Within Reach June 2019

Volume 10│Issue 2│June 2019 Carilion Medical Center, 1906 Belleview Ave, Roanoke, VA 24014 http://chsweb.carilion.com/nursserv/NursW eb.html nursingresearch@carilionclinic.org (540)266 -6216

Nursing at the NEW Radford University Carilion Lisa Allison-Jones, PhD, RN - Dean of the College, Jefferson College of Health Sciences It’s official! On June 17, Dr. Brian Hemphill, President of Radford University announced that the Southern Association of Colleges and Schools Commission on Colleges (SACSCOC) Board of Trustees granted approval for the merger of Jefferson College of Health Sciences and Radford University. This approval was the last step in the approval process for the merger. Earlier this year, the Virginia House of Delegates and the Senate of Virginia unanimously approved the bills establishing the Radford University Roanoke Division, and these bills were signed by the Governor on February 19. The merger will be effective on July 10, 2019.

The newly merged campus has been named Radford University Carilion (RUC) and will occupy the same space in Roanoke Carilion Community Hospital currently used by Jefferson College.

All programs previously offered by Jefferson will continue to be offered by RUC. Faculty and staff from both institutions have been working together to envision an institution that will result in enhanced educational opportunities and grow to meet the need for healthcare professionals in Virginia.

While this merger has exciting implications for all our healthcare programs, it is particularly exciting for nursing. Nursing will be Radford University’s largest academic program, and the second largest nursing program in the Commonwealth. Students will be able to enter the profession of nursing through the traditional BSN program, which will be offered both on the main Radford campus and at RUC, and through the Accelerated BSN program. This program, offered at RUC is designed for students who have earned a bachelor’s degree in another field and seek a second degree in nursing.

Nurses will be able to advance their nursing degree with the online RN-BSN program offered from both campuses, the MSN Nursing Administration and MSN Family Nurse Practitioner programs offered from RUC and the Doctor of Nursing Practice program offered on the main Radford campus.

Regardless of the nursing program, Carilion Clinic will play a significant role in the education of our future nursing workforce. RUC nursing faculty will work closely with our Carilion nursing colleagues to ensure that students receive the excellent clinical experiences for which Carilion is known. Together, Radford nursing faculty and Carilion Clinic nurses will prepare the nurses of the future.

~ Lisa

Carilion Clinic Roanoke Campus

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ARTICLES/NOTIFICATIONS 3 Within REACH Publication Timeline 4 2019 Carilion Nursing Research Conference Save the Date/Call for Abstracts 6 Pain Management Through Art & Relaxation Melissa Foster, BSN, RN; Sunayana Pydah, DHSc Candidate, PA-S, MHA, MBA; Kim Carter, PhD, RN, NEA-BC

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Article Review: Daily Goals to Facilitate Nurse-Physician Communication Brittany Roberts, Nurse Resident

10 Magnet® Exemplar During 4th Designation for Internal Dissemination of Nursing Research 12 “The Impact of Three Different Sleep Routines on Patient’s Perception of Sleep Quality” presented at 2016 Nursing Research Conference

RECOGNITION/EVENTS 14 Congratulations 2018 Nursing Research Fellowship Graduates 15 2019-20 Nursing Research Fellows Announced 16 EBP Concentration Presentation 18 Recognition 20 Conference Corner 22 Citations and Recognition 24 2019 Art & Science of Nursing Showcase Summary of Events 25 See Where Our Nurses Have Traveled 26 Nursing Research Classes 30 Additional Nursing Research Class Information Carilion Nursing Research Editorial Board: Kim Carter, PhD, RN, NEA-BC - Editor-in-Chief Michele Kosinski, DNP, MBA, RN - Co-Editor Deirdre Rea, MSN, RN, PMH-BC - Co-Editor Reviewers Lisa Allison-Jones, PhD, RN Nancy Altice, DNP, RN, CCNS, ACNS-BC Candace Asbury, BSN, RN Desiree Beasley, MSN, RN, CCRN, CCNS Ann Beheler, ADN, RN Mary Brewer, MBA, MSN, RN, RD Sarah Browning, DNP, RN-BC Molly Clemons, RN, ONC Monica Coles, DNP, RN-BC, ACNS -BC Sarah Dooley, MPH, BSN, RN Christine Fish-Huson, MSN, RN

