The SICU Quarterly. Table of Contents: Click on links below to jump to the page.

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1 The SICU Quarterly Issue # 1 Fall 2015 Table of Contents: Click on links below to jump to the page. SICU PI Committee Updates p. 2 Ongoing Projects and Research p. 2 Bedside Matters September 2015 p Fellows p. 3 New SICU Nursing Staff p. 4 SICU Great Saves p. 4 SICU Nursing Shared Governance p. 5 SICU Gives Back p. 5 SICU Advanced Practice Leadership Updates p. 6 FY16 Quality Metrics p. 6

2 Issue # 1 Fall, 2015 Issue #: [Date] SICU PI Committee Ongoing Projects & Research Dolor Sit Amet Current Initiatives: Developing Standards of Practice & investigating billing opportunities associated with Primary teams performing procedures on ICU patients. Contacts: Dr. Dennis & Dr. Hughes Finalizing SICU-specific patient & family insert for hospital patient handbook CLABSI & CAUTI prevention education Look for a more comprehensive list of current & past PI initiatives & outcomes in the Winter 2015 edition of the SICU Quarterly Newsletter. Next Meeting: September 15 th, 2015 at 2:30pm, SICU conference room Questions/Comments/Concerns: SICUPI2@ .mc.vanderbilt.edu PI Leadership: Brad Dennis, MD Physician co-chair Caroline Banes, NP NP co-chair Heather Hart, RN Nursing co-chair Bedside Matters The SICU has been invited to present at the next monthly Bedside Matters conference on September 16 th, 2015 at 12pm in Light Hall, 202. Our unit will be presenting the case of Mr. Andy Duncan and the profound impact his presence in our unit had on our staff. Featured speakers will include Caroline Banes, NP, Joe Fanning, MD, Lisa Weavind, MD, Emily Longbrake, RN and Beth Coughlin, RN. CPOT implementation study o Purpose: examine implementation and user satisfaction in a multidisciplinary setting o SICU contacts: Heather Hart, RN, Liz King, RN o Timeframe: April 2015-April 2016 Analysis of CPOT score in verbal & nonverbal patients o Scope: coordination between SICU & MICU, led by pharmacy resident, to analyze validity of CPOT in verbal population o Timeframe: this retrospective review will start after CPOT documentation is live in HED Lidocaine Infusion Medication Use Evaluation o Scope: hospital-wide effort, will closely affect SICU due to frequent use Aminoglycoside Medication Use Evaluation o Scope: determining the benefit of having double gram negative coverage in the SICU in late onset pneumonia protocol Heparin Infusion Medication Use Evaluation o Scope: examining number of heparin boluses, ordering of SICU protocol, and timing of aptt draws pre & post initiation of nurse-managed protocol SAT Outcome Study: o Scope: examining ventilator days, mortality, hospital LOS, ICU LOS, and use of sedation before and after implementation of SAT/SBT bundle in the SICU o SICU contacts: Brad Dennis, MD, Heather Hart, RN, Pratik Pandharipande, MD, Kelli Rumbaugh, PharmD MENDS II study: o Scope: comparing propofol and dexmedetomidine to determine the best sedative medication to reduce delirium and improve survival and long-term brain function in the ventilated septic patient. o SICU contacts: Pratik Pandharipande, MD, Chris Hughes, MD MIND USA study: o Scope: to define the role of antipsychotics in the management of delirium in vulnerable critically ill patients. o SICU contact: Pratik Pandharipande, MD 2 2

3 Issue #: # 1 [Date] SCC Fellows Aileen Ebadat, MD Julie Valenzuela, MD Andrew Hopper, MD Tim Johnson, MD Critical Care Anesthesia Fellows Dave Siddarth, MD Jennifer Elia, MD Alexander Greene, MD Michael LeCompte, MD Matthew Hulse, MD Reid Phelps, MD Ryan Parker, MD Marcos Lopez, MD 3

