Finally, I feel that I have finished this semester completely. I had my final physical assessment yesterday in my Advanced Assessment class and did great. Now I just have eto wait for a few grades to come through for this class and I can put my mind at complete ease. I picked up my cap and gown yesterday too. Finally I see progress towards my final goal of FNP. I can now say next year I will be done with my MSN. It feels great to meet goals and finishing my BSN was one of the biggest ones. Even though I will go to school this summer, I have a month off to rest and have my baby. So many great things to look forward too! This has been an educational semester and I feel that I accomplished so much, but I am glad it is over. I hope to never have to take 5 classes at once again, but it is doable!

I had a chance to speak with the DON today where my change project was implemented. She said that she had been receiving great feedback from nurses and lab personnel. Everyone is feeling comfortable using the new needles now, and some even say they are easier to use than the old ones. I will continue to talk to staff and the DON over the next few months to see how things are going. It will be interesting to see the needlestick log book after this has been in place for a while to see if there have been a reduction of needlesticks throughout the year. I have already received feedback that needlesticks have been prevented, so I think that when I go back to review the information after several months, I should see good results. I am especially glad that everyone is getting use to the new needles and feel that they have made a difference. This is a change that will need to be monitored over time though to see the real results, but so far so good!

Just wanted to give a quick update on my change project. I talked to one of the nurses at the hospital where the change from non-safety needles to safety needles was implemented and she had told me that she has already had several episodes where the new safety needles has potentially protected here from a needle stick. I think that it is great that this change was successful and there has already been good results from the change. The nurse also told me that everyone is really getting use to the needles and really like them, even some of the ones that at first did not like the idea. This change has only been implemented completely for several weeks now and already there have been potential preventions from needle sticks. I can't imagine how many needle sticks will be prevented through the years. Hopefully this will continue to be a success and everyone will continue to like and get use to the change.

Well, I can definitely say that this has been a very busy semester and I am so happy it is almost over. I will be finished with my BSN, but will continue on for my FNP. It feel great to be finishing up, but I still anticipate my summer classes, so it is a little hard to be completely relieved. I have learned a lot this semester, especially about being able to implement a change within the hospital. It does give me more confidence knowing that this is something that I can do. At the time it seems really overwhelming, but after you get started, everything just falls into place. The best thing for me is that I started the project last semester, so I did not have to start from scratch. Anyway, hope everyone has a great summer and does well in whatever educational goals they are pursuing.

Well, I am now finished with my change paper, but I still want to read over it a few more times before I submit it. I am very glad that we started this project last semester in Leadership. I feel that it helped me out so much by having already started this project and having an idea of what I was going to do. Now the only thing left for me to do is concentrate on studying for my final Physical Assesment in my Advanced Assessment class. I will feel much better once this is over. It seems strange to be graduating this May, but turn around and take classes this summer. But I am motivated to finish with my FNP by Dec 2011. It does feel wonderful though to finish the goal of getting my BSN. One step closer to my final goal of FNP!!!

Since this is towards the end of the semester, I have a lot going on with finishing up all my classes. I am now finished completely with 3 classes and still have a little to do in 2 (including this class). I am very ready to finish this semester and take a small break. I will graduate with my BSN May 15, but will then turn around and take 2 summer classes. I thought I would be off for the summer, but as it turns out I need to take a few classes. Only 18 more months to go and I will be completely finished with my FNP. I am fininishing up on writing my change paper for this class and hopefully will be done early next week. Then I will need to focus most attention to studying for my final physical assesment for Advanced Assessment class. I will be so glad to get that finished. I really need a break, even if it is only a couple of weeks!

As for the question Dr. Anderson asked about teaching VN students, I have thought about doing that before. Some programs allow you to teach LVN class with just your ADN. I was going to do that earlier this year but it was just not going to work with my schedule. It is a possiblilty that I would do this in the future while working on my FNP, but once I finish with my Masters, I have to work as a FNP. I have to admit it does have to do with the money aspect of things. I would rather teach if I had my ultimate choice, but the pay does make a difference in my choice. I wish money did not have to be an option, but unfortunately it does. I will enjoy being a FNP though, but in the future I hope to be able to just teach, whether it be LVN, ADN, BSN, or MSN. As for my week, I am going to start putting all my information about my change project into a paper. I am finished with everything and the project is in motion. Once all the new supplies are in, the hospital will no longer use the older style needles without a safety feature in place. Everyone is on board and the project I feel will be a success.

