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Miracle Workers

NICU nurses drive initiatives for optimum patient and family care.

When administrators at Children's Hospital Central California started planning renovations for its level III NICU, they turned to the nurses who worked on the unit for guidance. When new evidence-based practice models were suggested, it was by the RNs on the NICU. It was the nurses again who drove multidisciplinary councils addressing issues and practice opportunities.

For these actions, and more, the NICU staff was named ADVANCE's 2009 Best Nursing Team. Randy Guerrero, BSN, RN, NE-BC, executive director of critical care services, couldn't be more proud of the nurses he calls "amazing people providing incredible care." (Click here to view the ADVANCE Best Nursing Team award presentation!)

Multidisciplinary Marvels

Since 1974, Children's Hospital Central California has been providing NICU services for a nine-county, 45,000-square-mile area, from Los Angeles to Stockton and from the Pacific across the Sierras. Tucked in the rolling plains between Fresno and Madera on perfectly manicured grounds, the facility cares for about 1,000 neonates a year in an 88-bed level III NICU plus 16 level II NICU satellite beds. It takes a strong team, dedicated to the smallest patients, to meet the challenge.

That it is, Guerrero said. Made up of nearly 200 RNs; more than 50 aides, unit secretaries, lactation consultants, clinical nurse specialists, nurse practitioners and managers; and an equal number of physicians, therapists, case managers, pharmacists and dieticians, the team is ready to handle any situation, from the most delicate pre-term infant to parents about to take their child home. Children's Hospital, a Magnet facility, provides an environment encouraging and celebrating nurses' autonomy, decision-making, empowerment and initiative.

"Our NICU team has implemented unit-based, participatory governance committees that support practice, education and quality," Guerrero said. "In addition, staff nurses - not managers - have taken leadership roles on the councils, looking at practice, family-centered care, quality, professional development and recruitment and retention."

"This truly demonstrates what Magnet is to nurses," added Beverly Hayden-Pugh, MOB, BSN, RN, NE-BC, vice president and chief nursing officer. "What it means at the unit level is bedside nurses driving care drives quality. Evidence shows quality outcomes are better."

Quality Initiatives

Guerrero said team initiatives range from clinical (reducing catheter-associated bloodstream infections - CABSI) to didactic (2-day introductory orientation for new nurses emphasizing the unit's culture) to something approximating nursing's pure heart (efforts to provide Christmas presents to families staying at the associated Ronald McDonald House). No matter the focus, the drive comes from the staff.

"The Partners in Care (PIC) committee is one outstanding example of what these nurses have done," Guerrero said. "They recruited parents of three previous patients, then used their input to develop multilingual parent discharge courses for current families."

Miracle Workers

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