Introduction of a Yellow Flag List in a Call Center Setting
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.
Proper Hand Hygiene Practice in the Clinic Setting
The use of proper hand hygiene in the clinic setting is critical for infection control and prevention of nosocomial infections.
Orthostatic Blood Pressure Monitoring
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).
Carry Your Candle...and Light the Way
Tiffany Omann-Bidinger, Deb Eisenstadt, and Jenelle Brekken
The initial goal and purpose of this symposium was to develop a structured leadership class to prepare support charge nurses for the challenges they face in today's healthcare environment. Using a transformational leadership framework aligned with the Professional Practice Model (PPM): The Compass, a content outline was developed for the charge nurse's role. The focus was based on the charge nurse's role using the following components: autonomy, accountability, critical thinking, crucial conversations, innovation, productivity, coaching and mentoring, healthy work environment principles and shared governance. This would ultimately optimize the Neuroscience/Spine Unit and Inpatient Rehabilitation Unit charge nurse's professional function.
Collaboration to Improve Care of Oncology Patient
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.
I.D.E.A.L. Transition Plan
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?"
Decreasing Unnecessary Pharmacy Cost in the Cath Lab
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
RN Case Manager Case Consultation
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.
Preceptor Class Evaluation & Redesign
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.
Integrating Holsitic Care Modalities into an Inpatient Physical Rehabiliation Program
The purpose of this pilot project was to determine the feasibility of incorporating integrative therapies, including acupuncture, into the plan of care of patients undergoing physical rehabilitation in an inpatient setting, and to improve outcomes and patient satisfaction.
Music Heals: Therapeutic Music to Reduce Pain and Anxiety in Adult ICU Patients
To decrease pain and anxiety in adult intensive care unit patients through the use of therapeutic music as compared to no music intervention.
- Neurologic symptoms that are inconsistent with a neurologic disease
- Symptoms cause distress and/or impairment
- No radiological or laboratory findings for symptoms
- May have poor outcomes without proper treatment
Medication Assessment in the Older Adult: Using the Beer's List
- Describe appropriate pharmacologic principles of medication use in older adults
- Review Beer's List Criteria (American Geriatric Society)
- Identify inappropriate and/or overlooked medication for the older adult
- Share with BH Unit staff, patients, families
Quality and Quantitiy of Patient Sleep in the Hospital: Perceptions and Measures
Karen Chalich RN
Inadequate sleep may result in physical and cognitive dysfunction. During hospitalization, interruptions from excessive noise, lights, and interruptions contribute to poor quality sleep. Patient and nurse reports of perception of sleep quality differ, with few studies comparing perception to measured quality and quantity of sleep. This non-experimental study compared patient and nurse perception, quality, and quantity of hospitalized medical patient's sleep.
Quality Leadership Academy: CAUTI Reduction Project
In the fiscal years of 2014 and 2015, 31 out of 66 (47%) catheter-associated urinary tract infections (CAUTIs) were acquired in patients with neurological diagnoses. This led to increased costs, decreased reimbursement, and hospital-acquired condition penalties. A thorough review of CAUTIs revealed 15 of the 31 (48%) were attributed to insertion practices; infections were acquired within 6 days of urinary catheter insertion. Eleven of the 15 (73%) were inserted in the operating room (OR).
Reduced Cost and Decreased Length of Stay Associated with Acute Ischemic Stroke Care Provided by Nurse Practitioners: A Single Primary Stroke Center Experience
Leah Roering NP, Michelle Peterson NP, Muhammad Shah Miran MD, Melissa Freese, Kenneth Shea MD, and M Fareed K. Suri MD
Nurse practitioner (NP) have a wider role in modern stroke centers providing quality evidence based care to patients with both in and outpatient settings for acute ischemic stroke (AIS) and transient ischemic attack (TIA) patients. We studies the outcome measures, length of stay (LOS) and cost before and after implementation of nurse practitioners as the primary medical provider in a community based stroke center.
Beacon Journey: Improving Patient Outcomes: Reducing Adverse Drug Events Using an Inter-Professional Team Approach
Laurie Annett, Nicole Higel-Backes, Jaclyn Hoppe, Michelle Huffman, Teresa Jahn, Bridget Klein, Jessica Mackedanz-Johnson, Kirsten Skillings, Jayna Theis, and Jessica Thoma
Literature states that the use of sedation regimens that include routine reversal of benzodiazepines or narcotic agents are not recommded. An inter-professional team concurred that planned reversals would no longer be the standard of practice for patients post post-procedural sedation. An inter-professional team analyzed the use of reversal agents, reviewed literature related to sedation and analgesia by non-anesthesiologists, and proposed recommendations for practice changes.
Protecting Patients from Hospital-Acquired Infections
Goal: Implement chlorohexidine (CHG) bathing for patients on the Medical and Oncology Unit with a central venous catheter and/or urinary catheter in addition to existing prevention measures to reduce catheter associated urinary tract infections (CAUTIs) and central line associated bloodstream infections (CLABSIs), because increases in CAUTIs and CLABSIs were seen despite various unit and hospital prevention strategies in place.
Mindfulness Program at Work
Chelsie Bakken, Kathleen Mahon, and Kristi Patterson
Develop and implement a mindfulness based stress reduction program that is easily accessible, effective, and utilized by staff to improve care quality and positively affect the wellbeing of CCH employees.
SEP-1: Early Management Bundle, Severe Sepsis/Septic Shock
Roberta Basol and Jennifer Burris
To educate, monitor, and improve the sepsis core measure SEP-1 results required by CMS.
Moving Weekly Team Conference to Bedside
CMS has specific requirements for all Inpatient Rehab Facilities. Weekly team conferences on the patients is one of the requirements. Team members required are Dr, LSW, PT, OT, SLP and RN. Our Practice Nurse (RN) attended conferences, as she has working knowledge of the patient. Our challenge was to get the bedside nurse, instead of the practice nurse, to attend the weekly conference.
Improving Transitions of Care for Newborns Requiring Home Phototherapy Through Innovation & Collaboration
Carla Bieniek and Kristi Patterson
Improve transitions of care for newborns requiring home phototherapy by providing skilled nursing services through Home Care and changing the phototherapy modality from the BiliBed to the BiliSoft which provides more intense home phototherapy & is easier to administer.
Heart Huddle: Increasing Cohesiveness in CCU and CVTU
The American Association of Critical Care Nurses identifies six standards for a healthy work environment, two of which are skilled communication and true collaboration. CCU and CVTU are two separate units staffed by one Charge RN. A need to improve communication and collaboration has existed throughout both units. Thus, Heart Huddle has been developed. The objective of Heart Huddle is to bring cohesiveness to CCU and CVTU through improving communication and collaboration, which is imperative to a healthy work environment.
Reduction of Cesarean Section Surgical Site Infections (SSI): Progression and Implementation of Evidence Based Practice
Patricia Dumonceaux, Melissa Erickson, Kim Schuster, and Elizabeth Kiffmeyer
To improve cesarean section patient experience by reduction of postoperative SSI.
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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