2020 Nursing Annual Report by Catholic Health

Nursing Annual Report

2020: The year of the resilient, remarkable nurse

Welcome from Kenmore Mercy Nursing Leadership Dear Kenmore Mercy Hospital Nursing Team, The World Health Organization deemed 2020 as “The Year of the Nurse,” and extended that recognition into this year - 2021. Never has a tagline been more foretelling than this! We’ve always known that Kenmore Mercy Hospital’s nurses do not back down from a challenge. The year 2020 presented the entire team with so many challenges over an extended amount of time that rapid change became expected and a daily occurrence. As you make your way through this publication, you’ll see the faces of yourself and your peers planning, preparing, educating, collaborating and supporting each other through one of the most challenging years in healthcare. However, the silver lining is that together every associate at Kenmore Mercy Hospital stepped up here, and in the community, to ensure that our patients received the best care no matter what barriers and fears were ahead. I’ve been a nurse for 32 years and have never been so proud of a team as I am right now. Reflecting on the year 2020 brings tears to my eyes as I think of the enduring strength of this nursing team as you supported each other by changing processes, nursing practice and your surrounding environments to meet the needs of the Kenmore Mercy patients and their families. With the department walls and specialties broken down, each nurse cared for patients outside of their comfort zone to assist each other. Some nurses returned to their roots from the early days of their nursing career, while others learned brand new procedures and nursing practices to keep themselves and our patients safe. Through all of the obstacles, Kenmore Mercy nurses continued to learn, grow and approach things in a creative way. The planning, building and implementation of Epic in the middle of a pandemic was a true test of our collective focus and resilience. The entire team pivoted as needed to “take care” of both in an EPIC way. As I write this message, we are still caring for COVID patients while the community is racing against the virus spread with vaccine distributions. I am confident in the flexibility and adaptability of all of you who continue to give the best care possible to your patients the way you’ve always done so before. As you contemplate everything that was accomplished last year, be proud and be kind to yourself. It was truly an amazing year at Kenmore Mercy! Thank you for your commitment to Nursing Excellence. Sincerely,

Heather Telford, MS, BSN, CEN, NEA-BC Vice President of Patient Care Services & Chief Nursing Officer

Kenmore Mercy Hospital Nursing by the Numbers 298

Registered Nurses

Nurse Mentors

Mentees

Nurse Attendants

New Nursing Hires

Surgical Technologists

SPD Technicians

more than

nurses in school

80%

Advanced Practice Providers

of our nurses hold a bachelor’s degree or higher

28%

Nurse Leaders

10 Individual and Team Awards

DAISY Award • Beacon Award • Nurse of Distinction Outstanding Staff Nurse Outstanding Nurse Attendant Emergency Nurse of Distinction Nurse Mentor of Distinction Advanced Practice Provider of the Year Surgical Technologist of the Year SPD Technician of the Year

Research Led Improvement & Research Projects in 2020 Patient Falls Prevention • Early Ambulation CAUTI Prevention • ED Process Nurse/Anesthesia Hand-Off Communication Increasing MOLST Decisions in the ED • N-95 Mask Recycling Half Mask Project • Pre-surgical COVID Testing Tent/Shed

of our nurses eligible for certification are certified

10%

of our nurses participate in professional organizations

Average Nursing Experience is

17.7

Years Items funded by Foundation Mini-Grants Portable radio/walkie-talkies for Emergency Department Vital-check machine for 3 East

Point of Distribution (POD) COVID - 19 Vaccination Clinic

Mattresses, Christmas Tree and Break Room for ICU

Team Based Nursing - ICU and Med/Surg

Resiliency Activities

Care Model Redesign - Same Day Orthopedic Surgeries

Transformational Leadership

Victoria McDonald, BSN, RN, was one of the nurse Super Users.

Elizabeth Kaminski, BSN, RN, was one of many nurses who trained in the computer labs.

At-the-Elbow Epic support staff worked closely with Mary Lovullo, BSN, RN, and Sandy Gibson, MSN, BSN, RN.

It Was an Epic Journey Implementing a New EMR

Catholic Health started its journey to transition to a new Electronic Medical Record (EMR) in 2019, a long and bumpy ride that culminated with a systemwide go live on November 1, 2020. While the pandemic became a top priority in March 2020, Epic still remained in the forefront. Kenmore Mercy nurses soldiered on, playing an integral role in Epic’s build from start to finish. They shared their clinical knowledge and expertise; were part of the early EMR decision process; participated in direction sessions; and evaluated Epic workflows and new clinical pathways. They took on important leadership roles as Subject Matter Experts, Super Users (many who provided “At-The-Elbow” support after go live), and as Credentialed Trainers. In addition, the 2 East nursing team volunteered to be a pilot MyChart Bedside location, helping to trial the software by providing patients with iPads. Kenmore Mercy nurses accepted changes and overcame challenges. Each nurse committed to approximately sixteen hours of Epic training, but when the pandemic interrupted in-person plans, training was reimagined as virtual. Credentialed Trainers moved into lead instructor roles. As the cutover and go live days approached, nurses and other clinical team members devoted countless hours to moving salient inpatient information from the legacy Soarian system into Epic. Thank you to the Kenmore Mercy Nursing team for all you did throughout this great endeavor to ensure a smooth transition and continued quality patient care. We are truly blessed to have such a devoted nursing team!

