2018 Nursing Annual Report by Catholic Health

Nursing

2018 Annual Report Nurses Inspire, Innovate, Influence Empower Excellence Through Collaboration Sustain Excellence Together

Create A Healing Environment For All

Thank you from

the Vice President of Patient Care Services & Chief Nursing Officer The year 2018 was challenging and yet dynamic for Kenmore Mercy. It was a year of establishing new partnerships, pursuing excellence, and advancing through technology. While January started with a full house and a surge of patients related to the flu season, you rose to the occasion. Despite circumstances, you worked diligently to meet the needs of our patients with skill and compassion. One thing that Kenmore Mercy’s nurses do well is go above and beyond. In 2018, you achieved Bachelor of Science Nursing degrees, master’s degrees, and certifications. In fact, 75 percent of our nurses are BSN prepared. I’m proud to share that many of them were recognized above and beyond for their community service and patient care also. Another area where we have excelled is our Palliative Care Program. A leading light in the community, the program helps identify and provide empathetic care to dying patients and support to their families. In addition, nurses are in the community educating people about the importance of having advance directives. We worked to establish and enhance key partnerships in the community as well. In collaboration with the CWA, we developed a very successful mentorship program to support new nurses starting their career or employment at Kenmore Mercy. We also began a new endeavor with University of Buffalo to pursue two important nursing research studies focused on the impact of music therapy on PACU patients’ pain and night nurses’ sleep patterns. The new year holds its own challenges and changes. The building of EPIC, the upcoming Catholic Health electronic medical record, will begin the summer of 2019. Many of you will be involved with this project, ensuring its integration on how we practice nursing. At the end of June, I will relinquish my role of Vice President of Patient Care Services & Chief Nursing Officer to start a new chapter in my life. Together, we have experienced an incredible journey to nursing excellence. I am so very proud of all of you for your dedication to nursing, the compassionate care you provide, and for your compelling efforts to ensure patient needs come first. Stay focused on your work. Always provide compassionate care and advocate for what is best for your patient. Be kind and support one another. You need each other throughout your journey of excellence and exemplary care. Continue your commitment to nursing through education and the development of nursing practice. I wish you my best and I will miss you all. Always,

Cheryl W. Hayes, MS, ANP, NEA-BC Vice President, Patient Care Services & Chief Nursing Officer

Welcome from

the President & Chief Executive Officer

Welcome to Kenmore Mercy Hospital’s 2018 Nursing Annual Report. As President & Chief Executive Officer, I’m pleased to be able to share with you our many great nursing achievements over the past year. In the fast-paced healthcare environment, change is inevitable. Patient experience & safety, technology, and associate engagement pose unique challenges in the practice of nursing. Despite that, you, our outstanding nursing team, have continued to demonstrate a commitment to providing exceptional care to Kenmore Mercy’s patients and their families. You have shown a dedication to enhanced knowledge and skills, working to complete higher education degrees, achieve certifications, and complete specialized training. Your commitment to ensuring first-rate and safe quality care has led Kenmore Mercy to become a nationally recognized hospital. We are the only Magnet® recognized facility in the eight counties of Western New York, the only hospital in New York State to earn ten consecutive “A” grades from The Leapfrog Group, and the only local hospital to receive an overall four-star rating from Centers for Medicare & Medicaid Services’ Hospital Compare Report. What amazing accomplishments! Thanks to all of you for another positive year of safe, quality, and compassionate care.

Sincerely,

Walter Ludwig President & Chief Executive Officer

Editorial Staff

Anne Hedges-Creighton, MS, BSN, RN Dawn M. Cwierley, AS, BS Cheryl W. Hayes, MS, ANP, NEA-BC Amber Mazurek, BSN, RN, ONC Heather Telford, MS, BSN, CEN, NEA-BC

Leadership Messages Pgs. 2 - 3

Transformational Leadership Pgs. 4 - 7 Structural Empowerment Pgs. 8 - 15 Exemplary Professional Practice Pgs. 16 - 17

New Knowledge, Innovations, & Improvements Pgs. 18 - 21 Awards & Recognitions Pgs. 22 - 23

Transformational Leadership “Transformational leadership means my nursing practice is supported by my leaders” ~ Mary Jane Lodico, BSN, RN, WCC Medical Rehabilitation Department

Nurses given a voice through VOA Thank you to all of our nurses for participating in the 2018 Professional Nursing Practice Voice of the Associate Survey. The survey results showed that our nursing units outperformed the national average in four out of seven key excellence categories. Areas to celebrate: • Autonomy - Nurses are involved in decisions • Fundamentals of Quality Nursing Care - We strive for safe error-free care • Interprofessional Relationships - Effective communication between physicians, nurses and other medical personnel - Effective use of cross functional teams • Leadership Access and Responsiveness - Nurse leaders are accessible • Professional Development - Nurses have sufficient training needed to do the job

Areas of focus are: • RN to RN Teamwork and Collaboration - Nurses help others even when it’s not part of their job - Nurse manager encourages teamwork - Work units collaborate - Nurses help others to accomplish their work • Fundamentals of Quality Nursing Care - Nurses are involved in quality improvement activities All of us recognize that nursing teams who work together and collaborate for a common purpose are tied to outstanding patient outcomes and nursing satisfaction. Many of you have already been working hard in 2019 to improve the way your nursing unit works with each other to deliver high quality care. For our patients, and our peers, it’s an important and worthy goal to achieve. As Magnet® nurses working together, we can exceed the national average in all seven nursing practice categories.

