Nursing Posters

Nurses at CentraCare Health are engaged in finding ways to improve all aspects of practice of nursing in the clinical setting. The following are posters created in the process of Evidence-based Practice Projects and clinical improvement.

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A Tapestry for Sustaining Perioperative Participation

Larry Asplin and Joanne Oliver-Coleman

Perioperative nursing shortages are becoming critical. Many baby boomers are retiring. As a result, this team was tasked to create some basic principles that will help sustain the value of perioperative nursing by utilizing a multigenerational approach.

Perioperative Resources Nurses are pivotal in enhancing the quality and efficiency of care within surgical settings. These nurses operationalize evidence-based standards for healthy work environments and promote creativity in implementing these standards. They can be full-time, part-time, virtual, or volunteer.
Identification of Subarachnoid Hemorrhage: The Impact of a Nurse Led Screening Tool Utilizing the Ottawa Rule

Chandra Brower, Shannon Krumvieda, and Shalana Bolton

The ETC lacked a formal tirage process for identification of Subarachnoid Hemorrhage (SAH), which can lead to delayed treatment and suboptimal patient outcomes. Data showed SAH patients who presented to the Emergency Trauma Center (ETC) with headache (HA) and hypertension frequently had long wait times before evaluation by a provider.
Creating Standard Work to Improve Length of Stay

Jennifer Burris, Patricia Dumonceaux, and Lindsay Kephart

Plan:

Improve the geometric mean length of stay (GMLOW) from 1.071 to 1.024 by creating and implementing patient flow and throughput standard work.

Do:

Implement standard work for interdisciplinary team members.
- Create a culture of accountability with consistent use of the expected discharge date (EDD) and patient milestones in Epic, during hand offs, and use of My Care Boards.
- Ensure provider to nurse communication occurs daily using ALWAYS, a standardized tool
- Create and ensure beside nurse-to-nurse hand off occurs using a standardized method known as iALWAYS.
- Create and implement patient education tools.
- Enhance discharge readiness tools to improve real-time communication and gain efficiencies.
Improving Patient Outcomes & Decreasing Cost of Care

Kate Fischer and Christine Wiles

Increase patient's self-management of their chronic conditions while decreasing hospitalizations, avoidable ED visits and cost of care.
Innovating Clinical Documentation: The Role of Speech Recognition in Nursing

Caylee L. Hagen and Heather Thyen

As nurses, documentation is a critical part of our daily workflow, and it is time consuming. Speech-to-Text offers a hands-free, efficient solution that allows nursing to dictate notes.
High-Risk TCM Program & Decreasing Hospital Readmissions

Elise Hedman and Christine Erickson

Prevent hospital readmissions in high-risk TCM patients utilizing the Community Paramedic program as a resource to visit patients in the home.
Cardiac-Surgical Advanced Life Support (CALS-S)

Rachel Hewett, Lois Lenzmeier, and Amber Martin

Improve resuscitation outcomes of cardiovascular surgery patients through the adoption of the Cardiac Advanced Life Support-Surgical (CALS-S) algorithm for cardiac arrest.
iALWAYS Perform Bedside Report

Lindsay Kephart

The aim was to create a standard tool for handoff that aids nurses and providers to consistently communicate patient information in the inpatient acute care setting.

Key Driver:
- Staff reported confusion surrounding several different acronyms or tools used to discuss patient information across the care team.
Leveling Up EPIC Tools to Streamline Care

Lindsay Kephart, Holly Kockler, and Emily Eggert

The aim for this project was to improve discharge planning collaboration amongst the entire care team in 4 inpatient pilot depts at St. Cloud Hospital

Key Drivers:
- Improve communication across the care team
- Help to efficiently review a patient's discharge plan
- Track patient progress toward discharge in real-time
- Increase the visibility of outstanding care team tasks and discharge delays
- Improve data collection to enhance the discharge process
IV Infusion Pump Integration Journey

Holly Kockler and Heather Thyen

Implement Infusion Pump Integration systemwide across CentraCare (excluding Surgery, Endo, EP Lab, Cath Lab, NICU, and Special Care Nursery).

The aim for this project was to enhance patient safety by reducing infusion pump programming errors and increase nurse efficiency by reducing pump programming steps and decrease burden of documentation.
Improving Workflows for Filling Provider Contractor Needs - SW Region

Erika Lamb and Kristi Patterson

An interdisciplinary team was brought together to solve for the following problems:
- The process for filling contractor needs in Willmar was unclear. Willmar has high contractor utilization which is expected to continue into the foreseeable future.
- Turnaround Times: "Regular" provider hires: 90 days. Contractor hires: 120 days. At times, contractor needs at RMH were asked to be filled within 60 days.
- There were gaps in communication across roles regarding the progress, contractor onboarding, perceived challenges, and potential red flags.
Developing Education to Improve Confidence and Competence in Handling Physical and Mental Health Emergencies for Ambulatory Care Nurses

Teresa Nathan and Cathrine Robak

With over 60 clinics employing over 600 nursing staff, the educational needs for the CentraCare clinic system are vast and diverse. We conducted a learning needs assessment, identifying confidence and competence gaps in the subjects of physical health and mental health emergencies as a theme across the clinic system.
Don't Judge a Book by its Cover: Generational Diversity at CentraCare

