Nursing Update 2007 - 2008 - Yale-New Haven Hospital

Nurses improve practice
through transplant
certification
With the recent appointment of Sukru Emre,
M.D., an internationally known transplant
surgeon, the Yale-New Haven Transplantation
Center has witnessed a growing patient volume,
and cutting-edge surgeries such as the first split
liver and living donor liver transplant performed
in Connecticut. Last year, nurses expanded their
knowledge about transplantation in a study
group for a new Certified Clinical Transplant
Nurse (CCTN) credential exam developed by the
American Board of Transplant Certification.
Rick O’Connor, R.N., SICU, who led the study
group and was the first nurse to take the exam,
said research shows nurse certification improves
outcomes for transplant patients. The CCTN
exam covers heart, liver, kidney and pancreas
transplants, in addition to lung and small bowel
transplants. The certification also covers a
variety of nursing concerns and topics, including
vascular complications, infection control and
drugs that prevent rejection.
This year, three more YNHH nurses are planning
to take the rigorous test. Meanwhile, O’Connor
plans to begin a new study group and is targeting
all surgical ICU nurses to participate to
prepare for next year’s test.
Nurses standardize the
language of fetal monitoring
Families who decide to have babies at Yale-New
Haven Hospital can feel especially confident that
they will have a successful experience thanks to
an emphasis on safety in labor and delivery. A
perinatal patient safety nurse has instituted some
30 new evidence-based clinical guidelines, and
trained all perinatal teams in the proper use and
interpretation of fetal monitoring tests.
Her work has resulted in a 30-40 percent reduction
in adverse events in obstetrics, including
stillbirths, birth injuries and low Apgar scores
for newborns.
Training and certification in the use of fetal
monitoring alone made an especially significant
impact in the department. “Historically, doctors
and nurses trained separately in fetal monitoring,
and learned different terminologies,” said
Cheryl Raab, R.N., the perinatal safety nurse.
In the late ’90s, standard terminology was developed
to provide a common language pertaining
to variability and rates of acceleration and
deceleration of fetal heart rate.
Staff members on units that perform fetal monitoring
have taken and passed the fetal monitoring
training. Raab said the 223 obstetricians,
nurses and midwives who trained at YNHH
and took a national certification test had an
initial 99 percent pass rate, compared with a
national 87 percent pass rate.
Residency provides
support for new nurses
The hospital’s Post-Baccalaureate Nurse Residency
Program provides important support for
new nurses as they make the transition from
nursing students to acute-care professionals.
That support—unique among hospitals in New
England—has also become a draw for nurses
who choose to start their careers at YNHH.
In three years, 137 new nurses have completed
the year-long program developed by the
University Health System Consortium and the
American Association of Colleges of Nursing.
Residents cover such topics as clinical judgment
and leadership development. They meet monthly
in small groups with a resident facilitator
who may be from Southern Connecticut State
University, Yale School of Nursing or Yale-New
Haven Hospital.
In addition, 29 new associate degree and
diploma nurses have completed the New Graduate
Associate and Diploma Nurses First Year
Development Program, a parallel program to
the Nurse Residency Program.
Every new graduate nurse at YNHH is required
to participate in one of the two programs.
Graduates report that the programs gave them
the direction and support they need at a critical
time in their careers, giving them confidence and
introducing them to nurses who address their
questions in an encouraging environment.
“
Critical care nurses are feeling the impact of
the increased volume of transplant patients,
so it is becoming increasingly important for
us to enhance our knowledge as we set up
nursing guidelines and follow these special
patients through their ICU course. Advances
in medicine at YNHH are challenging nurses
to challenge themselves to keep improving
upon the way they provide care.”
— Rick O’Connor, R.N., Surgical Intensive Care Unit
and Staff Nurse Council Co-Chair
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