An integral component of nursing practice at Lurie Children’s is nursing’s contribution to interprofessional teams that positively impact patient care. Jaquie Toia, DNP, APRN, CPNP-PC, Infectious Disease and Lauren Sorce, PhD, APRN, CPNP-AC/PC, FCCM, FAAN, Founders’ Board Nurse Scientist and Assistant Professor of Pediatrics (Critical Care), are two examples of nurses co-leading interprofessional research teams that have improved patient outcomes.
Antimicrobial use at the end of life
The collaboration of pediatric nurse practitioner Toia and Sameer Patel, MD, in infectious disease research provided an evidence-based approach to antibiotic use at end of life. Toia’s years of working with complex patients and families at end of life as well as her attention to vital research and Dr. Sameer’s advanced research analytics on antibiotics utilization were crucial for bringing the project to fruition. “We hope our efforts can improve communication between families and providers, and between teams of providers regarding antibiotic use at the end of life in our most medically complex children,” said Toia. Today their insights are shaping how the hospital’s infectious diseases team determines antibiotic use and emphasizes the importance of recognizing family and patient viewpoints and including them in the conversation.
Critical care collaboration
The clinical trial experience and nurse professional development expertise of Sorce presented a unique opportunity to partner with Kelly Michelson, MD, MPH, Critical Care, and the Julia and David Uihlein Professor of Bioethics and Medical Humanities. Their interprofessional, collaborative approach has produced multiple outcomes that have improved the care of children in the Lefkofsky Pediatric Intensive Care Unit. One study looked at how nurses using a sedation algorithm could safely manage the sedation of children on ventilators and reduce the overall amount of sedation required in some cases. The investigator pair also focuses on support interventions to help patients, families and care teams navigate complex communications and decision-making in the intensive care environment. Additionally, Sorce and Michelson have partnered to overcome barriers to pediatric critical care research, such as complex issues with biospecimen collection, banking and multicenter trial implementation.
Code Rainbows successfully executed in FY22
Comfort and care for the youngest heart patients
The dedicated Fetal Cardiology Nurse Coordinators in Lurie Children’s Fetal Cardiology Program, Catherine Fitt, BSN, RN, CPN and Robin Norwood, MSN, RN, CNL, ensure continuity of care that begins before birth. The Coordinators work together with families and the interprofessional care team to coordinate care for patients with fetal cardiac diagnoses including scheduling needed prenatal imaging and tests, providing families with prenatal counseling based on fetal diagnoses, preparing complex fetal delivery plans, developing postnatal action plans and providing long-term care consults. In the past couple of years, Fitt and Norwood have played an integral role in the development of the Code Rainbow process. This process ensures patients with the most fragile fetal cardiac conditions have a seamless transfer from their birth hospital to Lurie Children’s Cardiac Care Unit, helping reduce the time a critically ill newborn spends on low oxygen or with low blood pressure.
To make sure each Code Rainbow runs smoothly, Fitt and Norwood design patient-specific Code Rainbow simulations before delivery day that bring together the multiple teams to walk through each step of the Code Rainbow plan. Together, the team identifies needed communication points, supplies, equipment, medication and specialty skills that will be needed to achieve the optimal patient outcome. Last year, the Coordinators led 16 Code Rainbows successfully. “The nurses are the glue that keeps all Fetal Cardiology team members together and informed, working toward a shared goal of achieving the best outcomes for our youngest patients with congenital heart disease,” said Sheetal Patel, MD, Medical Director of Fetal Cardiology Program.
“The nurses are the glue that keeps all Fetal Cardiology team members together and informed, working toward a shared goal of achieving the best outcomes for our youngest patients with congenital heart disease,”
— Sheetal Patel, MD, Medical Director of Fetal Cardiology Program.