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Affiliations

Lutheran General Hospital

Presentation Notes

Quality Improvement poster presented at Transforming Practice: The Intersection of Technology and Nursing Excellence; Advocate Health Nursing Research and Professional Development Conference 2025; November 12, 2025; Virtual.

Abstract

Background

This 18 bed Neuro Critical Care Unit (NCCU), within an accredited Comprehensive Stroke Care Center, actively worked to meet the target of 90% compliance for the documentation and removal of radial compression devices as ordered. While progress had been made, the site focused on achieving consistent compliance to resolve the non-conformance (NC).

Local Problem

NC-1 non-conformities in a stroke-certified program and intensive care unit pose significant risks to patient safety, accreditation status, and operational efficiency. This can lead to legal issues, and increased scrutiny. The unit was initially only 15% compliant with radial compression device removal, necessitating urgent action to achieve 90% compliance.

Method

A Plan-Do-Study-Act (PDSA) framework enhanced compliance with documentation and removal of radial compression devices. The multi-modal interventions involved revising the order set with neurovascular and cardiovascular stakeholders, optimizing EMR usability, and adding removal documentation in flowsheets. Multidisciplinary education included meetings, simulation training, site-led virtual education offering continuing education credit, and multiple revisions of bedside handoff and tip sheets. Monthly audits with leadership real-time rounding assessed the intervention's impact, with adjustments made based on nurse feedback.

Results/Conclusions

Over the past two years, the NCCU demonstrated steady improvement, correlating with the layered approach of the PDSA cycle. By the beginning of this year, compliance increased to 84%. Notably, the hospital successfully closed its NC-1 during the April regulatory visit, marking a significant achievement. These outcomes reflect the effectiveness of the implemented interventions, with no major unintended consequences reported.

Implications for Practice

The interventions improved nursing practice by increasing compliance with radial compression device removal while enhancing patient safety and care quality in the NCCU. The closure of the NC-1 during the most recent regulatory survey reflects its success. The sustainment plan includes ongoing targeted education, audits, and real-time feedback as NCCU strives to meet compliance consistently.

Document Type

Poster

Publication Date

11-12-2025


 

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Nov 12th, 12:00 AM

Fixing the Pressure Points: PDSA Framework helps close radial device nonconformities in Neuro Critical Care

Background

This 18 bed Neuro Critical Care Unit (NCCU), within an accredited Comprehensive Stroke Care Center, actively worked to meet the target of 90% compliance for the documentation and removal of radial compression devices as ordered. While progress had been made, the site focused on achieving consistent compliance to resolve the non-conformance (NC).

Local Problem

NC-1 non-conformities in a stroke-certified program and intensive care unit pose significant risks to patient safety, accreditation status, and operational efficiency. This can lead to legal issues, and increased scrutiny. The unit was initially only 15% compliant with radial compression device removal, necessitating urgent action to achieve 90% compliance.

Method

A Plan-Do-Study-Act (PDSA) framework enhanced compliance with documentation and removal of radial compression devices. The multi-modal interventions involved revising the order set with neurovascular and cardiovascular stakeholders, optimizing EMR usability, and adding removal documentation in flowsheets. Multidisciplinary education included meetings, simulation training, site-led virtual education offering continuing education credit, and multiple revisions of bedside handoff and tip sheets. Monthly audits with leadership real-time rounding assessed the intervention's impact, with adjustments made based on nurse feedback.

Results/Conclusions

Over the past two years, the NCCU demonstrated steady improvement, correlating with the layered approach of the PDSA cycle. By the beginning of this year, compliance increased to 84%. Notably, the hospital successfully closed its NC-1 during the April regulatory visit, marking a significant achievement. These outcomes reflect the effectiveness of the implemented interventions, with no major unintended consequences reported.

Implications for Practice

The interventions improved nursing practice by increasing compliance with radial compression device removal while enhancing patient safety and care quality in the NCCU. The closure of the NC-1 during the most recent regulatory survey reflects its success. The sustainment plan includes ongoing targeted education, audits, and real-time feedback as NCCU strives to meet compliance consistently.

 

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