1. Leadership Project Brittni M. Smith Middle Tennessee State University October 8, 2008

2. University Medical Center Lebanon, Tennessee Lebanon, Tennessee 257 bed hospital 257 bed hospital Over 800 employees Over 800 employees Health Management Associates, Naples, Florida Health Management Associates, Naples, Florida

3. University Medical Center Vision UMC will distinguish itself as a leader in redefining healthcare delivery and will be recognized for the passion of its people and partners in providing quality, innovative care to the patients it serves in each community

4. University Medical Center Mission To improve the level of health and well- being in the community by providing the physicians quality oriented facilities, support services, and programs in order to ensure the highest quality healthcare at competitive prices

5. Clinical Unit UMC Women’s Pavilion 6 labor rooms 6 labor rooms 1 operating room 1 operating room 14 postpartum/surgical rooms 14 postpartum/surgical rooms nursery nursery

6. Clinical Unit

7. Unit Director Laurie, MSN, RNC Democratic leadership Democratic leadership Policy enforcement Policy enforcement Staff compliance Staff compliance Budgeting Budgeting Staff evaluations Staff evaluations Mentoring/preceptorship Mentoring/preceptorship

8. Unit Director

9. Charge Nurse Anita, RN Nurse-patient assignments Nurse-patient assignments Staffing for following day Staffing for following day Questions or concerns of staff nurses Questions or concerns of staff nurses Crash cart check and Pyxis system count Crash cart check and Pyxis system count General flow and management of unit General flow and management of unit

10. Charge Nurse

11. Leadership Project Identifying Fall Risk Patients Fall policy throughout hospital Fall policy throughout hospital History of falls on unit History of falls on unit Staff failure to label patients properly Staff failure to label patients properly

12. Objectives Identifying Fall Risk Patients Educating staff on fall risk requirements Educating staff on fall risk requirements Increase staff compliance with labeling fall risk patients Increase staff compliance with labeling fall risk patients Improving patient safety on unit Improving patient safety on unit

13. Leadership Project

14. Staff reoriented to updated fall policy Staff reoriented to updated fall policy Staff compliance with labeling doors and using armbands Staff compliance with labeling doors and using armbands In compliance with JCAHO and standards of care In compliance with JCAHO and standards of care

15. Most unique Manager aspect Mother with no prenatal care Mother with no prenatal care Delivery of preterm baby Delivery of preterm baby Events post delivery Events post delivery Vanderbilt Angels team Vanderbilt Angels team Managers perception of event and actions taken Managers perception of event and actions taken

16. Most unique charge nurse experience Delivery with complications Delivery with complications Vacuum assisted delivery Vacuum assisted delivery

17. Organization Strengths BSN prepared nurses BSN prepared nurses Manager-staff relationship Manager-staff relationship Physician-staff relationship Physician-staff relationship All nurses cross-trained to work all areas All nurses cross-trained to work all areas

18. Organizational Weakness Lack of computer documentation Lack of computer documentation

19. Recommendation for Improvement Implementation of computer documentation Implementation of computer documentation Complete documentation Complete documentation Electronic health record Electronic health record Decreased number of forms Decreased number of forms Decreased time spent charting Decreased time spent charting

20. PICO question In newborn males undergoing circumcision, is sucrose water more effective in reducing procedural pain than using a pacifier? In newborn males undergoing circumcision, is sucrose water more effective in reducing procedural pain than using a pacifier?

21. Thank you