Case Studies

Southwest General Puts Greater Focus on Vascular Access Using Lippincott Procedures

Serving southwestern Cuyahoga, northern Medina, and eastern Lorain counties, Southwest General Hospital is a 360-bed, non-profit hospital located in Middleburg Heights, Ohio. Home to nationally recognized physicians and state-of-the-art technology, Southwest General is continuously making efforts to advance hospital operations, procedures, and practices within its facility.

“Prior to using Lippincott Procedures, we had hundreds of policies and procedures that lacked current evidence-based research,” says Sheila Blackmur, MSN, RN-BC, CMSRN, and Clinical Educator at Southwest General.

With the support of Martha Bauschka, RN, MSN, MBA, Vice President of Patient Care Services/Chief Nursing Officer, Southwest General was able to obtain Lippincott Procedures and Lippincott Advisor in 2013 to promote evidence-based practice throughout its facility. Additionally, in 2014, Lippincott Professional Development was integrated into the organization.

A Lippincott Adoption Plan was created by Mary Jo Krivanek, RN, BSN, MPA, who organized teams of content experts to review the more than 1600 procedures. To customize Lippincott Procedures to Southwest General, Clinical Nursing Educators Blackmur and Krivanek, along with Mary Ellen Campobasso, MSN, RN, ACNS-BC, and Beth M Weese, MSN, RN, GCNS-BC, worked to add any needed Critical Notes, hide any procedures not performed at Southwest, and lastly to discuss the need for unit education around evidence-based practice.

The Vascular Access Champions Program

As one of its many Lippincott-based programs to further improve patient care, Southwest General developed the Vascular Access Champions (VACh) program, an initiative aimed at increasing nurse competencies for vascular access procedures. Lippincott Procedures was considered an essential resource in the development of the vascular access program. Consequently, Southwest General Hospital was able to dramatically enhance the preparedness of its nursing staff for vascular-access related procedures and enable them to be more proficient and skilled in their practice.

Challenge

“Today there is so much involved with vascular access,” says Campobasso. “It has gone beyond simply putting in an IV. The subject encompasses so much practice and science-related concepts, including competence in skill performance, that some in the nursing profession are speculating that vascular access may become an area of advanced clinical specialty at the Master’s level for nurses.”

Many processes and procedures that VACh-trained nurses are responsible for had previously been supported by a small number of nurses. Unable to manage the volume of vascular access needs with its subset of trained nurses, Southwest General saw both nurse and patient frustration mount as wait times for central line removal and other access-related procedures increased.

Led by Blackmur and Campobasso, the VACh Program was developed to not only increase the number of nurses trained on the most current INS standards but to improve quality indicators and strengthen patient satisfaction.

Solution

Using Lippincott Proceduresas a foundational resource, Southwest General was able to create the VACh training program backed by up-to-date, evidence-based research. Over the course of approximately six months, Blackmur, Campobasso, and the Clinical Education team reviewed all of the procedures related to peripheral IV catheters, PICCs, implanted ports, and central venous access catheters. They then developed a one-day, 7.4 contact-hour course consisting of classroom instruction, demonstrations, and skills stations to certify nurses as vascular access champions. Southwest General now has ten core instructors and 109 VACh-certified nurses; their goal is to have 140 nurses trained by the end of the year and 300 to 360 trained within the next 3 years.

Results

While the VACh program is still in its early stages, Southwest General has already observed promising results. Since Campobasso and Blackmur’s creation of the VACh program, Southwest General has seen an improvement in patient satisfaction scores and less complaints by nursing staff.

“In our patient survey responses, there is a decrease in patient complaints regarding waiting for hospital discharge because a central line has to be removed or a port de-accessed,” says Campobasso. “The amount of time for insertion and removal of IVs has improved and we have seen an increase in the nurses’ level of vascular access expertise.”

In addition to strengthening the competency and self-confidence of Southwest General’s nursing staff around vascular access, Lippincott is responsible for an evolving culture. Clinicians no longer take policies and procedures at Southwest General for granted; Lippincott has brought about a higher standard grounded in evidence-based practice in everything they do.

 “Bedside nurses are now, more than ever, involved in scrutinizing procedures and skills. Nurses are now engaged and exhibiting a level of professionalism that I have not seen before,” says Blackmur. “I have never heard so many people talking about procedures and skills throughout my time as a nurse at Southwest General.”

Krivanek, Blackmur, Campobasso and Weese feel that their focus on evidence-based practice, through the influence of Lippincott Solutions, will lead to improvements in quality and safety for patient care at Southwest General.