Magnet® Excellence

Nurse leaders at NewYork-Presbyterian Lower Manhattan Hospital (NYP Lower Manhattan) recognize the importance of caregiver well-being in maintaining a positive work environment and high-quality patient care. In 2023, nursing leaders, including Barbara Alba, PhD, RN, NEA-BC, Director of Nursing for Maternal-Child Health; Courtney Bruck, MBA, BSN, RN, Business Manager for Nursing; and Germán Rodriguez, MS, RN, Vice President and Chief Nursing Officer, advocated for resources to support an initiative fostering gratitude among nurses. Research has shown that gratitude practices have been linked to reductions in stress and depression in healthcare practitioners and improvements in both productivity and quality of patient services. Through the advocacy of nurse leaders, resources were secured to cultivate a culture of gratitude and support the well-being of NYP Lower Manhattan nurses. This included development of a Gratitude Toolkit and the implementation of an event on World Gratitude Day during which senior leaders welcomed clinical nurses to express their appreciation for their contributions and provided additional information on gratitude and well-being resources available to them.

Outcome

Over 100 nurses attended the World Gratitude Day event and received well-being resources and expressions of gratitude from one another and their leadership team. Utilizing the toolkit, individual unit leaders were able to strengthen unit-based initiatives to instill a culture of gratitude, such as a “Cheers for Peers” program on the 5C Medical-Surgical unit. On a survey distributed at the end of 2023, NYP Lower Manhattan employees responded with high favorability when asked if NYP encourages them to focus on their health and well-being.

In Magnet® organizations, nurses are supported to lead and participate in local and community healthcare outreach. In 2023, nurses in the Medical Diagnostics (Cardiology) Unit, led by Gabriela Shea, BSN, RN, CV-BC, planned, coordinated, and implemented a Heart Month initiative that included outreach to the Lower Manhattan community as well as NYP Lower Manhattan employees. Events occurred throughout the month of February 2023 and included blood pressure screenings for employees and visitors, webinars discussing heart-healthy habits, EKG workshops, informational sessions reviewing common cardiac conditions, and a “Share your Heart” competition in which nursing units created artistic representations of the human heart as a teaching tool for patient education. Unit nurses also provided cardiac health screenings and education at neighboring Pace University as part of their community outreach.

Outcome

After planning and coordinating with multiple departments across NYP Lower Manhattan, Medical Diagnostics (Cardiology) nurses implemented a successful Heart Month with over 100 hospital employees and more than 30 community members participating in various events.

Prevention of patient falls is critical to keeping patients safe during their care. Patient falls in the hospital setting remain a pressing concern in health care and can lead to prolonged hospital stays and untoward patient outcomes. Although there are many potential predictors for falls, traditionally, risk assessment tools have relied on manual completion and are subject to variations in interpretation by providers. With advancements in data analytics and increasing uptake of electronic health records, developing comprehensive predictive models for fall risk is now possible. A Fall Risk Prediction Model was integrated into the electronic health record by key stakeholders from the nursing, informatics, and analytics departments as an artificial intelligence (AI) tool that looks for specific fall risk factors in the patient's medical record. The tool automatically queries for these risk factors every four hours, calculates a patient's predictive fall risk score based on those risk factors, and displays the results in the medical record. The results can assist nurses in determining the patients who are at highest risk and developing targeted interventions. After the tool was developed and education was provided, NYP Lower Manhattan nurses implemented the tool into their practice in October 2023.

Outcome

After implementation of the Fall Risk Prediction Model at NYP Lower Manhattan, the 2023 goal of 10 percent reduction in unassisted patient falls was met. The model will likely be expanded to other NYP sites due to its success by the NYP Lower Manhattan nursing team.

Electronic fetal monitoring (EFM) is an important obstetrical tool that tracks uterine contractions and fetal heart rate. Healthcare practitioners certified in fetal monitoring utilize EFM to identify fetal distress during the labor and delivery process. However, minute variations in tracings can lead to subjective interpretations by practitioners, which can result in delays in providing safety interventions. PeriGen Advanced Perinatal Systems offers PeriWatch Vigilance® – artificial intelligence software that aids in the early detection of warning signs of fetal distress and measurement of patient acuity. PeriWatch, by using multiple sources of patient information and identifying abnormal EFM tracings that may be indiscernible to trained practitioners, makes EFM interpretation more objective and may lead to reduction of morbidity and mortality of both mothers and babies. The PeriGen software was approved for implementation as a pilot initiative at NYP Lower Manhattan. The hospital’s nurses led the development of a comprehensive education and implementation plan for the interprofessional team to integrate PeriGen technology and workflows. In early 2023, the innovative PeriGen system was successfully implemented and adopted by the NYP Lower Manhattan perinatal teams. All levels of nurses had meaningful and extensive involvement throughout the implementation process.

Outcome

The PeriGen innovation was successfully implemented into the nursing and interprofessional practice environment. PeriGen status for each patient is now reported at change of shift multidisciplinary huddles, RN-to-RN handoff, charge nurse handoff, and Category II tracing rounds. In 2023, when compared to 2022, NYP Lower Manhattan observed an improvement in the percentage of neonates born with abnormal umbilical cord pH, and the PeriWatch technology has strengthened the culture of safety within the MCH service.

Poster Presentations

Alexa Shelley, MS, RN, CV-BC, FNP-BC; Esteen Ladson Barnes, DNP, MPA, RN, NEA-BC, CCRN-K; Karolina Walichnowska DNP, APRN, ACCNS-AG, CCRN; Daniella Camera, BSN, RN, CNOR; Kenrick Cato, PhD, RN, CPHIMS, FAAN. Zooming In: Usability of Virtual Meeting Tools for Professional Governance. May 2023: American Organization for Nursing Leadership (AONL) Annual Conference, Anaheim, CA.

Alexa Shelley, MS, RN, CV-BC, FNP-BC; Esteen Ladson Barnes, DNP, MPA, RN, NEA-BC, CCRN-K; Karolina Walichnowska DNP, APRN, ACCNS-AG, CCRN; Daniella Camera, BSN, RN, CNOR; Kenrick Cato, PhD, RN, CPHIMS, FAAN. Zooming In: Usability of Virtual Meeting Tools for Professional Governance. September 2023: NYONL Annual Meeting and Leadership Conference, Tarrytown, NY.

Alexa Shelley, MS, RN, CV-BC, FNP-BC; Esteen Ladson Barnes, DNP, MPA, RN, NEA-BC, CCRN-K; Karolina Walichnowska DNP, APRN, ACCNS-AG, CCRN; Daniella Camera, BSN, RN, CNOR; Kenrick Cato, PhD, RN, CPHIMS, FAAN. Zooming In: Usability of Virtual Meeting Tools for Professional Governance. October 2023: ANCC National Magnet Conference® and the ANCC Pathway to Excellence Conference®, Chicago, IL.