1: Delegation: A unit employs RNs, LPNs and PCTs (patient care techs) to provide direct care. The unit has had an issue with appropriate delegation. The PCTs and LPNs report that they are being asked to perform more than their fair share, and things they should not do. The RNs state that they are the only ones who do anything, and every time they ask the LPNs and PCTs to do anything they are told the PCTs and LPNs are not allowed to perform the task. The Unit manager recognizes that efforts to improve delegation need to be made. Your task is to research an intervention to enhance the quality and practice of delegation on this unit. 2: Decreasing wait times in ER or patient flow time to move from ED: A manager of an Emergency Department is concerned that patient satisfaction scores have dropped significantly for the department. The primary complaint is long wait times. Internal tracking of patient flow has shown patients are waiting up to 7 hours for transfers to patient care areas, or to hospital units. Your task is to research an intervention to decrease wait times with improved flow to the care areas. 3: New grad nurse retention: The manager of a medical surgical unit that is expanding needs to hire additional staff. Over the last 3 years 90% of the new graduates hired have quit within the first year of hire. The current RN staff is comprised of 8 nurses with greater than 10 yrs experience, 6 nurses with 5-10 yrs experience and 7 nurses with less than 5 yrs experience on the unit. Six new graduates are hired for the expansion. They will start 3 months before the new beds open. Your task is to research an intervention to enhance retention of the new graduates. 4: Reducing medication errors: A medical surgical unit manager has had a significant increase in medication administration errors over the last two months. The errors involve many staff members and are occurring on all shifts. The budget does not allow for the purchase of new administration system. Your task is to research an intervention to decrease medication administration errors from the nursing staff within these parameters. 5: Patient family centered care: The manager of a medical surgical unit has experienced a significant drop in patient satisfaction with the primary complaints being a lack of communication to patients and their family members. Your task is to research an intervention to increase patient-family centered care environment that would address this issue. 6: Evidence-based practice: A hospital is seeking Magnet Hospital status. The managers of the units are charged with enhancing the incorporation of evidenced based practice on a unit level. Your task is to research an intervention to enhance the exposure to and application of evidence-based practice among nurses on the medical surgical unit. 7: Enhancing teamwork across care provider levels: The manager of a medical surgical unit has observed, and had complaints about, lack of teamwork between the RNs and the patient care techs (PCTs). Your task is to research an intervention to enhance teamwork on the unit. 8: Call light response time: The manager of a medical surgical unit that employs RNs and patient care techs (PCTs) has had a significant increase in call light response time and decrease in patient satisfaction related to the answering of call lights. Your task is to research an intervention that addresses the answering of call light in a timely, respectful manner. 9: Decreasing the incidence of DVTs in post-op orthopedic patients: Quality assurance reports for an orthopedic surgery unit identify an increase in the incidence of DVTs over the last 6 months. The unit uses a standard prevention plan of Lovenox subQ and sequential compression devices (SCDs) for all appropriate post-op patients. A recent survey found that 64% of the patients did not have SCDs on while in bed and 32% did not receive Lovenox with the notation refused. Your task is to research an intervention to increase the use of SCDs and decrease the number of refused Lovenox doses.
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