This rural community hospital’s ICU nurses celebrate multiple patient safety accomplishments
TEAM: Cardiac & Intensive Care Unit nurses
ENTRY SUBMITTED BY: Laura Reilly, MSN, RN, CCRN, CNRN, Manager, ICU
Newton Medical Center is a 150-bed, rural, community hospital in New Jersey. The combined cardiac and intensive care unit (ICU) of 10 beds is staffed primarily with experienced RNs and a small compliment of nursing assistants. Our sickest patients arrive from the ED or other inpatient departments. It is an outstanding achievement that throughout 2015, the infection rate in the ICU was zero for ventilator- associated conditions and infections, central IV line infections, and device-related urinary tract infections. There were no MRSA infections and only one C Difficile infection. It has been more than 330 days since the one uninjured patient fall in 2015.
The Joint Commission’s Center for Transforming Health invited Newton Medical Center to take part in a national project, which originally included only 5 healthcare systems. Newton became the smallest hospital to participate. ICU nurses, in collaboration with ED nurses, physicians and other allied health professionals, enthusiastically volunteered to become part of the “big picture” for sepsis management. The implementation phase (including sepsis “present on admission” and “not present on admission”) began in 2013.
Newton’s ICU nursing team, still continuing to collect data, has hard-wired its evidence into consistent practice since this time. We consistently decreased severe sepsis mortality over the next three years, becoming recognized as the “Flagship for Atlantic Health System’s sepsis management,” and receiving acknowledgement from the New Jersey Hospital Association as the facility with the lowest severe sepsis mortality in 2015 (out of 70 hospitals in the state).
Newton has several policies in place that support patient care, ultimately resulting in excellent outcomes. Daily review during interdisciplinary rounds to evaluate the necessity for IV lines (and other devices) leads to early discontinuation. Central intravenous line insertion and management follows evidence-based protocols. ICU nurses, through a unit-based shared governance collaboration, modify and perform root cause analysis to prevent patient injury.
In 2014, Newton’s ICU nurses began working with our palliative care APN to develop a nursing plan of care that would allow patients and family members to digest, interpret and transition gradually toward a loved one’s end of life. Individualized plans of care are communicated and executed in phases by nurses on all shifts, every day, which ensures the patient is made comfortable during all phases of disease and injury assault.
Newton was further recognized by the New Jersey Organ and Tissue Sharing Network in 2015 for 100% referral compliance, resulting in 918 tissue and eye gifts from 18 donors. This organization recently commended our ICU for the successful harvest of 6 organ transplants from a single patient donor in December 2015.
Daily leadership huddles (with other clinical and support departments) and twice-daily department huddles keep staff informed about patient experience scores and clinical outcomes, reiterating ongoing efforts to keep high-quality patient care the focus of activities in all departments. Our chief nursing and operations officer, an extensively experienced critical care APN, assists the ICU in their efforts as a voting member of the medical executive committee.
The ICU nursing team also leads Newton’s “rapid response team” and the “cardio-pulmonary arrest team,” and in 2015, was added to the “stroke response team.” ICU’s collegial team contributed to Newton ‘s recognition by the NJ Department of Health’s Advanced Certification “Get With The Guidelines ® Stroke Gold Medal Plus achievement award” and with the “Target: Stroke Honor Roll Elite Award” from the American Heart Association and the American Stroke Association in 2015.
In summary, the ICU nurses at our facility represent a remarkable team of committed professionals who can adapt to the dynamic forces in healthcare. We are an essential, accountable core resource to nursing at Newton Medical Center.