The Medical Intensive Care Unit (MICU) at Christiana Hospital has earned a Gold Beacon Award, the highest honor of the American Association of Critical-Care Nurses (AACN), the largest specialty nursing organization in the world. The recognition follows the Beacon Awards the unit received in 2012 and 2008.
Christiana Care Health System is one of only 64 health care institutions in the nation to earn the prestigious award. The MICU was the first unit in the state to receive the Beacon Award and is now the only unit in Delaware to receive the award three times. Christiana Care’s Cardiovascular Critical Care Complex also earned a Gold Beacon Award in 2013.
“The MICU team exemplifies The Christiana Care Way, serving as respectful, expert, caring partners in their neighbors’ health and developing innovative models of care,” said Janice E. Nevin, M.D., MPH, Christiana Care president and CEO. “These awards demonstrate continuous learning and effective systems of care that can deliver optimal health and an exceptional experience to the people we serve.”
“The Gold Beacon Award reflects the dedication of the MICU team and their focus on patient- and family-centered care,” said Diane Talarek, MA, RN, NE-BC, senior vice president of Patient Care Services and chief nursing officer. “Their interdisciplinary collaboration and emphasis on ongoing education and excellence have resulted in better outcomes for patients.”
The MICU team cares for some of the health system’s most vulnerable patients, with multiple complex health issues. One of the unit’s most notable achievements has been avoiding central-line-associated bloodstream infections (CLABSI), a costly and potentially fatal complication. For 21 consecutive months, the MICU had zero incidences of CLABSI.
“Our success with CLABSI helped us to realize that we could reach other milestones in enhancing patient safety and patient satisfaction,” said nurse manager Carol Ritter, MSN, RN, CCRN, CNML.
To create a roadmap for success, the unit formed six value-improvement teams to focus on various concerns:
- Skin and pressure wounds.
- Ventilator-associated pneumonia, pain agitation and delirium, and mobility.
- Falls and restraints.
- Hand-washing and isolation.
- Safe practices and Joint Commission standards.
All MICU nurses are required to join a value-improvement team, which has multidisciplinary staff members, including physician assistants, dietitians, wound, ostomy and continence nurses, physical therapists, infection-prevention nurses and unit clerks.
Other MICU achievements include:
- Lowering the risk of falls by working with physical therapists to evaluate which patients are ready for physical therapy, designated with a red or green mobility card. The falls team also obtained external bed exit alarms. The result: seven months without a patient fall.
- Greatly reducing the use of Foley catheters by following evidence-based guidelines on preventing catheter-associated urinary tract infections.
- Participating in a Lean Six Sigma project to successfully reduce blood transfusions to align with national clinical guidelines.
“A key to our success was establishing a culture in which everyone feels comfortable and appreciative when another team member reminds them of best practices,” Ritter said. “Our team does phenomenal work supporting each other in addition to supporting our patients.”
The team also sought input from patients and families, making such recommended improvements as including relatives in bedside rounds and installing recliner chairs for visiting loved ones.
The MICU made strides in cultural competence, as well. In one example, the staff made arrangements for the family of a Muslim patient who died of cancer that allowed them to observe traditions of their faith, including burial within 24 hours of death.
To report on these initiatives, the Beacon application required a year of meticulous documentation. The application was written as a group effort with the committees and teams writing their specific sections. Andrew Vincent, BSN, RN, CCRN, took on most of the responsibility for the 48-page, 31,000-word application. Vincent, along with clinical nurse specialist Maureen A. Seckel, MSN, CCRN, FCCM, have been consulted by other institutions who are looking to apply for a Beacon award to share the experience and expertise of what it takes to compile and complete a Beacon application.
“The most important outcomes of our work benefit our patients so they might achieve optimal health,” Ritter said.
Founded in 1969, AACN serves the interests of more than 500,000 acute- and critical-care nurses with more than 235 chapters worldwide. The Beacon Awards were launched in 2003.