MINI-COG(tm) implemented and available for Nursing documentation. The MINI-COG(tm) is a simple and easy screen for possible cognitive impairment that can be completed by all RNs. The instrument combines an uncued three-item recall test with a clock-drawing test. Patients with a positive screen are at increased risk for delirium, falls, dehydration, inadequate nutrition, untreated pain, and medication related problems.
Oral Hygiene Procedure updated by NICHE Council Geriatric Resource Nurses
Implemented the use of the PAINAD Scale for the Patient with cognitive impairment, instead of the FLACC scale which is typically used for children.
Implemented Fever Management in Children Protocol in the Trauma & Emergency Center. This protocol allows the care team to administer antipyretics at triage.
The Trauma & Emergency Center developed and implemented an SBAR Communication Tool to improve communication and provide consistency of patient care/plan between shifts and units. Communication between team members (MD to RN, RN to RN, RN to PCA, PCA to PCA, etc.) has improved within the department since implementation in Fall of 2006 for utilizing a standardized and consistent format for handoff communication.
LIFE, LifeCare and South County Ambulances, in collaboration with the Bronson Trauma & Emergency Center, have added the capability to obtain 12 lead ECG data in the field prior to the patients' arrival at the hospital. This assists the team to provide data to enable activation of the AMI call down (STEMI Alert) system at an earlier time and even prior to the patient arrival at the hospital. Through our capability to obtain data and stabilization rapidly, along with the rapid response of the Cardiac Cath Lab team, we have decreased our door to dilation time to an average of 84 minutes, improved from an average of 100 minutes in 2005.
Initiated Sepsis Call Down to provide rapid response and intervention for early sepsis resuscitation within the Emergency Department improve outcomes and survivability of severe sepsis.
The ICUs have changed the care of the ventilated tracheostomy patient to be in line with the literature.
Care for the patient with an extraventricular drain has been updated to be in line with the literature.
SICU has redone the treatment guidlelines for care of patients with intracranial hypertension and management of cerebral oxygenation to match the literature.
The SICU has redone the care of the spinal cord injured patient to be in line with the literature.
DVT prophylaxis order forms for screening and prophylaxis is based on the recommendation of the American College of Chest Physicians.
Through the use of a Rapid Response Team, we have seen fewer incidences of non-ICU code zeros.
Development of two new Insulin Protocols, one for the ICU and one for the adult general medical surgical units.
Development and implementation of a Protein Calorie Malnutrition and Eating Disorders Clinical Pathway and Order Set for the pediatric patient. Tools for patient and family communication are included in a multilevel plan of care based on the patient's clinical progression.
Initiation of night-shift multidisciplinary rounds in the PICU to facilitate physician-nurse communication.
Implementation of Accupedia to increase the safety of pediatric vasopressor and other medication drips in the PICU.
Initiated Sepsis Call Down to provide rapid response and intervention for early sepsis resuscitation within the Emergency Department. This improves outcomes and survivability of severe sepsis.
601 John Street / Kalamazoo, MI 49007 / (269) 341-7654