The role of informatics in nursing

Ever evolving, nursing informatics assists in patient satisfaction and safety, associate engagement, and overall communication. Over the past year, Kenmore Mercy’s Nursing Informatics Committee worked in collaboration with the Information Technology and Public Relations Departments on the successful implementation of electronic message boards on inpatient care units. This technology allows nursing leadership and other areas of nursing to quickly and efficiently communicate with nursing and interprofessional teams.

White lab coats add to patient experience

“We are catching the attention of the staff by using photos of associate’s pets on communications,” noted nursing supervisor Carole Woomer, BSN, RN, CMSRN.

Appearance makes a difference. It creates a feeling of confidence and respect. In a hospital setting, that first impression becomes an important part of the patient experience.

The Nursing Informatics Committee has also been involved in the evaluation of the various forms of electronic communication in the hospital.

For our nurse leaders who are at the forefront of creating positive workplace cultures, they set their first impression by wearing white lab coats.

Nursing staff has provided feedback regarding Tiger Texting and Teletracking also.

In fact, studies have shown that patients prefer seeing a clinician in a white coat, noting that it makes them seem more “knowledgeable, trustworthy, caring, and approachable.” The Kenmore Mercy Foundation recently made it possible for all our nurse leaders to receive a white lab coat on which they proudly wear Magnet® patches.

Members of the Nursing Informatics team - registered nurses Jessica Schulte, Carole Woomer, Maria Robertson, and Nancy Nikisher - meet monthly at Shared Governance.

ICU Nurse Recognized by AACN Intensive Care registered nurse Mary LaMartina, BSN, RN, CCRN, received the Circle of Excellence Award from the American Association of Critical-Care Nurses (AACN). Each year up to 25 individuals who exemplify excellence in high acuity and critical care nursing practice are chosen for a Circle of Excellence award. Recipients are recognized at the AACN National Teaching Institute & Critical Care Exposition. Mary was recognized because of her community service through the Western New York chapter of the AACN. She is a leading organizer for service projects with The Girls and Boys Club of Buffalo - a “Back to School” backpack and school supply drive.

The white lab coat is a symbol of the trust that society places in these nurse leaders, an emblem of their expertise, and a sign of the critical relationship between them, the nursing staff, and their patients. The white coat is a representation of their professional responsibility in the healthcare professions. Mary has also been in charge of donations to the City Mission Cornerstone Division which serves homeless woman and children. She, in collaboration with other AACN members, led the donation drive making “Welcome Bags” for the new residents of Cornerstone. Other activities included providing the means for the Cornerstone staff to become CPR certified and arranging for a psychiatrist to speak to members about the issues they face. Mary is actively involved in the hospital’s Palliative Care Committee. She is an advocate for empowering the community to make educated decisions regarding their healthcare. She speaks at physician offices in the community and provides education for the hospital nurses to feel more comfortable having end of life conversations with patients and families.

Mentor program helping improve nurse retention

Kenmore Mercy is always striving to improve nurse retention rates and over the past year one activity that focused on that was the implementation of the Nurse Mentor Program. The Mentor Program was developed as a collaborative effort between CWA and Kenmore Mercy nursing leadership, as well as Daynell Rowell-Stephens, RN, from our corporate team. The program was developed based off of Academy of Medical-Surgical Nurses (AMSN) guidelines and is led by 2 West registered nurse, Johanna Boyd, CMSRN. Adopted from the AMSN Mentoring Program, it is the framework to guide for the passage of wisdom, caring, and confidence between new and experienced nurses. The mentor serves as an immediate resource and provides moral support, guidance and advice. It was no surprise that the Mentor Program was met with enthusiasm from experienced clinical nurses, with an overwhelming eagerness to represent each direct care unit and become mentors. Each mentor is provided education. They are supported by Johanna, who also carefully pairs each mentor and mentee based off of a nurse profile to ensure a good match. The intention is to guide a mutual relationship between an experienced nurse (mentor) and a new nurse or nurse transitioning to a new role (mentee).

