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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.
Effects of Education on Gardasil Administration within Varying Patient Demographics

Emily Zajac, Megan Amos, Farrar Jean Ford, Kelly Dubay, and Teresa Mccartney

Publication Date: 3-13-2025

The purpose of this quality improvement study is to evaluate how physician education impacts patient education and HPV vaccination rates within obstetric and gynecologic clinics affiliated with Corewell Health Farmington Hills Hospital, with the purpose of improving HPV vaccination rates among women. Patient demographics and incidence of physician education will be analyzed for the relationship to HPV vaccination rates within the three OBGYN clinics.

Current data indicates that this quality improvement measure is needed for the population seen by these clinics. According to MCIR, a small percentage of teenage patients in Michigan have completed the 3 dose HPV vaccination series (16.7% for males and 32.8% of females). Nationally, while HPV vaccination rates continues to increase, they remain lower than vaccination coverage with routinely recommended vaccines. Locally, Oakland county HPV vaccination rates remain lower than Michigan and national numbers.

OBGYN providers do not see the target population (11–12-year-olds) for the initial vaccine. Given that ACOG recommendations for vaccination have recently changed, we aim to increase provider knowledge of these recommendations and thus improve the vaccination rates. Provider education and recommendation for vaccines has been shown to correlate in favor of increased incidence of HPV vaccination.

Initial findings noted that after provider education and education to the patients, patients decided to review information on their own terms. Therefore, not showing a sudden increase in the vaccine rate
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).
Rotating Preceptors: (In)consistency is Key

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

Publication Date: 5-6-2024

Preceptors facilitate unit orientation, a critical phase of the development of new graduate nurses (GNs) as they begin their nursing career. Nursing turnover has increased at a startling rate since the start of the COVID-19 pandemic and GNs continue to be in high demand, but the waning number of qualified registered nurse preceptors (RNPs) presents a challenge (McDermott, 2023). This lack of qualified RNPs is a critical concern of nurse leaders, creating significant challenges for training GNs. RNPs precepting GNs on a frequent basis can lead to burnout and job dissatisfaction. A rotating precepting model could lead to more choice and ownership for RNPs over the preceptorship process, opting in when enthusiastic and energized about teaching and opting out when near burnout (Barrett, 2020). RNPs also need continuing professional development to validate competency. Conversely, GNs may feel uncomfortable with an assigned primary RNP’s teaching style or personality. Nursing education collaborated with nurse managers to ensure GNs received quality preceptor support during their 10-week unit orientation while also incorporating job satisfiers to reduce burnout, increasing job satisfaction and nurse retention for both RNPs and GNs, ultimately improving care delivery and patient outcomes.
Rebuilding the Nursing Team on a Medical Unit

Christina Maciborski, Sally Witt, and Kyle Kahsin

Publication Date: 5-6-2024
- Staffing challenges are complicated and multifaceted. Factors influencing registered nurse (RN) staffing include pursuit of agency contracts, continuing education opportunities such as completion of an advanced nursing practice role, burnout, retirement, economic pressures, and a competitive market2.
- Almost 200,000 more RNs will be needed in the US each year per the U.S. Bureau of Labor Statistics1
- The 6 North West Medical Progressive care unit (6NW) was largely affected by post-pandemic staffing and hiring challenges as evidenced by a functional vacancy rate of 70.3% in April 2023.
- Literature supports collaboration between nurse leaders and Human Resources (HR) to create sustainable recruitment strategies2.
- Unnecessary delays between interview and job offers can allow candidates time to pursue alternative offers and question the institution’s intention to follow up3.
- Nurse leaders should use innovative and creative methods for RN recruitment and retention5.
- The aim of this project was to utilize a multifaceted approach to RN recruitment and retention to achieve a decreased functional vacancy rate in the medical progressive care unit.
Virtual Reality for Labor Pain & Anxiety

Kristen Maki and Kathleen Blair

Publication Date: 5-6-2024

Managing pain during labor is a main component of the daily work of a clinician in labor and delivery. Pain control and prevention of suffering are key components in this area of nursing (Frey et al, 2019). While pharmacologic approaches to pain control (ie. epidurals) are widely utilized and seek to eliminate pain, non-pharmacologic approaches to pain management are also sought after by patients. Coping is encouraged, self-confidence can increase, and well-being is at the forefront of non-pharmacologic interventions. Virtual Reality (VR) has been shown to be effective in managing acute pain in a wide variety of settings including burn patients, cardiac surgery, and labor patients.

