2022 Nursing Annual Report

Children’s Minnesota and University of Minnesota form nursing partnership

On March 14, 2022, the University of Minnesota School of Nursing and Children’s Minnesota formed a partnership to generate, disseminate and apply knowledge for the improvement of nursing practice, education and patient outcomes.

The “Collaboratory” serves as a nursing think tank and incubator for creativity and innovation that engages nursing staff, nursing faculty and nursing students to enhance nursing education; research; practice; and diversity, inclusion and equity, while recruiting top talent into pediatric nursing.

“We celebrate this Collaboratory focused on the health of children and their families and look forward to community-creating with Children’s Minnesota the best practices to advance it,” says Connie White Delaney, PhD, RN, FAAN, FACMI, FNAP, dean of the School of Nursing. “This is about honoring our future that is held with children, and this partnership will have a profound impact on all of the School of Nursing’s Collaboratories.”

“As the kid experts, Children’s Minnesota is committed to improving children’s health by providing the highest-quality, family-centered care, advanced through research and education. This Collaboratory is very exciting as it strengthens our partnership with the School of Nursing by co-creating evidence-based pediatric nursing practice through research,” says Caroline Njau, MBA, BSN, RN, NEA-BC, senior vice president of patient care services and chief nursing officer (CNO) at Children’s Minnesota.

Among the Collaboratory’s initial areas of focus are fostering innovative educational experiences in both organizations, supporting the health of children and their families through research and evidence-based practice, addressing nursing workforce trends, and finding collaborative ways to support a smooth transition of graduates into practice.

members of nursing partnership

Welle training program improves care and safety for patients and staff

Nurses and other clinical staff see first-hand the increasing numbers of children and adolescents experiencing an acute mental health crisis daily, as well as families under greater stress. The safety of nurses and other clinical staff who care for all patients and families, and particularly mental health patients, is a priority which is being addressed with a new training program to develop injury prevention skills.

The Welle training program supports safe, trauma-informed care with a focus on prevention of incidents through verbal de-escalation. Approximately 70% of Welle training is focused on relationship building and verbal skills, with 30% focused on physical skills needed when escalation does occur. Decreasing incidents, rather than simply responding to them, is the goal.

Prior to selecting the Welle program, the Journey to Zero committee first developed criteria and evaluated several programs. Nurses and clinical staff provided feedback on the final choices. In May 2022, the Welle program was selected, in large part because it trains staff at the organization to lead the initiatives and train others. Children’s Minnesota’s strong commitment to having those who use the skills also train the skills is evident in the trainer group.

Twenty-one nurses, clinical support associates, social workers, therapists and security team members at Children’s Minnesota have been certified as Welle trainers and provided education to more than 450 staff in 2022. Initial training continues for expanding groups in 2023, and refresher training will be initiated later this year. In February 2023, additional trainers were added to the group. Members of the initial trainer team can be found below.

Trainer certification requires one week of training with an expert from the Welle program and passing both a written test and skills demonstration. Trainers must re-certify annually.

Having instructors from Children’s Minnesota who do this work daily helps staff see how this education will impact their own practice in a powerful way. Instructors share personal experiences in using Welle principles throughout the classes.

Feedback from the initial classes has been positive, including the following:

“I now know what to do when behaviors escalate, and I feel comfortable being a part of the team to help.”

“I will stop and think before restraining. I have so many more tools and ways to state things. It will help me in my personal and professional life!”

“This provides common language for our teams to be effective together, which will help staff and patients be safer.”

“This course makes me feel more confident in my abilities when a code green occurs and will help me to prevent them. I also feel like I have more skills to de-escalate a patient.”

