Patient Care Delivery and Outcomes

Family Centered Care

The delivery of nursing care to children at Nicklaus Children's Hospital is guided by principles of Family-Centered Care. The Nursing Department believes that each child is unique and an integral part of the family unit. Families are involved throughout the course of their child's care and are considered valued partners in the delivery of care. At all times, the nursing team strives to respect the dignity, values, religious and cultural beliefs of children and families.

All aspects of nursing care at Nicklaus Children's Hospital revolve around the concept of incorporating the parent and child's needs into the care of the child. Nicklaus Children's Hospital recognizes that supporting the needs of the patient, their family and their caregivers facilitates their involvement in the planning and delivery of care.

Nicklaus Children's Hospital accomplishes this by utilizing the following:

Comfort Model

The Nursing Department’s Conceptual Framework is Katharine Kolcaba’s Comfort Model. Nurses at Nicklaus Children's Hospital provide comforting measures for patients with an expectation of positive outcomes as described in The Comfort Model. The Comfort Model reinforces the need to comfort nurses. Dr. Katherine Kolcaba’s Comfort theory is embedded within Nicklaus Children's Hospital and its employees. Dr. Kolcaba addresses comfort utilizing the four contexts of holistic human experience listed below:

Physical

  • Breaks
  • Gym, healthy lifestyle incentives

Psycho-spiritual

  • Employee Assistance Program
  • Nursing support groups for new nurses
  • Leadership support and encouragement
  • Schwartz Rounds
  • CHAT
  • Project Dear
Sociocultural
  • iCREATE Way - our organizational culture
Environmental
  • Adequate staff and resources to perform job duties
  • Healing Garden
  • Serenity Rooms

Evidence-Based and Outcome-Driven Practice

The Nursing Department at Nicklaus Children's Hospital supports, engages, and empowers nurses to initiate nursing research, evidence-based practice (EBP) projects, and quality improvement initiatives throughout the organization. Nurses at all levels of care are continuously encouraged to explore and apply the most current and best practices, as well as to generate new knowledge when an identified need arises. Integration of EBP and nursing research into clinical and operational processes aligns with the Nursing Department’s commitment to provide high quality care and positive patient outcomes. Dr. Danielle Altares Sarik PhD, APRN, CPNP-PC directs nursing research through her role as Research Nurse Scientist at Nicklaus Children’s Hospital.  

At Nicklaus Children’s Hospital we constantly evaluate, critique, and update nursing practice based on emerging evidence, patient- and family-outcomes, and evolving best practices. In order to guide nursing practice, the Johns Hopkins Evidence-Based Practice Framework is taught to all incoming nurse residents, and continually reinforced to nursing staff, from leadership to bedside. By providing nurses with the tools to evaluate and apply evidence, we create a solid foundation for quality patient care and improved outcomes.

The Department of Nursing, in collaboration with inter-professional stakeholders, reviews and adopts position statements and standards of practice in alignment with groups such as the ANA Society of Pediatric Nurses, and American Academy of Pediatrics. We provide nursing leadership in the dyad model to the Clinical Effectiveness and Pathways Committee, which reviews and incorporates best evidence into practice at the hospital level.

Each nurse is an advocate for their patients and the families to whom they provide care, and we promote nurse autonomy at Nicklaus Children’s. It is of utmost importance that each nurse is able to practice to the full scope of their license and training, utilizing critical thinking, flexible problem solving, creativity, and scholarship to achieve optimal patient outcomes. We practice in collaboration with our inter-professional partners, and are full and valued members of the care team.

Ethics & Compliance

Nicklaus Children's Hospital has established a compliance department and program to advance the prevention, detection, and correction of violations of federal, state or local law or regulations governing health care and human services programs by employees, contractors or agents. The compliance staff is available as valuable resources in decision-making processes or to answer questions regarding the ethical conduct of practice at Nicklaus Children's Hospital. The Interdisciplinary Bioethics Committee is a forum that is consulted upon to hear complex ethical issues and provides directives for the healthcare team to address and to provide best practice to the ill and hospitalized child.

Magnet Standards

The American Nurses Credentialing Center (ANCC) Magnet Recognition Program recognizes healthcare organizations such as Nicklaus Children's Hospital for exceptional quality in patient care, nursing excellence and innovations in nursing practice. The Nursing Department at Nicklaus Children's Hospital strives to continuously meet and exceed these standards providing high-quality patient care with improved patient outcomes and patient satisfaction.

iCREATE Way

iCREATE Way is a system-wide training program developed with staff input reflecting expected work behaviors and the creation of a positive work environment as well as a positive patient/family experience. The organizational values and guiding behaviors of collaboration, responsibility, empowerment, advocacy, transformation, and empathy are discussed with demonstrations on how to practice these behaviors in the workplace. The iCREATE training empowers nurses to be better professionals that will in turn provide better care; therefore, further improving customer satisfaction.

Horizon Nurse Residency Program

In 2014, Nicklaus Children’s Hospital created the Horizon Nurse Residency Program, an ANCC accredited evidence-based nurse residency program for new graduate nurses. The Horizon Nurse Residency Program provides an extensive orientation that allows nurses to effectively transition into their new role as a registered nurse in an acute care pediatric setting. Training consists of didactic classes, skill training, simulation labs, unit-specific training with a preceptor, and self-directed computer modules. The program offers training within hospital units including the ICU setting, hematology-oncology, Emergency Department, and the ICU Float Pool, with the duration varying by unit of hire. The Horizon Nurse Residency Program prepares graduate nurses in every way possible to create a competent and happy workforce.

Bridge Nursing Program

In the 2016, the Bridge Nursing Program was developed to successfully onboard experienced nurses without acute care pediatric nursing experience. The program was created in alignment with key attributes from the Horizon Nurse Residency Program, which has improved outcomes such as increased retention and engagement. The Bridge Nursing Program training utilizes various educational modalities such as didactic classes, skill training, simulation labs, unit-specific training with a preceptor, competency-aligned performance, and self-directed online modules. Due to the transition nurses’ previous knowledge and experience, these nurses have a shorter clinical orientation time.

The Bridge Nursing Program qualifications includes any registered nurse with less than 6 months of acute care RN experience. The Bridge Nursing Program prepares experienced nurses in every way possible to create a competent and happy workforce.