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Healing the Healer: A Pathway Forward in the Medical Observation Unit (MOU)

Jasmine Marlow and Richard Werner

Publication Date: 5-2025

Nursing is a profession that encounters extensive demands, especially the Medical Observation Unit (MOU), where there is a high turnover rate of patients and nurses daily care for a wide variety of patient diagnoses. Burnout is a state of emotional and possible physical exhaustion because of the frequent stress that healthcare workers experience. The following presentation reflects on how nurses working on a fast-paced unit which has a high patient turnover rate leads to increased role expectations causing quicker burnout. Burnout can disrupt our nurse-patient relationships, aiding to decreased outcomes. By the end of this presentation, you will see what can help slow down or prevent nursing burnout on such a unit. Keeping our nurses’ minds and bodies healthy to fulfill the job, as an exceptional nurse, is a number one priority for our patients receiving care.
5 North RN Class: Clinic in the Classroom

Laura McWhirter

Publication Date: 5-2025

Newly hired nurses on 5 Northeast and 5 Northwest medical-surgical units attend an introductory 5 North RN class, which has been held quarterly for 15 years, to enhance nursing knowledge of the patient population for which they will be caring. Traditionally, the class was 8 hours in length with seven advanced practitioner speakers who reviewed patient specific care, followed by a simulation lab experience of an interactive mega code. During the 5 North RN class last quarter, the nurse professional development generalist (NPDG) received evaluations with requests from nurses to have more handson education to assist with increased learning and engagement of the nurses.

This project aimed to address the nurses' evaluation results and request for increased hands-on experiences within the class. Education is better received when multiple modalities of education are provided. Multiple education modalities can improve learning by engaging learners, collaborating with others, engaging in hands-on skills, enhancing muscle memory, and facilitating a team approach to care. Interactive education can also improve the application of critical thinking of a new nurse by building off their base knowledge and encouraging self-efficacy (Bautista & Bartos, 2019).

For new nurses coming into healthcare, involving themselves in a team approach to patient care is often difficult. With stronger collaboration between multidisciplinary teams, patient outcomes have the potential to soar. Introducing new nurses to the advanced practitioner speakers can help bring comfort and understanding to these disciplines' expectations for nursing. This allows for increased clarity of expectations and easier collaboration when the practitioners are visible on the unit. Collaboration aids in decreasing burnout by creating a relaxed work environment, improved morale of healthcare team, increases job satisfaction and decreases staff turnover (Ghattas & Abdou, 2025).
Improving Substance Use Disorder Care in the Emergency Department through Process Changes and Education

Tiffany Morelli and Cynthia Seferian

Publication Date: 5-2025

Corewell Health Beaumont Troy Hospital emergency department is a Level II trauma center that had an annual volume of 108,311 in 2023. In 2023 our team was consulted on 570 opioid use disorder (OUD) patients, provided 371 free take-home intranasal Narcan Kits, and connected 237 of them. In 2022, we saw 531 OUD patients, provided 311 free take-home intranasal Narcan Kits, and connected 271 of them. In July of 2022 we started to track patients here for other substances outside of OUD. This added an additional 1,956 patients to our consult list for 2022 and 2023. Our program was initiated in 2019, as we identified a need for additional resources for this population. We currently have a team that consists of an ER Physician, APP, and 3 RNs. We see patients 6 days a week, from 7am-7pm. This program is currently funded through a grant. Our goal is to identify, treat and connect with resources those at risk for or suffering from OUD/SUD. We also focus on educating our staff on decreasing the stigma associated with addiction. We provide free Narcan Kits, and offer initiation of medication assisted treatment (MAT).
The Utilization of a Reference Guide to Promote Nurse Confidence in Providing Parental Education About Nirsevimab Vaccine

Julia Nowak, Allison A. Drabek, Taylor Killich, and Audrey Kalasky

Publication Date: 5-2025

In July 2023, the FDA approved Nirsevimab (Beyfortus), a monoclonal antibody that provides direct protection to infants against respiratory syncytial virus (RSV), a dangerous respiratory virus that is the leading cause of infant hospitalization in the United States (CDC, 2024). During RSV season (November 1- March 31), Nirsevimab is ordered before the infant is discharged. Parents often have questions about Nirsevimab that they direct to the bedside RN.

