The Professional Nursing Staff Evidence-Based Practice and Research Committee provides a forum for clinical nurses to promote research and evidence-based practice that aligns with Rush’s strategic priorities. Through the forum, nurses receive research mentorship and make innovative links with clinical practice.

This opportunity to participate in translational research — research that is directly related to patient care — is a key component of our nursing practice model.

Several projects are ongoing and include the following:

• Nurse residency program
  In this program, new graduate nurses complete evaluations three times to assess for effectiveness in transitioning from novice to proficient nurse.
• Illinois emergency department asthma surveillance project
  A project to align asthma care with national guidelines.
• Improving palliative care in the intensive care unit
  Two nurses from each intensive care unit (ICU) attend end-of-life training and educate their units on end-of-life care in the ICU.
• Transitions of care in cardiac patients
  Acute care nurse practitioners and outpatient cardiology clinic nurses established a discharge protocol from cardiac ICU discharge to the cardiology clinic.
• Health outcomes and cost of breast milk feedings for very-low-birth-weight infants
  Monitored patients enrolled in program for improved outcomes.
• Effect of perioperative music on patient anxiety, pain and satisfaction levels
  Examining the effect of perioperative music on patient reports of anxiety, pain and satisfaction levels.
• Addressing delirium in the intensive care unit
  Identify barriers to using the Confusion Assessment Method delirium screening tool in Rush ICUs and subsequently create and implement interventions addressing identified barriers.
• Evaluating and improving the palliative care consultation screening
  Evaluate the established process for initiating a palliative care consultation, identify barriers in the process and develop improvement strategies for the process.
• Early mobility during hospitalization
  Implement an evidence-based mobility protocol for patients hospitalized on medical surgical floors to promote active mobility during hospitalization.
• Evaluation of the rapid response team to identify opportunities for improvement
  Evaluate the rapid response team at Rush to assess its current use, number of calls received and reasons for calls.
• Quality of life in adults with atrial septal defects
  Determine how overall quality of life and health status of newly diagnosed adult patients with an atrial septal defect change from before to after percutaneous closure of the defect.
• Use of digital pain and analgesic diary in reducing medication error in a hospice setting
  Develop and test a digital application to be used by caregivers to record patient pain and administration of analgesics, and by nurse case managers to monitor caregiver administration of analgesics.
• Use of animal-assisted therapy
  Assess the effects of animal therapy visits on patient’s pain, anxiety and fatigue.

Recently completed projects include the following:

• Nasogastric tube tape device to reduce nasal pressure ulcers
• Examining patient characteristics of those referred to palliative care consult service
• Improving hazardous drug safety in the non-oncology setting
• Reducing medication administration errors in acute and critical care
• The need for a bed management communication policy
• Evaluation of oral hygiene practices in oncology patients
• MOVE Project: Making steps to recovery — Rush University mobility pilot

Research, Technology and Publications

Nurses practicing at Rush Copley Medical Center are catalysts for change and are responsible for unlocking the power of innovation within the nursing community. Nursing research shapes our practice and ultimately affects the care our patients receive. Transforming patient care at the bedside leads to enhanced patient outcomes and empowerment of our nurses.

Research and Scholarly Activities at a Glance

Implementing High-Flow Nasal Cannula Therapy in the Emergency Department
The purpose of this study was to evaluate the implementation of the use of high-flow nasal cannula therapy that addresses hypoxemia and hypercapnia as effectively as CPAP and BiPAP. The interprofessional approach from RT and ED nursing teams to analyzing cost effectiveness of NIV therapy through retrospective chart review.  The use of high-flow nasal cannula therapy on patients meeting criteria reduced ICU admission from 94 in CY2017 to 56 in CY2018, which is a 40% reduction.

Gamification strategies incorporated into educational offerings for nursing staff to engage learners and improve knowledge acquisition and efficiency.
The purpose of this study was to increase knowledge acquisition and engagement of learners through the use of gamificaiton. The NPD department purchased technology to create an innovative structure to engage the nurses in educational offerings, increase knowledge, and improve efficiency. The technology included iPads, GoPro camera, and software (apps and website subscriptions). Some of the technology platforms used include: NearPod, Kahoot, Voki, Padlet, Pixton, Adobe Spark, Study Stack, SimpleSim app, SureWash app, QR Scanner app, on and demand videos.