Kenmore Mercy’s dedicated mentors are:

2 East/South

Jennifer Barone, RN Lynn DeGrasse, RN Samantha Belter, RN Holly Grimm, RN Sue Wasielewski, RN Kitty Scribner, RN Leigh Skrzynski, RN Heather Fell, RN Alan Chittley, RN Briana Geddis, RN Danelle Lalewicz, RN Kate Ritch, RN 2 West Daren Powers, RN Johanna Boyd, RN James McQuade, RN Leana Prokoshev, RN Emma Smith, RN Annette Gillies, RN Leah Jacobs, RN Morgan Crisco , RN

MRU Amy Shellman, RN Cindy Stogsdill, RN Mary Jane Lodico, RN 3 East Cheryl Tumia, RN Gina Willett, RN Liz Kaminski, RN Janice Ruffino, RN Amanda Stewart, RN Karen Duerr, RN Julie Wolcott, RN ICU Tonya Holscher, RN Laxy Lynch, RN Jessica Cianfrini, RN Ashley Page, RN Janelle Post, RN Patient Care Services Cheryl Hayes, RN Amber Mazurek, RN Joy MacNeil, RN Maria Richardson, RN

Emergency Department Marcia Powers, RN Amanda Kowalski, RN Maria Roberts, RN OR/PACU Rachel Santana, RN Anne Marie Hawn, RN Bonnie Shantz, RN Tracey Schmidt, RN Lydia Moreno, RN Michelle Weber, RN ASU Lisa Nikiel, RN Heidi Frushone, RN Nurse Practioners My Lan Le, NP Nursing Floats Morgan LePage, RN Interventional Kayla Hoffman, RN Radiology Kathy Daley, RN Judy Lalime, RN Endoscopy Marie Sullivan, RN

Nurses light the way with Magnet® recognition As part of Kenmore Mercy’s celebration of one year as a Magnet® hospital, there were multiple festivities throughout 2018. During Nurses’ Week in May, nurses and other associates gathered outside at dusk to officially light Magnet® banners hung on the sides of the building. “I’m so proud of each of you! Let your light shine! And tonight, we let our light shine brightly for anyone who passes our hospital from this day forward as we illuminate our Magnet® signs!” said Cheryl W. Hayes, MS, ANP, NEA-BC, vice president of Patient Care Services & Chief Nursing Officer, during the presentation. The continuation of our Magnet® journey was also strongly represented during the Fall Associate Forum sessions that occurred concurrently with the Fall Back Into Magnet® activities. Nursing associates enjoyed trivia, left messages about what the recognition means to them, took photos with the Magnet® selfie board, and much more. Currently Buffalo’s only Magnet® hospital, this designation represents the highest distinction a hospital can receive for nursing excellence and high-quality patient care.

It is the “gold standard” for nursing excellence. “Our goal is bigger than achieving the award, it is to build positive and improved patient outcomes, and the best working environment,” noted Cheryl. The nursing team is now working toward re-designation in April 2021. “Our team is truly deserving of this honor. However, to achieve Magnet® designation and maintain it, we must continually improve and outperform national benchmarks on nurse sensitive indicators such as Falls with Injury, HAPI, CLABSI, and CAUTI,” explained Amber Mazurek, BSN, RN, ONC, nurse manager and lead of Kenmore Mercy’s Magnet® program. “It is the right thing to do for our patients, to provide high-quality care, a safer environment and better patient outcomes,” she added.

Kenmore Mercy Building partnership with UB As a Magnet® recognized hospital, is it important that Kenmore Mercy’s nurses continue with research and innovation.

“It is widely recognized throughout the healthcare community as an essential component for achieving Magnet® status.”

On the recommendation of the lead appraiser from Kenmore Mercy’s Magnet® survey in 2017, the hospital’s nurses began a new endeavor, collaborating with the University of Buffalo (UB).

With Dr. Lorenz’s guidance, the Shared Governance Committee generated ideas centered on issues important to patient care and associate safety.

First initiated by a conversation between the hospital’s Vice President of Patient Care Services & Chief Nursing Officer Cheryl W. Hayes, MS, ANP, NEA-BC, and UB’s Marsha Lewis PhD, RN, FAAN, professor, Dean of Nursing, our nurses have since teamed up with associate professor Becky Lorenz, PhD, RN. Dr. Lorenz has now provided several presentations to the Shared Governance Committee on the importance of evidence-based practice. “Evidence-based practice is the gold standard for providing safe and compassionate care,” stated Cheryl.

Specifically for the Night Shared Governance Committee, they began addressing the effects that shift work has on sleep. In addition, the Post Anesthesia Care Unit developed a research study looking at the effectiveness of music on the post-operative pain among spinal surgery patients. “We are very grateful to both Dr. Lewis and to Dr. Lorenz for their support and assistance in developing and further promoting nursing research at Kenmore Mercy Hospital,” noted Cheryl. “We look forward to our continued collaboration.”

Structural Empowerment “Structural Empowerment means I contribute to the healthcare education of our community.” ~ Holly Grimm, BSN, RN Patient Care Services

BSN degrees preparing nurses for a broader scope of practice Kenmore Mercy Hospital remains ahead of the curve, having provided its nurses with resources to achieve advance degrees many years before New York State passed the “BSN in 10” law. One of our first graduates of the “RN to BSN” program was Deborah Micholas, BSN, RN, ONC, nurse manager of the 2 East Patient Care Unit. She was featured in Buffalo Business First this past summer, highlighting her success after completing a Bachelor of Science in Nursing. Debbie joined Kenmore Mercy ten years ago and quickly showed a thirst to learn and improve patient care, making her a prime candidate for higher education. She, like many other nurses at Kenmore Mercy over the last nine years, completed her Bachelor of Science through the Catholic Health and Niagara University 30 month-long “RN to BSN” program. Catholic Health covered the tuition, books and applicable fees. “This education has helped me fine tune my critical thinking, and communication and research skills to benefit both the hospital and our patients,” Debbie said.