Shanna Flowers, MA Cindy W. Hodges, BSHS, RNC, FCN James Ingrassia, MSN, RN Pam Lindsey, MSN, RN Margaret Perry, MSN, RN-BC Angelina Surgent, MSN, RN, ONC Diana Talmadge, RN Cindy Ward, DNP, RN-BC, CMSRN, ACNS-BC Stacy Wilson, Vivian Wilson, BSN, RN, CCRP Britmarie Witkowski, MPH

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https://carilion.ca1.qualtrics.com/jfe/form/SV_72FT7ClbMkQ7eWV

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Pain Management through Art and Relaxation Melissa Foster, BSN, RN; Sunayana C. Pydah, DHSc Candidate, PA-S, MHA, MBA; and Kim Carter, PhD, RN, NEA-BC - Rehab Unit Support, JCHS, Nursing Research Introduction Making art can be highly effective in dealing with intense conditions, such as chronic pain1. Chronic pain can lead to increased reports of depression, anxiety, and anger which impacts family life, contributes to decreased activity, affects self-image, mental deconditioning, feelings of loss, social stigma, memory deficit, suicidal ideation, and social isolation1. The engagement in art may redirect patients’ attention away from pain to other activities. There is a paucity of research examining the effect of creative art activities as an adjuvant for pain management. This study built upon the limited literature to evaluate the effect of a creative art and relaxation class on reducing pain scores, depression, and anxiety scores.

Literature Review Studies have shown decreased anxiety or depression, improved affect, improved emotional coping, developed an ability to project one’s self into the future and express grief 1. A variety of mind-body approaches can be used in the management of chronic pain, occasionally as a sole treatment, but more commonly as adjuncts to other therapies2. The relaxation response techniques such as laughter and medication causes muscle relaxation, reduces inflammation, and enhances mood2.

One study demonstrated that patients with the most improvement had acceptance of their pain and took responsibility of their personal well-being1. Another study showed a reduction in eight of nine symptoms after cancer patients worked on an art project for one hour3. Patients who participate in an arts in healthcare program have shorter hospital stays, are more adherent to recommendations, use less medication, and have fewer complications4. While findings from the limited research are promising, more work is needed5.

Study Design This IRB approved study examined the effect of a 4-week 2-hour creative art and relaxation class for ambulatory patients with chronic pain on self-reported pain, anxiety, and depression. A registered nurse with specific art class training conducted the art and relaxation classes. During the study, all participants had access to and were permitted to take their pain medications and were permitted to take them as prescribed.

Initially, a quasi-experimental design was planned. Challenges with enrollment required study modifications and revised strategies to support study enrollment. Despite efforts, such as monetary incentive, enrollment remained low; therefore, the design was revised to a case-study approach.

More than 60 adult participants were referred to the study by providers at Carilion Institute of Orthopaedics and Neurosciences Pain Management Clinics. However, only n=3 study participants consented and completed the study. The primary recruitment problems were related to having to sign a consent form, travel frequency to and from the classes, lack of transportation, and insufficient monetary incentive ($25 initially, increased to $100).

Following informed consent procedures, quantitative data were collected at pre-intervention, four weeks and at the completion of the classes using questionnaire assessments. The questionnaires included the Brief Pain Inventory (Short Form)6, Generalized Anxiety Disorder 7-item (GAD-7) scale7, and the Personal Health Questionnaire Scale (PHQ-8)8. Assessment data were transcribed into a secured excel document for analysis.

Results All three study participants verbally reported improvement in their ability to focus attention on other tasks instead of their chronic pain. The reality of the pain, symptom severity, and pain relief fluctuated inconsistently, but all subjects demonstrated a downward trend in depression scores.

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Figure 1: The Generalized Anxiety Disorder questionnaire assesses patients’ health status over the previous two weeks. The questionnaire asks seven questions regarding self-reported anxiety. GAD 7 scores above 24 indicate severe generalized anxiety disorder. Overall, among the 3 participants anxiety levels declined as they attended more art and relaxation classes however, there was fluctuation in the levels at baseline and at 4 weeks.

Figure 2: The Patient Health Questionnaire is an eight-item depression scale that assesses and monitors depression severity. PHQ-8 scores greater than 20 indicates severe major depression. Overall, the 3 participants depression levels declined as they attended art and relaxation classes.

