Oral Presentation Palliative Care Nurses Australia Conference 2022

Improving eMR Documentation of Nursing Plan of Care to improve South Western Sydney Local Health District’s After-Hours Palliative Care Service (#47)

Misbah Faiz 1 2 , Sandra Sullivan 1 , Therese Smeal 1 , Liliana D'Agostino 1
  1. South Western Sydney Local Health District, Sydney, NSW, Australia
  2. The Sydney Partnership of Health, Education, Research and Enterprise, Sydney, NSW, Australia
  • Introduction/Background/Significance

Palliative Care Unit registered nurses (PCURN) answer After Hour’s (AH) phone calls from palliative care patients/carers at home. Community Nurses document in the South Western Sydney Local Health District’s Electronic Medical Record. (EMR)

The PCURN’s face challenges locating relevant nursing documentation in the SWSLHD EMR

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  • Aims/Objectives/Hypothesis/Goals or Problem

Community Nursing documentation can be located in multiple sub folders within the EMR. This was a barrier for the PCURNs to provide informed and safe advice in a timely manner when taking an AH call from a carer at home.

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  • Approach/Methods/Procedure

We utilised the Stanford Medicine’s quality improvement methodology which is adapted from the Realizing Improvement through Team Empowerment (RITE) and Clinical Excellence Leadership Training (CELT) to identify a clear SMART goal. 31

 

  • Results/Findings/Outcomes

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Figure 1. Run chart demonstrating impact of multiple interventions against quality improvement SMART goal

 

The original SMART goal identified a 40% target in compliance of documentation but by the project end achieved a 73% compliance with the identified SMART goal. 26

 

  • Discussion/Implications for practice

The project demonstrated the potential to instigate impactful change in a short period of time, with limited resources through simple and low cost interventions.

It highlighted the importance of having specific documentation locations and ongoing education about nursing documentation to key staff involved in the care of palliative care patients. 50

Anecdotally the PCURNs have reported that the improvement in documentation location and content supports their nursing interventions when providing AH phone support to carers of palliative care patients.28

 

  • Conclusion

This QI project is the first step in exploring the quality of information in palliative care nursing documentation and how this relates to improving overall care of palliative care patients.

This QI project has also initiated documentation projects for inpatient settings to assist with seamless communication, continuity and safe transition of care for palliative care patients 56

  • Conflict of interest (where applicable)

Nil

  • Funding acknowledgement (where applicable)

Nil