Regional Spotlight on Nursing

December 20, 2019

Regional Spotlight on Nursing: Alaska

Each issue of Best in the West highlights the accomplishments of PSJH nurses in one region or service area within our organization. Continue reading to learn more about recent nursing achievements in the Alaska region.
By: Jim Reineke, Regional Chief Nursing Officer, PSJH Alaska Region

The Providence system and team of caregivers provide premier care in every facet of healthcare in Alaska… from birth to death, Providence leads the way for Alaska! In partnership together, we are the state’s largest medical center, only long-term acute specialty hospital, and most integrated long-term care system as well as providing superior hospice and home & community services together with our Critical Access Hospitals. I’m proud to work with a team committed to mission and service. Below are some recent highlights from your partner from the North!

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Regional Highlights

  • Initiation of Regional Clinical Council and collaborative support for nursing residencies
  • New site of University of Providence Accelerated BSN program
  • First Year Turnover for Clinical Academy residents from 2016 – 2019 = 5.7%.
  • Reverification of both adult and pediatric trauma center designation
  • Implementation of Opioid Use Disorder care across Med-Surg and Mother-Baby units.
  • Multiple program and technology roll-outs across the region (e.g., Alaris pumps, leader standard work, learning board implementation across all units/departments, Epic Rover, LEAF technology across select Medical Center units)
  • ED Patient satisfactions scores highest throughout the system
  • ED decrease of overhead pages leading to quieter environment for patients and fewer interruptions to facility operations
  • IDIRT work with Ebola and infectious disease training and readiness.  Ministry-wide readiness/preparedness training on “First Fridays”.

 

Critical Care

  • Fall ICU/CTICU fellowship supporting five RNs
  • ICU established standard of work on how to prone an intubated patient using ceiling lifts
  • Initiated Organ Donor Honor Walks so we may come together as a ministry to honor a donor’s life and gift
  • ICU/CTICU early mobility rounds for all patients. Rounds focus on sedation vacation compliance and mobility goal setting.
  • CICU 14 months since last CAUTI and 18 months since last CLABSI
  • E-ICU and Teleheath innovation: Telephone Triage taking after-hours first call for all home health patients. This collaboration between telephone triage and home health provides for immediate access to skilled nursing advice and, if needed, the dispatch of a home health nurse for in-person interventions.
  • Training and validation as AK’s Ebola Assessment Site

 

CardioVascular Services Collaboration

  • Initiation of early extubation/extubation in the OR for surgical patients leading to improved patient safety, throughput and a decrease in ICU hours by 19.6.
  • Observation unit nurses now doing select low risk procedures outside of the Cath Lab to support the Lab volume and utilize resources at their highest potential
  • Cardiac Pulmonary Rehab engaging our patients from a whole person approach through strengths building exercises, dietary planning and education, stress reduction skill building, meditation classes, and yoga
  • Initiation of new Mitral Clip, Convergent and CardioMEMs programs
  • Expanding care and capacity. New cardiovascular educator who is redesigning onboarding and ongoing education; new Surgical Navigator who follows the patient and family from pre-op, through the procedure, during the hospital stay and through the discharge planning process supporting care teams, providing support and education to the patients and families and assuring quality continuity of care.
  • Healthgrades awards PAMC 5-star recipient for treatment of Heart Attack
  • Recognized by US News and World Report for treatment of Heart Failure
  • NCDR platinum performance award for Chest Pain-MI

 

St Elias

  • Integration continues into the Providence/St Joseph Health system with the first go-live scheduled for 1 January 2020
  • Completed high acuity room upgrades increasing capacity by 80% for this population
  • Nursing re-alignment to provide additional leadership opportunity consistent w/ appropriate spans and layers for team
  • Plans for launch remote telemetry and eICU.

