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Lisa Mestas (left), USA Medical Center Chief Nursing Officer and Assistant Administrator and Dr. Valorie Dearmon (right), Chair of the USA College of Nursing's adult health department, pose for a photo with the 2014 American Association of Colleges of Nursing Exemplary Academic-Practice Partnership Award. The award was given, in part, in recognition of a series of initiatives and studies that engage frontline nursing staff in programs to improve patient care. These initiatives have garnered national honors for the partnership between our two institutions.
A series of initiatives and studies that engage frontline nursing staff in programs to improve patient care has brought national honors to the partnership between the University of South Alabama Medical Center and the University of South Alabama College of Nursing.
The partnership will receive the 2014 American Association of Colleges of Nursing Exemplary Academic-Practice Partnership Award during the AACN annual meeting in Washington D.C., in October.
“It’s wonderful to receive this recognition,” said Medical Center Administrator Beth Anderson, who also is a registered nurse. “We did a lot of work to participate in this research and translate it into better clinical outcomes for our patients. We are always focused on ways we can improve care for our patients.”
College of Nursing Dean Dr. Debra Davis said, “It is quite an honor to be recognized by the American Association of Colleges of Nursing with this award. It is a national competition and our receiving the award speaks volumes regarding the quality of the work and ongoing collaboration and dedication of Nursing Professionals at the College of Nursing and at the Medical Center."
The award recognizes a continuing relationship between the College of Nursing and the nursing staff at the Medical Center, as exemplified in three specific projects and studies over a seven-year period.
In the past, hospital procedures nationwide were developed by other health care professionals and evolved without the input of nurses although nurses are primarily responsible for providing the bedside care, says Dr. Valorie Dearmon, chair of the College of Nursing adult health department.
The nation’s 3 million nurses represent by far the largest group of health care providers, Dearmon said. “Traditionally nurses have been told what they need to do. Systems Processes were built with or without their involvement, but they’re the ones that see experience can see first-hand whether it the processes works.”
Lisa Mestas, chief nursing officer and assistant administrator at the Medical Center, said the partnership exemplifies the importance of working with staff nurses and researchers at USA to discover the best practices for patients.
Mestas said the collaboration demonstrates the nursing technique of basing patient care on the best practices as demonstrated through scientific literature.
“Our nurses are now taking it a step further,” Mestas said. “Through their research, they are determining current best practices and disseminating to others by presenting their results locally, regionally and nationally. The collaborative model between the College of Nursing and the Medical Center has been recognized at the 50th year celebration for the University of South Alabama as one of the 50 most valuable research studies and also presented last year at the International Sigma Theta Tau Summit in Prague.”
First came participation in a national study in 2007, Transforming Care at the Bedside, sponsored by the Robert Wood Johnson Foundation and Institute of Healthcare Improvement.
The Transforming Care study urged nurses to note routines that did not work effectively and look for solutions. Many of the solutions were simple and implemented immediately. While Medical Center nurses implemented the changes — with the 6th floor as the study area and the 5th as a control — data were gathered, analyzed internally, and submitted to the study investigators for further analysis, contributing to research findings of the larger study.
At the hospital, however, the results were quickly evident. Simple changes like white boards with information for patients and hourly rounding by nursing staff cut the number of nurse call lights, allowing the staff to respond more quickly when needed.
Second came Our Neighborhood Healthcare Clinic, a College of Nursing managed healthcare clinic on the Medical Center campus staffed by advanced practice nurses. Founded in 2010 by a grant from the Department of Health Resources and Services Administration, the clinic serves as an alternative for patients who come to the USAMC Emergency Department for non-urgent health care needs. ONHC also offers wellness services at several community-based sites including Dumas Wesley, Trinity Gardens, and 15 Place.
Third, between 2011 and 2013, the College of Nursing and Medical Center once again joined a national study on Frontline Innovations, focusing again on barriers to safe and quality hospital nursing care. The study, sponsored by the University of Texas Improvement Science Network Study, gathered data about the types and frequency of interruptions encountered by nurses while providing patient care.
For 14 days, nurses carried pocket cards to record every interruption. Though it wasn’t a surprise, the data showed clearly that “it didn’t matter who or where, but nurses faced tons of interruptions,” Dearmon said.
“We weren’t satisfied to leave it at knowing there were interruptions, but we wanted to fix it. So we created a team to try to resolve the process issues, working to empower nurses to know how to address these problems,” she said.
For 18 months, a team of frontline nurses, faculty, and the chief nursing officer met every two weeks to consider options for addressing the problems, Dearmon said, because interruptions are more than a nuisance — they can cause errors, such as missed medications or equipment failures.
Trying to solve all the problems caused by interruptions proved too broad a focus. So the team concentrated on missing doses of medication, concentrating on vancomycin, the most common missing medication identified by nurses.
The quality improvement efforts led to an evidenced-based protocol standardizing the dosing of vancomycin and reducing delays in administration.
While working to resolve issues related to missing medications, nurses recognized the complexity of organizational issues and the time involved in solving operational problems. The nurses, anxious to resolve other issues simultaneously, explored different nursing governance models to broaden nurses’ engagement in finding solutions. Staff nurses went to the University of Alabama at Birmingham and Ochsner Clinic in New Orleans to study their shared governance models for nursing and returned with great new ideas, which are now in practice at the Medical Center. Currently, faculty members participate on each improvement team, helping to facilitate further research and solutions.
Partnership between the College of Nursing and the Medical Center won’t end with the award, Dearmon said.
“We are constantly looking for ways for students and faculty and staff to grow. We have a vision of a very competent team — pace setters for the nation. We want our nurses to really be the epitome of a professional group that not only understands and uses best practices, but also shows others what best practices are,” she said.
In the end, it’s not about processes or professions but about patient care. “Anytime, we can improve processes, we improve care. More time at the bedside improves outcomes, so we need to get rid of the things that interfere with that.
“There’s a huge movement in health care to make us more efficient and give better quality care,” Dearmon said.
Because of their numbers and their role in direct patient care, “Nurses are the ones that can make the biggest difference.”
About the University of South Alabama Medical Center
The University of South Alabama Medical Center offers patient-centered care to the central Gulf Coast with unique services including Mobile’s only Level I Trauma Center and Regional Burn Center, plus Centers of Excellence in stroke care and cardiovascular diseases, and a wide range of acute care services.
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