EXEMPLARY PROFESSIONAL PRACTICE focuses on how nurses throughout the organization are involved in shared governance and shared decision-making, and explores how interprofessional collaboration promotes quality excellence in a culture of safety.
Largest Class of Nurse Residents
In August, Valley welcomed 63 nurse residents, its largest group to date. These aspiring nurses were placed in various departments including Medical/Surgical, Critical Care, PACU, Pediatrics, Women’s and Children’s Services, the Emergency Department, CDU, and the float pool.
Many were recognized by patients for their exceptional care, and some have prevented patient harm by using HRO tools. In October, the nurse residents participated in two simulations which focused on recognizing a deteriorating patient, as well as communication with a difficult patient/family member, and delivering medication safefly through common distractions.
Through simulation, the residents were able to practice real-life scenarios to have a better understanding of how to act in those situations.
We thank these nurses for their interest in Valley and wish them the best in their career pursuits.
A Thank You Celebration for Construction Workers
To show appreciation to the hundreds of highly skilled construction professionals working to build our new hospital, a noontime pause was held on June 21 to present a lunchtime health fair and complimentary lunch.
The workers viewed booths on men’s health, women’s health, the importance of getting a colonoscopy, and other important topics. Food trucks provided free lunch for all, and Radiation Oncology Thomas Kole, MD, PhD, spoke passionately about the need to be screened for prostate cancer starting at age 50.
The warm day provided an engaging environment for relaxation, camaraderie and learning.
VMG Launches Nurse Practice Council
In 2023, Valley Medical Group established a Nurse Practice Council with a mission to “set, implement, and maintain a nursing clinical practice standard in outpatient areas, according to evidence-based practice, research findings, and/or regulatory agency requirements.”
Improvement goals were established in the areas of: 1) communication between outpatient settings; 2) improving quality of care, patient outcomes, and staff and patient satisfaction; and 3) ensuring accountability for performing the highest levels of care.
The group meets monthly to discuss topics related to practice excellence, professional development, quality and safety, informatics and communication. The group’s responsibilities, as outlined in its bylaws, include:
- ensuring the scope of nursing practice at Valley Medical Group meets the regulatory standards, standards,
- incorporating evidence-based practice and research findings into clinical practice,
- reviewing clinical questions submitted to ensure current and best practice,
- consulting on interdisciplinary issues that impact patient care,
- participating in the review, evaluation, and communication regarding new clinical products and equipment, and
- representing the nursing perspective for any issues that impact clinical nursing practice.
The council complements the previously established Inpatient Nurse Practice Council at The Valley Hospital.
Hicuity Health and 24/7 Remote Monitoring
In August of 2023, Valley transitioned from an in-hospital central telemetry department to a partnership with a remote telemetry monitoring company, Hicuity Health, for all remote telemetry monitoring, providing an additional layer of monitoring in support of patient safety initiatives. While a patient’s nurse is still the primary source of cardiac monitoring, the partnership with Hicuity Health offers dual monitoring. This means during times when a nurse may not be able to visualize the patient's cardiac rhythm when away from the nurse's station, the patient's cardiac rhythm continues to be monitored by a telemetry technician.
Hicuity Health monitors all patients on telemetry in medical/surgical units, cardiac/telemetry units, and pediatric units. With the opening of the new hospital, the partnership will be expanded for Hicuity Health to monitor patients on cardiac monitors in critical care units and in the emergency department.
Hicuity Health has remote telemetry operations in St. Louis, Houston, Memphis and Bethesda. These remote centers all backup Valley and utilize integration with Vocera Edge on shared devices to communicate with a patient’s nurse should a concern be identified with a patient. Hicuity Health staff are experienced, trained, telemetry technicians.
HAC Coordinator Appointed
In 2023, Valley was pleased to welcome Lester Castor, MSN, RN, CCRN, as the Hospital Acquired Conditions Coordinator, a new role in the Quality and Performance Improvement Department.
Lester’s role is to coordinate the planning and implementation of the quality management and improvement programs for the hospital, with a specific emphasis on hospital acquired conditions, including (but not limited to) sepsis, falls, surgical site infections, pressure injuries, CLABSIs, and CAUTIs.
Lester brings great clinical and leadership experience from his time as a staff RN in the CCU, and as the Assistant Nurse Manager for two cardiac units at New York Presbyterian Columbia Medical Center. His initial work has included simulations for the Falls Task Force, Posey equipment training, and pressure injury reduction initiatives. With respect to sepsis, defined a workgroup charter, improved bundle compliance, and assisted in implementing an early warning system upgrade in Meditech for the Rapid Response Team.
Interdisciplinary Huddles Aim to Reduce Rehospitalizations
In line with other efforts at Valley to reduce patient rehospitalizations, interdisciplinary huddles were instituted in 2023 with a goal of keeping patients in their homes.
Each week for about 15 minutes, representatives from nursing, social work, dietitians, home care, rehab, case management, and other departments review patients who are considered high-risk for rehospitalization. Topics discussed include medication reconciliation, a patient’s access to transportation, family dynamics, likelihood to participate in a telehealth appointment, and their capacity to see a doctor with seven days of discharge. A new group of patients are reviewed each week and disciplines participating in the huddles vary based on the type of patients being discussed. Follow-ups may include speaking with a facility who will be accepting a patient and determining the safety of a patient’s home.
Beyond the primary goal of reducing rehospitalization, the huddles are a valuable learning experience for all involved.
Wound and Ostomy: Inpatient, Outpatient and Home Care Collaborate for Better Care
In 2023, nurses who comprise Valley’s wound and ostomy care, began meeting to share ideas, discuss best practices, and collaborate on challenging or interesting patient cases.
The collaboration began with simple “meet and greet” sessions but developed into true collegial partnerships as nurses even shared cell numbers when quick information-sharing was needed for a patient.
As the collaboration matured, it impacted treatment plans and improved how the patient’s next provider (outpatient/inpatient to home care, or vice versa) could be better prepared for the patient. Case conferences provided a forum to problem solve for challenging ostomies.
The goal is to improve continuation of care for ostomy patients to focus on continuation of care.