Don't Skip a Beat, Follow the Sheet!

Providence Saint John’s Health Center, Santa Monica, California

CSI Summary

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CSI Presentation

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CSI Toolkit

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Project Topic:

Reducing time to extubation and increasing nurse confidence

Hospital Unit(s):

Intensive Care Unit

CSI Participants:

  • Emily Enos, MSN, RN
  • Danielle Fogel, BSN, RN, CCRN
  • Gena Oppenheim, MSN, RN, CNL
  • Nico Vargas, ADN, RN

Project Goals/Objectives:

  1. Reduce time to extubation 5%
  2. Reduce length of stay in ICU 5% for open heart patients
  3. Increase nurse satisfaction 10%
  4. Increase percentage of patients extubated within 6 hours from 43% to 75%

Project Outcomes:

  1. Decreased time to extubation 20%
  2. Increased nurse satisfaction 6%
  3. Increased percentage of patients extubated within 6 hours from 43% to 88%
  4. These project outcomes resulted in an estimated annual fiscal impact of $4,550.

Project Overview:

Due to high turnover rates, our intensive care unit had a lot of new ICU nurses, as well as new nurses oriented to care for open-heart patients. Pandemic restrictions caused suboptimal education and training regarding how to care for open-heart patients. In our pre-intervention survey, the CSI team asked staff to score questions based on nurse satisfaction and nurse confidence. The question, “I am given training to do an effective job” scored 3.24 on the Likert scale.

In an effort to increase nurse satisfaction and nurse confidence, we designed a project to augment the education that nurses new to caring for open-heart post-op patients received. The team created and educated staff on The Cardiac Care Map. Post-intervention, the question “I am given training to do an effective job” scored 3.75 on the Likert scale. Overall, nurse satisfaction increased 6%.

Additionally, as a result of the education, open-heart patients were extubated 20% earlier, and the percentage of patients extubated within 6 hours increased from 43% to 88%.

Nurse engagement and feedback about our project was positive. The Cardiac Care Map has been successful and has become ingrained in the workflow of caring for an open-heart patient in our unit.

Permission to Reuse Materials
The materials associated with this AACN Clinical Scene Investigator (CSI) Academy project are the property of the participating hospital noted above, not AACN. Requests to use content contained in the CSI team’s summary, presentation or toolkit should be directed to the hospital. We suggest reaching out to the hospital’s Communications, Marketing or Nursing Education department for assistance.

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.