Clinical Change

Nurses First

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At Nurses First We Believe…

Access to reliable and predictable information is essential to safe and collaborative nursing practice. Every shift is a chance to actively ensure our patients stay safe in hospital. Co-produced care is better care. And, partnerships with patients and families is at the heart of nursing care.

“When nurses start ahead they stay ahead.”

Nurse Educator, South Carolina, US

The Spectrum of Surveillance for Nursing Teams


Recovering or avoiding worst outcome

Respond to presentation of deterioration

High stress and burnout environment

Often looks like:

  • Rapid Response
  • ACLS


Coping with the daily challenges of care

Detect and avert deterioration

Overcome ‘Diagnostic Error’ and ‘Normalization of Deviance’

Often looks like:

  • Collaborative cross-checking
  • Decreasing cognitive load


Exercising foresight to anticipate needs

Prevent predictable adverse events

Overcome deficits in ‘situational awareness’ and ‘clinical inertia’

Often looks like:

  • Quality-safety checklist
  • Triggering protocols

Solution Delivery


Training high-performance behaviors to ensure reliable communication within teams

  • Engaging patients and families with compassion and connection
  • Creating Shared Mental model of patient and provider priorities
  • Completing safety check for key nursing issues


Nurses First App
Online platform assists embedding processes

  • Built-in accountability for excellence
  • High-performance behaviors for all nursing processes
  • Peer facilitated feedback
  • Teammates helping other teammates be the best at what they do
  • Progress tracking
  • Visualize the improvement staff are making at each assessment

Nurses First People Process Technology


Training high-performance behaviors to ensure reliable communication within teams


Reducing the clinical noise experienced at critical times increases reliability of information transfer


Application-based software provides real-time feedback, performance tracking, and competency verification


Patient Experience

  • Mindful listening to patients and families
  • Increased mutual understanding of patient and family goals
  • Co-produced care plan with every nurse
  • Decreased length of stay by ensuring treatment plan is known and implemented
  • Improvement in unit-specific quality metrics

Staff Experience

  • Improved perception of patient safety culture
  • Lowered frequency of communications errors
  • True Teamwork
  • Lowering patient exposure to harm
  • Catches & saves recording
  • Quality-safety checklist
  • Improved joy in work for nurses
  • Staff/leader development
  • Improved safety and known expectations

Implementation Methodology

Onsite Training

• 60-minute live training sessions with Nurses First master trainer

– Schedule flexible to accommodate facility needs and staff size

• Individual training with Nurse Managers

– Facilitate orientation to online technology platform for competency verification

• Individual training with Superusers

– Promote internal capacity for rapid spread

Building Internal Training Capacity: Train-the-Trainer

• Pre-Implementation training with a master trainer
• Reinforcement of materials through observation and participation of onsite training
• Ongoing mentorship and competency verification after onsite training

Leadership Development

• Strategic Management

– Facilitate change

• Safety Science

– Evaluate performance data

• Performance Improvement

– Patient and staff engagement

• Curriculum & Technology Platform

– Support culture of innovation

Online Training

• Sequential and progressive delivery of content

– Ensures ongoing, consistent orientation to processes

– Eases burden of onboarding new staff members

– Short training modules to be respectful of education time resource

Charlie Davis, RN, MS

Nurses First Master Trainer
Bethany Robertson

Bethany Robertson RN, DNP

Nurses First Adviser

Contact us to learn more

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