UEXCEL Project

By enutting88

  • Intent to Credential

    I submitted my intent to credential because I had identified an issue that needed improvement. Without a clear direction for process improvement, I began my journey.

  • Explanation of Project

    After submitting my intent to credential, I spoke to the intervention cardiology physician group to introduce my project and create an understanding of what I would be working on for the next several months.

  • Begin Data Collection

    On the days I was acting as the relief charge nurse, I began to gather data on the types of issues that were creating limitations to case start times and increased patient costs.

  • End of Data Collection

    I collected data over a three month time span. This data was helpful to identify the most common issues with our current pre-procedural practice.

  • Accepted the Charge Nurse Position for the CCL

    I applied for and accepted the permanent charge nurse position for the cardiac cath lab.

  • Communication with CVC Nurse Coordinators

    I spoke with several of the CVC nurse coordinators to identify ways to improve the pre-procedural expectations for the cardiac cath lab. Because there was no existing guideline in place, this helped me to create a framework to build upon.

  • Communication with CVPP Leadership

    I sent an email to the CVPP nurse manager and charge nurses asking about an opportunity to communicate an update about the development of my uexcel project. At this time, I was not planning on a formal submission to the Nursing Practice Guidelines Subcommittee and was seeking the best way to communicate the change with the CVPP staff and CVC coordinators.

  • Email to Carolyn Swartz

    I reached out to Carolyn Swartz who is the responsible for all our point of care (POC) testing. I inquired about billable costs for POC testing of PT/INR and Creatinine (Cr). She was unable to give me billable costs to patients, but did note that POC testing is considerably more expensive than laboratory run testing.

  • Communication with Physicians

    After understanding the current workflow of the CVC nurse coordinators, I spoke with the physicians about the need of guideline development to decrease patient delay times and costs incurred. The physicians were supportive of the idea, but did not contribute ideas for action at this time.

  • Email to Joan Coleman

    I sent and email to Joan Coleman to inquire about costs of labs that were processed by the laborarory. Again, I was unable to obtain actual billable costs to patients. This information did provide the necessary data to determine that POC testing was more costly than standard laboratory testing.

  • Advisor Meeting

    I met with Katie Overbey to identify need for formal submission to the Nursing Practice Guidelines Subcommittee. We found that because this would be considered a guideline it would be most appropriate to have an official document that could be updated and assessed for practice change.

  • Email to Physicians

    The initial email to gather physician opinion and recommendation was sent out with an attached survey to all of the cardiologist who perform procedures in the cath lab. The physicians were all notified personally about the email and asked to return the online survey within one week.

  • Survey Results

    After not receiving a timely response from all of my physician colleagues, I personally delivered a paper form of the survey to each physician that had not responded. After gathering all necessary information, I placed the results into a digital form.

  • Physician Email

    After compiling the data gathered by the physicians, I sent an email suggesting creation of a guideline based on not only their expert opinion, but also the SCAI Best Practice Guideline.

  • Guideline Development

    I began to develop the guideline that would be submitted to the Nursing Practice Guideline Subcommittee.

  • Development of CVPP Flyer

    While developing the formal guideline, I also began to work on the educational information that would be provided to the CVPP nurses. I decided to call this document the CVPP flyer. This flyer will serve as a memo to all CVPP nurses informing them of the practice change and encourage autonomy in the preparation of cardiac cath lab patients.

  • Submission to NPGS

    My completed guideline was submitted to the NPGS.

  • NPGS email

    I received an email from the NPGS that they were unable to put me on the July agenda. I was scheduled for the meeting August 17, 2016.

  • Initiation of Guideline

    As of August 1st, 2016 the CVC nurse coordinators began to use the guideline to direct patient's pre-procedural preparation.

  • CVPP Education Flyer

    After assessing data post initiation, I found that improvements were not being made. The CVC nurse coordinators schedule three days ahead of time. If a patient has labs drawn in the three days prior to procedure, the guideline does not account for this. Therefore, the CVPP nurses would need additional education on the expectations of pre-procedural preparedness. I sent the CVPP educational flyer to the CVPP leadership.

  • Guideline Presentation

    I presented my guideline to NPGS.