Nurse Input and Leadership Needed in Health Care Design

A new book explores the importance of nurse-led innovations in the process of designing health care environments, Healthcare Design reports.

Nurses as Leaders in Healthcare Design: A Resource for Nurses and Interprofessional Partners, will be published this fall by Nursing Institute for Healthcare Design (NIHD) and Herman Miller Healthcare. Its goal is to inform and guide nurses through the design process with practical information and case studies.

NIHD President Nurses Stichler and Kathy Okland, a senior health care consultant at Herman Miller Healthcare are the executive editors of the book. In an interview with Healthcare Design they discussed the pitfalls of not including nurses’ perspectives in the design process.

“When the nurses’ point of view is absent from the design table, serious mistakes have been made,” Stichler said. “For example, there was a trend to eliminate the centralized communication hub when designing decentralized nursing stations. Unfortunately that was a huge mistake because both centralized and decentralized work stations are needed.”

The centralized station is where nurses and other health care providers meet to discuss unit activities and patients’ status, and interacting with family members, Stichler said. When the design eliminated that centralized space, staff had to develop workarounds, including setting up a folding table so that the interprofessional team could meet.  “So you can see how important it is to have a nursing voice that can speak up and say, wait, I don’t think you understand what goes on in that space, let me describe it to you.”

Okland and Stichler will lead an interactive discussion “Planning and Design for Healthcare Design: A Nurse’s Perspective” at the Healthcare Design Expo & Conference, November 14-17 in the Washington, DC area, for more information, visit HCDmagazine.com/conference.

The full interview is available here: http://www.healthcaredesignmagazine.com/article/bat-nurses-step-design-plate 

Nurses Succeeding in Bone Marrow Biopsy Program

A nurse-led bone marrow aspiration/biopsy program is providing evidence that the use of procedurists is good for patient outcomes and good for clinical practice, according to a presentation at the Oncology Nursing Society’s 40th Annual Congress in Orlando, Florida. The presentation was titled Multidisciplinary Development of a Bone Marrow Aspirate and Core Biopsy Performed by Registered Nurses.

This use of nurse procedurists in bone marrow biopsies “demonstrates an innovative partnership for clinical practice, as recommended by the Institute of Medicine (IOM),” said Daravan Kao of the Seattle Cancer Care Alliance. The IOM’s landmark 2010 report, The Future of Nursing: Leading Change, Advancing Health, states that nurses “should practice to the full extent of their education and should be full partners in the redesigning of health care delivery,” Kao continued.

Registered nurses who participated in the bone marrow program maintained a 98 percent score, as rated by pathologists, for the quality of the samples they collected. Furthermore, there were no reported incidences of post procedure complications, Oncology Nurse Advisor reports.

A multidisciplinary team developed and implemented the biopsy program, which included didactic training, technical skills acquisition, and ongoing quality assurance.

AACN Academy Shows Value of Investing in Nurse Leadership Development

After participating in a 16-month leadership and innovation training program, nurses at 42 hospitals nationwide went on to direct quality initiatives that improved patient outcomes and saved more than $28 million annually.

The AACN Clinical Scene Investigator (CSI) Academy is a 16-month leadership and innovation training program for staff nurses delivered by the American Association of Critical-Care Nurses (AACN) that seeks to empower nurses as clinician leaders and catalysts for change.

The CSI Academy trained 163 nurses to address clinical challenges such as health care associated infections, pressure ulcers, delirium, early mobility, falls, and patient handoffs. The nursing teams saw great success, according to AACN, significantly reducing many common hospital errors.

Regional groups working in Indiana, Massachusetts, New York, North Carolina, Pennsylvania and Texas showed progress in decreasing:

• Intensive care unit (ICU) and progressive care unit lengths of stay by one day; 
• Days on mechanical ventilation by 14 percent or approximately one day;
• Health care-acquired infections and ICU complications by 50 percent;
• Patient falls by 50 percent;
• Pressure ulcers by 40 percent;
• Catheter-associated urinary tract infections by 70 percent; and
• Confusion Assessment Method for the ICU (CAM-ICU) positive scores by 14 percent

“These outcomes solidly reaffirm the value of investing in bedside nurses’ leadership development,” AACN CEO Dana Woods said in a statement. “Our program evaluations confirm that dedicated time for nurses to apply their skills in leading organizational and behavioral change was vital to achieving the program’s impressive results.”

