MICU team wins award for reducing infections and falls

In 2020, the Medical Intensive Care Unit (MICU) at South Texas Veterans Health Care System in San Antonio received the DAISY Award for Exceptional Patient Safety Nurses.

This is an excellent honor that the MICU team has earned through initiatives which have nearly eliminated catheter-related peripheral bloodstream infections, catheter-related urinary tract infections, pneumonia, ventilator-related events and falls. This is kind of a feat. It took teamwork to do that.

Empowering the MICU team

The DAISY Foundation’s signature program recognizes nurses and clinical teams year-round for extraordinary, compassionate care. This coveted award emphasizes efforts to enhance worker and patient safety. The South Texas Veterans Health Care System’s MICU team of 27 physician specialists and five nursing assistants were initially recognized for his or her compassionate care of the veteran for greater than two years. During the time spent with the patient, the ICU increased situational awareness, or the power to perceive and understand the patient’s condition and predict a plan of action, from 62% to 98%. According to a DAISY press release, the result’s safer patient care and higher communication with staff. “Following high reliability principles, the team began holding twice-daily huddles, recruiting hand hygiene sheriffs and using evidence-based care packages to prevent infections,” the discharge said. Michael Pomager, RN Staff involvement led to high-quality care provided within the ICU, said Michael Pomager, MBA, RN, CEN, chief nurse within the intensive care unit – as did empowering nurses to guide nursing practice. “This culture has resulted in favorable performance rates, positive patient experiences and high staff morale.” The MICU team’s success in nearly eliminating hospital-acquired infections and falls will be attributed to many aspects, including a robust commitment to serving America’s veterans. They also created a culture of shared governance and leadership support, in response to Celida Martinez-Vargas, DNP, RN, who was the MICU/CCU/DARRT nurse manager [Dedicated Acute Rapid Response Team] from September 2016 to August 2020. Above all, nevertheless, it was vital to be sure that every team member was involved in every process within the unit, Martinez-Vargas said.

Celida Martinez-Vargas, RN

“Over the past two years, the team has implemented multiple nosocomial infection prevention systems and created a culture focused on failure,” she said.

This interest prompted the implementation of measures similar to:

• Implementing safety meetings
• Multidisciplinary fast rounds
• Bundles of catheter-related urinary tract infections
• Bundles of bloodstream infections related to the central line
• Ventilator-related event packets
• Hand hygiene sheriff

“Through these systems, we are exceptionally consistent in achieving our goals of avoiding potentially catastrophic errors and/or events,” said Martinez-Vargas.

Increasing situational awareness

The MICU improved situational awareness with improved communication initiatives learned from team strategies and tools to extend efficiency and patient safety (TeamSTEPPS) and HRO training, in response to Martinez-Vargas. “The initiative developed and implemented were safety meetings conducted by nurses. These meetings take place twice a day before each shift change and last about 10 minutes,” she said. During the huddle, team members share information in regards to the census, staffing for the day, and the health status of every patient, giving team members the chance to boost concerns, needs, or what they value regarding safety, methods and practices, equipment, supplies, and staffing , Martinez-Vargas said. Many lessons were learned that may help other nurses improve patient care and safety, but Martinez-Vargas says all of it comes all the way down to the essence of nursing. Nurses should continually examine their hearts to recollect why they’re nurses, their mission, and the way to do the correct thing even when nobody is watching. We start each meeting and conference with an outline of the mission and vision of the system.

“This will help us get back on track,” Martinez-Vargas said. “One of the lessons we have learned is to celebrate short-term goals that we have achieved, or as my grandfather used to tell me, ‘…you have to stop and smell the tortillas!’ It’s important to celebrate your short-term goals so that it continues to give you the momentum you need to achieve your long-term goals.

Jose Martinez, RN

Achieving success is not the end of the journey

Nursing practice continues to change and evolve, Pomager said, and the department’s success is due in part to the team’s “willingness to continually re-evaluate its processes to incorporate current, evidence-based practices and/or credible clinical guidelines,” he said. “This was particularly evident when the team modified strategies to prevent injury and infection in critically ill Covid-19 patients.” Martinez-Vargas said the MICU team has learned many things since receiving the DAISY award and the emergence of the Covid-19 pandemic. The processes utilized in the ICU were tested and the team learned that it was crucial for all ICUs to be standardized in all processes or packages related to the prevention of injuries sustained within the hospital, she added. “We must remain committed to ensuring access to education for everyone. During the pandemic a [hospital-acquired injury] a packet book was created, which was instrumental in ensuring we were all on the same page,” Martinez-Vargas said. Jose D. Martinez, BSN, RN, CCRN, MICU/CCU/DARRT nurse at STVHCS, said these initiatives have had a multi-faceted impact on the ICU. “Promoting continuing education definitely allows me to not only become a more competent nurse, but also to instill high standards in our practice and performance,” Martinez said. “We are able to see results through diligent work, which in turn provides our team with a sense of cohesion and camaraderie. In a naturally stressful environment, knowing that our team members care about each other definitely helps reduce that stress. I believe this has an absolutely positive impact on our patients, as seen in our great results.”

Take courses related to infection prevention:

Central line-related bloodstream infections (CLABSI) affect roughly 400,000 patients annually within the United States. Nurses can play a major role in eliminating these disturbing facts. Adhering to a bunch of evidence-based interventions often known as a central line bundle has been proven to cut back the incidence of CLABSI in healthcare settings. The components of the central line kit give attention to proper insertion and maintenance of central lines to cut back the incidence of infection. Methicillin-resistant Staphylococcus aureus is a crucial pathogen in health care settings and the community and is asymptomatically transmitted by healthy people affected by chronic diseases, hospitalized or living in long-term care facilities. It may cause serious infections, including blood infections, pneumonia, wound infections, skin and soft tissue infections, urinary tract infections and meningitis. All members of the health care team must play an energetic role in adopting, modeling, and inspiring practices that prevent the spread of MRSA in health care settings. These include consistently practicing hand hygiene, taking precautions when coping with MRSA-infected patients, and ensuring that equipment is correctly disinfected. This module discusses hospital-acquired and community-acquired MRSA infections, the history of MRSA, transmission, treatment, and prevention methods. Whether at the positioning of surgery or on the hands of a healthcare skilled, human skin is inherently laden with everlasting and transient flora. This course examines the way to reduce pathogens on the skin of caregivers and surgical patients to cut back the danger of infection. Provides historical context and explains proper use of gloves, skin antiseptics, surgical peels, and preoperative cleansing. The course will even discuss sorts of antiseptic solutions and considerations regarding their use.