Conclusion Overall, each subject experienced improvement on the depression scale; however, pain and anxiety scores were inconsistent. The small sample size limited the ability to interpret the findings beyond a casestudy level of evaluation. Further studies need to be conducted to examine the impact of art and relaxation interventions on pain, depression, and anxiety scores and to examine best strategies to engage patients with chronic pain in research. Expanding beyond the Pain Management division in future studies may increase the sample size and encompass participants with a wider variety of pain disorders. Additionally, the effect of a home module that enabled individuals to perform the art and relaxation exercises independently without an instructor in the comfort of their home.

References 1.

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Briggs, C. 2015, July 7. Art Therapy and Pain Management. PMIR Medical Center Website. Accessed online on November 23, 2016, from http://paininjuryrelief.com/art-therapy-and-pain-management/ Hassed, C. 2013. Mind-body therapies use in chronic pain management. Australian Family Physician, 42(3), 112-117.

Art Therapy Can Reduce Pain And Anxiety In Cancer Patients. (2006, January). Science Daily, 2. Retrieved November 21, 2016, from https:// www.sciencedaily.com/releases/2006/01/060102104539.htm Rollins, J., Snoke, J., Cohen, R., Boles, A., & Li, J. (2009). Arts in Healthcare. Retrieved November 20, 2016, from http://www.thesah.org/doc/ reports/ArtsInHealthcare.pdf Angheluta, A. & Lee, B. K. 2011. Art Therapy for Chronic Pain: Applications and Future Directions. Canadian Journal of Counselling and Psychotherapy, 45(2), 112-131. Retrieved November 20, 2016, from http://files.eric.ed.gov/fulltext/EJ930794.pdf Cleeland, C. S. 1991. Brief Pain Inventory (Short Form). Retrieved December 5, 2016, from http://www.npcrc.org/files/news/ briefpain_short.pdf Spitzer, R, Kroenke, K, Williams, J, & Lowe, B. 2006. A brief measure for assessing generalized anxiety disorder. Arch Intern Med, 166, 1092 -1097.

Kroenke, K, Strine, T, Spritzer, R, Williams, J, Berry, J, Mokdad, A. 2009. The PHQ-8 as a measure of current depression in the general population. J Affect Disord, 114(1-3):163-73.

Acknowledgements This study was supported by a Carilion Clinic RAP grant. A special thanks to Yaohua Lu, MD, Elizabeth RussoStringer, MD, Robert McNamara, Ph.D., Shaheen Lakhan, MD, Mendsaikhan Dagvadorj, RN, Tendai Ushe, RN, and Danyell Harrington, LPN for their assistance throughout the study.

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Article Review - Daily Goals Tool to Facilitate Indirect Nurse-Physician Communicaion Brittany Roberts, BSN, RN, Nurse Resident - CRMH 9M PCU

Article Reviewed: Perry, V., Christiansen, M., & Simmons, A. (2016). A Daily Goals Tool to Facilitate Indirect Nurse-Physician Communication During Morning Rounds on a Medical-Surgical Unit. MEDSURG Nursing, 25(2), 83-87.

Evidence shows a correlation between communication between the members of patient care teams and improved patient outcomes. Ideally, bedside rounds including both nurses and physicians together could help minimize gaps in communication regarding patient care plans and goals. However, there are still unavoidable barriers that exist within the hospital that lead to continued miscommunication and misunderstanding between healthcare providers. The authors of this article implemented a daily goals tool on their unit to incorporate indirect rounds into the coordination of patient care and improve communication among nurses and physicians.

Critique The FOCUS-PDCA model for process improvement was used to guide this project. The steps in this performance improvement cycle include: Find a process to improve Organize a team Clarify the current process Understand variations in current process Select the process to improve This phase helps nurses examine the process and identify areas needing change.

Plan the improvement Do the improvement Check for results Act to hold the gain This phase is a continuous cycle to learning and revaluation of the process.

A survey of all of the unit’s nurses reflected that less than half of the time did they understand or receive communication of the physician’s patient goal/plan of care for the day. A similar survey of Physicians’ perception of nurse’s understanding of their goals for the patient, as well as how often they communicate their plan to the nursing staff, resulted in similar findings of less than half the time for both questions.

