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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Inpatient Rehabilitation Performance Improvement: Skin Care and Guidelines

Golden Fisk

To improve skin integrity care as well as use of hospital policies and guidelines within Inpatient Rehabilitation.
Best Practice for Core Charge Nurse Orientation and Leadership Development

Melissa Fradette

Purpose Statement: Develop and implement evidence based, standardized orientation and leadership development for core charge nurses (CCN) compared to current unit-based orientation which has inconsistent content and structure.
ETC Code Stroke Improvement

Melissa Fradette and Jessica Miller

There was a 42% increase in median times for patients receiving alteplase (tPA) within 60 minutes from 48 minutes in Q3FY13 to 68 minutes in Q1FY15. Research indicates every 15 minute delay in stroke treatment, the odds of good outcome decreased by 10%. During two day rapid improvement event team members and content experts used process mapping to identify waste in current state ETC Code Stroke process and determine countermeasures to eliminate waste and improve throughout.
Finding the Missing Pieces: Comprehensive Cerebellar Assessments with Cytarabine Administration

Tara Hinnenkamp

A study conducted at the University of Maryland Greenebaum Cancer Center found that one in four nurses felt there were widespread inconsistencies with cerebellar assessments. One of every two nurses felt the current assessment was incomplete and the patient may be suffering as a result. Nurses need to have the means to accurately and consistently assess and document neurological changes noted with Cytarabine administration.
Improving Bedside ECG Monitoring in Telemetry

Teresa Jahn, Jennifer Lang, and Jaclyn Hoppe

To improve accuracy of bedside ECG (EASI lead) monitoring through accurate placement of electrodes and proper skin preparation.
Reducing Overnight Vital Signs

Jill Libbesmeier

As delirium has been identified to increase functional decline, cost per patient day of hospitalization, and length of stay, previous delirium work has been completed at St. Cloud Hospital. Changes in sleep pattern and sleep environment have been identified as a cause of delirium. The purpose of this project is to change frequency of vital signs on Med 1, Med 2, and Medical and Oncology, allowing for increased uninterrupted periods of sleep to help reduce delirium rates; in turn reducing average length and cost of stay.
National Database of Nursing Quality Indicators

May Schomer

National Database of Nursing Quality Indicators (NDNQI) was launched by American Nursing Association (ANA) in 1998, with an initial set of ten quality indicators that assessed the quality of patient care. The continued mission of the NDNQI's is to improve patient care and safety by providing evidence based national research to nurses by comparing nursing care data and the connection this data has on patient outcomes. A relationship between patient outcomes and nurse staffing practices was noted, but further data collection was needed to appraise the quality of nursing care on each hospital unit in order to assess, evaluate and improve patient care outcomes. Unit level of care measurements empowers the nursing units to enhance their quality of patient care. To improve the quality of patient care, evidence-based practices are researched, developed, trialed, and implemented where needed.
Optimal Perioperative Management of the Geriatric Patient

Sherry Sonsalla

Purpose: Review best practice guidelines, perform a gap analysis, and provide recommendations for areas of opportunity for geriatric surgical patients.
Integrative Therapy Program: Evaluation and implementation of aromatherapy in an inpatient setting

Wendy Wheeler

Purpose Statement: The purpose of this project is to implement integrative therapies, such as aromatherapy, in addition to current nursing interventions. Goal is to improve patient experience and outcomes and enhance the patient/nurse relationship.
Opening an Observation Unit

Emily Zempel

The definition, benefits, and structure of an observation unit within a hospital.
Utilizing a Protocol to Reduce Post-Operative Urinary Retention in Total Joint Arthroplasty

Gina Anderson-Malum and Naomi Schneider

Foley catheters have not routinely been used for our total joint patients for many years, leading staff to bladder scan and straight catheterize patients postoperatively. Bladder scanning and catheterization were identified as an inconsistent practice. Patients were commonly straight catheterized when nurses determind bladder scan volume and time of last void; yet the amounts for both and decision to catheterize were inconsistent. Also, the clinical evaluation and treatment was inconsistent among physicians. Variations in practice included rationale for a urology consult, use of medications for urinary retention, and documentation. Baseline urinary retention condition codes ranged from 8-18%, which led our team to choose urinary retention as a performance meansure in 2012 for The Joint Commission Disease Specific Care Certification. Objective: Describe the clinical and cultural impact the total joint urinary protocol has on decreasing urinary retention.
Inpatient Rehabilitation Unit Specific Orientation