Epic Project 2020 by the Numbers:

Nurse Subject Matter Experts involved in Epic build - 20 Nurse Credentialed Trainers and Super Users - 24 Credentialed Trainers and Super User hours completed - 5,808 hours Nurses involved in to Live Cutover Process - 21 Nursing Epic training hours completed - 5,984 hours

Vaccinations Clinics Gave Hope for Better Days Nurses have long played a prominent role in delivering and advocating for vaccines, going back to the 1900s when polio, tuberculous, and the Spanish Flu required public immunization clinics. With the rise of the COVID-19 pandemic, nurses at Kenmore Mercy Hospital followed in the steps of their predecessors, supporting and completing one of the many vaccine PODs (Points of Distribution) for Catholic Health. December 15, 2020 marked the first clinic in the hospital’s community room. A few short hours after the arrival of Western New York’s earliest vials of Pfizer-BioNTech, frontline staff working in the red zones – Emergency Department, Intensive Care Unit, and the COVID Unit on 2 South – received their vaccinations. The mood was a mix of anticipation, Katelyn Ritch, BSN, RN, from 2 South, was Kenmore Mercy anxiety and joy as a small group of masked onlook- Hospital’s first nurse to receive the vaccination. ers erupted in applause and cheers. “This really was the first time that we felt genuine hope that we could turn the corner on this,” said Anne Hedges-Creighton, BSN, MS, RN, Kenmore Mercy’s Director of Nursing Perioperative Services, who also led the POD efforts at the hospital. Throughout the next month, vaccinations continued based on associates’ risk of infection, while also staggering shots so not everyone in a group was vaccinated on the same day for safety. As New York State Department of Health eligibility to receive the vaccine changed, Kenmore Mercy continued to support Catholic Health’s efforts into 2021. According to Anne, the Kenmore Mercy POD has safely administered over 6,760 vaccinations during the 39 scheduled vaccination dates since December 2020.

Bridget Walborn, BSN, RN, Intensive Care Unit

Dennis Protas, BSN, RN, Emergency Department

DAISY Wall Unveiled as a Place to Honor Nurses

In June of 2020, Kenmore Mercy Hospital unveiled a new spot to honor some of its hard working nurses. The new DAISY Award Wall features the names of nurses who have won the nationally recognized award since 2014. Twice a year, friends, family, patients or coworkers can nominate nurses that have done extraordinary work. In June, Elizabeth Clark, BSN, RN, CWOCN, a wound ostomy nurse and clinical advisor (to the right with Heather Telford) was recognized.

“This wall is a way to show all who walk the halls of Kenmore Mercy that we have truly amazing nursing,” said Heather Telford, BSN, MS, CEN, NEA-BC, Vice President & Chief Nursing Officer, Patient Care Services.

Nurses Celebrates Retirement of Peers Over the last year, Kenmore Mercy celebrated more than two centuries of collective service with the retirement of the following Patient Care Services associates. Ambulatory Surgery Unit Kimberly DeGlopper, BSN, RN - 36 years of service JoAnne Luciani, RN - 44 years of service Intensive Care Unit Sandy Conti, BSN, RN - 37 years of service Operating Room Karen Thurlow, RN - 29 years of service Lynn Abrahamian, RN - 18 years of service

JoAnn Luciani, RN

Pre-Admission Testing Elizabeth Coone, RN - 19 years of service Janet Gonzales, BSN, RN - 8 years of service Nancy Tagliaferro, RN - 40 years of service 2 East Eileen Gramlich, BSN, RN - 18 years of service Thank you to all of our retirees for your years of dedication.

Registered nurses Karen Thurlow, Kim DeGlopper, and Nancy Tagliaferro

Nurses Planned for Worst Case Scenario At the same time that businesses and communities were preparing to shut down for safety, hospitals were planning for the inevitable COVID-19 patient to cross their threshold. Everyone knew with that first patient would follow many unknowns in healthcare and safety. In March 2020, Kenmore Mercy Hospital management and direct care nurses came together to work through a table top exercise designed to collaborate and learn about COVID-19 before it landed in the Emergency nurses met early on to make plans for care during United States. the pandemic. It was an unprecedented opportunity to plan for the worst case scenario from door-to-door for a novel virus. Included were a group of Emergency Department nurses who brought the much needed direct care perspective to the planning. Braced with the new knowledge of possible challenges, the ED nurses walked the predicted clinical pathways and scenarios with internal experts from infection control, nursing leadership, quality and ancillary departments. The goal was to confirm and agree on the safest possible way a patient under investigation would be taken care of in the ED then to plan out admission to other departments. The valuable input and work that was accomplished on that day established a ready structure that could be activated in a crisis.

Nurses Maintain Tradition of Empowerment Kenmore Mercy has a long tradition of an empowered Nursing Shared Governance Committee. Each department has a representative that speaks for the Unit Practice Councils to share feedback and information with their peers. Effective communication is essential to committee work that is done each month, so when the meetings had to be canceled in April 2020 because of COVID-19, the entire team felt the loss. By the end of April, the Shared Governance nurses began to inquire whether abbreviated meetings could resume in May by following all of the infection control rules designed to ensure safety. The themes were collaboration, i.e. celebrating what’s been accomplished by nursing in just eight weeks, as well as the importance of acknowledging loss and the need for self-care during the toughest times while supporting each other. Each nurse shared how their departments had changed and how each person approached every challenge presented. It was inspirational and also emotional to see each individual struggling. However talking about it as a group was a healing experience. Acknowledging the power of Shared Governance, everyone agreed to continue meeting virtually, where each member had to commit to using WebEx Teams and follow all of the rules of a virtual environment to ensure committee work and collaboration continued. The nurses had to think differently about how to approach their work life. The virtual world also presented new challenges for nurses which included navigating changing roles and mastering new skills. “We are all so proud of how our Shared Governance nurses collaborated and pulled together on a different level, always elevating nursing practice as the most important subject,” said Heather Telford, MS, BSN, CEN, NEA-BC, Vice President of Patient Care Services & Chief Nursing Officer. Agreeing to meet virtually, although not ideal, was a commitment to protect each other in a safe venue for however long the pandemic would last.

Structural Empowerment Nurses Recognized Through National DAISY Program DAISY, an acronym for Diseases Attacking the Immune System, is the name of a national program established in 1999 by the family of Patrick Barnes, a young man who died from Idiopathic Thrombocytopenia Purpura. The family was so moved by the compassion displayed by Patrick’s nurses that they created the DAISY Foundation in his memory to recognize extraordinary nursing care across the nation. Kenmore Mercy Hospital was proud to honor two nurses this past year with DAISY Awards. Elizabeth Clark, BSN, RN, CWOCN, a wound ostomy nurse and clinical advisor, received the award in the spring of 2020. Clare Hourihan, BSN, RN, from the Emergency Department, was awarded for the winter of 2020.