Over the course of 4 months, the unit utilized a laminated daily goals sheet for each patient that had a list of prompts that nurses on the unit identified as the most common non-emergent reasons for paging the physician. The prompts on the list included the plan of care for the day, diet, activity orders, fluids, etc. as well as a section for free text. The tools were posted outside of patient’s rooms with the side facing out resembling a plate with a room number so patient information was hidden from common view. On the other side, any information to be relayed or questions the nurse had for the physician were to be written before morning rounds on the unit.

When physicians rounded, they wrote their responses on the tool. After some time, a slip cover was used in order to facilitate the use of multiple sides. The sheet was green on the nursing side,

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red on the provider side, and the sheet would be flipped to the appropriate side to better indicate who had last written their response,and who needed to write a response next. Physicians were still paged with emergent patient needs. All staff members (with the exception of a few rotating interns and residents) were taught how to use the tool, and two unit champions encouraged its use.

After a 4 month time period, the participants were surveyed again asking the same questions.

All of the communication scores increased from both disciplines- the most remarkable result being the nurse’s perceived understanding of patient’s daily goals from 38% pre-study to 72% poststudy, and physician’s perception of nurse understanding from 27% to 87%. When asked if they would like to continue to use the tool, 81% of nurses and 75% of physicians said yes. Nine questionnaires were not returned - thought to be due to rotating physician interns and residents.

One study finding was the negative feedback loop that seemed to exist when one discipline felt the other did not use the tool; it decreased use by the other discipline as well. It was noted that a way to enforce continued adherence may be considered for future use.

Overall, using this tool improved perceived quality and coordination of care between healthcare providers and offered a way for the nurse to address concerns that may not have been communicated otherwise. While whiteboards have previously been used in many facilities as means of communicating with a patient, it is not necessarily effective between providers. In care areas where face-to-face communication can be challenging among providers-this structured communication tool may be a viable alternative.

Conclusion This study was relevant to practice because it takes the initiative of finding a way for physicians and nurses to communicate patient non-emergent needs in a more efficient way. Though this might not be a system that works in every facility, it opens the door for the idea of how the process can be improved. This study addresses the challenge that, while nurses and physicians would ideally round together, there are occasional unavoidable obstacles to this happening. I would recommend this article to any nurse, as it illustrates an innovative approach to addressing a common communication barrier with the goal of improved patient care and outcomes.

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Magnet exemplar during 4th Designation for Internal Dissemination of Nursing Research Editor’s Note: During our 2018 ANCC Magnet® site visit, the appraisers were impressed by the structures in place to support internal dissemination of Nursing Research, such as our own peer-reviewed publication (Within REACH), the Carilion Nursing Research Conference, and the Art & Science of Nursing Showcase. As a result, Carilion Clinic Roanoke Campus received a rare exemplar for NK2a: internal dissemination of nursing research. Jeanette Ives Erickson DNP, RN, NEA-BC, FAAN, Magnet® Commission Chair made the following announcement on October 18, 2018: OVERVIEW: The Commission on Magnet® is proud to recognize your 4th designation as a Magnet® organization! This credential is testament to the countless contributions your nurses, in collaboration with other team members, have made in their commitment to provide quality patient care through innovations in professional nursing practice. The Executive Summary is the final report of findings for your appraisal. Congratulations to the entire organization on your significant achievement! Nurses throughout the HCO used words such as “voice” and “professional autonomy” and that colleagues were their “work family” throughout the site visit.

Each unit/work area has a quality resource nurse who serves to coordinate and track all quality improvement projects. There is a strong Nurse Residency program with every new graduate assigned to a mentor. Experiences nurses have multiple online and in-person continuing education opportunities, and there is financial support for attendance at external conferences, certification review courses, reimbursement for professional certification and tuition reimbursement for formal education programs.

COMPONENTS OF THE MAGNET® MODEL: • Transformational Leadership • Structural Empowerment • Exemplary Professional Practice • New Knowledge, Innovations and Improvements Exemplar awarded in 2018 (with corrections) NK2a: Nurses disseminate the organization’s nursing research findings to internal and external audiences.

