Empowerment of the staff is the norm in the departments that Denise Fochesto manages. Nurses demonstrate empowerment through the generation of multiple award-winning, evidence-based strategies and formal research to improve patient care outcomes. For example, Denise has mentored ICU and Hyperbaric staff nurses, writing grants for funds in their areas. Both nurses received their grants and presented at conferences. The ICU nurse won the 2007 AACN Circle of Excellence Award for Nurse/Family Collaboration.
Evidence of collaborative problem solving can be measured by Denise's involvement in the Institute for Healthcare Improvement (IHI) in the development of a Rapid Response Team (RRT) using a zero cost strategy and a multidisciplinary, cross-trained, voluntary team to provide emergency management of in-house patient deterioration. Cardiopulmonary arrest on the two highest-volume patient units has decreased by 50% since the RRT inception.
Denise is an advocate for structured process change utilizing the Six Sigma methodology. To date, three multidisciplinary projects have been completed lowering UTIs, VAPs and BSIs to the lowest deciles of the CDC benchmarks. Denise volunteered the ICU to pilot a study for MRSA surveillance of all ICU patients to identify colonization, prevent infection and reduce mortality.
Denise's efforts led to funding for human simulators when nurse and physician educators identified a need for structured training to promote patient safety. Plans for implementation of new computerized patient care management systems motivated Denise to successfully negotiate for a nurse informatics coordinator for nursing oversight and education.
Development and accountability are evident among Denise's staff as they embrace curiosity and evidence-based practice. The ICU earned its first Beacon Award in 2006 and the second in 2007. In addition, 46% of ICU staff are CCRNs. Research includes "Driving Forces of Mentorship," "Readiness of Nurses to Use EBP" and "Pain Assessment in the Nonverbal Patient."
