand evidenced based practice.  However, Staffileno & Carlson (2010) comment that management teams need to allow for this engagement in formalized ways that include not just time, but mentoring and education.  I will certainly use some of the suggestions for teaching and encouraging evidenced based practice understanding: Journal Clubs as well as having someone come from Nursing Education to help us all learn how to better search databases and do literature review.  Actually, I feel that database research would be a nice addition to this program, perhaps integrated into the first Transition to Professional Nursing course. 

     The BSN completion program has helped emphasize the need for multi-disciplinary teams from everything to giving report and rounding to delivering patient centered care.  I head a monthly for the Burn Center at Shands where the emphasis is on patient outcomes: pressure ulcers, readmissions, sentinel events, and the like. These patient outcomes are easily measured because the hospital keeps track of them for us and my job is to discuss amongst an interdisciplinary team the possible causes for them.  The other part of my job is to come up with improvement initiatives.   The experience of working with a team to complete the Quality Improvement (QI) class project helped me in my own practice by emphasizing that outcomes need to be measurable. I’ve grown from implementing changes that “will obviously” have better outcomes, to a more mature way of implementing changes that I can ensure that are measurable and perhaps even publishable.  I have two projects going on at this time: A modified early sepsis warning measurement system (MEWS) for burn patients as well as a high touch surface area cleaning process in the Burn Center. Each will be measured to see if our numbers improve: What number is most predictive of impending septicemia for burn patients and will implementing the early warning decrease septic events?  And for the second project: Will implement a twice a day high touch surface area cleaning system and check-off sheet reduce hospital acquired infections and decrease the amount of bioburden that is cultured from those high touch surface areas? 

     Finally, the course content that I find the most challenging was reading about the various ways in which staffing was figured.  It was quite enlightening reading about hours per patient day.  What the reading revealed, along with investigating the way in which my area of practice has tried over the years to adequately staff, is that this challenge is one that is ongoing and incredibly complex. 

References

Stafffileno, B.A., & Carlson, E. (2010).  Providing direct care nurses research and evidence-based   

     practice information: An essential component of nursing leadership Journal of  Nursing Management,         18,  p. 84-89.