New Knowledge, Innovation and Improvements in Nursing at Inova

Inova Alexandria Hospital (IAH)

Non-Ventilated Hospital-Acquired Pneumonia (NVHAP) is a frequent and severe infection that can lead to increases in mortality and length of stay (LOS). Much attention is given to ventilator-associated pneumonia, however there is a lack of knowledge related to NV-HAP. To determine the extent of the issue at our facility, chart audits were performed on the designated inpatient unit for one calendar year. A bundle was developed by the inter-professional team utilizing risk factors identified in literature review and daily assessments. Over 100 patients were identified as high risk during the eight-week implementation period in 2017. Only two patients were identified as potential NV-HAP during the implementation period. This is a decrease of 66% when compared to the 2016 annualized expected rate and a 78% decrease compared to the same time period in 2016. As a result of these efforts, we’ve also achieved steady improvement in the “Attention to special/personal needs,” as captured in our patient experience scores.

Inova Fairfax Medical Campus (IFMC)

Integrating new knowledge and evidence into clinical practice is essential to continued professional development. Creating a culture of clinical inquiry requires that nurses continually ask questions about their practice. The Evidence-Based Nurse Residency Program implemented in October 2017, fosters a supportive environment enabling nurses to successfully transition to practice. Participation in the Inova System EvidencedBased Practice (EBP) Fellowship Program also facilitates the acquisition of new knowledge and skills. Two new graduates at IFMC created and implemented a pressure injury prevention bundle in the CCU in 2017 resulting in decreased hospital associated pressure injuries in their patient population.

Inova Fair Oaks Hospital (IFOH)

Nurses from IFOH consistently integrate evidence-based practice and research into their clinical practice. The nurses at IFOH express thanks to our colleagues in the Medical Library at Inova Fairfax Medical Campus who support our literature searches in an effort to identify best practices. Multiple evidenced-based practice projects were implemented at IFOH this year resulting in improved patient outcomes and experiences. Project results were disseminated both internally and externally at local, regional and national conferences. Research continues to be a focus including use of aromatherapy for pain control and nurses’ role in discharge planning for complex patients and impact on readmission rates.

Inova Loudoun Hospital (ILH)

Magnet^® Recognized organizations conscientiously integrate evidence-based practice and research into clinical and operational processes. This was evident at Inova Loudoun Hospital in 2017 with five ongoing research studies as well as three defined evidence-based practice projects. From dispelling the "sacred cow" that using a child’s IV for a blood draw would ruin the IV, to decreasing delirium in Intensive Care Unit (ICU), to using chewing gum to prevent an ileus, the culture of inquiry is supported and encouraged. Projects were disseminated via podium and poster presentations at local, regional and national conferences.

Inova Mount Vernon Hospital (IMVH)

IMVH nursing had four posters presented at the Inova Nursing Research and Evidence-Based Practice (EBP) Symposium conference in November 2017. The nurses from the Rehab units were awarded a grant to do an EBP project around the effects of structured discharge instructions as it relates to patient satisfaction and understanding. The team was awarded the best poster at the Inova Nursing Research and EBP Symposium. The project results showed significant improvement in Patient Satisfaction around discharge instructions.