Presenter: Dr. Kamran Hamid

Speakers:

Laura McGuire, MSN, RN, CMSRN, CNL, TNS; Clinical Nurse Leader, Loyola Medicine-MacNeal

Elizabeth Dickey, MSN, RN, CMSRN, CNL; Manager of Nursing Excellence & Magnet Program Director, Loyola Medicine-MacNeal

The purpose of this presentation is to highlight the impact of utilizing shared decision making to capture nurse engagement and sustained improvement of a quality indicator. Specifically in this case, a project was completed with an aim to decrease hospital acquired pressure injuries (HAPI). To accomplish this, a room readiness campaign was launched by a unit based shared governance council to target a decrease in pressure injuries by utilizing a ready-made admission kit and checklist, which included necessary preventative supplies for a patient at risk of developing a pressure injury. After an increase of HAPI were noted on a medical-surgical unit at an urban community hospital, a collaborative gap analysis was performed by nursing leaders and bedside staff to identify root causes. One root cause that was recognized was not having necessary supplies and interventions ready for the patient during the admission process. Various barriers were identified including waiting for delivery of supplies, out of stock supplies, and time spent away from patient care gathering supplies. In a comparative study utilizing a shared decision-making approach, the unit based shared governance council constructed a HAPI admission kit that included supplies of the organization's already established pressure injury prevention order set. A new process and intervention were developed and voted on by the unit's shared governance council. This process included that when a nurse identified a patient at risk for pressure injuries utilizing the Braden Assessment, a pre-made "HAPI Admission Kit" that was stocked on the unit was obtained and brought to the patient's room for implementation. The admission kit included repositioning wedges, bilateral heel protectors, Cavilon Skin Protectant, a sacral Mepilex, four Mepilex islands for various bony prominences, and a checklist that allowed nurses to ensure all measures of a pressure injury order set were implemented. Incidences of HAPI pre-intervention and post-intervention on the unit were compared. Post-implementation, not only have HAPI decreased, but there has not been a HAPI in 3 months. This project also contributed to decreasing our hospital wide monthly prevalence rate of pressure injuries from 2.63% in the month before intervention to .70% 2 months post-intervention. This has allowed our facility to maintain our fiscal year goal below our target of 1.68% at 1.14%. These findings suggest that not only does shared decision making provide for a platform for improved quality outcomes, but also sustainment of those outcomes.

Speakers:

Nicholas Dotson, DNP, PMHNP-BC; Senior Director, Inpatient Adult & Adolescent Psychiatry; University of Illinois at Chicago (UI Health)

Anil Jacob, MSN, RN; Clinical Nurse Consultant II, University of Illinois at Chicago (UI Health)

Workplace violence against health care staff, particularly nurses, is a growing concern across the nation. To address this issue at UI Health the Dynamic Appraisal of Situational Aggression (DASA) was implemented. DASA is a brief seven-item observer rated tool utilized to assess the risk for violence. Completion of the tool take less than five minutes and is done by simply rating whether each of the following seven items is present: 1) irritability; 2) impulsivity; 3) unwillingness to follow directions; 4) sensitivity to perceived provocation; 5) easily angered when requests are denied; 6) negative attitudes; and 7) verbal threats. Upon the identification of the patient’s risk level, clinicians are provided guidance regarding recommended interventions to prevent and mitigate aggressive behaviors. These interventions are tailored specifically to the patient’s stratified aggression risk score. Total DASA scores are reliably associated with subsequent violence, and the predictive accuracy of DASA has been repeatedly demonstrated in literature. DASA has been built in a user-friendly manner and is available in flowsheet format. Records of Aggression and Interventions are conveniently located directly beneath the tool for ease of access. A care plan is triggered by nursing documentation for a score greater than or equal to 1. In addition, a graph is available to visually identify trends in the patient’s level of aggression over time. DASA should be documented on at admission, every shift, and as needed to reflect changes in the patient’s condition. Staff can find prompts for Aggression Risk on their Admission and Shift Required Documentation lists as well. Initially, UI Health introduced DASA as a pilot in our Emergency Department in April of 2023. From April 2023 to April 2024, results of the Emergency Department pilot indicated a 23.6% reduction in total violent episodes and a 64.2% reduction in violent episodes. As of January 31st, DASA has been implemented house wide. Even more, a report is run daily indicating all those patients who are at high or imminent risk of violence, and nurse leaders respective to each area in which these patients are located are contacted to ensure that appropriate signage has been placed and that a “Safe Management Plan” has been developed (see below). The results of the house-wide roll out are encouraging, as we have seen a house-wide reduction in assaultive episodes.

