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.
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.
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.
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.
What's the Plan? Give me the Patient's Story

Holly Kockler and Amber Guzman

Plan:

The aim for this project was to improve staff satisfaction with care planning and bring the patient's plan of care to the forefront for all staff.

Key Drivers:
- Care Plan notes were difficult for care team to understand how the patient was progressing towards their goals.
- Care Plan lacked the ability to tell the patient's story and represent the interdisciplinary plan of care.
Technology Decreases Treatment Decision Times

Angela Moscho

Patients who experience a stroke while hospitalized have a higher mortality rate than those who present to the emergency department. Our plan is to utilize technology to allow the stroke provider to evaluate the patient while in their hospital room, instead of waiting until the patient is in the CT scanner. Utilizing technology of an iPad for inpatient code strokes will allow for quicker assessment of the patient, resulting in faster treatment decision for this population.
Creating a Centralized Immunization Resource Center

Teresa Nathan

To support clinic nurses in their knowledge & comfortability around immunizations, an Immunization Resource Center was created on SharePoint. Having resources and educational materials located in a single location can help ensure consistency across the clinic system in our work with immunizations.
Enhancing Patient Care: The Power of the Endoscopy Checklist

Emily Obermiller

Endoscopy procedures start at 8:00 a.m., but inpatients are often unprepared when report is required at 7:00 a.m. This lack of patient readiness causes delays in endoscopy start times, creates safety concerns, and delays in care. Nurses who are well-informed about procedural preparation are more likely to have patients properly prepared, improve safety, and increase effective communication.
Research Makes a Difference: Changing Post Surgical Vital Signs

Elizabeth Plante, Sadie Seezs, Jennifer Burris, and Tiffany Omann-Bidinger

Research Question:

Are reduced frequency of vital signs as effective in identifying patient deterioration in postoperative adult orthopedic and spine patients after a post anesthesia care unit stay with transfer to orthopedic and neuroscience spine units when compared to current practice?

Conclusions/Implications:
- Changing the frequency of post operative vital signs provides the same quality, not directly affecting an increased risk of death.
- Reduction in number of times vital signs needed completion, saving time for nurses to complete other duties.
- System wide change to routine post operative vital signs for floor level patients was implemented.
- Recommend future research for obstetric and pediatric patient population
Strategic Use of Storytelling as an Advocacy Skill for Social Justice in Nursing Practice

Theresa Reichert

The purpose of this practice project is to cultivate storytelling as a nursing skillset, preparing nurses as social justice advocates within nursing practice.
Sticks and Stones May Break My Bones, But Words Can Hurt Me Too: Psychological Safety and Microaggressions

Theresa Reichert, Janelle Maciej, and Julia Vang

To foster a healthy work environment, address reports of microaggressions, and improve psychosocial safety within the SCH Telemetry team
Standardized Orientation in a Multi-Site Clinic System

Cathrine Robak

There are over 50 clinics serving more than 8 counties in CentraCare. Managers and supervisors at each clinic lead orientation of new nursing employees. The ambulatory educator recognized a need for standard orientation tools and resources as clinic managers and supervisors shared that they were each completing orientation of new nursing employees in a different way.
Professional Development in Practice: Enhancing the NPD Role

Amy Stang

Inquiry:

The problem this project is addressing is a lack of knowledge related to NPD scope and standards in the organization. The education department is largely decentralized, with staff reporting to various leaders outside of NPD department. Some areas within the organization lack support and continuing education specific to NPD.
ICU CAUTI Incidence Reduction

Michelle Gamble

Situation:

Catheter-Associated Urinary Tract Infection (CAUTI) rates in the adult Intensive Care Unit (ICU) increased from nine infections in FY21 to 18 in FY22.

Backgroud:

CAUTIs are the most reported healthcare acquired infection. It is important for healthcare providers to understand the complications and effects of CAUTIs. CAUTIs contribute to extended length of stay, increased healthcare costs, and patient morbidity and mortality.

Most CAUTIs are directly related to inadequate urinary catheter care. Evidence based practice demonstrates a decrease in CAUTIs related to the use of Theraworx^® Protect wipes twice daily (BID) and as needed (PRN) for patients with a urinary catheter.