Shapiro 9 East Honored by AACN with Silver-Level Beacon Award

Members of Shapiro 9 East pose with their Beacon Award.

Shapiro 9 East, the Cardiac Intensive Care Unit (CCU), has received a silver Beacon Award for Excellence from the American Association of Critical-Care Nurses (AACN), making it the third unit at BWH to earn this national honor. (Shapiro 9/10 earned a silver Beacon Award in 2013, and the Cardiac Surgery ICU earned a gold Beacon Award in 2011.)

"This national three-year award recognizes the exceptional patient care delivered every day by the staff on Shapiro 9 East and the achievement of a healthy work environment," said Nurse Director Karen Reilly, MBA, RN. "We could not have achieved this recognition without the outstanding dedication of our staff to our patients and families."

The Beacon Award recognizes unit caregivers who successfully improve patient outcomes and align practices with the AACN's six Healthy Work Environment Standards, including outcome measurement; leadership structures and systems; appropriate staffing and staff engagement; effective communication, knowledge management, learning and development; and evidence-based practice and processes. The silver-level award signifies continuous learning and effective systems to achieve optimal patient care. 

For the CCU, the Beacon process has been a five-year journey that involved many staff across the 10-bed unit.

"I looked at the application process as a long athletic event-just keep on, keeping on, and we will get there, one mile or one page at a time," said Paul Sedgwick, BSN, RN, CCRN, nurse-in-charge. "We tackled a major project and were able to succeed."

Mary Sheehan, MA, BSN, RN, originally compiled and edited the responses staff developed for the application questions. During this process, the AACN changed its application, and Sedgwick took on the task of rewriting and editing the information before handing it over to Sharon Levine, BSN, RN, for a final edit.

The end result is a 50-page document that contains data on patient outcomes, quality improvement and narratives from nurses about patient care. 

"Our clinical nurses initiated the application and stayed committed to completing it," said Clinical Nurse Educator Kathleen Ryan Avery, MSN, RN, CCRN. "Through the application process, nurses were able to evaluate the many excellent systems and processes we have in place in the CCU and their effect on patient outcomes. It is evident in the application that outcomes are positively impacted when the patients and families feel known by their nurses."

Levine, who has worked on the unit since 1981, said she was surprised by how much she learned from the application process. "When you look at it and write about it, you see how important the work you do every day is to improving outcomes."

One application question asked how the unit fosters a "culture of inquiry." Even though many nurses on the unit, like Levine, have been there for a decade or more, they all appreciate how much cardiology and nursing have advanced, making it an environment that requires constant learning. 

"No two patients are the same," said Levine. "The CCU sees a population of patients with co-morbidities, such as cancer and endocrine or respiratory issues, and cardiology is just one part of their care. We're a major referral center and get patients from all over the country with all kinds of complexities."

One way that nurses helped to foster a culture of inquiry was by starting a blog and writing about what they learned when they attended conferences in order to share knowledge across the unit. 

Reviewers of the Beacon application highlighted many additional areas of strength for the CCU, including:

Patient outcomes: The unit has experienced zero patient falls with injury since 2012, and its central line-associated bloodstream infection (CLABSI) rate has been on a positive downward trend since 2010.

Effective communication: Unit leaders ensure nurses participate in daily physician rounds, use a daily care planning sheet, attend twice-weekly multidisciplinary rounds and follow a standardized process for hand-off communication. These tools and processes facilitate communication among the patient, family and members of the care team. 

Best practices: Weekly ethics rounds on the unit provide a forum for all staff to discuss and learn from ethical situations that arise.

"The Beacon Award validates what a great unit the BWH CCU is and has been throughout the years," Sedgwick said. He credits Reilly and unit leadership with helping to drive the application process. "It wasn't to wave the flag and say we are great, but rather to validate what staff do each day and night, whether that's saving someone's life or holding the hand of a dying patient." 

The unit will be recognized at the National Teaching Institute and Critical Care exposition in San Diego in May 2015.