Nurse manager and Niagara University “RN to BSN” alumnae Deborah Micholas reviews a copy of Business First.

At this time, registered nurses who hold a New York license will be grandfathered in - regardless of degree level. “BSNs give our nurses the knowledge they need to practice effectively in the increasingly complex health care industry,” said Cheryl W. Hayes, MS, ANP, NEABC, vice president of Patient Care Services & Chief Nursing Officer.

She started as a medical-surgical staff nurse and after completion of her BSN was promoted to a supervisor, and more recently to a manager, successes she attributed to her education.

The benefits of bachelor’s-prepared nurses have been documented by many studies including 2013 research by the University of Pennsylvania which found that a 10-point increase in a hospital’s percentage of nurses with BSNs was associated with a reduction of 2.12 deaths for every 1,000 patients.

New York State wants to see more nurses like Debbie and her BSN peers. After fourteen years of lobbying, New York State became the first state to pass a “BSN in 10” law that requires all nurses to obtain a Baccalaureate Degree in Nursing within 10 years of receiving their initial RN license. Many other states have plans to enact similar legislation in the near future.

Advanced degrees put nurses in good company with the interprofessional team with whom they collaborate regularly. Physical therapists, occupational therapists, speech therapists, pharmacists and social workers all are required to have bachelor’s, master’s or doctoral degrees.

Members of the graduating cohort — Christine Reaser, Nicole Palesh, Sue Ederer, Tonya Holscher with Cheryl Hayes (C) at their Catholic Health celebration in 2018.

As of 2018, more than 75 percent of Kenmore Mercy’s nurses had completed BSN programs. Additionally, 18 of our nurses completed master’s nursing degree programs. Congratulations to our latest graduates from the Catholic Health/Niagara University “RN to BSN” program - Christine Reaser, RN - 2 East/2 South; Mary Willis, RN - 3 East (not pictured); Tonya Holscher, RN - Intensive Care Unit; Sue Ederer, RN - Case Management; Nicole Palesh, RN - 3 East; and Cheryl Lewandowski, RN - Gastrointestinal (not pictured).

Kenmore Mercy has four nurses pursuing their Bachelor of Nursing degree in the next cohort that began in January 2018 - Bobby Gross, RN - 3 East; Amanda Kowalski, RN - Emergency Department; Kelly Martin, RN - 3 East; and Jessica Schulte, RN - 2 West/IT.

I’m proud to be a nurse at Kenmore Mercy because

“We’re working with our family.” ~ 2 South Patient Care Unit

The April active shooter program filled Kenmore Mercy Hospital’s Community Room with associates from the Operating Room.

Keeping nurses safe from harm A hot bed for emotions, hospitals across the nation are increasingly taking a closer look at their violence prevention plans. Kenmore Mercy specifically took action to create a safer workplace through training, communication, and creating physical barriers. That has included active shooter training, workplace violence seminars, addition of duress alarms in key locations, and the tightening of access points to the hospital, all actions that align closely with recommendations from The Joint Commission and OSHA. “It is important that our associates feel safer and more secure at work,” said Patrick Vaccaro, security supervisor at Kenmore Mercy Hospital. “When they know we are making efforts to ensure their safety, it removes distractions that could undermine their productivity.” In April 2018, Emergency Department registered nurse Jean Wood, MSN, RN, organized an active shooter program in collaboration with Michael Baumgartner EMT-P, from the Town of Tonawanda Police Department for the Operating Room staff as part of her Masters of Science in Nursing project. The session included real life videos and discussion about local incidents, as well as information about the hospital’s dangerous person policy.

“While working on my Masters Practicum in the OR, Linda Butski and I were struck by the Parkview Florida School shooting that left 17 dead. Together, we discovered the need to raise awareness for the potential threat of an active shooter within the OR and Kenmore Mercy,” said Jean. Many experts suggest that healthcare facilities should practice response plans with associates and take extra precautions to shore up their physical environment to ensure staff are as safe as possible. The addition of Allied Universal Security was noticeable in May 2018, a decision made to raise the level of security at the hospital. With that, officers are now stationed at the main doorways of Emergency Department, as well as Ambulatory Surgery and the front entrance during business hours. The rear entrances are only accessible by associates with their badges. Furthermore, panic alarms and CCTV cameras are located in high risk areas throughout the hospital. Using the newly developed Workplace Violence Prevention Program rolled out in 2018 as a guide, attendees better understood workplace violence and how it can impact them, while providing tips to on how to manage situations, reduce risk, and maintain personal safety.

