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Boston Childrenís ED basks in glow of ENAís Lantern Award

Monday September 10, 2012
Fran Damian, RN
Fran Damian, RN
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Determined to improve their care through research, ED nurses at Boston Childrenís Hospital are savoring the 2012 Lantern Award they received from the Emergency Nurses Association. But they vowed not to let the glow of the honor keep them from their quest to incorporate new evidence into their practice and to enhance patient care.

"Itís an amazing honor and a reflection of so much commitment and dedication from the whole team," said Fran Damian, RN, MS, NEA-BC, director of nursing and patient services for Boston Childrenís ED.

The Lantern Award recognizes an EDís commitment to quality, safety, a healthy work environment and innovation in nursing practice and emergency care. Twenty-seven EDs across the country applied for the honor, and only eight won the award.

"Working on the application was an interesting experience to reflect on the course of a year and put in a portfolio all of the things the nurses and team accomplished together," Damian said.

"Weíre on a great roll," said Diana Volpe, RN, BSN, an ED staff nurse 3. "We are committed to evidence-based practice, and when new evidence comes up, we look to incorporate that."

Using plan/do/study/act cycles of improvement, the ED nurses collaborated with physicians and changed processes, practice and guidelines for care.

Now when patients arrive with a long-bone fracture, the standard calls for intranasal fentanyl to control the pain. Asthma patients receive a bronchodilator within 30 minutes, and the team is now working on starting them on steroids within 60 minutes. Nurses administer antibiotics to children with fever and neutropenia within an hour. No behavioral health patients are restrained.

The Boston Childrenís ED has reduced specimen labeling errors by 75% and decreased contaminated blood culture specimens from more than 2% to 0.05%. The ED nurses also have improved handoffs and engaged parents in the process. The team has published findings from the research and process changes in several journals, including Pediatrics, this year.

To promote work/life balance, the ED tries to maintain a consistent schedule for off shifts that match personal needs and offers senior staff and two nurses each month — and four in May and November — the opportunity to select their shifts to work. Every nurse receives a 45-minute break each workday.

The hospital also was chosen No. 1 nationally this summer in U.S. News & World Reportís Best Childrenís Hospitals list.

Eight nurses will attend the ENA gala Sept. 15 in San Diego, when Damian accepts the award. The gala will take place on the final night of the ENAís 2012 annual conference.

"Getting the award feels so wonderful," Volpe said. "The wonderful care [the ED nurses] provide every day gave us the amazing material for the application."

Debra Anscombe Wood, RN, is a freelance writer.


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