The purpose of this evidence-based project was to inquire if a nursing gap in knowledge existed in providing parental education on Nirsevimab based on the novelty of this vaccine. Would a comprehensive evidence-based reference guide regarding RSV and Nirsevimab (Beyfortus), compared to vaccination instructions alone, improve confidence in providing parental education?
The Effect of the Adoption of the National Accreditation Program for Rectal Cancer Process on Compliance Standards at A Single Institution

Garrett W. Peters, Gregory Thomas, Jacob A. Applegarth, Forrest Bohler, Shelli Bergeron, and Harry J. Wasvary

Publication Date: 5-2025

• The National Accreditation Program for Rectal Cancer (NAPRC) was developed to decrease variability and increase a multidisciplinary approach among rectal cancer care.

• There is considerable variability among institutions in compliance with the “Patient Care: Expectations and Protocols” standards, and it is unclear how compliance changes once an institution undergoes the accreditation process.

• Corewell Health William Beaumont University Hospital (formerly Beaumont Hospital, Royal Oak) is a large-volume institution that adopted the NAPRC process into clinical practice starting in August 2019.

• In this study, we evaluate institutional compliance before and after NAPRC accreditation adoption was undertaken.
“ACE-ING Communication”

Mary Royse, Ester Joyce Szmyd, and Robert E. Lingerfelt

Publication Date: 5-2025

The patient experience is an important aspect of healthcare delivery, and it involves a variety of elements that influence a patient’s perception of the care that was provided to them. Specifically, the patient experience centers on if specific aspects of care occurred such as the quality of interactions between the patients and doctors, nurses and ancillary staff. Healthcare systems have recognized the importance of providing a positive patient experience which can lead to improved clinical outcomes, enhanced patient safety, improved care coordination and positive financial outcomes for the healthcare system. The 9 North Acute Care of the Elderly (ACE) unit embarked on a process to improve communication between the patients/family and nurses to positively impact the patient experience.
Using Visual Aids to Increase Compliance of Capping and Clamping IVs

Benjamin Rush, Cassidy Wagner, and Alexus Winkowski

Publication Date: 5-2025

Hospitalized patients are treated for the illness that brought them in. However, how many times have you heard of your patients being treated for a hospital-acquired infection, such as a bloodstream infection, or have had a patient lose their IV very quickly? Every patient that comes into the hospital to be treated gets an IV catheter placed and improper care, such as not capping and clamping your lines, can result in infections in the blood stream, sepsis, clotted lines, and the IV becoming infiltrated. If we can get nurses in the habit of capping and clamping every IV catheter after use, we can help prevent these extra illness patients keep seeing and decrease hospitalization and length of stay. Flushing and clamping an IV line helps maintain patency of an IV catheter when it is not in use. Research has shown that flushing the IV with at least 10ml of normal saline is vital in preventing malfunction (Gossens, 2015). The use of a disinfecting cap, according to Hou et al. (2023), has a reduction of infection by 73%, along with a 0.5-day reduction in length of hospital stay. To promote the use of capping and clamping IVs, we proposed the use of visual aid reminders, similarly to what has been done for handwashing (Wearn et al., 2015). According to this study, the use of visual aid reminders increased compliance in handwashing, thus supporting the possibility of visual aids in increasing compliance in capping and clamping IVs.
How A Novel Data Collection Approach Can Improve CTMU Alarm Acceptance

Damian Tomasik, Mary Royse, and Ban Haweel

Publication Date: 5-2025

The increasing use of digital technologies is changing healthcare professional’s activities, especially as it relates to patient quality data. Technologies that supply large amounts of data, that can be used to extract knowledge, can support nurses’ decision-making process and ultimately improve the quality of healthcare services. One such example is the regional database housing the Central Telemetry Monitoring Unit (CTMU) data. This enormous database provides valuable information on the number of CTMU alarms that are accepted by unit and individual caregiver in the east region of Corewell Health. To improve the CTMU alarm acceptance rate on 9 North Medical, a plan was put into place, utilizing technology, for nurses to better understand the overall process.
Warm Hearts & Cozy Starts Improving Newborn Health By Providing Families With Needed Resources