‘Stop The Bleed’ partnership teaches life-saving skills

Kenmore Mercy’s Emergency Department registered nurses partnered with the Town of Tonawanda Paramedics this past year to provide hands on “Stop The Bleed” training in the hospital, throughout the community, and eventually into local schools. The program was designed to help prepare anyone to act as an immediate responder for a massive bleeding event from any cause, but particularly from an active shooter or explosive event, where response is delayed. “A person who is bleeding can die from blood loss within five minutes. Sometimes, that’s not enough time for emergency workers to respond,” said Amanda Kramer, MSN, RN, CEN, nurse manager of the Emergency Department and a “Stop The Bleed” trainer.

Registered nurses Tonya Holscher and Bridget Walborn participated in the training.

“Stop The Bleed” is intended to cultivate grassroots efforts that encourage bystanders to become trained, equipped, and empowered to help in a bleeding emergency before professional help arrives.

According to Tom Scime, EMS liaison, nearly 600 individuals were trained in “Stop The Bleed” classes led by Kenmore Mercy nurses in 2018.

Thanks to the Kenmore Mercy Foundation, the Emergency Department was able to purchase three training kits (valued at $950 each), containing lifesaving bleeding control equipment such as tourniquets, pressure dressings and gauze bandages to put into the hands of the individuals learning how to help control bleeding and save lives.

Training included an educational and hands on exercise where individuals are taught how to pack wounds, apply pressure and use commercial tourniquets.

This included our own Emergency Department and rehabilitation associates, several Catholic Health departments, Community Emergency Response Teams, local fire departments and churches, the Town of Tonawanda Transportation and Highway Departments, and faculty at Kenmore and Tonawanda schools.

Night shift nurses get a seat at the table Nursing Shared Governance is a hallmark of top nursing programs. It is even more valuable with well-rounded representation from all shifts. Kenmore Mercy’s nursing team convened their first night meeting in 2017, working to draw more engagement from that shift. Throughout 2018, Night Shared Governance has been involved in sharing ideas for best practice. The meetings, held on the second Thursday, every other month at 7:30 a.m., are open to all night shift employees and led by night shift nurses. “When nurses have a voice through our Nursing Shared Governance, they are more empowered, satisfied, and ultimately inspired about their own nursing practice,” said Carole Woomer, BSN, RN, CMSRN, nursing supervisor.

Thanks to our night registered nurses Bridget Gregory, Jennifer Earls, Rachel Santana, Carole Woomer, Alan Chittley, and Cory Bloomingdale.

Carole, along with nursing supervisor Nancy Chojecki, MSN, RN, CMSRN, has facilitated discussions to improve practice relevant to the night shift, such as how to provide a quiet environment for our patients.

Nurses recognized through national DAISY program DAISY, an acronym for Diseases Attacking the Immune System, is the name of a 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.

Betty received two separate nominations from patients, both of which remarked on the exceptional and compassionate care she provided to them. The one patient praised Betty’s ability to make her feel well taken care of in an uncomfortable time.

Samantha Belter, RN - 2 East/2 South Melissa Ferber, RN - Emergency Department Lindsay Canali, RN - 2 East/2 South Jillian Dobson, RN - MRU Megan Fulton, RN - 2 West Bobby Gross, RN - 3 East Michelle Harris, RN - Endoscopy/GI Jenna Holevinski, RN - 2 East/2 South Emily Hughes, RN - 2 West Julie MacDonald, RN - 2 East/2 South Kelly Martin, RN - 3 East Kourtney Kijanka, RN -3 East Jennifer Lee, RN - Emergency Department Rachel Santana, RN - Emergency Department Kitty Scribner, RN - 2 East/2 South Cheryl Tumia, RN - 3 East Ann Uldrich, RN - 2 East/2 South Abbe Walsh, RN – 2 West Candice West, RN - Emergency Department Mary Yapp, RN - 2 East/2 South

In addition to Chris and Betty, the following individuals were nominated for the DAISY Award in 2018:

Dan Collins, NA - 2 East/2 South Delores Watkins, NA - 3 East

Chris Dowd (C) is seen here with his nurse manager Kristen Parisi and fellow registered nurse Sandy Conti.

Betty Coon was recognized by nursing leaders Margy Donofrio and Cheryl Hayes.

Kenmore Mercy Hospital was proud to honor two nurses this past year with DAISY Awards. Chris Dowd, BSN, CCRN, RN, from the Intensive Care Unit, received the award in the summer of 2018. And, Ambulatory Surgery Unit registered nurse Betty Coon was awarded for the winter of 2018. Chris’ nomination praised his professionalism and compassion shown to a traumatic brain injury patient who was unable to celebrate his wedding anniversary while hospitalized. Chris purchased a card, flowers, and candy for the man’s wife on his behalf.

Nurses caring for our community Caring for the community is an important component of a Magnet® organization and Kenmore Mercy’s nurses and associates extend their compassionate care beyond the walls of the hospital in a variety of ways.

