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North Carolina nurses learn about, implement care innovations

Tuesday March 4, 2014
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Nurses from seven North Carolina hospitals recently shared results from care initiatives that significantly improved patient outcomes while demonstrating anticipated financial savings of more than $2.5 million, according to a news release.

The results stem from the nursesí participation in a 16-month experiential, hospital-based nurse leadership and innovation training program sponsored and funded by the American Association of Critical-Care Nurses.

Known as AACN Clinical Scene Investigator (CSI) Academy, the team-oriented program empowers bedside nurses as clinician leaders and change agents whose initiatives generate quantifiable improvements in the quality of patient care and hospitalís bottom lines.

Earlier this month, the North Carolina AACN CSI Academy teams presented the results of their initiatives at a conference in Chapel Hill, reporting noteworthy clinical and fiscal outcomes.

Four teams focused on early progressive mobility. Growing evidence documents the benefits ó including a reduction in ventilator-associated pneumonia, pressure ulcers, deep-vein thrombosis and, potentially, length of stay ó of integrating early and progressive mobility into patient care protocols.

Among the early mobility-related clinical successes achieved by the CSI nursing teams at Duke Raleigh Hospital, Rex Healthcare, UNC Health Care and WakeMed Cary Hospital: decreased ICU length of stay by more than one day, reduced mechanical ventilation days up to 35%, reduced VAP up to 60%, decreased pressure ulcers up to 20%, reduced readmission rates and increased HCAHPS (patient satisfaction) scores.

The CSI nursing teams at Duke Regional Hospital, Duke University Hospital and WakeMed Raleigh Hospital reported similar positive outcomes from projects with other patient care focuses: They reduced patient falls by 30%; decreased catheter-associated urinary tract infections by more than half; and improved communication with patients and families, contributing to shorter average length of stay.

The North Carolina cohort is the second regional group to complete AACN CSI Academy, following Indianapolis last November. Groups continue at hospitals in Massachusetts, New York, Pennsylvania and Texas, where participants are undertaking projects to address prevention of delirium, VAP, central line-associated bloodstream infections and unplanned extubation, and improved communication, teamwork and patient handoffs.

The AACN CSI Academy Innovation Database provides access to a compilation of CSI team results and documentation. The searchable database of real-world project plans, clinical interventions, data collection tools, outcomes and references will grow as additional CSI teams complete the program.

Access the database from the AACN CSI Academy web page: www.aacn.org/csi


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