Welle Trainers

  • Elizabeth Bickford, BSN, RN, Clinical Nurse, 7th floor Minneapolis
  • Rolf Brathen, BSN, RN, Clinical Nurse, Minneapolis Emergency Department
  • Stephen DeLong, MSW, LICSW, Social Work
  • Morgan Dressely, BSN, RN, 5th Floor St. Paul
  • Lolita Granados, Clinical Support Associate, Minneapolis Float Team
  • Rachael Hayes, Clinical Support Associate, St. Paul Emergency Department
  • Katie Keefer, BSN, RN, Clinical Educator, St. Paul Float Team
  • Nate Kessler, Security Officer, Safety and Security
  • Jenna Kunkel, MSW, LICSW, Social Work
  • Claire Lindgren, MSW, LGSW, Therapist, Lakeville Partial Hospitalization Program
  • Mike Merino, Clinical Support Associate, St. Paul Emergency Department
  • Tanya Nienow, MSN, RN, CPN, Clinical Educator, 7th Floor Minneapolis
  • Katie Nims, Clinical Support Associate, 5th Floor St. Paul
  • Alison Peppler, MSN, RN, Clinical Nurse, 5th Floor St. Paul
  • Krista Petersen, RN, Clinical Nurse, Minneapolis Emergency Department
  • Kallie Ritchie, BSN, RN, Clinical Educator, 5th Floor St. Paul
  • Cathy Runtsch, BSN, RN, Clinical Nurse, 5th Floor St. Paul
  • Lynn Villagracia, BSN, RN, CPN, Clinical Nurse, St. Paul Emergency Department
  • Andrea Witt, Clinical Support Associate, Minneapolis Float Team
  • Colleen Wood, BSN, RN, CPEN, CEN, TCRN, Clinical Educator, Minneapolis Emergency Department
  • Sara Zeyen, RN, Clinical Nurse, St. Paul Float Team

Minneapolis and St. Paul PICU launch weekly active surveillance, decreasing hospital acquired pressure injuries

When stratifying pressure injury data by unit, it was found that the majority of hospital acquired pressure injuries (HAPI) occur in the pediatric intensive care unit (PICU) at Children’s Minnesota. In 2022, PICU leaders across Children’s Minnesota’s Minneapolis and St. Paul campuses committed to decreasing incidence of hospital acquired pressure injuries by engaging a deeper bench of clinical nurses trained to be Journey to Zero (JTZ) Champions. JTZ Champions perform a monthly Prevalence Day survey focused on HAPI and peripheral intravenous infiltration or extravasation (PIVIE) prevention.

Following a similar model, PICU patient care leaders collaborated with patient safety and wound ostomy care APRNs to establish a weekly HAPI active surveillance, an established best practice from the Solutions for Patient Safety Network. Weekly active surveillance not only helps with early identification of HAPI, but also provides an opportunity to mitigate risks and perform safety coaching on pressure injury prevention. This increased the number of JTZ Champions who receive safety coach training and scheduled days dedicated to assessing critically ill patients on the unit for HAPI.

Since implementing weekly active surveillance, the Minneapolis and St. Paul PICU HAPI rate for all stages decreased 47% in 2022 compared to 2021, and decreased by 69% for stage 3, 4 and unstageable HAPI. The weekly cadence has increased awareness of HAPI prevention among clinical nurses on the unit and inserted a pause in the flow of care delivery to think critically about best practices. Providing clinical nurses who are closest to the work with safety training gives them the skills, knowledge and ability to prevent harm.

graph of hospital acquired pressure injuries

Project members

  • Grace Brooks, BSN, RN, Clinical Nurse, Minneapolis PICU
  • David Burnham, BSN, RN, Clinical Nurse, Minneapolis PICU
  • Carolina Christensen, BSN, RN, Clinical Nurse, St. Paul PICU
  • Erica Eberhard, CNP, APRN, CWOCN, FNP, Wound Ostomy Care
  • Laura Gary, RN, MSN, Director of Critical Care Services
  • Alyssa Kuehn, BSN, RN, Professional Nurse, Wound Ostomy Care
  • Rachael Lamsal, MSN, RN, NE-BC, Manager of Patient Safety
  • Julie LeBlanc, MPH, CPHQ, CIC, Healthcare Epidemiologist / Quality Program Manager, Patient Safety
  • Natalie Lu, MSN, RN, Patient Safety Coach, Patient Safety
  • Natalja Mattson, BSN, RN, Clinical Nurse, Minneapolis PICU
  • Amanda Melin, RN, MSN, Patient Care Supervisor, Minneapolis PICU
  • Cathy Mellum, BSN, RN, NE-BC, Director of Pediatric Care Services
  • Heather Miller, BSN, RN, Clinical Nurse, Minneapolis PICU
  • Ann Marie Nie, PhD, APRN, CNP, FNP-BC, CWOCN, FNP, Wound Ostomy Care
  • Carrie Overgaard, BSN, RN, PHN, Patient Safety Coach, Patient Safety
  • Tonya Strauss, BSN, RN, Patient Care Manager, Minneapolis PICU
  • Jamie Walton, BSN, RN, Patient Care Manager, Cardiovascular Care Center
  • Caroline Witchell, BSN, RN, Clinical Nurse, St. Paul PICU

<< Back: Partners in care

Next: Shared governance >>