 

Ashlee Staley, Julia Badalov, Morgan Del Principe, Kylie Newman, Carolina Ley

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Carondelet St. Joseph’s Hospital
Neonatal Intensive Care Unit (NICU)
Focus: Education and training regarding amount
of IV insertion attempts on the NICU

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 Quantum leadership “builds on transformational
leadership and suggests that leaders must work
together with subordinates to identify common
goals, exploit opportunities, and empower staff
to make decisions for organizational productivity
to occur”.
 Charge RN meets with staff before the start of
shift to discuss goals and concerns
 Charge RN encourages staff to make decisions
about the unit and care given
Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions
in nursing: Theory and application (9th ed. p. 72). Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins. 3
 “A constructive culture requires interpersonal
and communication skills to ensure a shared
culture and patterns of change.”

 Manager not readily available

 No Rapid Response Team used
 Meeting/huddle at shift change
 No hospital wide
Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in
nursing: Theory and application (9th ed. p. 306). Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins.

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 Patient Focus: Core concepts that drive care (all patient-centered)
o Emotional support
o Respect for patients’ preferences and values
o Physical comfort
o Information, communication, and education
o Continuity and transition
o Coordination of care
o Access to care
 Staff Focus
o Career development
o Regular staff meetings
o Fair holiday scheduling
o Diversity in workforce

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management

functions in nursing: Theory and application (9th ed.). Philadelphia: Wolters
Kluwer Health/Lippincott Williams & Wilkins. 5
❧ Team based care teams lead to a commitment to
patient-centered care, better coordination of care
and an increase in collaborative problem solving
❧ Physicians perform morning rounds
❧ Physicians and Nurses work alongside each other
❧ Physicians’ offices are located on the unit
❧ Physicians and Neonatal Nurse Practitioners are
very encouraging and love to teach
❧ Occupational therapy on the unit Monday-Friday to
assist with feedings and teaching families about
care
❧ Minimal number of patients and have the time to
spend with them
Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management
functions in nursing: Theory and application (9th ed.). Philadelphia: Wolters
Kluwer Health/Lippincott Williams & Wilkins. 6
  Most hospitals now utilize hospital information systems which act as
“internal electronic data repositories as a way of cataloging internal
reference materials, such as policy and procedure manuals.”
 The American Recovery and Reinvestment Act pushed for health
care organizations to implement electronic health records (EHRs).
St. Joe’s utilizes Cerner as their current EHR program.
 WLAN connections (transmits vitals to Cerner, etc. Use of Voceras)
 Technology as an adjunct to nursing practice
o Internet as a communication tool and information source
o Potential for major breaches in confidentiality (i.e. social media
usage)
o Must find a balance between technology and need for human
touch
Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management
functions in nursing: Theory and application (9th ed. pp. 506-512). 7
Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
 Utilizationof audits as a quality control tool
o Outcome audits
o Process audits
 Benchmarking- measures best practices against
best performing organizations nationally
 Unit specific council that discusses areas for
improvement and what needs to be done to
address the change
Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management
functions in nursing: Theory and application (9th ed.). Philadelphia: Wolters
Kluwer Health/Lippincott Williams & Wilkins.
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❧ “The performance appraisal is more likely to have a
positive outcome if the appraiser is viewed with trust and
professional respect”
❧ Performance appraisals of staff each year
❧ Staff is evaluated by their charge nurses because
they work most closely with the staff
❧ If a new grad- after first month, after first 3 months,
after first 6 months, and then after first year
❧ Open unit where all members feel comfortable
discussing their concerns and improvements

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management

functions in nursing: Theory and application (9th ed. p. 649). Philadelphia:
Wolters Kluwer Health/Lippincott Williams & Wilkins. 9
  Education and Training
 Numerous attempts to start peripheral IV
catheters in NICU patients.
 Evidence-Based: Peripheral IV starts on NICU
patients should be limited to no more than 2
attempts.
 Increase training for peripheral vein cannulation
in neonates.
 Vascular access specialist team
Legemaat, M., Carr, P. J., van Rens, R. M., van Dijk, M., Poslawsky, I. E., & van den Hoogen, A.
(2016). Peripheral intravenous cannulation: Complication rates in the neonatal population: A
multicenter observational study. Journal of Vascular Access, 17(4),360 ̶ 365. 10
 Presentation of project to staff:
o Provide staff with patient data about how patients often receive
more than two IV start attempts from a single nurse even though
protocol states each nurse should have no more than two
attempts (Rational-empirical strategy)
o Ensure leaders are on board and will be a part of the education
and training processes to help influence the staff to make
needed changes (Normative-reeducative strategy)
 Education and training given to all RNs providing care on the NICU
o Provide education regarding reasons to limit number IV start
attempts
o Provide skills review and training regarding best practice when
starting an IV on a neonate
 Evaluate effectiveness of education and trainings on reduction of IV
insertion attempts

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 6th month

4th-5thmonth
Outcome
3rd month audit
Actively
2nd month ensure IV
Complete protocol is
1st month RN being
Enlist education followed by
educators/ and each RN
Process trainers, trainings
audit develop
program

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 Legemaat, M., Carr, P. J., Van Rens, R. M., Van Dijk,
M., Poslawsky, I. E., & Van Den Hoogen, A. (2016).
Peripheral intravenous cannulation: Complication
rates in the neonatal population: A multicenter
observational study. Journal of Vascular Access,
17(4),360 ̶ 365. doi:10.5301/jva.5000558
 Marquis, B. L., & Huston, C. J. (2017). Leadership
roles and management functions in nursing: Theory
and application (9th ed. p. 649). Philadelphia:
Wolters Kluwer Health/Lippincott Williams & Wilkins.

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