Exemplary professional practice

MAAP It Out:Preparing Patients For Their Health Journey

MAAP It Out©

Nursing professional governance empowers clinical nurses to positively impact patient care. The Transition of Care Committee (TOC) is comprised of nurses representing both inpatient and outpatient settings. TOC promotes continuity and coordination of professional nursing practice across the continuum to strengthen the patient experience, improve clinical outcomes and deliver cost-effective care.
Professional Practice Council (PPC) engages clinical nurses from each department, promoting ownership of nursing practice and accountability for outcomes.
Nurses in TOC identified an opportunity to decrease readmission rates. They shared the data with the PPC and together developed a Patient Education Project led by PPC Chair-Elect Allison Pinion, BSN, RN, PCCN, and TOC Chair Krista Yoder, BSN, RN, CCM. As a result, the TOC created the MAAP It Out campaign, which has a pending copyright application.
MAAP It Out, based on the Coleman Transitional Intervention model, guides nurses in any setting to educate patients about medications, appointments and action plan for symptom management. The model uses the teach-back method. Evidence shows that patients who understand these key topics will more effectively self-manage and navigate the health system.
A group of clinical nurses developed education for nurses across the continuum to understand the campaign and use the new model. The education included interactive videos, a competency validation process and a logo displayed throughout the health system.
Data reflected in TOC’s scorecard continues to show improvement in readmission rates through this collaboration. Patient satisfaction will continue to be monitored, as it is still early in the process to note a significant change.

CAUTI reduction

Catheter-associated urinary tract infection (CAUTI) is the most commonly reported hospital acquired condition. The reduction of urinary tract infections related to indwelling urinary catheter has been a high priority for nurses at Goshen Health. Nurses on the Unit Practice Council (UPC) routinely review all their unit’s nurse sensitive clinical data. While reviewing this data, the Intensive Care Unit UPC identified a high rate of CAUTI and committed to making CAUTI reduction a priority.

The UPC members investigated possible causes for infections, despite an existing CAUTI bundle. They reviewed literature and current hospital policies and compared them to the units’ practice for indwelling urinary catheter care. Nurses implemented an action plan, including:

  • Emptying catheter drainage bags before mobilization and every six hours
  • Performing perineal care at a minimum of every shift
  • Using a new securement device

Nurses reviewed education on CAUTI prevention. They introduced the use of an external female catheter, reducing indwelling catheter days. Intensive Care Unit (ICU) nurses performed real-time peer review of both documentation and clinical practice to assure the sustainment of CAUTI prevention practices and correct any deficiencies.
Immediately after nurses implemented the interventions, CAUTI rates in the ICU decreased to zero. CAUTI rates have sustained at zero for 32 months. Nurses continually review outcomes and nursing practice through interdisciplinary rounds and at each UPC meeting. The ICU/UPC nurses also shared best practice with peers at the Professional Practice Council meetings, spreading the knowledge throughout the system.

CEO with Nurse

Nurse satisfaction/Colleague engagement

Randy Christophel, President and CEO, invited Colleagues to participate in the 2018 Colleague Voice Survey. This survey, administered by Press Ganey, provides an opportunity for Colleagues to identify areas of strength and opportunities for improvement in the work environment. Survey results guide efforts to make positive change.
More than 92 percent of registered nurses participated in the 2018 survey. Results showed higher levels of satisfaction in every category when compared to other Magnet facilities across the nation.

ANCC Category Performance Scores