Transformational Leadership
Throughout this year, my involvement in the PACU has taught me about the role of a transformational leader. With managerial support and a shared governance approach, I recognized areas of improvement and enacted positive change in the perioperative area.
Most of my involvement was focused on improving patient care and safety. However, my manager, Michelle Ballou, encouraged me to consider resolving issues with the patient lockers in the waiting room. After collaborating with security, the UCH attorney, and the UCH marketing department, I made changes that decreased the principal problem. More importantly, I clarified a process so that Pre-Op and PACU charge nurses knew how to appropriately manage any problems.
Most of my involvement was focused on improving patient care and safety. However, my manager, Michelle Ballou, encouraged me to consider resolving issues with the patient lockers in the waiting room. After collaborating with security, the UCH attorney, and the UCH marketing department, I made changes that decreased the principal problem. More importantly, I clarified a process so that Pre-Op and PACU charge nurses knew how to appropriately manage any problems.
I have also grown as a leader through actively participating in the Stroke Champions Committee and PACU Competency Committee. As a Stroke Champion, I relayed relevant information to PACU staff and concentrated on stroke education. After reviewing Safety Intelligence reports on stroke alerts, I reeducated PACU RNs at staff meetings, which increased stroke alert awareness and knowledge of the procedure. By the end of the year, stroke alerts were running more efficiently.
As a member of the PACU Competency Committee, I collaborated with staff to create competencies for the 2014-2015 fiscal year. I was selected to write competencies and tools for EKG Interpretation and Joint Commission Compliance. Utilizing the Donna Wright Model, I considered a variety of learning styles and wrote several methods to verify competencies.
As a member of the PACU Competency Committee, I collaborated with staff to create competencies for the 2014-2015 fiscal year. I was selected to write competencies and tools for EKG Interpretation and Joint Commission Compliance. Utilizing the Donna Wright Model, I considered a variety of learning styles and wrote several methods to verify competencies.
As the Perianesthesia Quality and Patient Safety Council chair, I collaborated with management and council members to advance quality care and patient safety. We especially focused on improving unit-based outcomes. Throughout the year, I performed audits on medication labeling and reeducated RNs who failed to label medications properly. Other responsibilities consisted of: coming up with the agenda, identifying safety issues, promoting cooperation, managing conflicting ideas, and refocusing the team. I encouraged the council to act as a decision-making body by voting on quality and safety items. This led to multiple changes, including: taking ambu bags while transporting certain patients, improving hand hygiene, and reinvigorating the Catch-a-Bug campaign to decrease the risk of infection. To improve hand hygiene, the council identified obstacles and initiated change, including relocating hand sanitizers to more accessible locations. Currently, we are working with management to prepare staff for the Joint Commission visit.
Empowerment is a key component of transformational leadership. What better way to be empowered than write a guideline? Based on my project for preventing postoperative urinary retention (POUR), I wrote a voiding algorithm guideline and updated the unit-based guideline for bladder scan use in PACU. The AOP PACU also adopted the voiding algorithm guideline.
A great idea doesn’t mean anything without the necessary action and follow through. Throughout this year I learned that a transformational leader promotes teamwork and finds ways to motivate staff during times of change. With a positive and encouraging attitude, I worked with staff to implement multiple changes. Given that I work amongst fabulous nurses, they accepted changes that positively impacted patient care and satisfaction.
Empowerment is a key component of transformational leadership. What better way to be empowered than write a guideline? Based on my project for preventing postoperative urinary retention (POUR), I wrote a voiding algorithm guideline and updated the unit-based guideline for bladder scan use in PACU. The AOP PACU also adopted the voiding algorithm guideline.
A great idea doesn’t mean anything without the necessary action and follow through. Throughout this year I learned that a transformational leader promotes teamwork and finds ways to motivate staff during times of change. With a positive and encouraging attitude, I worked with staff to implement multiple changes. Given that I work amongst fabulous nurses, they accepted changes that positively impacted patient care and satisfaction.
