NURS 8730 Week 9 Staff Training Plan Example

Eight Minutes at a Time: A Training Plan That Prepares Twenty-Eight ICU Nurses and Nine Respiratory Therapists for Nurse-Led Mobilization Inside Huddles That Already Happen

Student Name

College of Nursing, Walden University

NURS 8730: Doctoral Seminar III

Instructor Name

Month Day, Year

Eight Minutes at a Time: A Training Plan That Prepares Twenty-Eight ICU Nurses and Nine Respiratory Therapists for Nurse-Led Mobilization Inside Huddles That Already Happen

Who Must Learn What

The protocol is delivered by two groups who learn it from someone else. Twenty-eight registered nurses, spread across day and night shifts with about one in ten shifts filled by agency staff, will complete the 0400 safety screen, read it at the round, mobilize patients who pass and record the daily mobility level. Nine respiratory therapists, who also cover the emergency department, will join mobilization attempts after 0900 and manage the ventilator during them. The two groups need different content. Nurses need the screen, the scale, the stopping rules and the recording. Therapists need the timing of the call, their role at the bedside and the stopping rules. Both need to know that a stopped session is reported, not hidden.

Pulling staff off the floor for a class was ruled out during the feasibility work: a half-time educator cannot run enough sessions to reach two shifts and seven days, and the unit cannot release nurses during the day. Training is therefore built from short segments attached to routines that already happen. Reviews of faculty and staff development find that education built into practice, with active rehearsal and feedback, changes behavior more reliably than single didactic sessions (Steinert et al., 2016).

Segments for Nurses

Nurses learn in three eight-minute segments at the 0700 and 1900 shift huddles, each repeated across two weeks so that nearly every nurse attends each segment at least once.

Segment 1: Recording the scale. The educator shows the eleven levels of the ICU Mobility Scale (Hodgson et al., 2014) on a laminated card, then reads three short patient descriptions aloud and asks the group to call out the level. The descriptions include the two most common borderline cases from the operational definition: a passive lift to a chair and a patient who sat briefly before the session was stopped.

Segment 2: The safety screen. The night champion walks through the one-page screen using a real, de-identified patient from the previous night, showing how each criterion is checked from the monitor and the ventilator and how the result and reason are written on the whiteboard.

Segment 3: Stopping rules and reporting. The educator states the stopping thresholds and shows the half-page event form. The segment ends with the message that a session stopped under the rules is the safety system working and must be reported.

The segments are short by design, and the plan accepts what that costs. Eight minutes cannot cover the evidence for mobilization, the physiology of ICU-acquired weakness or the details of every stopping rule. The plan leaves the evidence to a one-page summary posted in the staff room and focuses the segments on what each nurse must do on a given shift. Nurses who want more can attend an optional thirty-minute session the physical therapist offers twice during the baseline weeks.

Segment for Respiratory Therapists

Therapists receive one eight-minute segment at their own department huddle, delivered jointly by the respiratory therapy supervisor and the day champion. It covers when the page comes, what the nurse will have already checked, the therapist's role in securing the airway and ventilator circuit during movement and the rule that a call from the emergency department outranks any planned mobilization. It is repeated on three mornings so that all nine therapists attend.

Hands-On Practice Without a Class

Huddle teaching cannot include practice mobilizing a ventilated patient, which is the part nurses are most uneasy about. Instead, each day nurse's first mobilization under the protocol is paired: the day champion or the physical therapist attends, helps and gives two minutes of feedback afterward. The pairing is tracked on a list at the charge desk, so that a nurse not yet paired is assigned a pairing when a suitable patient passes the screen. Night nurses, who do not mobilize patients, complete a paired screen instead, with the night champion checking their first two screens on real patients.

A Competency Check Nobody Has to Schedule

Competence is checked inside work that already happens. For the scale, the weekly bedside observation already planned for data quality doubles as a check: when the observer's level and the nurse's entry disagree, the observer explains the difference to that nurse within the week. For the screen, the night champion reviews five whiteboards at random each night she works and corrects any screen with a missing reason. For mobilization, the paired first session is the check. None of these requires a separate appointment, and each produces a record the project lead can count.

Agency Staff and New Hires

Agency nurses arrive without having attended any huddle. Each ventilated bedside will carry a one-page sheet summarizing the screen, the scale's level 3 and the stopping rules, and the charge nurse will point it out at the start of an agency nurse's first shift. New permanent hires will receive the three segments as part of their unit orientation, using the same laminated cards and the same case descriptions. An agency nurse is not expected to start a mobilization session alone; until the sheet has been read and the charge nurse has walked through one screen with them at the bedside, the agency nurse completes the 0400 screen and hands any eligible patient to a permanent nurse for the session itself. New hires finish their own competency check during the second week of orientation, with their preceptor acting as the observer, so the record of who is cleared to lead a session stays complete as staffing changes over the project months.

How the Plan Will Be Judged

The plan will be judged by three counts at the end of week 10: the share of nurses who attended each nurse segment at least once, the share of day nurses with a completed paired session and the rate of agreement between observer and flowsheet in the first four observation checks. If attendance at any segment is below 80%, that segment will be repeated in the following two weeks. If agreement on the scale is below three in four, the scale segment will be repeated with new case descriptions. Training is treated as part of implementation rather than as a step that ends before it, consistent with accounts of implementation as a continuing process (Fixsen et al., 2005).

References

Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M., & Wallace, F. (2005). Implementation research: A synthesis of the literature. University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network.

Hodgson, C., Needham, D., Haines, K., Bailey, M., Ward, A., Harrold, M., Young, P., Zanni, J., Buhr, H., Higgins, A., Presneill, J., & Berney, S. (2014). Feasibility and inter-rater reliability of the ICU Mobility Scale. Heart & Lung, 43(1), 19-24. https://doi.org/10.1016/j.hrtlng.2013.11.003

Steinert, Y., Mann, K., Anderson, B., Barnett, B. M., Centeno, A., Naismith, L., Prideaux, D., Spencer, J., Tullo, E., Viggiano, T., Ward, H., & Dolmans, D. (2016). A systematic review of faculty development initiatives designed to enhance teaching effectiveness: A 10-year update: BEME Guide No. 40. Medical Teacher, 38(8), 769-786. https://doi.org/10.1080/0142159X.2016.1181851