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Technology improves safety rounding in behavioral health
On Friday, Oct. 13, at 12:30 p.m., Deborah C. Small, DNP, RN, NE-BC, and two other nurses from Cleveland Clinic Fairview Hospital will present a session entitled “Technology Improved Safety Rounding in Behavioral Health” at the ANCC Magnet Conference® in Houston. The session will explore the nurse-led development and implementation of an electronic solution to close gaps in safety rounds on behavioral health units. Covered in a June article on ConsultQD, the solution entails new functionality added to IRIS, Cleveland Clinic’s proprietary app that connects smartphones to the healthcare organization’s electronic medical record.
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Nurses on the Child & Adolescent Psychiatry Unit at Cleveland Clinic Fairview Hospital perform safety checks on patients every 15 minutes. However, paper documentation was laborious and time-consuming and not real-time sensitive. New mobile functionality now tracks safety checks, automatically updates the electronic medical record and prioritizes patients due for the next round using visual cueing.
“We have always completed safety checks, but the guess work of time and multiple paper charts were not always accurate,” says Dr. Small, Vice President of Patient Care Services and CNO of Fairview Hospital and Interim ACNO of Clinical Practice and Quality for the Cleveland Clinic health system. “Since implementation of IRIS, staff feels more comfortable with the rounding practices and can track more easily the next patient to round on. The process allows staff to provide a more methodical approach to direct observation.”
This is particularly important on behavioral units, where safety checks are designed to prevent patients from harmful behaviors ranging from throwing food or objects to cutting or attempting suicide. “The safety rounds allow the staff to monitor slight changes in behavior that might lead to volatility or acting out,” says Dr. Small. “These changes can be identified and managed before unsafe actions occur.” The Iris app streamlines the timing and provides the opportunity to round sequentially and non-sequentially, keeping the 15-minute time frame targets.
Dr. Small will share information on the development, implementation and outcomes of the new safety rounding process at the Magnet Conference along with her peers Janet Pier, MSN, RN, CPHQ, and Denise Ready, MBA, BSN, RN. More than a year after employing the smartphone rounding app, the electronic solution has proved successful. The addition of the app, education and awareness have improved rounding compliance on the Child & Adolescent Psychiatry Unit from 77 percent to 99 percent. In addition, timeliness and accuracy in documentation has been sustained at more than 99 percent.
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