AACN provides project materials from each team, including plans, data collection tools, practice resources and references in a searchable online database, which can be accessed at www.aacn.org/csiprojects.

INQRI Blog featured previously released data from the Academy from regional groups working in Massachusetts  and North Carolina.

Mobile Apps Empower Nurses to Use Evidence-Based Guidelines, Identify Health Problems

A new nurse-led study concludes that custom mobile health applications can help nurse practitioners use evidence-based guidelines, which would improve their ability to diagnose health issues during exams, MHealthNews reports.

Mobile apps that include clinical decision support tools helped clinicians diagnose chronic health issues, according to the study led by Suzanne Bakken, alumni professor of nursing at Columbia University School of Nursing.

The study, published in the Journal for Nurse Practitioners, examined the diagnosis rates of nearly 400 nurses during more than 34,000 patient exams and found significant diagnostic rate increases:

• Seven times more obese and overweight (33.9% vs. 4.8%)
• Five times more tobacco use (11.9% versus 2.3%)
• 44 times more adult depression (8.8% versus 0.2%)
• Four times more pediatric depression (4.6% versus 1.1%)

“What clinicians need is decision support tools that fit into their workflow and remind them of evidence-based practices,” Bakken said in a statement. "Our app focused specifically on the work that nurse practitioners do to identify health problems, counsel patients and coordinate care plans, resulting in higher diagnosis rates and more opportunities for intervention."

The goal of an INQRI-funded project “Dissemination and Implementation of Evidence-Based Methods to Measure and Improve Pain Outcomes” was to disseminate and implement evidence-based approaches to measure and improve pain care and outcomes in a sample of 100 hospitals across the United States. Two webinars are available detailing the results of the project: Webinar I and Webinar II. The interdisciplinary team was led by Susan Beck and Nancy Dunton.

Nurse-led Intervention Successful in Increasing Older Patients' Activity Levels

Nurse-led primary care interventions can lead to sustained increases in physical activity (PA) among older adults, according to a recent article published in PLOS Medicine by lead author Tess Harris of St George's University of London. Additionally, the participating patients indicated that they felt positively about the intervention, reports Medical Xpress.

Researchers enrolled nearly 300 people ages 60-75 in the trial, and randomly separated them by household, to receive either standard care or the nurse-led intervention. Primary care nurses delivered PA consultations over a three month-period to the intervention group, providing individualized activity plans and feedback on data recorded from pedometers and accelerometers worn by the patients.

At the three month mark, the intervention group reported that they took 1,037 more steps than the control group. Additionally, the intervention group spent 63 more minutes per week in PA sessions of 10 minutes or more. There was a sustained gap at the 12-month mark, although it decreased to 609 steps per day and 40 minutes per week.

The trial, funded by the National Institute for Health Research, suggests that this type of nurse-led intervention may be an effective way to increase PA in older adults, resulting in better health. However, the researchers said that additional trials are needed to discover what aspects of the intervention were most effective and how it would work in larger and more socio-economically diverse populations.


INQRI grantees Barbara Resnick and Sheryl Zimmerman also found success with an intervention designed to deliver Function Focused Care to residents in assisted living facilities. Their intervention was designed to maintain and improve function, PA, muscle strength, psychosocial outcomes (efficacy expectations and life satisfaction) and decrease adverse events (pain, falls and hospitalizations) among assisted living residents. Residents in intervention treatment sites demonstrated fewer declines in function and spent more time in moderate level physical activity at 4 months and more overall counts of activity at 12 months when compared to residents in control sites. There were also fewer transfers to the hospital among those in the treatment sites.

Nurses Lead Innovations in Geriatrics and Gerontology

This story originally appeared in the July 2014 issue of Sharing Nursing's Knowledge, a monthly email newsletter from the Robert Wood Johnson Foundation.

Nurse-led initiatives are intended to help the nation’s health care system prepare for a crush of elderly people with multiple chronic conditions.

Nurses have been leading health care innovations since the dawn of the profession. They have ushered in broad-scale changes in areas ranging from better hygiene practices for wounded soldiers to public health visits to overcrowded urban homes to reproductive health services for women.