Mid-Semester Evaluation

Course Objectives:
1. Communicate effectively, both verbally and in writing, with individuals, groups, and health care providers. I feel that I have had the chance to effectively communicate both verbally and in writing with the above during the process of implementing my change project. I have had to discuss this change project at length with the CEO and DON of the hospital as well as the nursing and lab staff. I have had the chance to give out written material as well that shows in great detail the reasons behind this project in order to have everyone understand the importance why I am implementing this project. I feel that being able to effectively communicate has been the key that has allowed me to continue on with this and the key to making the project successful.

2. Discuss current trends and issues in the nursing profession. We have had the opportunity to discuss some of these via DB. I feel that more and more nurses have decided to become politically active in order to make better working conditions for themselves and safer and better care for their patients. I also feel that the current trends of medical technology have been discussed via DB. We have had the opportunity to discuss how the change in technology has helped nursing as a profession. Being able to discuss this through DB has allowed me to really think about these changes and trends in nursing, especially the question that we had to discuss over EBP. This is definitely a trend in the medical profession that is being used to provide for better and safer care for our patients.

Personal Objectives:
1. Feel more confident in my abilities to implement my change project. I definitely feel more confident at this point after discussing this change project with the key personnel that will either make or break the project. The CEO and DON are very supportive of this change and have given great feedback on the information that I have presented. With the positive feedback, I have began to have a lot more confidence in myself and do not feel intimidated to keep pursuing this change.

2. Have a successful in-service to help nursing and lab staff understand the importance of the change project. I have had the opportunity to have an in-service with the nursing and lab personnel that went very well. For the most part, everyone feels comfortable with the newer style needles and are on board with the change. I have had very good feedback from the staff regarding this change.

Overall review of Personal Objectives: I feel that I have had the chance to meet my objectives so far. I have gained much more confidence in my abilities in making change within a facility. I also feel that I have brought very important information to the staff that has made them feel better about the use of the new safety system. I have received great feedback from all staff involved, from the nursing and lab staff to the CEO and DON.

One way these behaviors have fostered your growth as a professional nurse. I feel that I have better communication skills and have much more confidence in myself. Before I began this project, I felt that I may not have the ability to make such a change within a hospital. Now, I know it is possible with the increased confidence in myself and the positive feedback that I have received from others.

I have recently been working on getting information together on what it would cost switching from the original needles to the new safety needles. I talked to our DON to get a round about cost on what they spent monthly on the current needles they use. This is a small hospital, so the cost for this hospital is very small compared to a large hospital. Monthly, between blood collection needles, IV catheters, and injection needles, it cost the hospital approximately $658.00, or approximately $ 7,900.00 per year. After checking the cost of the more advanced safety needles, I found that it would cost the hospital approximately 1,200.00 per month, or 14,400.00 per year. It would cost the hospital about $6,500 more a year to switch to the newer style needles. From my research on needlesticks, one needlestick that does not result in transmission of blood borne illness can cost up to $3,000, and if someone is infected by a needlestick, it can cost 1 million or more with all the medical treatment, medications, and lawsuits. So I think that it is worth the extra money to help reduce the chance of needlesticks in order to protect the hosptial from possibly being out a million dollars or more if there were an employee that contacted an illness from a needlestick. I checked to see how many needlesticks the hosptial has had over the past 5 years, and it ranges from none to as many as 4 in one year. The total over the past 5 years has been 8 needlesticks between nursing and lab staff. Thankfully no sticks have resulted in transmission of disease, but if you think about the money spent by the hospital over the past 5 years, approximately $24,000, it could have been possible to reduce that amount by having the safety needles. I know that needlesticks can happen with the safety needles as well, but the chances are much less. Even a reduction of 3 sticks could have saved $9,000. I will take this information to the CEO and DON and continue to discuss the positive results that can occur by switching to the safety needles.

