Nursing Outreach: building partnerships to enhance care
by Mary Pat McGinnes, Children’s Hospitals and Clinics of Minnesota
Whether they need assistance caring for a patient in crisis, are unsure about preparing a newly diagnosed asthma patient for discharge, or want to improve their ability to provide culturally sensitive care, nurses at Children’s Hospitals and Clinics of Minnesota have a range of nursing experts at their fingertips. They are further supported by a multidisciplinary team who provide critical insights and interventions—respiratory therapists, child life specialists and more. But those pediatric resources are not so readily available for nurses in smaller communities or at hospitals with few pediatric specialty services.
To provide children with comprehensive care over a continuum of health and illness, we depend on nursing colleagues throughout the community and region. As a specialty pediatric hospital, Children’s feels an obligation to share its nursing expertise. While Children’s has had a medical outreach program for some time, nursing outreach is relatively new. Phil Kibort, M.D., M.B.A., chief medical officer, says that several years ago, he and others at Children’s began to realize that “we were missing an important nursing component in our outreach efforts. Not only were we hearing from nurses themselves, but there were also physicians who were requesting support for nurses in their local hospitals.”
In addition, when Ginger Malone, M.S.N., R.N., became chief nursing officer, “she really recognized the role that nurses could play in outreach. She saw that it could help improve care in the region as well as allow Children’s nurses to share their knowledge,” says Kibort.
In 2005, Children’s developed the role of nursing outreach and created two new positions. Lynn Eidahl, R.N., M.A., is outreach nurse liaison and focuses on pediatric nursing outreach; Jill Bauer, B.S.N., R.N., is neonatal outreach nurse liaison.
Although Eidahl and Bauer coordinate much of the work, nursing outreach wouldn’t exist without the participation of many. “We depend on nurses throughout Children’s who share their expertise and collaborate with us to support nursing outreach efforts,” says Eidahl.
Eidahl and Bauer say that a successful nursing outreach program hinges on building relationships. They make regular visits to hospitals in Children’s referral region to learn first hand about their needs and to share information about Children’s nursing resources.
“I really enjoy meeting with the nurses from different hospitals,” says Eidahl. “Sharing our expertise is very satisfying and I am always impressed by the experiences these nurses describe—an emergency department nurse in a small hospital may go from caring for a sick newborn to an adult trauma patient in the same shift.”
The backbone of nursing outreach is the Speakers Bureau, which sends caregivers from Children’s to hospitals throughout the region. Currently, 128 nurses are registered in the nursing outreach database as presenters. Last year 45 nurse-based Speakers Bureau events reached more than 1,000 nurses. One of the most popular topics is S.T.A.B.L.E. (sugar, temperature, airway, blood pressure, lab work and emotional support), a nationally recognized eight-hour program that helps nurses care for a premature or sick newborn during the post-resuscitation/pre-transport stabilization period. “At some of the smaller hospitals, nurses may not see a critically ill infant more than once every six months. This program helps them know exactly what to do until the transport team arrives so that when the team does arrive, they can just scoop up the infant and go,” says Bauer.
In addition to the Speakers Bureau, Children’s reaches out to nurses through conferences, nurse shadowing, rural nurse manager meetings, and streaming education.
Collaborative projects extend Children’s reach
Nurse experts throughout Children’s Hospitals and Clinics of Minnesota collaborate with many organizations to create innovative outreach programs for pediatric health care providers, such as:
Emergency care simulation. Karen Mathias, M.S.N., R.N., AP.R.N., B.C., director of simulation, oversees the Kohl’s Mobile Simulation Center—a specially designed motor coach staffed with experts in emergency simulations. It is the first pediatric program of its kind in the nation. Inside the center, participants work together on a simulated pediatric or neonatal emergency. The “patient” is a computerized mannequin that mimics symptoms of distress and responses to treatment. “In community hospitals, emergencies with children are less common and are especially stressful,” says Mathias. “Simulation training is a risk-free way for clinicians to understand each other’s roles, improve clinical skills, and learn to communicate in crisis situations.” A generous donation from Kohl’s Department Stores provided the initial funding for the project.
Palliative care. Jody Chrastek, M.S., R.N., C.H.P.N., pain and palliative care program coordinator, provides training, continuing education, resources, consultation and technical assistance to health care providers who are interested in developing more opportunities for pediatric palliative care in their communities. Children’s Institute for Pain and Palliative Care has received grants from the federal government, the Robert Wood Johnson Foundation, and the Bremer Foundation to support outreach activities. “There has been more interest in this area since the Institute of Medicine released a report in 2002 showing that pediatric palliative care lagged far behind adult palliative care,” says Chrastek. To meet the growing need, she and other colleagues have developed a variety of programs including inviting health care providers to attend workshops at Children’s, hosting regional workshops and following up with phone consultation and email. The pain and palliative care program also provides care for inpatients, outpatients, and home care patients.
“Inreach” is important, too
Gathering feedback from referral hospitals about their interactions with Children’s is another important part of outreach. “Part of doing outreach is actually doing ‘inreach’—using what we learn externally to change processes internally,” says Angela Stoltz, medical outreach program supervisor.
For example, neonatal transports are routinely reviewed. “This is a great way to identify opportunities to strengthen the relationships we have with referral hospitals. Children’s transport teams are at the front lines because they have direct contact with nursing colleagues in referral hospitals,” says Bauer.
While some might question whether sharing Children’s nursing resources so freely might hurt Children’s in the competitive health care marketplace, chief nursing officer Malone says that is not the case. “Outreach offers a way to learn from one another. Moreover, there is a strong commitment throughout the organization that nursing outreach is at the core of Children’s mission to provide next generation care.”
“Children’s is a leader in both neonatal and pediatric care, and as a leader it only makes sense that we would want to promote the best nursing care for all babies and children,” says Eidahl. By working with other hospitals Children’s strengthens nursing practice by continually evaluating processes and procedures.
More information is online. Go to the “Nursing at Children’s” page and scroll to the Nursing Resources links, or contact Jill at firstname.lastname@example.org or Lynn Eidahl at email@example.com or (612) 813-6904.