McKenzie Trecha

Publication Date: 5-2025

In 2022, 41% of children in Michigan lived in households that were struggling to afford essentials. A large portion of these households are immigrant or minority families. Access to clean, warm clothing is vital for the thermal protection of newborns in our community. Keeping babies warm reduces mortality and morbidity in newborns. Nurses on the Mother Baby Unit at Corewell Health Beaumont Troy noticed a trend in their patients not having access to appropriate clothing for their children at time of discharge. These nurses expressed a desire for access to clothing that can be given to families in need. It is vital for healthcare providers to be cognizant of social determinants of health and their impact on our new mothers and infants. The Mother Baby Care Unit implemented an Infant Clothing Closet with clothing, swaddles and more that can be given to families in need to ensure all infants are discharged from the hospital dressed appropriately.
Our Journey: Learning to care for oncology overflow patients

Janet Trethewey and Jennifer Martens

Publication Date: 5-2025

In the U.S. the number of hospitalized oncology patients has been increasing faster than medical-surgical patients. This is in part due to factors like increased cancer incidence, an aging population and new treatment options. New graduates and nurses practicing in non-oncology settings such as Med-Surg, may be lacking essential knowledge and skills in caring for cancer patients and families. Given the multidimensional impact of cancer care across the trajectory, it is imperative to develop competencies for nurses in all settings.

Bakker, et. al. (2013) describes how for the nurse caring for a cancer patient, each day was unique and determined by treatment, procedures and tasks required by the patient. It meant use of therapeutic presence or “being there” for the patient. Another described it as ‘caring in a climate of scientific research.’

As our inpatient oncology unit at William Beaumont University Hospital has had increased overflow, it made sense to begin to direct those patients to its sister unit, 6 Center Medical, Palliative/Hospice. 6 Center nursing staff already have the knowledge, skills and experience of symptom management and emotional support for palliative/hospice patients but voiced a need to learn more about oncology diagnoses, treatment and symptom management.
Challenging Tradition-Based Practice: Continuous Pulse Oximetry Monitoring Criteria

Sally Witt, Kim Matthews, and Meghan Harris

Publication Date: 5-2025

Alarm fatigue is defined as repetitive and continual exposure to environmental beeping from devices, leading to desensitization of clinicians and lack of response3 . Alarm fatigue poses a significant safety risk as an excessive volume of alarms and noise may distract clinicians from responding to alarms that are clinically significant and require intervention.

Continuous pulse oximetry (SpO2) monitoring is utilized in acute care settings to quickly detect oxygen desaturation. Continuous pulse oximetry monitoring is associated with a large volume of insignificant and inactionable alarms such as loose pulse oximetry sensors or disconnection of the patient from monitoring equipment.

The literature supports standardizing practices across clinical environments to support monitoring patients with appropriate clinical indications1,2,3

Traditionally, all patients admitted to the 6 North East Medical Progressive Care Unit (6NE MPCU) were placed on continuous hardwire pulse oximetry monitoring, regardless of eligibility criteria. There is a current policy in place at the institution which defines eligibility criteria for continuous pulse oximetry monitoring of patients admitted to progressive care units.

The aim of this evidence-based practice project was to utilize existing eligibility criteria for continuous pulse oximetry monitoring to decrease the volume of inactionable pulse oximetry related alarms.
An Innovative Approach: Educational Rounds

Sarah K. Young and Erin M. Agrusa

Publication Date: 5-2025

The Nursing Resource Team (NRT) is a vital division within William Beaumont University Hospital that allows both nurses and nursing support staff to float between all units of the organization, thus bridging staffing shortages and optimizing patient care outcomes. Because of their widespread deployment throughout the facility, it can be challenging to ensure that all NRT staff members receive adequate education and are informed of new rollouts. The NRT education team has worked diligently to mitigate this barrier, knowing that it is vital for the success of the team. “Float pool nurses are in a unique position to observe practices across multiple units or microsystems. This facilitates learning and sharing of best practices from one unit to the next…” (Straw, 2018, p.32).

