Under the Pathway to Excellence programme, TTSH Nursing began a transformational journey to flatten the nursing dynamics from a traditional hierarchical model of interaction to a culture of empowerment. A Shared Governance Model was introduced to support nurses in defining their practices and improving quality and patient satisfaction, through a collaborative decision making process. Thus, the whole paradigm of management-led decision-making was redesigned to include ideas and views from all levels of nurses.
With the introduction of flexible-rostering, nurses can now request for half-day leave or mutual exchange of shift among staff with similar skill mix. It facilities better integration of work, personal time and family responsibilities.
The demands of coping with a new job in today’s acute and highly complex environment can be daunting for our new nurses, more so for our foreign nurses. Although the existing preceptorship scheme had been in place, our buddy system offers an informal and friendly support to help them assimilate and integrate better in TTSH.
We aim to promote health and wellness within the nursing workforce. A couple of key events we organised over the past year were the health screening and flu vaccinations, our collaboration with Allied Health Department to elevate the well-being of our nurses through Traditional Chinese Medicine, Podiatrist and Dietitian services, and even free yoga sessions.
Clinical Exchange Program
Clinical exchange program allows staff to experience other nursing areas through attachment, cross training or internal transfer. The nurse can have better insight on the different work cultures and environments, and a platform to enrich clinical knowledge and skills. The program could also help nurses to identify potential interest or specialty areas for further career development.
In alignment with the goal of the innovation subgroup which is “for every nurse to know what is innovation”, NQR set up the all-year-round innovation fund.
This fund aimed to encourage creativity in nursing practice and built a culture of innovation. As of 2013, 49 innovation ideas were given funds to prototype their ideas along with advice and mentorship from the NQR GC on how to improve the idea via an innovation clinic session. NQR GC concluded the year with an innovation awards day where innovators were invited to share their ideas on stage such that other nurses could learn from their experience.
Nursing Innovation Fund
"We nurse our patients with cutting-edge technology to save time and effort as well as cutting done errors."
Radio Frequency Identification (RFID) technology and SmartSense Vital Sign Monitoring System
What it is: A system using Radio Frequency Identification (RFID) technology to track a patient’s location as well as body temperature.
- Location tracking – RFID facilitates patient location tracking at the inpatient wards and reduced time taken to locate patients out of the wards. It promotes better coordination of patient flow, better manages utilization of limited resources and provides real-time status of ward capacity to the Emergency Department (ED), Bed Management Unit (BMU) and wards.
- Temperature monitoring – The RFID constantly monitors patient’s body temperature and wirelessly upload the readings to electronic clinical chart. It also keeps a permanent electronic record of vital signs like blood pressure, pulse and respiration, which are entered manually to the system.
Closed Loop Medication Management System (CLMMS)
What it is: An electronic system for the processes of medication prescribing, reviewing, dispensing and administration to ensure that the correct medication is served to the right patient at the right time. It consists of three components:
- Electronic Inpatient Medication Record and Inpatient Medication Administration Record (eMAR-iMAR) – e-records for medication prescription, medication review and administration purposes.
- Electronic Medication Administration Record System (EMARS) – Medication administration system used by nurses to administer medications. Paired with a PDA (in process of switching to mini iPads) to scan the barcodes of medication and patient’s identification on the wrist band, it ensures that the right patient is given the right drug at the right time, and even indicates any allergies or contraindicative medication.
- Omnicell Automated Dispensing Cabinet (ADC) – A secured system for efficiently managing, storing, dispensing medications. The guiding lights guide the user to the desired location in the cabinet to remove the correct medications. Other safety features include bin-locked compartments and controlled access such as thumbprint verification. The system also facilitates medication inventory process and triggers resupply of medications to the specific Omnicell cabinet.
Intellivue Clinical Information Portfolio (ICIP)
What it is: A comprehensive patient-data management system, which complies their parameters, assessment and notes from doctors, nurses and Allied Health Service (AHS) staff in one place for easy referring and sharing. This system is used in intensive care units.