Indiana Program Illustrates Potential of Nurse-Led Initiatives

A series of nurse-led initiatives in Indiana improved patient outcomes and is projected to save health care organizations in the state more than $5.2 million. These results demonstrate the importance of increasing nurses’ leadership opportunities, a key recommendation of the Institute of Medicine’s (IOM) landmark “Future of Nursing” report.

The American Association of Critical-Care Nurses (AACN) launched the Clinical Scene Investigator (CSI) Academy last year as a team-oriented and hands-on educational experience that placed nurses as clinician leaders. The nurses led initiatives and generated quantifiable improvements in the quality of patient care and hospital finances. Nurse-led initiatives studied in the program helped to:

• Improve patient satisfaction by as much as 20 percent;
• Reduce stays in the pediatric intensive care unit (ICU) by 0.5 days;
• Cut incidences of patient falls and hospital-acquired device-related nose and mouth pressure ulcers by more than 50 percent;
• Decrease overall pressure ulcers by more than 60 percent; and
• Drop mechanical ventilation days for ICU patients by 0.44 days.

Forty-two hospitals spanning six U.S. regions are participating in the preliminary national program rollout. The program continues to run at hospitals in Massachusetts, New York, North Carolina, Pennsylvania, and Texas. Ongoing projects include preventing ventilator-associated pneumonia, catheter-associated urinary tract infections, central line-associated bloodstream infections, pressure ulcers, falls, extubation, and improving communication and teamwork.

Media coverage of the AACN findings included Infection Control Today, Nurse.com and Advanced Healthcare Network for Nurses.

INQRI-funded research has focused on nurse-led initiatives in many of these areas,  including patient falls, central line-associated bloodstream infections and pressure ulcers.