St Mary’s ICU & CVICU merited Beacon Award for excellence
By Nancy Lofholm/For St. Mary’s Medical Center
In a small conference room on the units where the sickest of patients are cared for at St. Mary’s Hospital, dozens of slips of paper fringe a wall board.
These handwritten notes seem almost out of place in a unit where so much attention is focused on the high-tech array of life-saving equipment. But these notes impact many facets of care – for patients, as well as families and staff — in St.
Mary’s Intensive Care Unit and Cardiovascular Intensive Care Unit.
All employees in these adjacent units, including nurses, respiratory therapists, pharmacists and certified nursing assistants, have been encouraged to post their thoughts about problems and potential improvements on what has been dubbed ‘the idea board.’ The changes that have come from these ideas range from the simple to the complex: laminated cards now identify when a nursing cart has been cleaned; a more comfortable needle is used to inject patients with blood-thinning drugs; anti-bacterial wipes are used on a schedule that maximizes their effectiveness for patients with arterial lines; busy staff can order food by phone to pick up from the cafeteria; family members of patients have better signs directing them to the proper unit when they exit the elevator.
“Nothing is too small or too big for the idea board,” said ICU nurse manager Kelly Coffin, who has been caring for critically ill patients at St.
Mary’s for 19 years. “All ideas are given consideration. This is very much a collaborative process.”
The idea board — and more importantly, the attitude behind it — was a factor that recently merited Beacon Award for Excellence recognition for St. Mary’s ICU and CVICU. The awards, from the American Association of Critical Care Nurses, are given to units within hospitals and health-care facilities that can demonstrate they have met or exceeded quality standards. The awards take note of good leadership, effective communication, staff engagement, continuing education, and outcomes for patients.
The awards put a positive spotlight on the two critical care units at St. Mary’s where 105 nurses and certified nursing assistants oversee 32 rooms that are often near capacity.
Patients who are brought to the emergency department with serious illness or trauma often end up in these units.
The intensive care staffs must be ready to handle an across-the-board list of maladies that include serious head and spinal injuries, sepsis, runaway infections, organ failures, heart attacks, cancer complications, respiratory issues, and accident and gunshot trauma.
In this life-and-death environment where emotions can run high for patients’ families and where violent behavior is not that unusual for patients with brain injuries, a well-trained, cohesive staff is vital to administering the best in intensive care.
Danette MacMillan, the nurse manager for CVICU, said that is why she and Coffin work closely together to ensure the staff in these difficult units feel supported and listened to.
“Our management style is transformational. We are right there with our staff. We are not barking orders at them,” MacMillan explained.
That goes to the heart of two factors the critical care nursing association considered in the detailed 49-page application from St. Mary’s — staff retention and job stability.
Coffin and MacMillan said they make it a point to connect face-to-face with each of their staff members every day.
Staff members have their
cellphone numbers to help in crisis around-the-clock.
At each shift change the nurse managers gather in the conference room with the nurses, the certified nursing assistants, respiratory therapists, dieticians, infectionprevention personnel and pharmacists for what is called ‘the huddle.’ That is when everyone shares input on patient care. It is also when problems, ideas and solutions listed on the board notes can be discussed.
The Intensive Care Unit and Cardiovascular Intensive Care Unit at St. Mary’s Hospital post ideas and review solutions on their “idea board’ in an effort to better support the community.
MacMillan and Coffin say knowing each of the people working in their units has made a difference in staffing.
The units have been able to move from having as many as 30 travelling nurses — nurses who rotate in and out of various hospitals — to having only full-time St. Mary’s employees on the nursing staff in the ICU and CVICU.
They have been able to attract new graduates of nursing schools by offering a residency program and by being open to the career paths of the millennial generation.
MacMillan said, because critical care nursing is so difficult, and because it gives newly minted nurses wide experience, many will work in the units for a year or two and move on to another specialty. MacMillan and Coffin recognize that as a reality in critical-care units and encourage nurses to be open about their plans. They let them know they won’t suffer consequences if they are seeking other jobs or planning to move on. They will still be valued and will be trained in the best way possible.
“I want to support people and give them the best education I can even though they may only be with us for two years,” Coffin said. “I want them to be the best nurse they can be no matter where they are working.”
“We both have an opendoor policy. Staff can come in and vent. They can get acknowledgement that their jobs are tough. They can get it all off their chests so they can be at the top of their game with the patients,” MacMillan added.
There are three levels of Beacon awards — gold, silver and bronze. St. Mary’s ICU and CVICU were awarded silvers.
That award recognition is good for three years. The units can then apply again.
Coffin and MacMillan are planning to go for the gold.
The feedback on their Beacon Award stated that they needed more research tools to track particulars about their units — thus the silver rather than the gold.
Because this is a unit where all details are important, all feedback is welcome, and large and small improvements are constantly taking place, Coffin and MacMillan are already looking at ways to improve their research methods.
“We were told we need to be better data collectors,” MacMillan said. “And we will be.”