Skip to main content Skip to navigation Skip to navigation
  • 844-4CHILDRENS (844-424-4537) 844-424-4537
  • Patient Login (MyChart) Visit our MyChart Guide to learn more about how to create and use your MyChart account.
  • Employee and Provider Login
  • Pay My Bill
  • Careers
  • Donate Now
Visit the home page

No disponible en español

  • Home
  • Treatment
  • Patient Families
  • Visitors
  • Provider Resources
  • Research and Innovation
  • Health and Community Resources
  • Donate or Volunteer
Visit the home page
Call children's health Access medical records by logging in to MyChart Find Bill Pay options here Find Children's Health Locations Find Children's Health Doctors
  • Home
  • Treatment
    • Treatment Home
    • Departments and Programs
    • Conditions and Treatments
    • Preventative Care and Immunizations
    • Primary Care
      • Primary Care
      • Primary Care Home
      • When to See a Primary Care Physician
      • New Patient Information
      • Preparing for Your Appointment
    • Urgent Care
    • Emergency and Trauma Care
    • Outpatient Pharmacies
    • Specialty Pharmacy
    • Remote Patient Monitoring
    • Rehabilitation and Therapy Services
      • Rehabilitation and Therapy Services
      • Rehabilitation and Therapy Services Home
      • Integrated Therapy
    • Virtual Care
      • Virtual Care
      • Virtual Care Home
      • School-Based Programs
      • Virtual Visit
      • Virtual Visit Specialty Clinics
    • Find a Doctor or Provider
    • Find a Location
    • Request an Appointment
    • US News and World Report 2022 - 2023 Ranking

      Proud to be ranked in all 10 pediatric specialties the last five years.

  • Patient Families
    • Patient Families Home
    • Resources for Your Child
      • Resources for Your Child
      • Resources for Your Child Home
      • School Services
      • Transitioning to Adult Care
      • Activities for Kids
      • Child life
    • Parent Resources
      • Parent Resources
      • Parent Resources Home
      • Language and Interpreter Services
      • Hospital Guide
      • Social Work
      • Family Resource Library
      • Medical Records Request
      • MyChart Guide
      • MyChart Bedside
      • Patient Experience
      • Preparing for Your Visit or Stay at Children's
      • Spiritual Care and Education
      • Mobile App
      • Family Advisory Network
    • Travel and Lodging
      • Travel and Lodging
      • Travel and Lodging Home
      • Patient Family Lodging
      • Public Transportation
    • Diversity and Inclusion
    • Billing and Insurance
      • Billing and Insurance
      • Billing and Insurance Home
      • Pay My Bill
      • Family Guide to Billing
      • Billing Dictionary
      • Financial Assistance and Support
      • Common Billing Questions
      • For Patients with Insurance
      • Your Rights and Protections Against Surprise Medical Bills
      • Cost Estimates
    • Write a Review
    • Weather Updates
  • Visitors
    • Visitors Home
    • Policies and Procedures
      • Policies and Procedures
      • Policies and Procedures Home
      • Contacting a Patient
      • Visiting Hours and Policies
    • Hospital Guide
      • Hospital Guide
      • Hospital Guide Home
      • ATM Locations
      • Dining and Food Services
      • Gift Shops and Retail
      • Courtyard
      • Wheelchair and Disability Accessibility
      • Parking
      • WiFi and Internet Access
      • Frequently Asked Questions
      • Guest Relations
      • Amazon Hub Lockers
      • Charging lockers
    • Amazon Lockers Logo with Lockers

      Children’s Health is proud to become the first pediatric health system in the country to offer Amazon Lockers, self-service kiosks that allow you to pick up your Amazon packages when and where you need them most – 24 hours a day, seven days a week. Learn more about Amazon Lockers.

