MICU Team Earns Award for Reducing Infection, Fall Rates

In 2020, the medical intensive care unit (MICU) at South Texas Veterans Health Care System in San Antonio received the DAISY Award for Extraordinary Nurses in Patient Safety.

It’s a great honor the MICU team earned by instituting initiatives that have nearly eliminated central-line associated bloodstream infections, catheter-associated urinary tract infections, pneumonia, ventilator-associated events, and falls. This is no small feat. And it took teamwork to get it done.

Empowering the MICU Team

The DAISY Foundation’s signature program recognizes nurses and clinical teams throughout the year for extraordinary, compassionate care. The coveted award places emphasis on efforts to improve workforce and patient safety.

The South Texas Veterans Health Care System’s MICU team of 27 RNs and five nursing assistants was initially recognized for its compassionate care of a veteran patient over more than two years. During their time with the patient, the MICU increased situational awareness, or their ability to perceive and comprehend a patient’s status and project the course of action, from 62% to 98%. The result is safer patient care and better staff communication, according to a DAISY press release.

“Following high-reliability principles, the team began conducting twice-daily huddles, enlisting hand hygiene ‘sheriffs,’ and using evidence-based care bundles for infection prevention,” according to the release.

Michael Pomager, RN

Staff engagement led to the high-quality care delivered on the MICU, said Michael Pomager, MBA, RN, CEN, chief nurse, critical care — as did empowering nurses to drive nursing practice. “This culture has resulted in favorable performance metrics, positive patient experiences, and high staff morale.”

The MICU team’s success in nearly eliminating hospital-acquired infections and falls can be attributed to many factors, including having a strong commitment to serving America’s veterans. They also created a culture with a foundation in shared governance and leadership support, according to Celida Martinez-Vargas, DNP, RN, who was nurse manager MICU/CCU/DARRT [Dedicated Acute Rapid Response Team] from September 2016 to August 2020.

But, above all, it has been important to ensure each team member is engaged in every process in the unit, Martinez-Vargas said.

Celida Martinez-Vargas, RN

“For the past two years the team has put in place many systems to prevent hospital-acquired infection and have created a culture that is preoccupied with failure,” she said.

That preoccupation pushed to implement measures such as:

  • Implementing safety huddles
  • Multidisciplinary rapid rounds
  • Catheter-associated urinary tract infection bundles
  • Central-line associated bloodstream infection bundles
  • Ventilator-associated event bundles
  • Hand hygiene sheriff

“Having these systems in place has made us exceptionally consistent in accomplishing our goals in avoiding potentially catastrophic errors and/or events,” said Martinez-Vargas.

Increasing Situational Awareness

The MICU improved situational awareness through enhanced communication initiatives learned from their Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) and HRO training, according to Martinez-Vargas.

“The initiative developed and implemented was the charge nurse-driven safety huddles. These huddles occur twice a day before the change of each shift and take approximately 10 minutes,” she said.

Team members share information during the huddle about the census, …read more

Read full article here: nurse.com