Challenging the process for changing a dressing

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By James Scarfone

The problems and challenges confronting us in healthcare today are too big and too complex for top-down solutions. We need the collective wisdom of our large workforce to find solutions.

At Hamilton Health Sciences (HHS), we’re empowering and equipping our frontline staff to make improvements to their work environment and to patient care on a daily basis. This is occurring with our Continuous Quality Improvement (CQI) model.

CQI has created a culture change within HHS that allows staff and physicians to see opportunities to improve the way a hospital unit works. People are more receptive to changes in process and embrace fixing even seemingly minor issues if it will make the job easier and more effective.

Staff in pediatric oncology unit at HHS’ McMaster Children’s Hospital identified that the adhesive remover they regularly used for IVs and dressing changes was not overly effective. It also was supposed to reduce pain for patients but that was not always the case due to it being ineffective. Nurses had to sometimes re-apply the remover or spend extra time cleaning the area multiple times in order for the next dressing to be applied properly.

The product also emitted a strong scent that bothered several members of the team and violated HHS’ fragrance-free policy.

The team also found there was a different process in practice on the inpatient and outpatient pediatric oncology units. Therefore, they identified it as a process improvement to go through CQI. A small group was formed to tackle finding a solution.

As part of the CQI process, the group met with several other units that were high users of this brand of adhesive remover. They created a list of pros and cons of continuing with the product.

Then the group met with other areas in the hospital, namely housekeeping staff. Here they discovered the use of a similar product, as part of the cleaning routine, which was more effective.

This other product was actually safer for patients, didn’t smell as much, and was already available within the hospital. Due to this, switching to the other adhesive remover turned out to be a relatively simple solution that could be implemented in a short period of time with few resources.

After implementing the solution, staff within the unit provided positive feedback on the new product. It’s now being used all throughout McMaster Children’s Hospital.

“We knew a better way existed, we just needed the tools to find it,” says Stephanie Furtado, a skin, wound and ostomy nurse clinician at HHS and the person who identified the problem and led finding the solution.

Switching products was not only safer for patients and easier for staff, but it also saved HHS money. Though a small amount, the savings add up quickly with a large workforce working together to create positive change.

“Even something trivial can have a big impact,” says Stephanie.

James Scarfone is a Public Relations Specialist at Hamilton Health Sciences.