Elizabeth

Elizabeth’s nomination applauded her clinical skills, compassion, dedication, and encouraging attitude that helped a patient through the life changing transition of using a colostomy. Clare’s nomination celebrated her professional skills, compassion, kindness, and thoughtfulness when working with a homeless patient. Clare went above and beyond, not only treating this individual’s healthcare needs, but treating with dignity and respect when she provided fresh clothes.

In addition to Elizabeth and Clare, the following registered nurses were nominated for the DAISY Award in 2020.

Congratulations! Megan Bolton – 2 West

Mary LaMartina – ICU

Melissa Cavalluzzo – Emergency Department

Brooke LaGreca – 3 East

Melissa Coppola – Emergency Department

Josephine Mangahas – MRU

Lynn DeGrasse – 2 East

Victoria McDonald – 2 East

Kora Ettinger – 2 East

Christina McGee – IR

Deanna Farina – Emergency Department

Natalie Niemel – 2 West

Bridget Gregory – 3 East

Kitty Scribner – 2 East

Janine Grotke – 3 East

Brett Sullivan – ICU

Taylor Horne – Emergency Department

Ann Uldrich – 2 East

Kourtney Kijanka – 3 East Tiffany Klis – 2 East Marissa Krzyzan – Emergency Department Clare

Julie MacDonald – 2 East

Melissa Pollina – 2 West

Recognizing our Certified Nurses Adult Nurse Practitioner (ANP) Esther Sprehe, MSN, BSN, ANP

Certified Emergency Nurse (CEN) Sue McClure, MSN, BSN, RN Heather Telford, MS, BSN, RN Board Certified Nurse Practitioners (CNP) Andrea Campagna, NP Mary Dowd, NP Patricia LoRusso, NP Maureen Ryan, NP Esther Sprehe, MSN, BSN, ANP Colleen Storms, FNP Sister Mary Walter, NP Certification in Cardiac Medicine (CMC) Sandra Conti, BSN, RN Certified Gastroenterology Nurse (CGRN) Janet Gonzalez, BSN, RN Jane Weidner, BSN, RN Certification for Nurse Managers and Leaders (CNML) Christine Schwinn, MSN, BSN, RN Ellen Swan, BSN, RN Certified Nurse Operating Room (CNOR) Michelle Anderson, BSN, RN Rachel Achtziger, BSN, RN Linda Butski, MSN, BSN, RN Ellen Colan, BSN, RN Marilee Cosgrove, BSN, RN Scott Fox, BSN, RN Linda Gromada, BSN, RN Deborah Hays, RN Cara Howitt, RN Melissa Kowalski, BSN, RN Jason Meder, RN Colleen Olsen, BSN, RN Kristiane Piskor, BSN, RN Crista Rodriguez, BSN, RN Lauren Spencer, RN Esther Sprehe, ANP Jacob Walck, BSN, RN Certified Post Anesthesia Nurse (CPAN) Scott Berube, BSN, RN Pam Farrell, BSN, RN Sue Hartl, BSN, RN Rene Marriott, RN Certified Professional in Healthcare Quality (CPHQ) Jeanette Hughes, MSN, BSN, RN Certification in Wound Ostomy Nursing (CWON) Elizabeth Clark, BSN, RN Certification in Diabetic Education (CDE) Megan Kosmoski, RN Critical Care Registered Nurse (CCRN) Scott Berube, BSN, RN Sue Conover, RN Sandra Conti, BSN, RN Brenda Cramer, BSN, RN Christopher Dowd, BSN, RN Rachael Kaplan, BSN, RN Mary LaMartina, BSN, RN Julie Marshall, BSN, RN (CCRN-K) Lori Ann Meder, BSN, RN Kristen Parisi, BSN, RN (CCRN-K) Maria Richardson, MSN, BSN, RN (CCRN-K)

Emily Rotolo, BSN, RN Samantha Ruda, BSN, RN Bridget Walborn, BSN, RN Elizabeth Wood, RN Interventional Radiology Nurse Certification (CRN) Kathleen Daley, BSN, RN Christine McGee, RN Robert Morello, RN Med-Surg Certification (CMSRN) Johanna Boyd, BSN, RN Nancy Chojecki, MSN, BSN, RN Jessica Cianfrini, BSN, RN Brenda Cramer, BSN, RN Kelly Ford, RN Annette Gillies, BSN, RN Deborah Green, BSN, RN Emily Hughes, BSN, RN Kayla Hoffman, BSN, RN Elizabeth Kaminski, BSN, RN Brooke Little, BSN, RN Jessica Schulte, BSN, RN Carole Woomer, BSN, RN Nurse Executive, Advanced-Board Certified (NEA-BC) Heather Telford, MS, BSN, RN Sandra Gibson, MSN, BSN, RN Nurse Executive, Board Certified (NE-BC) Elaine Schrutt, BSN, RN Jeanette Hughes, MSN, BSN, RN Orthopedic Nursing Certification (ONC) Alan Chittley, RN Briana Geddis, BSN, RN Holly Grimm, BSN, RN Pamela Koetzle, BSN, RN Amber Mazurek, MSN, BSN, RN Deborah Micholas, BSN, RN Susan Wasielewski, BSN, RN Suzanne Zeisz, RN Certified Case Manager (CCM) Nina DiCarlo, BSN, RN Lisa Hixon, BSN, RN Deb Hurd, BSN, RN Janet Kay, BSN, RN Ella Mendez, BSN, RN Sandy Olear, BSN, RN Chris O’Mara, BSN, RN Certified Registered Nurse First Assistant (CRNFA) Esther Sprehe, MSN, BSN, ANP Colleen Storms, FNP Stroke Certified (SCRN) Sandra Conti, BSN, RN Joy MacNeil-Ennis, MSN, BSN, RN Wound Care Certified (WCC) Robert Gross, BSN, RN Mary Jane Lodico, BSN, RN Kristen Nazaruk, BSN, RN Sue Zeisz, RN This list includes certifications completed prior to December 2020.

