Implementing and integrating new technology into patient care can be difficult at times, but with the right strategy, success is possible! One level IV NICU team was recently successful in developing an all-encompassing strategy to drive consistent utilization of transcutaneous monitoring with the goal of improving patient care.
The team identified 5 key areas that made their implementation successful:
1: Make sure all your team members are informed and know their roles.
“Develop a training program that addresses all members of the neonatal team: nurses, respiratory therapists, neonatal nurse practitioners, and neonatologists.”
Why? Only training or informing a few staff members can cause problems with the technology and the team. Everyone has a role to play, and making sure everyone knows theirs and why it matters is key to successful implementation.
2: Educate on the factors that influence correlation of tcpCO2 to PaCO2.
“Drive a high level of competency about the relationship between perfusion, device calibration, site selection, and correlation.”
Why? If users don’t understand the factors that impact correlation (such as perfusion, site selection, and device maintenance), they don’t have the tools they need to get the best results from their transcutaneous system. Training your team well on correlation avoids challenges and arms your staff with competent problem-solvers who know how to use transcutaneous monitoring successfully with a variety of patients.
3: Develop trust in the technology.
“Build broad trust in the technology by generating quality correlation data at the bedside with a review of proper blood sampling technique, and attention to detail with logging tcpCO2 values at the moment the blood draw is performed.”
Why? Once you have trained your team on how to get the best results from the monitor, document it and talk about it – some teams even communicate the tcpCO2 readings and correlation to last blood gas at rounds. There’s nothing like seeing the results for yourself. And when your team learns to trust the readings? That is when true practice change can occur.
4: Organize a proactive device maintenance program.
“Establish “super users” and a proactive maintenance strategy to ensure monitors are always ready for use and to minimize time spent troubleshooting.”
Why? While transcutaneous monitors are easy to use, they do require regular maintenance, not unlike other technology in the NICU. Getting your team organized and identifying a few point people who own this responsibility ensures good performance from your devices and that they are always ready to use on patients when needed.
5: Don’t forget the “why” behind adopting transcutaneous technology.
“Educate the entire team regarding the potential impact of fewer blood draws in relation to blood loss, pain, and infection, as well as the lung-protective value of titrated ventilatory care.”
Why? It’s likely your team is adopting transcutaneous monitoring with the goal of reducing the frequency of blood draws in the NICU. This is a big goal that requires a team effort! Blood draws cause pain that can lead to developmental challenges for NICU babies later in life. They also cause blood loss that can lead to transfusion. Making sure your whole team knows the story and understands how transcutaneous monitoring aligns with your care goals in the NICU is likely the most important thing you can do for successful implementation of the technology for your staff and your patients.