 

Valdez – CAH & LTC

  • Sustaining High Reliability: 1165 since last SSE
  • Remote monitoring TeleSitter, Telemetry, and eICU operating smoothly with satisfied Providers
  • Trauma and Safe Patient Handling Fairs with all caregivers completed for 2019
  • Recertified as a Level IV Trauma with no deficiencies
  • LTC Awarded 2018 & 2019 Quality Award.
  • Shared Governance model in LTC
  • CAUTI: 3½ years since last incident (n=605)
  • SSI: 5 ¾ years since last incident (n=71)
  • C.Diff and MDRO’s: 5 years since last incident (n=19973)
  • Falls with injury : 600 days since last incident (2,015 patient/resident days)
  • Population Health: 67% percent decrease of ED visits due to Population Health efforts with partners  

 

Seward

  • First CAH to participate in PSJH Clinical Academy for new graduate nurses.
  • Hired our first part-time nurse educator, solely dedicated to improving education and competencies of PSMC. All previous educator roles were a dual role.
  • Brought STABLE class down for nursing staff. STABLE and ENPC are now requirements for PSMC nursing staff
  • Offering annual labor and delivery class to nursing staff (Fall of 2018 & 2019). Last class was 2015.
  • We are the only CAH in Alaska to participate with PAMC in the Pediatric Readiness Quality Collaborative. We are focusing on two areas.
  • Obtaining pediatric weights in kg
  • Reporting all abnormal VS to MDs and noting in Epic
  • Passed Level IV Trauma recertification w/ flying colors.
  • Working with PAMC Pharmacy to reduce waste and improve current PAR levels to match usage.
  • Implemented huddle board to communicate with areas affected by nursing
  • Partnering w/ local correctional facility for access and specialty care in their vulnerable population.

 

Chiniak Bay Elder House - Kodiak

  • Won the Mountain Pacific Nursing Home Quality award
  • Continuous improvement in aim for zero harm: 707 days since last SSE
  • High Reliability: use change of shift huddles and learning boards as a team approach to process improvement
  • Communication/training to improve quality of life for the residents by early recognition of symptoms to keep the residents in their home environment
  • Focus on age-appropriate care for residents
  • Involving the residents in community activities to promote their quality life such as: drives to see wildlife, fishing trips, crab fest, church events, shopping and much more!

 

Providence Transitional Care Center (PTCC) and Providence Extended Care (PEC)

  • PEC and PTCC received the 2019 Innovation in Transformation of Patient Safety and Quality Award from the Alaska Hospital and Nursing Home Association. The award recognizes a hospital and a nursing home that have developed and implemented an innovative patient safety and quality process, project, or program with measurably improved outcomes. 
  • PEC received a Quality Excellence gold pan from Mountain-Pacific, our Quality Improvement Organization
  • PEC and PTCC successfully implemented the new Patient Driven Payment Model (PDPM) on October 1st

 

The Children’s Hospital at Providence

  • New glucose gel protocol for normal newborns
  • Successful move of the state’s only Forensic services into a new building while implementing new workflows to better support the sensitive care provided to children and adults suffering from domestic abuse, neglect, and sexual assault
  • NICU Total Preemie Nutrition work group poster presentation at VON related to focused work on improving the growth of babies while minimizing the chances of NEC
  • NICU focus team poster presentation related to work on increasing nurturing encounters for infants and improving neurodevelopmental growth.  This group engaged parents, caregivers, and their volunteer Cuddle Core to significantly increase kangaroo care and infant holding times.
  • Maternity has increased the % of patients appropriately prescribed opioids when discharged after vaginal or
    c-section delivery (from 32.7% to 61.7% compliance!)
  • Successful integration of the Nurse Family Partnership team into the TCHAP areas to link this program with like services 

 

Kodiak Island Medical Center

  • Continue to sustain High Reliability through use of a daily facility safety huddle, change of shift department huddles, impromptu safety huddles around care of patients, ICU rounding and caregiver engagement using learning boards.
  • Continuous Improvement in aim for zero harm: 311 days since last SSE
  • Decreasing medication errors: Implementation of huddles when a medication error occurs involving leader, caregiver and pharmacist to develop solutions together.
  • Decreasing our take home opioid prescribing post-delivery
  • Recently started SIMS with our new manikins (Sophie & mum and a newborn simulator)
  • High focus on age-appropriate care & cultural diversity
  • Focus on providing safe/compassionate care for our behavioral health patients with increased length of stay
  • Community outreach with health fairs, education and donation campaigns to improve the outcomes of our community.