4 Issue #:# 1 [Date] New SICU Nurses Welcome! 2015 Fall Nurse Residents: Jenna Ische, RN; Meredith Burbank, RN; Chris Tench, RN; Colleen Martell, RN New SICU experienced Nurse Recruits: Kayla Leonardi, RN; Grace Woo, RN SICU Great Saves Ed Baldwin Ed was a SICU patient beginning in May 2014, after his liver transplant. He remained a SICU patient through most of the summer, with many highs and lows. He celebrated the 4 th of July with his family, watching fireworks from room 9631, while on CRRT. His case challenged our staff for more than two months, and we now cherish the relationship our staff has established with him & his family. Our journey so far has been one full of miracles and God's grace. Prayer support is ongoing and we are so blessed to have so many great people in our lives. From the doctors and nurses (some who are turning out to be lifelong friends) to our friends and family and to perfect strangers who have embraced us with prayers and love, our lives are forever changed and for the better. -Ed & Laura Baldwin SICUGreatSaves@ .mc.vanderbilt.edu 4

5 Issue #:# 1 [Date] The SICU Unit Board is a shared governing body empowered by the Nursing Shared Governance bylaws. Its goal is to make changes and decisions to improve patient care and the condition of work life on the SICU. The UB has four subcommittees: Education and Competency, People and Work, Quality, and Clinical Practice and Research. The subcommittees meet monthly at individual times and report their progress during the monthly unit board meeting. All staff members on the SICU are members of the Unit Board, and are encouraged to attend meetings and share ideas and concerns. The UB is organized as follows: Chair of Unit Board: Liz King SICU Nursing Shared Governance Education and Competency subcommittee chair: Sarah Hayden. Recent projects include organizing the High risk OB lecture for CEUs and developing nursing protocols for common patient populations. People and Work subcommittee co-chairs: Tanna Walker and Erica Schoch. Recent projects include Great Saves project and coordinating monthly volunteer outings. Quality subcommittee co-chairs: Heather Hart and Bethany Cones. Recent projects include CPOT rollout to nursing staff, tracking quality metrics such as falls, CAUTI, and CLABSI, and developing quality metrics unit Champions. Clinical Practice and Research subcommittee chair: Beth Coughlin. Recently revamped, the primary focus of this committee is keeping up to date with EBP and recommending changes in nursing practice. SICU Gives Back SICU Gives Back Volunteer Volunteer excursions in in the Nashville Community Community In the past year, the People and Work subcommittee have worked for the Humane Society, the Bridge Ministry, Global Outreach Clinic, and many more. For more information or if you want to get involved, Liz King. Pictured above from left: Josh Gifford, Rochelle Bayoli, Tanna Walker, LaToya Hannah, Haleigh Power, Danielle Shuette, and Erica Schoch. 5

6 Issue #:# 1 [Date] Advanced Practice Provider Leadership Updates In April, after years of service, Billy Cameron, our former APP Leader, took on the role of Assistant Director of Advanced Practice for the Surgical PCC and is excelling in that role. Caroline Banes stepped into the Lead APP Role thereafter. We also welcomed Julie Hutchison as our newest APP. Various Pillars of Leadership have been developed in order to create an environment in which the APPs feel productive, purposeful, have ownership, and stay involved in the SICU. Initiatives formed under each pillar will help serve our patients with best practices. The Pillars of Leadership include: Julie Hutchison as the Social Work Liaison Team Leader Caroline Banes as the Process Improvement Team Leader Lauren Wrisley as the Billing and Information Technology Leader, most recently working with IT to develop a new sign out tool to help streamline shift change sign out. The sign out tool will include a full synopsis from the written note, current labs, I&Os, medication list, and POD. Lauren is also working on the development of a new consult note. Laurie Ford as the Rapid Response Team Leader; she has received wonderful feedback regarding the SICU APPs from all floors in which we respond to RRTs. They say the SICU has the nicest, most helpful nurse practitioners. What an honor! Courtney Cook and Sarah Davis as the Research Involvement Team Leaders, recently forming an SICU APP journal club. They have also formulated a survey for the SICU APPs to assess research and QI project interests in hopes of gathering and forming different research projects for the NPs to participate and/or lead. Contributors & Contacts: FY16 Quality Metrics Heather Hart, RN Heather.McMurray@vanderbilt.edu Kelli Rumbaugh, PharmD Kelli.Rumbaugh@vanderbilt.edu Caroline Banes, NP Caroline.F.Tucker@vanderbilt.edu Jennifer Graham, RN Jennifer.R.Graham@vanderbilt.edu Tanna Walker, RN Tanna.Walker@vanderbilt.edu Liz King, RN Elizabeth.M.Bishop@vanderbilt.edu Erica Schoch, RN Erica.M.Schoch@vanderbilt.edu Hand Hygiene 98% CAUTI 0 Days since 362 CLABSI 2 Days since 40 Fall with harm 0 Days since 367 6