June 29, 2009
Johns Hopkins Bayview Medical Center announced that its Cardiac Intensive Care Unit (CICU) nursing team was awarded second place and ‘Best in Initiative’ in ADVANCE for Nurses magazine 2009 Best Nursing Team Contest for Maryland, Washington, D.C. and Virginia. The 37-member CICU team is a part of Johns Hopkins Bayview, a 500-bed academic medical center.
A panel of judges evaluated the contest entries by awarding scores in: initiative, adaptability, teamwork, recruitment/retention and knowledge. The awards honor the Johns Hopkins Bayview CICU nurses for developing and implementing a solution to create a faster "door-to-balloon" time for patients suffering from heart attacks.
The CICU nurses were challenged to improve patient care times for treating acute myocardial infarction, commonly known as heart attacks. The goal was to decrease "door-to-balloon" time for patients with heart attacks, in order to save cardiac muscle and decrease mortality rates. "Door-to-balloon" time refers to the period from when the patient arrives at the hospital until inflation of the balloon catheter in their blocked artery, and is important because the shorter the time, the better the survival rate.
A unique solution was proposed and implemented by the CICU nurses and other members of the cardiology care team. Nurses in the CICU were educated to provide basic care and monitoring for patients in the cardiac catheterization lab until the on-call team could arrive. This "bridge team," which consisted of a CICU nurse, X-ray technologist and resident physician, would meet the patient in the emergency department when the heart attack team was activated. Next, the "bridge team" would escort the patient to the catheterization lab, prepare the patient for the procedure, and in some cases, assist with the procedure as needed.
CICU nurses in the pilot program began cross-training in the cardiac catheterization lab in 2007. At that time, the median "door-to-balloon" time was 122 minutes, well above the American Heart Association and American College of Cardiology’s target of 90 minutes. The average "door-to-balloon" time is now 77 minutes. Also, nurses have experienced a new sense of pride and satisfaction that their actions have made a difference in the lives of their patients.