AACN Honors Kenmore Mercy Nurse with National Award Kenmore Mercy Hospital critical care nurse Mary LaMartina, BSN, RN, CCRN, was honored with the American Association of Critical-Care Nurses (AACN) Circle of Excellence Award in 2020. She was New York State’s only nurse to receive the prestigious national award and one of only fifteen individuals recognized nationally that year. Mary, who was nominated for the Circle of Excellence Award by her critical care peers and leaders, helped author three successful submissions for AACN silver Beacon Awards. She has also been involved in several important critical care initiatives, including the Modified Early Warning Score System; palliative care; and the Awakening and Breathing Coordination, Choice of Drug, Delirium Monitoring and Management, and Early Mobility (ABCDE) bundle, which was adopted throughout Catholic Health. “Mary is a visionary leader who relentlessly pursues best practices for optimal patient outcomes at the bedside. She went beyond becoming certified in critical care and encouraging others to do so by recruiting a physician to voluntarily teach review courses. Her commitment to excellence and evidencebased care has helped improve patient care, support the local community and create a healthy work environment throughout the hospital,” said 2019-2020 AACN President Megan Brunson. Healthcare professionals who receive the Circle of Excellence Award exemplify why AACN is a community of exceptional nurses. Criteria used to evaluate award candidates includes relentless promotion of patient-driven excellence; communication skills; true collaboration; effective decision making; meaningful recognition of others; ability to transform thinking, structures and processes; and ability to address challenges and remove barriers to excellent patient care and achieve visible results through leadership. “Mary absolutely deserved this national recognition for her outstanding contributions toward nursing excellence,” said Kristen Parisi, BSN, RN, CCRN-K, nurse manager of the hospital’s Intensive Care Unit. “She is passionate about patient care, is a strong advocate for education, and played an integral role in the implementation of the Healthy Work Environment.”

Nursing Team Living Catholic Health’s Mission Congratulations to nursing team members who were recognized with LOVE Awards in 2020. Amy Klopp, MSN, BSN, RN, a nursing supervisor at Kenmore Mercy and Sisters of Charity Hospital was awarded for the third quarter, acknowledging how she demonstrated respect, kindness, generosity, and compassion to a homeless patient being discharged from the Emergency Department. Jackie Mobley, a nurse attendant on the 3 East Patient Care Unit, was nominated multiple times and awarded for the fourth quarter. Jackie is known for her compassion shown to patients and their families. She always has an open ear for all who need her and bring smiles to her patients’ faces.

The LOVE Award recognizes outstanding associates who demonstrate a personal commitment to Catholic Health’s core values.

Amy

Jackie

2020

Recognizing our excellent nursing associates Nurse of Distinction

Outstanding Staff Nurse

Jennifer Earls

Cynthia Stogsdill

Emergency Department Intensive Care Unit

Medical Rehabilitation Unit

Shining Star Award

Emergency Department Nurse of Excellence

BSN, RN, TCRN

Melynda White Unit Clerk

Matt Dent RN

Knee & Hip Center Emergency Department

Advanced Practice Provider of the Year

Central Sterile Processing Technician of the Year

Jessica Brown MS, PA-C

Sheila Kaczmarek

Intensivist Services

Sterile Processing

Surgical Technologist of the Year

Outstanding Nurse’s Attendant

Chelsea Bacchetti

Sherrie Chandler

Operating Room

Sherrie chose to not submit a photo.

2 East

Thank You to the Community for their Support As our clinicians and staff worked selflessly around the clock during the hardest hit months of the COVID-19 pandemic, we were blessed by the generosity of our community – friends, neighbors and strangers, local businesses and organizations, schools, churches and supporters from all walks of life - who provided donations of personal protective equipment, supplies and meals, and found ways to lift our spirits. Thank you also to the Kenmore Mercy Foundation for their ongoing efforts to work with local restaurants to provide meals for our hardworking healthcare heroes and to ensure the hospital had much needed PPE.

March. Hospital associates were moved to tears when they caught sight of uplifting chalk messages left by a local family on the sidewalks outside.

This support has been a reminder of the generosity inherent in our community.

April. Local police, firefighters and EMTs teamed up to thank the healthcare workers at Kenmore Mercy. The first responders drove by with their lights and sirens blaring as associates lined the back entrance holding up signs.

March. Firefighters from Kenilworth Volunteer Fire Company showed up at Kenmore Mercy Hospital with 125 meals for staff there. The fire company had originally planned to serve the meals for a fundraiser, but that event had to be canceled because of the COVID-19 crisis. Kenilworth’s firefighters said they wanted to show appreciation for hospital workers who were on the front lines responding to COVID-19.

May. The 914th Air Refueling Wing and 158th Fighter Wing saluted our healthcare heroes with an amazing flyover. Associates and neighbors gathered outside to watch the magnificent display as they flew over the hospital.

June. The case management team dressed in recognition of Juneteenth on June 19. Sometimes called Freedom Day or Emancipation Day, Juneteenth commemorates the end of slavery in the United States in 1865. Clothing was an important element in early Juneteenth customs as a way to reclaim and express social and political freedom. That self-expression through dress remains an important part of the holiday today.

July. Staff at Kenmore Mercy Hospital experienced some much needed puppy love thanks to Paws for Love - A Program of the SPCA Serving Erie County. On leave since March due to the pandemic, the therapy dogs were eager to show their appreciation for our healthcare heroes.

August. To help celebrate summer and thank our hard working associates, we hosted a fair themed “picnic on the go.”

October. Operation Gratitude made a special delivery to our healthcare heroes at Kenmore Mercy Hospital. Handwritten thank you notes and snacks went a long way to boost morale and continue to remind these individuals fighting COVID-19 that they are appreciated.

Exemplary Professional Practice Innovative Resuscitation Program Implemented at Catholic Health As the pandemic continued to change lives, the drive of nursing to persevere and provide the highest quality care to patients remained unchanged. Challenges to providing education within healthcare shifted with equal velocity to the way clinical care was provided to the community. Catholic Health and Kenmore Mercy Hospital rose to meet challenges in maintaining necessary certifications and continued education by offering virtual learning to associates by way of the American Red Cross Resuscitation Program. The program offers competency based learning followed by completion of physical skills graded in proficiency performance.