Speakers:

Debra Harper, MSN, RN, NE-BC; Manager 6 Medical Care, Advocate Sherman Hospital

Donna Kruse, MS, RN, NE-BC, EBP-C; Director of Inpatient Acute Nursing, Radiation Oncology, Magnet, and Professional Development, Advocate Sherman Hospital

This project aims to reduce catheter-associated urinary tract infections (CAUTIs) by decreasing overall catheter days, implementing urine culture stewardship, and standardizing protocols for catheter insertion, maintenance, and peri-care. Through these targeted strategies, the initiative seeks to enhance patient safety, prevent infections, and improve the overall quality of care. CAUTIs remain one of the most common healthcare-associated infections (HAIs) reported to the National Healthcare Safety Network (NHSN). Research shows that up to 50% of urinary catheters are placed without an appropriate medical indication, which increases the patient’s risk of infection by 3%–7% with each additional day of use. Beyond infection, catheters can also cause noninfectious complications such as inflammation and reduced patient mobility. These risks emphasize the critical need for prevention strategies and align with the organization's Magnet® culture of safety and high-quality care. To address these concerns, a comprehensive approach was implemented. The team conducted data analysis using Standardized Infection Ratios (SIR) and Standardized Utilization Ratios (SUR) to identify trends and opportunities. Nursing departments evaluated hygiene products and documentation, while multidisciplinary teams in the ICU, Emergency Department (ED), and Surgery reviewed catheter indications and established clear discontinuation plans. Dashboards were developed to monitor catheter orders, hygiene compliance, and timely catheter removal. Additionally, daily huddles and scheduled audits helped identify prolonged catheter use and missing documentation. A culture huddle algorithm and detailed CAUTI drilldowns engaged key stakeholders in real-time problem-solving. Staff education on acute urinary retention protocols, including straight catheter trials, ensured clinical competency and promoted alternatives to indwelling catheterization. Monthly safety huddles celebrated achievements, including CAUTI-free days, to reinforce positive outcomes and sustain momentum. The results of these interventions have been significant. In the fourth quarter of 2023, the organization reported a CAUTI rate of 3.20 per 1,000 catheter days, which exceeded the national benchmark of 0.76. However, by the first half of 2024, the rate was successfully reduced to zero, with no reported CAUTIs during Q1 and Q2. In Q3 2024, only one CAUTI was identified, which involved a patient who returned from a skilled nursing facility with a catheter already in place. The infection was identified within 24 hours of discharge, highlighting the need for continued vigilance across care transitions. Overall, this project demonstrates that focused interventions—such as urine culture stewardship, standardized clinical protocols, and ongoing staff education—can lead to sustained reductions in CAUTI rates. These efforts have improved patient outcomes, reduced infection risks, and strengthened the culture of safety within the organization.

Speakers:

