The Beacon Collaborative: A Journey to Excellence.

TOPIC: The development of the Critical Care Beacon Collaborative to achieve meaningful recognition. CLINICAL RELEVANCE: Recognizing nurses for contributions to their work environment and care delivery is important for their professional and personal fulfillment, job satisfaction, and retention; such recognition can occur at the individual, unit, or organizational level. The American Nurses Credentialing Center's Magnet Recognition Program acknowledges nursing excellence at the organizational level. It would, however, be difficult for an organization to achieve Magnet designation without nursing excellence at the unit level. To recognize excellence at the unit level, the American Association of Critical-Care Nurses developed the Beacon Award in 2003. OBJECTIVE: To describe one academic medical center's journey toward winning Beacon Awards across 8 units within the adult critical care service. CONTENT COVERED: The Critical Care Beacon Collaborative resulted in a Beacon Award for each unit and important staff outcomes. This article describes the organization, the process before the Critical Care Beacon Collaborative convened and the desired state, and the methods used to achieve our goal. It also discusses unit- and service-level stakeholder involvement. The successes, lessons learned, sustainability, and growth of the Critical Care Beacon Collaborative are shared to assist readers who aspire to pursue a Beacon Award.

"If the glove fits": Hospital-wide universal gloving is associated with improved hand hygiene and may reduce Clostridioides difficile infection.

OBJECTIVE: To determine whether a hospital-wide universal gloving program resulted in increased hand hygiene compliance and reduced inpatient Clostridioides difficile infection (CDI) rates. DESIGN: We carried out a multiple-year before-and-after quasi-experimental quality improvement study. Gloving and hand hygiene compliance data as well as hospital-acquired infection rates were prospectively collected from January 1, 2015, to December 31, 2017, by secret monitors. SETTINGS: The University of Rochester Strong Memorial Hospital, an 849-bed quaternary-care teaching hospital. PATIENTS: All adult inpatients with the exception of patients in the obstetrics unit. INTERVENTIONS: A hospital-wide universal gloving protocol was initiated on January 1, 2016. RESULTS: Hand hygiene compliance increased from 68% in 2015 reaching an average of 88% by 2017 (P < .0002). A 10% increase in gloving per unit was associated with a 1.13-fold increase in the odds of hand hygiene (95% credible interval, 1.12-1.14). The rates of CDI decreased from 1.05 infections per 1,000 patient days in 2015 to 0.74 in 2017 (P < .04). CONCLUSION: A universal gloving initiative was associated with a statistically significant increase in both gloving and hand hygiene compliance. CDI rates decreased during this intervention.