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1 st Things 1 st ….and hurry up!

1 st Things 1 st ….and hurry up!. Managing Patient Care. RANC Objectives. Apply principles of priority setting to patient care situations. Apply time management strategies to the reality of delivering effective nursing care. Relate time management strategies to enhance personal productivity.

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1 st Things 1 st ….and hurry up!

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  1. 1st Things 1st….and hurry up! Managing Patient Care

  2. RANC Objectives • Apply principles of priority setting to patient care situations. • Apply time management strategies to the reality of delivering effective nursing care. • Relate time management strategies to enhance personal productivity.

  3. Why prioritize? • Identifies relevance & /or significance • Increases quality care • Allows for delegation & collaboration • Enhances preventative care • Promotes time management • Increases productivity • Not a linear activity • variables occur • simultaneous actions (multitasking) is a must

  4. Elements of Managing Pt Care • Competency (Box 21-1) • Facility/Unit Vision • Model of Care • Organizational Structures • Leadership • Decision-Making Skills • Knowledge Base & Con’t Educ • Communication • Teamwork! Are You Ready??

  5. On Your Mark… • Know yourself! • Strengths & limitations • Increase knowledge • Holistic care • Specialization • Evidence-based practice • Strive for excellence • Sharpen critical thinking skills • Practice hands-on skills • Communicate effectively • Team-player (aka “collaboration”)

  6. …Get Set… • Assessment 1st • Focused vs complete assmnt • Thoroughness • Developing rapport • Critical thinking • Making clinical judgments • Affects decision-making • Nursing process • Know your limitations & ask for help

  7. …Go!!! • Anticipate pt needs look for cues • verbal/nonverbal, history info, meds, environment, etc • Involve the pt • Priority setting • High • life-threatening (“MUST do”) • Intermediate • Non-emergent (“SHOULD do”) • Low • Related to other needs (“Nice to do”) • Note condition changes • Time availability • Length of stay, interruptions, etc

  8. Start with the ABC’s! ABC's • 1st priority sustain life & safety • Physiological needs usually 1st unless psychosocial need • Physiological: • Airway • Breathing • Circulation • Psychosocial: • Anxiety • Fear • Depression • Ineffective coping

  9. Maslow’s Hierarchy of Needs ▪ Physiological 1st ▪ Safety 2nd *See p48, 71-72

  10. Prioritizing on the “same” level • Most urgent 1st • If the airway isn’t clear the oxygen won’t get to the lungs to be circulated to the tissues! • If the need to void is more urgent than the need to eat • If rest is more important than sex! • Acute vs. Chronic problems • LOC change: acute confusion vs Alzheimer’s • Surgery-related pain vs. arthritic pain • Immobility post-op vs. anxiety

  11. Patient Preference prn • Motivation to participate • Perception of event • Value system of the patient(not the nurse!) • Advocacy prn • Family/Significant Other involvement • Right to refuse care • Informed consent • *Nurses are responsible to act in the best interest of the client

  12. Case Study • A 16-yr-old male pt was involved in a MVA and was ejected from the car. Initial assmnt reveals a patent airway, response to painful stim, laceration (L) thigh covered with drsg, contusions to (L) flank. • Prioritize these interventions: • Immobilize head and neck • Assess LOC & Neuro deficits • Assess (L) thigh & Apply clean pressure drsg • Call parents for consent to Tx • Insert Foley catheter

  13. Managing Time • Time analysis/assessment • How do you usually spend your time? • When are you most efficient? • Time frame • Organized method of planning • Principle of time mngmt • “Organize & execute around priorities” • (Covey, 1989, p149) • ADOPIE (Nrsg Process) • Avoid “Pitfalls” along the way: • Procrastination, easiest thing done 1st, distractions, 1st seen=1st done, socialization overload, failure to differentiate priorities, or accepting someone else’s priorities!

  14. Time Management Tips Personal & Pt Care! • ID important aspects/ needs • ID barriers to completion • Prioritize needs • Develop reasonable time frames • Delegate appropriate tasks • Avoid the need to be perfect • Evaluate your efforts & note areas to be improved Lipe, S. K. & Beasley, S. (2004) Critical thinking in nursing: A cognitive skills workbook

  15. Managing to Find the Time! • Organize priorities after shift report • Nursing Process • Make lists & cross off items as you go • SET GOALS • “A goal without a deadline is a dream” • Judith Brumm, RN, CNOR • THINK ahead-be prepared! • “If you don’t spend time using your brain, you’ll spend time using your feet!” (E. Heim, ) • Plan time for documentation

  16. Personal Time Management • Nursing Spectrum: Student Corner • http://www.nursingspectrum.com/StudentsCorner/StudentFeatures/TimeSide.htm • Student website • http://caring4you.net/tests.html Use your resources!

  17. Finally….

  18. The End • All pictures in these powerpoints are intended for educational purposes only and have been obtained through internet search engines such as Google & MSN Live Search. I take no individual credit for content other than assembling them for presentation and learning opportunity.  Garret, my brand new grandson! eheim productions 

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