Post by Lavinia on Feb 16, 2009 12:08:32 GMT -5
In December 2008, the Institute of Medicine released recommendations on resident duty hours and GME (graduate medical education) supervision and safety. The report called for some immediate changes to ensure the appropriate education as well as safety of residents and the patients in their care.
See a summary here: www.iom.edu/Object.File/Master/61/038/ResHrsRecommendations.pdf
The ACGME (Accreditation Council for Graduate Medical Education) is responding to these issues by calling for stricter enforcement of requirements which are currently in place and will convene a world-wide conference on resident duty hours this March.
The report has several implications to nursing practice, I believe.
The first thing that struck me might more appropriately belong on the nursing education board- namely, that nursing education needs something like this. Maybe we can start a thread about this issue on the education board.
Another concern, is how these changes may affect the workload of nurses in institutions that have GME programs. Several nurses have already contacted some of us saying that there have been changes in their hospitals which are increasing their workload but no commensurate increase in nurse staffing.
You can read about institutional requirements for GME programs here: www.acgme.org/acWebsite/navPages/nav_IRC.asp
The IOM recommendations for GME that may result in an increase in the nurses' workload appear in the report:
"Recommendation: To ensure that residency programs fulfill their core educational mission, ACGME should require that institutions sponsoring residency programs appropriately adjust resident workload by providing support services and redesigning health care delivery systems to minimize the current level of residents’ work that is of limited or no educational value, is extraneous to their graduate medical education program’s educational goals and objectives, and can be done well by others; and
providing residents with adequate time to conduct thorough evaluations of patients and for reflective learning based on their clinical experiences."
For example, nurses are reporting that they have been directed not to call residents for stat bloods, to have at least five people try before calling a resident for a difficult IV and that residents should no longer be called to transfer a patient that needs monitoring to radiology, etc.
Although both the IOM and ACGME advise that institutions increase will need to allocate additional resources- both financial and human- to meet the recommendations, nurses are reporting that staffing has not been increased to allow for additional responsibilities which have been placed on them.
Nurses are reaching out to leaders that they know for help- any ideas or similar experiences to report appreciated.
See a summary here: www.iom.edu/Object.File/Master/61/038/ResHrsRecommendations.pdf
The ACGME (Accreditation Council for Graduate Medical Education) is responding to these issues by calling for stricter enforcement of requirements which are currently in place and will convene a world-wide conference on resident duty hours this March.
The report has several implications to nursing practice, I believe.
The first thing that struck me might more appropriately belong on the nursing education board- namely, that nursing education needs something like this. Maybe we can start a thread about this issue on the education board.
Another concern, is how these changes may affect the workload of nurses in institutions that have GME programs. Several nurses have already contacted some of us saying that there have been changes in their hospitals which are increasing their workload but no commensurate increase in nurse staffing.
You can read about institutional requirements for GME programs here: www.acgme.org/acWebsite/navPages/nav_IRC.asp
The IOM recommendations for GME that may result in an increase in the nurses' workload appear in the report:
"Recommendation: To ensure that residency programs fulfill their core educational mission, ACGME should require that institutions sponsoring residency programs appropriately adjust resident workload by providing support services and redesigning health care delivery systems to minimize the current level of residents’ work that is of limited or no educational value, is extraneous to their graduate medical education program’s educational goals and objectives, and can be done well by others; and
providing residents with adequate time to conduct thorough evaluations of patients and for reflective learning based on their clinical experiences."
For example, nurses are reporting that they have been directed not to call residents for stat bloods, to have at least five people try before calling a resident for a difficult IV and that residents should no longer be called to transfer a patient that needs monitoring to radiology, etc.
Although both the IOM and ACGME advise that institutions increase will need to allocate additional resources- both financial and human- to meet the recommendations, nurses are reporting that staffing has not been increased to allow for additional responsibilities which have been placed on them.
Nurses are reaching out to leaders that they know for help- any ideas or similar experiences to report appreciated.
