Good as Gold : Cardiac Surgery ICU Earns Beacon Award Gold Status
Cardiac Surgery ICU nurses celebrate their most recent honor as recipients of the AACN’s gold status Beacon Award for Excellence.
Nursing staff in the Cardiac Surgery ICU were thrilled to learn in August that they had received the American Association of Critical Care Nurses (AACN) gold status Beacon Award for Excellence—the only adult patient care unit in New England to do so. But equally important to them was that this award validates the ongoing work they have been engaged in as a nursing community to improve patient outcomes, develop patient- and family-centered care and advance nursing practice. The award application process served as an opportunity to bring all the elements of the work together.
“To some degree, completing the application organized us to reflect on all the components of our nursing work that contribute to better patient outcomes and impact care at the bedside,” said Nursing Director Matt Quin, BSN, RN. “And it galvanized the staff because we were all working toward common goals.”
Nurse Educator Maria Bentain-Melanson, MSN, RN, CCRN, CSC, agreed. “Staff nurses are even more involved in quality improvement work now than they were a few years ago,” she said. “They are the ones who drive all of our quality work; they identify where we need to improve and then work with the leadership team in developing strategies to help us meet our goals.”
In recognition of its efforts to improve every facet of care, the unit first received the Beacon Award for Excellence from AACN in 2010. This year, the AACN began designating a gold, silver or bronze status to award-winning units, and the Cardiac Surgery ICU received the highest level of recognition. Now a three-year award, the recognition lasts through 2014. Cardiac Surgery ICU staff will be recognized in 2012 at the National Teaching Institute (NTI) conference in Orlando, Fla.
“I am thrilled to congratulate the leadership and staff of Shapiro 6 West on this incredible acknowledgment of the exquisite care they provide to our patients and their families every day,” said Jackie Somerville, PhD, RN, senior vice president of Patient Care Services and chief nursing officer. “This award recognizes the nursing care in the Cardiac Surgery ICU as among the best in the country.”
To be considered for the award, nurses and nursing leadership outlined their work in the areas of evidence-based practices and processes; patient outcomes; appropriate staffing and staff engagement; leadership structure and process; knowledge management and best practices; and effective communication, among others.
The result is a comprehensive story that illustrates how nurses’ efforts in quality, safety and nursing practice translate to better patient outcomes.
“We have a sense of pride in the nursing care we provide, and it was nice to see it detailed in this application and to be recognized by the AACN,” said Theresa Seeley, BSN, RN, staff nurse on the unit.
A Focus on Quality
The Cardiac Surgery ICU has always maintained a strong commitment to quality improvement. In the past few years, the unit has focused its efforts on glycemic management, as well as reducing pressure ulcer rates and central line infections. With the support of Mary Fay Enrichment and Lily Kravitz awards, staff have traveled to other hospitals to research best practices in these areas and devise ways to adapt them for the Cardiac Surgery ICU.
Seeing the data on patient outcomes over time on the application made an instant connection for nurses to quality improvement when the unit filled out their first application for the 2010 award. “The application puts everything into perspective,” said Bentain Melanson. “You see not just the numbers and the data, but how our actions have truly had an impact on care at the bedside.”
It was also clear to the reviewers of the application that there is a deep-seated commitment among staff on every shift to continuously find ways to transform care.
“The application showcases a problem-solving process on our unit that involves everyone,” said Marija Walsh, MS, RN.
Commitment to Patients, Families and Professionalism
In addition to quality improvement initiatives, the application also focuses on many other areas including patient- and family-centered care, professionalism and education.
In the past few years, staff have worked to involve family members in the care of patients as much as possible, especially since the opening of the Shapiro Cardiovascular Center, which provides dedicated space for families in every patient room.
“The application really reflected our focus on patient-family centered care,” said Karen Politano, BSN, RN. “Everything we do is geared toward taking care of both patients and their families.”
With so many efforts to enhance every aspect of care, it’s no surprise that staff are committed to continuing their education and learning all they can. Many nurses are pursuing bachelor’s and master’s degrees in nursing and other certifications.
“Most nurses have joined the AACN, and many of us have taken or are going to take the CCRN exam,” said Dawn Tessier, BSN, RN, CCRN. “There’s a real commitment on this unit to continuing education.”
A Continuing Journey
Though the nurses appreciate the recognition, they also make it clear that this isn’t the end of their work to improve patient- and family-centered care.
“The award has informed us that we’re on the right path with the work that we’re doing,” said Quin. “But just as importantly, it has provided us with a roadmap of the work ahead and areas that we want to focus on improving. Reaching the next level of care is always central to our thinking and actions. This is by no means a stopping point for us – it’s a journey we’ll continue in order to provide the best care possible to our patients and their families.”
Associate Chief Nurse Mary Lou Moore, MSN, RN, agreed. “Under the leadership of Matt Quin and Maria Bentain-Melanson, the entire staff of Shapiro 6 West realized its power and strength,” she said. “Receiving the Beacon Award, now for the second time, does not mean that the journey has been completed. Instead the Beacon Award is a milestone. The journey, characterized by a total commitment to delivering the best care to patients and families, continues.”
What Does a Beacon Award-winning Unit Look Like?
The following are just a few of the areas of strength that application reviewers identified in the Cardiac Surgery Intensive Care Unit.
- Leadership: The leadership infrastructure consists of several groups, including the Cardiac Surgery Leadership Group, the Nurse in Charge group and the Clinical Colleague group. Clinical nurses play a significant role in identifying and addressing issues that affect patient care and nursing practice. Staff input is assured through multiple modalities, and all unit members have shared accountability in decision-making. There is open and supportive communication between leadership and staff, including a strong commitment by staff to develop a plan of action to promote respectful communication among the health care team.
Staff satisfaction: The unit systematically evaluates staff satisfaction regarding communication processes between staff and leadership. Leadership openly discusses results with staff and solicits input for improving processes.
Communication: Multiple structures, processes and practices are in place so that unit leaders can ensure effective communication among team members. These include: Nurse Practice Council, communications workshops, role modeling, staff meetings on all shifts and a variety of patient-focused rounds.
Quality benchmarking: The Cardiac Surgery ICU is committed to quality patient care as part of its mission. This commitment includes quality benchmarking, not only of the typical indicators such as CLASBI, CAUTI and VAP, but also unit specific indicators reported to and included in the specialty (Society of Thoracic Surgeon) database. These indicators are measured, feedback is provided to staff and processes to improve outcomes are developed.
Hand-off protocol: The Cardiac Surgery ICU has established proactive communication with the receiving intermediate care unit that promotes informed planning for patient transfers. This advance preparation supports a smoother care transition for staff, patients and families.
Support for new hires: The unit provides ongoing support for newly-hired nurses after they complete the formal orientation phase. Nurses new to the unit are paired with a clinical buddy, who provides ongoing support and helps them transition to more complex and higher skill-level assignments.