Nurse educator Maria Richardson, MSN, BSN, RN, CCRN-K, was integral in the roll out of the program at Kenmore Mercy.

Catholic Health’s introduction of the American Resuscitation Program leverages associate skills in BLS, ALS, and PALS to continue providing the highest quality care. The single greatest identifier to survival of cardiac arrest is high quality CPR.

Audio-visual assisted resuscitation training offers conditions that simulate a patient experiencing cardiopulmonary arrest with feedback regarding quality of CPR delivered. In 2021, Zoll defibrillators were also implemented across the system. With their inception, the defibrillator features feedback in the quality of CPR delivered to a patient experiencing a cardiopulmonary arrest. Catholic Health’s transition to training associates with feedback from audio-visual assisted manikins will improve the quality of care delivered to patients experiencing cardiac arrest in collaboration. The American Red Cross Resuscitation Program offers resuscitation suites at all Catholic Health locations. The implementation of the program promotes autonomous, competency based training, first by completion of computer based learning modules followed by simulation of skills with feedback, aided by our audio-visual resuscitation manikins.

Nurse Educator Provided Important Education in the Red Zone Not all healthcare heroes fighting the pandemic were at the bedside. Sarah Sattler, MS, RN, CCRN, a clinical educator at Kenmore Mercy Hospital last year, reflected on her experience preparing nurses to care for COVID-19 patients in a June American Association of Critical-Care Nurses article. As an educator and critical care certified nurse, she was right in the ‘red zones’ along with many of these ‘deployed’ nurses (both critical care and non-critical care) who were caring for critically ill patients. “Some nurses perceived their education as useful, whereas many others were overwhelmed and anxious about providing this level of care to their patients,” said Sarah.

Nurse educator Sara Sattler, MS, RN, CCRN, talks with ICU nurse Emily Rotolo, BSN, RN.

Sarah acted as a resource to help these nurses and provided just-in-time education. This included helping them to prone their first patient and initiate their first vasopressor; teaching them how to zero an arterial line; helping them through their first train-of-four peripheral nerve stimulation; and helping them provide oral care to their first intubated patient. Looking back at the year, “I was also there to see the positive outcomes that brought a glimmer of hope during a scary time,” said Sarah.

“Great Catches” Prevent Potential Patient Harm The Great Catch program is a Quality & Patient Safety initiative designed to help Catholic Health catch and avoid situations that have the potential to cause harm to patients. Melissa Coppola, RN, from the Emergency Department, was recognized by Kenmore Mercy for her Great Catch in August 2020. Allyson Gay, BSN, RN, from the Emergency Department, was recognized by Kenmore Mercy for her Great Catch in October 2020. Registered nurses Barbara Kanaley, BSN, RN, and Lisa Nikiel, RN, from the Ambulatory Surgery, received the Catholic Health Great Catch Award in 2020.

Melissa

Alyson

Barbara

Lisa

Weekly Huddles Helping with Fall Reduction

From September of 2019 to April of 2020 there were an increased number of falls at Kenmore Mercy Hospital. In response, the Kenmore Mercy Hospital nursing leadership team, led by Director of Nursing Jeanette Hughes, MSN, BSN, CPHQ, NE-BC, started weekly falls meetings in May. The team consisted of all the nurse managers who would review the falls, complete chart audit and review with staff to look for opportunities to improve. In June, bedside nurses and nurse attendants joined the team weekly. The addition of bedside leaders to this work group added valuable insight related to causes of falls and solutions to prevent further falls. Kenmore Mercy Hospital had a decrease in the fall rate for five consecutive months following the implementation of the weekly falls meeting.

Hospital-Acquired Pressure Injury Stage 2 and Above 16

Percent of Patients Surveyed

14 12

Pressure ulcer or injury prevention remains one of the most common and significant tasks in healthcare for decreasing harm.

10 8 6 4 2 0

1Q20

2Q20

3Q20

4Q20

2 South

2 East

2 West

3 East

0 0

MRU

Pressure Injury Prevention a High Priority

ICU

14.29

NDNQI Mean

0.99

1.29

1.15

1.2

Preventing pressure ulcers is accomplished through interprofessional teamwork and leadership, including ongoing education and collaboration. In 2020, the medical surgical areas outperformed the national average in all four quarters with zero pressure injuries, stage 2 and above.

The Intensive Care Unit outperformed the national average in the second, third and fourth quarters. During 2020 the skin champions, certified wound care nurses and dedicated wound and ostomy nurses identified the need to have pressure relieving surfaces and products more easily accessible for bedside staff. New pressure relieving mattresses were purchased for the Intensive care unit and pressure relieving heel boots were made available on all patient care units.

National BSN Challenge Met at Kenmore Mercy Hospital The Institute of Medicine’s 2010 The Future of Nursing report recommended the proportion of nurses with a Bachelor of Science in Nursing (BSN) increase to 80% by 2020, which Kenmore Mercy’s nursing team accomplished as of December 2020. Furthermore, they exceeded the national number which was most recently only 57 percent. Research suggests that BSN nurses are better prepared to meet the increasing needs and complexity in nursing care. BSN preparation for nurses correlates with lower patient mortality rates, fewer medication errors, and increased positive outcomes, according to the 2014 American Association of Colleges of Nursing (AACN) assessment. Furthermore, AACN suggests that BSN prepared nurses higher competency in nursing practice, communication and leadership. In 2017, Kenmore Mercy Hospital nursing leaders worked with Catholic Health leadership and government representatives in Albany to advocate for “BSN in 10,” a law that requires all nurses to obtain a BSN within ten years of receiving their initial registered nurse licensure. That same year, the Kenmore Mercy nursing team set an internal goal to increase their BSN rate from 75% to 80% by 2020 to meet the national challenge. This stretch goal required everyone’s dedication to elevate hiring practices, work closely with local academic institutions to leverage student experiences and to provide opportunities to our current nursing team to increase their education. With the BSN challenge met, the nurses at Kenmore Mercy Hospital are true to the IOM report’s description of being consistently dedicated to better patient outcomes and are prepared for the complexity of their patients. SE6EO Organization Results for RNs Who Have Earned a Bachelors or Higher Degree in Nursing

81% 80%

Percentage

79% 78% 77% 76% 75% 74% 73% 72% Org. Level BSN or Higher Degree in Nursing

2018

2019

2020

75%

77%

80%

77%

79%

Goal: 2% Annual Increase

Congratulations to our 2020 grads from the Catholic Health/Niagara University RN to BSN program - Robert Gross, BSN, RN; Amanda Kowalski, BSN, RN; Kelly Martin, BSN, RN; and Jessica Schulte, BSN, RN. Thank you to our graduates for all their hard work and continued commitment to their professional development.

