New nurse-led research into bedside healthcare places focus on improving patient outcomes, addressing points of quality, compassion and dignity.

New diagnostic tools, procedures, medications and treatment programs have advanced healthcare over the decades, the products of high level physician research.

At the same time, hands-on patient care continues to improve in Providence St. Joseph Health hospitals across Los Angeles and Orange counties, thanks to research conducted by nurses whose sole focus is excellence in bedside care.

Providence St. Joseph Health, Southern California, will hold its annual Research and Evidence-based Practice Day Tuesday, sharing successful projects that have addressed everything from managing cancer patients’ pain to safeguarding their dignity.

“Nurses are the front lines in hospital care and are the experts in determining how to continuously improve bedside care,” said nurse Sherri Mendelson, director of research at Providence Holy Cross Medical Center who is coordinating Tuesday’s program. “Their research addresses a multitude of focus areas to improve patient outcomes by looking for areas for improvement and testing solutions.”

Nurse Marysol Cacciata leads the research council at St. Jude Medical Center in Fullerton.

“Nursing research is focused more at improving patient outcomes,” Cacciata said. “It overlaps with research by doctors and scientists who are looking at the disease. Nurses are looking at how to impact patients’ lives.”

Melissa Reilly, a St. Jude critical care nurse, wanted to help patients on ventilators better communicate when the tube down their throats prevents them from speaking.

Reilly created a board with pictures, signs and wording patients point at to communicate. She measured outcome by comparing patients’ satisfaction before and after and found a vast improvement. The result: the hospital will buy 10 iPads with communication apps for patients unable to speak.

Such efforts improve patient satisfaction, which not only matters for professional and ethical reasons, but for hospital funding. U.S. hospitals’ reimbursements for Medicare and MediCal are based in part on Hospital Consumer Assessment of Healthcare Providers and Systems – HCAHPS – surveys of a random sample of patients after they leave the hospital.

On Tuesday, a nurse from Providence Holy Cross in Mission Hills, Carolyn McManus, will present research that indicates many new nurses did not learn to effectively assess pain in cancer patients during their clinical rounds while in nursing school. Because of this research, a problem has been identified and solutions considered to help ease the suffering of these most vulnerable patients.

At Providence Little Company of Mary Medical Center Torrance, nurses sought to improve patient outcomes on their medical-surgical unit by encouraging co-workers to earn national certification in this specialty to advance their skills, said nursing research coordinator Trisha Saul.

Nurses were provided with education resources, encouragement and in some cases scholarships to fund testing. Review questions would be asked during daily huddles, and mentors worked with colleagues to help them pass their tests. The unit experienced a 10 % increase in nurse-certified nurses.

Similarly, nurses worked together at Little Company of Mary to coach one another on communications skills to ensure patients were kept informed of their care plans and progress. The results surpassed their goal – patient scores on how they were kept informed increased from 66.2% to more than 71% over 8 months.

In another study at St. Jude, a nurse sought to stop frequent interruptions while distributing medications because timing is important to maintain the proper levels of medications in the bloodstream. Signs were posted to avoid interruptions between 8:30 and 9:30 a.m., and calls were handled by the charge nurse.

The results included on-time distribution and more time with patients to explain medications. The rate of delays fell from 1.13% to 0.35%.

Holy Cross nurses Elizabeth Mayfield and Martha E. F. Highfield, seeking to define courtesy and respect, found patients appreciated nurses who listened to their life stories and who shared their own. The nurses came away with some surprises. One of the HCAHPS, questions asks if patients were treated with courtesy and respect.

“Smiling and listening to the patients was important, but that was not what we expected to hear,” said Mayfield, who now works at sister hospital St. Joseph Hospital in Orange. “Nurses have training on cultural awareness; we address personal preferences, values and cultures. That’s important to patients but they didn’t verbalize it that way. For them it was simply about how the nurses made them feel.”

Not all research is focused on direct patient care. St. Jude created Tea for the Soul to ease the burdens on nurses who work in more stressful areas – the ICU and the Emergency Department, for example.

Coordinated by the spiritual care department, a chaplain visits a few times a week with bring tea and cookies and offers to talk with nurses feeling particularly drained. Nurses appreciate the break and feel they’re being supported and renews their sense of purpose.

“It reminds you why you are a nurse,” Cacciata said.

Ed. Note: This press release provided to KHTS by Providence Saint Joseph Health.

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