Keeping this philosophy in mind, in April of 2025, the NRT education team trialed three different education delivery methods to determine how to best disperse information to staff. The methods consisted of virtual information dispersal via email, small classroom focus groups, and 1:1 education on the units through “rolling in-services”. Staff members were asked a series of standardized questions after each method, to prove whether the method was helpful in their understanding of new content.

Based on the results of the standardized questions, the NRT education team discovered that the best means of providing education to the float pool staff members is via “rolling in-services”. This education design focuses on “meeting the nurses where they are”, and bringing educational tools, flyers, and competency checklists to the units in which they have been deployed. “Float pool nurses need to feel valued; taking time to visit each nurse provides a personal and professional connection” (Straw, 2018, p.34). During the “rolling in-services”, NRT staff were also able to ask questions in real time, develop a rapport with their team leaders, and felt that less time was taken away from their busy day on the unit.
We’ve Got Your Number: Using the Predictive Model Fall Risk Score to Identify Patients with a High Risk of Falling on an Inpatient Rehabilitation Unit

Pamela Zawadzki, Catherine Horne, Fatima Ibrahim, and Rita Leone

Publication Date: 5-2025

For decades, patient falls have been the most prevalent adverse safety event and quality of care issue in hospitals nationwide (Moskowitz, et al, 2020). Approximately one-third to one-half of these falls are classified as a fall with injury, some serious, including fractures, subdural hematomas, bleeding, and even death. (Moskowitz, et al, 2020). Falls are also a financial burden, potentially costing $30,000 per event due to increased length of stay, treatments, and litigation (Moskowitz, et al, 2020). In 2024, a 64-bed unit hospital inpatient rehabilitation (IPR) unit within an acute care teaching hospital had an increase in the Injury Falls rate (per 1000 patient days) in comparison to peer Magnet facilities. Accordingly, IPR nurse leaders collaborated with hospital leadership to develop intervention strategies to decrease IPR fall rates. IPR leaders designed a fall prevention strategy that focused on the predictive model fall risk score (PMFRS). The PMFRS is calculated automatically within the electronic medical record (Epic) by analyzing data from the patient’s record such as medications, labs, and flowsheet values (i.e. vital signs). The numeric score calculated for each patient is then translated into a low, medium or high risk for falls. The Epic PMFRS utilized by the hospital system, was found to be slightly superior to manual assessment (i.e. MORSE fall scale) at calculating fall risk, with 60% of patients who fell being identified as high risk using the manual assessment and 62% using PMFRS (Hagemann, 2025).

The aim of this quality improvement (QI) project is to evaluate the effectiveness of a fall prevention program emphasizing the PMFRS of IPR patients identified to be of increased fall risk.
Aromatherapy Intervention for ICU Delirium

Hailey Abro, Julia Bartus, Trevor Beerer, Jasmine Davis, Nick Elgert, Morgan Ellis, Geraldina Gjelaj, Kayla Goisdzinski, Heba Karmo, Chloe Konopitski, and Danielle Lafata

Publication Date: 5-6-2024

Sleep is crucial in sustaining physical and psychological welfare (Karadag et al., 2015). Unfortunately, patients in the intensive care unit (ICU) commonly experience sleep disorders due to the various interruptions they may receive while being provided care. Reduced or inadequate sleep is associated with adverse effects on cognitive functions, wound healing, and immunological response (Garbarino et al., 2021). Although sleep disorders are treated with pharmacological methods, such as sedatives, patients may experience additional side effects as a result. (Lee et al., 2017). Thus, it is essential to pair medications with non-pharmacological interventions. Aromatherapy is a non-invasive nursing intervention that can be used to facilitate relaxation and improve sleep quality among critically ill patients. This project aims to use aromatherapy as a holistic approach to reducing stress, anxiety, and agitation for patients in the ICU.
Effect of Emsella Chair Therapy on Stress Urinary Incontinence

Ayman Alam, Bernadette Zwaans, Erica Zagaja, and Kenneth Peters

Publication Date: 5-2024

Stress urinary incontinence (SUI) is the unintentional loss is urine that occurs during a stress event, such as coughing, sneezing, laughing, or exercise. It is caused by the weakening of the pelvic floor muscles or urethral sphincter. It is more commonly seen in women, with up to 33% of women experiencing the condition at least once in their lifetime, while less than 3% of men experience SUI1. Risk factors for women include obesity, smoking, and past pregnancy, while SUI in men mainly develops due to iatrogenic causes such as radical prostatectomy.
Making Stryker IsoTour Pumps Nurse Driven