As part of the Research Council, Carilion Clinic has three subcommittees: Dissemination of Research, Nurse Research Day, and Education. The Dissemination Committee publishes a peer-reviewed internal journal, “Within REACH.” The journal includes research studies completed by clinical nurses, article reviews, and recognition of external presentations of nursing research done by clinical nurses. Peer Reviewers are given editorial training and review articles for acceptance. They use a standard template, and the articles are blinded for review.

The Carilion Nursing Research Conference is an annual day for clinical nurses to present their research and evidence-based practice projects. Posters, presentations, and national speakers are part of the day; average attendance is 150 nurses. In 2016 and 2017 combined, 42 research/ studies/evidence-based practice projects were presented at the Carilion Nursing Research Conference.

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The Education sub-committee provides basic education to all nurses in nursing research, providing 26 classes throughout the year (in partnership with the Office of Nursing Research). Carilion also conducts a Nursing Research Fellowship annually where proposals from 8-10 nurses are selected, and the nurses are mentored by internal research experts as well as nursing faculty from local schools of nursing throughout the year to complete their research. The nurses are provided with four hours of paid time each pay period to work on their research. Carilion Clinic nurses are well supported in disseminating their Organizational research to the internal audience and are deeply rooted in research.

NK2a from the 4th MagnetÂŽ Designation follows on page 12.

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“The Impact of Three Different Sleep Routines on Patients’ Perception of Sleep Quality” presented at 2016 Carilon Clinic Nurisng Research Conference Editor’s Note: The following is from the 4th Magnet®Designation document that Carilion Clinic Roanoke Campus submitted in 2018. NK2a was noted as an exemplar, and represents the first exemplar in nursing research in Virginia.

NK2a: Provide one example, with supporting evidence, of how clinical nurses disseminated to internal audience knowledge obtained through the organization’s nursing research.

The Carilion Clinic Office of Nursing Research and Evidence-based Practice and the Tau Phi Chapter of Sigma Theta Tau International through Carilion’s Jefferson College of Health Sciences jointly sponsor an annual Nursing Research Conference to provide an opportunity for nursing employees, faculty, and students to disseminate research to an internal audience. Submissions are reviewed by a panel of peers. The study described in the following paragraph of NK2 Example A was approved and presented during the oral presentations on November 3, 2016, and the presentation was favorable evaluated by participants. The conference had a record attendance of 139 Carilion employee participants. Additionally, the study was presented to the Cardiothoracic Surgery Interdisciplinary Quality Team on October 27, 2015.

Carilion Clinic offers a Nursing Research Fellowship to support the development of research ideas proposed by clinical nurses. One of the approved fellowships for 2015 was conducted by clinical nurses Heidi Mock BSN, RN, Sarah Curran BSN, RN, and Camaryon Huddleston BSN, RN. Cathy Jennings DNP, RN, ACNS-BC served as the team’s mentor for this IRB approved, quasiexperimental prospective study to compare the impact of two interventions (eye masks/ear plugs and back rubs) and no intervention on patients’ perception of sleep quality in a progressive care (PCU) setting. Hospitalized patients who report poor sleep quality and impaired sleep experience increased length of stay, poorer outcomes, and increased readmission rates 1. Nothing to date had been published to evaluate selected sleep interventions in PCUs. Study subjects on 9 South PCU were randomized into groups by time of enrollment. Subjects were asked in a post-sleep survey which of the devices they used and for how long. Sleep quality was measured with the Richards-Campbell Sleep Questionnaire2 . Ten subjects were enrolled into each group: eye mask/ear plug, back rub, and standard of care (no intervention). Patients reported noise levels at consistently low levels (mean = 80.4, with 100 being “Very Quiet”). Although there were no statistically significant differences between groups in mean SCSQ score (p=0.993), verbal feedback from patients approached for the back rub group was positive. Of the subjects approached to participate, 50% consented. Of those, 100% completed the study in the control and back rub groups, but only 63% completed the study for the eye mask/ear plug group.

This study was limited by a small sample size and difficulty enrolling subjects in the eye mask/ear plug group. More work is needed to understand best practice to support patient sleep. Many patients refused to enroll, stating that they slept well as long as staff would not wake them.

Additional study with larger sample size may yield different results and is warranted. Refusal to participate in wearing eye masks and ear plugs warrants further investigation of the hospital’s investment in these products. Finally, the very low noise level finding is in conflict with current HCAHPS scores related to quiet in the hospital environment and warrants more investigation.

