Other Nursing Commons^™

Icu Liberation: Early Mobility And Exercise, Vanessa Fuller, Andrea Nyquist

Nursing Posters

ICU Liberation:

The Society of Critical Care Medicine’s (SCCM) Intensive Care Unit (ICU) Liberation Bundle was created to reduce the harmful effects of events that occur in the ICU setting. Early mobility and exercise is part “E” of the ICU Liberation Bundle; goals are to reduce ICU and hospital length of stay (LOS), prevent readmissions, reduce discharges to long term care facilities, reduce delirium and coma days, and reduce likelihood of hospital mortality (SCCM, 2021)

Preoperative Weight Loss For Patients Undergoing Lumbar Spine Surgery Utilizing Motivational Interviewing To Decrease Postoperative Complications: A Quality Improvement Project, Amanda Welle

Nursing Posters

Do patients who are obese, based on BMI>30 and are offered lumbar spine surgery, who undergo preoperative MI via telehealth to lose weight, compared to those who don’t undergo MI have decreased postoperative complications at 30 days postoperatively?

Conclusions/Implications:

• Results from this QI project suggest a higher BMI class is associated with postoperative complications-wound infection.
• However, given the small sample size no conclusions could be drawn
• This QI project should be replicated on a larger scale
• The process for recruitment and intervention is established. The Neurosurgical providers are supportive of the continued study.

Very Important Discharge Appointment (Vida), Jennifer Burris, Holly Kockler, Gail Olson, Kristi Patterson, Natasha Pflueger, Jennifer Salzer, Leann Volkers

Nursing Posters

To improve patient flow, access, and decrease strain on resources by enhancing the current process of Discharge and Loop Back Huddle by identifying two patients for early discharge the next day.

Current Practices:

• Discharge huddle and Loopback (Discuss care progression for all pts)
• Discharge planning using the IDEAL Model (Patient and Family Engagement with Discharge)
• Electronic Discharge Readiness Tools (Exp Discharge Date, Discharge milestones, etc.)

Next piece of the puzzle:

• VIDA: a framework to identify 2 patients to be discharged before 11 am – so the bulk of our discharges do not occur between Noon and 4:00 pm.
• Decreasing the …

Neurointerventional Post-Procedure Assessment And Documentation Compliance, Chandra Brower

Nursing Posters

Per stroke best practice guidelines, pulse and groin checks need to be completed post-neurointerventional procedure per orders. Our plan is to improve assessment and documentation of post-procedure pulse and groin checks by improving the flow of the Electronic Medical Record (EMR). By enhancing clinical documentation and improving the documentation process, nursing practice can be supported, and best patient care delivered.

Implementation And Standardization Of Evidence Based Practice For Reprocessing Of Flexible Endoscopes, Patricia Dumonceaux, Jenna Rooda, Dena Walz

Nursing Posters

To improve patient safety and quality of care by implementing a standardized process for high level disinfection (HLD) of flexible endoscopes

Increasing Access To Data Through Microsoft's Power Bi, Rumana Ahmad, Kristi Patterson

Nursing Posters

What is Power BI?

• A collection of software services, apps, and connectors that work together to turn unrelated sources of data into coherent, visually immersive, and interactive insights.

What’s in it for me?

• Users can quickly & easily explore trends for CC inpatients across common outcome measures including case counts, length of stay, mortality, & unplanned readmissions to help identify variation & opportunity for improvement. For example, compare COPD patient case counts, length of stay,and in-house mortality across CC hospitals.

No One Goes Missing: Creating An Elopement Risk Safe Plan Of Care, Jennifer Burris, Kathryn Collins, Holly Kockler, Tiffany Omann-Bidinger, Elizabeth Plante

Nursing Posters

To identify patients at risk for elopement by developing an evidence-based elopement risk screening tool and plan of care.