Timeline
August 2013
Completed literature review on preventing postoperative urinary retention (POUR).
8/27 Drafts for voiding algorithm and physician order for “patient voiding prior to discharge instructions” completed.
September 2013
PACU nurses completed POUR pretest.
October 2013
Selected as the Stroke Champion representative for AIP PACU.
Preventing POUR
10/2 Voiding algorithm completed based on an extensive literature review.
10/8 Phase II committee met to finalize physician order for “patient must void prior to discharge.”
10/17 Department heads and general surgeons emailed for feedback and approval of new order and algorithm to prevent POUR.
10/21 Via PowerPoint presentation, PACU nurses educated at staff meeting on standard definition of POUR, prevention, risk factors, how to use the algorithm, and the new order.
November 2013
Preventing POUR
11/18 Epic supervisor contacted to enter new order for “patient voiding prior to discharge instructions”
11/25 Posters delineating POUR pretest results and initial knowledge gap hung in PACU. PACU nurses completed remediation questions.
December 2013
Patient Lockers
SBAR report and action plan written for resolving issues with patient lockers in the waiting room.
January 2014
Patient Lockers
1/2 Sent action plan on patient lockers to perioperative leadership
1/6 Received feedback from nurse manager, associate manager, and charge nurses.
1/6 Spoke with Head of Security for suggestions on managing locker issues.
1/7 Spoke with UCH Compliance Officer in Human Resources for suggestions on managing locker issues. He advised speaking with UCH attorney.
1/8 Emailed UCH attorney for approval of language. Also discussed hospital’s liability for items lost or stolen.
1/24 Emailed marketing department for signage approval
1/28 Signage approved by Alexandra Thome (UCH marketing)
1/29 Signage sent to Brenda Wilkinson (Perioperative Secretary) to forward to Fed Ex
February 2014
Assumed Chair for the Perianesthesia Quality and Patient Safety Council
Patient Lockers
2/5 Brenda Wilkinson met with Fed Ex to make signage
2/10 PACU permanent and relief charge nurses educated on procedure for managing locker issues
2/24 New signage posted in the waiting room. Including instructions for locker use and cards to write down locker number and code
Preventing POUR
New Epic order for “voiding prior to discharge instructions” available for use.
2/26 Presented POUR interventions to Clinical Quality and Risk Management Committee
March 2014
Preventing POUR
Chart audits conducted to assess use of voiding algorithm and new order.
3/3 Presented POUR PowerPoint, voiding algorithm, and new order at AOP Staff Meeting
3/27 Presented POUR PowerPoint, voiding algorithm, and new order to Perianesthesia Quality Improvement Council.
Patient Lockers
3/3 Extra locker cards relocated in FCC desk for restocking. FCC will let Brenda know when she needs more cards.
3/3 Pre-Op charge nurses educated on new procedure for managing locker issues.
3/25 FCC reeducated on procedure for managing locker issues.
3/25 Admissions staff educated on new procedures for managing lockers.
April 2014
PACU Competency Committee
Wrote competencies for EKG Interpretation and Joint Commission Compliance based on the Donna Wright Model
Preventing POUR
Chart audits conducted to assess use of voiding algorithm and new order.
4/29 Emailed Joanne Becker to get approval of 2 Unit-Based Guidelines:
1. University of Colorado Hospital Guideline: Voiding Algorithm for Preventing Postoperative Urinary Retention
2. Updated: University of Colorado Hospital Guideline for Bladder Scan Use in Post Anesthesia Care Unit
May 2014
Completed competency tools for EKG Interpretation and Joint Commission Compliance for the PACU Competency Committee.
June 2014
Preventing POUR
Chart audits conducted to assess use of voiding algorithm and new order.
6/5-6/7 Received approval of guideline by the Perianesthesia Quality and Patient Safety Council.
6/10 Presented the Voiding Algorithm and updated Bladder Scan Use Guidelines to the Perioperative Guideline Task Force.
