An oncology unit at a Washington, DC, hospital has improved patient safety by focusing on “relationship-based care,” a model that aims to help nurses focus more on caring for and connecting with other people.

The 5E Medical Oncology/Hematology Unit at MedStar Washington Hospital Center recently received AMSN Premier Recognition In the Specialty of Med-Surg (PRISM) Award. It is co-sponsored by the Academy of Medical-Surgical Nurses (AMSN) and the Medical-Surgical Nursing Certification Board.

The unit had made strides in recent years in improving quality and safety on the unit as well as the overall culture, explains Rebekah Groff, RN, BSN, OCN, patient care manager on the 5E unit.

“We were establishing relationship-based care with each other and with our patients,” Groff says. “Oncology patients are a vulnerable population, with lots of issues associated with infections. The hospital helps us address those infection risks, but as a unit we wanted to band together as a team and strive to prevent infections in these patients with whom we’ve established these wonderful relationships.”

The relationship approach resulted in reduced infections and falls, and staff retention rates climbed, says Jane McGee, MSN, RN, CMSRN, RN-BC, senior nursing director for medical and behavioral health services at MedStar Washington Hospital Center. She was the senior nursing director for 5E at that time.

As part of the improvement efforts, McGee and Groff realized that they needed more certified nurses on the unit. MedStar Washington Hospital Center created a program that presents review courses on several certification exams, and staff can take the exam for free. The oncology unit urged nurses to participate.

The unit also sought to improve the education of techs and other staff besides nurses.

“We wanted to make sure we were retaining our staff because that allows you to cultivate and maintain those really good relationships on the unit that ultimately helps to reduce infections because everyone is working together,” Groff says. “We also made sure that everyone on the unit, down to our unit techs and clerks, were involved with reducing falls and infections. If our unit clerks hear a bed alarm down the hall, they may get up from their desk and go check on that patient and call the appropriate people in.”

The unit also sent nurses to participate in the hospital’s central line-associated bloodstream infection committee, Groff notes. They also re-educated staff members on fall prevention to make sure they were conducting proper fall assessments, checking bed alarms on hourly rounds, and proactively toileting patients.

After those changes, the unit went six months without a fall and has maintained a very low fall rate. McGee attributes that largely to the unit staff’s policy of taking patients to the bathroom whenever they are in the room, rather than waiting for the patient push a call button or try getting out of bed on their own.

“We also emphasized that we are responsible for all of the patients on our unit. A patient is not Jane’s patient or Susie’s patient, but rather we all collaborate. If you hear an alarm, you go in and assist the patient,” Groff says. “The central theme was developing relationships with each other and with the patients, which ultimately will help keep the patient safe.”

SOURCES

  • Rebekah Groff, RN, BSN, OCN, Patient Care Manager, 5E Unit, MedStar Washington Hospital Center, Washington, DC. Phone: (202) 877-7000.
  • Jane McGee, MSN, RN, CMSRN, RN-BC, Senior Nursing Director, Medical and Behavioral Health Services, MedStar Washington Hospital Center, Washington, DC. Phone: (202) 877-7000.