American Nurse Journal announces 2024 All Pro Nursing Team Awards.
Effective healthcare team collaboration can make the difference in patient outcomes. When nurses, providers, therapists, leadership, and other professionals work together as a cohesive team, patients benefit—and so do nurses and all healthcare workers.
This year’s winners of the American Nurse Journal All Pro Nursing Team Awards exemplify that ethic of collaboration. Each of the nursing teams you’ll read about on the following pages found opportunities to collaborate, strategize, and implement successful projects and programs with their interprofessional teammates to enhance patient care and improve outcomes, engage nurses, and ensure a healthy work environment for everyone. They conducted literature reviews to better understand the concerns they were trying to address. They then developed opportunities for improvement based on vital feedback from the nurses who would be directly affected.
All of us at American Nurse Journal extend our gratitude to every team that submitted an application. You’re all incredibly busy professionals who made the effort to tell us about the critical work you do. All of your applications inspired us and reminded us why we love working with nurses.
To the winners, congratulations. Your work hasn’t gone unrecognized. Thank you for all you do.
Winner
HMH Raritan Bay Medical Center ICU Team
Successful patient outcomes rely on interprofessional collaboration—individuals from various disciplines with unique skills working together for the benefit of the patient. The ICU team at HMH Raritan Bay Medical Center understands that. They’ve been using the Society of Critical Care Medicine (SCCM) A-F liberation bundle since its introduction in 2014 to reduce ICU length of stay, increase mobility, and decrease mortality. The ICU Team also takes meaningful steps to engage nurses and reduce turnover. Here’s their story in their own words:
The A-F bundle summarizes patient care in five elements: pain management, awakening and breathing trials, sedation, delirium prevention, early mobility, and family involvement. During COVID, we abandoned the bundle to address the crisis, but we returned to it after the SCCM released data validating that integration is associated with decreasing hospital death, reducing delirium and coma, reducing physical restraint use, cutting ICU readmission rates in half, and reducing discharges to rehabilitation facilities.
To ensure bundle compliance, the intensivist leads daily multidisciplinary bedside rounds at 9:00 am. Patients and their family members participate. Every aspect of the bundle is reviewed and catered to patient-specific needs. The focus is on ensuring the patient is being wholly cared for—physically, emotionally, and spiritually.
Each day, ICU nurses perform awakening trials to assess for ICU delirium. If the patient is intubated and can safely pass the awakening trial, the respiratory therapist initiates a spontaneous breathing trial. If the patient tolerates the trial, the intensivist evaluates if the patient can be extubated. If so, the endotracheal tube is promptly removed.
Physical therapy assesses patients daily and determines their functional capacity and capability. If the patient can’t safely ambulate, physical and occupational therapy assist in range of motion exercises and transfers until the patient reaches optimal functional capacity. As soon as the patient can safely ambulate, functional independence is promoted.
All interventions are entered into the ICU liberation bundle flowsheet in the EHR so that everyone can clearly see what each discipline accomplished that shift. Each of these seemingly separate activities are pieces of the puzzle that lead to improved outcomes.
In the first two quarters of 2014, the average ICU length of stay was 4.2 days. In 2023, average length of stay was 1.47. This confirms the effectiveness of the bundle in reducing length of stay and, in turn, improving patient outcomes.
Despite the exceedingly high turnover rate of ICU nurses nationwide, Raritan Bay Medical Center’s ICU had an RN turnover rate of 3% in the third quarter of 2022. In the last quarter of 2022, and year to date in 2023, we have a 0% nurse turnover rate. The Clinical Advancement Program, one of many incentive programs, provides financial support for 3 consecutive years after an application is completed and submitted. The ICU has a 75% program participation rate, validating team members’ engagement. In addition, the organization provides annual financial incentive for RNs who hold a certification in their field.
First Runner-Up
Baptist Health Clinical Learning Team
Understanding the vulnerability of newly licensed nurses (NLNs), the Baptist Health Clinical Learning Team developed Real Talk Sessions (RTS) to address their unique challenges.
