Implementing quick reference materials for the improvement of rarely performed clinical procedures: a quality improvement project

Abstract

This QI project sought to create and implement quick reference tools with the aim of enhancing compliance with clinical practice guidelines for rarely encountered clinical procedures. With collaboration from the Nurse Educator and Quality Improvement Officer on the medical floor at a southwest Montana hospital, the management of chest tubes and implanted ports were identified as inconsistently or infrequently performed procedures, and medical floor staff felt ill-prepared when executing these procedures. The following steps for this project required reviewing and adapting information from the existing clinical guideline materials condensing pertinent information into easy-to-use quick reference information sheets. Next, transcripts were outlined for short 2-minute video tutorials corresponding with each procedure on the quick reference sheets. These quick reference materials were designed using the cognitive and multimedia learning theories, which utilize clear verbal and graphic information that optimize deeper learning and recall. Finally, the implementation phase of this project introduced the quick reference information sheets on the medical unit, covering the skills necessary to manage both chest tubes and implanted ports. Additionally, recording the short video tutorials occurred while implementing the quick reference sheets was underway. It is planned that the QR codes will be added later to the quick reference sheets, allowing stakeholders to access the videos tutorial that correlates to each procedure. A survey of 10 medical floor nurses evaluated the utilization and helpfulness of the resources. The project's initial implementation results indicate a positive response from stakeholders to the quick-reference sheets. In addition, proxy outcomes show that nurses agreed on satisfaction, usefulness, and self-confidence survey questions regarding the use of the quick reference sheets. Future actions for this project are to add the video QR codes onto the quick reference sheets and implement these in the medical unit. It is predicted that a combined approach of using quick reference sheets and short videos will be an operative teaching method for advanced clinical skills of rarely encountered procedures, support clinical decision-making, and further enhance patient outcomes.