Jessica Parker- Staff Nurse, ICU
In the ICU, interprofessional relationships are enhanced through interdisciplinary care team rounds. The purpose of interdisciplinary rounding is to enhance seamless, patient-centered care facilitated by effective communication among care team members.
Rounds are held Monday through Friday at 0900. Members of the care team include the patient’s nurse; Intensivist with his/her nurse practitioner, nurse or physician’s assistant; case manager; dietitian; respiratory therapist; ICU clinical supervisor; and the social worker.
Each patient session lasts from 3 – 10 minutes and provides an efficient and effective way for the nurse to address multiple concerns with all members of the care team and coordinate care involving multiple physicians and the clinical staff. “Green Sheet” checklists guide the discussion and are updated daily with the patient’s progress in the continuum of care and toward discharge.
Patient Care Delivery Model
LeAn Smith - Staff Nurse, Women's and Children's Health
Nurses working in Women’s & Children’s Health must be prepared to manage pregnancy loss as well as successful delivery. Following the Patient Centered Care Delivery Model, nurses work with the patient, family and members of the care team to identify, plan and support the unique needs of patients who experience the loss of pregnancy. The patient and family are integral members of the care team where there is open communication about the family’s values and their cultural and spiritual needs. Nurses working with these families are dedicated to providing excellent and compassionate clinical care. This is accomplished through continuity in caregivers; providing a room for family and friends to gather nearby; coordinating food cart catering by Nutrition Services; assembling a memory box with photographs and other keepsake items such as foot and hand prints, photos, bracelets, a lock of hair and a gown or baptismal shell; and a sympathy card signed by the nurses and other care providers.
The interprofessional Fetal Demise Committee uses lessons learned from each experience to continually improve the quality of the care provided. With patients and their families as part of the care team we can achieve better outcomes, improve the care for all patients and increase staff satisfaction.
Leadership & Shared Decision Making
Kelli Herbold - Staff Nurse, Medical Specialties
After review of their fall rate data, the combined Unit Practice Council for Neuroscience Specialties/Medical Specialties/Rehab Unit began looking at evidence-based practice resources for methods to decrease their fall rates.
Their literature review identified several additional interventions that could be implemented to provide safer care for the patients. They began by teaching and adopting a new culture and attitude toward falls, that of “zero tolerance.”
Nurses signed a contract signifying commitment to do whatever was possible to prevent falls from occurring.
A falling star pin was awarded to those signing the contract. Patients at highest risk for falling were identified with a red “catch a falling star” sign outside the room and “Stop, Don’t Fall” sign in each room visible at the foot of the bed and in the bathroom. They improved documentation and communication of the safety and “Get Up & Go” assessments for each patient.
Other interventions included
developing a “fall resource kit,” noting the date of the most recent fall on the patient’s in-room white board and scripted hourly rounding.
Reduced fall rates demonstrated the value of these changes and through the leadership of this Unit Practice Council plans were made to implement these fall reduction measures in other care areas in the hospital.
Recognition & Rewards
Amanda Cundiff - Staff Nurse, Neonatal Intensive Care Unit
One of the ways Boone Hospital Center recognizes and supports the growth and development of a nurse is through the Professional Nurse Development Program (PNDP). This program promotes the life-long pursuit of clinical expertise. The overall goal of the program is to provide opportunities for clinical nurses to experience professional growth and advancement which results in excellent care and patient outcomes.
The program is based upon the work of Dr. Patricia Benner which addresses these progressive levels of skill acquisition: novice, advanced beginner, competent, proficient and expert. The criteria for achieving each skill level are progressively more complex within the PNDP and require a defined amount of experience and knowledge.
Nurses demonstrate achievement within the levels and readiness to advance through clinical practice and submission of an exemplar; demonstration of leadership, professional growth and contribution by completing defined tasks; earning continuing education units; and excelling in a clinical skills evaluation that is conducted by the Clinical Supervisor.
Nurses choose to participate in the PNDP program as they take responsibility for their own personal and professional growth, for financial reward and recognition of the work they do; and to ensure accountability for being a knowledgeable worker who can help patients achieve better outcomes.
Amanda shared, “participation in the PNDP provides a way for me to advance my career during a time when I am not ready to go back to school, but want to grow both personally and professionally; to be more efficient and organized; highlight my clinical skills and knowledge; and to feel rewarded for my efforts and work.”