Two cohorts of San Rafael clinical nurses and healthcare professionals participated in the Caring Science Series led by Caritas Coaches Lori Aston-Dixon, MSN, RN; Sarah Montague, BSN, RN; Angelica Rincon, MSN, RN, NEA-BC, CNOR; and Gail Sims, DNP, RN, CRRN, Heart Math Instructor.
Kimberly Shankel, MSN, RN, CNL, Co-PI and Chief Nurse Executive Denise Laws, DNP, RN, NE-BC, Caritas Coach and Faculty led San Rafael’s KP Cares 2.0 research study.
15 Nurse leaders participated in a four-module series enhancing our culture of caring, beginning January 30 through April 12, 2024. 14 participants graduated from the series.
KP Cares 2.0 is a multi-site regional qualitative research study that expands on the KP Cares 1.0 study by adding experiential learning content related to equity, inclusion, and diversity (EID) and associated evaluation instruments.
The aims of this mixed methods prospective study are to 1) evaluate effectiveness of providing an experiential education program based on Dr. Jean Watson’s Human Caring Theory and the Ten Caritas Processes and Belong at KP pre-compared to post- and repeated measures at 6 months; 2) explore if and how participants applied the principles of Caring Science, HeartMath and EID into their professional and personal lives and the associated impact 1) at the end of the program and 2) 6 months post program.
The CALM Initiative is a project by the NICHE committee, who collaborated to create a bundle of interventions to minimize delirium risk in patients 70 and older on the 4th floor.
The focus was on clustering care, assessing alarms, offering calming items such as essential oils, eye masks, herbal teas, ear plugs to help improve sleep quality, reduce interruptions during sleep, and prevent delirium symptoms over three months. NICHE committee nurse champions for this project were Anecia Mayes, BSN, RN; Febe Rios, BSN, RN; Happy DePalma, BSN, RN.
Romel Jimera, MSN, RN, CNOR, perioperative nursing professional development specialist, partnered with the perioperative team to ensure a safe surgical environment for a patient with an anaphylactic allergy to red meat.
Using evidence-based practice, the team reviewed medications, supplies, and equipment and ensured that everything used for the procedure was safe for use on this patient, which led to a successful procedure in the operating room team.
Patients from emergency and inpatient units were transferred to the preoperative holding area with missing elements needed for surgery such as signed consents, required lab tests, full medical histories, and NPO status, thus causing surgical delays. This was a direct source of frustration for the patients and the surgical team.
In alignment with the Kaiser Permanente Nursing Professional Practice Model, the patient and family are at the center of this initiative. The objectives were to prevent delays in care, improve communication, empower nursing teams, optimize the surgical journey, and increase patient satisfaction. Using the PDSA model, the team created the Ticket to Ride (preoperative checklist) with a QR code.
The nurses from the ED and inpatient units can now scan the QR code to see the checklist of preoperative requirements adapted to individual procedures and patient situations. Baseline data in 2023 started at 5% completion of the preoperative checklist and by January 2024, preoperative checklists were completed 80% of the time. January through April 2024, increased up to 88% and has been sustained. In addition, secure chat, a messaging tool designed to allow users to communicate through a secure messaging channel has allowed for more efficient ED to OR times because it has decreased delays and reduced the amount of phone calls needed to convey pertinent information.
The project was lead by Sheri Berniklau, BSN, RN, CPAN, CAPA and Indie Mari, BSN, RN.
The inaugural San Rafael Magnet Fair was held in May during Nurses Week. Members of the professional governance councils collaborated to select a theme, identify topics that would highlight council work from core councils to unit councils, best practices, poster presentations, how to get certified, and advancing degree opportunities. The event also included learning opportunities such as interactive care experience patient/nurse simulations, and fun games such that highlight NICHE, delirium initiatives, senior surgical care program, mindfulness practices, and fall prevention.
Caritas nurse, Giovanna Aiello, BSN, RN, Ipictured above) a member of the Interventional Services unit council, identified an opportunity to collect the voice of the patient. Giovanna and the unit council members wanted to collect anonymous feedback from patients to gain insight into patient’s satisfaction with the care provided while in interventional services.
A brief paper questionnaire was created and distributed at the time of discharge. The volume of returned questionnaires was low, so a change was made to include the questionnaire in the patient’s kp.org email, which has significantly increased feedback that was overall extremely positive and a few opportunities for improvement that the team will work on in 2025.
In November, Denise Laws, DNP, RN, Chief Nurse Executive, Kimberly Sommerhaug, MSN, RN, NP-C, Briana Deguara, MSN, RN, and Dr. Canio supported the Alzheimer’s Walk. The team hosted an educational booth sharing knowledge about age friendly care and Senior Surgical Care Program in San Rafael.
San Rafael emergency department staff volunteered during the Sidewalk CPR event in August. This community outreach event provided free training to the community at several locations across Marin.
Community members learned to assist during a cardiac arrest, overdose, or severe bleeding. Training included hands only CPR, AED, Stop the Bleed, and Narcan. Our San Rafael team taught hands only CPR and had a table with educational materials and teaching about how to use Narcan.
An interdisciplinary team of clinical nurses, patient care technicians, nurse leaders, HBS, PT, and quality partnered to improve mobility across inpatient units at the San Rafael Medical Center. The mobility workgroup merged with the Falls Committee, and the team was able to improve mobility and exceed the mobility goal of 75%.
The clinical nurse team: Tim Jackson, BSN, RN; Virginia Breslo, BSN, RN, Shirley Hasson, BSN, RN, Vivi Chang, BSN, RN; Ashley Thompson-Brundidge, MSN, RN; Arleen Velasco, BSN, RN; and Sarah Villareal, MSN, RN created materials and educated colleagues on CLOF, documentation requirements, inclusion and exclusion criteria, and championed the work as rounders.