RTS features two components. A 30-minute stress management seminar focuses on well-being, stress management strategies, and guided meditation. This is followed by a 1-hour facilitated virtual support group session. Facilitators, who undergo comprehensive training by the Clinical Learning department, include trained staff nurses, unit educators, and nurse leaders, as well as members of the Clinical Learning team. To tailor support, 8 to 10 participants are grouped by specialty and entity to foster a sense of camaraderie. Throughout the residents’ immersion period, the team conducts three mandatory 1.5-hour sessions, each addressing specific themes pertinent to NLNs’ transition into professional nursing practice.
Because feedback is integral to the success of any program, the Clinical Learning team conducted post-cohort evaluations to gauge effectiveness. Since July 2022, 665 new graduates have completed post-cohort RTS evaluations—97% affirmed that the debriefing sessions empowered them and provided the support they needed to successfully complete their residency. Resident comments emphasized feelings of security, the value of sharing experiences, and the comfort in discussing previously daunting topics. This affirmation validates the program’s efficacy and underscores its positive impact on NLN well-being and confidence. In addition, out of 124 facilitators who completed post-cohort RTS evaluations since July 2021, 96% expressed satisfaction with the tools and training provided.
The Baptist Health Clinical Learning team describes the RTS program as extending beyond numerical data. They believe it signifies a cultural shift within their organization toward prioritizing mental health and fostering a supportive environment for their nurses.
Second Runner-Up
Chilton Medical Center Cardiac Rehabilitation Department
To address the high rate of depression among patients who’ve experienced a major cardiac event, the Cardiac Rehabilitation Team at Chilton Medical Center (CMC) aims to improve patients’ mental health during their cardiac rehab therapy. The team partnered with the Atlantic Health System’s marketing and behavioral health teams to develop a 12-part virtual meditation podcast. The program, Grow Your Mental Health, focuses on mindful breathing. Each week emphasizes a specific topic, such as mindful movement, mindfulness of the body, mindful eating, and mindful self-compassion.
The Cardiac Rehab clinical nurses distribute the Grow Your Mental Health brochure (which has a QR code for the podcast) at each patient’s first visit and discuss the significance of mental health. To foster collaboration, the nurses routinely remind patients to engage in meditation activities and solicit feedback on its effectiveness. The 12-week podcast design (which coincides with the 12-week rehab program) provides patients with a structured resource for consistent meditation practice to help them develop healthy habits.
Before project implementation, the mean percentage change in the pre- and post-PHQ-9 (an evidence-based scale for measuring depressive symptoms) was only 27%. After implementation, the mean percentage change increased to 59%, indicating a greater reduction in depressive symptoms during therapy.
An example of CMC’s commitment to nurturing nurses’ well-being and fostering professional growth and development can be found in its Scholar Program, which aims to empower participants with the skills and knowledge needed to critically assess research findings, incorporate them into practice, and make informed decisions based on the best available evidence.
Third Runner-Up
Parkland Health 12B Hospitalist Medicine Team
To ensure a healthy work environment that addresses nurse burnout, nurse retention, and good patient outcomes, Parkland Health’s 12B Hospitalist Medicine Team initiated the C.R.E.A.T.E. mentorship project (Collaborating to Raise the bar on Engagement [enthusiasm, spirit, morale], pro-Activity [education, critical thinking, anticipating], Teamwork [trust, relationships, communication], and Excellence [high reliability, outcomes, winning]).
The program brought RNs and physicians together once a month to discuss the roles and expectations of each to properly manage various conditions, including congestive heart failure, sepsis, and diabetes. Meetings were arranged around nurse and physician schedules, and groups were notified weeks in advance to ensure the nurse buddy and charge nurse could provide support.
After the initial 1-year program, nurses and physicians expressed gratitude for the project. They noted that it enhanced comradery, effective communication through listening, new learning, critical thinking, and workflows.
