Nursing Initiatives Improved Patient Care
» Pressure Ulcer Prevention
Ana Lisa Besa-Tse RN, MICU, Jacqueline Boyd RN, G. Watson–Grey , Assistant Director of Nurng
The journey to pressure ulcer prevention in our Medical Intensive Care Unit (MICU) started in 2007 with the recognition that half of the patients who developed ulcers had them on the sacrum (at the base of the spine) and heels. A comprehensive educational plan was implemented for all staff. An educational pamphlet was also developed for patients and their families to engage them more fully in this aspect of their care. Improvement was rapidly noted.
In 2010, a multidisciplinary team was formed to conduct weekly rounds on all MICU patients, offering bedside clinical instruction as well as recommendations for treatment. Rounds were then extended to all inpatient areas. Gainosuke Sugiyama, MD, assistant professor of surgery, joined the pressure ulcer team in 2011, and due in large part to his knowledge, teaching, and support, our outcomes continued to improve dramatically. By the second quarter of 2011, our national benchmark data showed that our median prevalence rates for hospitalacquired pressure ulcers stage 2 and above was 0.00 in the MICU.
Wound Care and Ostomy Nurse Bruno Valcin, RN, who heads UHB's Pressure Ulcer Prevention Program, says that hospital-acquired pressure ulcers have dramatically decreased throughout the hospital in 2012. "We now have one of the lowest rates of hospital-acquired pressure ulcers as compared to the more than 1,800 hospitals in our benchmark database," he reports.
The Nursing Department was honored to have the MICU nurses present a poster on pressure ulcer prevention at the University HealthSystem Consortium's Annual Meeting Research Day Conference in September 2012. This was the first time a nursing poster from SU NY Downstate was presented at this conference.
» Reducing Noise on Our Clinical Units
Yunona Zaytseva, RN, gets the green light for keeping
things quiet at NS 32
Noise reduction is one of the most inexpensive corrective actions that nursing staff can implement in their hospital units to improve patient satisfaction and promote healing.
Excessive noise can make patients sicker and extend their length of stay unnecessarily.
To make sure that noise is kept to a minimum, UHB's Women and Children's Services has installed an ingenious and very effective early-warning system. At nursing stations 31, 32, 35, 42, and 43, we use a device modeled to look like a traffic light to let staff know when it is necessary to quiet down. If the noise level rises above a set threshold, the light changes from green to amber. If the noise continues to rise, the light will change to red.
The settings for the different units vary depending on competing noises. In the PICU and NICU, for example, the noise thresholds are higher due to the sounds from mechanical equipment.
At some of the nursing units, the traffic light has a smiley face whenever the noise level is kept down, but a frown appears as soon as the noise rises. This is a friendly reminder to staff that the unit needs to be kept quiet for healthy healing to take place.
Thanks to this simple innovation, Press Ganey patient satisfaction scores for these units have all gone up.
» Nursing Affiliation Program:
Reaching Out to International Nurses to Share Innovations in Nursing Practice
Pictured (l. to r.): International Nursing Affiliation Coordinator Tao Liu, MSN, RN; Lili Duan, RN; Hongdi Du, RN; Chief Nursing Officer Margaret Jackson, MA, RN; and Xia Zhao, RN
Tao Liu, RN MSN, CLC, assistant director of nursing, Department of Nursing Education, Professional Practice, and Research, recently welcomed three registered nurses from Beijing, China, who will be living on campus for three months to observe how we provide nursing care.. As coordinator for UHB's International Nursing Affiliation Program, Ms. Liu has hosted five contingents of Chinese nurses since the program began in 2011.
"Our visitors from China are not licensed to practice here, but they can learn a great deal by shadowing our nurses as they make their daily rounds," stated Ms. Liu. "Nursing intervention and documentation requirements in China are very different than in the United States. In China, hospitals do not generally have nursing assistants, unit clerks, social workers, nutritionists, and rehabilitation therapists on staff, Their nurses handle such roles."
On April 11, 2013, Ms. Liu welcomed a second group of foreign observers from Holland. These observers, who all have advanced nursing degrees, were most interested in hearing about the level of autonomy and collaboration that exists between nurses and physicians in various specialty areas here, and about future trends in advanced nursing practice.
The International Nursing Affiliation Program offers experiences that equally benefit foreign observers and our nurses. "It's a terrific opportunity to share ideas, promote cross-cultural understanding, and gain a broader perspective on global healthcare needs," says Ms. Liu. "It's a win-win for everyone involved."
Downstate nursing leaders Dianne Forbes Woods, Nellie Bailey, and Tao Liu (center) welcomed a large contingent of Dutch observers in April.