Ana Arriaga, Elizabeth Makuch, Mary Reynolds-Tharp, Laura Meyer, Janette Bell, Grace Gierak, and Sherri Tumminello

Publication Date: 5-6-2024

Pressure injuries (PIs) are unfortunately a common finding on oncology units. Pressure redistribution is essential in pressure injury prevention and control strategies, which include the use of support surfaces. In this evidence-based practice (EBP) project, we have highlighted current best evidence on the use of equipment to prevent new or existing pressure injuries. Implementation includes having Stryker Isotour pumps readily available on the unit instead of having to consult the wound care team to order the pump for a patient. PIs are associated with an estimated excess mortality rate of 72 deaths per 1,000 and excess cost of $18,000/case (Kahn & Jonusas, 2019). Systemic support surfaces such as foam mattresses, gel foam mattresses, and alternating pressure-reducing mattresses are key to the prevention of pressure injuries (Huang et al., 2023). The pressure relief performance and comfort of mattresses have an extreme effect on the quality of life (Ren et al., 2023). A suitable mattress or chair option can aid in reducing pressure and shear. However, even with these technologies, people still need to be moved. (Zeng et al., 2023). A study using a new breathable silk-like, 3-layer ventilating mattress sheet that allowed for patients to self-reposition in bed found that it led to a decrease in PIs (Van Leen et al, 2022). Another study found no difference in PI prevalence when comparing manual repositioning to a specialty mattress (DeMellow et al., 2023). Hospital-acquired PIs (HAPIs) have a serious effect on patient outcomes and systemic support surfaces coupled with repositioning can reduce the incidences of HAPIs. This EBP project evaluated the effectiveness of Stryker IsoTour pumps versus Hill-Rom beds in preventing PIs on an oncology unit.
Labeling Intravenous Tubing: Grab-and-Go

Lindsay Bailey and Yulissa Garza

Publication Date: 5-6-2024

4 Center is a 24 bed Transplant and Nephrology Unit and as in many inpatient units, intravenous therapy is a common practice. Each medication has a different stability, and IV lines should be changed according to the policy that the hospital has set in place to prevent infection or medication errors. With the goal of improving our compliance, we propose that if there was informational signage and the labels were placed in an organized fashion in the medication room, that this would help to not only remind nurses to label their lines but also assist in which labels to use.
Multidisciplinary Approach to Pulmonary Arterial Hypertension Therapy Transition: A Patient Case Report

Jacqueline Brewer, Tania Saeed, and Bhavinkumar Dalal

Publication Date: 10-2024

Pulmonary arterial hypertension (PAH) is a rare, incurable disease that causes vasoconstriction of the pulmonary vasculature

Therapy goals include improving hemodynamics as well as alleviating symptoms

Therapies range from injectable to inhaled to oral to parenteral

PAH treatment teams often transition between the various forms of therapies to reach therapy goals but also to improve patient’s quality of life

The use of a supportive, multidisciplinary team approach, including physicians, nurse practitioners (NP), pharmacists, and nurses during these therapy transition phases is beneficial to achieve success and improve patient care
Decreasing Healthcare Acquired Clostridium Difficile

Casey Brooks and Gabrielle Jaworowski

Publication Date: 5-6-2024
- Clostridium difficile (CDI) is the leading cause of hospital-acquired infections.
- CDI is associated with increased costs, hospital length of stay, morbidity, and mortality in the adult population.
- Outbreaks within the hospital setting are often related to contact contamination and a lack of antibiotic stewardship.
- Evidence supports several strategies to prevent CDI:
Antimicrobial stewardship

Personal Protective Equipment (PPE)

Meticulous hand hygiene

Environmental decontamination
- In the Center North Tower, the hospital acquired CDI rate at the end of 2022 was 0.81 per 1,000 patient days (Figure 1)
- The aim of this project was to identify practice gaps and decrease the rate of healthcare acquired CDI specific to 4 Center North (4CN) Intermediate Medical Progressive Unit.
Helping Hands Nurses: An Innovative Team-Based Model of Care Delivery