In more recent decades, nurses have begun developing innovations in geriatric care to help meet the massive health care needs of an aging population. They are finding new ways to improve the quality of care for older adults and ensure that it takes family and community considerations into account; improve access to highly skilled health care providers with training in geriatrics; narrow disparities that disproportionately affect older minorities; avoid preventable hospital readmissions; and more.

Their work answers the call from a groundbreaking report on the future of nursing that was released in 2010 by the Institute of Medicine (IOM). It urges nurses to continue their long legacy of innovation “as the health care needs of the population change from acute and infectious disease to that of an aging population with chronic disease.”

The country is, indeed, undergoing dramatic demographic changes. As Baby Boomers age and immigration patterns change, America is becoming older and more diverse. By 2050, the number of Americans age 65 and older will hit 40 million, about 20 percent of the population, according to the U.S. Census Bureau. These changes will strain the health care system and the nursing profession, the largest segment of the health care workforce.

Experts say the nursing workforce is not adequately prepared for a crush of elderly patients who are living longer, and sicker, with more chronic and complex health conditions. To meet these growing health care demands and bridge gaps in services for older Americans, the IOM said nurses “must continue to develop innovative care models based on current successes” in rural aging and other areas.

Fortunately, many nurses are already leading efforts to meet current and future health care needs. “Nurses are beginning to home in on the chronicity and the larger number of older people coming down the pike,” said Jennie Chin Hansen, RN, MS, FAAN, CEO of the American Geriatrics Society and a member of the study committee supported by the Robert Wood Johnson Foundation (RWJF) that drafted the IOM’s nursing report.

She pointed to the Transitional Care Model, developed by Mary Naylor, RN, PhD, FAAN, national program director for RWJF’s Interdisciplinary Nursing Quality Research Initiative (INQRI). The model utilizes nurses to reduce hospital readmissions among elderly patients after they have been discharged from the hospital. As many as one-third of re-hospitalizations are considered preventable, so reducing readmissions not only improves patients’ quality of life, but reduces health care costs.

The Program for All-Inclusive Care for the Elderly (PACE) is an example of a nurse-driven innovation in geriatric care. A replication of a program spearheaded many years ago by Chin Hansen, PACE is a now a federally legislated program in which interdisciplinary teams of providers give frail elders coordinated health, medical, and social services support by a one-stop system, a process that enables many to live in their own homes for longer periods of time.

Another nurse-led innovation, Nurses Improving Care for Healthsystem Elders (NICHE), was developed to better meet the needs of older adults in a health care system that, in general, lacked access to gerontology-trained providers and to care coordination services. The NICHE program is helping hospitals and, increasingly, community health systems, provide older Americans with “sensitive and exemplary care.” Under the program, “nurses are empowered by knowledge to provide high-quality care for older adults and, in doing so, teach others about the uniqueness of caring for older adults,” said Tara Cortes, PhD, RN, FAAN, executive director of the Hartford Institute for Geriatric Nursing in New York and an alumna of the RWJF Executive Nurse Fellows program (1999-2002).

And that’s just the beginning:

Promoting cancer screening among older African American women

Nurses all over the country are studying ways to improve care for older Americans. In North Carolina, for example, Dee Baldwin, PhD, RN, FAAN, a nurse educator at the University of North Carolina-Charlotte and an RWJF Executive Nurse Fellows program alumna (2000-2003), has spent decades exploring ways to prevent cancer in older African American women, who are more likely to die from the disease than other groups.

In 1992, Baldwin launched Project Breast Health, a culturally sensitive educational program to encourage more African American women to take advantage of cancer screening services. She also led an effort to hire lay navigators to raise awareness about breast and cervical cancer among older women in African American communities and developed electronic computer messaging to target the population. “We tried to look at different ways to reach people.”

Improving the quality of care in assisted-living facilities

Anna Beeber, PhD, RN, an RWJF Nurse Faculty Scholar (2011-2014) also from North Carolina, is exploring ways to improve the quality of care in assisted-living facilities. She is conducting research that examines staffing, service delivery, and resident outcomes in order to help assisted-living communities better match services with resident needs. “We really don’t know in assisted-living communities what, if any, influence nurses have on quality of care,” she says. And that is a critical piece of information that has the potential to improve care for the roughly 1 million Americans who currently live in the country’s 22,000 assisted-living facilities.

