My critical role in decreasing patient infections
Written by: Sherley John
I knew I wanted to join Northwell Health because the entire system strives to improve our communities through education, conduction of research and providing quality healthcare. I chose North Shore University Hospital primarily because it is a teaching hospital and offered the William Randolph Hearst Critical Care Fellowship. I already knew I wanted to be a critical care nurse when I graduated and this unique fellowship that was offered was just the beginning of my journey. When I began my fellowship 10 years ago, it was broken down into three phases which included patient simulation experiences, didactic learning sessions and direct patient care assignments. The various phases provided the required tools and prepared me to be an effective Neurosurgical ICU nurse. Now, I have the privilege of being a preceptor for the new fellows and thoroughly enjoy the experience.
After my fellowship ended, I received an RN position within the same department, Nerosurgical ICU (NSCU), and each day brings a new experience. Being at the bedside and advocating for my patients at a crucial time during their recovery is what drives me. The NSCU team is exceptional and I consider them my family. Over the years I have served in various capacities such as the co-chair for the Collaborative Care Council, Beacon committee member, peer interview panel member, and participate in various performance improvement projects such as Quiet time and serve as the CAUTI champion. I am currently enrolled in the first Manhasset cohort for a Masters in Leadership program, which is a great opportunity provided by the health system.
I knew I wanted to continue to do great things for this health system and when a Catheter Associated Urinary Tract Infection (CAUTI) problem arose in 2011 I was able to make a real difference in decreasing the percentage of patients that acquired an infection. The team that I was on developed an evidence-based CAUTI bundle that consisted of insertion and maintenance of indwelling urinary catheters (IUC), early catheter removal with development of a straight catheterization protocol and focused collaboration between nurses and physicians to review catheter necessity during patient rounds. Initially focus was on urine backflow prevention, creating criteria for when to obtain urine cultures and developing a protocol for straight catheterization based on bladder ultrasound results. Once we had our goals and a plan in place we began implementation from the years 2012 to 2014. In 2012 a 19% reduction in CAUTI was achieved. In September 2013, four NSCU nurses including myself were accepted into the AACN CSI Academy with CAUTI reduction as our leadership project and in 2014, the four CAUTI Champions hosted a week of CAUTI prevention. We created and distributed unit based t-shirts with the acronym NSCU (Nurses Stopping Catheter Usage), performed peer skills validation on perineal and IUC care and further revised the protocols for straight catheterization and bladder scanning. In 2014, CAUTIs were reduced by 24%, the number of device days were reduced by 31% and this outcome resulted in a, $112.000 saving. Various practices initiated on our unit were then presented at the hospital wide CAUTI carnival. This brought about a change in the culture of our unit and we have presented the results at various hospital sessions and conferences nationwide. We continue to focus on sustainability and have noticed a significant decrease in all other Hospital Acquired Infections (HAI).
Working for this health system has provided me with all of the opportunities I could hope for in a nursing career – from fellowship training to becoming a mentor, complex cases, educational aid, and leadership opportunities – I wouldn’t want to have established my career anywhere else. All this was possible because of the commitment and dedication of the NSCU team. I would like to thank my manger, Laura Iacono, for her encouragement and guidance as well as, Tara Laumenede, our director. My gratitude to my AACN CSI mentors Marian Altman and Debbie Brinker who provided the necessary tools for the success of our project. A special thank you to my coach, Launette Woolforde, who was instrumental in the success of the CAUTI initiative and our CNO, Kerri Scanlon, who is an inspiration.
Picture: From left to right, Sherley is the second women on the left.
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Sherley was my preceptor when I was a brand new nurse right out of school! She was great and I’m thankful for the guidance she gave me! Great job Sherley, Merin, and Laura!! I miss North Shore. You can appreciate the staffing and team work when you have worked in other hospital systems!