QI Interventions

The QI methods developed by the PICU NST were targeted to ordering providers as well as nurses and were implemented over a 3-month period by the PICU NST. These interventions included Web-based online education utilizing Power Point slides to review the importance of anthropometry measurements and detailed descriptions of the correct age-appropriate techniques to obtain such measurements. Additional hands-on training was provided at clinical practice skills fairs to reinforce PICU RN education. The online training and the skills fair education were mandatory components of the quarterly instruction for PICU RNs. A third layer of bedside, “just-in-time” training was provided to PICU RNs and nursing aides by the PICU NST within 12 hours of the child being admitted to the PICU. The “just-in-time” training methods used standardized scripts with the PICU-specific RDs supervising training of RNs and nursing aides at the bedside with use of actual equipment to demonstrate the correct approach to obtaining anthropometry measurements in a consistent manner. Equipments to perform anthropometry were upgraded and standardized throughout the PICU and stored in standard locations to facilitate performance of anthropometry measurements. The equipment upgrades included beds capable of electronically weighing patients and length boards. The time and date of obtaining the most recent weight and the actual weight value were added to the PICU RN bedside rounding script as a prompt to discuss the importance of weight measurement during daily bedside rounds. Lastly, orders to obtain anthropometry measurements were preselected in the PICU admission order set in the EMR. Figure ​Figure11 summarizes the QI methods employed in this project. Training and education reminders were sent to ordering providers and nurses at regular intervals by the PICU NST during this QI project via group e-mail distribution lists and the use of screen savers on desktop computer workstations. Additional methods used for staff education and reminders included notices posted on staff bulletin boards and regular announcements with real-time implementation updates in the recurring PICU multidisciplinary QI meetings.

Summary of QI interventions with PICU NST.