Professional Practice at Inova Fair Oaks Hospital

Professional Practice - Inova Fair Oaks Hospital
Shared Governance

A fundamental requirement of an organization with Magnet designation is to have an effective shared governance structure.

Shared Governance is a decision-making model focused on empowering the nurses who care for the patients, the frontline of decision making.

The Shared Governance councils are comprised of clinical nurses, clinical nurse educators, clinical nurse specialist with representation from each nursing unit. The Inova Fair Oaks Hospital council also has interprofessional colleagues from pharmacy, laboratory services, infection prevention, physical therapy, informatics, respiratory, and quality as ad-hoc members.

Inova Fair Oaks Hospital Shared Governance

The IFOH Care Site Council meets monthly and is led by clinical nurses. This is council is the decision-making body where process improvement activities, practice changes, and other patient care, work environment, and professional practice objectives are discussed. These initiatives are then brought back and shared with our patient care units through established Unit-Practice Councils (UPCs). The UPC’s provide decision-making resources at the unit level encouraging all clinical nurses to participate in improving and developing their professional practice.

The sub councils at the care site include:

Nursing Research and Evidence-Practice

This council promotes knowledge development and contributions to nursing science. Supporting and facilitating the initiatives and ideas of our nurses who are undertaking evidence based practice projects and research. Through 2019-2020 clinical nurses led and/or participated in two completed nursing research studies.

Professional Development

Supports and facilitates nurses in obtaining professional nursing certification, advancement on the clinical ladder (ADVANCE), BSN, and/or advanced degrees. Leads and oversees the DAISY nurse recognition program. Council reviews certification, BSN, ADVANCE, and RN satisfaction data and provides Professional Development and Recognition activities for IMVH nurses. As of the end of 2020, currently have 93 nurses on the clinical ladder and over 160 nurses hold a professional nursing certification.

Clinical and Patient Experience

This council examines IMVH’s quality and patient satisfaction data. Supporting and facilitating the work of the UPC’s in linking work process to outcomes. IFOH consistently outperform the national benchmarks on all nurse sensitive indicators including falls with injury, HAPI’s, CAUTI’s, and CLABSI’s

Night Council

The overall goal of this council it to support patient care on the night shift, to promote nurse satisfaction of nurses who work on night shift, and improve the nurse practice environment. It is composed of representatives from all practice areas throughout the organization.

In 2020, many IFOH clinical nurses were part of the Inova Health System Shared Governance work group to evaluate current state of shared governance at Inova and review the literature for current best practices. Information flows from the care site council to the system council in shared decision making.

The development and restructuring of four IFOH Shared Governance Councils with Specific areas of focus:

2021 Shared Governance Highlight

Reduced in hospital fall rate by 15%
Contributed to the reduction of in-hospital mortality rates
Achieved patient satisfaction scores of likelihood to recommend at 92%
Achieved targets for nurses with BSN (current rate: 90%)
Achieved targets for nationally certified registered nurse (current rate 47%)

Inova Nursing Professional Practice Model

Shared Transformational Leadership (Decision Making, Empowerment, Autonomy, Accountability, Succession Planning, Innovation)
Meaningful Recognition (ADVANCE Clinical ladder, Education Advancement, Professional Certifications, Award and Honors)
Collaborative Relationships (Community, Inter and Intradisciplinary Collaboration, Effective Communication)
Professional Vision and Value (Culture of Safety, Clinical Excellence, Work Life Balance, Appreciation of Diversity)
Care Delivery System (Patient Focused, Respect of Patient and Family Preferences, Team Approach, Efficient)
Evidence-Based Practice (Nurse-driven Research, Clinical Inquiry, Translate/Incorporate Findings into Practice, Evaluate Patient Outcomes)

Inova In-Patient Care Delivery Model

The Inova In-Patient Care Delivery Model is divided into three circles with the mission as the core.

In-Patient Care Delivery Model Sustaining – The outer ring of the care delivery model represents our commitment to sustaining a culture of safety and innovation leading to optimal patient outcomes. We achieve this objective by using tools such as our safety huddles, visual management boards, Team STEPPS, and Lean Six Sigma.

