Sunday September 21st 2014

Nurse leads the way in reducing falls

Pat Quigley, PhD, MPH, ARNP, CRRN, FAAN, FAANP, is the associate director of the VA Sunshine Healthcare Network (VISN8) Patient Safety Center of Inquiry at the James A. Haley Veterans’ Hospital in Tampa, FL, where she leads interdisciplinary, prototype falls clinics and programs aimed at developing, testing and promoting interventions and tools to reduce falls and prevent falls-related injuries in vulnerable populations. She also serves as associate chief for nursing for research at the Research Center of Excellence: Maximizing Rehabilitation Outcomes.

How did your career path lead you to your current role?

Pat Quigley

I’ve always worked in rehabilitation to help promote the independence and mobility of people living with disabilities and chronic diseases. I know dearly the impact of falls and fall-related injuries in these populations. I started in 1975 as a staff nurse, then worked as a rehabilitation clinical nurse specialist for about 17 years, conducting program evaluation and research. I moved full time into patient safety and research in 1999. I was already with the VA when I was awarded a $3.2 million grant as principal investigator to set up the prototype falls clinics in multiple parts of the country. So I’ve stayed in rehabilitation, but expanded the depth and breadth of my knowledge and skills so I have a greater influence to help shape practice and patient outcomes.

How do you use your nursing skills and knowledge in this position?

I’ve always been clinically focused, because patient care is the heart-beat of my being as a nurse. So, I know nursing practice and patient needs and can identify gaps in practice. When I’m designing or making changes to a falls program or tool, I’m always making sure they are clinically relevant. Sometimes there is no evidence-based practice or conflicting evidence to guide program development. As a nurse, though, I understand that clinical decisions are based on individual patients’ needs and clinical knowledge — implementing actions that we know will benefit a patient. For example, what do you consider when providing care to an 85 year old versus a 40 year old, or to someone who is on an ICU versus a different type of unit? Each nurse has to use expert knowledge, clinical judgment and common sense to make decisions that are population- and setting-specific.

How did you develop your leadership skills?

It’s really an intrinsic drive. All I wanted to do in my lifetime was to be a nurse, and it’s been a joy and a privilege. I also always wanted to be involved and have a voice to influence the profession and nursing practice beyond where I went to work. I’ve been involved in the American Nurses Association (ANA) since 1975 and a delegate in ANA’s House of Delegates since 1982 (the former governing and broad policy-setting body). Being involved in ANA and the Florida Nurses Association (FNA) has given me the opportunity to lead, network, learn and bring back new knowledge that I can use in my own practice and share with others. I’ve always viewed opportunities — like serving on a committee at work or as president of FNA — as a vote of confidence in me. By engagement in the profession, the learning opportunities are tremendous and help us to stretch our potential and actual contributions. I believe in two founding assumptions as a professional nurse:  First, because I am engaged in the profession, the profession shapes my practice. Second, because I am engaged in the profession, my practice shapes the profession.

What can other nurses do to lead efforts in their work environment?

If you have a passion, look for those pathways where you can have influence, and then use your voice to gain support for that passion. For me, it was falls, which was an orphan issue. Everyone gave up on it. But it’s the No. 1 injury-related death in older adults. So, you can start by taking a leadership role in shared governance committees — at the unit or organizational level — where you can help shape practice where you work. I also encourage nurses to get involved in ANA. You’ll learn more about yourself and build leadership skills.

What’s on the horizon for professional nursing, and what advice can you give to nurses to prepare for potentially new or different roles?

The IOM (Institute of Medicine) report talks about nurses taking on more leadership roles. And there are more opportunities for us to lead — not just be team members — especially in areas such as the implementation of electronic health records and transitions in care across the continuum. We really need to start “owning” our patients. When a vulnerable, 85-year-old patient comes into the ED, we need to talk with her about how to stay safe at home and then follow up with her. We also need to be lifelong learners. There are lots of learning communities, like through ANA’s National Center for Nursing Quality webinars, where you can ask questions and share best practices.

Do you know an exceptional nurse leader? If you want to recommend an ANA member to be profiled in this column, please write to the TAN editor at 8515 Georgia Avenue, Suite 400, Silver Spring, MD 20910-3492 or via e-mail at taneditor@ana.org.

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