National Evidence-Based Practice Initiative Adopted at CVMC. According to the Institute for Health Care Improvement (IHI), more than 750,000 individuals develop severe sepsis in the United States each year. This devastating condition can be life-threatening. Partnering together, the Society of Critical Care Medicine (CCM), the European Society of Intensive Care Medicine (ESICM), the International Sepsis Forum (ISF) and the IHI, developed the Surviving Sepsis Campaign. Its goal is to improve the diagnosis, survival and management of patients with sepsis by addressing the challenges associated with this condition. The Sepsis Bundle is an evidenced-based initiative born out of the Campaign. In March of this year the Emergency Department at CVMC implemented the Sepsis Bundle to help improve outcomes for patients with sepsis.
As defined by IHI, a"bundle" (www.ihi.org/IHI/Topics/CriticalCare/Sepsis/Tools/SevereSepsisBundle.htm) is a group of interventions related to a disease process that, when executed together, results in better outcomes than when implemented individually . The Sepsis Bundle, is comprised of two phases: Phase One, Resuscitation and Phase Two, Management. Components of the Sepsis Resuscitation Bundle include serum lactate measured, blood cultures obtained before antibiotic administration, broad-spectrum antibiotics administered within 3 hours of ED admission or 1 hour of non-ED ICU admission. The Sepsis Management Bundle should be accomplished as soon as possible and scored over 24 hours.
Initial Campaign guidelines were released in 2004, yet many Emergency Departments across the country have yet to adopt them. The IHI predicts a that a 25% reduction in mortality due to sepsis could potentially save the lives of 50,000 people in the United States and perhaps 1.1 million individuals worldwide each year. Our ED was eager to implement the Sepsis Bundle because of the potential impact the interventions can have on patient outcomes. The Critical Care Center implemented the Sepsis Bundle in June 2009. The key to success at CVMC will be to track the Sepsis Bundle measures, monitor compliance with the its use, as well the continued efforts of our nurses to advocate for their patients in recommending use of this evidenced-based practice. §
We tip our hats to these nurses who have recently completed professional training.
Mary McDaniels MNA, RN, ACM, CPHM and Lisa Yount BSN, RN, ACM, ONC, CPHM: Certified Professional Healthcare Management
Peggy Brown BSN, RN, OHC: Occupational Hearing Conservationist Certification
In November, Nasin See RN, Judy Parker RN, Michele Guinn RN and Sandra Williams RN completed the Oncology Nurses Society Chemotherapy/Biotherapy course. Now all CVMC oncology nurses (100%) have successfully completed this course.
2009 First Responder of the Year for Burke County is our own Tom Robinson BSN, RN, Emergency Department. Congratulations, Tom. §
Community Service Award. Recognized for his exemplary service in speaking out against sexual assault, Van Haygood MSN, RN, NE-BC, Emergency Department received the Annual Teal Award from the Rape Crisis Center of Catawba County, Inc. He has been a member of the Center’s Board of Directors since 2003, and has served as President of Board since 2004. At the awards ceremony, the Center announced dedication of the boardroom in Van's honor. Thank you for outstanding community service, Van. §
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Saturday Morning 20 February 2010 0800-1200
EBP Education Mini-Retreat Sponsored by the Research and Evidence-Based Practice Council
Are you interested in learning more about evidence-based practice? or research? Do you want to facilitate a journal club? or lead a journal club discussion? Then the mini-retreat is your one-stop opportunity to gain new skills or further hewn those you have. Courses to be offered include: Let’s Get Cooking with EBP, Searching the Literature, Appraising the Literature and NEWGrading the Evidence. Mark you calendar now. More information will be coming your way in early January 2010. §
Thank you. The Research and Evidence-Based Practice Council sincerly appreciates all LPNs, RNs and advanced practice nurses who participated in the 2009 EBP in Nursing Survey. We received 205 surveys - a 38% response rate. Thanks for your feedback. §
Chris Bowman BSN, RN, NIC, Special Care Nursery
Since she began working in the nursery in 1984, Chris has seen many changes at CVMC. Back then the nursery was shifted every 3 days, closed down and cleaned. In the years following, she has seen remodeling, creation of the NICU, the first TPN baby, and the addition of neonatologists and nurse practitioners. Chris says, “we now see premature babies as early as 24 weeks.” The use of surfactant, to increase lung compliance, has improved our patient outcomes.
Practice changes in the nursery result from questions raised by staff, research literature and professional guidelines. Recently, clinical evidence regarding feeding cues or feeding readiness practice was brought to staff attention with a hospital-sponsored conference. Nursery nurses, nutrition staff, occupational therapists and physical therapists participated in the conference. “The evidence presented confirmed my beliefs and what I was seeing in my practice,” Chris states, regarding the fact that the feeding practice in the Special Care Nursery at that time did not match evidence-based practice for feeding readiness.
The next step was to discuss the evidence and educate staff, but Chris admits, “change challenges us all.” Seeing babies tolerate feedings with less spiting up and faster increase in weight helped nurses, who were less willing to accept the EBP change initially, get on board. When asked what was the best thing about her job, she enthusiastically replied “no two days are alike and I get to teach every day.” Chris strives to make a difference every day and wants to tackle developmental care next using the EBP process.
Chris graduated from Ball State University in Muncie, Indiana in 1981, and began her nursing career caring for adult renal transplant patients at Duke. Just recently, she attained high-risk neonatal certification. Chris and Dan Bowman RN, Cardio-Pulmonary Rehab, have been married for 26 years and have 3 children. Josh is 25 and in medical school, Erica is 22 and Sarah is 20. Chris enjoys yardwork, walking, hiking, cooking and spending time with her family. §
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