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How should we educate charge nurses about policies and procedures?

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The nursing leadership team should meet to discuss which policies and procedures are appropriate to incoporate into the charge nurse orientation program. Think about all possible scenarios that you have encountered in your professional career as a nurse and try to list what administrative and clinical policies you needed to refer to in the past. It may be difficult to complete this exercise alone and be easier to do this in a group meeting with other nurse leaders. What you hope to gain from this brainstorming session is the ability to match a policy to an event that could occur when the charge nurse is on duty. You also need to consider emergency situations, infection control issues, and low-frequency, high-risk events that have occurred in the past. The ultimate goal is to educate charge nurses and provide the necessary resources in the charge nurse orientation manual.

Your facility can hardwire this even further into your charge nurse program by listing the policies by name on an attestation page and having charge nurses sign that they have reviewed the policies, which can then be placed in their employee files. Or you could just have employees sign the last page of each policy that is reviewed and place these copies in the employee file. Either way, as The Joint Commission has stated in its human resource chapter, staff must be oriented to their duties and reponsibilities, and this orientation must be documented.

The other consideration that you will want to review with your nursing leadership team is the opportunity to revisit certain policies annually. Often, we have not  done a specific skill set in a few years because it may be a low frequency skill that is rarely used on the unit.. If you have a low-frequency use of certain skill sets in your unit, then there may be an opportunity to review the skill sets annually.Wen you have these low-frequency events, then you can have a higher risk of making an error, simply because you are not actively practicing the skill on a regular basis. Consider revisiting this annually to assess whether there is a need for re-education on certain policies.

--Tammy L. Berbarie, BA, RN-BC

(July 2011)