Zinnia Feliciano, MS, RN, AGCNS-BC, CNRN, presents her poster “Implementation of a Fall Prevention Intervention: Overcoming Barriers” at Discover Brigham on Nov. 10, 2016.

On April 1, BWH will submit a body of evidence in the next step toward Magnet designation which demonstrates how BWH meets 49 standards within the five components of the Magnet model: Transformational Leadership, Structural Empowerment, Exemplary Professional Practice, New Knowledge, Innovations and Improvements and Empirical Outcomes. The 75 initiatives selected for submission illustrate our deep commitment to quality, nursing excellence, interprofessional collaboration and innovation. Beginning with this issue of Heart & Science, we will use “Magnet Matters” to share some of these initiatives with you. We hope you will be inspired by the broad range of examples and the work being done across BWH.

TRANSFORMATIONAL LEADERSHIP
Nurse Leaders and Clinical Nurses Advocate for Resources to Support Nursing Unit and Organizational Goals

Example 1: Employing Nurse Super Users for Successful Partners eCare Implementation

To ensure the safety of patients, uphold the highest quality of care and maintain satisfaction among clinical nurses, nurse leaders advocated for additional resources to train and support clinical nursing staff throughout the Partners eCare (PeC) implementation process, from preparation
to optimization.

As a result of this advocacy, more than 350 clinical nurse super users attended clinical validation sessions, participated in 16 to 24 hours of Epic training sessions and attended three 4-hour organizational impact sessions before go-live. In addition, nearly 300 clinical nurses were hired, trained and scheduled to backfill units, allowing clinical nurse super users to be released from the staffing plan. Associate chief nursing officers and nurse directors continued to support unit-based super users by enabling them to attend ongoing monthly education sessions to further optimize PeC.

Example 2: Tower 14CD Unit-based Practice Council Advocates for Resources to Support Unit Goals

Tower 14CD, a general medical unit, cares for patients with complex medical concerns who often have several co-morbidities, including social, psychological and substance abuse issues. Nurses felt they needed more education about opioid addiction issues in order to provide the best care to this patient population. After bringing their concerns to unit leadership, the unit’s practice council advocated for unit-based clinical nurse education and training that would help optimize nursing care for these patients. Nurses have also had the opportunity to attend conferences specific to caring for opioid-dependent patients.

In addition, the unit-based practice council also wanted to focus on the health and well-being of nurses and developed a “wellness week” focused on positive reinforcement and resilience. Reiki, hand massage techniques, acupressure and meditation were just some of the activities offered. The staff also created a meditation room, supplied with calming imagery and meditation recordings, where staff continue to seek quiet reflection after difficult moments during their shift.

Interventions resulting from this advocacy have been sustained for more than three years and have supported Tower 14CD staff in providing a healing environment in which to deliver care and receive care.

NEW KNOWLEDGE, INNOVATIONS AND IMPROVEMENT
Nurses Disseminate the Organization’s Research Findings to Internal and External Audiences

Example 1: Nurses Disseminate Research Findings within BWH Community

BWH nurses interested in exploring clinical questions and advancing research can seek mentorship through the BWH Immersion in Research Program, which provides clinical nurses with a foundational skill set to formulate research questions, develop and conduct a study and disseminate the findings. Full and half-day courses prepare nurses for oral and poster presentations through avenues such as Discover Brigham, an annual event to educate and inspire collaboration around discovery and innovation, and Nursing Grand Rounds.

As a result of the opportunities for research mentorship and support, clinical nurses have been featured in the annual research events, with a nurse as first author on approximately twenty percent of the posters displayed each year.

Example 2: Nurses Disseminate Research Findings Beyond BWH

In 2015, unit-based practice council members from Tower 4BC, 10BA, 10CD and 12B began collaborating on a fall prevention study to test a new bedside poster, Fall TIPS (Tailoring Interventions for Patient Safety). The purpose of the poster was to engage patients and their families in the three-step fall prevention process. Members of the practice councils served as champions and assisted with training staff, monitoring adherence and providing peer feedback.

At the conclusion of the six-month pilot period, the team found an 82 percent adherence rate with the protocol across study units and a decrease in the mean fall rates and fall-related injury rates compared to the same six-month period the year prior. Following an external presentation about the Fall TIPS Toolkit, the team was invited to publish the results in The Joint Commission’s Journal of Quality and Safety. Each practice council selected one or two members to serve as co-authors in writing the manuscript, Pilot Testing Fall TIPS (Tailoring Interventions for Patient Safety): A Patient-centered Fall Prevention Toolkit. The manuscript has been accepted for publication and has an expected publication date of June 2017.