Lindsay Colby, Patricia Delgado, and Mary Beth Strand

Publication Date: 5-6-2024

In March 2023, registered nurses on 6 South Gynecology/Medical expressed concern to the nursing management team about frequently being pulled to other medical-surgical units, while mother baby nurses replaced them. Despite mother baby nurses being pulled to 6 South Gynecology/Medical, an examination of data revealed that the cancel rate of mother baby nurses was high at 16.77%. A declining birthrate in Southeast Michigan led to this high cancel rate (State of Michigan, 2023). Recognizing a need to support inpatient medical/surgical units, and decrease mother baby nurses from being canceled, the 6 South Gynecology/Medical nurse management team and clinical nurses sought to innovate a new care delivery model.

This poster highlights a new care delivery model, where in lieu of a canceled shift, mother baby nurses are paired with medical-surgical nurses to deliver patient care. In light of current nurse staffing shortages (Auberbach et al., 2022), and increasing patient age and acuity (McNabney et al., 2022), innovative care delivery models are needed to support in-patient medicalsurgical nurses. Collaborative and team-based models of care offer a way in which to redesign nursing workflow and practice (Sherman, 2023).
Delirium Reduction in Patients in an Intensive Care Unit

Madison Firth and Sava Melakuqi

Publication Date: 5-6-2024

Delirium presents a significant dilemma for patients in the hospital setting. Delirium not only prolongs the amount of time that the patient’s body requires to properly heal, but can negatively impact their emotional and physical sense of well-being as well. Patients that become delirious may not have the ability to participate in upcoming daily activities and mobilization due to safety concerns, can become emotionally distraught due to confusion/frustration, and may cause un-intentional self-injury from pulling at invasive medical devices such as arterial and central lines. When a patient progresses to this state, they often require non-violent soft restraints for their own protection or pharmaceutical agents, which can further increase their agitation.

Various delirium reduction studies have been performed around the world in efforts to prevent this prevalent issue. In a study projected by Matsuura et al. 2022, evidence found that 20%-50% of patients on Intensive Care Units (ICUs) struggle with hospital-acquired delirium. A separate project project conducted by Baldwin et al., summarized that intense patient-monitoring combined with high levels of noise and bright light throughout the night increased the rates in which patients became confused.

Due to the amount of time that hospital nursing staff spends providing direct patient care, nurses have the chance to directly affect patient outcomes during their stay. We have chosen to implement a non-pharmacological sleep bundle on our unit in efforts to decrease the rate of ICU delirium.

The purpose of this study is to investigate if incorporating a non-pharmacological sleep bundle in adult patients in the Cardiovascular Surgical Intensive Care Unit (CVSICU) will decrease the prevalence of patient delirium during their length of stay on the unit.
Culture of Safety – Constant Observation Communication Project

Ira Fjolla, Wendy Blanchard, Sarah K. Young, and Erin Agrusa

Publication Date: 5-6-2024

The Nursing Resource Team (NRT) is a vital division within William Beaumont University Hospital that allows both nurses and nursing support staff to float between all units of the organization, thus bridging staffing shortages and optimizing patient care outcomes. Nursing support staff within the NRT are the primary source of constant observers for both medical safety patient cases and suicidal patient cases hospital wide. Constant observers play a vital role in patient safety by providing 1:1 care to a patient requiring continuous monitoring for high-risk safety or suicidal precautions. Communication between nursing personnel and the constant observation staff is crucial, contributing to improved outcomes and overall safety. “Nurse communication…affects the provision of effective health care, with the ability to create good cooperative relationships and foster trust between professions in order to improve the quality of service delivery and patient safety” (Wieke et. al., 2021).

In April 2023, the NRT Professional Nurse Council (PNC) conducted a survey questionnaire to all constant observers within the hospital over the course of a 15-day period. The survey consisted of 3 questions that focused on the constant observer receiving report on the assigned patient. After the survey was completed, a thorough data analysis was performed and the NRT PNC met to determine a plan of action.