Increasing the number of geriatrics-trained nurses

In North Dakota, Jane Strommen, PhD, project coordinator of the North Dakota Gerontology Consortium, an initiative supported by Partners Investing in Nursing’s Future (PIN), is working to ensure that older people have more access to geriatrics-trained nurses. She and her team are promoting gerontology nursing via marketing materials, nursing conferences, nursing-themed summer camps, and stipends for nurses and nurse educators who study gerontology and geriatric nursing. “We have a growing population of older adults in our state, and we know the need for nurses who have the skills and training to care for them is just going to increase,” she says.

Creating safer homes

And in Maryland, Sarah Szanton, PhD, ANP, an RWJF Nurse Faculty Scholar (2011-2014) and associate professor of nursing at Johns Hopkins University, has come up with an innovative program to use “handymen” to turn older people’s homes into safe environments. Her goal is to enable elderly people to continue living in their homes as long as they are willing and able—and to stay out of nursing homes, which create considerable taxpayer expense. Read more about Szanton’s work here.

These projects are among the many nurse-led efforts under way across the nation to improve care for older Americans—a natural outgrowth, Chin Hansen says, of nurses’ skills, abilities, and population focus. “One of the things that nurses have always done is advocate for the patient and the family,” she says. They will continue to do that as their patients get older, and they will likely have a greater ability to transform health care as more earn master’s and doctoral degrees and assume positions of leadership in health care and society. Says Chin Hansen: “More nurses are being sought out for their leadership and their ability to change the current culture of medical care towards health and health care in an aging America.”

Nurses Collaborate Across Oncology Departments to Address Fractured Care

A team of oncology nurses at the Torrance Memorial Medical Center in California recognized that patient care was hindered by inconsistent communication between departments and weak collaboration among providers. To address this problem, they conducted an analysis of patient feedback and then initiated regular meetings to improve patients' oncology care experiences through a collaborative approach, Oncology Nurse Advisor reports.

In a poster presentation from Torrance’s Miriam Sleven at the National Coalition of Oncology Nurse Navigators Conference in Atlanta, she outlined how the team addressed the fragmented care that was occurring across settings at their facility.

Nurses representing clinical, administrative, inpatient oncology, outpatient infusion, palliative care, and radiation oncology departments, as well as the Breast Diagnostic Center, and the Cancer Resource Center, met monthly and discussed projects they were working on to improve cancer services from the planning to the evaluation stage. During the meetings, the nurses identified issues and projects that spanned the scope of oncology nursing practice and the patient experience.

The meetings were successful, leading to improved communication between all oncology nurses, and improved patient experience, reports Oncology Nurse Advisor.

National Nurse Leadership Training Program Yields Results in Boston

A nursing team from Boston that took part in a national leadership training program has shown measurably improved patient outcomes and a combined $8 million in anticipated annual savings for their hospitals. The Boston initiative is part of a broader training program conducted by the American Association of Critical-Care Nurses (AACN).

AACN directs and funds the AACN Clinical Scene Investigator (CSI) Academy, a 16-month, hospital-based nurse leadership and innovation training program. The program empowers bedside nurses as clinician leaders whose initiatives generate quantifiable improvements in patient care and cost savings, according to an AACN media statement. Teams of staff nurses from participating hospitals take part in the training.

The Massachusetts AACN CSI Academy teams recently presented the results of their projects at an Innovation Conference in Boston, reporting successes such as:

• Decreased the average length of stay in the intensive care unit (ICU) for ventilated patients by nearly eight days using an early mobility program;
• Reduced incidence of pressure ulcers acquired while in the ICU by 50 percent;
• Improved communication between units, leading to a 100 percent decrease in patient handoff incident reports;
• Decreased the average number of mechanical ventilation days for ICU patients; and
• Improved assessment of ICU-related delirium in critical care patients, leading to improved cognitive scores and decreased benzodiazepine use in patients with documented delirium.

The Massachusetts team is the third group to complete the Academy, after Indiana and North Carolina. Hospitals in New York, Pennsylvania, and Texas are currently participating and nursing teams from 42 hospitals will have completed the program by the end of 2014, according to AACN.

AACN’s searchable Innovation Database provides access to a compilation of CSI team results and documentation, including real-world project plans, clinical interventions, data collection tools, outcomes and references.