This study, combined with two other Carilion Nursing studies provided the foundational information being used for an internally funded study of sleep interruptions launched in 2016.

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References 1. Richardson, A., Allsop, M., Coghill, E., & Turnock, C. 2007. Earplugs and eye masks: Do they improve critical care patients’ sleep? Nurs Critical Care, 12(6), 278-286.

2. Richards, K., O’Sullivan, P., & Phillips, R. 2000. Measurements of sleep in critically ill patients.

Journal of Nursing Measurement, 8, 131-144.

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Congratulations 2018 Nursing Research Fellowship Graduates!

l - r: (Front row)Breanna Kawa; Samantha Delieto; Niki Hale; Carly Gathje; Shannen Schucker; Kelli Loftus (Back row) Donna Bond; Sandra Chitwood; Sarah Dooley; Phyllis Whitehead; Ellen Harvey; Kim Carter; Lisha Osborne

If you are interested in applying for a Nursing Research Fellowship, go to: Inside Carilion/Nursing Research and Evidence Based Practice/Highlights/Nursing Research Fellowship or contact Kimberly Carter, PhD, RN NEA-BC kfcarter@carilionclinic.org / 540-981-7536

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1st Carilion EBP Scholars Present Findings On June 28, EBP Scholars Taylor Brogan BSN, RN, CCRN; Sandra Hubbard BSN, RN; and Kalyn O'Connor BSN, RN presented findings from their 3-month EBP Concentration to complete a systematic review to identify current knowledge related to the use of diffused aromatherapy to decrease stress for nurses.

(l-r: Taylor Brogan, Sandra Hubbard, Kalyn O’Connor)

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(Sandra Hubbard)

(l-r: Sandra Hubbard, Kalyn O’Connor)

(Taylor Brogan)

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Commitment!

Donna Bond, DNP, RN, CCNS, AE-C, CTTS, FCNS CRMH Nursing Professional Practice Clinical Nurse Specialist Institute (CNSI) Inaugural Class of Fellows “Thirty-eight highly skilled clinical nurse specialists from 242 states have been selected as the inaugural class of fellows for the Clinical Nurse Specilist Institute (CNSI). Upon induction, these individuals will begin using the new credential, “FCNS”. Each have made outstanding contributions to the nursing profession, the clinical nurse specialist role, and nursing and health care leadership and scholarship. The CNSI trustees have judged the quality and character of their work as exceptional. Each one is remarkably accomplished”

Commitment!

Amanda Kidd, MSN, RN, ACNPC-AG, NEA-BC, CCRN-K Carilion Nursing Quality & Transformations Administrator ANCC Certified Nurse Award Winners of this award demonstrate the value and impact that specialty certification has on nursing practice and patient outcomes.They demonstrate that, through certification, they can provide superior care to their patients and become even greater assets to the healthcare organizations at which they work. They continue to contribute to the advancement of nursing in their specialty areas through innovation, collaboration, leadership and professional risk-taking, and patientcentered care.

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Community!

Lauren Johnson, RN Carilion Stonewall Jackson Hospital House Bill 1362 - “Rhett’s Bill” Through personal tragedy came a mission to improve the lives of the communities we serve. Lauren was instrumental in getting House Bill 1362 signed into law that mandates lab work for newborn screenings be done seven days a week, instead of just Monday-Friday. She knew firsthand that test results could be a matter of life and death in an infant. She succeeded in reaching out to delegate Terry Austin who wrote and submitted the bill, which went throught the Virginia House and the Senate with full support. HB1362 is lovingly referred to as “Rhett’s Bill”, in memory of Lauren’s son.

Community!

Dottie Cook, BSN, RN CRMH 7S CCU CCU Sustainability Champion Dottie is one individual who is helping lead Sustainability on 7S CCU at CRMH. She has linked her Sustainability values with her daily work, and unit operations. She holds Sustainability meetings with fellow staff on initiatives to decrease waste and hospital costs. With her influence, her unit has seen noteworthy cost savings.