February

Go Red for Women Awareness Day and National Heart Day

March

Chamber of Commerce of the Tonawandas Women’s Expo Gastrointestinal Education Event Pulmonary Rehabilitation Week Informational Table

Nursing played a major role in helping a wounded soldier walk pain free when Kenmore Mercy Hospital joined forces with Franco Vigna, MD, and the military veteran support Operation Backbone. The PACU and 2 South nursing teams, along with Dr. Vigna’s surgical team are seen transferring veteran Kurt Santini, US Army 10th Division, to the second floor post surgery.

May - September

Stepping Stones Running/Walking Program

August

Gateway Harbor Food Truck Thursday Rockin’ on the River

October Our Pulmonary Rehabilitation nurses celebrated their week, March 11-17, 2018, by hosting an informational table in the hospital’s lobby. They addressed chronic respiratory illnesses and provided screenings.

April

National Healthcare Decision Making Day

May

Operation Backbone Surgery

November

Palliative Care & Advance Directives Event Thanksgiving Basket Donation

December

Christmas Shoppe Program

Stroke Education Fair Ken-Ton Community Days

Joy MacNeil, BSN, RN, SCRN, stroke coordinator, along with an interprofessional team, took blood pressures and distributed educational materials during the Stroke Fair.

Nursing associates throughout the hospital generously donated items to Gerard Place the winter of 2018. This included cleaning products, diapers, baby wipes, and blankets that will help homeless families in the Buffalo area. The Care Management nursing team collected the largest number of items.

Recognizing our certified nurses Adult Nurse Practitioner (ANP) Esther Sprehe, ANP Certified Emergency Nurse (CEN) Amanda Kramer, RN Sue McClure, RN Heather Telford, RN Kelsey Wielgosz, RN Board Certified Nurse Practitioners (CNP) Andrea Campagna, NP Mary Dowd, NP Patricia LoRusso, NP Maureen Ryan, NP Esther Sprehe, NP Colleen Storms, FNP Sister Mary Walter, NP Certification in Cardiac Medicine (CMC) Sandra Conti, RN Certified Gastroenterology Nurse (CGRN) Heidi Frushone, RN Janet Gonzalez, RN Jane Weidner, RN Certification for Nurse Managers and Leaders (CNML) Margy Donofrio, RN Christine Schwinn, RN Ellen Swan, RN Certified Nurse Operating Room (CNOR) Rachel Achtziger, RN Linda Butski, RN Ellen Colan, RN Cara Howitt, RN Melissa Kowalski, RN Esther Sprehe, ANP Jacob Walck, RN Certified Post Anesthesia Nurse (CPAN) Scott Berube, RN Margy Donofrio, RN Pam Farrell, RN Sue Hartl, RN Rene Marriott, RN Certification in Wound Ostomy Nursing (CWON) Mary Applegate, RN Certification in Diabetic Education (CDE) Megan Kosmoski, RN Critical Care Registered Nurse (CCRN) Julie Marshall, RN (CCRN-K) Sandra Conti, RN Christopher Dowd, RN Rachael Kaplan, RN Brenda Cramer, RN Mary LaMartina, RN Lori Ann Meder, RN Kristen Parisi, RN (CCRN-K) Maria Richardson, RN Emily Rotolo, RN Samantha Ruda, RN Bridget Walborn, RN Elizabeth Wood, RN

Interventional Radiology Nurse Certification (CRN) Deborah Arnet, RN Kathleen Daley, RN Christine McGee, RN Robert Morello, RN Med-Surg Certification (CMSRN) Johanna Boyd, RN Nancy Chojecki, RN Brenda Cramer, RN Annette Gillies, RN Jessica Cianfrini, RN Kelly Ford, RN Deborah Green, RN Kayla Hoffman, RN Jessica Schulte, RN Carole Woomer, RN Nurse Executive, Advanced-Board Certified (NEA-BC) Cheryl Hayes, NP Heather Telford, RN Nurse Executive, Board Certified (NE-BC) Elaine Schrutt, RN Orthopedic Nursing Certification (ONC) Delreta Billips, RN Alan Chittley, RN Briana Geddis, RN Mary Hojnacki, RN Pamela Koetzle, RN Amber Mazurek, RN Deborah Micholas, RN Susan Wasielewski, RN Suzanne Zeisz, RN Certified Ambulatory Nurse (CAPA) Margy Donofrio, RN Certified Case Manager (CCM) Nina DiCarlo, RN Lisa Hixon, RN Deb Hurd, RN Ella Mendez, RN Sandy Olear, RN Chris O’Mara, RN Janet Kay, RN Certified Registered Nurse First Assistant (CRNFA) Esther Sprehe, ANP Colleen Storms, FNP Stroke Certified (SCRN) Joy MacNeil-Ennis, RN Sandra Conti, RN Wound Care Certified (WCC) Robert Gross, RN Kristen Nazaruk, RN Mary Jane Lodico, RN Sue Zeisz, RN

This list includes certifications completed prior to December 2018.

