Developing a Tool to Improve Critical Care Nurses' Access to High-Risk, Low-Volume Resources.

Publication Title

Critical care nurse

Authors

• Sean Robinson, Sean Robinson is a staff nurse in the medical and surgical intensive care units (ICUs) at Providence Swedish First Hill Campus, Seattle, Washington. He is the chair of the Critical Care Nurse Practice Council and serves as a stroke champion for the unit.Follow
• Kirianne Green, Kirianne Green is a staff nurse in the medical and surgical ICUs at Providence Swedish First Hill Campus. She is the co-chair for the Critical Care Mentorship Program and co-chair of the Practice and Safety Council.Follow
• Amber Depew, Amber Depew is a nursing manager for the medical and surgical ICUs and STAT team at Providence Swedish First Hill Campus.Follow
• Michelle Dedeo, Michelle Dedeo is a clinical nurse specialist for Swedish Health System, Seattle, Washington.Follow
• Cara Gallegos, Cara Gallegos is a nurse scientist for Providence Health and Services in the North Division supporting all Providence hospitals in Alaska and Western Washington.Follow

Document Type

Article

Publication Date

2-1-2026

Keywords

Humans; Critical Care Nursing; Nursing Staff, Hospital; Female; Adult; Male; Middle Aged; Critical Care; Surveys and Questionnaires; Intensive Care Units; Clinical Competence; washington; swedish; alaska

Abstract

BACKGROUND: The increased complexity of critical care nursing has resulted in nurses performing more high-risk, low-volume (HRLV) procedures, which may increase patient risk.

LOCAL PROBLEM: The purpose of this project was to develop a resource for critical care nurses to more effectively manage HRLV scenarios at intensive care units at a large urban hospital to improve nurses' practice.

METHODS: CINAHL and Medline databases were searched using the keywords high-risk low-volume, HRLV, badge buddy, just in time, and nurse competency. Twenty articles were identified, and 4 were included in this project. An accessible printed resource packet was created as a form of education and reference in HRLV scenarios. Each packet was laminated and kept at nurses' stations and included summaries, "pearls" (highlights), diagrams, checklists, and QR codes that linked directly to facility policies. Nurses were invited to complete an 8-question survey 8 weeks after implementation.

RESULTS: Forty-three nurses completed the survey: 63% worked day shift, and 100% found the resource relevant. On average, the nurses agreed the packet increased knowledge, saved time, helped access policies, and influenced practice. On a scale of 1 to 10, the nurses rated the packet "very helpful" (mean, 9.09). When asked what was useful, participants indicated "easily accessible" and "finding information."

CONCLUSION: The resource packet has been used in HRLV scenarios and with new nurses during downtime. It was easy to implement and can be individualized for many units and patient populations. It serves as a bridge to easily bring best practice information to the bedside.

Specialty/Research Institute

Nursing

Specialty/Research Institute

Critical Care Medicine

DOI

10.4037/ccn2026668