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2019 AORN Global Surgical Conference & Expo, Nashville, TN Jennifer McCormick, MSN, RN, CNOR, EMT-B was invited to present her poster titled Operating Room Retention & Orientation Redesign at the Association of PeriOperative Registered Nurses Global Surgical Conference & Expo in Nashville, TN, April 2019. The project centered around factors and interventions that could positively impact the retention of Operating Room nursing staff. Pattie Vari, PhD, RN, CNE from Jefferson College of Health Sciences was a co-author on the project.

2019 VONEL Spring Conference, Glen Allen, VA Even with a delayed notification, Tammy Mitchell, MSN, RN reached down into her bag of creative techniques and produced a poster the night before she had to travel to the VONEL Conference in Glen Allen, VA . Her project titled, 5 West: The Hope Floor won first place for Best Poster at the conference.

Awarded 1st place for best poster among VONEL presenters! Voted on by the attendees.

2019 National Student Nurses’ Assoc. Conference, Salt Lake City Utah Sarah Dannhardt, (on the right in the picture) Nursing Research Intern and JMU Nursing Student attended the National Student Nurses’ s Association Conference in April, 2019. She stated it was an incredible experience and “so much fun to be surrounded by hundreds of nursing students.” There were inspiring guest speakers and several breakout sessions. There were also opportunities for certification (Naloxone training, American Red Cross Disaster relief, etc.) JMU NSA won 2 awards for some of the work they have done this past year.

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2019 VONEL Spring Conference, Glen Allen, VA Amanda Kidd, MSN, RN, ACNP-AG, NEA-BC, CCRN-K was a member of a team of nurses and project staff, led by Brandon Jones, MSN, RN, CEN, NEA-BC, whose project titled “Implementing a Simulation-Based Program for Nurse Leader Patient Rounding� was chosen to be presented at the 2019 Virginia Organization of Nurse Executives & Leaders (VONEL) conference in Glen Allen, VA. The data and analysis from this project yielded insight into deficiencies in the process for preparing leaders in our organization to round.

Other co-authors involved with the project were, Amanda Anderson, BSN, RN, PCCN-K, CHSE; Ashli Semones, MPA; Kim Carter, PhD, RN, NEA-BC

2019 Carilion Clinic Research Day 2019 Carilion Clinic Research Day saw a number of Carilion staff present their projects in April. 160 abstracts were featured and more than 200 staff registered to attend the event.

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February 2019 - June 2019 Morris, M., Liebhardt, B., Lindsey, B., Subbiah, V. 2019, January 31. Panel: Trends in patient access, capacity management and patient flow. Patient Flow Management Summitt, Las Vegas, NV

Gerow, R., Altice, N. 2019, April 9. Early cardiac rehab to reduce heart failure readmissions. Carilion Clinic Quality Conference, Roanoke, VA

Dinwiddie, S., Lareau, S., Howell, R. 2019, April 9. Engaging nurses and bedside staff in injury prevention efforts. TraumaCon, Lexington, KY

Jones, B., Anderson, A., Semones, A., Kidd, A., Carter, K. 2019, April 9. Implementing a simulation-based program for nursing leader rounding. Carilion Clinic Research Day, Roanoke, VA Dinwiddie, S., Lareau, S., Howell, R. 2019, April 9. Engaging nurses and bedside staff in injury prevention efforts. Carilion Clinic Research Day, Roanoke, VA Boggs, B., Collins, L., Ward, C. 2019, April 9.

Impact of use of stroke and dysphagia severity algorithm. Carilion Clinic Research Day, Roanoke, VA Bond, D. 2019, April 9. They are breathing aren’t they? Why counting respiratory rate is important. Carilion Clinic Research Day, Roanoke

McCormick, J., Vari, P. 2019, April 6-11.

Operating room nurse retention and orientation redesign. Association of PeriOperative Registered Nurses (AORN), Nashville, TN

Gerow, R., Altice, N. 2019, May 4-5. Early cardiac rehab to reduce heart failure readmissions. Virginia Association of Cardiac and Pulmonary Rehab Conference (VACVPR), Portsmouth, VA

Hamilton, Y., Steffey, B., Psathas, J., Mullins, D., Kinzer, M. 2019, March 11. A call to all to prevent falls. Carilion Clinic Quality Conference. Roanoke, VA

Mitchell, T., Sebastian, D. 2019, May 17.

