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.

Printing is not supported at the primary Gallery Thumbnail page. Please first navigate to a specific Image before printing.

Switch View to Grid View Slideshow

Improving Hepatitis B Vaccination Rates in Nephrology Patients with Chronic Kidney Disease: A QI Initiative

Jill Swanson
- Hepatitis B vaccination is an important health maintenance preventative measure for patients with chronic kidney disease (CKD)
- Prior to initiating dialysis, hepatitis B vaccination administration is proven to be more effective than waiting until patients begin dialysis treatments.
- Efficacy and immune response of the hepatitis B vaccine is greater when kidney function is greater
- To better improve hepatitis B vaccine administration among the CKD stage 4 population, education measures and Epic modifiers will be implemented to achieve change
- Nursing knowledge and hepatitis B vaccine administration will improve after implementation of these measures
Rapid Evaluation Teams (RET): No Longer Just for Hospitals

Amanda Thorson

Study:

Everyone goes to the Nursing Home for End of Life - Right? Wrong Cumulatively, over a 4-year study there were 678 residents with Full Code status residing at Carris Health Care Center and 687 residents the DNR/DNI status. That is only a 10-resident different between Full Code and DNR/DNI

Plan:
- Improve long-term care staff's ability to call for, and receive, support to rapidly evaluate and address an urgent or concerning situation.
- Need for this plan is supported by increased number of OHFC substantiated events related to code status in MN and number of residents with Full Code status in long term care facilities.
- Barriers to Change: amount of education needed to increase number of CPR certified staff and to train on RET process, establishing one true source for code status for residents, establishing facility equipment needs for crash cart.
A Practice Innovation to Improve Staff Vaccination Knowledge and Skills

Ijeoma Ugochukwu

Abstract:

The practice improvement project explored the best practices for equipping CentraCare Health System's (CCHS) Licensed Practical Nurses (LPNs) and Certified Medical Assistants' (CMAs) with childhood vaccination knowledge and communication skills necessary to educate hesitant patients and parents about the benefits of vaccination compliance. Innovative computer-based education (CBE) was identified and developed to empower LPNs and CMAs working in the ambulatory setting with childhood vaccination knowledge and communication skills to improve their ability to educate hesitant patients and parents about the benefits of vaccination. The CBE module was guided by the Theory of Planned Behavior in identifying vaccination knowledge and communication intention. Intentions to use acquired vaccination knowledge and communication skills were assess pre and post the CBE.

Results:

The results are statistically significant indications that both new and existing LPNs and CMAs gained the necessary vaccination knowledge and communication skills to be advocates of vaccination compliance. Post CBE mean scores on vaccination knowledge and communication skills were statistically higher in both new and existing employees (all p< 0.0005). Self-reported intentions to use vaccination knowledge, initiate vaccination conversations, and utilize the vaccination communication skills post CBE were high. Continuation of the CBE vaccination education may increase vaccination compliance rates and avert potential outbreak of communicable diseases. Further studies should explore LPNs and CMAs experiences with hesitant patients at the point-of-care.
Performance Improvement Leadership Rounding Implementation

Dena Walz

To improve patient experience scores and address patient concerns in real time.

A proactive behavior that facilitates leaders building relationships with patients and families, managing expectations, and achieving and validating consistency of key behaviors.

A member of leadership will conduct a purposeful conversation with a chosen patient three days a week regarding the care provided during their procedural appointment.
Providing Education Regarding Antimicrobial Stewardship for the Bedside Nurse

Anna Boeke
- Two million people acquire drug resistant bacteria and around 23,000 die from infection-related resistance each year (CDC, 2018a) and Up to 50% of antibiotics are incorrectly prescribed, including usage, dosage, and duration (CDC, 2017)
- Clostridium difficile (C.diff) is a common problem seen in the hospital
- Antimicrobial stewardship (AMS) as a proven method of addressing the problem of antibiotic resistance by education, multidisciplinary efforts, and refined resource utilization
- The biggest problem is nursing staff are unsure how to participate in AMS!
Preventing CRBSI'S in Hemodialysis

Kristen Dombovy

The aim of this project was reducing CRBSI’s below the predicted number of bloodstream infections with the implementation of the ClearGuard® chlorhexidine-based antimicrobial disinfecting cap.
St. Cloud Hospital Hand Hygiene Achievers

Patricia Dumonceaux, Sara Maciej, Jessica Reed, and Tamara Welle

Develop and adopt a culture change to increase hand hygiene compliance across all St. Cloud Hospital (SCH) inpatient and outpatient departments
- Hand hygiene is the best method to prevent the spread of infection (CDC, 2017).
- Historical data for SCH indicated below desired goal of 95% compliance with hand hygiene practices and continued identification of hospital associated infections.
- Employee engagement best achieved through promoting culture of safety supporting hand hygiene best practices (Piras et al., 2018).
- Educating staff on the WHO 5 Moments of Hand Hygiene, developing monitoring process for assessing opportunities to complete moments of hand hygiene, and providing detailed feedback can enhance results and improve culture (Haas, 2014).
- All staff survey identified best sources of performance feedback comes from peers and direct leadership.
Reduced Frequency Monitoring Post-Stoke Treatment

Melissa Freese

In 2020, the nation was faced with a pandemic that quickly depleted health care resources. Standards of care were reviewed to identify opportunities to reduce the burden on healthcare resources. One of the standards of care that was reviewed nationally and locally at the St. Cloud Hospital (SCH), was the postalteplase/ thrombectomy patient placement and monitoring.

