Updating External Ventricular Drainage Care and Intrahospital Transport Practices at a Community Hospital.

BACKGROUND: Frontline neurointensive care nurses from 1 community hospital were invited to assess the current state of care related to use of external ventricular drains (EVDs) and intrahospital transport (IHT) policies, investigate and plan practice changes, and implement skills review for nurses caring for the adult patient with an acute brain injury. PROJECT: Our team researched best practices related to EVD care and IHT procedures, updated current EVD insertion checklists, developed nurse role cards to assist with EVD insertion at the bedside, revised current EVD care policies and procedures, and created a new IHT policy. The same nurses shared updated information and skills review for neuroscience nurse peers. CONCLUSION: The goals for the project were met, and practice variation is being reduced.

Innovative solutions: beds, baths, and bottoms: a quality improvement initiative to standardize use of beds, bathing techniques, and skin care in a general critical-care unit.

As a quality improvement initiative, nurses in a general critical-care unit at a Midwest hospital constructed a plan for interventional hygiene. A nationally recognized nursing expert inspired the theoretical framework used as a basis for the initiative. A critical-care nursing clinical excellence team examined the current state and developed, implemented, and evaluated the interventional hygiene plan. Goals included standardizing bathing procedures and use of beds and reducing nosocomial infections and incontinence-associated dermatitis in critically ill adults. During the evaluation period, incidence of unit-acquired methicillin-resistant Staphylococcus aureus and incontinence-associated dermatitis decreased. Nurses reported favorable reviews for new skin care products and decreased nursing time associated with bathing.

Graduate nurses' perceptions of a critical care nurse internship program.

Graduate nurse internship programs (NIPs) have existed for a number of years as tools for recruiting and retaining nurses. A recent literature review uncovers the rare NIP dedicated to orienting the graduate nurse to a critical care environment. Few have addressed the nurse interns' perceptions of these programs. Ongoing evaluation is vital to improving existing programs and giving credence to other hospitals with similar initiatives. A retrospective descriptive design study with the purpose of disclosing the critical care graduate nurse interns' perceptions of the critical care NIP at Elkhart General Hospital, a 330-bed community hospital in Elkhart, Indiana, provided information for this study. Patricia Benner's novice-to-expert model served as the theoretical framework. The critical care NIP questionnaire provided satisfaction scores for program components. Mean scores between groups were explored using the t test. Mean satisfaction score for the overall program was 5.62 (SD = 0.371), with a retention rate of 76.9% (20 of 26). Statistically significant differences in satisfaction scores were not found in this pilot study between nurse interns currently working in critical care and those who are not.

Innovative solutions: providing specialized nursing care to the patient with acute neurologic injury in a general critical care unit.

A general critical care unit at a community hospital in the Midwest sought to improve care delivery to patients with acute neurologic injury. Nurses passionate about caring for this patient population were identified. Work groups established a plan and goals for improving care. Goals include standardized education for group members, standards of practice and policy development and revision, and equipment review and upgrading. This article reports on the results of this innovative strategy.