Background/purpose: Walk by survey identified that 43 TVs in patient waiting areas at one healthcare system were not turned on. On average, patient wait times in healthcare clinics range from 5-30 minute. TVs can be used for entertainment, education, inspiration, information sharing, and stress reduction. The use of television screens to display health education topics in clinic waiting rooms is cost effective and can positively impact patient outcomes. Additionally, TV displaying information explaining access for care options can direct patients to the use of health specific phone applications. 97% of Americans are connected to the world of digital information while “on the go” via smartphones and 90% of those are smartphones with the functionality to run applications for health-related services. Displaying health-related information and adding QR codes to access more information in clinic waiting areas can increase app utilization and potentially decrease unnecessary clinic visits. The goal of this project was to utilize all available TVs in patient waiting areas and display information to provide patients with health care information and access to additional resources via QR codes.
Description: A multidisciplinary team of 39 members worked on creating a PowerPoint presentation that could be utilized on TVs. Inventory list of TVs/monitors in public-facing areas throughout organization was created as well as a list of all point of contacts for each TV location. Several factors were considered: physical environment of the waiting areas, number of slides per service, how often to replace content, content distribution, involving regulatory members, creating a mechanism of updating each slide, assigning a point of contact for each slide, and collecting data from observations and patient interviews.
Results/outcome: A TV PowerPoint with 50 slides was created which included information on managing most frequent diseases, high risk conditions, suicide prevention, intimate partner violence, wellness programs, farms program, maternity care, military sexual trauma, acupressure, physical therapy, nursing awards, release of information, and many others. Slides contained relevant information to the patient population as well as QR codes for patients to access additional information and resources. A table with all contributed services and their point of contact was created for future content updates (new class scheduled, additional services, and so on). The PowerPoint was displayed in 30 locations throughout the healthcare system. Each slide was displayed for 10-15 seconds. Average number of patients in waiting area was 5, with average wait time of 10.6 minutes. From observations, only 64% of patients were facing the TV and none of the 103 observed patients were using their phones to scan QR codes; however, feedback from patients indicated they appreciated information but wished the slides were longer. Data will continue to be collected to assess the long-term outcomes of TVs in waiting rooms.

The formation of a widespread clinic board fosters front-line nurse engagement and supports inclusion and belonging. A strong shared governance structure with active participation in the ambulatory care setting improves patient experience, supports nurse retention, and is a pillar of the ANCC Magnet model; supporting ambulatory care entities in pursuit of Magnet designation.
We used the shared governance model to create an inclusive board for a large ambulatory care women’s health practice with 17 regional clinics. This initiative was driven by a staff engagement survey highlighting concerns about lack of involvement in decision-making.
Previously, participation in the shared governance board was limited to in-person attendance with option to phone in. The goal was to establish a more inclusive board and normalize shared governance across multiple locations to improve quality of care, safety, and work life.
Clinical nurse co-chairs and leadership were identified and attended system-level shared governance training. A virtual meeting platform launched the foundational elements, including shared governance training, charter construction, and establishment of ground rules. Front-line staff submit topics to be addressed at monthly meetings. Co-chairs and leadership use the organization’s shared governance resources to guide initiatives and goals.
Representatives from 11 clinical locations regularly attended virtual monthly meetings. Despite high attendance, staff engagement was low. To address this, in January 2024, we restructured to a huddle model, promoting shared governance at each clinic with quarterly meetings of all clinics. This change increased local staff engagement and provided a forum for idea sharing and collaboration.
The model involves regular short meetings at individual clinics where staff discuss and decide on local issues. These huddles are designed to be inclusive, giving all staff members a voice. Quarterly board meetings then bring representatives from each clinic together to share insights and collaborate on common goals.
This approach has improved engagement and fostered a sense of ownership and accountability among staff. By addressing issues at the local level and then bringing them to the larger board, we ensure decisions reflect the entire team’s needs and ideas.
Effectiveness is measured utilizing patient satisfaction data as increased patient satisfaction is closely correlated with nurse satisfaction. The Press Ganey rank for nurse/assistant overall satisfaction increased from top box score of 78.46% in May 2022 to 87.55% in October 2023. Data for 2024 are pending. The annualized RN retention rate increased from 77.7% in FY22 to 90.91% in FY24. The Qualtrics engagement composite score increased from 4.19 in FY22 to 4.3 in FY23.
This innovative approach to shared governance provides a unique opportunity to create structural empowerment from all levels of practice. Improved patient satisfaction, staff turnover, and engagement outcomes are positively impacted while cultivating an inclusive, enriched workplace.

We created a shared governance committee for ambulatory care coordination to improve communication and collaboration amongst our care coordination team since our nurses work in various locations and many practice remotely. We hope this model serves as a guide for others to establish their own unique specialty shared governance committee that will foster communication, collaboration, education, and best practices that support their team and patients.

Learning outcome: Learners will be able to articulate ways the nurse can facilitate treating opioid use disorder within primary care.
Opioid use disorder (OUD) is a chronic, relapsing condition that has become a major public health crisis, necessitating comprehensive multidisciplinary accessible treatment strategies. Primary care is uniquely positioned to play a pivotal role in treating OUD due to its broad reach, continuity of care, and reduced stigma of treating addiction just like any other chronic disease. Treating OUD with buprenorphine in the primary care setting is proven to be safe and effective. Nurses within primary care have an important role in the identification, treatment, and management of OUD.
The nurse’s role in treating OUD within primary care includes screening, assessment, ongoing care coordination, and patient education of medication for opioid use disorder (MOUD). Nurses are often the first point of contact for patients seeking care and are well situated to screen for opioid misuse through routine assessments like the 5Ps prenatal substance abuse screen for alcohol and drugs; the Vermont treatment needs questionnaire; and the tobacco, alcohol, prescription medication, and other substance use tool (TAPS). Early identification of at-risk individuals enables timely intervention and the initiation of evidence-based treatment strategies.
In primary care, every nurse has a baseline of knowledge regarding MOUD, but there is also a core group of RNs who have a specialized knowledge to assist with more complex situations within MOUD. In collaboration with primary care providers and behavioral health specialists, a core virtual nurse team assists in the follow-up after initiation of MOUD (buprenorphine) assessing withdrawal symptoms and providing psychosocial support. Nurses monitor patients' progress and offer harm reduction strategies, all of which are critical for improving treatment outcomes and reducing the risk of relapse or overdose.
Patient education is an important role of the primary care nurse in OUD treatment. Nurses provide information about this chronic disease, the MOUD program guidelines and expectations, the importance of medication adherence, and buprenorphine treatment agreement. They also review the social determinants of health that contribute to OUD, advocating for holistic care that includes psychological, social, and medical interventions.
Nurses serve as liaisons between patients and multidisciplinary care teams, ensuring that communication and documentation are clear, care plans are implemented consistently, and patients are scheduled for timely appointments. Nurses help navigate the complexities of the healthcare system. One example of this is having a core nursing team for MOUD prescription renewals and other controlled substances to better streamline renewals of these high-risk medications.