  • Provider Resources
    • Provider Resources Home
    • Refer a Patient
      • Refer a Patient
      • Refer a Patient Home
      • Direct Admit
      • Request Medical Transport
      • Contact my Provider Liaison
      • Email Sign up Provider Newsletter
      • Login to Provider Portal
      • Provider Tools
      • Infusion Therapy Referrals
    • Education and Training
      • Education and Training
      • Education and Training Home
      • Fellowship and Subspecialty Training Programs
      • Pediatric Residency
      • Administrative Fellowship
      • Vizient/AACN Nurse Residency
      • Continuing Education
      • Pharmacy Residency
      • Clinical Pastoral Education
      • Child Life and Music Therapy Training Opportunities
      • Pediatric Emergency Services Network
      • Student Affiliations
      • Student Internships
      • Pediatric Advanced Life Support (PALS)
      • Scholarships
      • Andrews Physical Therapy Residency
      • Community Partner
    • Medical Staff Services
    • Nursing Services
      • Nursing Services
      • Nursing Services Home
      • Our Nurses
      • Our Nursing Model
      • Nursing Annual Report
      • Nursing Transition to Practice Programs
      • Nurse Externship
  • Research and Innovation
    • Research and Innovation Home
    • Clinical Trials
      • Clinical Trials
      • Clinical Trials Home
      • Research FAQs
      • Why is Research Important?
      • Research Glossary
      • Pediatric Clinical Trials & Experimental Medication
    • Research Focus Areas
      • Research Focus Areas
      • Research Focus Areas Home
      • Cardiology
      • Endocrinology
      • Gastroenterology
      • General Surgery
      • Hematology & Oncology
      • Neonatal/Perinatal
      • Nephrology
      • Neurology/Neurosurgery
      • Pulmonology
      • Urology
    • Publications
    • Research Library
    • Innovation
      • Innovation
      • Innovation Home
      • PEDS Score
      • Hackathons
      • Telemedicine
      • Center for Clinical Simulation
      • Mobile Resources
  • Health and Community Resources
    • Health and Community Resources Home
    • Health & Wellness Library
    • Community Resources
      • Community Resources
      • Community Resources Home
      • Family Education
      • School-Based Partnerships and Programs
      • Children’s Health Care Network
      • Resources for Transgender Youth and Their Families
    • DFW Children's Health Assessment
      • DFW Children's Health Assessment
      • DFW Children's Health Assessment Home
      • Beyond ABC Symposium
    • Podcasts
    • Expansion Projects
    • Fight Seasonal Allergies

      Fight seasonal allergies in kids. Learn more.

  • Donate or Volunteer
    • Donate or Volunteer Home
    • Volunteer
      • Volunteer
      • Volunteer Home
      • Adult Volunteer Program
      • Student Volunteer Program
      • Volunteer Pet Therapy Program
      • Group Service Projects and Events
    • Donate
      • Donate
      • Donate Home
      • Donate Items
      • Make a Financial Gift
      • Handcrafted Items
    • Share Your Story
{}
Exemplary Professional Practice

Exemplary Professional Practice

Every day, nurses at Children’s Health expand and nurture their role with patients, families, the community and team members. They demonstrate their commitment to professional nursing by applying new evidence to drive innovative best practices that improve their workplace and enhance children’s lives. In 2022, our nurses applied new knowledge by:

  • Launching an RN clinical coach model to advance cardiac clinical nursing care
  • Reducing pressure injuries in the pediatric intensive care unit
  • Standardizing evidence-based prevention techniques for central line-associated bloodstream infections (CLABSIs) in the cancer center
  • Reducing incidents of workplace violence through consultation of clinical nurse experts

Coaching to Enhance Proactive Thinking and Advance Clinical Care

Research shows that surgical mortality for inpatients in pediatric cardiac care is significantly impacted when more than 20% of nursing staff have less than two years of experience. As our overall RN experience level began to decrease in the Cardiac Intensive Care Unit (CICU), nurse leaders developed a new clinical coach model to advance new nurse competency and critical thinking skills.

The model’s goals:

  • Accelerate newer nurses’ clinical reasoning and decision-making
  • Retain highly skilled, expert nurses at the bedside

Coached staff quickly began to see the personalized, in-depth training gave them a deeper understanding of complex patient anatomy and physiology, allowing them to anticipate clinical changes and respond quickly. After the traditional, intense, nurse residency orientation to CICU, graduate nurses are paired with a coach for one shift every three months for their first three years.

“Our inpatients are sicker and more fragile than ever before. Proactive coaching accelerates how quickly new nurses recognize the subtle signs of patient deterioration. It’s also a great source of pride for our experienced nurses to help them on this journey.”
Andrea Torzone, ARNP, CPNP, CNS, Clinical Nurse Specialist, CICU

Coaches plan their shifts in advance, shaping the day according to nurse need and patient acuity. Coaches also focus on junior preceptors and nurses new to high-risk modalities, such as ventricular assist devices and renal replacement therapy.

Surveys reveal an increase in nurse-reported preparedness to effectively care for patients and increased confidence at the bedside. Turnover has been significantly reduced, and experienced nurses appreciate a chance to advance in their career without moving away from direct patient care. This innovative coach program is being spread to the other critical care areas.

Reducing HAPIs in PICU Patients

Guidelines call for pediatric intensive care unit (PICU) patients to be turned every two hours. However, critically ill and unstable patients can respond poorly to being repositioned. The organization saw rates of serious hospital-acquired pressure injuries (HAPIs) increasing and sought to understand why. Personal observation by a senior nurse and surveys indicated nurses and doctors sometimes avoided or delayed turning routines due to fears of clinical deterioration in an unstable patient.

An interdisciplinary team of nurses, doctors, physical and occupational therapists, and wound care specialists conducted a literature review.

