Transformational Leadership

A Year of Nursing Excellence

UT Southwestern Medical Center (UTSW) takes pride in the contributions of our nurses by supporting transformational practice across the spectrum of health care services, including all nursing functions established by the American Nurses Credentialing Center (ANCC). UTSW was redesignated in 2021 for its sustained efforts in nursing excellence throughout the organization. The ANCC’s Magnet Recognition Program is esteemed worldwide as the gold standard of nursing excellence. Nationally, just more than 600 hospitals out of more than 6,000 in the country have received the Magnet designation, and we are proud to be in that top 10 percent.

UTSW nurses have a powerful voice and continually enhance care across the health care system and North Texas. In 2024, UTSW Medical Center continued its consecutive eight-year run as the No. 1 hospital in DFW, ranking in 11 specialties, the most nationally ranked specialties in Texas by U.S. News & World Report. Also, this past year, we had a UTSW nursing leader inducted as a Fellow in the American Academy of Nursing, among many other accolades and awards.

Nurses at UTSW are the institution’s lifeline, exemplifying influence, compassion, and clinical excellence. Transformational leadership begins with our frontline nurses, who consistently demonstrate vision and expertise through numerous awards, peer-reviewed articles, and podium presentations. UTSW nurses continually set the pace and cultivate a culture that supports patients, families, communities, and staff.

As in previous years, our nurses in 2024 were recognized locally, nationally, and internationally as transformational servant leaders at every level through direct patient care and beyond. The hallmark for UTSW nurses is that “excellence is our starting point, not our finish line.”

Accolades

Accreditations reflect the professional expertise and facilities validation of UT Southwestern nurses in providing the highest level of care and treatment for patients.

William P. Clements Jr. University Hospital continues to rank in the 97th percentile in overall hospital patient experience (Vizient).

Staff Nurse-Led Case Studies: Improving Stroke Knowledge Through APP-Nurse Collaboration

In 2021, we expanded our Acute Stroke Unit (ASU) from six beds to 16 beds with the opening of the Orange Tower at Clements University Hospital. This expansion led to the rapid hiring of additional staff and an increase in our nurse resident numbers to care for patients. It’s important to note that the literature consistently confirms the pivotal role of specialty stroke nurses in patient care. Their expertise has been shown to significantly reduce disability, shorten lengths of stay, and improve patient outcomes (Theofanidis, 2016), providing reassurance and confidence in our patient care strategies. As we hired experienced staff, we recognized a gap in stroke knowledge at the progressive care level. Furthermore, our neurovascular advanced practice providers (APPs) expressed observations during neurology stroke rounds of staff nurses’ lack of understanding and knowledge of stroke pathophysiology, neurological assessment, and implications and rationales of stroke-related patient care interventions in the ASU. This led to a collaboration between our neurovascular APPs, unit-based educator, and unit leadership team to establish a nurse-led Stroke Case Study Conference series. The goal of this series was to increase stroke knowledge, confidence, and collaboration among nursing and APP staffs.

The APPs and unit-based educator introduced the Stroke Case Study Conference Series to the bedside nursing staff and asked for volunteers. Interested staff nurses were encouraged to participate as presenters and used the opportunity as part of their annual professional development goal. Staff nurses were instructed to assemble a case study on a recently cared for stroke patient, being careful to avoid any patient identifiers. Their presentations included relevant information such as hospital courses, pertinent labs and imaging, diagnoses, and interventions. Nurses were also mentored by the unit-based educator and APPs in conducting relevant literature reviews and evidence-based practices related to their topics.

Presentations were assembled in APA format, and staff nurses formally presented to their peers in a hybrid presentation setting that was both in person and virtual. The presentations consisted of two parts: presenting the patient story in a case study format and expanding on lessons learned via literature review and evidence-based practices. Presenters expanded their chosen topics by discussing opportunities to improve patient care, process improvement opportunities, or sharing any interesting and relevant literature findings. For example, one case study reviewed stroke in pregnancy and best practices regarding thrombolytics and thrombectomy treatment in pregnancy. At the conclusion of the presentation, the audience was encouraged to participate in a short discussion and question-and-answer session. To encourage audience attendance, all presentations met criteria to offer nursing continuing education hours and annual stroke hours.

The impact of the case study conferences was twofold: The presenter acquired new stroke knowledge and learned valuable professional development skills such as conducting literature reviews and presenting to an audience, and the collaborative approach of the series allowed the staff to learn in a nonjudgmental, safe, and supportive environment, while learning skill sets to carry over to future professional endeavors. Professional opportunity, growth, and empowerment items were measured by the annual employee engagement survey and showed positive results. “I have the same opportunities for professional success as my colleagues” increased from 78 to 84, “I have good opportunities to learn and grow at UTSW” increased from 82 to 87, and “I feel empowered to make decisions regarding my work” increased from 71 to 86. Additionally, this series cultivated the nursing staff-APP relationship, as evidenced by an increase in the annual employee engagement survey item “Teams at UTSW collaborate effectively to get things done” from 76 to 85.

Theofanidis D, Gibbon B (2016). Nursing interventions in stroke care delivery: An evidence-based clinical review. Journal of Vascular Nursing, 34(4):144–151. doi.org/10.1016/j.jvn.2016.07.001

Contributors:

• Alexa Collins, M.B.A., B.S.N., RN, SCRN
• Anna Ellis, B.S.N., RN, CCRN, SCRN
• Elizabeth Lindstrom, PA-C