Patient Care Delivery and Outcomes

Family Centered Care

The delivery of nursing care to children at Nicklaus Children's Hospital, formerly Miami 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 a family unit. Families are involved throughout the course of their child's care and are considered valued partners in care delivery. At all times, the delivery of patient care ensures respect for 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 patent, familu and caregivers facilitates their involvement in the planing and delivery of care. One example of supporting the needs of the family is the construction of the Michael Fux Family Center, a family friendly campus enhancement at Nicklaus Children's Hospital, formerly Miami Children's Hospital.

Nicklaus Children's Hospital, formerly Miami 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 as reinforces the need to comfort nurses. Dr. Katherine Kolcaba’s Comfort theory is embedded within Nicklaus Children's Hospital, formerly Miami 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
  • Free massage sessions
Psycho-spiritual
  • Employee Assistance Program
  • Nursing support groups for new nurses
  • Leadership support and encouragement
Sociocultural
  • MCHS Way- our organizational culture
Environmental
  • Adequate staff and resources to perform job duties

EBP/Outcome Driven Practice

Nicklaus Children's Hospital believes a critical component of the evaluation of existing nursing practise is the acceptance that nursing is an ongoing learning experience that must be constantly evaluated and adapted based on current evidence based best practises.

The focus on patient quality and outcome measurements of continuous improvement is integrated into nursing practice and in the foundation for improving patient outcomes. The Nursing Department establishes position statements and standards of practice in alignment with the ANA and Society of Pediatric Nurses. Assuring safety is principal in the delivery of quality patient care. Measures to assure safety are promoted and supported by technology such as Bar Coding for Medication Safety and wireless phones which connect the patient or doctor directly to their nurse. Ownership of the processes which promote patient safety and educational components based on the JCAHO National Patient Safety Goals is fundamental for all staff. We are committed to excellence in practice through nursing autonomy and the utilization of critical thinking. We encourage creativity, team work, and patient advocacy in achieving optimal outcomes for each individual and family. Our scope of practice extends beyond the walls of the institution into the community, through Nicklaus Children's Hospital's commitment to the promotion of health and wellness.

The Nursing Research department is led by the Director of Nursing Research who works to expand and advance nursing research and evidence ased practise throughout the organization.

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 of 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, formerly Miami 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.

MCHS Way

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

S.O.A.R.

Safety, Opportunity, Attitude & Responsibility (S.O.A.R) which was previously known as Life Wings ™ was an initiative originally started at Nicklaus Children's Hospital in 2009 to improve patient safety.

The emphasis of this program is enhancing communication, developing checklists to ensure standardization of processes (eliminating as much human error opportunities as possible) and creating enhanced teamwork among all staff members, ultimately improving patient safety.

Horizon Nurse Residency Program

In 2010, Nicklaus Children’s Hospital created the Horizon Nurse Residency Program, an evidence-based nurse residency program for new graduate nurses. It has been recognized as a best practice program for nursing education by the Nursing Executive Center of the Advisory Board Company. In 2014, the Horizon Nurse Residency Program was reformatted to include an extensive orientation which allows the nurses to effectively transition into their new role as a registered nurse in an acute pediatric setting. Training consists of didactic classes, skill training, simulation labs, unit specific training with a preceptor, performance demonstration, and self-learning computer modules. The Horizon Nurse Residency Program is the only entry point into the organization for new graduate nurses. Orientation varies from 4 months- 9 months depending on the unit of hire. The Horizon program hires three cohorts annually in March, July and November. The amount of candidates selected vary on unit and hospital needs, however, the amount hired has ranged from 25-50 graduate nurses per cohort. The Horizon Nurse Residency Program prepares graduate nurses in every way possible in order to create a competent and happy workforce.

Transitional Nursing Program

In the Spring of 2016, Susan Fornaris MHSA, BSN, RN, SCRN, CMSRN, Administrative Director for Nursing Operations and Medical-Surgical Nursing, identified a gap in the onboarding process of experienced nurses. In July 2016, the Transitional Nursing Program was created. The transitional nursing program was developed the program in alignment with key attributes from the Horizon Nurse Residency Program which has improved outcomes such as increased retention and engagement. The Transitional 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-learning online modules. Due to the transition nurses’ previous knowledge and experience, these nurses have a shorter clinical orientation time. Fornaris identified the qualifications for the Transitional Nursing Program as experienced nurses without pediatric acute care experience. The Transitional Nursing Program hires three cohorts annually in March, July and November. The amount of candidates selected vary on specific unit needs. To date each cohort has hired between 5-10 transition nurses. The Transitional Nursing Program prepares experienced nurses in every way possible in order to create a competent and happy workforce.