“There is lots of pressure on nurses to decrease pressure injuries, but not much in the literature specific to high-risk pediatric patients. Our interdepartmental team is changing that.”
Ginger Young, MSN, APRN, PCNS-BC, Clinical Nurse Specialist, PICU

The HAPI team developed a clinical practice guideline based on their combined expertise and evidence adapted from the literature on adult patients. A short trial allowed the guidelines to be fine-tuned after PICU nurse feedback before full-scale adoption. The nurses now feel empowered to discuss medically unstable patients during daily rounds, suggesting strategies to decrease HAPIs proactively.

All PICU staff are trained in the new guidelines and partner on safe, smaller repositioning techniques rather than full turns when a patient is unstable. A video was created to demonstrate various methods and tools nurses and physical therapists can use for smaller repositioning.

Best-In-Class CLABSI Prevention

Approximately 80% of Children’s Health oncology and stem cell transplant patients have an indwelling central line. Central lines allow the clinical team to obtain the necessary lab work to evaluate a child's condition and to safely and effectively infuse medications, such as chemotherapy.

Every time a central line is accessed, there’s an opportunity to prevent or introduce an infection risk. For the last three years, the central line-associated bloodstream infection (CLABSI) rate for the Pauline Allen Gill Center for Cancer and Blood Disorders outperformed the national average by 50%.

These outstanding results are the product of a multi-year effort by the nursing team to build tools, checklists and processes for accountable behaviors that minimize CLABSI infections. During 2021 and 2022, this team added regular observations by a dedicated central line nurse to validate competency for all nurses, including new graduates and temporary agency nurses.

The dedicated central line nurse conducts clinical surveillance rounds on patients, provides real-time coaching to team members on central line management and unique dressings, and performs audits to ensure CLABSI best practice adherence. This dedicated nursing resource also educates families on ways to reduce infection risks.

“We hypothesized that everyone was following protocols and using the CLABSI bundle accurately and correctly, given our results. This year we verified that evidence-based nursing interventions are making the difference.”
Susan McCollom, ND, RN, CPHON, BMT-CN, Clinical Manager, Hematology/Oncology

Reducing Workplace Violence and Improving Patient Safety

Like all pediatric hospitals in the United States, Children’s Health nurses experienced higher rates of abuse, assaults and harassment from patients in 2021. A lack of child and adolescent mental health care was exacerbated during the COVID-19 pandemic, leaving lasting effects on our youth. On top of this, our nurses were seeing more inpatients with increased behavioral health concerns in conjunction with comorbidities, such as asthma, diabetes or cystic fibrosis.

Nursing staff feedback revealed that current methods of patient management were not effective enough to address this growing population of patients.

Children’s Health surveyed nurses about their top concerns in caring for patients with mental health needs, then tailored a rapid response to address those concerns using our Professional Practice Model for Nursing.

First, a new role, psychiatric resource nurse, was created and filled from the existing psychiatry teams. They provide real-time, in-person support and training upon a nurse’s request for a consult. They also connect medical patients and clinical nurses with the Behavioral Emergency Response Team (BERT) and coach nurses new to the complex charting of behavioral issues.

Literature shows that adverse childhood experiences can negatively affect how pediatric patients respond to stress and hospitalization. These expert psychiatric RNs focus on de-escalating a patient’s behavior through real-time demonstration of evidence-based best practices in intervention strategies and techniques.

This new role was overwhelmingly successful, decreasing the nurse assault rate (including patient hitting, punching, slapping, biting and kicking) from 2021 to 2022. Nurses report feeling more confident in de-escalating strategies and greater knowledge of in-house and community resources available for their patients and themselves.

Share:
2d0b3b0e-2b8a-4aa1-8160-69a6b85e58ea
We’re growing in Dallas and Plano!
View our nursing jobs

  • Nursing Annual Report
    • Transformational Leadership
    • Structural Empowerment
    • Exemplary Professional Practice
    • New Knowledge, Innovation and Improvements
    • Past Nursing Annual Reports
Follow Children's Health on social media
Facebook Twitter Instagram YouTube Linked In
Subscribe to our email newsletter
1935 Medical District Drive Dallas, Texas 75235 844-4CHILDRENS 844-424-4537
  • Why Children's Health
  • About Us
  • Diversity and Inclusion
  • Our Difference
  • Our People
  • Sustainability Program
  • Working at Children's Health
  • Careers
  • Employee Resources
  • Billing and Insurance
  • Cost Estimates
  • Policies and Procedures
  • Patient Rights and Responsibilities
  • Notice of Privacy Practices
  • Terms of Use
  • Quality and Safety
  • Complaint Resolution
  • International Patient Services
  • CHNA Report
  • Supplier Portal
  • Media Toolkit
  • Newsroom
  • Gain template information in the Brand Center
  • Shop Children's Health
  • Contact Us
  • Sitemap
  • Accessibility
Badge: Institutional member - Children's Hospital Association

© 2023 Children's Health. All rights reserved.