6/11 Guidelines approved.
Completed literature review on preventing postoperative urinary retention (POUR).
8/27 Drafts for voiding algorithm and physician order for “patient voiding prior to discharge instructions” completed.
September 2013
PACU nurses completed POUR pretest.
October 2013
Selected as the Stroke Champion representative for AIP PACU.
Preventing POUR
10/2 Voiding algorithm completed based on an extensive literature review.
10/8 Phase II committee met to finalize physician order for “patient must void prior to discharge.”
10/17 Department heads and general surgeons emailed for feedback and approval of new order and algorithm to prevent POUR.
10/21 Via PowerPoint presentation, PACU nurses educated at staff meeting on standard definition of POUR, prevention, risk factors, how to use the algorithm, and the new order.
November 2013
Preventing POUR
11/18 Epic supervisor contacted to enter new order for “patient voiding prior to discharge instructions”
11/25 Posters delineating POUR pretest results and initial knowledge gap hung in PACU. PACU nurses completed remediation questions.
December 2013
Patient Lockers
SBAR report and action plan written for resolving issues with patient lockers in the waiting room.
January 2014
Patient Lockers
1/2 Sent action plan on patient lockers to perioperative leadership
1/6 Received feedback from nurse manager, associate manager, and charge nurses.
1/6 Spoke with Head of Security for suggestions on managing locker issues.
1/7 Spoke with UCH Compliance Officer in Human Resources for suggestions on managing locker issues. He advised speaking with UCH attorney.
1/8 Emailed UCH attorney for approval of language. Also discussed hospital’s liability for items lost or stolen.
1/24 Emailed marketing department for signage approval
1/28 Signage approved by Alexandra Thome (UCH marketing)
1/29 Signage sent to Brenda Wilkinson (Perioperative Secretary) to forward to Fed Ex
February 2014
Assumed Chair for the Perianesthesia Quality and Patient Safety Council
Patient Lockers
2/5 Brenda Wilkinson met with Fed Ex to make signage
2/10 PACU permanent and relief charge nurses educated on procedure for managing locker issues
2/24 New signage posted in the waiting room. Including instructions for locker use and cards to write down locker number and code
Preventing POUR
New Epic order for “voiding prior to discharge instructions” available for use.
2/26 Presented POUR interventions to Clinical Quality and Risk Management Committee
March 2014
Preventing POUR
Chart audits conducted to assess use of voiding algorithm and new order.
3/3 Presented POUR PowerPoint, voiding algorithm, and new order at AOP Staff Meeting
3/27 Presented POUR PowerPoint, voiding algorithm, and new order to Perianesthesia Quality Improvement Council.
Patient Lockers
3/3 Extra locker cards relocated in FCC desk for restocking. FCC will let Brenda know when she needs more cards.
3/3 Pre-Op charge nurses educated on new procedure for managing locker issues.
3/25 FCC reeducated on procedure for managing locker issues.
3/25 Admissions staff educated on new procedures for managing lockers.
April 2014
PACU Competency Committee
Wrote competencies for EKG Interpretation and Joint Commission Compliance based on the Donna Wright Model
Preventing POUR
Chart audits conducted to assess use of voiding algorithm and new order.
4/29 Emailed Joanne Becker to get approval of 2 Unit-Based Guidelines:
1. University of Colorado Hospital Guideline: Voiding Algorithm for Preventing Postoperative Urinary Retention
2. Updated: University of Colorado Hospital Guideline for Bladder Scan Use in Post Anesthesia Care Unit
May 2014
Completed competency tools for EKG Interpretation and Joint Commission Compliance for the PACU Competency Committee.
June 2014
Preventing POUR
Chart audits conducted to assess use of voiding algorithm and new order.
6/5-6/7 Received approval of guideline by the Perianesthesia Quality and Patient Safety Council.
6/10 Presented the Voiding Algorithm and updated Bladder Scan Use Guidelines to the Perioperative Guideline Task Force.
6/11 Guidelines approved.