Well, this week we had an in-service which let the nurses see some of the new needles and work with them. They were able to practice with them on fake arms to try and get the feeling of how they work. I know a fake arm really is not the perfect way to get the true feeling of using these new needles, but it allowed the nurses to be able to learn how to use the safety feature on them. At first, the older nurses were hesitant and not very happy about the whole issue, but after a while they seemed to calm down and were willing to practice. I spent some time explaining why I was doing this project and how important it was to take every precaution available to us as nurses to protect ourselves from blood borne diseases. I also discussed how how important it is to ALWAYS wear gloves, since a big majority of the older nurses do not. I had no problems with any of the younger nurses because these are the types of needles we learned on, and therefore have no problem using them. After the in-service, everyone was feeling better about using the new needles and most of the nurses said that they think that they can change with no problems. One nurse still has issues, she is the same one who is completely against going to computer charting as well and plans on quiting as soon as computer charting is implemented in the hospital. She is just stuck in her old ways and refuses to budge. I think she will retire soon now that newer changes are coming to this very out of date hospital. I think that it is probably time if she is not willing to change with the times. This hospital cannot stay in the dark ages forever and has to update it's technology if it wants to keep up with today's changes in health care. I think that this change project will go over well and feel that it will be successful.

Because I started my change project last semester in Leadership as a proposed project, this semester I will work on implementing the change in the hospital where I do some prn work. As I discussed in an earlier post, I will work on implementing the use of only needles with safety devices in place for IV sticks and blood draws and needleless systems by using only blunt tips with IV pushes, etc to help prevent possible needle sticks. The director of nursing thinks it is a great idea, as does a majority of the staff. But the biggest barrier so far is some of the nurses who have been nurses for a very long time and feel that they will not be able to comfortably use the new needles. They feel as if they cannot use them as well as the older needles they have used "forever". Currently, the hospital has some newer styles, but the majority of the needles are the older style without a safety feature in place. Because I feel that it is very important to take every precaution possible to reduce the chance for a needle stick, I need to keep working on helping the staff understand the importance of the safety features now available. Many of the staff members who are uncomfortable with the new style are the same ones who half the time will not wear gloves. I think that they feel that it will not happen to them, especially in a small, hometown hospital. But just the other night we had a patient come through who was HIV positive, and only then did one of the usually hesitant nurses decide to wear gloves and use a IV needle with a safety feature in place. What about universal precautions? She should treat everyone the same, because there may be a time when the HIV status is not known. So, I will have an in-service that will discuss the importance of these newer style needles and will give the nurses an opportunity to look at and use different brands of needles, as there opinion will come in to play when the final product is chosen. I feel that if they have the chance to look at different brands and have their opinions listened to, they will be more likely to except the change.

Do I feel that having my BSN is more than just a piece of paper? Yes, definitely! Not that you make more money having your BSN over your ADN, but the opportunities for growth in your career are tremendous. With your BSN, you do have the opportunity to apply for jobs that you would not be able to otherwise. You may or may not make more money with this position, but I feel that there will be more room for growth and excepting even bigger positions in the future. I am in the ADN-MSN program, so without receiving my BSN, I would not be able to move on with my education. Whether you plan to move on with education immediately or later in life, or maybe not at all, at least you have your degree when and if you are ever ready to get your MSN, or maybe even more. Having my BSN is not only a pathway for receiving my MSN, it is an educational goal that I have had, and I feel that it is necessary to fulfill your educational goals in life.

This week I will start planning on implementing my change project that was started last semester in Leadership. My plan is to implement the use of safety needles and a needleless system at the hospital in which I do some prn work for. Currently this hospital still uses older style needles and does not use a needleless system more than half the time. There are some nurses that use the new safety systems, but the majority of nurses at this hospital have been there for 20 plus years and hates the newer system. They just do not feel comfortable with it because they are use to using the older style. Many times I cannot even find a safety needle available and am forced to use a needle without a safety feature in place. So, my main goal is to try and get the newer safety system implemented and have the hospital do away with any needle that does not have a safety feature. I think my biggest barrier will be the older nurses who do not like change. This is a very small hometown hosptial and most of the nurses are set in their ways. Hopefully this project will be a succuess!

NURS4823 Test blog

Just seeing if I know how to do this before I have to for a grade!