This past fall, Purdue University Calumet, Hammond, IN, partnered with 10 area clinical sites to provide senior nursing students a glimpse into the inner workings of healthcare organizations through collaborative projects.

A brainstorming session among the faculty prompted Ellen Moore, MHSN, RN, CS, FNP, associate professor of nursing, and Gail Wagner, MS, RN, to develop an improved senior capstone experience. The course enables students to choose from projects submitted by the clinical sites and work with the submitting organization on a solution to the problem presented.

As a result, one group of students under the supervision of Janet Landrum, MS, RN, CNS, visiting assistant professor at Purdue Calumet, worked with an Indiana patient safety leader to develop and present findings to the chief nursing officers of an entire healthcare system, as well as the chief executive officers of hospitals throughout northwestern Indiana.

And did I mention part of their project has been adopted by the Indiana Patient Safety Center as part of its Wristband Standardization Toolkit?

Where Students & Clinicians Meet

BREAKING THE CODE: Purdue University Calumet Senior Capstone nursing students recently gave a presentation at Saint Anthony Medical Center, as part of a university-hospital education program, on the feasibility of the state using standardized, color-coded patient wristbands. Shown with part of their display are Ashley Canon, (left) Madilyn Moran, Jessica Langlois and Sarah Goranovich. courtesy Purdue University Calumet

Susanne Heinzman, MS, RN, ACNS-BC, is the adult health clinical nurse specialist at Saint Anthony Medical Center, Crown Point, IN, and also serves as the student liaison for the facility. As one of the clinical sites that participate with the Purdue Calumet senior capstone nursing course, Saint Anthony submitted three topics to be considered for student projects.

"Our projects are 'real' projects," Heinzman said. "We don't have the students do anything we don't utilize. They've done projects on pressure-ulcer prevention and creating a brief-free environment, and this semester's specialty was the wristband project."

There is a growing national movement to standardize color-coded alerts in hospitals to avoid medical errors resulting from confusion over what a wristband color indicates. For example, if a nurse works in two hospitals and yellow means fall risk in one location and do not resuscitate in another, it's easy to see the potential for grave error.

In the footsteps of Pennsylvania and Wisconsin, the state of Indiana is striving to standardize wristband colors within the state as well as with adjacent states. Heinzman thought bringing the students' unbiased, fresh perspective to the issue would help pull northwest Indiana hospitals together and improve communication among them.

According to Peggy Gerard, DNSc, RN, dean and professor at the Purdue Calumet School of Nursing, students work in groups of three or four, and begin their capstone project by reviewing the literature to obtain current evidence related to their chosen topic. They then synthesize the evidence and propose a solution.

"In some cases, they have been able to implement the solution to the point of developing a toolkit - close to what Project Wristband was able to do. In other cases, the students will review the literature and make recommendations," Gerard said.

Project Wristband was actually completed over 2 semesters. The first group of students reviewed the literature, synthesized the evidence and began to develop recommendations. The second group picked up with the recommendations and looked further into what was happening around the country regarding color-coded wristbands.

It was a student during the second semester of work, Jessica Langlois, who called the Indiana Hospital Association, and spoke with "someone there named Betsy Lee," who was a "wealth of information." When Langlois shared this information during a project meeting, Heinzman's eyes grew wide with excitement. "Do you know what she does there?" Heinzman asked.

That would be Betsy Lee, MSPH, RN, director of the Indiana Patient Safety Center, who communicated with the group throughout the past semester as the students developed their toolkit, and is now incorporating some of their work into the Wristband Standardization Toolkit available on the safety center Web site.  

Foundation for Success

Gerard described Project Wristband as "one of these times where an idea develops and gets implemented, and turns out to have positive benefit beyond what you anticipated." Both she and Heinzman used the term "snowballed" when talking about the momentum the project has gathered.

In addition to their class requirement of creating a poster presentation, Langlois, Madilyn Moran, Sarah Goranovich and Ashley Canon also made a PowerPoint presentation to the vice presidents of risk management, quality and patient care at Saint Anthony Medical Center and to the chief nursing officers from Saint Anthony affiliate hospitals. Finally, they presented their wristband recommendations at Methodist Hospital in Merrillville, IN, to an audience of chief executive officers from northwest area Indiana facilities.

"Our entire corporation has been meeting to standardize [wristband colors] across our organization, and it's all been led by the student initiative," Heinzman said.

Gerard added, "It's been a great opportunity for the students to see the many ways nurses can make an impact on patient care and patient outcomes. They also learn how to work well in teams and how to collaborate with people from other disciplines. They are able to experience how to implement change in an organization and all the factors that need to be taken into consideration when trying [to do so]."

The project, which consisted of a policy template, staff education and competency tools, and patient education materials, has been adopted by Saint Anthony Medical Center and its affiliates.

"[The students] diligently worked on the project and have been rewarded with unexpected opportunities and positive outcomes. One of the opportunities I found especially rare was a chance for the students to observe hospital executives discuss the pros and cons of a practice change and collectively make a decision," Landrum said.

"Not many frontline nurses get this kind of opportunity, let alone undergraduate students."

Barbara Mercer is senior associate editor at ADVANCE.