Nursing at Homestead Hospital

Advocating for Patients

•  The Homestead Hospital Magnet Designation department developed a nurse-practitioner led inpatient acute pain management consultative service program that utilizes pain management best practices.
• Through the efforts of a nurse-led interprofessional Safe Sleep Task Force, the Mother and Baby Unit began distributing sleep sacks and safe sleep education materials to new parents to decrease sleep-related deaths in the community.

Mentorship and Collaboration

• The hospital’s Workplace-of-Choice team formalized a mentoring process and recruited and trained a pool of 33 mentors to cultivate a supportive culture across the organization.  Collaboration in healthcare has been shown to improve patient care and outcomes.

Professional Development

• Homestead Hospital’s overall RN certification rate is 51 percent and overall BSN and higher degree rate is 77 percent. Nurses with advanced education are better prepared to care for patients in an increasingly complex healthcare delivery system.

Teaching and Role Development

• Through an educational intervention, the hospital’s Med-Surg 5 unit maintained a central line-associated bloodstream infection rate of zero for 12 months after the intervention.

Community Involvement

• Homestead Hospital had 185 nurses provide 1,425.5 hours of community service. Outreach activities included appearances on the PBS television show, the Health Channel, and participation in various health fairs, first aid stations, health/chronic disease education seminars and mentoring activities.
• Clinical nurses established and led a hospital-wide Diversity and Inclusion Committee that organized two educational events on the care of autistic and LGBTQ patients.

Nursing Recognition

• Homestead Hospital has earned the Certified Nurse in the Operating Room (CNOR) Strong designation from the Competency and Credentialing Institute (CCI) for the sixth time (2013, 2015, 2016, 2017, 2018 and 2019) and is listed as a CNOR Strong facility on the CCI website map. In Surgical Services, more than 56 percent of the nurses are CNOR certified.

Professional Practice

• Homestead Hospital achieved 95 percent participation in the 2018 National Database of Nursing Quality Indicators (NDNQI) RN Survey. These survey results and the annual RN and direct care RN engagement survey denoted high engagement and work environment satisfaction among nurses.  Engaged and satisfied nurses can lead to quality improvements and better patient care.

Care Delivery

• Through various performance improvement initiatives, Homestead Hospital’s overall observation length-of-stay average decreased, which directly benefits patients.
• By partnering with community representatives and organizations, the Bereavement Support Group Committee established monthly bereavement support group meetings (in English and Spanish), so the healthcare team could provide a resource for employees, families and community members who need bereavement support.

Interprofessional Care

• The Emergency Department conducted a trial using a device that improved blood culture testing methods.

Nurse Autonomy

• Homestead Hospital nurses implemented the external female urinary collection device, giving clinical nurses the autonomy to select less invasive means of managing female fluid output and incontinence needs. This initiative contributed to an overall decrease of urinary catheter usage and resulted in zero catheter-related urinary tract infections in some units.

Safety Culture

• The Infection Control committee implemented the hand hygiene Targeted Solutions Tool, improving hand hygiene compliance and decreasing infection rates.
• Our nurses participated in the 2019 Global Handwashing Day and obtained 700 signatures.

Research

•  The Evidence-Based Practice and Research Council initiated six research projects and presented two publications, five posters and one podium presentation at regional and national conferences. Conducting and advancing nursing research are important for delivering the most effective nursing care.
• The research study “Implementation of an Inpatient Diabetes Team: Impact on Hypoglycemia Recurrence,” conducted by the Diabetes Care team, demonstrated that patients seen by the team (consisting of a diabetes nurse educator and diabetes nurse practitioner) had lower rates of hypoglycemia recurrence.

Evidence-based Practice

•  The Obstetric Code Blue Task Force developed and implemented the obstetric code blue policy and procedure to promote maternal/fetal safety during a cardiac arrest.

Innovation

• Homestead Hospital nurses were actively involved in the design and opening of two new departments to improve patient care: Transitional Stay Unit and Inpatient Rehabilitation Unit.

• The Perinatal unit practice council implemented an evidence-based, nurse-driven intervention utilizing the peanut ball that reduced the time of the second stage of labor for women delivering at Homestead Hospital.
• Through interprofessional collaboration and the addition of the Transition-of-Care Coordinator role, the Multidisciplinary Cardiovascular Collaboration Committee reduced the 30-day readmission rate of patients treated for heart failure.
• The Multidisciplinary Stroke Committee improved the turn-around time for the administration of lifesaving clot-busting medication for the treatment of stroke in the Emergency Department. The team also established a Stroke Unit to provide outstanding patient care. 
• The Infection Control Committee deployed an educational campaign that reduced the hospital-wide Clostridium difficile infection rate.
• Perinatal Services participated in the Enhanced Recovery after Surgery (ERAS) pilot for elective C-section patients, which decreased the average length-of-stay and reduced the use of opioids for pain among C-section patients. 
• For hospital-acquired pressure injury (HAPI), medical-device HAPI and catheter-associated urinary tract infection, five out of five departments at Homestead Hospital exceeded the majority of national benchmarks during the last eight quarters. These positive results reflect the outcome of professional nursing care.