It is well documented that breast milk is the best source of nutrients for a newborn baby, and Kaiser Permanente has long supported our new moms on their breastfeeding journey. However, alternative resources are needed to support the most vulnerable newborn patients in some cases. According to published research, when there is a need for human milk that cannot be completed through breastfeeding or using the milk from the mother, utilizing donor human milk that is screened and is safe is a valid alternative. Looking to expand a donor human milk program outside the NICU and into the newborn space, a team at the Modesto Medical Center began an evidence-based research project to discover whether implementing a human donor milk program would increase exclusive breastfeeding rates at discharge. ”Our primary outcome measure was Perinatal Core Measure-05 (PC-05), which assesses the number of newborns exclusively fed breast milk during the newborn’s entire hospitalization,” said Christine Pierce, RN, Maternal Child Health, Nurse Manager, Modesto Medical Center. Within the initial pilot, an increase of PC-05 was observed from an average of 72% to greater than 80%, which has held steady for more than a year since the pilot and continues in an upward trend. “While this data is outstanding, one of the most impactful results from this work was a 19% increase in the exclusive breast milk feeding rates among our Black and Hispanic members,” added Christine. Based on the success in Modesto, the initiative was expanded to Antioch, San Francisco, and Vallejo, and is expected at all medical centers by the end of 2024. A poster of this work will be presented at the 2023 KP National Nursing Conference.
With the opioid overdose crisis escalating in communities across the country, nurses in the Vacaville emergency department set out with a project to not only help Kaiser Permanente members, but also people in Solano County communities. As part of a statewide effort, the Vacaville emergency department has successfully provided free Naloxone devices, which is a nasal spray used to reverse the effects of an overdose, to anyone coming into the emergency department. Despite their efforts, staff realized that to truly impact deaths related to opioid overdoses, distribution was needed in the community. The most recent county data shows in 2021, 58 people in Solano County died from an opioid overdose, a nearly 500% increase since 2017. “We looked at county data for overdose related emergency room visits and deaths, and that showed us the ones that needed this free lifesaving device the most weren’t necessarily coming to us, until it was too late, so we wanted to focus our efforts out in the community,” said Michael Williams, MBA, MSN, RN, Emergency Department Director, Vacaville Medical Center. A grant was received from CA-Bridge Naloxone Distribution Program, which allowed the Vacaville team to implement their project in a meaningful way. The first event they attended at Hope Resource Fair, the team provided 500 devices to unhoused individuals along with resources and hands-on education about how to administer the drug. Since the inaugural event in March of this year, ED staff have had booths at fairs and events throughout Solano County, and have distributed 2,800 Naloxone devices. “We know that our outreach has led to the successful use of Naloxone in 19 cases,” added Michael. “We hope our work will continue to have a positive impact in our communities.”
Kaiser Permanente Northern California (KPNC) Regional Telestroke Program, also known as the KPNC Stroke Express, emergently responds not just to patients who present to the Emergency Department with suspected stroke but also to inpatient stroke alerts. The program remotely enables a stroke neurologist to be at the patient’s bedside within minutes using the Care Agility Carts or the remote Tele-Critical Care monitors, virtual computerized platforms with high-quality audio and visual features allowing for two-way communication. Nurses are essential in ensuring timely treatment, starting with the initial communications with Emergency Medical Services and Emergency Department triage, and pivotal in treating inpatient stroke alerts. With a stroke, time is of the essence. For each minute during an ischemic stroke, approximately 1.9 million neurons are permanently lost. The two primary emergent treatments, intravenous thrombolytics and mechanical thrombectomy are time-limited, with earlier treatment associated with better patient outcomes. Over the past year, the team treated 3,207 stroke alerts, of which 978 people received IV thrombolytics and 443 received mechanical thrombectomy. According to Elizabeth Scruth, PhD, RN, CCNS, FCCM, Regional Executive Director, “Our program is nationally recognized for providing high-quality care, ensuring stroke patients receive timely and specialized care around the clock regardless of location. We are proud that 79% of all patients who receive IV thrombolytics are treated within 30 minutes of ED arrival. This helps to ensure that our members have the best chance of having good functional outcomes.” Stroke coordinators and stroke champions at our medical centers also participate in numerous community events each year to educate our members and others to recognize signs and symptoms of a stroke, and the need to call 911.
