Nurse-led Initiatives Improve Cardiac Care in Underserved Communities

Empowered to initiate change and improve everyday processes, progressive care and critical care nurses at nine hospitals developed initiatives to address diverse healthcare challenges, with noteworthy clinical and operational results.

The results stem from the nurses’ participation in a yearlong, hospital-based nurse leadership and innovation training program offered by the American Association of Critical-Care Nurses (AACN).

AACN Clinical Scene Investigator (CSI) Academy is a team-oriented program that builds additional skills for direct care nurses and leverages their expertise, preparing and supporting them as clinician leaders who effect positive changes that improve patient, nurse and hospital outcomes. Nationwide, more than 469 nurses at 95 hospitals have completed the program since its launch in 2012. In total, the program has touched nearly 1.2 million patients and more than 6,150 nurses, with an estimated positive fiscal impact to hospitals of $89.1 million.

AACN provided the program free of charge to the nine most recent hospitals, thanks to a $200,000 donation from Edwards Lifesciences Foundation as part of its philanthropic initiative Every Heartbeat Matters. Cardiac surgery critical care and/or progressive care units selected for the Edwards-supported program were required to care for a significant proportion of patients from underserved* populations in the United States, with an emphasis on Black communities.

“As we mark this milestone 10th anniversary for CSI Academy, our ongoing partnership with Edwards Lifesciences Foundation means this transformational experience will continue reaching new communities,” said Dana Woods, AACN CEO. “The program’s expanded range makes it even more inclusive, with life-changing impact to under-resourced cardiac patients and their progressive and critical care nurses.”

During the 12-month all-virtual program, teams of nurses identified high-priority issues affecting their units and then developed, implemented and evaluated solutions. The clinical successes of their initiatives include achievements such as:

• Decreased healthcare-associated infections
• Reduced hospital-acquired pressure injuries
• Increased mobility among ventilated patients
• Decreased length of stay in an intensive care unit
• Improved glucose management, leading to fewer hyperglycemic events

Two teams developed initiatives to address nurse well-being and the health of work environments. Their results included a decrease in perceived moral distress and burnout, improved communication, and increased camaraderie and teamwork, all of which are essential in this pandemic environment.

In addition to improving patient and nurse outcomes, the Edwards Lifesciences Foundation CSI Academy teams documented a total anticipated positive annual fiscal impact of $3.2 million and a median return of 846%.

Hospitals participating in the program include:

• Grady Memorial Hospital, Atlanta
• Harbor-University of California Los Angeles (UCLA) Medical Center
• Lenox Hill Hospital, New York City
• North Shore University Hospital, Manhasset, New York
• Penn Presbyterian Medical Center, Philadelphia
• Seattle Children’s Hospital
• Temple University Hospital, Philadelphia
• The George Washington University Hospital, Washington, D.C.
• University of Alabama at Birmingham Hospital

“We are inspired by the results of this first group of AACN CSI Academy nurses, which contribute to our Every Heartbeat Matters initiative impacting underserved patients,” said Amanda Fowler, executive director, Edwards Lifesciences Foundation. “These accomplishments illustrate the benefit of donating resources to elevate healthcare in underserved communities around the world, measurably advancing our mission of improving the lives of an additional 2.5 million underserved structural heart and critical care patients by the end of 2025. We hope these results encourage others to support this work alongside us.”

AACN has received a second grant from Edwards Lifesciences Foundation to bring AACN CSI Academy, free of charge, to a new group of nurses caring for underserved critically ill cardiac patients at Southern California hospitals. The geographic proximity of the hospitals will enable a hybrid approach to learning, combining in-person workshops with web-based sessions. The new cohort launched in July.

AACN offers online access to its collection of CSI Academy innovation projects ― including project plans, clinical interventions, data collection tools, outcomes and references ― as part of the program’s goal to inspire and empower as many progressive and critical care nurses as possible. With over 103,000 unique downloads of project materials, the CSI innovation project library has become a resource for hospitals, healthcare administrators and clinical leaders seeking solutions that improve outcomes and reduce costs.

*Edwards Lifesciences Foundation identifies underserved people as “… those who have a health disparity as defined by the U.S. Department of Health and Human Services, and lack awareness of, or access to, medically appropriate healthcare.” (Every Heartbeat Matters webpage, 2022)

About the American Association of Critical-Care Nurses: For more than 50 years, the American Association of Critical-Care Nurses (AACN) has been dedicated to acute and critical care nursing excellence. The organization’s vision is to create a healthcare system driven by the needs of patients and their families where acute and critical care nurses make their optimal contribution. AACN is the world’s largest specialty nursing organization, with more than 130,000 members and over 200 chapters in the United States.

American Association of Critical-Care Nurses, 27071 Aliso Creek Road, Aliso Viejo, CA 92656; 949-362-2000; www.aacn.org; facebook.com/aacnface; twitter.com/aacnme