Admission Documentation Overhaul, Jennifer Burris, Holly Kockler, Hillary Waldum

Nursing Posters

Improve the admission documentation workflow by revamping the admission Navigator and Functional Health Assessment

High Reliability Principles In Safety, Abby Henderson, Leigh Klaverkamp

Nursing Posters

• Subject matter experts compare actual performance to expected performance.
• A standard set of questions for specific subtypes of events help establish trends.
• HRO's (High Reliability Organization) equip leaders and frontline staff to spot systemic causes of human error.

Improving Hepatitis B Vaccination Rates In Nephrology Patients With Chronic Kidney Disease: A Qi Initiative, Jill Swanson

Nursing Posters

• Hepatitis B vaccination is an important health maintenance preventative measure for patients with chronic kidney disease (CKD)
• Prior to initiating dialysis, hepatitis B vaccination administration is proven to be more effective than waiting until patients begin dialysis treatments.
• Efficacy and immune response of the hepatitis B vaccine is greater when kidney function is greater
• To better improve hepatitis B vaccine administration among the CKD stage 4 population, education measures and Epic modifiers will be implemented to achieve change
• Nursing knowledge and hepatitis B vaccine administration will improve after implementation of these measures

A New Approach To Sternal Precautions: Keep Your Move In The Tube, Kelijo Fernholz, Jayna Theis, Erik Anderson

Nursing Posters

Purpose:

• To guide patients and staff in a new approach to sternal precautions following median sternotomy

Current Practice:

• 10-pound lifting restriction for 4 weeks
• 20-pound lifting restriction until 3 months post operation
• Limited arm exercises
• Sit to stand push restrictions

Why Change:

• Literature review demonstrates great variation in sternal precautions
• Currently too restrictive; may hinder recovery and long-term mobility. Too many restrictions can create fear of movement, resulting in short term rehab discharge needs
• To create more independence for the patient, less reliant on family members for ADLs and basic needs. Patients to return to regular home and work activities …

Performance Improvement Leadership Rounding Implementation, Dena Walz

Nursing Posters

To improve patient experience scores and address patient concerns in real time.

A proactive behavior that facilitates leaders building relationships with patients and families, managing expectations, and achieving and validating consistency of key behaviors.

A member of leadership will conduct a purposeful conversation with a chosen patient three days a week regarding the care provided during their procedural appointment.

Contemporary Treatment Options For Pulmonary Embolism, Tanya Glenz, Teresa Jahn

Nursing Posters

Purpose:

Provide RNs education on the classifications of PEs and new catheter directed treatment options.

Significance:

• PE remains a common and lethal entity
• PE is the 3rd leading cause of cardiovascular death in hospitalized patients (60,000-1000,000 per year)
• 150,000-250,000 PE related hospitalizations per year
• RNs must be knowledgeable of the classifications of PEs and catheter directed therapies to promote positive patient outcomes
• Prior to catheter directed therapies, submassive PEs had a mortality rate up to 20% at 3 months and were traditionally treated with IV heparin, or oral anticoagulant therapy

Routine Post Surgical Vital Signs: Time For A Change, Kristina Kjellberg, Elizabeth Plante, Sadie Seezs

Nursing Posters

Purpose Statement:

The purpose of this evidence-based practice project is to evaluate the current routine post operative vital signs and determine if reduced frequency of vital signs is as effective in identifying deterioration after a post anesthesia care unit (PACU) discharge.

Synthesis of Evidence:

• Patient survival in the post operative time period is maximized with the recognition and management of abnormal vital signs
• Post op periods can carry great respiratory and circulatory complications, which are identified by abnormal vital signs especially heart rate and blood pressure
• Multiple sources have identified that current frequency of post operative vital signs is based …

Rapid Evaluation Teams (Ret): No Longer Just For Hospitals, Amanda Thorson

Nursing Posters

Study:

Everyone goes to the Nursing Home for End of Life - Right? Wrong Cumulatively, over a 4-year study there were 678 residents with Full Code status residing at Carris Health Care Center and 687 residents the DNR/DNI status. That is only a 10-resident different between Full Code and DNR/DNI

Plan:

• Improve long-term care staff's ability to call for, and receive, support to rapidly evaluate and address an urgent or concerning situation.
• Need for this plan is supported by increased number of OHFC substantiated events related to code status in MN and number of residents with Full Code status in …

Suspension Of Independent Double-Check For Subq Insulin Administration, Mallory Mondloch, Jennifer Watson

Nursing Posters

Study:

After a 1-month pilot of suspending the dual sign-off/independent double-check process, 160/163 random subQ insulin administrations from various units were administered correctly. This yielded a 98% success rate. No patient harm occured.

