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Leadership Project Paper 1

Kimberli I Johnson
Leadership Project Paper
NUR 4144
October 22, 2017
I pledgeKIJ
Leadership Project Paper 2

QI Project

This past summer, I had the opportunity to work on Intensive Care Unit at St. Marys

Hospital. During that time and my current immersion on the unit, hand hygiene and infection

control has been the number one priority for patients. Overall, Bon Secours Health System has

implemented several infection control methods, and one that the educator on this specific unit

has started educating other nurses on are the use of Curos, which are alcohol-containing caps

that twist onto intravenous access points for disinfection and protection (3M, 2017). Although,

this product is available around the hospital, they arent utilized as much as they should be. So,

as a nurse manager, my plan is to implement the use of Curos caps to decrease the number of

infections via IV ports.

Model the Way

On my unit, we have several patients that need IVs for some type of bolus or medication

due to their critical state. When my nurses begin to administer medications, the only thing they

do is clean the IV port off with an alcohol wipe, which is a very good measure, but when the port

is not in use, this allows all sorts of bacteria and foreign matter to live on it. Our patients are

already critical, so we dont want their health to deteriorate due to a simple act. As their

manager, I find that it is important to implement this process. Whenever I am in the room,

assisting with patients, my plan is to first make sure there are Curos available. If not, I will get

some that will strictly be for that patient. While I initiate capping the IV ports, I will make sure

that my nurses are watching me at the same time, and ask them if they are using it. Being the

nurse manager, you must model the way for your employees. People do what they see. So, if

they see you doing it, they are more likely to do it as well.
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Inspire a Shared Vision

I believe the use of Curos must be implemented. It is all about the safety of the patients

that we care for. I think as nurse manager it is important for us to care for our patients with the

highest standards. I know attempting to get everyone to join in on this will not be an easy task.

So many nurses are constantly rushing to complete a task, so I know an extra step as little as

putting a cap on the IV tubing, will put more stress on them. I think the important thing here is

that I explain why this implementation is so important to me. If the staff understands the

significance of doing this then they will more than likely be involved in the movement. My plan

isnt to push the importance on them one day, instead, take it a day a time because change

doesnt happen overnight.

Challenge the Process

I am always looking for new ideas to implement this process with different ways to

remind staff to use it. Again, the nonexistent use of Curos is not a careless thing, it is due to no

one has made it a necessary thing. Everyone on the unit has the mindset that if its used its used.

If not, no big deal, but it is important. As the leader, my job is to make the transition easier for

my staff. If I must stock each room before my shift starts, that is what I will have to do. At least I

know that the caps are in the rooms and available to the nurses. There will not be an excuse that

they didnt have it available to them in the room. Im here to serve my patients. They are here to

get to a better state of health. I dont want them to suffer from any other ailments, that couldve

been prevented.

Enable Others to Act


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I know as a leader, I wont be able to do this alone. I understand the importance of having

my staff assist me with this process because its for the protection of our patients that we care

for. I have to make sure I get opinion of those around me because trusting leaders give people

the freedom to innovate and take risks. They nurture openness, involvement, personal

satisfaction, and high levels of commitment to excellence. (pg. 28) I want feedback on how we

can make this process better, if they noticed the importance of doing it, and if they see a decrease

in hospital acquired infections. I must remember that I am the nursing manager, I have developed

this trust with my staff and they should develop trust with me, this creates an environment for

growth.

Encourage the Heart

Although, it will be hard for everyone to remember to cap the IV ports each time, I find

rewarding them when they do is important. Whether it is a simple thank you or a kudos, I will

recognize the contribution of others and celebrating victories lets everyone in the organization

know that were all in this together. (pg. 36) I dont want my staff to lose motivation or forget

the vision because it can happen. So, the importance of acknowledgement is very important. As

Blanchard stated, if we encourage the heart like Jesus did, we have to examine two internal

domains and two external domains.

The Heart

As the nurse manager on my unit, I need to personally seek my motivation or intent for

this change or implementation. Why do I want to implement it? Who do I want to serve or help?

To answer these questions, the patients are the ones I want to see get better. Patients arent here

so their health deteriorates; they are here to get better. If we can change one simple task to avoid
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them from staying here long term then that is what we should do as nurses. I am here to serve our

patients. It is not about what I want to implement, its about why. I want to better their

circumstances. I think having this idea will better not only the patients, but the nurses who are

caring for them.

