I would like to nominate the nursing team from the South Texas Veterans Health Care System Medical Intensive Care Unit (MICU) for their extraordinary commitment to patients and safety. Their healing hands, kind hearts, and desire for excellence epitomize the organization's core values. The team has created a positive environment that has yielded favorable experiences for our patient population. By implementing principles of high-reliability organizations, the MICU team has successfully tackled several projects to improve patient safety and enhance patient outcomes. Initiatives include but are not limited to, the adoption of rapid rounds, daily huddles, CAUTI bundles, CLABSI bundles, VAE bundles, and hand hygiene sheriffs. Thus far, the MICU team has had zero CLABSIs since December of 201, zero CLABSIs since October 2018, zero VAE since April 2019, and zero falls since March 2019. The MICU’s commitment to high-quality care, safety, compassion, and evidenced-based practice aligns the unit with the DAISY Foundation.

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High-quality, reliable, and safe patient care is in our DNA. These words can be heard in the Medical Intensive Care Unit (MICU). Working in the MICU is challenging and demanding. Despite these challenges, the MICU nursing team (27 Registered Nurses and 5 Nursing Assistants) continues to provide unwavering holistic care to patients when they are in their most vulnerable state. Being the recipient of the Team DAISY award for providing excellent care to a patient for over two and half years was an honor. However, in the MICU, we are always pursuing high-quality patient-centered care and safety.

For the past two years, the team has put in place many processes to prevent hospital-acquired infection and has created a culture that is preoccupied with failure. Our preoccupation of failure has assisted us in implementing safety huddles, multidisciplinary rapid rounds, CAUTI bundles, CLABSI bundles, VAE bundles, and Hand Hygiene sheriffs. The charge nurse-driven safety huddles occur twice a day and provide situational awareness. Since the implementation of safety huddles, situational awareness amongst the nursing staff has increased from 62% to 98%, lending to improved patient safety and increased commutation amongst the staff. The rapid rounds are interprofessional rounds that bring the team together to review the patients’ care plan once a day in the morning before formal rounds. Rapid rounds review each patient’s plan of care utilizing an ICU checklist. The checklist includes a review of medications (i.e. antibiotics, vasopressors, etc…), the need for lines/tubes (i.e. foley catheters, central lines, etc…), ABCDEF bundle, and HAPU bundles. As a result of the implementation of these processes, the MICU has seen a decrease in the incidence of CAUTIs (i.e. ZERO since December of 2017), CLABSIs (i.e. ZERO since October 2018), VAE (i.e. ZERO since April 2019), and falls (i.e. ZERO since March 2019), and in providing quality and safe patient care. Therefore, I would like to nominate the MICU team as they have demonstrated time and time again their passion and commitment in serving our Veterans through the embodiment of high reliability and ICARE values.