Joyce Belanger and Becky Kastanek

CMS has specific requirements for all Inpatient Rehab Facilities. Data collection in the form of FIM "Functional Independence Measure" is one of them. Due to these requirements, it was felt that we needed to provide further education to our new hire staff from all disciplines.
Developing Cultural Competence

Patricia Blonigen-Heinen and Roberta Basol

Caring for patients from many cultures is an important part of health care today. Why learn about cultural competencies? Because developing cultural competencies benefits everyone. You can: help patients receive more effective care; help your facility meet standards of The Joint Commission; and improve your job performance.
Sustaining Pressure Ulcer Prevention: Implementing a Skin Champion Model

Jennifer Burris

Purpose Question: Will an evidence-based skin champion model in the ICU improve nursing knowledge and perceptions about pressure ulcer prevention and reduce hospital acquired pressure ulcers?
Treating Early Sepsis Outside of the ICU Using a Bundle of Interventions

Jennifer Burris

To decrease cost and length of stay for sepsis patients by standardizing treatment in the progressive care units (PCUs).
Pneumonia: Ongoing Efforts to Improve Outcomes

CentraCare Health

Background: Original improvement efforts emphasized correct antibiotic, early mobilization, adequate hydration, and early and ongoing oxygen weaning. Ongoing efforts include: early mobilization, obtaining room air sats on admission, early and ongoing oxygen weaning, and patient education.
What the Heck is Value-Based Purchasing??

CentraCare Health

Medicare has changed the way hospitals get paid. The new payment program is called Value-Based Payments (VBP). VBP is made up of two parts: incentives & penalities.
Cultural Competency at the Bedside: Developing a Plan of Care for Limited English Proficiency Patient Populations

Jenna Czech

To improve nursing skills and competency in caring for culturally diverse and limited English proficiency patient populations.
Improving SCIP-4 Glucose Measures

Melissa Fradette

A performance improvement project was initiated to increase the Surgical Care Improvement Project (SCIP) glucose measure compliance. Order sets were modified to standardize glucose monitoring frequency and initiate insulin infusions. A previous practice of double documentation (manual and glucose meter interface documentation) were abstracted as 2 separate results. When glucose interfacting became an option, the practice of manual entries did not stop. The use of manually documented results for decisions failue to prompt interface confirmation; non-validated results do not interface. The plan: implement order set changes; eliminate manual documentation; and rely on interfaced measures to make clinical decisions.
Giving Time Back: Implementing a Electronic Nursing Protocol for Skin Care

Amy Gorecki, Sue Omann, and Kim Schuster

Purpose Statement: To improve the accessibility of evidence based skin care interventions for the clinical nurse without the need of a CWOCN consult.
Shifting the Paradigm of Classroom Nursing Orientation

Mary Leyk

Purpose Statement: The purpose of the Evidence-Based Practice Nursing Orientation Project is to find evidence to support a change in teaching strategy for newly hired RNs (both New Grads as well as experienced nurses), from the current process in order to improve outcomes of clinical competence, independence and nurse confidence, and retention.
Using Core Competencies to Help Staff Remain Proficient

Mary Leyk

Problem: Implement a competency program that engages staff compared to usual computer-based training modules. Objective: Design a multi-modal competency program for bedside nursing staff.
Creating Successful Mentoring Relationships

Mary Leyk and Colleen Porwoll

Literature suggests that a formal mentoring program increases nursing engagement and retention. Objective: Develop a nurse mentor program to enhance new nurse satisfaction and retention.
Heart Failure and Depression: Reducing Readmission Rates

Janelle Maciej

Purpose Statement: Reduce heart failure readmissions through implementation of a depression assessment in the acute care setting.
I Heard it through the Grape Vine

Terri McCaffrey

Purpose Statement: Patients who are informed and active in their care are more likely to follow recommendations. Providers play a vital role in accomplishing positive communication with cleft team and families.