New Knowledge, Innovation & Improvement

MultiCare nurses continue to advance the art and science of nursing through research, quality improvement efforts and a culture of clinical inquiry. Their efforts contribute directly to patient care, quality and safety outcomes, and the organization’s success. — and help fulfill our 10-year strategies of building and bringing technology and innovation to support nursing practice.

In addition to the work described in the next few pages, successes and highlights include:

• Collaborating with the staffing company Insight Global to hire and train nurses in the Philippines through our Grit Academy Fellowship Program. The medical-surgical fellowship helps nurses transition to clinical settings at MultiCare through a variety of coursework and lab simulations.
• Showcasing the skills, experience and knowledge of MultiCare nurses through 20 nursing publications, podium presentations and poster presentations.
• Creating “Zen dens” and respite rooms at various hospitals and clinics to allow for stress breaks.

A culture of innovation

Angela Bennett, MSN, MPH, RN, NPD-BC, CEN, NPD Generalist, Unit – Float Pool, The Center for Clinical Practice and Development

Jamie M. Emery, MSN, RN, NPD-BC, CEN, CFRN, Program Manager, RN Residency and Preceptor, The Center for Clinical Practice and Development

Jessica Paine, MSN, RN, CMSRN, NPD-BC, NPD Specialist, System, The Center for Clinical Practice and Development

Kelay Trentham, MS, Senior Operations Specialist, The Center for Clinical Practice and Development

Robin Petersen, MSN, RNC-OB, C-EFM, NPD-BC, Program Manager, Nursing Continuing Education

Thomas Purbaugh, MSN, RN, NPD-BC, CNL, CCRN-K, Program Manager for Special Projects, The Center for Clinical Practice and Development

The essence of nursing never changes — enhancing and advocating for the health and wellness of patients and communities.

What has changed significantly over the past 20 years is the environment in which nurses carry out their duties. More than ever, nurses are dynamic forces behind these changes, participating in process improvements and initiatives that transform health care.

In 2023, MultiCare nurses were at the center of this transformation, challenging the trends driving nurses across the country to leave the nursing profession: burnout due to isolation, lack of professional development and work without a clear purpose.

You read about our efforts to combat nurse burnout and build connections in the earlier “Shared voice, shared impact” story. Now we’ll turn our attention to new tools, resources and programs that position MultiCare nurses as innovators and leaders in our field.

Gratitude practices for Transition to Practice RNs

New graduate nurses in the Transition to Practice setting encounter stressors that can have a profound impact on their careers and lives. Jessica Paine, DNP, RN, CMSRN, NPD-BC, and Kimi Clark, MSN, NPD-BC, CCRN, conducted quantitative research to determine whether an intervention of gratitude education reduced perceived stress among this sample population.

Gratitude is a powerful force for well-being, with a real impact on physical health, emotional well-being, motivation, engagement and belonging. Gratitude is recognition that we have goodness in our lives, often from the actions of other people. When we’re grateful, we recognize the intention and effort behind those actions.

Paine and Clark introduced gratitude practice education to registered nurses with less than 12 months of acute care experience. They analyzed results within the Transactional Theory of Stress and Coping framework, which has been instrumental in shaping stress and coping research over the past several decades.

Major findings from this project provide new knowledge about the practice of gratitude and stress reduction among new graduate nurses. This includes recommendations for nursing leaders to promote the practice as a stress management strategy. Paine and Clark will present their results at the ANCC’s Transition to Practice Symposium in 2024.

Practical guide for team-driven quality improvement

A nursing team from MultiCare Tacoma General Hospital won most outstanding quality improvement (QI) project at MultiCare’s ninth annual Research Day. Kristin Johnson, Angela Bennett and Kim Thorvilson developed a user-friendly QI guide for team-driven projects using the ID-PDSA model (identify, determine, plan, do, study, act).

The guide is a step-by-step toolkit for facilitating interdisciplinary collaboration, engaging leadership teams and yielding measurable outcomes in tackling critical health care issues at the front line — all grounded in a rigorous scientific process and externally benchmarked outcomes.

The guide was developed and tested by Tacoma General’s shared leadership council, in collaboration with MultiCare’s operational excellence, quality and safety, and nursing research teams. It was also adopted as part of MultiCare’s systemwide QI process.

Nurses and other clinicians used the guide to advance practice and protocols, with projects ranging from evaluating oral care kits for VAP reduction and optimizing patient transfers to mitigating sepsis and enduring patient sunshine initiatives. Adopting the guide has emboldened frontline clinicians to adeptly confront obstacles, nurturing a spirit of ownership and empowerment.

The guide’s impact is also felt beyond MultiCare. It was presented nationally at AACN’s Transform Research Symposium and accepted at a global NurseCon conference. It is also being used as part of the MSN and DNP curriculums at several universities throughout the country.

Resuscitation Quality Improvement

By implementing Resuscitation Quality Improvement (RQI), MultiCare embraced the power of technology to transform CPR quality and save more lives.

Developed by the American Heart Association and Laerdal Medical, RQI is an on-demand training model for basic and advanced life support. Clinicians complete computer-based learning through a learning management system and hands-on skills training with real-time feedback at simulation stations.

Nurses have embraced RQI and its purpose of verifying learners’ competency and improving their skills via real-time feedback and coaching. Instead of being away from the floor for hours, clinicians can complete the skills training sessions in 15 or 20 minutes each quarter, ensuring regular practice and up-to-date CPR skills.

From implementation in March through Dec. 31, 2023, MultiCare nurses and other clinicians practiced more than 4.7 million individual compressions and over 982,000 individual ventilations.

After just one skills training session with feedback, passing scores improved by 14 percent for adult compressions, 53 percent for adult ventilations, 94 percent for infant compressions and 75 percent for infant ventilations.

Relias learning platform

MultiCare took a big step forward in professional development and transforming nursing practice with a new resource, the Relias learning platform.

We began with Relias OB, which is designed to build and reinforce the proficiency, knowledge and judgment of our obstetric nurses and improve care and outcomes for birthing patients and babies. Nurses use Relias OB to assess their current knowledge, judgment and areas of strength. Then the module validates their proficiency and tailors a learning plan based only on what they need to know.

Then we launched the course library for all nurses and staff, with 2,400-plus self-directed development modules for a variety of roles. Many modules offer accredited nursing contact hours (CEs) or continuing medical education (CME) credits.

We’ll continue to expand Relias in 2024, including adding Relias Clinical Assessments as a system learning needs assessment tool. Data gathered from these assessments will assist our nursing professional development team and operational leaders in identifying strengths and opportunities, leading to customized plans for professional development.

The Relias platform and modules add to a growing toolbox that helps us establish a baseline for our nursing practice and measure our future growth.