What's behind a top-notch nursing staff?
When a hospital cares about its nurses, they can provide the best care for patients
Saint Peter’s University Hospital, a member of the Saint Peter’s Healthcare System, employs more than 600 full-time, part-time and per-diem nurses. These dedicated professionals possess a combination of knowledge, skills and commitment to excellence that is among the highest, I feel, not just in the state, but in the country. Yes, I’m biased. As their leader, I see their work every day. As someone with more than 25 years of experience in nursing, I know how well they perform their very challenging duties, caring for patients from before they are born until the end of their lives.
But you don’t have to take my word for it. Instead, listen to the American Association of Critical Care Nurses, which recently gave our Intensive Care Unit (ICU) the Beacon Award for Critical Care Excellence. This honor recognizes the nation’s top ICUs, and only 56 units in the country have received this prestigious award. To earn it, Saint Peter’s ICU nurses had to demonstrate that they adhere to nationally recognized best practices, maintain low rates of infection and pneumonia in patients, have a high percentage of specialty certifications in critical care, attend continuing education sessions offered on the unit, actively participate in clinical research and actively influence and improve patient care, among other criteria.
Or listen to the American Nurses Credentialing Center of the American Nurses Association, which honored Saint Peter’s as the seventh hospital in the country to be designated for a third consecutive term as a "Magnet" hospital. This honor is considered the highest recognition for nursing excellence that a facility can receive. In 1998, we were the 10th hospital in the nation to initially receive this designation. Magnet status is awarded to hospitals that deliver an extraordinary level of patient care, meet high standards of nursing excellence, establish an environment that encourages nurses to pursue their professional development and emphasize teamwork.
Or listen to Diversified Clinical Services, the largest wound care management company in the world, which presented our Wound Care Center and Hyperbaric Services a Center of Distinction award for healing rates above national benchmarks. We were one of only five recipients in the country. Awards are very nice, but what do they mean for someone who may someday need our services? Independent research has shown that Magnet hospitals consistently provide the highest-quality patient care and outperform other hospitals in recruiting and retaining quality nurses, which in turn is directly connected to attracting high-quality physicians. Recognitions like these let you know we will provide you the safest and most effective health care.
Let me share with you a few of the accomplishments we are most proud of.
Nurses can earn certification in specialty areas, such as oncology or pediatrics, and it requires both several years of practical experience and continuing education well beyond a basic nursing degree. Saint Peter’s has one of the highest nursing certification rates in the country: Sixty-five percent of our nurses hold at least one specialty certification, and many maintain multiple certifications. Earning these certifications takes a tremendous amount of personal initiative and ongoing education. Candidates study for and take the tests on their own time, as well as participating in continuing educational offerings in order to maintain their certifications. But it’s worth it, for our nursing staff and for you. Research has documented that certified nurses take a more active role in their patients’ care and that patient outcomes improve as a result.
Every nursing unit is involved in a research project of its own choosing to help us find new and better ways of caring for our patients. For example, one unit wondered if care could be improved by regularly scheduled nurses’ rounds, in which a nurse or nurse’s aide visits all patients at least once an hour to help them to the bathroom, adjust their positions, assess their pain or perform other services. Care on this unit was so well received that this program has since been expanded throughout the hospital.
Another question now being studied is a walking program, in which hospitalized seniors are regularly helped to exercise, improving muscle tone and balance. Yet another project is providing high-risk pregnant women, who may be in the hospital for weeks or even months before delivery, with access to computers so they can interact with their family and friends while hospitalized, which should improve their emotional and spiritual well-being.
NICHE stands for Nurses Improving Care for Healthcare Elders. It’s a national program, and Saint Peter’s became a NICHE site this past spring. To meet the NICHE criteria, we established a training program in conjunction with the Hartford Institute for Geriatric Nursing at New York University. These programs focus on age-related changes in health and function, delirium and dementia, medication and quality measures in our elder population. As a result of this program, we now have a geriatric resource nurse in each unit of the hospital to oversee care for our elderly patients. These nurses help coordinate our new eldercare services, such as the Silver Spoons feeding program (in which trained volunteers help seniors at mealtime), Care Companions, pet therapy and the walking program I mentioned earlier.
Along with our in-house geriatric care, we have contracted with many of the adult communities in Monroe Township to provide an on-site nurse. Some communities have a nurse on site 24/7, others may have one on hand five days a week, with access to help if the need arises off-hours. Our nurses help with daily care, perform health screenings, make appointments, coordinate transportation to and from doctor visits, conduct education sessions and help with anything else residents may need.
PERSONAL ADVOCATE DAY.
We have a monthly forum in which nurse managers meet with administrators to address our patients’ comments and concerns. We talk about everything from standards of care to what’s on the patient menu. We expanded our meal options after just one of these sessions. We also replaced several TVs that had drawn patient complaints. In addition, we addressed problems with patient flow in the Emergency Department by hiring a director of bed management to streamline the admission process and make sure patients weren’t waiting in the ED for a hospital bed.
PROFESSIONAL PRACTICE COUNCIL.
This staff-led nursing group works to improve care and nursing processes through evidence-based practice models. The council is made up of staff nurses from every unit in the hospital, who meet monthly to share best practices in their areas and discuss ways to improve care for their patients. One example is how our ICU nurses, working with physicians and pharmacists, developed and implemented comprehensive protocols for high-risk medications in addition to the specialized care each patient requires.
We have a strong mentoring program for new nurses. Mentors have proven effective in helping new nurses acclimate to our culture. The mentor, who comes from a different unit than the new hire, is able to answer questions, solve problems and make a new nurse feel like part of the team. Our turnover rates are well below the national average, and that’s important for patients. Since constant turnover disrupts teamwork and increases variability of care, it has been shown that outcomes are better when there’s a strong and stable team whose members trust one another and communicate well.
These are just some of the things that make the Saint Peter’s nursing staff so remarkable. Each of our 600-plus nurses believes in and follows our nursing philosophy, which closely follows the hospital’s overarching mission of humble service to humanity (see left). Nothing reveals the essential spirit of a hospital more than its nurses, and we’re extremely proud of ours