North Florida/South Georgia Veterans Health System

Malcom Randall VA Medical Center SICU/CTICU Nursing Staff wins the Silver Beacon Award for Excellence. Pictured in the photo: Jamie Gilliam, Clinical Nurse Leader, Debra Irish, Nurse Manager, Jean Matmor, Staff Nurse, Tanaya Lindstrom, Staff Nurse, Mary Jane Murphy, Assistant Nurse Manager and Tonja Hartjes, Clinical Nurse Educator.

In 2010, a dynamic and interactive group of nurses in the Surgical Intensive Care Unit (SICU) and the Cardiothoracic Intensive Care Unit (CTICU) at the Malcom Randall VA Medical Center decided to take on the challenge of obtaining a Beacon Award for Excellence.  This designation, awarded by the American Association of Critical-care Nurses (AACN), recognizes caregivers who successfully improve patient outcomes and align practices with AACN’s six Healthy Work Environment Standards.

The SICU/CTICU is comprised of 12 SICU beds and 6 CTICU beds.  SICU patients are recovering from a variety of surgical procedures including vascular surgery, general surgery, and ear, nose and throat surgery to name a few.  The CTICU provides care to patients recovering from lung surgery, coronary artery bypass surgery (CABG) and/or value surgery.  Staff members are served by a team of formal leaders known as the Nursing Leadership Team along with shared governance councils.  The team also uses an interdisciplinary approach with the assistance of other services including pharmacy, chaplain, and psychology in an effort to provide a plan of care between the team, the patient, and the family.

“As staff nurses, we have always known the VA SICU is an wonderful place to work and it’s awesome for our team to be recognized nationally for taking excellent care of our Veteran’s and their families,” said Clinical Nurse Educator Tonja Hartjes. 

In the beginning of this journey toward receiving the award, staff realized there is a positive correlation between staff satisfaction and patient outcomes.  They believed that by creating an environment that attracted the best nurses in their profession would in return create positive outcomes for patients.  With leadership commitment and financial support, the SICU/CTICU challenged themselves to obtain the Beacon Award for Excellence.  They realized they all had expertise in certain areas, along with access to data, and that as a unit they could achieve this goal.

“As a Surgical Critical Care attending physician, I am very proud of our nursing staff and leadership for this well deserved reward,” said Charles Hobson, M.D.  “Those of us who work here know implicitly that we have a great unit.  We have a well-trained and hardworking staff, a collegial and supportive working environment, and we provide excellent patient care that result in exceptional patient outcomes.  It is gratifying to have our work recognized by the AACN with the Silver Beacon Award.”

The foundation of this successful program is shared governance within the unit.  The Unit Practice Coordinating Council is comprised of dedicated staff nurses devoted to improving education, nursing practice, and process, which in turn promotes positive patient outcomes.  Staff from all shifts is represented in the council, which also has three sub councils that focus on evidence-based practice, professional development and performance improvement.  Part of this model is open communication among staff.  A staff question and suggestion box, face-to face interactions, e-mail and numerous education and bulletin boards has achieved effective communication and collaboration.  With this structure, the team has built a framework for nursing practice and research as well as encouraging recruitment, retention and professional growth of staff.

Another aspect of achieving this designation involves improving performance of the unit based on evidence-based practices and processes. One example of this was a noise reduction initiative.  In 2012, the Survey of Healthcare Experiences (SHEP) quarterly data showed that surgical patients rated the noise level in their room as worse than other facilities in VISN 8.  Following this discovery, the team decided to put a plan together to decrease noise and improve the quality of care.  Staff used a decibel reader to gather data at four-hour intervals and during various events such as admissions, family visits and patient treatments.  This lead the staff to look at changing various practices such as changing the lab draw times, reducing function of entrance doors to reduce noise created when opening/closing and establishment of a “quiet time” to allow for patient rest.

This “journey” over the last three to five years resulted in a positive outcome for the staff as well as patients - the designation of a Silver 2012 Beacon Award for Excellence.  The silver-level award signifies continuous learning and effective systems to achieve optimal patient care for meeting the following criteria: leadership structure and systems, appropriate staffing and staff engagement, effective communication, knowledge management, learning and development, best practices, evidence-based practice and processes and patient outcomes.  The team also has the distinct honor of being one of only three Department of Veterans Affairs units to receive this award.

“This award signifies the hard work and dedication of the SICU/CTICU staff,” said Nurse Manager Debra Irish.  “Next time we are going for the gold.”

For more information on the Beacon Award for Excellence, visit: www.aacn.org/beacon.