1. © 2009 On the CUSP: STOP BSI Nurse Empowerment

3. © 2009 Learning Objectives To understand the importance of nurse empowerment To learn strategies to help empower nurses

4. © 2009 What Have We Learned So Far? Work involves technical problems – Evidence – Measurement Adaptive problems – Engagement of nurses, physicians, leaders – CUSP – Daily goals – Competing priorities

5. © 2009 Improving ICU Culture by Creating Trust Caring – Keep Patients your North Star – Preventable harm is not tenable – Tell your own Josie Story Competent – Learn from mistakes and implement teamwork tools (CUSP)

6. © 2009 Ensure Patients Reliably Receive Evidence Pronovost: Health Services Research 2006 SeniorTeam Staff leaders Engage How does this make the world a better place? Educate What do we need to do? Execute What keeps me from doing it? How can we do it with my resources and culture? Evaluate How do we know we improved safety?

7. © 2009 Nurse Empowerment Keep Patient as north star Decision to speak up – Must feel competent – Must feel it is safe – Must feel it will work Policy level (code of conduct) – Helpful if enforced

8. © 2009 Strategies for Nurse Empowerment Policy Level – Code of conduct – Require nurses to assist with central line placement – Require adherence to checklist – Policy to deal with disruptive behavior – Require that bedside nurse attend rounds

9. © 2009 Use tools to practice nurse empowerment in safe space – Nurse attends rounds – Daily Goals with nurse read back – Learning from Defect Address disruptive behavior quickly Strategies for Nurse Empowerment

10. © 2009 In conflict, keep focus on patient as north star Remind staff that teams make wise decisions with diverse and independent input – Do not play man down Strategies for Nurse Empowerment

11. © 2009 Action Plan Meet with ICU team Discuss what policies can be put in place to enhance nurse empowerment Create strategy to involve beside nurses in this project use the 4Es Discuss what tools you can use to enhance nurse empowerment