Recent nurse-led initiatives addressing some of critical care's most pressing challenges resulted in shorter average lengths of stay and other positive patient and fiscal outcomes in seven Philadelphia-area hospitals.
Teams of staff nurses developed the initiatives while participating in AACN Clinical Scene Investigator (CSI) Academy, a 16-month, hospital-based nurse leadership and innovation training program delivered and funded by the American Association of Critical-Care Nurses (AACN). The program empowers bedside nurses as clinician leaders and change agents whose initiatives generate quantifiable improvements in the quality of patient care and hospital bottom lines.
The Pennsylvania AACN CSI Academy teams measurably improved patient outcomes while demonstrating a combined fiscal impact of $2.7 million in anticipated annual savings to their organizations.
During a recent Innovation Conference in Philadelphia, the teams presented the results of their projects, reporting noteworthy clinical and fiscal outcomes. These results and supporting materials are available online in the free AACN CSI Academy Innovation Database.
Patient care quality improvements addressed by the teams include:
•Improving early mobility
•Preventing delirium
•Preventing pressure ulcers
•Reducing noise
•Improving teamwork and communication
•Eliminating readmissions
Among the most significant outcomes from the various initiatives were decreased average lengths of stay, ranging from reductions of less than a day to four full days. In addition to the direct benefit to patients, shorter lengths of stay can save hospitals thousands of dollars. The initiatives also achieved decreases in the incidence rates of pressure ulcers and repeat ICU admissions.
Anne Jadwin, RN, MSN, AOCN, NE-BC, vice president of nursing and chief nursing officer at Fox Chase Cancer Center, Philadelphia - whose CSI Academy team focused on delirium prevention - noted how the program empowered participants to be nurse leaders and quality improvement champions.
"By developing more proactive assessment protocols to recognize the delirium spectrum of symptoms early, our nurses now have the confidence to implement evidence-based nursing interventions that help minimize the delirium experience for patients," Jadwin said. "AACN CSI Academy is a wonderful model in combining didactic content with practical tactics to influence patient care. I hope to build on our experience, empowering more of our staff nurses to influence practice changes in collaboration with their medical and ancillary department colleagues."
The seven Pennsylvania hospitals participating in AACN CSI Academy were:
•Abington Memorial Hospital, Abington
•Fox Chase Cancer Center, Philadelphia
•Hospital of the University of Pennsylvania, Philadelphia
•Lankenau Medical Center, Wynnewood
•Lehigh Valley Hospital-Muhlenberg, Bethlehem
•Pennsylvania Hospital, Philadelphia
•Penn Presbyterian Medical Center, Philadelphia
"Open sharing of clinical solutions and patient care innovations is a keystone of AACN CSI Academy's broader goal to inspire and empower all acute and critical care nurses to lead change that benefits their patients and improves the effectiveness of their organization," said AACN CEO Dana Woods. "Our CSI Academy Innovation Database supports this goal by providing open access to an expanding compilation of CSI team learnings, results and documentation."
AACN's searchable database of real-world project plans, clinical interventions, data collection tools, outcomes and references will continue to grow as additional CSI teams complete the program. Access the Innovation Database from the AACN CSI Academy Web page or www.aacn.org/csi.
The Pennsylvania nursing teams represent the fifth regional group to complete AACN CSI Academy, following Indiana, Massachusetts, North Carolina and Texas.
A sixth cohort continues at hospitals in New York, where nurse participants are undertaking projects to prevent catheter-associated urinary tract infections, central line-associated bloodstream infections and delirium, and to implement early mobility programs.
In total, nursing teams from 42 hospitals will complete the program by the end of 2014, with cohorts in two additional regions scheduled to begin in the near future.
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