Unit-based councils at Parkland help to support and engage nurses. For 6 years, 10% of the 12B Hospitalist Medicine Team has volunteered or been nominated to serve on the UBC committee. In addition, the team initiated a Rewards, Recognition and Retention Committee, which strives to ensure a positive work environment. Every quarter, the committee awards an employee (nominated by coworkers) who embraces Parkland ICARE values. The 12B vacancy rate continues to drop (from 15.31% in October 2021 to 08.04% in 2023).
Honorable Mention
Boston Children’s Hosp. Culture Works Team
The Culture Works Team at Boston Children’s Hospital established the Secret Garden as a quiet nurturing environment for staff who need to reset and recharge. Culture Works collaborated with the AV department, marketing, and senior leadership to obtain a space open around the clock for various activities. Offerings include self-directed yoga and stretch areas, loungers, massage chairs, and journal materials. Meditation music and nature videos enhance the relaxed environment. Staff have access to literature related to coping skills, breath work, resilience, recognizing bias, and navigating grief. Practitioner-led sessions (offered in-person and via Zoom) include 30 minutes of a sound bath, Reiki circle, guided mediation with breath work, journaling, or chair yoga. Data collection indicates increased use and a decrease in staff-perceived stress levels. Daily staff badge counts are collected monthly to understand space use. Since opening in November 2022, use increased 337% (454 badges in November 2022 to 1,531 in June 2023).
Honorable Mention
Jefferson Methodist B5 Team
To decrease fall rates, the Jefferson Methodist B5 unit council developed an intervention that would empower nurses and patients to feel more aware, educated, and prepared. A literature search revealed several barriers to preventing falls, including patient perception of what it means to be a “falls risk,” use of nonstandardized falls risk tools, lack of staff education and engagement, patient and family nonadherence to falls risk procedures, and lack of hourly rounding.
Based on the literature search, and feedback from a staff survey, the unit council adapted an education process on “What it means to be a fall risk.” They then created a patient-focused handout on preventing falls. Combining routine, standardized patient and family education on falls risk with meaningful hourly rounding has decreased unit falls from July 2022 through the present. Out of 17 months, the unit maintained a 0-falls-with-injury rate for 15, which translates to an 88% success rate.
Honorable Mention
Thomas Jefferson University Hosp. MICU Team
The Thomas Jefferson University Hospital MICU implemented interdisciplinary targeted rounds to reduce unnecessary use of indwelling urinary catheters (IUC) and decrease CAUTIs. The team included the nurse manager, nurse educator, charge nurse, advanced practice clinician and/or physician, bedside nurse, and infection control clinician. Targeted rounds addressed IUC days, reason for insertion, daily necessity reason, removal plan, if the IUC was nurse driven or physician driven, and protocol compliance.
The interdisciplinary team educated staff with bulletin boards, huddles, and just-in-time education. They also incentivized bedside nursing staff to remove catheters and follow protocols with earned days off.
Six months before implementation, the unit had three CAUTIs and 1,413 device days. During the first six months of targeted rounds, one CAUTI occurred and device days decreased to 1,004.
A year after implementation, device days have dropped to 945.
Honorable Mention
Hosp. of the Univ. of Pennsylvania MICU Healthy Work Environment Committee
The pandemic, multiple moves, and the opening of a second MICU had led to staff burnout and interprofessional team tension on the MICU at HUP. Nurses left the unit to work in other departments, which led to more burnout among remaining staff.
In response, MICU nurses instituted a Healthy Work Environment (HWE) Committee, which aims to improve patient outcomes by improving the work environment. This evidenced-based solution, founded on the American Association of Critical-Care Nurses’ six HWE standards, is designed to engage staff, lower turnover rates, decrease burnout, and enhance patient care. At monthly meetings, the committee focuses on one of the standards to identify areas of need and develop strategies.
The committee has implemented several interventions. For example, MICU-specific debriefing classes at the Simulation Center help charge nurses gain the knowledge and skills to run interdisciplinary debriefs after critical events.
American Nurse Journal. 2024; 19(4). Doi: 10.51256/ANJ042417
