Around here, we've found that checklists and signs are often overlooked. But with the specter of more new nurses on the horizon, we've started (after nearly 4 years of having a trached child) to document and write it all down, so there are no excuses when it's not done correctly.
First we had a sign on the wall when we had 7 different nurses covering night shifts - the important bit was really #7, where it talks about how to pack the suction bag.
When I recently cleaned out the suction bag, I found over 2 dozen gloves, used suction catheters, and more that just didn't belong there, which is how I got on this rampage to begin with.
But now it's moved on to attempts to document trach care instructions and house rules and how to feed her (because our brand new dayshift nurse this week was struggling with "feed her some baby food from this shelf in the fridge. If you don't get to 250 calories, figure out how much formula she needs to get there. She will likely drink it from a cup, but if not, use the g-tube."
My other big beef lately is not having what we need in our diaper bag/go bag, so we're documenting it via pictures. I put them in a power point with detailed lists of what needs to be where.
Everything that goes in the backpack:
Wipes bag for diaper changes:
Bag of feeding tube supplies:
Bag of other medical supplies (would you believe I found an entire package of 100 cotton swabs in here?)
Our emergency box (most people use a bag; we use a clear plastic box for ease of finding things):
I'm not sure this will help as much as I'm hoping, but it'll sure make training new nurses easier to have everything written down.