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YON 2020 Day 30: Nurses spearhead collaboration, improve patient care

When they saw a procedural gap that they could fill, nurses at St. Joseph Warren Hospital with Mercy Health Youngstown took the lead to collaborate for improved patient care.

The PICC team at St. Joseph Warren Hospital (L to R): Vicky Marino, RN; Angela Massacci, RN, MSN; and Lisa Bayus, RN.

Last year, the Manager of Perioperative Services at St. Joseph Warren Hospital, Angela Massacci, RN, MSN, collaborated with the hospital’s Radiology Department to initiate a new service to be provided by nurses. Prior to this initiative, Peripherally Inserted Central Catheters (PICC lines) were inserted in radiology by a radiologist. The hospital did not have any PICC line or IV team nursing teams prior to this unique care model. As the need for PICC lines to provide IV access for patients in a timely manner grew, a gap for which affected prompt patient care and length of stay was identified. It was clear that collaboration was necessary to address this gap. Radiologist were supportive of this endeavor.


Angela developed training for a PICC line team and selected PACU and Infusion nurses who could assist in meeting the growing demand for inpatient PICC lines. This strategy was not easy as it posed challenges for cross training due to fluctuating patient care demands for perioperative departments and the Infusion Center. Such challenges for tightening staff availability for fluctuating inpatient volumes has become the new norm.


Lisa Bayus, RN, and Vicky Marino, RN, were cross-trained for PICC line services. In addition to providing post op care, they are able to meet patient needs for PICC lines. Careful collaboration between the Manager of Radiology, Stacy Pasquale, the Manager PACS, and Angela, regarding patient needs and department scheduling is required for success. These individuals use a safety huddle and know that success requires clear communication throughout the day. As a result, patient needs are accommodated and most patients receive their PICC lines on the day the order is received rather than having to schedule for another day.


This collaboration requires agile performance by Lisa and Vicky. These nurses prioritize patient care needs, patient safety, and handoff communication when leaving PACU/Infusion Center to meet the need for PICC lines. Lisa and Vicky complete PICC lines at the bedside. This is especially helpful for patients who exceed weight limits for radiology tables or are physically compromised making for difficult transport to radiology. Addressing difficult patient care needs at the bedside requires excellent nursing assessment and IV skills.


Collaboration to address patient care needs for PICC lines in expedited time has resulted in improved patient care and improved length of stay. Managers such as Angela and Stacy and staff RN’s such as Lisa and Vicky illustrate how their agility enables the gap of fluctuating patient care needs to be closed.

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