On any given day, the Roseville Pediatric Care Transport rig can be seen traveling any freeway in Northern California to pick up our youngest Kaiser Permanente members in need of a higher level of care. “An ICU on wheels” as Melissa Lathuras, RN, refers to the unit, which has been in service since the fall of 2019. Between January and July, the Roseville Pediatric Care Transport team ran 166 calls – which can range from near drownings, cardiac or neurologic events to respiratory viruses. In partnership with a local ambulance company, the unit has 24-hour coverage with a specialty trained registered nurse and respiratory therapist onboard during each shift and a supporting physician partner at the Roseville Medical Center. “We have maintained consistent “out the door” times, meaning from the time the patient is accepted to the team leaving the building, in under 45 minutes,” said Elyssa Lakich, MSN, RN, Assistant Nurse Manager. The nurses, who are all experienced PICU nurses and have received specialized transport-specific training through Kaiser Permanente’s Transport Academy, get to work as soon as they get the call, explained Brian Mestressat, RN. “We review vitals and what’s been done so far so that we can jump in to provide care as quickly as possible.” They take over care to stabilize critical patients for transport, many of which are on constant intravenous medication, cardiac monitors, or even intubated. When they arrive back in Roseville, they hand-off care to the awaiting PICU team. When they aren’t caring for a patient in transport, the team ensures all their equipment is ready for the next call, and also provide support in the PICU and ED. “It takes a special team to do this work,” said Debbie Reitter, DNP, RN, CNS, NEA-BC, Roseville’s Chief Nurse Executive. “You can sense the love they have for nursing through the outstanding care they provide under some of the most challenging circumstances to our young patients and their families.”
Join your colleagues to learn, network, and celebrate Kaiser Permanente's Extraordinary Nursing at the Kaiser Permanente National Nursing Conference being held Sept. 21 and 22nd from 8:30 a.m. to 4 p.m. The virtual event is open to all nurses across the continuum, and provides professional development opportunities and continuing education credits. The conference has a line-up of nationally renowned experts who will provide insight on topics including workforce wellness, caring science, high-reliability principles, health equity, and diversity and inclusion. Hear about ways to strengthen Kaiser Permanente's Nursing Culture of Excellence and how to prepare for Magnet designation. Breakout sessions will include topics related to Magnet, shared-decision making, evidence-based practice, research, patient safety, technology, caring, and use of virtual reality in healthcare. To learn more and register for the event, click here.
Please join me and the KP Northern California leadership team in congratulating the team at our Vallejo Medical Center, led by Chief Nurse Executive Juanita Jularbal-Walton, for achieving the prestigious American Nurses Credentialing Center (ANCC) Magnet Recognition® for nursing excellence. Kaiser Permanente Vallejo is the first Northern California hospital to receive this esteemed designation. Magnet Recognition is the gold standard for nursing excellence, quality care, and innovations in nursing practice, which less than 10% of hospitals in the United States have currently earned. This remarkable achievement is the culmination of years of hard work by our nurses in the hospital and emergency department, interdisciplinary team members and leaders, to demonstrate nursing excellence by outperforming national benchmarks in the areas of quality, safety, care experience, and nursing engagement; a set of rigorous criteria established by the ANCC. The team’s collective commitment to reaching the goal of Magnet Recognition has never wavered – even during the challenges of the global pandemic. In fact, during the years of preparation, the number of medical center nurses who advanced to bachelors, masters, or doctoral degrees in nursing rose from 25% in 2019 to 81% in 2022 – incredible! During the call on Monday where Magnet Recognition program leaders shared the news about this exciting achievement, they specifically acknowledged the Vallejo team for their record of outstanding patient safety, clinical innovation, and the Preparedness Assessment to Transition Home (PATH) tool that supports culturally and socially sensitive care to new caregivers that has expanded beyond Kaiser Permanente and is now utilized across the United States and around the world. Magnet Recognition is both an impressive and important distinction for our organization and staff as well as the communities we serve. The designation reaffirms Kaiser Permanente’s steadfast commitment to consistently deliver superior patient care and outcomes, demonstrate professional growth opportunities and recognition of nurses, support nurse retention, and attract and retain outstanding professional talent. To our outstanding Vallejo team, -- bravo! Thank you for leading the way!
The former Kaiser Permanente leader received the prestigious DAISY award with colleagues by her side. Pictured, Marilyn Chow at home in San Francisco with her new Healer’s Touch sculpture presented to DAISY lifetime achievement recipients. The sculpture is carved by artists in Zimbabwe.
Deloras Jones served as Kaiser Permanente’s first statewide chief nursing executive. Pictured, Jones speaks to nursing students receiving scholarships in her name in January 2020.