SE - Structural Empowerment

SE5EO-Commitment to Professional Development: Describe and demonstrate the effectiveness of two (2) educational programs provided in SE5.

The following are examples of the effectiveness of two educational programs.

Effectiveness of stroke education

In the spring of 2009, Jersey City Medical Center (JCMC) began taking steps to build a stroke program with the goal of achieving designation as a primary stroke center by the Department of Health and Senior Services. JCMC believed that the benefits of having a stroke program were multi-faceted. Patients would receive comprehensive care from various healthcare professionals during their hospitalization and rehabilitation. Standardized physician order sets and nursing documentation tools had been implemented to coincide with evidence-based practice outlined by the American Stroke Association.

In April of 2010, the Stroke Program at Jersey City Medical Center successfully achieved designation as a Primary Stroke Center by the New Jersey Department of Health and Senior Services. The stroke program is currently led by Kelly Sietsma BSN, RN, Stroke Program Coordinator. In February of 2010 the organization began the “Code Stroke activation. “Code Stroke is announced over the loudspeaker when patients arrive in the Emergency Department exhibiting signs and symptoms of a stroke within the previous three hours. The stroke response team arrives within 15 minutes and provides emergency care to the patient. This code may be activated with inpatients as well and a “Rapid Response-Code Stroke” is called.

Prior to implementing this process and on an ongoing basis, massive education is provided to the inpatient units as well as the Emergency Department. The educational program named Care of the Stroke Patient for Registered Nurses  (Appendix SE5EO-A) is an eight hour program and provides 6.0 contact hours. Objectives include:

  1. Define the term “Stroke”
  2. Identify risk factors for stroke
  3. Define the different types of strokes
  4. Review of basic anatomy and physiology
  5. Discuss the treatment of stroke patients

This program is not just for nursing staff. Ms. Sietsma also educates the Patient Care Technicians, Emergency Medical Personnel and Medical Residents. This is definitely a team effort. She also performs countless community events in order to educate the surrounding community.

Ms. Sietsma states, “the results of all our education are easily quantified. Patients are arriving at the hospital quicker when they develop signs and symptoms of stroke, and Jersey City Medical Center staff is identifying the potential stroke patient more readily in both the Emergency Department and the inpatient units. See results below:

Identification of Potential Stroke Patients

SE5EO-Table 1

This rate of increase is justifiable due to the education of stroke awareness. The American Stroke Association and the American Heart Association both issue awards to hospitals based on quality achievement. The Medical Center has won the following awards:

  1. 2010-Bronze Award: 90 days of 75% or higher on achievement measures
  2. 2011-Silver Award: 12 months of 85% or higher on all achievement measures
  3. 2012-Gold Plus Award: 24 months of 85% or higher on all achievement measures and at least 75% or higher on selected quality measures. This is the highest quality award that a hospital can receive from the AHA/ASA

Example of effectiveness of falls education

The Falls Program, led by Peggy Petrucelli BSN, RN, has been very successful. Ms. Petrucelli noticed that the falls rate in Behavioral Health was high. In an area like Behavioral Health they have problems that differ from the other units. For example, patients who are “attention-seeking” may just sit on the floor in order to be noticed by staff. Patients on this unit may also be on drug therapy such as anti-anxiety medication or sedatives, which of course would predispose them to falls. Ms. Petrucelli collaborated with Selena Bray BSN, RN Nurse Manager of Behavioral Health Department to address this issue. Ms. Petrucelli met with the staff to discuss options and an action plan. She encouraged the staff to discuss the challenges dealing with high risk falls patients. Through education in early 2010, and discussion with the staff, the following action plan was initiated (See Reference SE5EO-A for Fall Prevention PowerPoint).

  1. Move the first dosage of Ativan from every four hours to every six hours for those patients aged 50 years and older
  2. Have “Huddles” during the course of the shift to discuss patient needs
  3. Increase communication through shift endorsements between nursing staff and patient care technicians
  4. Team communication on treatments that have been successful in relation to the patients diagnosis
  5. Identify those patients who are attention seeking

Please review the improvement in outcomes between 2010 and 2011

5 West Behavorial Health Falls