Nursing Update 2009 - 2010 - Yale-New Haven Hospital

the sickest patients for care. The doctors
and nurses who work in the Heart and
Vascular Center are highly trained and
experienced in helping patients recover
from heart disease and complex surgery.
Heart and Vascular nurse leaders have
tapped into the expertise and creativity
of their staff nurses to improve patient
benefits and outcomes. On the Cardiac
Intensive Care Unit (CICU), staff nurses
have conducted research on continuous
ischemia monitoring using new software
called the ST-map. The study was
completed in late 2008, and YNHH nurses
presented the results at national nursing
and medical conventions.
“We worked with an outside vendor to
get our bedside monitors upgraded with
the ST-map software. At the same time,
we secured a research mentor to help us
collect and analyze the data,” explains
Prasama Sangkachand, RN, service line
educator, Cardiac Intensive Care Unit.
“Continuous ischemia monitoring
helps us identify patients with acute – but
often silent – myocardial ischemia before
he or she becomes symptomatic – improving
patient care,” says Sangkachand.
“Based on the results of this study,
continuous ischemia monitoring using
the ST-map is now a standard of care in
the CICU.”
Innovative approach helps
staff help psychiatric
patients
In 2007, Yale-New Haven Hospital
estimated that more than 30 percent of
non-psychiatric and non-OB patients had
a secondary diagnosis of mental health
issues. In 2008, that translated into more
than 10,000 cases.
“At first, the numbers surprised us but
they really made sense when we analyzed
them,” said Leslie O’Connor, APRN,
director, Psychiatric Nursing Services,
Yale-New Haven Psychiatric Hospital.
“In the U.S., the psychiatric population is
aging and developing the same pains and
illnesses that the rest of us are developing.
As patients, they have co-occurring
psychiatric disorders that can interfere
4 n u r s I n g u P D A T e
During the Year of the Unit, the Staff Nurse Council was also proud of its year of accomplishments. The members
shown are (front row, l-r): Mary Ann Meehan, RN, General Medicine; Roseann Della Ventura, RN, and Laurie
Jonason, RN, both of the Newborn Special Care Unit; SNC co-chairs Nora O’Keefe, RN, Heart and Vascular
Center (HVC) Nursing Procedures, and Heather Miska, RN, Children’s Psychiatric Inpatient Service; Rhonda
Pattberg, RN, Labor and Birth; Shelley Harrigan, RN, Adult Primary Care Center; and Liliana Lara, RN, Post-
Partum Unit. In the second row are (l-r): Sandy Cayo, RN, Medical Oncology Unit; Laurie Finta, RN, Perioperative
Services, Ambulatory Services; Ebony Wright, RN, Children’s Hospital Operating Rooms; Lisa Waterbury, RN,
HVC Nursing Procedures; Sybil Shapiro, RN, Shoreline Surgery Center: Endoscopy; Kelly Baran, RN, Gyn/
Oncology Unit; Jason Malia, RN, Surgical Intensive Care Unit; and Deborah Gallagher, RN, Pediatric Emergency
Department. Missing from photo is Mary Kelly O’Shea, RN, Pediatric Post-Anesthesia Care Unit.
with their ability to participate in their
own treatment and recovery.”
O’Connor worked with nursing and
medical staff leaders, and William H.
Sledge, MD, medical director, YNHPH, to
develop the Behavioral Intervention Team
(BIT). The interdisciplinary BIT includes a
clinical nurse leader, an advanced practice
registered nurse, a social worker and a
psychiatrist.
BIT members train staff on the medical
and surgical units where these patients
are most frequently admitted. Once patients
are identified, BIT members consult
with clinicians – and with the patients.
“With the BIT, we’re able to address
the special needs of psychiatric patients
on inpatient units,” said Susan King,
RN, clinical nurse leader, YNHPH, and a
founding member of the BIT.
“BIT training is helping our nurses better
care for our patients who have psychiatric
needs,” explains King. “The results
are very positive: patients are better able
to participate in their own care, and we
are providing a safe environment for the
patient and staff.”
nurses play pivotal role
in move to patient- and
family-centered care
YNHH has embarked on a hospital-wide
model of care known as patient- and familycentered
care, and its nurses are considered
the champions and educators of its core
concepts: information sharing, dignity and
respect, collaboration and participation.
“Nurses are helping to lead the charge
on this initiative because they are pivotal
caregivers, present for every decision
from admission to discharge,” explains
Cheryl Hoey, RN, director, Pediatric Nursing.
“Focusing on the patient and his or
her family will change the entire culture of
how we care for our patients.”
Measures such as providing patients
and families with a phone number that
they can call to activate a team if they
feel that the patient needs help urgently,
allowing family members to be present in
Emergency Department trauma rooms,
and referring to family members as
“guests” rather than visitors, all reinforce
the concept that at YNHH, the patient is
truly at the center of his or her care. ■