aacn roadmap for implementing abcde bundle by HC121107141652

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									                                   AACN Roadmap for Implementing Change
                                             ABCDE Bundle

Change is a fact of life, and that can be a good thing. Taking something we’ve learned – such as new evidence-based care practices – and
introducing it within our workplace to enhance patient care and improve outcomes is a change for the better. However, change is often a
difficult process. AACN Roadmap for Implementing Change is a tool intended to assist you in sharing and implementing new learning and
practices within your unit and hospital. This Roadmap serves as guide to assessing your unit’s level of readiness for change and identifying
strategies for implementation. It is best used once you and your team have determined a specific practice or area to change.



                 Action Steps                               Supporting Resources                               Key Stakeholders

                                                       Unit and Staff Assessment

Assess your unit’s structure and readiness to         Change Readiness Assessment                    Unit leadership (may include managers,
support change                                                                                         charge nurses, council chairs, CNS,
    Schedule meeting of key stakeholders                                                              educator, etc.)
    Discuss reason for the assessment                                                                Staff nurses
    Distribute assessment tool – set                                                                 Multidisciplinary team members (as
      completion date for one week                                                                     determined by the change initiative)
    Schedule follow-up meeting to discuss
      results and determine level of
      engagement
                Action Steps                                Supporting Resources                             Key Stakeholders

Assess current knowledge of problem, practice         Complete Unit Gap Analysis                   Nursing staff
or procedure                                          Survey Monkey survey                         Nurse Manager
    Schedule a meeting of identified                 Informal discussion                          Clinical Nurse Specialist
       stakeholders (three or four)                   PI data                                      Nurse Practitioners
    Discuss reason for completing the gap            Discuss article at journal club – Balas      Quality improvement teams
       analysis (e.g., What is the problem we          M, Vasilevskis E et al. “Critical care       Physicians
       are trying to solve?)                           nurses’ role in implementing the             Other members of multidisciplinary team
    Distribute analysis tool – set completion         ‘ABCDE Bundle’ Into Practice.” Crit           (as determined by the change initiative)
       date for one week                               Care Nurse 2012;32:35-47
    Schedule follow-up meeting to discuss
       results, determine practice gaps, and
       identify the high priority needs
    Discuss Critical Care Nurse article on
       the ABCDE Bundle at the next journal
       club meeting


Evaluate results of assessments                       Discuss at unit council meeting              Nursing staff
   Formulate the team                                Discuss with unit leadership (manager,       Nurse Manager
   Gather all assessments and determine               CNS, physician director)                     Clinical Nurse Specialist
      change readiness and areas targeted for         Engage PI/Quality department                 Nurse Practitioners
      change                                                                                        Quality improvement teams
   Identify change strategies based on the                                                         Physicians
      assessments                                                                                   Other members of multidisciplinary team
                                                                                                     (as determined by the change initiative)




    AACN Roadmap for Implementing Change – ABCDE Bundle                                                                      2|Page
               Action Steps                                 Supporting Resources                                Key Stakeholders

                                                   Determine Change Strategies

Readiness Level: Low                                  Information sharing                             Unit staff nurses
    Raise awareness, advocacy                        Email blast (see sample)                        Clinical Nurse Specialist
          o Create tools                              Posting flyers (see sample)                     Nurse Educator
                                                      Materials to hospital or unit journal club      Physicians
                                                      Huddle (see sample)
                                                      Newsletter write- up (see sample)
                                                      Tell a peer

Readiness Level: Medium                               All “Low” level resources                       Nurse Educator
    Education                                        PowerPoint                                      Advanced Practice Nurses
                                                      Lunch & Learn                                   Nurse Manager
                                                      Staff meeting                                   Unit staff nurses
                                                      Poster presentation                             Physicians
                                                      Competency Day
                                                      Compliance audit

Readiness Level: High                                 All “Low” and “Medium” level resources          Nurse Educator
    Implement change initiative                      Form/participate on a committee                 Advanced Practice Nurses
                                                      Evidence-based project initiation               Nurse Manager
                                                      Identify a leadership champion                  Unit staff nurses
                                                      Inter-professional task force                   Physicians
                                                      Roll-out plan                                   Multidisciplinary team leaders




    AACN Roadmap for Implementing Change – ABCDE Bundle                                                                             3|Page
                Action Steps                                 Supporting Resources                               Key Stakeholders

                                                             Measure Success

Evaluate efforts: Awareness/advocacy level             Monitor dialogue                               Quality improvement team
                                                       Discuss at future staff meeting or huddle      Staff nurses

Evaluate efforts: Education level                      Knowledge checks                               Quality improvement team
                                                       Competency validation                          Nurse Manager
                                                       Assess use of audit tools                      Clinical Nurse Specialist
                                                                                                       Educator

Evaluate efforts: Implementing change level            Compliance audits                              Quality improvement team
                                                       Quality indicators (such as patient            Nurse Manager
                                                        outcomes)                                      CNS
                                                       Satisfaction: staff, patient, team             Educator
                                                       Length of stay                                 Unit quality team
                                                       Cost

Evaluate efforts: Sustained change over time           Monitor outcomes regularly                     Quality improvement team
                                                       Report outcomes to unit leadership             Nurse Manager
                                                       Continually audit for compliance               Clinical Nurse Specialist
                                                       Re-educate as needed                           Educator
                                                                                                       Unit quality team




     AACN Roadmap for Implementing Change – ABCDE Bundle                                                                       4|Page
                 Action Steps                               Supporting Resources                               Key Stakeholders

                                                          Disseminate Findings

Share learning                                        Discuss at organizational critical care        Quality improvement team
                                                       team meetings                                  Nurse Manager
                                                      Share with other units and/or                  Clinical Nurse Specialist
                                                       organizational practice councils               Educator
                                                      Hospital newsletter                            Unit quality team
                                                      Poster presentation or educational
                                                       session at local or national professional
                                                       meetings
                                                      Submit for publication

                                                           Celebrate Success

Determine meaningful recognition                      Scale the recognition for the level of         Quality improvement team
                                                       success                                        Nurse Manager
                                                      Evaluate recognition mechanisms                Clinical Nurse Specialist
                                                      Involve staff in selecting recognition         Educator
                                                       methods                                        Unit quality team

Tell AACN your story                                  Submit a poster or abstract for                Nursing staff
                                                       presentation at NTI                            Quality improvement team
                                                      Send an email to practice@aacn.org             Nurse Manager
                                                                                                      Clinical Nurse Specialist
                                                                                                      Educator
                                                                                                      Unit quality team



    AACN Roadmap for Implementing Change – ABCDE Bundle                                                                       5|Page

								
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