Plan:

Per Institute of Safe Medication Practices, dual sign-offs/independent double-checks are more effective for select high risk meds and not all. Since implementation of the insulin calculator, medication errors related to subQ insulin administration have reduced compared to previously when solely two licensed staff members performed a manual, independent double-check. After implementation of the validated eMAR tool - the insulin calculator - it was still required for …

A Practice Innovation To Improve Staff Vaccination Knowledge And Skills, Ijeoma Ugochukwu

Nursing Posters

Abstract:

The practice improvement project explored the best practices for equipping CentraCare Health System's (CCHS) Licensed Practical Nurses (LPNs) and Certified Medical Assistants' (CMAs) with childhood vaccination knowledge and communication skills necessary to educate hesitant patients and parents about the benefits of vaccination compliance. Innovative computer-based education (CBE) was identified and developed to empower LPNs and CMAs working in the ambulatory setting with childhood vaccination knowledge and communication skills to improve their ability to educate hesitant patients and parents about the benefits of vaccination. The CBE module was guided by the Theory of Planned Behavior in identifying vaccination knowledge and …

Implementation Of A Chemotherapy Guideline: A Quality Improvement Project To Standardize The Chemotherapy Delivery Process, Sara Maciej

Nursing Posters

Adjusting chemotherapy rates is one gap in chemotherapy practice that evokes inconsistency. The purpose of this project was to implement a standardized guideline for staff to utilize in adjusting rates of chemotherapy medications.

Deep Tissue Injuries, Mary Pohlmann, Katie Meyer

Nursing Posters

Purpose Statement from Poster:

• Recognize and identify Deep Tissue Injuries
• Ability to describe and define Deep Tissue Injuries
• Increase awareness of Deep Tissue Injuries in order to promote early identification and treatment

Implementation Of Proper Lead Selection Based On Ecg Practice Standards In Hospitalized Patients, Teresa Jahn, Nicole Hubbard, Samantha Pohlmann, Lauren Hoeschen, Shayna Lahr

Nursing Posters

Ensure adult patients in a 36 bed Telemetry Unit and 14 bed Cardiac Intensive Care Unit (CICU) with the diagnosis of STEMI and NSTEMI are being monitored in the appropriate leads to detect acute or silent ischemia and arrhythmias.

Meeting The Educational Needs Of The Busy Bedside Nurse: Curbside Education An Innovative Program, Ashley O'Connell, Kayla Waldoch, Amy Junes

Nursing Posters

• Seek out educational needs of staff based on current changes, trends and new hires
• Provide on the spot reinforcement of skills, policies, education and policy changes for all staff
• Implement skill stations, including "off shifts", to increase staff cohesiveness and preparedness in emergent and nonemergent scenarios

Huddle To Enhance Patient Progression Of Care, Melinda Jennings, Kristi Patterson, Jennifer Salzer

Nursing Posters

CentraCare (CC) is committed to improving patient flow and is now using the Geometric Mean Length of Stay (GMLOS) Index as our primary measure of success. This is a Key Performance Indicator that is monitored by the Patient Flow Steering Committee and Executive Leadership. In recent years, SCH GMLOS Index is higher than expected.

Providing Education Regarding Antimicrobial Stewardship For The Bedside Nurse, Anna Boeke

Nursing Posters

• Two million people acquire drug resistant bacteria and around 23,000 die from infection-related resistance each year (CDC, 2018a) and Up to 50% of antibiotics are incorrectly prescribed, including usage, dosage, and duration (CDC, 2017)
• Clostridium difficile (C.diff) is a common problem seen in the hospital
• Antimicrobial stewardship (AMS) as a proven method of addressing the problem of antibiotic resistance by education, multidisciplinary efforts, and refined resource utilization
• The biggest problem is nursing staff are unsure how to participate in AMS!

