Though only with our unit for a 1 ½ years, Giuliana has rapidly jumped into her role as a Clinical Specialist by providing supportive education to the staff, facilitating necessary change, enhancing communication, coordinating orientations and inspiring those to elevate their level of practice. She has availed herself truly 24/7 for staff questions about procedures, policies or equipment. Using a newer platform for monitoring brain oxygenation, some technical challenges are likely to occur. The staff contacted Giuliana overnight with a question and rather than talking them through the challenge over the phone, she appeared on the unit to provide support real-time, so that the technology could be used to best manage the patient and optimize outcomes. With the many changes in today's healthcare landscape, communication is paramount.
Giuliana's overall organization ensures that each and every member of our staff receives information on quality measures and interventions, organizational initiatives, new equipment, and regulatory requirements. She provides a weekly Huddle Update, which is shared daily as well as emailed to each staff member so that everyone is aware of care priorities. Giuliana also keeps the staff up to date with a monthly Quality Newsletter highlighting accomplishments and opportunities to improve the care of patients.
Her use of available technologies to facilitate and streamline education is noteworthy. She has utilized Nearpod as an interactive presentation and assessment tool to roll out high priority education, so staff can engage in new information wherever or whenever is convenient for their schedules. Identifying an education gap (due to low volume) with some of our newer staff, she and one of her colleagues along with the multidisciplinary team, devised Sim Lab sessions to address this. I believe that these sessions helped individuals to identify areas in which they could improve their knowledge base, while also cementing the relationship among the intraprofessional team participants.
A firm believer in creating processes that focus on efficiency, safety and improving communication. She was instrumental in the development of our current rounding model and tool, believing that standardization in care will lead to fewer missed opportunities. In addition, this process provided for the nursing staff to have an active voice during rounds. Historically, Nursing was a bystander in rounds. The tool developed set expectations of all team members by role in order to provide information about each patient. Nursing's role was to provide all data about the patient, participate in the physical exam and articulate any nursing needs the patient may have. Giuliana's mantra is that the creation of a standardized means to approaching care will ensure that care is ALWAYS delivered the same way and will not vary by individuals.
Giuliana has not hesitated to involve herself in projects to improve her unit and organization but has also availed herself to assist those facilities that have joined the enterprise, as well. She has taken on an active role in ensuring all patients benefit from evidence-based VTE prophylaxis by enlightening nursing (and physicians alike) about our current challenges and appropriate interventions to decrease VTE. Highlighting the importance of VTE prevention, she also developed a notification escalation pathway, so that if a patient declines VTE prophylaxis, education is provided by the frontline staff, then manager or Clinical Specialist, then a midlevel provider and ultimately the Attending physician. Undoubtedly, this will improve our patient outcomes and continue to highlight the excellent care provided at Jefferson.
Obviously, Giuliana is quite dynamic in her approach to her own nursing practice, but it does not stop there. She willingly shares any information she has to improve the quality of care delivered and encourages her team to aspire to new heights. Engaging staff to professionally develop, she teaches a stroke certification course to prepare those for the SCRN (Stroke Certified Registered Nurse) exam. She offers advice to those who seek out education leading toward advanced practice roles. She also engages frontline staff to present evidence-based practices, such as the presentation of data supporting the creation of EVD (external ventricular device) bundles to decrease infections, which was presented at the American Association of Neuroscience Nurses Annual Meeting this past year.
Despite the fast-paced changes in healthcare leaving many questioning "why", Giuliana has a way of putting forth changes, which have staff asking "why not"? She engages and inspires all who work around her to provide the best care for all patients!
Giuliana was recognized as our DAISY Advanced Practice Nurse for 2019