Nurse Recognition Week 2008 is our annual reminder of all the valuable work performed by nurses here in Georgia and across the country. While much time has been dedicated to issues of the demand and supply of these versatile and well-respected professionals, relatively less attention has been paid to the specifics of nursing work and the value found there. In acute care hospitals—the largest setting of registered nurse practice—nurses function with a broad spectrum of responsibilities that range from patient assessment to medication administration to health-related teaching. The number of work elements spanned and the pace at which nurses work have both been distinguishing features of nursing practice noted through the years, and they continue today. Because of this, nurses have been seen as masters in making systems work for patient care despite the inevitable obstacles in the way. The recent difference in considering the work of nurses is the increasing emphasis on the nurse as an agent of change in healthcare. The background for this observation is the national patient safety movement, which is motivating hospitals to critically consider and improve systems that impact patient outcomes.

As hospital leaders strive to improve performance and hardwire a culture of safety, nurses are often called upon to participate in developing more effective systems. The typical project includes tapping into nurses’ detailed technical knowledge of front line operations, utilizing their critical thinking skills and leveraging their ability to partner with other clinical disciplines to solve problems. Nurses review the literature for evidence-based information to use in enacting change and readily embrace the concept of learning from others’ experiences.

Here at North Fulton Regional Hospital there has been increased involvement and leadership of nurses in performance improvement initiatives. One example is found in the effort to prevent pulmonary embolism, which is the leading cause of death in hospitalized patients. Working with staff from the quality and pharmacy departments as well as key physicians, nurses assume responsibility for (1) crafting procedures to insure that each surgical patient’s risk of deep vein thrombosis is evaluated and (2) obtaining medical orders for appropriate preventative measures. When it was identified that emergency surgical patients were presenting challenges to the new system, staff instituted another checkpoint. As a result, prevention of thromboembolism has greatly improved.

Reducing urinary catheter infections in hospitalized patients is another important safety and infection control goal which has included staff nurse leadership. Recognizing that patients develop urinary infections from unnecessary or prolonged use of bladder catheters, nurses have participated in protocol development to prompt catheter removal through collaboration with physicians. The nurses have been involved in peer education to reduce the use of urinary catheters, and with regular assessments of these changes, nurses are working to ensure that the gains experienced become permanent.

Hourly staff rounding on patients is a recognized tactic to increase patient safety and satisfaction. Staff nurses, with support from their leadership, have developed an implementation plan to make this rounding a reality on medical and surgical units at North Fulton Regional Hospital. The staff determined what nurses and patient care technicians would contribute to the process, when it would occur and how it would be documented. They also developed key words to be used by staff in communicating with the patients and families in the hourly rounds. Each staff member is responsible for adjustments to the system over time to achieve project goals of reducing patient calls for assistance and improving clinical care.

As we celebrate the work of each member of the nursing profession this May, it is appropriate to salute nurses for making a difference in delivering care to their patients. We should also recognize and celebrate those nurses who are readily offering their unique insight and considerable energy to reshape healthcare. These individuals make our hospitals and the entire healthcare system stronger.

North Fulton Regional Hospital (NFRH), part of Tenet Georgia, is a 202-bed, acute-care hospital located on Highway 9, Alpharetta Highway, in Roswell. Opened in 1983, NFRH serves North Fulton and surrounding counties through its team of over 1000 employees, 400 staff physicians and 200 volunteers. NFRH is a state-designated Level II trauma center and provides a continuum of services through its centers and programs, including neurosciences, orthopedics, rehabilitation, surgical services, bariatric surgical weight loss, gastroenterology and oncology. The hospital is fully accredited and also is certified as a Primary Stroke Center by the Joint Commission on the Accreditation of Healthcare Organizations, the nation’s oldest and largest hospital accreditation agency.

For more information about North Fulton Regional Hospital and its various quality programs and services, call 770-751-2500, or visit www.northfultonregional.com.