Description: A clinical coordinator (dedicated charge nurse) of a medical-surgical unit beset with contracted staff and newly licensed registered nurses sought to integrate education into daily workflows. This unit leader witnessed significant knowledge gaps in day-to-day work. In December of 2021, collaboration between this medical-surgical leadership team and nursing education specialist (NES) led to the development of shift huddle education. Historically, daily huddles at 1100 and 2330 were approximately five minutes long and designed to discuss patients at risk for skin injury or falling. Staff quickly became disengaged and few prioritized joining their colleagues at the huddle. Common huddle feedback was that no new information was shared and there were few benefits to attending. Inserting 2-3 minutes of education into huddles was determined to be an efficient and cost-effective way to both close knowledge gaps and level-set expectations with core and contracted staff.
Methodology: The clinical coordinators and the NES identified education topics from analysis of quality metrics and environmental scanning. The NES designed monthly education topics with a weekly sub-category pertaining to the main topic. During shift huddle, staff gather in a known location and are provided a laminated handout. The clinical coordinator or relief charge nurse has a separate facilitator sheet to present the content, engage staff, ask questions, and lead the huddle. The standardized facilitator sheet ensures all staff receive the same message at each huddle. The last week of each month is reserved for reflection and teach-back regarding the content from the previous three weeks, giving staff an opportunity to share what they’ve learned and sparking discussion about evidence-based practice. In addition to information shared on the handout, other engagement methods have been utilized to share information, such as case studies, role playing and videos to engage learners with different learning styles.
Analysis: A level-one evaluation (di Leonardi & Perron, 2022) was provided to unit staff three months after implementation to assess the response to education provided in shift huddles. Six staff members responded (out of approximately 30 core staff), and 100% of respondents agreed or strongly agreed that the information was relevant to practice, was delivered effectively, and deepened their understanding of the topics. Daily huddle attendance increased significantly, allowing for the same message to be shared amongst all staff.
Results: Quality indicators continue to be tracked per hospital routine and are discussed in monthly unit practice council meetings. For example, in quarter 4 of 2021, this unit recorded a total of 14 hospital-acquired pressure injuries (HAPIs). HAPI prevention was the huddle topic for January, and in the first quarter of 2022, the unit recorded a total of three HAPIs. Implementing this process at daily shift huddle has allowed for consistent education and expectations to be shared among all staff members. Ongoing work includes continued evaluation of both staff response/knowledge and patient outcome quality metrics.
Evidence-based references 1. di Leonardi, B. C., & Perron, S. F. (2022). Getting Started in Nursing Professional Development: Focus on the Learning Facilitator Role. A N P D. 2. Lee, Y. M., Jahnke, I., & Austin, L. (2021). Mobile microlearning design and effects on learning efficacy and learner experience. Educational Technology Research and Development, 69(2), 885–915. https://doi.org/10.1007/s11423020-09931-w