Recognizing our excellent nursing associates Nurse of Distinction

2018 Outstanding Staff Nurse

Esther M. Sprehe

Lynn De Grasse

Outstanding Nurse’s Assistant

Emergency Department Nurse of Excellence

MSN, ANP-BC, RN, CNOR, CRNFA Surgical Services

Lisa Gonzales 2 East/2 South

Advanced Practice Provider of the Year

Stephen Griggs MSN, FNP, RN

Medical Staff’s Associate of the Year

Cheryl Tumia RN 3 East

BSN, RN 2 East/2 South

Melissa Cavalluzzo BSN, RN

Surgical Technologist of the Year

Janelle Ganje CST Surgical Services

Medical Staff’s Associate of the Year

Kathy Kanaley

Patient Representative

Exemplary Professional Practice “Exemplary Professional Practice means we conduct nursing research studies to improve our patient outcomes.” ~ Julie Marshall, MSN, RN, CCRN-K Nursing Education

Nursing helps pierce needle stick problem Sharp tools, instruments and needles have been used in the practice of medicine for thousands of years. Although they have become sophisticated over the years, needle stick injuries are among the most common accidents reported by healthcare workers, including doctors, nurses and non-clinical staff. In 2016, Kenmore Mercy had 17 associate needle / sharp reportable injuries, and in 2017, there were 15. Thanks to the work of an interprofessional team that reviewed Kenmore Mercy’s situation and devised a plan to attack the problem, there was significant decrease in injuries in 2018.

Needle Stick Injuries 7 6 5 4 3 2 1 0 2 2 2 3 East South West East

EVS

ICU MRU

Phar OR macy Resp CSPD 0

2016

2017

2018

According to the Centers for Disease Control and Prevention, most reported needle stick injuries involve nursing staff. However, laboratory staff, physicians, housekeepers, and other healthcare workers are also injured. “This type of injury can be concerning, as it puts the individuals at risk of contracting viruses that are carried in the bloodstream,” said Anne Hedges Creighton, MS, BSN, RN, director of nursing for Perioperative Services who led the interprofessional needle stick safety team.

“Prevention can save not only the individual the tremendous suffering from the results of a sharps injury, but it also impacts the hospital’s bottom line,” she added. Kenmore Mercy’s needle stick safety team, consisting of individuals from nursing, pharmacy, quality, safety and facilities, met regularly for more than nine months to analyze the hospital associates injuries and devise a plan to address the issue. Part of their process included conducting a hospitalwide survey which provided associates the opportunity to share their concerns and ideas. According to Anne, the survey was successful and provided them with a road map to start a plan. It identified issues with promptness in disposal of sharps containers, the number of sharp disposal receptacles available and their location, and lack of knowledge on how needles should be used. This prompted the needle stick safety team to devise site wide education for anyone with needle contact. Additionally, it helped to ensure strict adherence to occupational health and safety policies and protocols and promote frequent emptying of sharp containers. According to Anne, this yielded positive results with only three reportable incidents in 2018. “Furthermore, we realized that processes needed to be hardwired even for re-education if there was a needle stick,” said Anne. Moving forward, every new associate that uses needles will receive education on the types of needles and their safety features. If there is a needle stick, the associate will be sent to be retrained on the safety mechanisms of the needles.

Improving patient safety with modified early warning scoring

With the introduction of the Modified Early Warning System (MEWS) in Kenmore Mercy’s patient care units during fall of 2018, nurses and medical providers are working to improve patient safety and clinical outcomes. Relatively new in the United States, the idea of MEWS has seen success throughout Europe to promote early intervention. According to Kristen Parisi, BSN, RN, CCRN-K, nurse manager of the Intensive Care Unit, “MEWS is a proactive scoring system designed for use with any patient or diagnosis using a numerical scoring tool based on physiological assessment.” Parameters include subtle vital sign changes, especially in respiratory rate, oxygen saturations, and changes of level of consciousness that precede most rapid responses. These subtle changes commonly start six to eight hours prior to a patient showing actual recognizable clinical deterioration.

Unlike rapid responses which are single parameter reactions triggered by one particular change in condition, MEWS is a multi-parameter utilization tool that identifies the first earliest sign of any change in clinical condition. Kristen and Mary LaMartina, BSN, RN, CCRN, a critical care staff nurse, learned about the value of the implementation of the MEWS when they attended the 2017 Magnet® Conference. MEWS aligns with a recent proposal from the Institute for Healthcare Improvement to identify a more quantitative system to recognize deterioration of high risk patients sooner. “Although the research study is ongoing, since inception of the MEWS tool, we have already noted a positive trend related to a decrease in rapid responses, non-ICU codes and transfers to the ICU,” noted Mary. “It has great potential to improve outcomes with patients in multiple areas including ICU transfers, length of stay, ventilator usage, and mortality scores,” she added.

“Great Catches” preventing 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 our patients. James McQuade, BSN, RN, from 2 West was honored with the Catholic Health Great Catch Award in June 2018. James’ knowledge and detailed nursing assessment of his patient who had been previously admitted resulted in a lifesaving intervention. In addition, registered nurses Delreta Billips, Kimberly DeGlopper (not pictured), and Marianne Lovullo from the Ambulatory Surgery Unit; and Russell Duerr, NA, and Crista Rodriguez, RN from the Operating Room, were recognized at the hospital level. Thank you, James, Delreta, Kim, Marianne, Russell, and Crista for your attention to detail and helping to improve the safety of our patients and associates.