Jessica Flores, RN; Nurse Practice Specialist, Ascension Saint Alexius

George Lukowski, RN; Nurse Practice Specialist, Ascension Saint Alexius

Adam Tiltz, RN; Nurse Manager, Ascension Saint Alexius

Catheter-Associated Urinary Tract Infections (CAUTIs) are a major contributor to healthcare-associated infections, leading to increased patient morbidity and healthcare costs (CDC, 2022). Ascension Saint Alexius aimed to reduce CAUTI rates through a focused process improvement initiative targeting the proper use and care of indwelling urinary catheters. Purpose of the project: Preventing CAUTIs is the primary goal. The committee aims to improve hospital practices by leveraging lessons learned from national and local CAUTI assessments. It seeks to maintain active participation in CAUTI initiatives, especially with the Ascension Saint Alexius CAUTI champions and the ED, promoting a culture of zero insertions. Methods: The “Crush CAUTI Crew,” a nursing committee of CAUTI champions, was reinvigorated to lead the effort. With renewed energy and focus, champions were required to commit to 75% meeting attendance, active participation, and specialized training in catheter insertion and maintenance. The monthly meetings played a pivotal role in shaping the education implemented within our organization. Through consistent communication and sharing of lessons learned, the meetings highlighted areas for improvement and informed the training of nurses. These initiatives focused on key aspects such as catheter insertion, maintenance, irrigation, and documentation. Additionally, the discussions led to collaboration with the Resource Group, resulting in the standardization of PAR carts and color coding the coude catheters for easy identification. Insights gained from the meetings also addressed the need for bladder scanners on each unit and tools such as catheter algorithms and insertion “time-out” protocols which all helped to reduce CAUTI risk. Lastly, a culture of open communication between Providers and nurses was encouraged, supported by annual assessments, audits, and live demonstrations to ensure continuous quality improvement. Results/outcomes: These initiatives led to significant improvements in CAUTI prevention and the initiation of maintenance bundle audits, with the expectation to enhance consistency and ensure best practices are followed. Over the past 12 months, Ascension Saint Alexius reported a CAUTI rate of 0, which is 100% below the market benchmark of 0.48. This achievement reflects a reduction of two infections, with the last recorded cases occurring in August and September 2023. Conclusions/implications for practice: The success of the “Crush CAUTI Crew” demonstrates the effectiveness of a collaborative, structured approach to CAUTI prevention. The committee’s model emphasizes teamwork, training, transparency, and evidence-based practice, all contributing to continuous quality improvement and a strong commitment to patient safety. Moving into 2025, the committee plans to expand its efforts by incorporating a Physician Champion and developing a Nurse-Driven Foley Removal Policy. The ongoing efforts, along with those already implemented, have not only reduced CAUTI rates but also serve as a model for other hospitals striving to improve patient safety and reduce healthcare-associated infections. References Centers for Disease Control and Prevention. (2022). Catheter-associated urinary tract infections (CAUTIs) prevention. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/infection-control/hcp/cauti/background.html

Speakers:

Corinne Kodama, PhD; Senior Research Analyst, Women Employed

Efrata Sasahulih, M.A.; Program Coordinator, Women Employed

Morgan Kelley, MSW; Research Assistant, Women Employed

Many women, particularly women of color, enter the healthcare workforce as a Certified Nursing Assistant (CNA), Medical Assistant (MA), or other entry-level position with the goal of becoming a nurse. However, for these workers who did not go straight into a BSN program right out of high school, the path to a nursing career is anything but straightforward and instead often proves to be confusing, complicated, and time-consuming. While it seems like relatively straightforward paths exist (for example, from a CNA to an RN), rarely are those completed in a direct or timely manner. This session is based on findings from interviews of nurses (and prospective nurses) in Chicago, primarily Black and Latina women, who started their healthcare careers at an entry level. The desire to work in nursing was often a challenging journey through different training programs, colleges, and employers, often not in an upward trajectory and with pivots for both personal and professional reasons. At the education and training level, prospective nurses were often confused over which nursing credential (LPN, ADN, BSN) would get them the desired job and career path they wanted, as they heard conflicting information from both their personal and professional networks. This was particularly true for those who did NOT start as a CNA, such as the many MAs who desired nursing as their next step. Working nurses expressed the importance of “who you know, not what you know” in their career advancement, from initial hiring through promotion which made hiring and advancement challenging for those who did not have the “right” networks. This was particularly true for Black nurses who had significant challenges in getting raises and promotions due to systemic racism, despite many years of experience and accomplishments. Finally, there was not a clear relationship between credentials earned, hiring criteria, wages, years of experience, and promotional opportunities. We found that what employers say (or what is in writing) about what criteria is required for particular jobs was often not reflected in their actual hiring practices, perhaps due to the effect of COVID on nursing shortages. We also observed a disconnect between what training providers think are clear, obvious paths to upskilling that did not reflect participants’ professional goals nor the reality of their career journey. We hope to engage conference attendees in a discussion of how to address these barriers that entry-level healthcare workers face in pursuing a nursing career. In order for nursing career pathways to work, training providers and employers need to better align their education, training, and workforce goals so that future nurses can make informed choices about their education and career plans. Employers in particular need to be transparent about hiring and promotion policies, provide anti-racism training for managers, and establish mentorship programs in order to provide opportunities for nurses from all racial backgrounds to obtain meaningful employment and to get promoted commensurate with their skills and experiences.

