An integral piece to Rehabilitation is the Functional Independence Measure (FIM). All staff having a love/hate relationship with FIM scores. How do you make your staff understand the importance of FIM?
Heather D. Blais, Melissa M. George, and Jessica M. Thoma
To improve RN new hire orientation in the Cardiac Care Unit (CCU). Research reveals we tend to assign two patients to a new hire too early. They may not be able to safely care for two acutely ill patients, causing both the new hire and preceptor to become frustrated.
The purpose of this project is to improve nursing competency in caring for culturally diverse populations within St. Cloud Hospital through nursing education and initiation of a care plan related to Limited English Proficiency (LEP) patient populations.
The practice of the RN is well defined and supported across the profession. But, there is little published information supporting the practice of the LPN and MA in ambulatory care.
Patricia Dumonceaux MSN, RN, CIC, PHN and Dana Schmidt RN
Clostridium difficile (C. difficile) is a life threatening bacteria spread in spore form through diarrhea. C. difficile effects approximately 500,000 people annually (CDC, 2016). From 2009-2016, the incidence rate of C. difficile in Minnesota* has increased from 50 to 227/1000,000 persons, with 58% of cases considered community associated** (CA), 17% healthcare facility onset (HCFO), and 25% community onset-HCFO (MDH, 2016). MDH 2016 data indicates C. difficile is being transmitted within healthcare and community settings and among patients primarily greater than 65 years of age, with 54% of CA cases using antibiotics during the 12 weeks prior to positive specimen (2016).
Bedside report is part of the nursing handoff policy at St. Cloud Hospital. This research was used to identify benefits of bedside reporting to present to staff to reinforce the importance of following this hospital policy.
For nurses (P) that document motor strength on the assessment flow sheet, will a new prototype for documentation (I), compared to the current system (C), reduce confusion (o) as to where motor strength should be located?
Project Goals: decrease double documentation , decrease confusion, improve end-user satisfaction, improve patient outcomes, improve ability to mine data.
To increase patient satisfaction with the discharge process based on patient's readiness; for patients with uncomplicated vaginal and Cesarean birth through the application of the IDEAL model.
The purpose of this evidence-based project is to reduce the number of suicide attempts by identification of at risk patients with the Adult and Adolescent Mental Health Units (MHUs) through implementation of the APNA Psychiatric-Mental Health Nurse Essential Competencies for Assessment and Management of Individuals at Risk for Suicide as compared to the use of No-Suicide Contracts (NSCs).
Urinary incontinence is commonly observed in patients recovering from a stroke. Bladder management and nurse-led interventions such as timed voiding, and double voiding, may be helpful to decrease the risk of urinary tract infections and incontinence episodes in these patients.
To reduce bloodstream infections related to tunneled dialysis catheters through implementation of aseptic, sterile dressing changes completed by RN's.
The purpose of this evidence-based practice project is to improve the content and quality of Computer Based Training (CBT) education and reduce the average CBT module time, through the application of evidence-based guiding principles for CBT content and development, compared to previous practice of ineffective guidelines.
Clinical Research: Evaluation of Healing Touch's Effect on Coronary Artery Bypass Grafting (CABG) Recovery, a Randomized Study
Bridget Klein; Kirsten Skillings; Roxanne Wilson PhD, RN; Kathleen Sowada; Teresa Jahn; and Jessica Thoma
This study is assessing the efficacy of Healing Touch on patients receiving Coronary Artery Bypass Grafting at St. Cloud Hospital. A single previous research study determined Healing Touch, when added to standard nursing care, can significantly reduce anxiety and length of stay in patients undergoing CABG procedures.
IrriSept is the only FDA-Cleared device that delivers a pressurized solution containing Chlorhexidine Gluconate (CHG) for cleansing and debridement. As a final rinse, prior to closure in surgical procedures, IrriSept has the potential to help reduce SSIs and associated treatment costs. IrriSept was developed with the goal of becoming the "Standard of Care" and improving patient outcomes.
IrriSept has a wide range of activity against gram positive and gram negative bacteria, fungi, and viruses. It has demonstrated antimicrobial efficacy and persistence in laboratory testing.
Melissa Lampert and Anne Major
Increase the number of 72-hour post-discharge follow-up phone calls for patients hospitalized with a primary diagnosis of heart failure.
This is a quality measure required for Joint Commission Heart Failure Certification and also to maintain American Heart Association Gold Plus Status.
Hanni Lyon, Sara Maciej, and Alea Stanger
The policy changes reflect the current guidelines and standards used to prevent central lines and associated bloodstream infections and its complications.
Improve work processes of newly established triage/scheduling call center by creating a nurse driven yellow flag list that supports RN scope of practice, improves access to care, and an overall goal of reducing total cost of care.
The use of proper hand hygiene in the clinic setting is critical for infection control and prevention of nosocomial infections.
To apply the evidence of orthostatic blood (O B/P) pressure monitoring techniques as compared to inconsistent O B/P monitoring. Enhance the knowledge and skill of staff completing O B/P to promote consistent technique and reliable assessment data. Identify and modify order sets which include O B/P monitoring to ensure the order is written for use based on the evidence.
Enhancing Retention for Patient Care Assistants: Effective Strategies to Implement to Reduce Turnover
Develop and implement a hospital-wide, evidence-based recruitment and retention program to reduce turnover rates for Patient Care Assistants (PCAs).
Kara Panek and Melinda Jennings
It was identified that there were opportunities to enhance the care of the inpatient oncology patient when they were not on the Medical and Oncology Unit. Upon completing leadership rounding, patients identified that they did not receive consistent oncology specific interventions when they were transferred to a higher level of care.
The purpose of this evidence-based practice project is to increase the number of discharges prior to noon by using the IDEAL discharge planning tool with noncomplex total joint replacement patients and maintaining score of discharge phone call follow up. "Were you aware of the discharge plans and felt prepared?"
Scott M. Scepaniak and Kristi Patterson
AngioMax is a single dose heparin alternative introduced in 2002 that is used in cardiac patients undergoing percutaneous intervention (PCI). Bivalirudin costs $377 per dose; heparin is less than $15 per dose. Noting practice variations, the Cath Lab set out to eliminate unnecessary pharmacy cost for PCI patients by:
- Using current literature to inform clinical care
- Standardizing practice
- Using data to track and guide implementation
Nancy A. Schug
Apply the Collaborative Care Management Practice Model to address:
- Complex transition planning
- Clinical progression
- Readmission risk
Promote professional growth
Increase knowledge of the ACMA Scope and Standards of Practice for RN Case Managers.
Katherine A. Schulz
In August 2016, Education Committee identified need to comprehensively evaluate Preceptor Class for curriculum structure, content, teaching modalities, etc. Preceptor Class Subgroup was formed to lead evaluation efforts.
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.
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