New Knowledge, Innovations & Improvements

Nurse Mary LaMartina, BSN, RN, said goodbye to Joseph.

Associates Bid Farewell to Recovered COVID-19 Patient The lobby, stairwell, and balconies of Kenmore Mercy were filled with associates on April 22, 2020, as they gathered to bid an emotional farewell to 27-year-old Joseph Marquez, the hospital’s first successfully extubated COVID-19 patient. Presenting with serious respiratory issues when he first arrived at the ER on March 31, Joe came to the hospital in the middle of the pandemic. After a brief stay in the designated COVID-19 Unit, he began to decline and was transferred to the ICU, where he was intubated and put on a ventilator to help him breathe. Due to his COVID-19 status while on 2 South, he was unable to be admitted to the Medical Rehabilitation Unit for the therapy he needed, so the nurses decided to bring the MRU care to him, something that had never been done before. Developmentally disabled, Joe has always had his mother, Carol, by his side. Due to visitor restrictions, she was unable to visit her eldest son during what she described as “the longest and scariest journeys” of their lives. Three weeks later, he went from being in the ICU on a vent for two weeks to the hospital’s first successful COVID extubation. And, he was back to baseline! The nurses not only cared for him clinically, but worked to ensure that he stayed in contact with his mother through the use of an iPad when he was on 2 South. This approach comforted him when he wasn’t able to able to see her in person. Joe and the nurses developed an immeasurable bond that is representative of the compassionate care that Kenmore Mercy Hospital is known for. One of the most precious stories was how one ICU registered nurse, Mary LaMartina, BSN, RN, CCRN, sang “You are my sunshine” to him because that’s what his mom would have done to keep him calm. The clinical team was very touched by their experience meeting and caring for Joe. As he left the hospital, it was truly a celebratory scene as he was ushered in a wheelchair through the lobby surrounded by the many individuals involved in his care. Medical/surgical and critical care nurses, rehabilitation staff, respiratory therapists, case managers, spiritual care, and so many others came to say goodbye to Joe and his mother. Seeing Joe go home gave everyone hope that many more could beat COVID-19.

OR Innovations Lead to Creation of Anteroom In late March 2020 as COVID-19 became a reality in Western New York, the nurses at Kenmore Mercy were concerned about how to care for their surgical patients safely. To do so, they presented a plan to construct a specialized “anteroom” to accommodate COVID positive patients within the operating suites. Using a negative pressure air chamber that isolates clean work space from contaminated work space was the brain child of Melissa Kowalski, BSN, RN, CNOR. Thanks to the collaboration of the operating room nurses, this original idea was turned into reality in just six days …. from Kent Chittley, RN, drawing up a design to implementing the plan.

Aaron Lange, BSN, RN

Working as a team with plant operations, the anteroom was constructed. Within 24 hours of construction, the perioperative team safely cared for the first of many COVID positive patient emergencies in surgery. Their innovative plans ended up adapted across Catholic Health. As the only Magnet designated hospital in Western New York, the operating room nurses at Kenmore Mercy Hospital strive to be leaders in excellent patient care and nursing knowledge. This same group of nurses did not let the events of 2020 disrupt their professional goals, with six operating room nurses having studied and passed a challenging exam during the pandemic to receive their Certified Nurse Operating Room certification.

Anteroom

They join many others at Kenmore Mercy who have been successful before them, bringing the operating room team up to 60% certified. Education and professional development is a key goal for Kenmore Mercy’s nurses through every career stage, leading to greater innovation and autonomy. The operating room nurses’ continued successes and excellent patient outcomes during such a challenging year is an example of their dedication to the nursing profession.

Original draft of anteroom plans by Kent Chittley, RN.

Nurses in Driver’s Seat for COVID-19 Drive-Thru Testing As the COVID-19 pandemic spread quickly through the community in the spring of 2020, it was clear that a method for testing associates, as well as patients undergoing invasive procedures, was needed. Working in collaboration with volunteers from the Emergency Department, Post Anesthesia Care Unit and 2 West, ER Nurse Manager Sue McClure, MSN, CEN, and Director of Nursing Jeanette Hughes, BSN, MSN, CPHQ, NE-BC, set up a process for drive-thru testing. With surgical volume reduced at the time due to a state halt on elective procedures, as well as a low inpatient census, the hospital was able to take advantage of the availability of these nurses during this critical time. Thanks to their experience and creativity, a temporary tent was set up behind the hospital and COVID-19 nasal swab testing started in May.

Lori Ann Meder, BSN, RN, CCRN, and Rachel Achtziger, BSN, RN, CNOR, from PACU, along with Leana Prokoshev, RN, from 2 West, were key players in setting up the COVID testing site.