Theresa Reichert, Lora Gullette, and Britney Winkelman

The American Association of Critical Care Nurses (AACN) identifies key elements of a health work environment. Key elements to build belonging within a health work environment (HWE) include:
- Recognizing the value each person brings to the team
- Open, respectful, and effective communication
- Helping teams identify missing "F"s by valuing multiple perspectives
- Avoiding communication breakdowns
- Building departmental cultures where it is safe for employees to speak up with safety concerns
- Advancing collaboration and mutual respect, even during conflict.
- Strengthening employee fulfillment, retention and morale
At CentraCare, many different generations work together to care for patients and one another. Understanding generational strengths and differences is essential to promoting belonging, building HWE's, and advancing patient safety.
Consistent Inventory of Sterilized Instruments Ensures a Safe and Uncompromised Supply of Instruments for Procedural Use

Tiffany Tammen, Amber Eckstein, and Ellen Simonson

CentraCare Rice Memorial Hospital received a regulatory citation related to sterile instrument integrity and storage. Infection Prevention and Control (IPC) created a systematic approach to assess instrument inventory and integrity to ensure an uncompromised supply of instruments for procedural use.
Improving Monticello Emergency Department Stroke Door to Drug Time

Andrew Winter EPPA, Alea Stanger, Jessica Miller, Naomi Schneider, and Kristi Patterson

The aim of this project is to decrease the Monticello ED Stroke Door to Drug measure performance from the baseline of 67 minutes in CY2024 to < 60 minutes by September 30, 2025.
Immunotherapy Serum Mixing: 2023 Best Practice Changes

Eyas Abla MD, Paul Faybusovich DO, Matthew Lies, and Mallory Mondloch

Background Story:

CentraCare - Plaza Allergy & Asthma Clinic compounds immunotherapy serum with advanced training of licensed nurses. Effective November 1, 2023, USP (797) Pharmaceutical Compounding guidelines were updated and endorsed by the American Academy of Allergy, Asthma & Immunology (AAAI). The Allergy Clinic completed a gap analysis to determine what process needed to change to comply with these latest guidelines.
EYE CODE Protocol

Christina Anderson MD, Maiya Dietz, Kelsey Bade, and Mallory Mondloch

Purpose of EYE CODE:
- Retinal artery occlusion (RAO) is a rare but detrimental adverse effect of cosmetic facial filler injections.
- Requires prompt treatment and reversal to avoid patient blindness.
- EYE CODE is a new protocol in place to avoid this complication.
- Assist staff during a high stress event. •Improve patient safety & staff confidence. Way to receive continuing education credits through the clinic.
Implementation of a Two-Person Urinary Catheter Insertion Practice Change

Brandy Berends, Elizabeth Kiffmeyer, Jenelle Overgaard, Amy Railson, and Morgan Thiry

Decrease incidence of Catheter Associated Urinary Tract Infections (CAUTIs) for inpatients by implementing a two-person urinary catheter insertion practice change using a checklist.
You've Got to Move It, Move It!

Jennifer Burris and Elizabeth Plante

An increase in reportable hospital acquired pressure injuries (stage 3, 4, or unstageable) was found to be associated with patients refusing to participate in the prevention plan of care.
Progression of Care/Discharge Delay Panel

Jennifer Burris, Jennifer Salzer, and LeAnn Volkers

Plan:
- To reduce the number of patients with a length of stay (LOS) greater than or equal to 26 days by 25% (from 199 to 150).
- to reduce the average patient days for patients with a length of stay greater than or equal to 26 days by 25% (from 39.7 to 30).
Gamification: Integrating into the Perioperative Environment

Tammy Filippi, Nicole Helgeson, Jennifer Salzer, and Courtney Van Vickle

What is Gamification?
- Using game attributes in a non-game context.
- Including game elements such as points, prizes, leaderboards, etc.
- Goal is education rather than entertainment.
Why Gamification?
- Increase staff engagement.
- Optimizes the learners' outcomes.
- Research has shown no negative outcomes.
- Improved learning behaviors and attitudes towards learning.
Barriers to Implementation of Practice Guidelines against Fluid Restriction in Heart Failure

Mary Geisenhof

The overall goal was to support best practice around fluid restriction in care of the patient with heart failure.
Code Blue Debriefing

Micaela Herbst-Bialke

Situation and Assessment:

Opportunities to improve code blue events have been identified by comments received on code blue critiques and results from a survey completed by 120 code blue team members.

Background:

As referenced by the American Heart Association along with Get with the Guidelines, post code debriefing is a key element to promote continuous quality improvement in patient care. Post-event debriefings are a foundational behavior of high performing teams in improving individual and team performance.
Top of Scope Work and Bringing Joy to the Workplace for Clinical RNs

Julie Karls, Gini Pilles, and Renee Doetkott

Purpose Statement:

Support primary care transformation and team-based care goals through the utilization of RNs

Objectives:
- Encouraging all care team members to work to the top of their scope of practice, increasing joy, and pride in work while strengthening team relationships.
- Creating access for providers through co-management of chronic disease (Diabetes, Asthma and Hypertension).
- Improving patient outcomes related to chronic disease through close monotiling, relationships, and accountability
Healthy Eating & Shift Work

Lisa Kilgard

To provide knowledge and education to individuals who engage in shift work. Which may assist them in maintaining a healthier eating and lifestyle.