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At left: Marguerite Ganthier, Gilmara Alves and Marines Matos, patient care associates and observers; At right: Rosemond Polynice, patient care associate and observer, with Lauren Wilkinson, BSN, RN.

When CLABSI rates in intensive care units increased at the end of 2018, the CLABSI Prevention Task Force, co-chaired by Maria Bentain-Melanson, DNP, RN, nursing director of Shapiro 6 and 7, developed a plan to eliminate these infections, including:

  • Identifying inconsistent use of the central line insertion checklist as an area for improvement and conducting a best-practice literature review.
  • Developing a process to ensure a dedicated, trained observer (a patient care associate) was available for every central line insertion to ensure checklist compliance.
  • Creating a checklist tool for observers to complete and for the task force to review to determine additional opportunities for improvement.

Bentain-Melanson worked with Allison Webster, DNP, RN, nursing director of the Float Pool, and Professional Development Managers Carol Daddio Pierce, MSN, RN, CCRN, and Karen Morth, MSN, RN, CCRN-CSC, to develop and implement observer training sessions in the Neil and Elise Wallace STRATUS Center for Medical Simulation.

As a result of these efforts, the CLABSI rate per 1,000 central line days in the ICUs decreased from 1.66 (October – December 2018) to 0.82 (July – September 2019); and from 1.42 (October – December 2019) to 0.93 (January – March 2020).

Why it’s Magnet: Magnet designation requires one example of an improved patient outcome associated with a nurse director’s membership in an organization-level decision-making group as part of the Transformational Leadership component (TL5EO). It’s who we are.

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At left: Sara Pitman (center) with patients Delphine (left) and Celestin (right) in Rwanda during this month’s mission; at right, Kevin McWha and Susan Gabriel on a past mission.

Over the past 15 years, a group of Brigham nurses and other staff have volunteered with Team Heart, a nonprofit organization working to build a sustainable program to address the burden of cardiac disease for those with advanced rheumatic heart disease in Rwanda.

Brigham nurses who have volunteered include: Susan Gabriel, BSN, RN, CCRN, Lisa Kelley, BSN, RN, and Barbara Williams, BSN, RN, of Shapiro 6 West; Kristin Bartucca, RN, PCCN, and Cynthia Scherer, BSN, RN, of Shapiro 7; Sara Stankiewicz Pitman, BSN, RN, of the MICU; Leslie Grignaffini, BSN, RN, CCRN, CMAN, LNC, of the Patient Access Center;  Kevin McWha, BSN, RN, of the PACU; Katie Morrison, BSN, RN, of the Operating Room; Denise Mackey, MSN, RN ,of the Pain Clinic in Foxboro; Marie Caulfield, MSN, RN, of Shapiro 9/10; and others.

These nurses have traveled to Rwanda to care for patients and provide education and support to staff over the years, with Pitman participating in the 2022 mission this month.

The nurses and team members raise their own travel funds and additional funding to support patients’ post-operative care and medications.

The Brigham has supported these efforts by providing supplies for trips to Rwanda, accommodating staff schedules and recognizing the efforts of nurse volunteers in hospital communications.

Why it’s MagnetThe Structural Empowerment component of Magnet requires an example of the organization’s support of nurses who volunteer in a local or global population health outreach initiative (SE10b). It’s who we are.

Jennifer Riley

While pasteurized donor human milk (PDHM) has well-known benefits for infants in the newborn ICU setting, Jennifer Riley, MSN, RN, IBCLC, sought to understand its impact on healthy infants as an alternative to formula.

She developed a research proposal, received a $2,500 Karsh Enrichment Grant and collaborated with the Pediatric Newborn Medicine Department.

After data collection and analysis, the team found:

  • No difference in breastfeeding outcomes between parents who chose PDHM and those who chose infant formula for medical supplementation.
  • Differences in maternal education, body mass index and breastfeeding intent between feeding groups.
  • That mothers in both groups demonstrated comparable levels of breastfeeding self-efficacy and lower breastfeeding self-efficacy scores at one month postpartum.

In April 2021, the study was published in Breastfeeding Medicine.

Other staff who participated included: Mandy Belfort, MD, MPH; Sarbattama Sen, MD; Kaitlin Drouin, MA, MS; and Sara Cherkerzian, SM, ScD

Why It’s Magnet: Magnet designation requires an example of how clinical nurses disseminated the organization’s completed nursing research study to external audiences as part of the New Knowledge, Improvements and Innovations component (NK2b) of the Magnet model. This is one of many examples demonstrating how nurses are contributing to the body of evidence surrounding patient care and nursing practice.

It’s who we are.

New infusion pumps line a hallway in the Shapiro Center in 2019

The Brigham was the first hospital within Mass General Brigham to transition to the Baxter Spectrum IQ pump in 2019 as part of a systemwide initiative to integrate the electronic health record with a large volume smart infusion pump.

This required interprofessional teams across the Brigham to replace approximately 3,800 large-volume infusion pumps on the main campus and off sites with the Baxter model.

Anne Bane, MSN, RN, BC, nursing director, Informatics and Medication Safety, co-led the conversion with Biomedical Engineering and Pharmacy leaders. The interprofessional team also included IS, Anesthesiology, Central Transport and Materials Management.

In preparation, Bane engaged clinical nurses from the divisional committees to complete the nursing validation of the pharmacy’s drug library.