While the virus itself posed many challenges, the nurses were also faced with outside elements like snow, rain and strong winds. With the start of Buffalo’s frigid temperatures in October, a permanent solution was needed. A trailer was set up at the front of the hospital by November. “We had to adapt quickly to this new world of COVID-19,” said Jeanette. “Throughout the last year, so many of our nurses had to be deployed to other places to support the needs of our COVID-19 patients. People have been very willing to step up and learn and to take on this challenging situation,” she added. When COVID-19 forced Kenmore Mercy’s pulmonary rehabilitation clinic to close in 2020, this group of nurses stepped up and accepted any task that was needed, and today operate the drive-thru testing site with a few volunteers from other areas when needed. The nurses began their days helping set up the testing site with needed supplies and required personal protective equipment. Nurses needed to be sure they were up to date with any changes regarding proper donning and doffing of PPE, what PPE was needed for each testing site patient care role, as well as proper swabbing technique. Changes sometimes occurred overnight. Testing continued to change over the course of the year, with result turnaround improving as Catholic Health worked with local partners and processed the tests in-house. Initially the patients were called with their results if positive from a provider or department. The new Epic electronic medical record made it possible for patients to access their medical records with an online account using MyChart. “Adaptability has been key for our COVID-19 drive-thru testing site to be successful,” said Jeanette. Testing criteria and supplies have been changing since this site opened. “We are so grateful for all of our nurses who stepped up to this challenge and worked outside their comfort zone to fill this need.”

Despite a worldwide pandemic ... life went on, families grew, and people graduated 2 West. Ryan Lewis purchased a new home. Daren Powers and Jim McQuade both welcomed new babies. Alyssa Anderson is expecting a baby. Wendy Lin, Fred Rich and Morgan Aversa became registered nurses. IXR. Rob Morello started taking guitar lessons. Tina McGee got a dog. Kathy Daley’s daughter passed her BAR exam.

PACU. Together with her husband Jason, Lori Meder got a new dog. Linda Korniker welcomed a new grandson. Cara Matiash was a maid of honor. Janelle Post bought thirty new house plants in 2020.

Pulmonary Rehab. The nurses kept in touch with their patients who were sheltering in their homes safely. They served as associate screeners, keeping everyone safe. Ann Carroll welcomed her eighth grandchild. Karen Hamp welcomed a new in-law in a military wedding.

Critical Care Team Adapted to COVID at Lightening Speed Kenmore Mercy’s Intensive Care Unit nurses found themselves rapidly altering the way they cared for patients with COVID-19 in 2020. This ranged from using new protective gear to new treatment protocols. In addition, they were faced with staffing changes as their nurses and the intensivist team were shared with Catholic Health’s St. Joseph Campus, the region’s first COVID-19 only inpatient treatment facility. New nurses from throughout the hospital stepped in to help, while physician residents and hospitalists shifted their focus to critical care. James Fitzpatrick, MD, formally the intensivist director, returned to help ICU caregivers Tonya Holscher, RN; Rae Ann Alexander, RT; Sandy Conti, BSN, RN, CCRN; Jessica Cianfrini, BSN, RN, CMSin the ICU also. RN; and Laxey Lynch, RN, treated patients while in full PPE. Many new protocols went into effect quickly. Nurses were instrumental in “out of the box” thinking, finding creative ways to effectively care for the isolated, yet critically ill patients. They implemented IV set ups outside the room in order to manage the multiple critical IV drips and used extensions on ventilators and feeding tube equipment, etc… to protect the nurses and staff from additional COVID exposure where possible. Donning and doffing “buddies” were in place to assist with ensuring proper technique when utilizing protective attire and equipment. Medical-surgical nurses were used as ICU nurse helpers and worked side by side with them, proving to be invaluable to the team. Before the opening of Catholic Health’s COVID treatment facility, Kenmore Mercy’s ICU was packed with infected patients, challenging the nurses to adapt and learn new protocols quickly. And adapt and learn they did – from new medication and protocols, to expanded roles in their daily nursing activities. They also shared their vast experience, teaching Continuous Renal Replacement Therapy (CRRT) and proning to ancillary associates, as well as St. Joseph Campus ICU nurses. The ICU team worked amazingly well with all the changes in protocols and staff mix. They never lost sight of their calling – to care for the sickest of the sick patients with compassion, respect, dignity and excellence. They were all at once nurse, sole supporter and encourager, and friend to these patients when no visitors were allowed. Sitting with a patient during their final hours or facetiming with the patient’s family to provide comfort and updates, were all part of the new routine – while never missing a beat in providing the critical care needs of the patient. “I cannot stress enough how courageous and selfless this team was during what could definitely be considered the most difficult days of our career. Thank you to these nurses for their innovation, collaboration, and expertise that were vital in ensuring a continuity of care for all ICU patients,” said ICU nurse manager Kristen Parisi, CCRN-K, BSN. ... People learned new skills, nurses started new journeys and changed roles 2 South. Rachel Tronolone is in school for a master’s degree in education. Holly Grimm’s daughter got married and is pregnant. Marisa Rauber adopted a yellow lab. Elizabeth Kremers got married and is pregnant. Sarah Schultz graduated nursing school. Rachel Tronolone got engaged to Zachary Boyd.

ICU. Ashley LaFave and Brett Sullivan both had babies. LaPorscha Gardner and Emily Rotolo graduated from NP programs.

OR. Jillian Vilardo and Lauryn Papierski are expecting. Melissa Kowalski had a son. Alycia Anderson got married, Desaire Evaldi and Michelle Weber welcomed granddaughters. Pre-Admission Testing. Sr. Mary Walter Melissa Brockman bought a house. and Mary Dowd both assumed the Judy Rockwood remodeled her dining role of N95 mask reprocessing. Jilroom. Becky Anderson went to Disney lian Hoover is expecting a baby. Kathy ten times. Steinkirchner had a new granddaughter.

Emergency Department Nurses at Frontline of Pandemic Kenmore Mercy’s Emergency Department nurses were on the frontline throughout the pandemic, serving an essential function in identifying COVID positive patients and isolating them early, while still providing urgent medical care. As cases started popping up across the country, the ER team was tasked with designing optimal safe patient pathways. When the first case was identified in Western New York, the team had already conducted practice drills. Collaborating and communicating with the EMS became vital to ensuring the safe care for and transport of emergency patients. Prenotification from EMS allowed for rerouting of patients with COVID symptoms to enter through a separate door and placement into a negative pressure room, keeping everyone safe. As the testing platforms for COVID changed multiple times, the ER nurses worked closely with the lab for the processing of tests. In anticipation of a potential patient surge, the nurses were also tasked with the set up and management of an outdoor clinical tent (above) to keep the waiting room safe for patients and to swab associates who were exhibiting symptoms. Confronted with rapidly evolving circumstances, the ED nurses faced the challenges head on and adapted. Thank you to everyone for their resiliency, spirit of fortitude, patience, tolerance, and hope.

