SE2EOb
Professional Organization SE2EO
Using the required EO presentation format, provide one example of an improved outcome associated with the application of nursing standards of practice implemented due to a clinical nurse’s(s’) participation in a nursing professional organization.
Example b: Clinical Nurses’ Participation in Reducing HAPIs in MICU/SICU
The Surgical and Medical Intensive Care Units (SICU/MICU) at Catholic Health Initiatives (CHI) St. Vincent Hot Springs (SVHS) had an increase in their rate of hospital acquired pressure injury (HAPI).
Pre-Intervention
In January 2024, HAPIs in the Surgical ICU (SICU) and Medical ICU (MICU) significantly increased. Multiple interventions to prevent pressure injuries had been initiated before January 2024, without success. On January 17, 2024, ICU Unit-Based Council (UBC) members Logan Jenkins, BSN, RN, CCRN, Clinical Nurse and Patient Care Coordinator, and Brooke Rowland, BSN, RN, CCRN, Clinical Nurse, collaborated with Eric Riggan, BSN, RN, CWOCN, COCN Clinical/Enterostomal Nurse to address the recent increase in HAPIs on the SICU and MICU. During their meeting, Riggan, a WOCN and COCN certified nurse, shared guidance from the Wound, Ostomy, and Continence Nurses Society (WOCN), a nursing professional organization. Riggan uses the standards of practice outlined in the WOCN Society’s Core Curriculum on Wound Management to drive wound prevention and management practices and make recommendations at CHI SVHS.
The WOCN Society’s Core Curriculum on Wound Management provides evidence-based practice nursing guidelines to address all crucial aspects of wound care, including general principles of wound management, assessments, interventions, and standards of practice for pressure injury prevention. The WOCN Society supports using air pressure beds to reduce HAPIs in ICUs. Riggans, in collaboration with Jenkins and Rowland, identified the need for hospital-owned beds with alternating pressure mattresses in the SICU/MICU to reduce pressure injuries.
Jenkins and Rowland collaborated with Riggans to recommend to the Vice President of Patient Care Services, Assistant Chief Nursing Officer (role of CNO), Teresa Lambert, MBA, BSN, RN and ICU Clinical Director, Renee Fechuch, MSN, RN to transition all SICU/MICU beds to alternating pressure beds/mattresses by Linet air beds. Purchasing these beds specifically for the SICU/MICU would ensure these departments no longer experience shortages of active support surfaces and ensure they have the resources needed to prevent pressure injuries.
On January 20, 2024, Clinical Nurses Jenkins and Rowland submitted to Lambert a Situation, Background, Assessment, and Recommendation (SBAR) to request the purchase of the specialty Linet air beds for the SICU/MICU. Transitioning to Linet air pressure beds would be cost effective in the long run by decreasing the costs related to HAPIs, the average length of stay, and the resources required to replace patients’ beds (pulling multiple nurses, technicians, and respiratory therapists away from other patient care). Lambert approved the immediate purchase of the Linet air beds.
The SICU/MICU HAPI rate was 19.66 in January 2024. This rate is calculated by dividing the total number of HAPIs in the SICU/MICU for the month by the number of patients surveyed in the SICU/MICU for the same month and multiplying by 100.
Goal Statement
Reduce the HAPI rate in SICU/MICU.
Participants
SICU/MICU HAPI Workgroup
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Name/Credentials |
Discipline |
Title/Role |
Department |
Eric Riggan, BSN, RN, CWOCN, COCN |
Nursing |
Clinical Nurse, Enterostomal Nurse |
Inpatient Diabetes/Wound |
Logan Jenkins, BSN, RN, CCRN |
Nursing |
Clinical Nurse, Patient Care Coordinator |
Surgical ICU |
Kaitlyn Atkins, MSN, RN, |
Nursing |
Clinical Director of |
Nursing |
Renee Fechuch, MSN, RN |
Nursing |
Clinical Director of Nursing |
Nursing Administration |
Teresa Lambert, MBA, BSN, RN |
Nursing |
Vice President of Patient Care Services, Assistant Chief Nursing Officer (role of CNO) |
Administration |
Brooke Rowland, BSN, RN, CCRN |
Nursing |
Clinical Nurse |
Surgical ICU |
Description of the Intervention
February 2024
- Clinical Director of Nursing Kaitlyn Atkins, MSN, RN, CPN collaborated with CHI SVHS national purchasers to order the Linet air beds.
- T. Lambert contacted Delana Lambert, MNSc, RN, ACNS-BC, Clinical Educator, to connect with the Linet air bed vendor representative about education for the SIUC/MICU clinical nurses.
- D. Lambert contacted Don Brown, the vendor representative for Linet air beds, to come to CHI SVHS to educate the SICU/MICU clinical nurses on the beds.
- Brown educated the SICU/MICU clinical nurses on the full operation of the Linet air beds, including the mechanics of the frame, how to operate the alternating pressure options, how to use the transfer assist function, and how to weigh patients. Brown set up the Linet air beds in a room from 0900-1200 on February 22, 2024 as an open forum to enable nurses to come by for an in-service, operate the beds, and ask questions.
- The Linet air beds arrived at the hospital and were placed in the SICU/MICU, and the clinical nurses started using them immediately. The SICU/MICU team coordinated the transfer of current patients to the new beds based on patient assessments using the Braden score for pressure injury risk.
The interventions were fully implemented by the end of February 2024.
The implementation of the WOCN Society nursing standards of practice due to Clinical Nurse Riggan’s participation in this nursing professional organization, was associated with an improved outcome in the SICU/MICU.
References:
Bambi, A. A., Yusuf, S., & Irwan, A. M. (2022). Reducing the incidence and prevalence of pressure injury in adult ICU patients with support surface use: A systematic review. Advances in Skin & Wound Care, 35(5), 263–270. https://doi.org/10.1097/01.asw.0000824552.38110.e7
Doughty, D., & McNichol, L. (2016). Wound, Ostomy, and Continence Nurses Society core curriculum. Wound management. Wolters Kluwer.
Kamdem, S. F. (2022b). (dissertation). An ICU-specific pressure injury risk assessment tool to improve outcomes. Scholars Crossing.
Wåhlin, I., Ek, A., Lindgren, M., Geijer, S., & Årestedt, K. (2020). Development and validation of an ICU‐Specific Pressure Injury Risk Assessment Scale. Scandinavian Journal of Caring Sciences, 35(3), 769–778. https://doi.org/10.1111/scs.12891
Outcome
(Evidence SE2EOb-1, SICU/MICU HAPI Rate Graph)