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Nursing Excellence

The Online Newsletter for Children's Nurses
e-Edition, Issue 6

Denise Vermeltfoort

Shining Stars

By Denise Vermeltfoort, MSN, RN, NE-BC
Director Regulatory and Clinical Practice

A “Magnetic Moment” is a moment in time in which nurses and members of the healthcare team provide extraordinary service. These moments are not random; they are performed by dedicated professionals, “shining stars,” and are a reflection of our excellence. These dedicated professionals stand out; their efforts shine, just as a star in the sky. They provide hope, caring, healing and comfort to those in need; our patients and families as well as each other.

Two years ago we received our second Magnet Recognition Program® Award, the highest recognition of nursing excellence. The Magnet Interim report has been completed. It shares the story of where we are today on the journey of excellence. Excellence is demonstrated through the outcomes which have been achieved because of the dedication, knowledge and expertise of healthcare professionals… such as you!

Highlights Include:

  •  Nurses, physicians and respiratory care therapists worked together to decrease the occurrence of ventilator associated pneumonia (VAP). The PICU achieved 151 and the NICU 144 days between occurrences of VAP.  Acute Care has had zero occurrences of VAP.  Since June 2008, the PICU has had zero VAP for 13 out of 24 months. The NICU monitors VAP in five weight categories. They achieved zero VAP during the past 24 months in three of the five categories and 20-21 months of zero VAP in the other two weight categories.

  • The dramatic impact of the Patient Throughput Initiative has continued. The initial decrease in the percentage of patients leaving without treatment (LWOT) was dramatic and has continued to be maintained. Although the number of emergency room visits continued to increase from 45,237 in FY 2005 to 67,263 in 2009, the annual LWOT was only 1.9% in FY 2009.  We have seen a significant decrease in the “wait time” in the emergency room exceeding the benchmark 100% of the time during the last two fiscal years.  Patients awaiting admission from the emergency department has decreased by 45% since 2005 and there has been a 63% decline in the number of patients declined or diverted due to the lack of staff beds from FY 2007 to FY 2009.

  • Children’s Hospital partnered with pediatric nurse researchers across the nation in a Child Health Corporation of America (CHCA) collaborative for a multi-center nursing research study. The organizational median fall rate among the eight inpatient units has remained at or below the Children’s Health Corporation of America (CHCA) benchmark median of 1.09 falls per 1000 patient days the majority of the time.

  •  Children’s Hospital recognized the importance of preventing hospital-acquired infections and took a proactive approach towards decreasing central line infections (CLABSI). In 2009, the PICU achieved 205 days without an infection, decreasing CLABSI by 42%, compared to the infection rate in 2008. During 2009, the NICU had 87 days without an infection, decreasing CLABSI by 64%. The acute care areas have demonstrated a 40% decrease in CLAPSI since October 2009.

  • Perioperative Services, in partnership with the Department of Surgery, the Department of Anesthesia and the Infection Prevention and Control Department have worked together to reduce surgical site infections. The goal of zero surgical site infections, during 10 months since December 2008, has been achieved.

  • A nurse practitioner in the Diabetes Clinic developed an innovative program to improve the outcomes of adolescents with Type 1 diabetes. These innovative approaches have resulted in a 3.9% reduction in hemoglobin A1C for these high risk patients.

  • We are gaining a better understanding of research methodology and application to practice to further enhance the care we provide.  Nursing research studies, such as the Pediatric Early Warning System (PEWS) study, are resulting in changing how we deliver care. The PEWS tool supports the early identification of patients at risk for deterioration to improve patient outcomes.

  • Nurses have increased their involvement in governing their practice through participation on organizational and unit-based governance committees.  Many of the committees are led by nurses who provide direct patient care, ensuring that the evaluation of practice, identification of opportunities for improvement and solutions, meet the needs of the patients we serve.

These are just a few shining examples by shining stars. Each one of us is a star; together we create a light that will lead the way for excellence, providing innovative solutions and quality outcomes.

In This Issue

Great Moments

Shining Stars

Pediatric Early Warning Tools

Patient Safety Survey

Informatics: The Language of Nursing

Nursing Peer Review

NICU Outreach Education

What is “Just Culture”?

Patient Satisfaction Comments