2021 Nursing Annual Report

2021 Evidence-Based Practice (EBP) cohort

The Evidence-Based Practice (EBP) Program at Children’s Minnesota is designed to educate staff on the integration of evidence-based knowledge into practice. EBP projects lead to improved quality of care, patient satisfaction and outcomes.  

In January and February 2021, 14 project leaders launched their EBP projects by attending the Advanced Practice Institute: Promoting Adoption of Evidence-Based Practice. The training was co-taught by the University of Iowa Hospitals and Clinics and Children’s Minnesota faculty.  

Project leaders who attended the training received the book Evidence-Based Practice in Action, which offers tools, guidelines and processes to assist with EBP projects including the identification of topics, implementing practice changes and disseminating results.  

After the training, project leaders were supported through teleconferences with the University of Iowa Hospitals and Clinics faculty for ongoing consultation and direction. At the end of 2021, two projects were fully implemented with an additional eight projects on track to implement practice changes by fall 2022.   

Each project is guided by individual project mentors as well as EBP nursing leaders, including Kim Lorence, MS, RN, NPD-BC, CPNP; Jennifer Rivera, MSN, APRN, ACCNS-N, RNC-NIC; and Shayna Fleming, DNP, RN, CNOR.  

Evidence-based practice projects in process

Kayla Albrecht, MN, BS, RN, CCRN, Clinical Nurse, PICU St. Paul

Purpose: to assess for the presence of delirium and implement delirium prevention measures in critically ill patients 30 days to 25 years as compared to inconsistent delirium assessment or prevention measures.    

Aric Braaten, BSN, RN, CCRN, Clinical Educator, Pre-Op/PACU Minneapolis

Purpose: to reduce the rate of perioperative hypothermia of 35°C or less through active preoperative warming for neurosurgical patients in Minneapolis pre-op.   

Delaine Frasier, RN, Clinical Nurse, Limited Stay Unit St. Paul

Purpose: to reduce interruptions, which wake the child, for St. Paul 5th floor med/surg patients through implementation of a sleep program.  

Bonnie Groeneveld, MSN, RN, Clinic RN Supervisor II, Primary Care Clinic

Purpose: to implement the TeamSTEPPS® for office-based care with RN, MA staff, and managers in the Partners in Pediatrics Brooklyn Park and Rogers clinics. The expected outcome will be to increase teamwork attitudes and perceptions, communicate results and reduce SLRs related to lab errors.    

Deb Nelson, BSN, RN, CPN, CPHON, Clinical Nurse, 7th Floor Minneapolis

Purpose: to standardize the central line dressing change procedure using the CASI algorithm as compared to current practice for pediatric 7th floor Minneapolis patients. The expected outcome is a decreased number of dressing changes and decreased number of alternative dressings with a potential impact to reduce CLABSI rates.   

Naomi Szczepanski, BSN, RN, CPN, Clinical Educator, Pre-Op/PACU St. Paul

Purpose: to pre-plan for potential behavioral issues related to surgery through the use of a pre-operative patient preference plan in St. Paul.   

Nicole Woodworth, MSN, RN-BC, Clinical Nurse, 6th Floor Minneapolis

Purpose: to improve consistency and quality of bedside report between clinical nurses on 6th floor Minneapolis through the implementation of TeamSTEPPS®  communication strategies training. The outcome will be to increase the received bedside report question score on the NRC Health survey from the year-to-date score of 58.8.    

Sarah Woolever, MM, MT-BC, Musical Therapist, Music Therapy Minneapolis

Purpose: to implement evidence-based group dynamic music therapy sessions for outpatients at Lakeville Partial Hospitalization Program for ages 13-17 with behavioral health needs to decrease verbal anxiety and/or feelings of depression.   

EBP project highlights

Philip Johnson, BSN, RN, Clinical Nurse, 7th Floor Minneapolis

Purpose: to decrease nasogastric tube-related pressure injuries by implementing a standardized securement sequence (with Cavilon™, DuoDERM®, Tender Grips®, NG, Tegaderm™) and every four-hour comprehensive skin assessment for Minneapolis med/surg pediatric patients with an NG tube.    

Johnson felt there was an opportunity to standardize nasogastric (NG) tubes securement on the 7th floor Minneapolis after noting inconsistencies in practice. He consulted the literature and wound ostomy team (WOC) and identified a standardized practice to secure NGs and reduce the risk of skin injuries. Johnson launched this standardization in fall of 2021 through a pilot on the 7th floor and is now in the process of collecting data on the outcomes.    

Victoria Peter, BSN, RN, CPN, CNRN, Clinical Nurse, CVICU

Purpose: to increase clinical RNs’ knowledge and confidence, and assess their attitude toward trauma-informed care (TIC) through education. Knowledge, confidence and attitude will be measured by comparing pre- and post-tests.   

