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, <strong>Yale</strong>-<strong>New</strong> <strong>Haven</strong> <strong>Hospital</strong> 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 <strong>Nursing</strong> Services, <strong>Yale</strong>-<strong>New</strong> <strong>Haven</strong> Psychiatric <strong>Hospital</strong>. “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 <strong>New</strong>born Special Care Unit; SNC co-chairs Nora O’Keefe, RN, Heart and Vascular Center (HVC) <strong>Nursing</strong> 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 <strong>Hospital</strong> Operating Rooms; Lisa Waterbury, RN, HVC <strong>Nursing</strong> 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 <strong>Nursing</strong>. “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. ■
Connecticut <strong>Hospital</strong> association’s <strong>Nursing</strong> Workplace Environment assessment Survey Through participation with the Connecticut <strong>Hospital</strong> association, YNHH nursing provided the leading benchmark for all other participating Connecticut hospitals on a fall 2008 staff engagement survey. This survey revealed that a majority of YNHH nurses feel empowered to create a quality and safe environment for all patients and their peers. % 80 70 60 50 40 30 20 10 0 RNs believe they have shared decision making at all levels of the hospital/ organization ■ YNHH (n=608) ■ all CT <strong>Hospital</strong>s (n=2083) RNs believe they are recognized for their performance RNs believe they have opportunities at work for them to learn and grow RNs are proud to work at YNHH SNC members Sybil Shapiro (second from left), RN, Shoreline Surgery Center: Endoscopy, and Liliana Lara (right) RN, Post-Partum Unit, paid a nighttime visit to General Medicine (9-7) on one of their SNC “road shows” to show staff the kind of information they can now access on the nursing website. Shown (l-r) are: Chizuru Bosley, RN; Shapiro; Susan Nichols, RN; Jasmin Rosales-Ancheta, RN; and Lara. Y A L e - n e w h A V e n h o s P I T A L 5
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