Nurses Lead Fall Prevention Trials for NIH/PCORI and NC Initiatives

The National Institutes of Health and the Patient Centered Outcomes Research Institute (PCORI) are launching a new study to prevent fall-related injuries that utilizes “fall care managers,” typically nurses or nurse practitioners, who will evaluate patients’ risk and create individualized plans to avoid falls, Bloomberg’s Businessweek reports.

The study will track 6,000 elderly patients at risk for falling at 80 clinics. At half of the clinics the “fall care managers” will tailor specific interventions to patients’ needs, while patients at the other 40 clinics will continue to receive standard treatment. The fall care managers will take a more custom approach to each patient, such as adjusting medication to decrease dizziness, encouraging physical therapy to improve balance, or prescribing new glasses to improve vision. Funding for the five-year trial is provided by PCORI under the Affordable Care Act.

In related news, New Hanover Regional Medical Center in Wilmington, North Carolina found success with a similar nurse-led approach to preventing patient falls, Fierce HealthCare reports.

New Hanover formed a patient safety services fall team to examine the underlying causes of falls and develop a system to prevent them. The team found that many patients fell while trying to reach the bathroom, because they were medicated or disoriented and had physical impairments. As a result, nurses at New Hanover now check on patients every hour and try to anticipate bathroom visits. They also administer medication at strategic times, so that patients are more likely to sleep through the night. Other preventative measures include visual markers that highlight high-risk patients and having patients sign a "fall prevention partnership" agreement with nursing staff. These and other measures led to a fall decrease of 22 percent estimated and a savings of more than $500,000, according to a New Hanover blog post.

INQRI grantees Patti Dykes and Blackford Middleton created a tool designed to prevent patient falls by translating an individual patient's fall risk assessment into a decision support intervention that communicates fall risk status, and creates a tailored plan that is accessible to care team members (including patients and family members).

The team constructed the Fall Prevention Toolkit (FPTK), and conducted a randomized controlled trial to examine whether the FPTK led to a decrease in the incidence of patient falls and a decrease in the incidence of patient falls with injury. The use of their toolkit did significantly lower the incidence of falls in the intervention units and several units wished to continue using the tool after the conclusion of the study. By establishing links between nursing fall risk assessment, risk communication and tailored interventions to prevent falls, Dykes and Middleton hope to raise awareness of fall risks for patients, nurses and other providers and to lower mortality and morbidity for potential fall victims.

New Hospital Initiative Involves Nurses Conducting Universal Screening for Depression

Hospital patients who have undiagnosed depression often have a slower and more difficult recovery. Now, nurses at Cedars-Sinai hospital in Los Angeles, are leading efforts to screen all patients for possible depression, Nurse.com reports.

The new process is designed to help nurses detect symptoms of clinical depression characterized by a severely disheartened mood, lowered activity level, and persistent negative thoughts lasting longer than two weeks.

“We know, based on multiple medical studies over several years, that addressing depression improves all aspects of patient health,” Linda Burnes Bolton, Cedar-Sinai’s vice president for nursing, CNO, and director of nursing research, said in a news release. Burnes Bolton served as liaison to INQRI’s national advisory committee prior to joining RWJF’s Board of Trustees. “By routinely screening our patients for depression upon admission, we can ensure that they receive the appropriate treatment and protocol.”

For the new initiative, an RN will interview each patient within 24 hours of admission, asking questions about mood and energy level. If the answers indicate possible depression, the nurse will use a standard, detailed questionnaire to assess other depression symptoms, including any thoughts of suicide. If possible depression is found, Cedars-Sinai social workers and physicians will determine an appropriate intervention for the patient. For patients who are suicidal, the nursing department will notify the patient’s physician and protect the patient from self-harm.

Nurse-Led Initiatives Benefit Patients and Finances at North Carolina Hospitals

Nurse-led initiatives at several North Carolina hospitals significantly improved patient outcomes and could result in savings of more than $2.5 million, according to the American Association of Critical-Care Nurses (AACN), which funded the program.

