Nurse Innovator Works to Improve Patient Safety
After a nearly 20-year nursing career, Patricia (Tricia) Cady, RN, ADN, BSN, decided to return to school to pursue her BSN at the University of Virginia (UVA) School of Nursing, where she observed a long-standing problem with extubations in the neonatal intensive care unit (NICU). To help address this issue, Tricia developed the idea for the Cady Hug, a flexible vest that helps protect neonates from accidental extubations while keeping them comfortable and their tubes accessible for their care providers.
We spoke with Tricia about her experience as a nurse and nursing student, her invention, and her advice for fellow nurses with innovative ideas.
Can you tell us about your nursing journey up to this point?
I became a nurse at 35 years old, once our three sons were all in school full time. After attending college part time for four years to earn my Associate of Applied Sciences degree and sit for the NCLEX, I spent nine years in the newborn nursery and NICU working with both healthy-term infants and premature infants. We then decided to move to Charlottesville, where I accepted a job in interventional radiology (IR) at UVA Medical Center, working with adults in a procedural area, and later moved to cardiac rehab.
For years I contemplated returning to school to achieve my BSN, but there was always a reason why I didn’t. Finally, as the idea of retirement was looming less than 10 years away, I knew I would never regret putting forth the effort, but definitely feared I could regret not doing it. So, at 54 years old, I enrolled in classes to work toward my prerequisites. Once I was in the UVA RN-BSN program, the first semester gave me the inspiration to return as a bedside nurse, and to my true passion: the NICU.
What was the inspiration and innovative thinking behind the Cady Hug?
In returning to the bedside in the NICU, I was reminded of the frustration of attempting to protect the airway of my patients. For those infants who are intubated and on a ventilator, it is imperative that we keep the endotracheal tube (ETT) from dislodging accidentally. This inspired me to think of a way to keep their tiny hands contained, but also support them in their musculoskeletal development. I wanted them to have free movement of their arms and hands, but also remain aligned in a midline fashion.
I had to think about escape routes for IV lines, both peripheral and umbilical. This led to the vest length, which allows full visualization of the umbilical area. For soothing comfort, I wanted the ability to also wrap the infant through swaddling. By using stretchy material, the Cady Hug can promote musculoskeletal development by mimicking the uterine wall.
Why is an environment that fosters innovation so important for nurses?
I don’t think nurses are aware of the funding that is available to them to advance an idea to improve patient care. We are taught how to do the research to create change at the bedside, but innovation is missing from our training. Perhaps it’s time to change that dialogue, integrate it into the syllabus, and encourage nurses to think outside of the box and not accept the status quo.
How are nurses in unique positions to be innovators in healthcare?
Since nurses are at the bedside providing expert, evidence-based care, we are aware of the extraneous needs to accomplish this goal. Nurses are performing workarounds on a daily basis in order to provide the best care to their patients. We just need to take that workaround one step further and develop new tools to help us improve care. My thinking was that if I can develop a vest that will allow a nurse to decrease their worry about an accidental unplanned extubation, then they are free to concentrate on other areas of care.
What are the next steps for the Cady Hug?
At this point we are in the extremely early phase, known as acceptability. We have four-to-five types of fabric to create prototypes, and once those are complete, we will work with our UVA NICU nurses and respiratory therapists while they attempt to place them on dolls. The acceptability refers to their perception of whether they feel the design is intuitive to work with, if they think the infant’s arms will remain contained, which fabric they prefer, and their ideas for any changes they feel should be made to the design.
As a recent graduate, what is your advice for nursing students who are inspired to bring their innovative ideas to life?
You must remain committed to your idea. This means from beginning to end, which could include a four-to-five-year commitment. Find the support system you will need to walk you through the process. My professional nursing staff organization (PNSO) has been invaluable to me, as research has not been my area of expertise. They are aware of the people to contact in order to get your questions answered. Have faith that there is a team out there to support you.
To learn more about UVA’s RN to BSN program and the opportunities to continue a nursing education, visit the UVA School of Nursing website here. Additionally, listen to Tricia share more about her innovation journey and the steps she’s taking to bring her invention to life in our Nursing Notes Live podcast.