2004 BAYADA Award Winner

Mary Kay Bader, MSN, RN, CCRN, CNRN

Use of New Technology to Change Nursing Practice

Mary Kay Bader, MSN, RN, CCRN, CNRN and the nursing surgical ICU team at Mission Hospital, in Mission Viejo, California used information obtained from new technology to change nursing practice for patients with traumatic brain injury.

In December 2000, the Food and Drug Administration approved a new technology used to directly monitor oxygen levels in the brain. Ms. Bader wrote the insertion procedure and provided leadership to the staff in managing patients upon whom this new technology was being employed. It was the first time every nursing intervention instituted led to direct feedback to the nursing team. The team discovered many of the management strategies used prior to employing this technology caused oxygen levels in the brain to fall to critically low levels. With this technology, they discovered that certain situations such as decreasing blood pressure (resulting in increased intra cranial pressure) led to potentially poorer outcomes.

Ms. Bader assembled and led a team to determine how to effectively use the monitor, interpret the data, and develop critical thinking algorithms to guide the care team members in decision making. As a result, a series of protocols with bedside nursing critical thinking plans were designed and instituted. This technology provided the nursing team with a “window” or look into the complex process inside the cranial vault. In the best nursing tradition, reminiscent of Florence Nightingale, the team observed and analyzed patient data made available through innovative technology.