Making Your PRN Program Rock

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Making Your PRN Program Rock Barbara Borbeck, MS RN BC Claudia Campbell, BSN RN Criteria for Pain Resource Interest in sharing knowledge Role modeling and teaching evidenced based practices Collaboration Commitment to professional development 1

Criteria for Pain Resource Interest in Pain Management Problem Solving Effective verbal and written communication skills Responsibilities of PRN Pain education for staff Role model: Pain assessments Interventions & outcomes Communicating pain issues in report or rounds Pain education for patient and families Responsibilities of PRN Perform needs assessment of clinical unit Oversee pain management practices of clinical area Identify areas of improvement 2

Responsibilities of PRN Disseminate pain information Unit In-services Annual Competencies Journal article reviews Clinical guidelines & unit standards Responsibilities of PRN Pain Assurance studies Medication management Opioid dose calculations Equinalgesic calculations Responsibilities of PRN Develop patient education materials Update policies & procedures 3

Requirements Pain Resource Nurse course Annual pain management education National Pain Certification Participation in professional associations PRN Immersion Education Patient Care Council Pharmacy Therapeutics PRN Palliative Care Research Hospitalist Anesthesia Pain Management Needs Assessment Identify 3 most important areas Pain assessment Pharmacologic management Technical skills (PCAs) Psychosocial issues in pain Pain in speciality populations Non-pharmacologic interventions 4

How to make it work Communication Internal list serv Newsletter Unit meetings Accepting and Embracing the Challenges Making your Pain Resource Nurse Program rock takes commitment and planning. Guide your program through the stages of growth and plan activities to support and sustain it through all those stages. Creating a Program That Will Last Begin with an understanding of the stages of team growth Forming Storming Norming Performing 5

The Forming Stage: Creating the Program Energy Excitement Nervousness Testing the boundaries and leadership s commitment Strategies for Success Begin with the basic activities & plan to implement additional activities as your program gains strength Basic patient consultations Supervise competency documentation (Infusion pumps, etc.) Basic unit education (1-3 inservices/yr) If you want someone to do a good job, give them a good job to do. 6

Strategies for Success Provide positive feedback Personal (oral) thanks Written thanks Public praise Morale-building meetings CEUs for training and continuing education Gifts / Door prizes / Certification Review Course / Scholarship to ASPMN / etc. Strategies for Success Report success stories Institutional newsletters Reports to administration / management Present during Medical Staff Meetings Presentation in PRN meetings / training Provide a way for patients to give feedback Surviving the Storming Stage Panic Realize the difficulties Impatient about the lack of progress Question leadership Progress is minimal 7

Strategies for Success Reinforce training and provide support as skills are developed Clearly define responsibilities and be sure they understand them Be sure they have the training necessary to be successful Give too much information rather than not enough 8

Strategies for Success Avoid adding responsibilities Allow success with what is already required Provide special projects for those who are ready Be ready to support one-on-one those not succeeding with some responsibilities Creating the Norm Accept responsibilities Follow ground rules Roles are established Support grows Fear disappears Belief that goals can be accomplished 9

Strategies for Success Begin to build on responsibilities Journal articles / Journal club Quality assurance activities Determine clinical guidelines and policy Patient education materials Assist with roll-out of change Performance Changes Practice Growth in relationships Insights into behavior Substantial progress towards goals Working at peak efficiency Working together to achieve 10

Strategies for Success Begin to look at outcomes Case studies Clinical research Quality improvement projects Standards of care Questions? 11