Taking a unit from worst to first: The Saudi Arabian Experience

Purpose:
31 nationalities are working collaboratively in our facility, all from diverse backgrounds and nursing care models. The challenge is to achieve one objective; provide world class nursing care as seen in our outcome indicators. How do we achieve buy in? All nurses need to come back to the basics.

Significance:
Around the world nursing has become very task oriented.Bringing 20 Nationalities together from physician driven care models and asking them to affect change at the bedside is a daunting task, especially when you are on a Magnet journey & this isnt a priority for the nurse who has a different agenda.

Strategy and Implementation:
One unit was identified as being the most challenging unit for change in our facility. RN-MD interaction was low, collaboration between nurses or ethnic groups was minimal, the nurses were task oriented & 'click' charters. We had to find ways to change a culture that was deeply embedded on the unit. We needed to instill pride, advocacy and ownership in a unit with no hope. We approached this by trying to find out two why questions? Why was the nurse here in Saudi Arabia and why did they choose nursing. After initial implementation of an NDNQI indicator, an inservice was given asking these two questions. When we kept asking why, many stories would surface.Nurses were here to support families or provide a better life for their families. The nurses were given in services on NDNQI indicators with examples relating to their own family situations, with an emphasis on why we chose this profession and our morale obligation to our patients.

Evaluation:
The effectiveness of the innovation is demonstrated through our NDNQI indicators. going from <6 pain assessment to >23 in 24 hours. Reduction in pressure ulcer and restraint use and no PIVs. Nurses are leading this innovation throughout their division and the effect is being seen and rewarded.

Implications for Practice:
Bringing the bedside nurse back to the basics of why they became a nurse allows them the opportunity to change focus from the task and technology to their primary focus. This allows the nurse to then change focus, prioritize care appropriately and assist them to advocate for what they believe in.