During the May 2019 go-live of the Baxter pumps, nurse super users and professional development managers provided continuous support to clinical nurses using the pumps.

When programming an infusion on the pump, nurses are now directed to the Baxter drug library, a safety feature which has improved compliance. The library has enhanced patient safety with dosing guardrails, including hard and soft limits, for about 1,100 intravenous medications.

In recognition of these efforts, the Baxter Pump Implementation Team received a Partners in Excellence Award (now called the Pillar of Excellence Award) for optimizing collaboration in 2020.

Why it’s Magnet: Magnet designation requires one example of the organization’s recognition of an interprofessional group inclusive of nursing for their contributions in influencing the clinical care of patients as part of the Structural Empowerment component (SE13). This is one example demonstrating the collaboration of interprofessional teams and meaningful recognition. It’s who we are.

Kim Ladouceur, RN, nurse in charge for Braunwald Tower 11ABD, demonstrates the bedside organizer.

An out-of-reach call button or a misplaced TV remote or personal belonging may increase some patients’ risk of falling if they attempt to get out of bed on their own to access these items.

In 2019, this was top-of-mind for Maureen Tapper, MSN, RN, PCCN, a nurse in-charge (now nursing director), and Sarah Thompson, MSN, RN, CCNS, CWON, a Wound, Ostomy and Continence nurse, who was the professional development manager on Thoracic Intermediate and Surgical Care at the time.

Working with the Brigham Digital Innovation Hub, Tapper and Thompson identified a cost-effective product that attaches to the patient’s bed and secures items like cell phones, TV remotes and the call button.

They received funding from Estrellita Karsh, longtime friend and donor of the Department of Nursing, for a pilot.

Tapper and Thompson provided education about the bedside organizer and surveyed clinical nurses, PCAs and patients during the pilot.

One patient shared: “In the past, I was always dropping the phone, TV remote, and other items on the floor. They were cluttering my bedside table or under the sheets somewhere. With the organizer, everything was in reach and in one place. This made calling the nurse in the middle of the night so much easier. Thank you, Thoracic nurses, for developing the bedside organizer.”

Based on survey results, Tapper and Thompson worked with the vendor to tailor the bedside organizer, which was later approved by the New Products Approval Committee.

Because of its impact on safety, quality of care and patient experience, the organizer is now given to every Thoracic patient upon admission. Tapper and Thompson are also exploring opportunities to implement the product more broadly.

Why it’s Magnet

Magnet designation requires an example of an innovation involving nursing as part of the New Knowledge, Improvements and Innovations (NK5) component of the Magnet model. This is one of many examples throughout the Brigham demonstrating how nursing-led innovations improve the care and experience of patients and loved ones.

It’s who we are.

During Patient Care Associate (PCA), Medical Assistant (MA) and Emergency Services Assistant (ESA) Week , staff gathered in the Bornstein Family Amphitheater on June 16 for a celebration of compassionate care.

Maddy Pearson, DNP, RN, NEA-BC, senior vice president, Patient Care Services, and chief nursing officer, presented TULIP Award certificates and pins to three PCAs—Michaela Fox, Martine Lauture and Farah Marcel—in recognition of their tremendous contributions.

TULIP stands for Touching Unique Lives In Practice and celebrates PCAs, MAs and ESAs for going above and beyond to provide outstanding, compassionate care. Fox, Lauture and Marcel were nominated by colleagues for getting to know their patients, understanding what was important to them and improving their experience.

Michaela Fox
Connors Center 8 North, Surgical Oncology–Gynecology

Michaela Fox

“Michaela, who recently graduated from nursing school, floated to 12BC, an orthopedic unit. Michaela’s care and compassion shined brightest while helping me care for one of my patients who was very frustrated that she had to rely on others to perform basic activities of daily living. Michaela helped her shower, wash her hair, eat breakfast and aided in other activities. When I asked Michaela if everything was okay, she told me the reason it took longer than usual was because she wanted to afford the patient the opportunity to participate in each activity. The next time I went into the patient’s room, she was sitting up in her chair, smiling. She was able to find some of her own strength because Michaela took the time and patience to help her do that. The patient reported that it was the best day she had so far in the hospital. Sensing the patient’s anxiety and frustration with her own situation, Michaela took the extra time to give the patient what she needed to feel more confident in herself.”

Farah Marcel
Braunwald Tower 15, Surgical Intermediate Care

Farah Marcel

“I had a patient who was admitted and was clearly afraid. Farah went out of her way to make her feel safe. Farah spoke to the patient in a soft manner and took the time to make her feel more comfortable. Farah made sure the patient had food and drink choices because the patient could remember her likes or dislikes. I would welcome Farah to take care of any of my family members after witnessing her tremendously caring ways.”

 

 

 

 

Martine Lauture
Braunwald Tower 10A, Cardiovascular Interventional Care

Martine Lauture

“Martine floated to our floor to sit with a patient who was confused. . Martine was exceptional in her role as a sitter; she was attentive, compassionate and extremely patient. Martine engaged with her all day, talking about her life, family and hobbies. The patient had been barely eating in the days prior, but Martine took the time to get to know the patient and ordered her several meals throughout the day, all of which she loved and ate. Martine truly went above and beyond for this patient, holding her hand when she was upset and giving her the TLC she needed. I could not have done my job without Martine. I am so appreciative of the exceptional care she provided to this patient.”