[Sharon]

Now that you have reviewed the PCNA Utilization Toolkit, can you identify one benefit and one difficulty with the PCNA Utilization Toolkit? If your organization has used this tool, did you participate and did it change practice?

[Melanie]

Hi Marilyn,
I am unsure what the PCNA Utilization toolkit is? I didn’t see any documents or anything in the suggested readings about the PCNA toolkit. Can you please help me find this?
Thank you, Melanie

[Melanie]

Hi Marilyn,

Please disregard my previous entry, I was searching all the readings in Module 3 for info on the PCNA kit but I found it in the Module 1 readings for the Role Clarity/It’s all about Synergies.
Sorry about that!
Melanie

[Melanie]

Upon review of the PCNA Utilization Toolkit the benefits I identified were the fact that it is evidence based. It also takes into account the 3 factor framework (nurse/client/environment) and focuses on key elements : stability, complexity, predictability and risk for negative outcomes. The study focused solely on RN’s and RPN’s.

The difficulty with this toolkit is that the study was specifically conducted in a hospital setting (med/surg units) and acute care hospitals. It doesn’t encompass many other settings where nurses work. For example, I have worked in 2 OB/Gyn clinics where I was the only nurse, there were no RN’s or NP’s just
myself (RPN) and the MD’s and a receptionist.
Not all places of employment have both RN’s and RPN’s.
This toolkit seems to also be aimed more at nurses who have direct hands on patient care, by the bedside.
It doesn’t seem to account for the many different settings and roles nurses may have and/or work in.

My current organization does not use this tool, therefore, I did not participate. The OB/Gyn clinics that I worked in also did not use this tool, therefore, I did not participate. There was no change in practice.

[Teresa]

Hey Melanie

I totally agree with you. The PCNA is great as it gives concrete “guidelines” about RPN utilization, but it is mostly for in-patient acute care, and not necessarily for out-patient or primary care. I think it can be simplified or adapted for out-patient care, or just use the CNO 3 factor framework. In our setting, RPN rarely works alone, so NP is always there for support.

[Marion Catherine]

An overall benefit of the PCNA is that the nurses use the same criterion for assessment. This leads to consistency and any variations to the patient’s norm can be quickly identified and supporting interventions put in place immediately.
Things I found missing in the tool kit are: measurement and management for pain; Range of motion and patient’s physical mobility status, also intake/output and elimination data may also provide insight to a patient’s overall wellness and indicate subtle and progressive changes in a patient’s status.
As far as I can tell, this Tool has not been applied in any of the facilities that I have either trained or worked in.

[Alexandra]

I do not believe that the tool kit has been used in the office I work for as we do not see patients that are critical or unstable so there is no difference in which nurse can take care of them.
I do see the benefit of this tool in other setting though as in a hospital setting or urgent care clinic for example the tool kit can aid in providing the best care possible and the safest most efficient care for the patients.

[Author]

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