West nurses share personal and institutional patient care plans for 2011, and how those goals will affect patient care
From obtaining new certifications to taking the time to listen and interact with those under their care, nurses focus on the bedside to take their practice to a whole new level.Colleen Hallberg, RN
Colleen Hallberg, RN, MSN, FACHE CNO Banner Good Samaritan Medical Center, Phoenix
My resolution is to set goals that reflect zero incidents or never levels of standards so that we are stretched to achieve improvement that is very significant, not just incremental. Indicators such as ventilator-acquired pneumonia, falls or central line infections are all hospital-acquired conditions that we need to eliminate. Nurses, working with physicians and other clinical colleagues in a respectful, team-based culture, will yield the highest level of practice outcomes. Using evidence, developing an evidence-based project, conducting research and closely monitoring processes and clinical outcomes are all strategies that will help us achieve lofty goals. Every patient deserves to feel safe in the hospital setting. Listening to patients and families about their fears of hospitalization continues to compel me as a leader to set the highest of goals for the patients benefit. Nursing is uniquely poised to directly impact the morbidity and mortality associated with hospital-acquired conditions, and this potential continues to be very inspiring to me.Melissa Edmister, RN
Melissa Edmister, RN, BSN clinical manager surgical acute Providence St. Peter Hospital, Olympia, Wash.
My resolution is to draw on relationship-based care and partner with our patients and their support persons to foster a therapeutic environment that encompasses the art and science of healing. For example, implementing evidence-based care, taking more time at the bedside, etc. We have found success with evidence-based care, small tests of change, the glitch book, rounding with patients and support persons. Also, a culture of transparency helps us learn from each others mistakes, and our multidisciplinary team works together to gather ideas and address concerns. We are diligently working on multidisciplinary rounding, and nurses have been engaged in a plethora of other patient-centered safety initiatives. Our dedicated interdisciplinary team plans to achieve our goals in a culture of respect, accountability and collaboration.We have learned to keep our patients and their support persons at the center of our bedside care as active participants, rather than relegating them to be passive spectators in the process of their healing.Trudy Lovell, RN
Trudy Lovell, RN, BSN, CCRN critical care services John Muir Medical Center, Walnut Creek, Calif.
My resolution is bringing patient-controlled epidural analgesia to the bedside at my facility. It is well-known that PCA can increase patient satisfaction, as the patient has control of his or her own comfort. To achieve my goal, I will first seek the approval and support of our interdisciplinary Pain Management Priority Team. Next will be to secure funding for purchase of the PCEA buttons to add to our current epidural pumps. A small group of stakeholders will need to be formed to develop a plan for successful rollout of PCEA. This group will include anesthesiologists as well as bedside nurses. Metrics will need to be developed to measure success of implementation while keeping our goal in mind. My main goal is to deliver quality care that meets or exceeds the expectations of my patients and their families. Managing pain is a large component of that goal. Offering PCEA as a method of pain control can increase patient satisfaction and comfort, ensuring the delivery of quality care.Alisha Patrick, RN
Alisha Patrick, RN staff nurse Eisenhower Medical Center, Rancho Mirage, Calif.
Eisenhower Medical Center comes into 2011 aiming to improve patient satisfaction. Our nursing units have set up specific practice improvement projects to get at the heart of what our patients see as their most pressing needs. These projects are based on the Press-Ganey survey scores that we receive from our discharged patients. One of the things our hospitals step-down unit is working on is keeping our patients informed. We aim to keep our patients updated on any results, their pending procedures and/or tests for the day, and their overall plan of care. We accomplish this by talking with our patients and families, and encouraging physicians to do the same. We also write on a white board provided to each patient, simply to remind them of important information. These things seem simple, and yet they go so far. Patients have let us know that when they feel like their nurse keeps them as well-informed as possible, they are far more comfortable, and therefore satisfied, with their overall stay.Ina Reynolds, RN
Ina Reynolds, RN, CCRN, CNRN neurological ICU St. Josephs Hospital Barrow Neurological Institute, Phoenix
Our goal is back to basics. We have been working on proving how important simple things we do every day make a huge difference in patient outcomes. Our unit did a two-year study on the impact of oral care on ventilator-acquired pneumonia. We had full education with staff on how to brush a ventilated patients teeth. Many nurses had questions; we demonstrated the proper mechanics, and they developed a new comfort zone. I noticed a wave in pride around oral care. Families communicated with me how important their loved ones teeth were. The evidence showed that oral care reduced VAP rates. The most important thing our patients and families taught us during this time was that oral care a small, everyday activity allowed our patients to feel normal. Having something we do every day can have not only a medical benefit but an emotional impact. From these findings, we developed an oral health protocol.Amy Goldstein, RN
Amy Goldstein, RN, BSN, OC staff nurse St. Josephs Hospital and Medical Center, Phoenix
As a bedside nurse for vulnerable cancer patients, my resolution is the same as last year to decrease central line infections throughout my hospital. I have participated in updating IV policies in the hospital to be aligned with current evidence, and the education surrounding the changes made is still ongoing. We have seen big improvements in some areas of the hospital but still have opportunities to improve in other areas. The educational efforts will be continuing with the help of the shared governance councils, and some new products are being trialed in different areas that we hope will help us continue to improve our infection rates. I have learned from my patients not to be discouraged by small improvements. If I protect one patient from an unnecessary bloodstream infection, that can mean a lot in terms of valuable time for that individual and their family, for whom cherishing one more holiday at home together will be remembered long after we have forgotten what our statistics were for December 2010.Christie Chapman, RN
Christie Chapman, RN Eisenhower Medical Center, Rancho Mirage, Calif.
“What responses do you get when you ask folks how to do something anything? Well, if you ask my financially conservative husband, hell tell you to do it the cheapest way. If you ask your employer, they might tell you that productivity is most important, so do it the fastest way. If you ask your friend, who is ready to get on the road and get some shopping done, they might tell you to do it the easiest way. Every day we, as nurses, have to consider how we are going to do things for our patients because, frankly, most of the time we can choose to do it most anyway we want. Our patients either are not familiar with medical options or they trust us to make good choices for them. My journey through the BSN program at California State University has shown me that there really is only one way to do things the right way. Nursing practice based on science, evidence and knowing why we do the things we do is the right way to take effective care of our patients. My goal for the coming new year is to complete my BSN at CSU and continue exploring ways to practice nursing the right way, every single day, for each and every one of my patients.”