The standard of care for the placement and monitoring of post-alteplase patients was established during the 1996 NINDS trial and has not been studied since. Very minimal literature is available on the standard of care for patient placement and monitoring post-thrombectomy.
Implementation of Proper Lead Selection Based on ECG Practice Standards in Hospitalized Patients

Teresa Jahn, Nicole Hubbard, Samantha Pohlmann, Lauren Hoeschen, and Shayna Lahr

Ensure adult patients in a 36 bed Telemetry Unit and 14 bed Cardiac Intensive Care Unit (CICU) with the diagnosis of STEMI and NSTEMI are being monitored in the appropriate leads to detect acute or silent ischemia and arrhythmias.
Huddle to Enhance Patient Progression of Care

Melinda Jennings, Kristi Patterson, and Jennifer Salzer

CentraCare (CC) is committed to improving patient flow and is now using the Geometric Mean Length of Stay (GMLOS) Index as our primary measure of success. This is a Key Performance Indicator that is monitored by the Patient Flow Steering Committee and Executive Leadership. In recent years, SCH GMLOS Index is higher than expected.
Implementation of a Chemotherapy Guideline: A Quality Improvement Project to Standardize the Chemotherapy Delivery Process

Sara Maciej

Adjusting chemotherapy rates is one gap in chemotherapy practice that evokes inconsistency. The purpose of this project was to implement a standardized guideline for staff to utilize in adjusting rates of chemotherapy medications.
Meeting the Educational Needs of the Busy Bedside Nurse: Curbside Education an Innovative Program

Ashley O'Connell, Kayla Waldoch, and Amy Junes
- Seek out educational needs of staff based on current changes, trends and new hires
- Provide on the spot reinforcement of skills, policies, education and policy changes for all staff
- Implement skill stations, including "off shifts", to increase staff cohesiveness and preparedness in emergent and nonemergent scenarios
Deep Tissue Injuries

Mary Pohlmann and Katie Meyer

Purpose Statement from Poster:
- Recognize and identify Deep Tissue Injuries
- Ability to describe and define Deep Tissue Injuries
- Increase awareness of Deep Tissue Injuries in order to promote early identification and treatment
Neuroscience Spine Float Buddy Program

Jenna Czech

Why?

In our commitment as a unit to role model best practice as we support the staff that float to us from other departments, we initiated a new process so all staff that come to our unit will feel welcome, well-prepared, and supported in their roles with our patient population, environment, and our team. It has been identified that we had opportunities related to resources for staff floating from other units.
St. Cloud Hospital Nursing Director Orientation and Mentorship Program

Deb Eisenstadt, Tiffany Omann-Bidinger, and Diane Pelant

Develop and implement an evidence-based orientation and mentorship program for nursing directors using AONE’s Nursing Executive Competencies along with a structure curriculum.
Journey to Zero NG-related HAPI's

Kristin Gaarder

From October 2015 to April 2016, there were five Stage II or higher inner nares hospital acquired pressure injuries (HAPIs) caused by nasogastric (NG) tubes, with one being unstageable. These occurred despite previously implemented evidence- based prevention strategies, which included:

• Two-person skin assessments on admission and return from surgery

• Two-person skin assessment upon transfer from unit to unit

• Daily skin assessments including under devices

• Access to the Wound Ostomy Continence (WOC) team
Magnetizing: Post Operative Nausea and Vomiting

Andrea Nyquist

Purpose:

To guide nursing care in the early recognition and treatment of PONV.

Prevalence:

Postoperative nausea and vomiting (PONV) is the most prevalent postoperative complication occuring within 24 hours of surgery.

Risk Factors:

Adults at a higher risk of PONV include:
- Female
- History of PONV, motion sickness and/or gastroparesis
- Postoperative opioid recipient
- Volatile anesthetic and/or nitrous oxide administration intraoperatively
- Pregnancy
- Use of birth control pills
Implications:

PONV can create a plethora of adverse events for the patient: anxiety and a sense of dread, increased risk for bleeding, dehydration and electrolyte imbalance, risk for aspiration and airway obstruction, vasovagal response, wound dehiscence, increased intracranial pressure, and increased cost with use of antiemetics and potential for prolonged length of stay.
Enhancing Retention for Nursing Assistants: Effective Strategies to Reduce Turnover

Tiffany Omann-Bidinger

Develop and implement a hospital-wide, evidence-based recruitment and retention program to reduce turnover rates for Nursing Assistants (NAs).
Reducing Falls in the Neuroscience Patient Population

Elizabeth Plante

Purpose Statement:

The purpose of this evidence-based practice project is to reduce the fall rate from 5.52 to less than 4.80 on a Neuroscience/Spine Unit through increasing staff and patient awareness of fall risk and application of evidence-based fall prevention practices of communication, patient involvement and bedside report.
What? Not Another Fall!: Reducing Falls in the Neuroscience Patient Population

Elizabeth Plante

The purpose of this evidence-based practice project is to reduce the fall rate from 5.52 to less than 4.80 on a Neuroscience/Spine Unit through increasing staff and patient awareness of fall risk and application of evidence-based fall prevention practices of communication, patient involvement and bedside report.
If You Can Dream It, You Can Do It: Building an Escape Room to Meet Learning Needs

Katherine A. Schulz and Melinda Jennings

Use an Escape Room as an effective learning strategy to fill a gap in knowledge and practice in a fun, interactive, and competitive learning atmosphere.
The Hidden Impact of the Functional Independence Measure

Joyce Belanger

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?
Overcoming New Hire Obstacles with an Individualized RN Orientation in the Critical Care Area

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.
Improving Nursing Skills in Caring for Culturally Diverse Patients

Jenna Czech

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.
Building the Foundations of Practice of the LPN and CMA in Ambulatory Care

Renee Doetkott

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.