The Head

Since becoming a nurse, the learning has not stopped. Studies have shown that

significant results in reduction when passive alcohol disinfection caps are used (48-86%

reduction). (Moureau, N. & Flynn, J. 2015). It is important as a nurse manager of a unit for me

to continue to do my research on processes or items we use daily. This allows for better patient

outcome and decreases the risks of possible infections. When I receive more education or

information on things, it is my job to pass that on to my staff. I am not the only one who needs to

continue to learn. I would make sure we include all education in staff meetings. Continually

providing updates on new practices that we should implement. I believe that if my staff knows

that this process has worked then they are more likely to get motivated to use it.

The Hands

My plan is to continue to assist my staff in understanding the importance of using Curos.

How effective it is to preventing infections. If I see that a patients line doesnt have any ports

then I will go into the room and apply them and let them know I have done it. I think I want to

implement a goal for us to reach to make sure every patient gets Curos caps while on the unit.

Also, making sure that the staff isnt just documenting the application of the caps, but confirming

it. The hands represent the behavior. If my staff sees what I am doing and how I am doing, again,

they are more than likely to do the same.


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The Habits

I know it will not be easy for me, as a leader, to make sure that everyone is doing and I

must accept. All I can do is trust that my staff cares about the patients equally as much as I do. I

want the staff to offer feedback, and be open to it as well. As a leader, it is important for me to

stay consistent with the staff members and make sure that I am using the product as a should

with every patient. I must be committed to this change. It all about the patients that we serve, and

to get them back to state of well-being.

Professional Practice Implications

The use of Curos caps does no one any harm. Using the caps will decrease the amount of

infections that may escalate an issue a patient already has. In a critical care setting, the nurse is

making sure that the patient stabilizes while they are there. Any interruption in any body system

could cause the patients health to decline. Using Curos caps will decrease the amount of

infections the patient is exposed to. It is easy for a nurse to come in the room, push medication

through a line that wasnt clean off prior to administration, and whatever foreign material is on

that port is now in the patients blood. As a critical care nurse, you do not want to deal with any

other complications besides the one(s) the patient was admitted for. So, it helps with the

stabilization of the patient.

Using Curos not only helps the nursing practice, but helps the health system in general.

When patients come to the hospital they dont want to leave with more issues. Some patients are

discharged, but they may return because of an infection that obtained while being treated. In the

emergency room, nurses are moving constantly. They are always on the go. Its not always easy

for them to remember to clean off the IV ports. Along with that, they may forget hand hygiene or
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forget to glove. It happens. It could be that one patient that meds or anything is entered and the

port isnt cleaned off. That patient could get treatment to feel better and come back later in a

week for an infection they acquired because that nurse didnt use a Curos cap when the IV

wasnt in use, they didnt use hand hygiene, or they didnt glove. It is little things that can cause

a big issue. Once again, you have the same patient coming back which is causing us to use

additional resources for something that couldve been avoided.

Outcome Evaluation

The use of Curos caps is a simple task. It should be engrained everything time an IV is

used, a cap should be applied. If we did this, we can guarantee that if a patient is in a critical care

setting and his/her conditions worsens, it is not due to our carelessness of not applying a cap to

the IV ports. It will be much easier for us to narrow the source of infection if any issues arise. I

personally, have seen many nurses using the caps on every patient, but there are some that dont.

It is important for the ones who dont use them to understand the importance of the caps, and

how much they help in decreasing the amount of infection. Patients will get back to a state of

well-being faster, and it will decrease the number of readmissions we get. It really is simple to

use the small green caps, that twist on the ports of IVs.
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References

3M. (2017). Curos Needless Connectors for Medical. Retrieved October 22, 2017, from

https://www.3m.com/3M/en_US/company-us/all-3m-products/~/All-3M-

Products/Health-Care/Medical/Curos/Needleless-Connectors/

Blanchard, K. H., Hodges, P., & Goyer, T. (2013). Lead your family like Jesus: Powerful

parenting principles from the creator of families.

Ellcessor, B. (2017). Module II Practices of Exemplary.

Moureau, N. L., & Flynn, J. (2015). Disinfection of Needleless Connector Hubs: Clinical

Evidence Systematic Review. Nursing Research and Practice, 2015, 1-20.

doi:10.1155/2015/796762