The 16-month hospital-based nurse leadership and innovation training program, known as the AACN Clinical Scene Investigator (CSI) Academy, seeks to empower bedside nurses as clinician leaders and agents of change. The nurses’ initiatives must seek to generate quantifiable improvements in quality of care and hospital finances. The North Carolina cohort is the most recently completed project. An Indianapolis academy was completed last year and work continues at hospitals in Massachusetts, New York, Pennsylvania, and Texas

Four of the North Carolina Academy’s teams focused on early progressive mobility, which can help reduce ventilator-associated pneumonia (VAP), pressure ulcers, and deep-vein thrombosis. Among the outcomes, early progressive mobility: 

• Decreased intensive care unit length of stay by more than one day;
• Reduced mechanical ventilation days up to 35 percent;
• Reduced VAP up to 60 percent;
• Decreased pressure ulcers up to 20 percent; and
• Reduced readmission rates.

The AACN CSI Academy Innovation Database includes a compilation of CSI team results and documentation.

The program is part of AACN’s response to the Institute of Medicine’s landmark The Future of Nursing: Leading Change, Advancing Health  report, which explored the vital role that nurses can and should play in transforming health care.

Interdisciplinary Team Approach Needed to Battle HAIs Effectively

Nurse-led, interdisciplinary team-based approaches are needed to effectively prevent hospital-acquired infections (HAIs), according to a new study led by former INQRI grantee Patricia Stone. Neither nurses alone, nor the presence of infection-prevention policies, are enough to keep HAI rates down, HealthLeaders Media reports.

The study was published by Columbia School of Nursing, where Stone is Centennial Professor of Health Policy, and is featured in the American Journal of Infection Control. Among the findings:

• Central line-associated bloodstream infections (CLABSI): 92 percent of ICUs had a policy for an insertion checklist, but only 52 percent of the health care professionals were seen to adhere to that policy;
• Ventilator-associated pneumonia: 74 percent of ICUs had a ventilator bundle checklist, but only 52 percent of those treating patients adhered to it; and
• Catheter-associated urinary tract infection: 27 percent of ICUs had a policy for a nurse-assisted catheter insertion, but only 22 percent were seen to observe that practice.

"Some of these things are really [linked to] nursing," Stone tells HealthLeaders. “But just because HAIs are a nursing-sensitive outcome, doesn't mean that nurses alone bear the responsibility for them. It takes a team, it takes top leadership, it takes everyone on the same page. It's not just a nursing problem."

However, nurse leaders can and should take the lead on making sure that an interdisciplinary team is adhering to infection prevention policies, and establishing such policies when needed. This can include ensuring that nurses have carts for central line insertion and resources like portable bladder ultrasounds. Strong policies, interdisciplinary checks and balances, and leadership are all needed to battle HAIs, according to the study.

Reducing CLABIs was the focus of an INQRI-funded study led by David Thompson and Jill Marsteller. Their study, involving 45 intensive care units in 35 hospitals in 12 states, tested a nurse-led intervention that used a bundle of evidence-based practices to reduce infections. The intervention was successful in significantly reducing infections and also highlighted the importance of promoting a culture of safety and communication. It also established that nurses should play a central role in quality improvement interventions.

Patricia Stone’s INQRI-funded project: “The Impacts of Nurse Staffing, Skill Mix, and Experience on Quality and Costs in Long-Term Care” examined whether there is a causal relationship between nursing input and patient outcomes in long-term care (LTC) facilities.

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.

Implementation Research Program Focuses on Hospital Staff Nurses

Leadership development is important at all levels of nursing, especially when it can contribute directly to improved patient care. The American Association of Critical-Care Nurses (AACN) Clinical Scene Investigator Academy (CSI) gives critical care nurses the opportunity to learn leadership skills and become change agents by developing, managing, and sharing quality improvement initiatives in their hospitals.

NurseZone.com reports that seven Pennsylvania hospitals were recently selected to participate in this important initiative that is an expansion of a project funded by the Robert Wood Johnson Foundation: the Bi-State Nursing Innovation Center in Kansas City, Mo. 

The seven Pennsylvania hospitals will each receive a $10,000 grant from AACN. They are: Abington Memorial Hospital; Fox Chase Cancer Center; Hospital of the University of Pennsylvania; Lankenau Medical Center; Lehigh Valley Health Network; Penn Medicine-Pennsylvania Hospital; and Penn Presbyterian Medical Center.

The AACN CSI Academy also has projects in Indiana, Massachusetts, North Carolina and Texas. Over the next three years, AACN will invest $1.25 million to fund implementation of the program.