The Hope Floor. Virginia Organization of Executives and Leaders (VONEL) Spring Conference, Fredericksburg, VA

Salazar, C., Delp, K., Davis, C. 2019, March 11. Blood culture contamination improvement.

Carilion Clinic Quality Conference, Roanoke, VA

Jones, B., Anderson, A., Semones, A., Kidd, A., Carter, K. 2019, May 17. Implementing a simulation-based program for nursing leader rounding. Virginia Organization of Executives and Leaders (VONEL) Spring Conference, Fredericksburg, VA Gathje, C., Chitwood, S. 2019, June 8-12 Neonatal abstinence scoring: Does the simplified Finnegan rival the gold standard?

Association of Women’s Health, Obstetirc and Neonatal Nurses (AWHONN) Conference, Atlanta, GA

Bramblett, H. 2019, March 11. Serving culturally diverse populations while upholding Carilion’s values - interpreter services department. Carilion Clinic Quality Conference, Roanoke, VA

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Gerow, R., Altice, N. 2019, June 27-29. Early cardiac rehab to reduce heart failure readmissions. American Association of Heart Failure Nurses Conference (AAHFN), Austin, TX.

Klaess, C., Urton, M., Whitehead, P., Rosier, P., Burnie, J., Michel, M. 2019 Pain management pillars for the clinical nurse specialist: Summary of national association of clinical nurse specialists opioid pain management task force. Clinical Nurse Specialist, 3(3), 136-145

Saunders, J., Ahmadzadeh, S., Bush, M., Wright, R., Granger, B. 2018, December.

Improving patient experience and treatment adherence in adult outpatient hemodialysis.

Journal of Nursing Quality, Digital prepublication article DOI: 10.1097/NCQ.0000000000000373

Gathje, C., Lockhart, E., Chitwood, S., Whitehead, P., Dooley, S. 2019, June. Does the simplified Finnegan neonatal abstinence scoring system rival the gold standard in neonatal abstinence scoring? Journal of Obstetric, Gynecologic & Neonatal Nursing, 48(3), S154

Kook, S., Defilippis, S. 2019, March. Efficacy of intermittent heparin flush versus normal saline flush in adult implanted ports in prevention of catheter occlusions. Oncology Nursing Forum, 46 (2), 267 Gates, R., Musick, D., Greenawald, M., Carter, K., Bogue, R., Penwell-Waines, L. 2019, April.

Evaluating the burnout-thriving index in a multidisciplinary cohort at a large academic medical center. Southern Medical Journal,112(4),199204.

Epstein, E., Whitehead, P., Prompahakul, C., Thacker, L., Hamric, A. 2019, April. Enhancing understanding of moral distress: The measures of moral distress for health care professionals.

AJOB Empirical Bioethics,10(2),113-124 Harvey, E., Freeman, D., Wright, A., Bath, J., Peters, K., Meadows, G., Hamill, M., Flinchum, M., Shaver, K., Collier, B. 2019, May. Impact of advanced nurse teamwork training on trauma team performance. Clinical Simulation in Nursing, 30, 7-15.

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Impact on Patient Care Award & Judges Choice

Impact on Patient Care Award

Visual Award

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Judge’s Choice

Scholarship Award

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People’s Choice

Professional Poster Award

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“The World is a book, and those who do not travel read only a page.” – Saint Augustine United Kingdom

Natl. Harbor, MD Williamsburg

Palm Springs

Lake Buena Vista

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REGISTER IN CORNERSTONE FOR ONE OF OUR additional RESEARCH CLASSES!

Pre-Nursing Research Fellowship Brainstorm Sessions CE354L July 17, 2019 ********** Open Mentored Writing Lab CE037L August 20, 2019 (available as a walk-in no registration needed) *********** Developing a Competitive Abstract for the Next Magnet Conference & Similar Events CE335L October 3, 2019 ************* Keep an eye out for our 2020 dates for these classes which have already been held for 2019:

Courageous Editing and Compassionate Critique CE192L Creating Professional Posters Workshop CE238L

Need editorial or financial support to present your work at a national nursing conference?

Contact Nursing Research & EBP for: • Assistance with writing your abstract • Poster development • Financial support through Nightingale grants. nursingresearch@carilionclinic.

Carilion Clinic Roanoke Campus