MRU Helps Patients Get Home The Medical Rehabilitation Unit played an important role for postCOVID patients who had spent months on a ventilator and came to Kenmore Mercy Hospital functionally impaired. The intensive therapy and specialized nursing care in the MRU helped numerous individuals get back on their feet and to home over the last year. The nursing team coordinated countless virtual and window reunions with their patients and families who wouldn’t have seen each other for months due to restrictions from the pandemic. With COVID ever-present, the team also re-imagined rehabilitation services to ensure patients could continue their therapy while preserving safety during strict isolation precautions. Despite COVID, Kenmore Mercy’s MRU doubled its bed capacity to help meet the needs of patients from throughout Catholic Health, working in collaboration with three other nursing units to do so.

Russel Day, an 88-year-old patient, took a break from his therapy to see his wife Shirley and their family through the glass window of the community room. Hospitalized early in the pandemic after a brain bleed, it was the first the time the family had seen one another since then.

... Milestones were celebrated, babies were born, and dogs found their “furever” families. ASU. Barbara Kanaley’s and Patricia Harter’s sons just got engaged. Susan Wasielewski’s daughter got married in Houston. Medical Surgical Floats. They were deployed to the ED and ICU and helped in whatever way was needed. They started an ACLS certification initiative. Julie Marshall had a baby.

3 East. Bridget Gregory, Victoria Holetke, Cory Bloomingdale each got engaged. Jackie Loss bought a house. Anzu Khanzuman and Kourtney Donaldson are expecting babies. Shannon Donnovan graduated from NP school. Svitlana Pietre graduated from nursing school. Kelly Martin had a baby boy. Mary Willis was recognized for charitable work.

ER. Liz Rutowski, Amanda Kowalski, and Allyssa Greis had babies. Hana Mehmedovic got engaged. Sue McClure, Lindsey Guzdek, and Maria Roberts each adopted puppies.

In the Red Zones, Change Became the Norm The COVID-19 pandemic required nurses across Kenmore Mercy to rapidly adapt as they turned 2 South, 2 West, and 3 West into red zone areas to treat patients infected with COVID-19. In mid-March, with elective surgeries on hold, the hospital’s Knee & Hip Center on 2 South discharged or transferred all remaining patients off the unit. Thanks to the innovation of the team, it quickly became a closed COVID only unit. While 2 South was a designated red zone for COVID-19, Terri Viverett, Marisa Rauber, Liz Budzinski and there was also a need to offer patients who were in isolation Melynda White cared for patients in the red zone. with the virus medical rehabilitation level of services. The nursing leadership teams from 2 South and MRU met to create a plan to care for MRU patients on 2 South. The 2 South nurses cross trained to learn rehabilitation documentation and also partnered with the MRU nurses to ensure appropriate care continued despite the barriers they faced.

MRU nurses Christine Schwinn, MSN, BSN, RN, and Mary Jane Lodico, BSN, RN, WCC, met with 2 South nurses Sue Zeiz, RN, and Deb Micholas, BSN, RN, ONC.

In anticipation of being able to resume elective surgeries, with the need to still care for COVID-19 patients, a new location for a red zone was needed. In April of 2020, the 2 West nurses helped to design the red zone on that unit and were positioned to take over the care of COVID-19 patients.

Over the course of the year, 2 West transitioned from a whole red zone to a partial red zone, adapting to the increases and decreases in the COVID-19 patient volumes. As Kenmore Mercy saw a return to its usual inpatient volume with COVID-19 patients still present in the hospital, 3 West was used as a COVID-19 red zone. Nurses and nurse attendants throughout Kenmore Mercy volunteered to be temporarily reassigned to 3 West or pick up extra shifts, working as a team to care for these patients. By May, elective surgeries resumed, but COVID cases spiked again shortly before Thanksgiving, leading to the reopening of the 2 South as a COVID only unit. Faced with New York State restrictions, a number of the nurses also worked closely with Ambulatory Surgery for same day orthopedic surgeries.

Leah MacPherson, BSN, RN, helped set up the 3 West red zone.

... Kindness was spread and new hobbies were started. Perioperative Float. Nancy Nikisher has a new granddaughter. Jill Baker’s son is graduating from high school. Christine Fleming has two daughters in college for nursing in Virginia. Benedetta Induddi’s daughter got engaged. SPD. Rapheal Washington had twin granddaughters. Charise Hampton’s grandmother turned 93.

2 East. Tina Ouellette, Jenn Barone, Andrea Gaeta and Gena Long all started NP programs. Jenna Holevinski, Alex Sloan and Erica Homme graduated from NP programs. Teresa Oldfield and Justin Szeluga graduated nursing school. Lynn DeGrasse adopted a labradoodle. Victoria McDonald is pregnant. Jessica Burzynski had a baby.

MRU. Zac Capolla and Jill Dodson completed the FNP program at D’Youville. Jill got engaged. Cardiology. Jennifer Rennells’ daughter graduated with a Civil Engineering degree from UB. Tara Groulx ‘s son turned 13. Alanah Rzeznik celebrated her 30th birthday.

OUR VALUES

OUR MISSION

Reverence - We honor the inherent dignity We are called to reveal the healing love of and uniqueness of each person. Jesus to all. Compassion - We unconditionally demonstrate empathy, kindness, and OUR 2025 VISION acceptance. Integrity - We are honest, transparent, and As your trusted partner, inspired by faith and committed to excellence, we lead the accountable. transformation of healthcare and create healthier communities. Innovation - We continually learn, find creative solutions, and embrace change. Nursing strives to interact with our patients to achieve their goals, promote, Community - We work together to build maintain and sustain health and to ensure community and promote social justice satisfaction of the care the patient in our organization and in society. receives. Excellence - We commit to exceed the expectations of all the people we meet at Catholic Health