Empirical Outcomes

As hospital-acquired condition (HAC) rates rose within the pediatric intensive care unit (PICU), the department’s nursing leadership team created a competition to engage a staff of more than 300 people in hospital initiatives addressing the challenge.

For the yearlong HAC-Down Smackdown, teams encompassing all PICU disciplines were headed by nursing team leaders. An interprofessional leadership team developed a scoring system whereby teams earned points by participating in HAC-focused initiatives and lost points when a hospital-acquired condition or safety event occurred. Quarterly recognition and awards were given, including overall winner and most valuable players.

Results:

• In Q1 and Q2 2023, HACs decreased by 43% compared to the same time period in 2022.
• Average staff attendance in unit-based HAC committees increased by 93% from 2022 to 2023.
• An increase in staff adherence to evidence-based practice bundles.
• The creation of several unit-based HAC reduction initiatives.

Interprofessional program seeks to prevent injuries from falls

Nurses are improving patient safety through an interprofessional fall-prevention program.

The nurse-led program initially focused on addressing falls related to patient bed type, a top reason for falls. Team members piloted a bed-safety initiative, which launched in February 2023 in the Dallas Neurosurgery department. Aligning to best practices, patients younger than 24 months old were required to be placed in a crib instead of a normal patient bed. Fall prevention team members conducted daily audits to ensure they were in cribs and reinforce safety education with families. As a result, Neurosurgery had zero injury-related falls in 2023.

Nurse-led, quality-improvement initiative reduces adverse drug events

The need to address increased adverse drug events (ADE) led to a collaborative, multi-pronged solution.

Using the newly developed Nursing Medication Safety Council, nurse leaders engaged clinical nurses in a quality-improvement initiative designed to enhance safe administration of medications by nurses.

Also, oversight of medication-safety initiatives across the organization were centralized with a group of safety officer leaders representing three key areas: physician, pharmacist and nurse. Nurses used data to identify barriers related to medication administration and used this information to standardize practices in alignment with evidence-based practices. Leaders updated education and competencies, and they engaged preceptors to ensure nurses received consistent training during onboarding.

In addition, a six-month campaign, “I Got Your Back,” reiterated the importance of two nurses working together when administering a high-risk medication or procedure. Both nurses independently verify the correct steps will be followed to keep the patient safe.

These initiatives contributed to the reduction of the total number of ADEs by 80% from 2022 to 2023.