Based on the survey results, the NRT PNC agreed there was an educational need hospital-wide to review and reinforce the constant observation policy amongst nursing personnel and nursing leadership. Further, it was decided that a practice alert would be beneficial to provide additional education regarding the expectations for RN and CO communication for all constant observation cases hospital wide.

The 3 primary goals of this project:

1.) Promote patient and staff safety with correct and timely communication.

2.) Clarify expectations and responsibilities related to report.

3.) Improve culture and safety scores throughout the organization
Proactive Toileting for Proactive Fall Prevention

Donna Gannon, Jennifer Martens, and Caroline Medcoff

Publication Date: 5-6-2024

There are 700,000 to 1,000,000 patient falls each year in U.S. hospitals, 35% of those resulting in patient injuries per year, costing the health industry $34 billion a year (MarketScale, 2020), resulting in increasing patients' hospitalization duration and placing nursing staff on edge. While protecting patient autonomy and encouraging independence, safety in the form of fall prevention remains a top priority among staff in the hospital system. Fall prevention can be grouped into three categories: education, risk assessment, and interventions. This formula can help patients and staff work together to increase safety and lower healthcare costs. Proactive toileting assesses a patient's need to use the bathroom regularly. This could be done simply by asking the patient if they need to use the toilet or implementing a set schedule to get patients up and placing them on the toilet to encourage voiding and regularity.

According to a study done at Saint Catherine Hospital in East Chicago, the majority of falls had occurred because of patients' need to go to the bathroom. To better serve their patients, they started implementing proactive toileting, which has reduced falls and urged patients to address their other needs at the scheduled time, allowing for care clustering and more healing time (Swenson et al., 2019). In another study. an inpatient oncology unit ran a study implementing proactive toileting when the unit was performing low on falls and fall indicators. They found that asking the patient, instead of teaching them, would still lead to falls because patients would rather decline to go at that time only to fall later, getting up without help, or the patient would not want to bother staff and therefore decline the toilet at that time altogether (Schmutter & St Fleur-Delbrune, 2021).
Prevalence and Supplementation of Virtual Visitation in the Aftermath of the COVID-19 Pandemic

Ryan Gondek

Publication Date: 5-6-2024

The COVID-19 pandemic resulted in changes of many hospital policies in an effort to protect patients and staff. Strict visitor restrictions and constant mask use by staff was implemented to Corewell health specifically as well as hospitals across the nation. These changes were done to help protect the physical health of patients, staff, and visitors. However emotional health can be an overlooked aspect of providing quality care and during this time many patients were unable to receive emotional support from their loved ones during a difficult time. As this problem became more prevalent, hospitals had to adapt to meet the emotional and spiritual needs of the patient population. The use of tablets and other devices as a means of virtual communication became more common. With the increase of resources and awareness, more patients were able to communicate with loved ones, providers, and spiritual leaders while maintaining safety for all parties involved. As we now reach the aftermath of the COVID-19 pandemic and visitor restrictions are less severe, I decided to examine how virtual visitation and telecommunication is still being used on 3 East, and what information is being provided regarding it.. Although patients are now able to have visitors and meet with providers more often, there is still plenty indication for the use of virtual visitation. Visits and communication with loved ones, providers, and spiritual leaders is crucial in improving emotional and spiritual health in patients. I examined the current practices and resources of the unit I work on. I looked to improve the resource availability and awareness of these resources for patients and families.
Improving the recording of surgical drain output

Aja Hutchins, Melanie Miller, and Vicki Rayburn

Publication Date: 5-6-2024

As orthopedic surgeries in the United States are projected to dramatically increase over the next 10 years (Bohl, D. et. al., 2017), Unexpected delays in discharge and surgical infections in orthopedic surgery can have adverse effects. It can negatively impact costs and patient outcomes. Prevention of the infections and delays in discharge that is considered nursing related is a priority.

The output from surgical drains often guides management as drains are commonly not removed until the wound bed drains less than 50 milliliters a day. Failure to have documented drainage output over a 24 hour period often leads to drains that could be safely removed staying in-situ for a further day. This could result in increasing risk for infection and unnecessary pain. Research has shown that prolonged surgical drains indwelling times increases the risk for surgical site infection (Pennington, Z.et. al.,2019).