VR came to be in the 1980s to refer to a user-computer interface that allows for real-time simulation of an environment that users can interact with via multiple sensory channels (Lanier, 2001; Gonzalez-Franco & Lanier, 2017). So not only does it provide sound distraction but engages multiple senses while isolating a patient from the immediate clinical setting (Hoffman et al, 2011). VR has long been cost prohibitive to widespread application, however with advances in technology, the cost of high-quality headsets has decreased.

Nurses who provide labor support play a vital, unique role in supporting birthing women. This is another tool that nurses can draw from to provide labor support, to women who meet criteria and are interested in VR. Additionally, assistive personnel who have been trained, are able to set up this modality for patients.
Responsive Neurostimulation (RNS) of the Centromedian Nucleus (CMN) of the Thalamus for the Treatment of Drug Resistant Idiopathic Generalized Epilepsy (IGE)

Angelique Manasseh, Hannah Guider, Brooklynn Bondy, Sanjay Patra, David Burdette, M. Ayman Haykal, Nour Baki, Ashleigh Terrell, Michael Staudt, Christopher Parres, and Andrew Zillgitt

Publication Date: 5-9-2024

Idiopathic generalized epilepsy (IGE) accounts for nearly 1/3 of all epilepsies.

Approximately 20-30% of people with IGE are refractory to adequate anti-seizure medication trials.

RNS implantation is a unique closed-loop neuromodulation therapy, and case reports as well as case series have demonstrated improved seizure control in patients with drug resistant IGE.

More recently, targeting the centromedian nucleus of the thalamus with RNS has been explored as a potential surgical treatment option for patients with drug resistant IGE.
Timing is Everything! Ordering Newborn Screens Within the Correct Timeframe

Alison Mannella and Audrey Kalasky

Publication Date: 5-6-2024

Newborn Screening (NBS) is a public health program required by Michigan law to detect babies with rare but serious disorders that require early treatment. All babies should be tested to find the small number who look healthy but have a rare medical condition. The newborn screen is recommended to be drawn within 24-36 hours after birth, preferably within 24-30 hours of life.

At William Beaumont University Hospital, lab has a six-hour window to obtain a lab once the order is placed. Previously, the clinical assistant (CA) on the Mother Baby Unit (MBU) would enter the NBS order to be drawn when the baby was transferred from Labor and Delivery. The CA would adjust the timing of the lab draw to 24 hours of life. This allowed the NBS to be drawn within the preferred 24-30 hours after birth. The process was changed in the fall of 2023, requiring the registered nurse (RN) to input the order for the NBS. The RNs were not adjusting the timing of the lab draw when entered, and NBS were either not being drawn or missed the 24–36-hour timeframe. The window to obtain the NBS is critical to obtaining results as quick as possible.
Heartbeat In A Bottle Initiative

Miranda McFadden and Brooke Waligora

Publication Date: 5-6-2024

Death and the dying process are a reality on our unit, CICU. We take care of people who are at the end stages of chronic illness and acutely decompensate. When starting in the ICU, learning terms like “terminal wean” or “withdrawal of care” were used to communicate expected deaths between staff members. The healthcare culture around death in the CICU has been slowly changing toward a more holistic family-centered approach; however, we identified opportunities for improvement. We developed the Heartbeat in a Bottle Initiative. The aims of this project are to

a) Develop a Heartbeat in the Bottle Initiative Protocol

b) Help families with grieving process
Micro-Learning Improves Clinical Nurse Confidence and Success with Peripheral IV Insertion

Holly McGran, Lindsay Colby, and Patricia Delgado

Publication Date: 5-6-2024

Peripheral intravenous catheter (PIVC) insertion is an essential inpatient nursing skill, although it is infrequently practiced during nursing school. Difficulty with PIVC access leads to worse patient outcomes including delayed care, increased pain due to increased access attempts, and more frequent use of central venous access which can lead to increased morbidity and mortality (Amick et al., 2022). Our nursing staff on 6S GYN/MED expressed the desire for additional education and opportunities surrounding PIVC insertion, so we looked to the literature. A study by Keleekai et al. (2016) used a blended learning strategy of simulation-based learning and self-paced online education which showed significant improvements in nurse knowledge, confidence, and skills in PIVC insertion.

We also wanted to find a self-paced learning experience that was an alternative to hours of online modules or classroom instruction. Micro-learning is up-and-coming in the field of electronic learning that has a positive effect on the knowledge and confidence of health professionals using small volume tutorials, pictures, and short video clips (Zarshenas et al., 2022). We decided to utilize both micro-learning and the use of a hands-on venipuncture practice arm to educate and instill confidence in our clinical nurses surrounding PIVC insertion.