Evidence
Nurses Act to Reduce Hospital Acquired Conditions
Carrie Kass, BSN, RN, CPHON, CPN and Stephanie Jones, MSN, RNC, NIC, CBC
Any hospital on the journey to be a High Reliability Organization must address hospital-acquired conditions (HAC), and nurses have taken a lead role in this work at Lurie Children’s. All HAC reduction work is co-led by a nurse with a physician or other healthcare professional. The Clinical Quality Coordinators (CQC) play a pivotal role in this work and recognized the importance of clinical nurse involvement, thus starting the RN HAC Committee. Led by Stephanie Jones, MS, RN, RNC-NIC, CBC, CQC and Carrie Kass, BSN, RN, CPHON, CPN, CQC, the committee was formed to coordinate HAC prevention efforts within nursing workflows and engage all nurses in HAC prevention. The committee hosted its first quarterly prevalence day in March 2023. Over the course of an 8-hour day, every patient in the hospital was assessed for their risk of developing a HAC. Nurses assessed 269 patients that day and identified 162 interventions.
“It was a very successful day of education about HACs and provided a lot of engagement from the clinical nurses. Many issues were identified and escalated,” said Jones. “We want nurses to realize what a huge role they play in HAC reduction and that Lurie Children’s can't reduce injuries related to HACs without them. Their education and championing of the HAC reduction work is crucial.”
Lurie Children’s is one of just 3 hospitals across the country offering a pediatric CRNA Fellowship program.
Lurie Children’s CRNAs: Leaders in their specialty
Lurie Children’s Certified Registered Nurse Anesthetists (CRNA) is a team of advanced practice registered nurses with specialized training in the administration of anesthetics. CRNA expertise is a crucial aspect of high acuity procedures including cardiac and maternal/fetal health where sub-specialty teams provide nuanced anesthesia care to some of the most vulnerable children. Lurie Children’s CRNAs are industry leaders in academia and mentorship. In addition to educating nurses, APPs and physicians in airway management, the team has a regional and national presence and consistently represents Lurie Children’s among professional peers. “At the AANA 2023 Annual Congress, we had five CRNAs at the podium, which is more than any other medical center in the country,” says CRNA Manager Audrey Rosenblatt, PhD, APRN, CRNA. Impressively, five of our CRNAs were also contributors to the field’s first pediatric anesthesia textbook, and Lurie Children’s is one of just three hospitals across the country offering a pediatric CRNA Fellowship program. The program became accredited in 2021 and the first CRNA fellows were enrolled last year.
30+
Nurse led research projects in progress
Interpreters for families with limited English proficiency
Lakisha Williams, MSN, RN, CBC with patient
Over the last two years, the Nursing Patient/Family Experience Committee (PFE) has been making efforts to bridge the gap in equity and quality of experience for patients and families with limited English proficiency. The PFE Committee’s initiatives to increase nurses’ usage of interpreting services have been successful. “We have made efforts to educate nurses on how to utilize an interpreter and when. In addition, we have made it easier and more intuitive for nurses to access an interpreter with portable tablets that can be rolled to the bedside,” said Sarah Wilson, MSN, RN, CPN, Resource Team, Chair Patient and Family Experience Committee. Through these education efforts and improved access to interpretation technology, the PFE committee has improved EPIC documentation of interpreter usage and had a positive impact on patient satisfaction scores.
Preventing suicide through evidence-based screening
Ashley Miller, BSN, RN, CPN and Skyler Tomko, BSN, RN
The pandemic unmasked the mental health crisis among youth and adolescents. Early identification and treatment of patients at elevated risk for suicide is a key suicide prevention strategy. The Nursing Quality Council recognized an opportunity to help address the growing number of patients in need of intervention and mental healthcare. “Using the National Institute of Mental Health’s Ask Suicide-Screening Questions (ASQ), an interprofessional team led by Lurie Children’s nurses developed an algorithm for standardizing the operation of the ASQ in our organization,” said Anna Lund, MSN, RN, CNL, CPN. ASQ is an evidenced-based tool that consists of four yes or no questions and takes only 20 seconds to administer. Screening identifies individuals who require further mental health and/or suicide safety assessment and is conducted in the Emergency Department, procedural areas, inpatient units and some outpatient settings. “Often a patient’s first point of contact with care is in the Emergency Department. The suicide screening work led by Skyler Tomko in the Emergency Department has positively impacted our patients. They are getting connected to needed resources, appropriate interventions and care,” said Lund.
269
Patients assessed in 1 day for hospital-acquired conditions in first quarterly prevalence day