The UVAHS Professional Nursing Staff Organization

Ensuring A Safe Environment for Patients and Caregivers

UVAHS structures ensure that nurses are working and caring for patients in a safe practice environment. Many of the activities to assure a safe and secure environment of care for patients also support a safe environment for our staff. The link between safe, competent practice, high-quality patient outcomes and a healthy productive work environment is well-established in the healthcare and business literature. 

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Promoting Patient Safety

Education is critical to creating a culture of safety in health care organizations. Multiple strategies are utilized at UVAHS to weave safety education and outcomes into the life of the organization. Visit UVAHS's patient-oriented safety promotion site.

The New Employee Orientation program emphasizes specific job-related aspects of patient and employee safety. All employees complete mandatory annual training to demonstrate competency with maintaining a safe and healthy environment. Ongoing continuing education programs also reinforce these specific job-related skills.

The Environment of Care Safety Plan provides guidelines and procedures to promote a safe environment of care for our patients and a safe work environment for our staff. In addition, the plan delineates institutional safety programs that meet regulatory requirements of federal, state and local government agencies. The Patient Safety Subcommittee drives activities designed to meet National Patient Safety Goals through initiatives focused on issues such as medication safety, infection control, equipment safety, and bed safety.

A multi-dimensional Safety & Security Program in conjunction with our Quality & Performance Improvement Program promotes a culture of patient safety enhancement at UVAHS. The approach is systematic and based upon data and staff inputs. The Health System has a no-fault quality reporting system, and staff are encouraged to document events that fall outside the expected outcomes of operations and/or clinical activities. Reports are analyzed and trended, with safety enhancement outcomes resulting from the process.

The PNSO sponsors committees to pursue areas of focus identified through the Nursing Quality Plan and other nurse-sensitive quality indicators. Nurse-driven improvements to patient care are numerous, and include adoption of the Braden Scale and other wound-care and skin-care algorithms, strengthening of fall-prevention strategies, attention to best practices in pain management and medication safety, development of a pre-procedure checklist, improvement of clinical alarm audibility, and adoption of Diligent™ Minimal Lift devices to facilitate patient mobility in a manner promoting the safety of both the patient and the health care provider. Many of the associated reference materials supporting these changes are available on the PNSO's Clinical Resource Portal.

The PNSO also promotes patient safety through the evidence-based standardization and improvement of nursing practice through the adoption of procedure manuals, clinical pathways and guidelines, and other core references. The PNSO Clinical Practice Committee holds monthly meetings and an annual Evidence-Based Practice Day conference to address practice questions and improvement opportunities, issuing updates to nursing staff in their monthly newsletter, the Practice News.

All RN staff wear with their nametag a bright-colored hang tag bearing the symbol ‘RN' visible below the main identification badge.  Supported by Nursing Cabinet and UVAHS Administration, this initiative both promotes patient safety and satisfaction, and provides visible recognition for each UVA RN's important role as caregivers. 

Community outreach is another way in which UVA nurses promote patient safety. One example is Safe Kids, established in 2003 by UVAHS's Children's Hospital with the Thomas Jefferson Planning District as a chapter of the "Safe Kids Worldwide" Campaign, the first and only national non-profit organization dedicated solely to the prevention of accidental childhood injury - the number one killer of children ages 14 and under. The goal of this free, multi-faceted program is to provide leadership in childhood injury prevention in our community. Since its inception, Safe Kids has reached more than 6,200 families through its community outreach programs on sports safety, heat-related illness, and pedestrian, bicycle, gun, transportation and water safety. Nurses play a vital role in Safe Kids, distributing safety information and bike helments in our pediatric clinics, volunteering for Safe Kids Week, serving as speakers on safe grandparenting on Seniors Day, and serving in various capacities on committees and other projects.

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Promoting Workforce Safety

Continuing Development: A healthy work environment supports nurses in building skills, growing competence and fostering collaboration. There are extensive resources to help clinicians maintain and build competence and develop professionally, sponsored by the HR Center for Organizational Development and PNSO groups such as the Professional Development Committee and Nursing Educational Coordinators. 

Healthy Work Environment Standards: UVAHS nurses are actualizing the standards of the American Association of Critical Care Nurses 2005 Healthy Work Environment (HWE) project. The HWE project was introduced to staff in a 2005 PNSO Leadership Forum, and practice areas are actively engaged in bringing these principles to life in their units. Our organization is fortunate to have on staff Suzanne Burns, MSN, RN, RRT, ACNP, CCRN, FAAN, FCCM, FAANP, APN II, one of the HWE authors. Ms Burns has partnered with PNSO leaders to move this initiative forward. Nurses in our Critical Care region have been early adopters of the AACN HWE standards. Three Critical Care units are on the path to attain the AACN's Beacon Award with applications planned for submission beginning in March 2006.

Minimal Lift Environment: UVAHS was among a handful of academic medical centers nationwide to comprehensively embrace a "minimal lift" environment more than four years ago. The Medical Center entered into an agreement with Diligent™ Company in 2003 to provide a program of equipment, training and operational support to organize and promote a minimal lift patient handling environment centered on the use of assistive equipment.

Exposure Control and Sharps Injury Prevention Program: Nurses are provided with state-of-the-art technology for the provision of their patient care. UVAHS was an industry leader in the adoption of a needleless system. In 2001, the organization made a philosophical and financial commitment to provide nurses with the safest products available on the market. In all cases of sharps safety device introduction, direct care nurse feedback is sought and used to make final product selection decisions. Exposure control plans to assure safety systems to minimize staff risk for exposure to blood and body fluids are in place in all patient care areas. Whenever staff experience an exposure, expedited care is delivered within the Emergency Department to support rapid treatment and peace of mind for our staff. Blood exposures and sharps injury events are closely studied to determine whether processes or products can be changed to enhance safety. PNSO Clinical Practice Committee members hear monthly updates from nursing liaisons on interdisciplinary safety committees such as the Sharps Injury Prevention Task Force.  

Security: Security services are available 24/7 both to support special needs as well as to intervene in emergencies identified by staff. Nurses can request a security escort to outlying parking lots for added safety during off-shift timeframes in the event that the shuttle service does not meet their needs. Routine training opportunities are available in Crisis Prevention Institute (CPI) techniques to aid in de-escalating potentially violent situations; in certain practice areas, such as the Emergency Department and inpatient Psychiatry, all staff undergo this training.

Parking and Transportation: As the largest component of the workforce, Nursing has more representatives on the Parking and Transportation Committee than any other discipline. Nurse representatives on this committee keep nursing concerns at the forefront to assure that all factors affecting safety and convenience for staff are prioritized. Nursing feedback on this issue regularly flows through Nursing Cabinet, which also publicizes outcomes achieved through its actions. For instance, off-shift shuttle timeliness and availability was examined and improved last year due to direct-care nursing feedback raised through Cabinet to the Parking and Transportation Committee.

Influencing the Physical Environment: Environmental Services' work to maintain cleanliness of the patient care and work environments is key to both infection control and safety as well as the pleasant atmosphere of the patient care areas. Significant feedback on the part of nursing staff and management was instrumental in the institution deciding to change its contract to another vendor. Also, with a main hospital building constructed in 1989, remodeling, renovation and expansion are constantly underway to improve space and services. Nursing staff and managers have major input into the renovation designs, to help identify the best pattern of patient flow, ensure space for both patient care and staff/administrative functions, and promote the convenient placement of fixtures and resources - even improving lighting levels.