Speakers:

Colleen Calhoun, MSN, RN, CMSRN, CNL; Behavioral Health Inpatient Nurse Manager, Loyola Medicine - MacNeal Hospital

Jennifer Grenier, DNP, RN, CENP; Regional Executive Director Behavioral Health Services, ACNO, Loyola Medicine - MacNeal Hospital

Blaine Stringer, MSN, RN, CEN, NE-BC; Director of Emergency Services, Loyola Medicine - MacNeal Hospital

Kerry White, MSN, RN, CEN; Nurse Manager Emergency Services, Loyola Medicine - MacNeal Hospital

In the high-pressure environment of emergency departments (EDs), psychiatric patients often face fragmented care and prolonged wait times, leading to worsened outcomes and increased strain on healthcare resources. This presentation introduces a pioneering model of care designed to prioritize and streamline psychiatric patient management in ED settings. The model integrates a multi-disciplinary approach, combining dedicated psychiatric triage teams, real-time risk assessment tools, and tailored care pathways to ensure timely and effective interventions. Key components include the implementation of specialized psychiatric care navigators who facilitate immediate assessment and stabilization, as well as enhanced collaboration between psychiatric and emergency staff to create individualized care plans. This model also emphasizes collaboration with security partners to assure colleague safety. Preliminary outcomes indicate significant improvements: reduced length of stay and decreased incidence of adverse events. This presentation will discuss the development, implementation, and evaluation of this model, offering insights into its potential to transform psychiatric care within the ED and improve overall patient and colleague outcomes.

Speaker:

Karin Smith, DNP, RN, NEA-BC, CENP, CCRN; Associate Professor and DNP Program Director, Bradley University

In response to evolving healthcare complexities and the American Organization for Nursing Leadership (AONL) Nurse Leader Core Competencies, Bradley University’s Master of Science in Nursing (MSN) program has undergone a strategic transformation, transitioning from "Nursing Administration" to "Nursing and Healthcare Leadership." This curricular revision aligns with national trends emphasizing leadership over administration, as advocated by the Commission on Collegiate Nursing Education (CCNE), the American Association of Colleges of Nursing (AACN), and the American Nurses Association (ANA). Key program modifications include expanding credit hours, integrating an interdisciplinary financial management course in collaboration with the Foster College of Business, and increasing practicum hours to meet AACN Essentials standards. Additionally, a new advanced health assessment, pharmacology, and pathophysiology course ensures compliance with updated CCNE accreditation requirements. These changes enhance leadership development by fostering competencies in strategic decision-making, quality improvement, financial stewardship, and interdisciplinary collaboration. The curriculum now places a greater emphasis on preparing nurse leaders to drive healthcare transformation, effectively manage resources, and implement evidence-based practices that improve patient and organizational outcomes. This presentation will explore the successes, challenges, and lessons learned from these curricular enhancements, reflecting on their impact on student preparedness for executive nursing leadership roles. Attendees will gain insights into best practices for curriculum innovation in graduate nursing education and strategies for aligning academic programs with AONL Nurse Leader Core Competencies and the AACN Essentials.

