Although the posters at Kindred’s Clinical Impact Symposium came from different Kindred facilities and covered different topics, the one thing each had in common was the passion and enthusiasm of the people presenting the projects and information.

While the posters were filled with technical terms and acronyms, the patient was never forgotten and there were often pictures of patients surrounded by their care teams, many having defied the odds for a successful outcome. While it wasn’t possible to cover all of the presentations, we had a chance to talk to the people behind three of them.

_________________________________________

Poster: Nurse-Driven Foley Catheter Removal Protocol to Decrease CAUTIs
Presenters:
Brenda Mayfield, RN, ICP, Tanya Trotter, MSN, APRN, PHCNS-BC
Goal:
The project goal was to decrease hospital-acquired CAUTIs by providing a tool to empower the nurse to discontinue Foley catheters that do not meet the criteria for indwelling urinary catheters.

 

 Attendees talk to Brenda Mayfield and Tanya Trotter about their poster presentation. Attendees talk to Brenda Mayfield and Tanya Trotter about their poster presentation.

 

Tanya Trotter from Kindred Hospital Dayton was excited to be attending her first symposium and about the work her team has accomplished in reducing UTIs. She gave credit to team member Brenda Mayfield, but as the two spoke, it was clear this was a team effort that started with getting the physicians on board. Both women spoke about the importance of “trust relationships,” especially between the doctors and nurses. The physicians trusted the nurses’ assessment of the issue and the intervention needed. With this support, the Medical Executive Committee approved a nurse-driven Foley catheter removal protocol.

  • Following the protocol, the nurses have a detailed guide for when the Foley catheter needs to remain in place and when it can be removed.
  • The physician doesn’t need to sign off on the removal with the protocol.
  • There is a bladder management algorithm so the nurses can do daily monitoring of patients who’ve had their catheters removed.

The team effort met with great success in the first year. Pre-intervention, there were 20 confirmed UTIs in 2012. In 2013, the number was reduced to four.

_________________________________________

Poster: Interdisciplinary Care Coordination for the Patient Discharged to Home with a VAD (Ventricular Assist Device)
Presenters:
Andrea Stanley, MSN, RN, NEA-BC; Jacqueline Levesque, LICSW
Goal:
Prepare patients and their families to return home after discharge

 

 Andrea Stanley answers questions about patients discharged to home with a VAD. Andrea Stanley answers questions about patients discharged to home with a VAD.

 

Andrea Stanley of Kindred Hospital Boston is quick to note that her facility is unusual in that it handles patients with a Ventricular Assist Device (VAD). The pride she and colleague Jacqueline Levesque have in their team and hospital is obvious, and with good reason. They’ve developed a comprehensive plan so that when patients are discharged to home with a VAD, they’re truly ready to handle any issues that arise with their device. This is important because, as Andrea notes, there aren’t any skilled nursing facilities close by that can handle patients with a VAD.

Going home means a coordinated approach from an interdisciplinary team that includes everyone from the physician to the pharmacy. The patient caregiver is an important part of this team, and it is this person who will need to know exactly how to troubleshoot and fix VAD problems once the patient is at home.

  • Patient and caregiver education begins on admission.
  • Both the patient and a caregiver are trained and then checked on all competency requirements, and these are evaluated by nursing, rehab and the STAC Cardiac Team.
  • There’s even a written test to pass so the team knows the patient and caregiver fully understand what has been covered and what to do once they go home.

With the care coordination plan in place in their facility, the team is looking to work with the staff of a skilled nursing facility to get them ready to handle patients with a VAD.

_________________________________________

Poster: The Roadmap to Quality
Presenters:
Margie Ripple, DCM; De Harrington, DDCM
Goal:
Implement LTACH Messaging project to improve quality of care, increase customer service, reduce unnecessary returns to acute care and improve communication between providers of care.

Kindred Employees Share Their Success at CIS Poster Session . With this process, the team has mapped out a strategy for success. There are four modules of their “Roadmap to Quality.”

  • First module:  The patient is introduced to the Kindred facility through the liaison in the field. The liaison explains the benefits of Kindred and sets expectations for the patient and family. This last part – setting expectations – is critical and it’s a part of module four as well. As Margie notes, “Unmet expectations are resentments under construction.” Helping the patient and his or her family understand what will happen at each step of the way helps set the stage for success and increased patient satisfaction.
  • Second module: Involves family tours and a pre-admission conference, which helps increase family engagement.
  • Third module: The Transition Planning and Care Considerations List helps the team assess high-risk patients and increases understanding of critical information prior to admission.
  • Fourth module: Sets expectations and involves educating on the plan of care and daily check-ins with the patient family.

Attendees talk to Brenda Mayfield and Tanya Trotter about their poster presentation.Andrea Stanley answers questions about patients discharged to home with a VAD.