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Care

Delivery Model: Team Nursing and Multidisciplinary

o STICU at BUMC
o Type of care: Emergent and Critical Care
o Conditions: TBI, GSW, Burns, and MVA
o Services: RT, PT, OT, Case Management, Social Work

o 20 beds

o Nurse to patient ratio

Madison Bardsley, Kevin Cornett, Mariya Isarevich, Rayna McParlane,

Michelle Splaver
12/2/2015

1:1 or 1:2

Nursing

leadership includes Clinical Nurse Leader and

Nurse Manager
Leadership positively influences care
o
o
o
o
o
o
o
Why

Currently there is a basic patient

organization form, but not
evidence-based or standardized
This leads to inconsistencies
when transferring patients
Banner supports this unit
through:
o Providing resources to
succeed, CEUs, recognition of
nurses, promoting team
environment

Ensures the staff has equipment needed

Teamwork encouraged through nurse rounds
Mandates and encourages ongoing education
Equal opportunity/work environment
Empowers nurses
Holds nurses accountable
Strives for constant improvement of unit

is strong leadership important?

o Studies show that positive leadership, such as relational

leadership, results in improved patient outcomes (Wong,
Cummings & Ducharme, 2013).

Patient

Interdisciplinary

teamwork
supporting patient-centered
care

Focus

o Implementation of individualized care

o Leadership rounds and check patient/family satisfaction
o Committed to exceptional patient care
Staff

o
o
o
o
o

o Clear and receptive

communication

Focus
Continuing education
Collaborative patient assignment process
Staff support with complex patients
Importance of staff wellbeing/debriefing (Keene, et al., 2010).
Voices are heard

o Universal respect and trust

o Interdisciplinary collaboration
o Valuing specific roles of each

individual

o Overall improves patient care

outcomes and patient

satisfaction (Wen & Schulman,
2014)
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Integration

Quality

improvement activities
o Concurrent Audits occur daily
o Data directly impacts the quality of Pt care
Both the nurse manager and clinical leader are in
charge of these audits
Examples- Catheter Associated Urinary Tract Infection
(CAUTI) and central line audits

of information with patients

o Patient education, family education, language translation

resources, My Chart
Integration

of information with providers and staff

o EPIC, cellphones/pagers, physician/resident available on

unit, pre-shift meeting

Integration

of information with technology

o EPIC, Pyxis, patient barcode scanning, online policies,

electronic EKG
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Concurrent

and process
audits to assess compliance
after improvements

Organization

support issue

o Patient handoff during report on Trauma ICU

Patient

handoff to Trauma ICU can be unclear

leads to decreased patient outcomes,
quality of care, and safety
Specific problems seen on Trauma ICU

o Re-Audits
o Accountability checks
for CNLs performing
audits

Miscommunication

Data

reported back to
nursing staff
o Individual meetings
o Results publicly posted
9

10

In

order to implement our intervention of providing a

standardized shift report we as the unit leader would:

Pilot

of evidencebased, standardized
report tool in Trauma
ICU

o
o
o
o
o

o See Handouts!

Goal:

Decrease
miscommunication and
consequential errors

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Month 1- plan intervention and design seminar

Month 2- hold 3 seminars for Trauma ICU staff
Month 3- initiate standardized shift report on the unit
Month 4- Progress report with staff
Month 6- Evaluate intervention

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Cresswell,

K. M., Bates, D. W., & Sheikh, A. (2013). Ten key

considerations for the successful implementation and adoption
of large-scale health information technology. Journal of the
American Medical Informatics Association, 20(e1), 9-13.
doi:http://dx.doi.org/10.1136/amiajnl-2013-001684
Jukkala, A.M., James, D., Autrey, P., Azuero, A., & Miltner, R.
(2012). Developing a standardized tool to improve nurse
communication during shift report. Journal of Nursing Care
Quality, 27(3), 240-246. doi: 10.1097/NCQ.
0b013e31824ebbd7
Keene, E. A., Hutton, N., Hall, B., & Rushton, C (2010).
Bereavement debriefing sessions: An intervention to support
health care professionals in managing their grief after the
death of a patient. Pediatric Nursing, 36(4), 185-189.
Retrieved from http://www.medscape.com/viewarticle/729872
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Lacroix, D. Management, leadership, power and politics [PDF

document]. Retrieved from Lecture Notes Online Website
https://d2l.arizona.edu/d2l/le/content/434224/viewContent/3634
200/View
Marquis, B.L. & Huston, C.J. (2015). Leadership roles and
management functions in nursing. Philadelphia, PA: Wolters
Kluwer Health
UC Irvine Health (2015). Traumatic and critical care surgery
services: Conditions and treatments. Retrieved from
http://www.ucirvinehealth.org/medical-services/trauma-criticalcare-surgery/conditions-treatments/

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Wong,

C. A., Cummings, G. G., & Ducharme, L.

(2013). The relationship between nursing
leadership and patient outcomes: A systematic
review update. Journal of Nursing Management,
21, 709-724. doi:10.1111/jonm.12116
Wen, J., & Schulman, K. A. (2014). Can team based
care improve patient satisfaction? A systematic
review of randomized control trials. PLoS
ONE, 9(7). doi:10.1371/journal.pone.0100603
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