Speaker:

Gina Ashbrook, DNP, MEDSURG-BC, NPD-BC; Nursing Retention Strategist, Nursing Professional Development Outcomes Leader, Southern Illinois Healthcare

Advancement and recognition programs support professional growth, succession planning, and retention in healthcare organizations. Registered nurses (RN) who seek out professional growth and lifelong learning opportunities allow clinical expertise to remain at the bedside facilitating positive patient outcomes, achieving strategic goals, and creating a positive work environment. The SPARK Program empowers bedside RNs to hone their bedside expertise while growing professionally in their nursing practice. The SPARK Program was developed to fortify the clinical expertise needed to care for a complex patient population. A strong foundation built on theory, organizational structure, evidence-based practice, and a culture supportive of a positive work environment has been key to the program’s success. The program categories are reflective of the Elements of Performance in the American Nurse Credentialing Center’s Pathway to Excellence® designation. The program is voluntary and allows nurses to determine how they earn points to advance based on individual preference. Another important aspect of the SPARK Program is recognition. Research indicates that meaningful recognition can serve to rejuvenate a nurse’s commitment to the nursing profession, instill pride in nursing practice, and deepens the loyalty a nurse feels toward their team and healthcare organization (Cleveland Clinic, 2022). RNs who advance a clinical level are recognized in multiple ways throughout the year and receive a financial bonus. Reference: Cleveland Clinic. (2022). The importance of celebrating and recognizing nurses. Consult QD. Showing Love for Nurses

Speaker:

Jennifer Stringham, MSN, RN, CMSRN, NE-BC; Magnet and Nurse Excellence Manager, Advocate Sherman Hospital

Ready to conquer Nurse Leader Certification? This session offers strategies to manage study time, overcome certification fears, and build confidence. Gain practical tools to stay organized, reduce anxiety, and successfully navigate the certification process, empowering you to achieve your leadership goals. Purpose: The Magnet Manager developed a structured program to identify and address barriers to national certification, encouraging nurse leaders to pursue certification. A cohort of leaders who had not yet achieved certification was formed to go through the process together, providing support and accountability. Significance: Nurse leader certification demonstrates advanced knowledge, helping leaders stay current and develop expertise. It empowers them to lead nursing teams effectively, ensuring high-quality care in a complex, ever-changing healthcare environment. Certification enhances leadership credibility and fosters professional growth. Implementation Plan: To address the challenge of certifying nurse leaders, nursing leadership certification was added to the strategic plan, with the goal of 100% certification within one year of assuming a new position. Eight leaders needed certification but faced competing priorities. The Magnet manager developed a timeline, starting with a lunch-and-learn kickoff to outline the steps. Tactics included: 1) Reviewing certification criteria and signing up for the class together for support; 2) Providing a list of free and hospital-paid resources for CEUs; 3) Covering costs for an online review course. This structured approach helped leaders stay on track despite their busy schedules. Outcome: In the past year, nurse leader certification rates increased from 74% to 94%, with all but one leader passing the certification exam. Without this initiative, many nurse leaders indicated they would not have completed the certification due to time constraints and competing responsibilities. Achieving certification allows nurse leaders to set a positive example for clinical staff, enhancing credibility and demonstrating a commitment to excellence. It also improves patient outcomes by ensuring leaders are equipped with current, evidence-based practices. Certification boosts professional growth and strengthens leadership, which ultimately improves patient care and nursing practice. Implications for practice: Nurse leaders should become certified to set an example for clinical staff. Certification demonstrates commitment to excellence, enhances credibility, and improves patient outcomes by ensuring leaders are equipped with the latest evidence-based practices. It also opens career opportunities, boosts professional growth, and strengthens leadership influence, ultimately elevating the quality of patient care and advancing the nursing profession.

Speakers:

Renee Scheier, MSN, RN, CMSRN; Executive Director, Inpatient Nursing, Loyola Medicine MacNeal Hospital

Jennifer Scheeringa, MSN, RN, ACM, CENP; Chief Nursing Officer, Loyola Medicine MacNeal Hospital

Imagine a healthcare organization where nurses not only survive but thrive. Our vision was to take this organization from merely getting by to achieving Magnet with Distinction. By investing in our nurses, fostering a culture of continuous improvement and aligning our practices with the highest standards, we elevated patient outcomes and enhanced job satisfaction and retention among our nursing staff. We will share our roadmap to achieving Magnet with Distinction designation.