Mindful Moment for Nurses: A Study for nurses that experience stress and burnout from work.
The purpose of this study was to provide a mindfulness, meditation and yoga program for nurses at Rush Copley that experience stress and burnout from work. This program encouraged the participation from nurses who were interested in learning self-care practices. A manuscript from the study entitled Favorable Outcomes from an In-person and Online Feasibility Mindful Moment Pilot Study was accepted by the Journal of Holistic Nursing Practice.

A Nontraditional Approach: Hybrid Competency Evaluation in for Emergency Nurses
The purpose of this study was provide a non-traditional approach to competency evaluation that included open house/drop-in for mock events for nurses who were unable to complete competencies in real-time. The change from the traditional Annual Competency Day to a unit-based hybrid competency evaluation process yielded a savings of 124 nursing salary hours from staff, validators and CNE. However, there was a decrease in percentage of completion of competency evaluation when compared to previous years.

Preoperative Prevention of Surgical Site infection in Spine Surgery
The purpose of this study was to determine if preoperative bathing with 2% chlorhexidine gluconate (CHG) impregnated cloths versus 4% CHG solution would reduce SSIs. Infection rates were measured using simple percentages. Outcome data showed a reduction in SSIs from 3.9% to 1.85%. This process change has been combined with a strengthened preoperative bundle approach to reduce SSIs and has been implemented across the organization for all surgical groups. Currently, the spine service line has a zero SSI rate.

Technology

Technology is continuously changing the health care environment, and nurses at Rush Copley are leading the way. Nurses play a major role in the planning, implementation and evaluation of technological advancements throughout the health continuum. Implemented advancements include:

• Use of tablets at the patient’s bedside for virtual visits with family
• Video Monitoring of patients in isolation
• Use of gamification technology to enhance nursing education, including software such as Nearpod, Kahoot, Padlet
• Barcoding system for NICU patient breast milk identification
• NICU E-Visits for parents to visit their newborn and speak to the nurse when they are unable to be at the bedside
• Epic electronic patient medical record
• Nurse Simulation lab

The Professional Nursing Staff Evidence-Based Practice and Research Committee provides a forum for clinical nurses to promote research and evidence-based practice that aligns with Rush Oak Park Hospital’s strategic priorities. Through the forum, nurses receive research mentorship and make innovative links with clinical practice.

We have several completed and ongoing research projects that include the following:

• Mealtime difficulty subjective vs. objective assessment of persons with dementia in the acute care hospital setting, a pilot study
• Evaluation of nursing shared governance at Rush Oak Park Hospital
• Improvement of inpatient colonoscopy preparation
• Clinical nurse implementation of a new evidence-based practice and program entitled, “Choosing Wisely Early Adult Mobility Program” (CWEAMP)
• Clinical nurse Melody Kwan, RN3, ROPH Intensive Care Unit, uses evidence-based practice to review an existing practice related to care of the patient with hyperglycemia in the organization
• Clinical nurses on ROPH Skilled Care Unit incorporate Centers for Medicare and Medicaid Services (CMS) specialty standards for Skilled Care Facilities to implement a new practice related to baseline care plan templates to the organization
• The innovation of the Edinburgh Feeding Evaluation in Dementia (EdFED) subjective nursing assessment tool implemented in the inpatient setting by nursing as a tool for mealtime difficulties screening in the elderly
• Improved patient perception of nursing concern for blood draw comfort, an outcome in the Emergency Department and Ambulatory setting, associated with clinical nurse involvement in the adoption of an ultrasound-guided peripheral intravenous catheter technology
• Improved surgical site infection rate in the Perioperative clinical environment at Rush Oak Park Hospital associated with clinical nurse involvement in the Adoption of iPad and tracer software to promote patient safety and decreased infections
• Improved lab-related event type safety event rate in the Emergency Department associated with nurse involvement in the design and redesign of the work environment
• Improvement in patient-reported feedback regarding “Information you received prior to surgery” scores, related to clinical nurse involvement in redesign of workflow in Pre- Admission Testing and registration process for same-day surgery ambulatory unit