The Nursing Clinical Decision Team (CDT) is doing something new in 2019. Each month, a region or hospital will present clinical initiatives and accomplishments, and these will also be featured here in the Best in the West Newsletter.
Providence Alaska Medical Center is a Magnet hospital! The highlight of 2018 was a successful Magnet survey, and the designation was announced early enough to allow the team to join the recognition celebration at the 2018 ANCC National Magnet Conference in Denver.
PAMC’s approach to clinical improvement demonstrates the innovation and interdisciplinary collaboration that characterize Magnet. They have employed a new technology, LEAF, to help reduce pressure injuries. LEAF is a sensor that is placed directly on the patient to collect and transmit data about the patient position, allowing nurses to prioritize turns for those patients who need it most. Early results are promising. They have also engaged multi-disciplinary teams to devise creative tools and processes to improve performance in CAUTI and CLABSI measures.
The Northern California Region has initiated an interdisciplinary workgroup to implement the ERAS protocol. This Enhanced Recovery After Surgery (ERAS) protocol is designed to improve both patient outcomes and patient satisfaction with the entire perioperative experience. The protocol will be implemented in phases, with pre-op interventions ready for roll-out. The ERAS protocol is an opportunity for nurses to practice at the top of their license in assuring patients have a positive surgical experience and outcome.
Providence Holy Cross Medical Center, in the Southern California region, is also a Magnet hospital. Their recent nursing-focused initiatives include reduction of adult patient medication-related hypoglycemic events and improvement of the discharge home process. The interdisciplinary hypoglycemia reduction process resulted in a significant decline in events, from 12.5 events per 1000 patient days in January 2017 to 6.63 events per 1000 days in December 2018. Early results from Project HOME, the discharge project, also indicate improvement, with improved patient satisfaction scores.
Another Southern California Region hospital, St. Jude in Fullerton, created a nurse-driven blood pressure management order set to assist nurses in responding to fluctuating pressures in hemodialysis patients. This is another example of nurses using improvement processes to address clinical concerns and also demonstrates that top of license practice can be a powerful intervention to help a vulnerable patient population.
For more information about any of these initiatives, contact Julie Heiser, Nursing CDT Project Manager.