Congress Abstracts 2006

97

IMPLEMENTING TRIAGE AND RESOURCE NURSING ROLES IN AN AMBULATORY INFUSION UNIT. Stefanie Walsh, RN, BSN, OCN^®, Ieva Broks, BSN, RN, OCN^®, and Nicola Gribbin, BSN, RN, Massachusetts General Hospital, Boston, MA.

Nurses at Massachusetts General Hospital practice a Collaborative Governance Model. In January 2005 two Oncology Ambulatory Infusion Units combined into one. The implications of this move included changes such as, staffing levels and differing experience levels, nursing resources, patient volume/acuity, medical equipment, and electronic information systems.

To undergo a smooth integration, a Transition Team was formed nine months prior to the scheduled move, consisting of clinical, pharmacy, and support staff from each unit. A subgroup of unit nurses then formed to further define and formalize potential needs.

This subgroup was responsible for identifying barriers to the transition and strategizing ways to manage these barriers. After several meetings it became evident that the roles of Triage nurse and Resource nurse would need to be clearly defined.

Nurses from both units met regularly to identify the clinical skills, character traits, and experience required of the triage and resource nurses. The staff nurses were queried through writing, staff meetings, and individual conversations with members of the subgroup for their thoughts about each of the roles. This feedback was incorporated into a role description that was distributed to and agreed upon by all staff.

It was decided that the new unit would require two triage nurses and two resource nurses daily. The Triage nurse would manage patient volume, nursing assignments, coordinate admissions to the hospital, triage MD practice calls, and assess patients requiring urgent care. The Resource nurse would manage clinical issues, assist staff in the care of acutely ill and/or complicated patients, and have an overview of the unit acuity. Nurses in these roles would become the "point persons" in the unit to coordinate the smooth running of daily activity.

Four months after implementation, a questionnaire was distributed to staff exploring their understanding and the effectiveness of the roles to their daily practice. It was found that these roles needed further clarification, but were necessary for smooth unit operation.

The triage and resource nurses meet bimonthly with unit management for the ongoing evaluation of the roles and unit operations. This model appears to be successful in the new Infusion Unit.