Agency Nurse Usage of Infusion Interoperability: Identifying Barriers and Improving Workflows

Over the past several years, hospitals have utilized agency staffing to combat staffing shortages. Increased use of agency staffing presented an opportunity for implementation of an education project related to the potential variance in practice of permanent staffing, specifically with the use of infusion interoperability in the inpatient setting at the University of Pittsburgh Medical Center St Margaret hospital. Discussion around variables causing agency nurse setbacks with utilizing infusion interoperability while trying to meet the required standard laid the groundwork for this project. Improving agency workflows allowed for process improvement including enhanced quality, documentation, and adherence. Early data analysis revealed variance in adherence between agency and permanent staffing prompting further analysis. Investigational methods included assessment of agency nurse infusion interoperability usage through interviews and observations, review of adherence reports, review of education and onboarding, and interviewing of nurse leaders. Findings suggested lack of experience, inability to troubleshoot, and underutilized resources contributed to lower adherence with agency compared with permanent staff. These findings lead the informaticists to make changes to the curriculum for new hire onboarding, increase rounding and interactions with agency staff, and increase access to resources. These interventions resulted in increased adherence scores and verbalized satisfaction by the agency nurses.