CSI Summary
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Project Topic:
Standardization and use of education materials for pre and post op median sternotomy surgical patients
Hospital, City and State:
Advocate Good Shepherd Hospital, Barrington, Illinois
Unit:
CVICU
CSI Participants:
- Anndria Cluster, MSN, RN, CCRN
- Rachel Osburne, BSN, RN
- Rachel Warren, BSN, RN, CCRN
Project Goals/Objectives:
- Decrease readmissions 2%
- Increase HCAHPS scores 5% on education focused questions (“Understand managing of health", "Understood side effects of medications”) over 12 months
- Increase reported nurse confidence in providing pre/post op education for median sternotomy patients by 10% over 12 months
Project Outcomes:
- Decreased readmissions 58%
- Increased HCAHPS scores: “Understood management of health” 33%, and “Staff Described Medication Side Effects” 14%
- Increased reported nurse confidence in providing pre/post op education for median sternotomy patients 14%
- These outcomes resulted in a positive estimated annual fiscal impact of $114,480
Project Overview:
While investigating pain points on our unit, we were able to identify that our nurses did not have a standard routine of how to educate our median sternotomy patients. We interviewed staff members about the materials they were currently using to educate their patients. There was a variety of materials being used and each nurse had different handouts they sent home with patients. Our unit did have difficulties with our Hospital Consumer Assessment of Healthcare Providers (HCAHPs) scores in the categories of “Understood managing of care” and "Understood medication side effects”, with an average of 59.5 and 40 respectively. We felt that this could be attributing to our readmission rates, of which there were 12 from November 2023 to May 2024. This also made staff unsure of how to properly educate their patients, decreasing nurses' confidence in their effectiveness in education.
Once we found this issue, we began going through all of the materials utilized on our unit. For the patients, we created a pre-op education pamphlet and a booklet that covered daily activities. For the nurses, we created a daily flow sheet of expectations for patient care, standardized the resources for each patient, and made a dot phrase in our electronic health record (EHR) describing discharge instructions. At intervals throughout the roll out of the information, we sent surveys to the nurses to measure their confidence in providing education to the median sternotomy patients.
Post-implementation we found that our HCAHPs scores increased for the question “Understood Management of Health” by 33% (from an average score of 59.5 in November 2023-June 2024 to an average score of 79.7 in November 2024- June 2025). HCAHP scores also increased for the question "Staff described medication side effects” by 14% (from an average score of 40 in November 2023-June 2024 to an average score of 45.8 in November 2024-June 2025). Surveys sent to nursing staff showed a 14% increase in reported confidence in educating patients pre and post-surgery. During the study timeframe readmissions also decreased from 12 to 5. Overall, the implemented changes made a lasting impact on our patient population.
Permission to Reuse Materials
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Disclaimer
The AACN CSI Academy program supports change projects based on quality improvement methods. Although CSI teams seek to ensure linkage between their project and clinical/fiscal outcomes, data cannot be solely attributed to the project and are estimations of impact.