A major improvement in the way nurses record and access patient information is about to be introduced at the Douglas. Called the Therapeutic Nursing Plan (TNP), it will save precious time for nursing staff and their colleagues, and improve patient care. The TNP responds to the demands of Bill 90, which allocates more responsibility to nurses in their areas of expertise (assessing, monitoring and follow-up).

What Is the TNP?

The TNP is an easy-to-use, two-part form. Part 1 of the form records mental or physical problems that are considered to be a priority for a patient, and require clinical follow-up (for example, an increase in anxiety or a diabetes-related problem). The form also records the date and time a problem occurs.

Part 2 of the form records how the nurse in charge of the patient plans to respond (for example, by adjusting treatment or by requesting input from a nutritionist). During each shift, all nurses who are responsible for specific in-patients and out-patients will complete this form. If a problem is detected and follow-up is required, the team will use the information on the TNP as a guide when it responds.

Nursing assistants will help to evaluate the condition of patients as part of the care planning process.

The TNP is currently in paper form, but will eventually be computerized. All nurses working in healthcare facilities in Quebec will be required to complete and sign TNPs as they record the problems they treat and the decisions they take, in keeping with new Ministry regulations.

Here are some major advantages for staff and patients :

• Until now, when a nurse or other team member returned to work after a long weekend or a vacation period, it could be difficult to obtain a quick update on patient problems, and what had been done to treat those problems. Now returning team members can quickly read the TNP for the period and know what has happened. If a change is noted in the TNP, the team can refer to nurses’ notes for details.
• For “floaters” (nurses who work in various areas) or for people on the Recall list, the TNP will help them get a quick update on patients in the area to which they’ve been assigned.
• When a nurse changes a care plan for a patient (for example, stopping or modifying a treatment), the change is recorded on the TNP. This allows all nurses and other members of the treatment team to stay up-to-date. They refer to the nurse’s notes for details.
• Patient care will benefit, since it will be easier to spot emerging problems and solutions. This will be especially useful for clients with complex conditions.
  
  The TNP will be used by Douglas nurses hospital-wide by April 1, 2009.