Safe handling: implementing hazardous drug precautions

Occupational exposure to chemotherapy is a significant and ubiquitous danger to oncology nurses. The Oncology Clinical Nurse III/IV leadership group at the University of North Carolina Hospitals embarked on the challenge of a comprehensive standards review regarding personal protective equipment necessary when handling waste after hazardous drug administration. This review led to practice improvements in education, the use of chemotherapy-rated gloves when handling hazardous waste, and changes in the disposal options available to staff. A discharge teaching pamphlet on safe handling for the caregivers of patients receiving hazardous drugs was created and piloted.

What do adult surgical patients really want to know about pain and pain management?

This study investigates the informational content about postoperative pain and pain management that patients identify as being most important. In a descriptive quantitative study design, a convenience sample of 150 general day surgery patients were surveyed by telephone within 72 h after discharge from a hospital day surgery unit. The survey consisted of 19 items rated on a 10-point Likert scale of importance. Composite mean scores were calculated for each item. Chi-squared analyses were used to probe for intergroup differences. Mean information item importance scores ranged from 5.9/10 to 8.7/10. The top three were discharge-related items. The majority of the lowest ratings were for general pain management information items. "If I can get addicted to drugs used to treat my pain" was rated the fourth lowest in importance. "I would have liked to have known other ways of dealing with my pain in addition to pain medicine" was significantly associated with duration of pain preoperatively (chi-squared = 0.010). None of the other information items were associated with preoperative pain duration. All of the pain and pain management survey information items were of moderate (5-6/10) to high (>7/10) importance to the general day surgery patient participants. Of prime importance was information related to what to do about pain and side effects after discharge. Because patients place high importance on information about the pain experience, the pain management plan after discharge, and side effect management, health care professionals need to focus their pain management counseling in these areas.

Developing an innovative care delivery model: interprofessional practice teams.

An interprofessional project team at the University Health Network (UHN) completed a project to develop an Interprofessional Patient-Centred Practice (IPCP) Framework, explore enablers and barriers to collaborative practice and recommend a model of care delivery and interprofessional practice. The following recommendations were made: adopt proposed IPCP Framework as the basis for developing interprofessional teams, implement an IPCP tool kit as a resource, develop evidence-based interventions across health care teams, and educate health professionals on IPCP.

Building leadership capacity through peer career coaching: a case study.

Today's demanding healthcare environment requires resiliency, creativity and innovation in delivery of patient care and service. Hospitals must create a workplace where staff are supported to develop professionally as knowledge workers. In 2003, University Health Network (UHN) partnered with donnerwheeler, career planning and development consultants, to provide a program for its 2,700 registered nurses. One component of this project, a peer coaching program called Coach Mastery, is profiled in this case study, which describes how it was implemented and the successes, challenges and outcomes in building internal leadership capacity and supporting staff development through career planning and development.