Reduced Frequency Monitoring Post-Stoke Treatment, Melissa Freese

Nursing Posters

In 2020, the nation was faced with a pandemic that quickly depleted health care resources. Standards of care were reviewed to identify opportunities to reduce the burden on healthcare resources. One of the standards of care that was reviewed nationally and locally at the St. Cloud Hospital (SCH), was the postalteplase/ thrombectomy patient placement and monitoring.

The standard of care for the placement and monitoring of post-alteplase patients was established during the 1996 NINDS trial and has not been studied since. Very minimal literature is available on the standard of care for patient placement and monitoring post-thrombectomy.

St. Cloud Hospital Hand Hygiene Achievers, Patricia Dumonceaux, Sara Maciej, Jessica Reed, Tamara Welle

Nursing Posters

Develop and adopt a culture change to increase hand hygiene compliance across all St. Cloud Hospital (SCH) inpatient and outpatient departments

• Hand hygiene is the best method to prevent the spread of infection (CDC, 2017).
• Historical data for SCH indicated below desired goal of 95% compliance with hand hygiene practices and continued identification of hospital associated infections.
• Employee engagement best achieved through promoting culture of safety supporting hand hygiene best practices (Piras et al., 2018).
• Educating staff on the WHO 5 Moments of Hand Hygiene, developing monitoring process for assessing opportunities to complete moments of hand hygiene, and providing detailed …

Magnetizing: Post Operative Nausea And Vomiting, Andrea Nyquist

Nursing Posters

Purpose:

To guide nursing care in the early recognition and treatment of PONV.

Prevalence:

Postoperative nausea and vomiting (PONV) is the most prevalent postoperative complication occuring within 24 hours of surgery.

Risk Factors:

Adults at a higher risk of PONV include:

• Female
• History of PONV, motion sickness and/or gastroparesis
• Postoperative opioid recipient
• Volatile anesthetic and/or nitrous oxide administration intraoperatively
• Pregnancy
• Use of birth control pills

Implications:

PONV can create a plethora of adverse events for the patient: anxiety and a sense of dread, increased risk for bleeding, dehydration and electrolyte imbalance, risk for aspiration and airway obstruction, …

St. Cloud Hospital Nursing Director Orientation And Mentorship Program, Deb Eisenstadt, Tiffany Omann-Bidinger, Diane Pelant

Nursing Posters

Develop and implement an evidence-based orientation and mentorship program for nursing directors using AONE’s Nursing Executive Competencies along with a structure curriculum.

Enhancing Retention For Nursing Assistants: Effective Strategies To Reduce Turnover, Tiffany Omann-Bidinger

Nursing Posters

Develop and implement a hospital-wide, evidence-based recruitment and retention program to reduce turnover rates for Nursing Assistants (NAs).

Journey To Zero Ng-Related Hapi's, Kristin Gaarder

Nursing Posters

From October 2015 to April 2016, there were five Stage II or higher inner nares hospital acquired pressure injuries (HAPIs) caused by nasogastric (NG) tubes, with one being unstageable. These occurred despite previously implemented evidence- based prevention strategies, which included:

• Two-person skin assessments on admission and return from surgery

• Two-person skin assessment upon transfer from unit to unit

• Daily skin assessments including under devices

• Access to the Wound Ostomy Continence (WOC) team

What? Not Another Fall!: Reducing Falls In The Neuroscience Patient Population, Elizabeth Plante

Nursing Posters

The purpose of this evidence-based practice project is to reduce the fall rate from 5.52 to less than 4.80 on a Neuroscience/Spine Unit through increasing staff and patient awareness of fall risk and application of evidence-based fall prevention practices of communication, patient involvement and bedside report.