Everyone in Piedmont Hospital's cardiac care unit is wearing a new Beacon Winner button and a beaming smile to match. The unit is the first in Georgia to win the prestigious Beacon Award for Critical Care Excellence. After a rigorous application process, the American Association of Critical-Care Nurses recognizes a small number (10 to 12) of outstanding units twice a year.
"About a year ago, two of our nurses, Wendy Cook, and Nancy Laster came to tell me about the Beacon Award and suggest we apply," said Paula House, clinical manager of the Atlanta hospital's cardiology intensive care units. "I knew of the AACN award, but had dismissed it as too much work. We had been preparing for a joint commission accreditation visit and were already overloaded."
Cook and Laster, however, were undeterred by the daunting application process. The two nurses had done their homework, researched the award, taken the audit test and knew the unit had what it took to be a winner. "We had been reading about what other great units were doing and realized that we already did those things, too," Cook said. "We thought, why not get everyone on the same page, gather the information and do this thing?"
"They were so gung-ho, so after a few months, I told them if they were willing to run with the ball, I'd support them," House said. Laster went to the AACN National Teaching Institute last May and gathered all the information she could about the Beacon Award. Knowing it would take everyone's involvement, she and Cook began brainstorming about a theme and ways to build enthusiasm for the application.
They started a Jump on the Beacon Bandwagon campaign, giving out Beacon beads, pens, candy and talking up their efforts at staff meetings. At their Bold Voices Commitment Meeting, the entire 45-member staff signed commitment cards. They hung everyone's picture and card on the wall and formed committees to address the seven parts and 42 questions of the application.
"We couldn't have done this without everyone's involvement," Laster said. "From our secretaries, telemetry techs, clerical staff to nurses ¨ it takes everyone to really give the best patient care."
"It really does take a village," echoed Cook. "Our phone rings constantly with families worried about patients admitted. Our secretaries know that each call is important."
To become a Beacon critical care unit, the staff is required to exhibit the highest quality standards in recruitment and retention, patient outcomes, staff training, healthy work environments, leadership and evidence-based practice and research.
"Our staff has always set a very high standard," House said. "They insist that anyone new come up to that standard, so orientation is however long it takes. Our nurses practice very autonomously, using a lot of critical thinking and independent judgment, and they encourage each other to keep learning and get certified." Cook came to the unit as a traveling nurse three years ago.
"When they asked me to stay, I didn't have to think twice about it; it's one of the best places I've ever worked," Cook said. A unit can't achieve Beacon status unless it is already doing many things well.
For two years, the unit at Piedmont had worked with infection control to achieve a low ventilator-associatedpneumonia rate and to reduce its patient urinary tract infection rate. The last 10 new hires had been recruited from staff. The unit's policies and procedures already met AACN standards. A palliative nurse was available to help patients and families cope with end-of-life issues.
"People have transferred into our unit, because of our reputation, but the purpose of going through the Beacon process is that you see ways you can improve," House said. "Whether you win or lose, you become a strong and tighter unit. It's all about the journey, and I'm proud of our staff."
"When I found out [about winning the award], I called Wendy and then we woke Paula up at 11:30 at night," Laster said. "We knew this was worth shouting about. Everyone is so excited.
"We're all different and we don't always agree, but we function well as a team. It's good to know we can pull together and that we really are giving good quality care."