TIC is a framework of thinking and interventions that are directed by a thorough understanding of the profound neurological, biological, psychological and social effects trauma has on an individual – recognizing a person’s constant interdependent needs for safety, connections, and ways to manage emotions and impulses. Peter created an e-learn that was piloted in the emergency department to determine what nurses knew about TIC. She then shared the feedback and the e-learn with all of the nursing staff in the organization during the Annual Competency Fair. Peter continues to champion the knowledge and understanding of trauma-informed care to better care for Children’s Minnesota patients. She presented her poster at the University of Minnesota Research Day in March 2022. 

Nursing Scope and Standards of Practice developed

What does it mean to be a nurse at Children’s Minnesota? How are nurses guided in their clinical practice, professional development and nursing excellence? The answers to these questions are at the root of the newly developed Nursing Scope and Standards of Practice.   

Nursing scope of practice statements describe the who, what, when, why and how of nursing practice. The standards of practice statements describe the responsibilities for which nurses are accountable. These reflect values and priorities of the profession, guide practice and provide a framework for evaluation. While the American Nurses Association develops a framework for nurses throughout the country, each organization is unique, which requires customization to ensure it is genuine and representative of nursing practice at Children’s Minnesota.   

After approval by the Nursing Board in March 2021, the nursing team began disseminating the scope and standards to key nursing groups. Each month, a standard within the Nursing Scope and Standards of Practice was introduced at Nursing Executive Council (NEC) and accompanied by an activity for unit councils. The goals of these activities were to facilitate discussion and prompt nurses to consider ways to embed the scope and standards into their practice. To further disseminate beyond Nursing Shared Governance, each monthly standard shared at NEC was communicated through Clinical Minute, Children’s Minnesota’s internal newsletter dedicated to clinical practice.   

Dissemination of the scope and standards will expand in 2022, advancing the practice of professional nursing across the organization.   

Nursing scope and standards team

  • Roberta Basol, MA, RN, NE-BC, Senior Director, Center for Professional Development and Practice
  • Dawn Derks, MSN, APRN, ACNS-BC, OCN, Clinical Nurse Specialist, Emergency Departments
  • Donna Eull, MA, RN, CHPPN, Clinical Practice Specialist, Pain and Palliative Care
  • Shayna Fleming, DNP, RN, CNOR, Clinical Practice Specialist, Perioperative Services
  • Jarell Koras, MSN, RN, PED-BC, CPN, CLC, Nursing Excellence Program Manager, Center for Professional Development and Practice
  • Melanie Kuelbs, DNP, APRN, PCNS-BC, CCRN-K, Clinical Nurse Specialist, PICUs
  • Kristin Mccullough, MS, APRN, ACCNS-N, Clinical Nurse Specialist, NICU St. Paul
  • Erin Morhack, MSN, APRN, ACCNS-P, CPHON, Clinical Nurse Specialist, Hematology-Oncology
  • Jennifer Rivera, DNP, APRN, ACCNS-N, RNC-NIC, Clinical Nurse Specialist, Neonatal Services Minneapolis
  • Heidi Shafland, MSN, APRN, ACCNS-P, CCRN-K, Clinical Nurse Specialist, CVICU
  • Sara Wiplinger, MN, RN, CCRN, Clinical Practice Specialist, Acute Pediatrics

Pediatric Intensive Care Unit (PICU) offers virtual lectures   

Due to COVID-19, the 2020 pediatric intensive care unit (PICU) spring education days were canceled and minimal ongoing education was available to clinical registered nurses (RNs). Jedd Nivala, BSN, RN, CCRN; and Amanda Melin, MSN, RN, CPN, CCRN, PICU Minneapolis clinical educators, identified the opportunity to offer continuing education in a virtual format to support learning and continuous improvement while keeping patients and staff safe. Nivala and Melin developed one-hour online lectures about various topics of interest. The sessions were recorded and stored to provide future access to those unable to attend the day of the event.  

This series has highlighted the skills I will need to have by the end of the orientation, which is very useful to know before I start with a preceptor. I feel much more confident. Thank you for implementing this program!”  

Responding to education requests  

Through conversations with staff, Nivala and Melin identified current diagnoses, situations, needs and knowledge gaps on the unit and requested experts in their field to discuss a specific topic for one hour. They selected speakers to record lectures, talks or discussions that critical care RNs, respiratory therapists, rehabilitation specialists, social workers and chaplains could access and watch at their convenience. RNs receive one hour of paid time and one continuing education unit (CEU) per lecture.  

Between October 2020 and November 2021, the lectures were watched live by 189 participants and 348 participants watched the recordings. Topics included everything from self-care to titrating vasoactive medications to the latest information on multi-inflammatory syndrome in children. Feedback on the content and format was positive with an appreciation for convenience and flexibility for both speakers and participants. These opportunities will continue to be provided because of this positive feedback from staff.  

PICU virtual lecture team

  • Charney Grone, Professional Development & Learning Coordinator, Center for Professional Development and Practice
  • Amanda Melin, MSN, RN, CPN, CCRN, Clinical Educator
  • Jedd Nivala, BSN, RN, CCRN, PICU Clinical Educator  

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