Nursing Update 2009 - 2010 - Yale-New Haven Hospital

Bedside reporting increases
patient safety and
satisfaction
Before bedside reporting began last summer
on General Medicine units 5-7 and 9-7, their
data showed that a significant percentage of
patient falls occurred during shift changes.
“At change of shift, nurses gave report
in a large conference room,” said Kathleen
Kenyon, RN, director of nursing, Medicine.
“Up to 16 staff could be talking about patient
plans of care. It was not an optimal environment
for sharing information or learning.
“On our units, we have moved change
of shift right to the patient’s bedside,”
continues Kenyon. “Staff now roll their
workstation on wheels into the patient’s
room to do the handoff. We used
evidence-based research to introduce a
change that is improving both patient
safety and patient satisfaction.”
Rochelle Mikolinski, RN, patient
service manager, General Medicine Unit
(7-5), points to the additional benefits of
the bedside hand-offs. “We increase our
patients’ involvement in decisions that
affect their care and help novice nurses
develop critical thinking through a goalcentered
report. Bedside reporting is also
very efficient: it takes less time, so it has
allowed us to reduce incidental overtime.”
“By doing bedside reporting at changeof-shift,
we include the patient in the process,
and he or she has an increased sense
of ownership in their own care because
they are involved in information-sharing
and decision-making,” said John Sward,
RN, patient service manager, General
Medicine Unit (9-7). “Nurses now start
their shift with improved understanding
of each patient’s status.”
Yale Pediatric Advanced
Care Team improves quality
of life for patients
Cindy Jayanetti finds that her pediatric
patients most appreciate the smallest gestures
– offering a drink of water or asking
how school is going. Jayanetti, APRN,
coordinates the Yale Pediatric Advanced
Care Team (YPACT), which provides the
extra support measures her chronically ill
patients and their families need. Whether
it’s scheduling a much-in-demand massage,
a Reiki or aromatherapy session, or
providing better communication within
and among the patient’s interdisciplinary
teams, Jayanetti works to improve the
quality of life for her young patients. With
the support she receives from collaborating
nurses and physicians, she’s been
able to increase the number of patients
she cares for over the past year.
“I see how patients improve when they’re
able to relax, whether it’s because of a massage
or having their questions answered,”
she said. “It makes a real difference.”
Palliative care helps
adult patients
Leslie Blatt, APRN, coordinator of palliative
care, recalls a 59-year-old cervical
cancer patient who had had a resection.
For 15 years, she had done well until a
fistula caused increasing pain and then
hospitalization. While the patient was
hospitalized, it became clear that her
cancer had reoccurred and that she was
nearing the end of her life.
“Working with a team of physicians,
nurses, a social worker and chaplain, we
managed her physical and emotional pain
which enabled her to be alert with her
loved ones,” recalls Blatt. “She was able
to say good-bye and also help ease their
burden because she was able to make her
own end-of-life arrangements. What was
most valuable to this patient was having
the ability to tell everyone in her life what
they meant to her.”
nurses lead chest pain
center accreditation
YNHH is the first and only Connecticut
hospital to receive Cycle III accreditation
from the Society of Chest Pain Centers
(SCPC) as a Chest Pain Center with Percutaneous
Coronary Intervention. Cycle III
is the highest level of accreditation that
the society gives.
“Gaining this three-year accreditation
is a major accomplishment that says
volumes about the quality of care patients
receive here at Yale-New Haven,” said
Mariane Carna, RN, MSN, executive
director, Heart and Vascular Services,
who notes that YNHH is the largest
provider of heart and vascular services in
the state.
Charlotte Hickey, RN, the clinical coordinator
of our Women’s Heart Program,
was responsible for organizing staff
and meeting the SCPC’s deadlines. The
rigorous accreditation process examined
the hospital, its policies and processes,
the competencies and training of the
staff who care for cardiac patients, community
education on heart disease, and
performance measures for diagnosing
and treating patients with acute coronary
syndrome.
“We are a designated chest pain center
that provides the best in cardiac care to
our patients,” said Hickey, who also does
community outreach. “But we also work
hard to keep people from developing
cardiac disease in the first place.”
A truly patient-, familycentered
care experience
Kelley Reddington, RNC-OB, admitted a
patient at 34 weeks gestation, whose
baby – with Down syndrome – had died in
utero and was to be induced. The family
also had an 8-year-old son, to whom they
wanted to introduce – however, briefly –
his sister. However, the unit’s visitor policy
excludes children under the age of 12.
“After conferring with the family, I
knew their emotional needs were of the
utmost importance,” explained Reddington.
“By using a team approach, I was
able to create a unique plan of care for this
grieving family that would allow their son
to visit.”
As the mother was about to be discharged,
Reddington visited the patient,
who told her that she had gone “above and
beyond” in her care for the entire family.
“I just treated them the way I would want
to be treated,” Reddington recalls. “They
touched my life and made me realize I love
being a YNHH nurse because I have the
autonomy to change the standard of care
to meet the needs of my patients.”
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