Sara Mennen is a rare kind of nurse. Usually Akron Children’s nurses are either niched in the inpatient or outpatient setting and don’t do much crossover. But, that’s not the case for Sara, who spends 2 days a week as an inpatient float nurse and 2 days a week in the infectious disease clinic. The uniqueness of her situation isn’t lost on Sara, and she says it has enhanced the quality of the care she delivers.
“Working as an outpatient nurse has actually helped make me a better inpatient nurse,” she said.
Sara says patients who have been discharged from an inpatient stay often come to her office in infectious disease with many questions and concerns about follow-up care.
“Working in the outpatient clinic has helped me better understand what my patients need to know before going home from an inpatient stay,” she said. “An inpatient stay is a moment in time for patients and the nurses caring for them. Once a patient is discharged you likely won’t see that patient again. Hospital stays can be confusing and stressful for families. Imagine being discharged with unclear instructions on medication administration or follow-up care.
“I’ve seen parents come in sleep deprived from waking up at 3 a.m. to give their child medication every 8 hours,” she added. “That makes sense in the hospital because the nurse is awake and that is her job, but it doesn’t necessarily make sense for mom or dad to lose sleep and get up at 3 a.m. to give a medication. It’s these kinds of areas where I feel like discharge instructions could be clearer.”
In her outpatient job Sara says she does a lot more follow up and hand holding and she wanted to find a way to have her inpatient parents feel just as supported. It was because of this that Sara began an initiative that is being piloted with inpatient infectious disease patients to help improve the discharge planning process.
“We found tools other hospitals have used as best practice and have started to implement some of them here,” she said. “It’s important to start the discharge planning as soon as a patient is admitted.”
Sara says things like scheduling follow-up testing and appointments for patients, making sure they have medication either ordered or in hand, and simply ensuring patients have the correct phone number to call with questions before they leave the hospital is paramount.
Sara is working with Dr. Eric Robinette, infectious disease specialist, and nurse program coordinator Michelle Craver to standardize discharge instructions in Epic for infectious disease patients so residents, who often write the discharge instructions, are on the same page.
“As a department we feel obligated and empowered to fix what may be broken or what can be improved upon,” she said. “We’ve found evidence-based articles, processes and workbooks to improve discharge for patients. We need to be discharging patients with the correct information in an easy-to-understand format with minimal work required from parents. Making the discharge process as streamlined as possible could help eliminate unnecessary readmissions due to poor compliance.”
“There have been innumerable times where Sara’s cross-functional knowledge has helped us seamlessly pass critical information across the inpatient-outpatient interface,” said Dr. Robinette. “This handoff is one of the more critical challenges facing modern medicine. We’re hoping to leverage Sara’s unique experiences and knowledge to help us develop reliable processes that can replicate the things that she helps us do.”
“I see these kids at their worst when they are inpatients and then I get to watch them come full circle and get back to normal,” Sara added. “It’s very rewarding to play a role in helping in their recovery.”