Partnering – The middle ring of the care delivery model represents our commitment to involving the patient/family in the planning and delivery of care. The tools we use to achieve this objective are discharge planning, ISHAPED, hourly rounding, whiteboards and multidisciplinary rounds.

Caring – At the center of our care delivery system is our mission: to provide world-class healthcare – every time, every touch – to each person in every community we have the privilege to serve. We place the patient/family at the center of all we do. This philosophy is at the heart of nurses' accountability for patient care and clinical outcomes

Daisy Award

Meet a few of our nurses here at Inova Fair Oaks Hospital making a difference in the lives of our patients and healthcare.

Amy Buchanan, BSN, RNC-OB, C-EFM – Labor and Delivery

Amy Buchanan Patient centered care is what all hospitals strive to be the best at. On January 31, 2022, my nurse exemplified just that. In every way possible, Amy showed me the true meaning of being a nurse. She went out of her way to help, comfort, and educate. She did everything in her power to make me comfortable during the birth of my first child.

Nurses are so amazing and Amy showed me that day the heart and passion it takes to make a difference in a patient’s life. Amy showed me what it truly means to be a nurse. She is the reason my stay at Inova Fair Oaks hospital was such a positive experience. Amy worked tirelessly the entire day to help me through the extremely long and painful labor. That day, Amy was never too busy for me. No request too big. She stayed in the room with me and nearly the entire day. Amy made me feel like a VIP, or the only patient in the entire hospital. She held my hand through painful contractions. She helped to preserve my dignity. She took into account my religious beliefs and respected everything I wished for my delivery.

Amy went out of her way to ensure my wants were made clear to everyone on the delivery room. She even stayed after her shift was over to make certain I was comfortable, and that everything was in place before leaving for the day. That day, Amy truly felt like family. I will never forget Amy and the exceptional, empathetic, patient-centered care I received from her.

Maile Kalinowski, MSN, RN – Labor and Delivery

I was a patient in labor and delivery on February 1, 2022, in labor with my firstborn child when I met Maile Kalinowski, RN. My labor, delivery, and birth was such an intense experience, to say the least. I was in labor with my firstborn child for almost 36 hours from the start of my first contraction and was running on only 2.5 hours of sleep. As soon as nurse Maile walked into the room during change of shift, my husband and I immediately knew we were in good hands. Her exceptional attention to details, such as asking right away when my IV line was last flushed to make sure it was still working, did not go unnoticed. I stayed 6 cm dilated for 4 hours and was losing confidence about my dream of having an unmedicated birth. We asked Maile about initiating nitrous oxide to help me relax and reduce my perception of labor pain. Although she had no prior experience with nitrous oxide in her 20 years plus experience in working in labor and delivery, she was more than willing to help us make this a reality.

She quickly consulted the clinical educator who taught her how to safely administer it. As a result, I was able to use it effectively and did not get a epidural, which I was trying to avoid. Maile also suggested running IV fluids to help me stay hydrated and avoid dizziness from the nitrous oxide, which did help me perk up. I was even able to tolerate a low dose pitocin drip to get my contractions going by using the nitrous oxide. When I was in the pushing stage of labor and having difficulties, she quickly used her nursing judgement and realized I had not urinated for several hours. She inserted a straight catheter, which help relieve my distended bladder; this allowed the baby to move down into my pelvis and soon after our beautiful baby girl was born.

Maile is an extraordinary nurse who embodies nursing professionalism in the way she delivers care to her patients. My husband and I have such gratitude for the positive impact she had on the delivery of our firstborn and want to recognize her for her exceptional care!

Michelle Tidwell, BSN, RN – Post Anesthesia Care Unit

Michelle Tidwell I had a total knee replacement (TKR) on August 30. Michelle was my recovery nurse. While in recovery, it was discovered my tibia was fractured and I would require a TKR revision the next day. I was upset and concerned. Michelle was so kind and reassuring. She was also comforting to my daughter who was out of town. The next day August 31, I went back into surgery. When I awoke in recovery, the first words I heard were, "Olivia, its Michelle. You are doing fine." I responded, "Michelle, I am glad to have you again."Her response was, "I changed my schedule so I could be your nurse again." I was so touched by her caring. My daughter, who only spoke to Michelle by phone, said it was obvious Michelle loved caring for me.