Delreta Billips

James McQuade (second from the right) was awarded the Great Catch at a Catholic Health management meeting by Kenmore Mercy CNO Cheryl Hayes; Catholic Health CEO Mark Sullivan; Kenmore Mercy nurse manager Ellen Swan, and Kenmore Mercy CEO Walt Ludwig.

Russell Duerr

Marianne Lovullo

Crista Rodriguez

New Knowledge, Innovations & Improvements “New Knowledge, Innovations & Improvements means we are always looking for new and innovative ways to care for our patients.” ~ Samantha Belter, BSN, RN 2 East Patient Care Unit

Nurses present at research conference

State Senator lends an ear to Kenmore Mercy nurses

Kenmore Mercy’s nursing team presented three research posters at the 31st Annual Nursing Research & Scholarly Activities Conference in April 2018. The night long event, sponsored by the Professional Nurses Association of Western New York and the Nursing Honor Society “Sigma Theta Tau International” (Gamma Kappa, Gamma Theta and Zeta Nu chapters), brought together nursing colleagues from across the Buffalo area to share their contributions to research. The three Kenmore Mercy research projects included: Collaboration to Serve the Community: Nurses and Paramedics Implement Stop the Bleed Training Presented by Amanda Kramer, BSN, RN, CEN; and Sue McClure, BSN, RN, CEN Promoting Nurse Autonomy to Accelerate Inpatient Palliative Care Services Presented by Amber Mazurek, BSN, RN, ONC; and Thomas Nader, BSN, RN DTI vs. ALL THINGS PURPLE: Three end of life case studies Presented by Mary M. Applegate, BSN, RN, CWOCN

I’m proud to be a nurse at Kenmore Mercy because “We treat our patients like family!” ~ Care Management

As a member of the Senate Health Committee, having a better understanding of important healthcare issues is a priority for State Senator Chris Jacobs. He stopped by Kenmore Mercy Hospital in spring of 2018 to hear directly from our nurses about important matters like safe staffing and how New York State officials can help nursing provide excellent patient care.

Nurses published in national journal

Several of our nurses answered the call to share their knowledge through national publications. Registered nurses Meredith Chamberland, BSN, from the 2 East/2 South Patient Care Unit was published in the Journal of Scientific & Technical Research for her and Kayla Limardi, FNP, BSN’s quality improvement research project. Amber Mazurek, BSN, RN, ONC, nurse manager and lead of Kenmore Mercy’s Magnet® program, in collaboration with Dr. James Fitzpatrick, vice president of Medical Affairs, were published in the Journal of Palliative Medicine with an article highlighting how early initiation of palliative care services can benefit patients and hospitals. Ellen Swan, BSN, RN, CNML, nurse manager of 2 West, was published in Nursing Management for Kenmore Mercy’s Move with Care program and how it promotes safe patient handling.

Foundation funding gives nursing staff a step up Knowledge is a powerful tool for nurses that continue their education and keep up-to-date with medical advancements and new research. The Kenmore Mercy Foundation makes this easier by setting aside annual funds specifically for associate education. In 2018, the Foundation was able to distribute over $31,000 in Staff Education Grants to more than 50 nursing associates. A significant portion of those grants were made possible by the Kenmore Mercy Medical Staff, which donated $30,000 in 2018 to assist the Foundation in supporting associate educational opportunities. The Foundation also received a $5,000 gift from Lawley to ensure additional Magnet® Conference education for Kenmore Mercy Hospital’s nurses. Educational opportunities include, but are not limited to, national conferences, certifications, and classes as seen below.

2018 Staff Education Grants 2 East Master the Art of Working with People Seminar (1 nurse) 2 South NAON Fueling the Future of Orthopaedic Nursing (2 nurses) 2 West Academy of Medical-Surgical Nurses Annual Convention (2 nurses) 3 East Master the Art of Working with People Seminar (2 nurses) Emergency Department Master the Art of Working with People Seminar (6 nurses) STAR 7th Regional Stroke Management Symposium (3 nurses) ICU ENLS: Emergency Neurological Life Support (1 nurse) Basing Your Practice on the Evidence … A Critical Care Nursing Conference (5 nurses) National Teaching Institute for Critical Care (2 nurses) American Nurses Foundation (1 nurse) Palliative Care Immersion Course (1 nurse) MRU Association of Rehabilitation Nurses Conference (1 nurse)

Registered nurses Chris Clark, Debbie McCoy, Samantha Belter, Pam Koetzle, and Lindsay Canali keep up their education to ensure the safety of our patients.

Thank you to the Kenmore Mercy Foundation for their ongoing support of nursing. This also helps to provide resources to treat patients with the high quality care for which Kenmore Mercy Hospital was recognized in 2018.

PACU Critical Care Nursing Symposium (2 nurses) Patient Care Services Building your Self Care Practice for Greater Personal and Professional Happiness Conference (3 nurses) NRC Health Symposium (2 nurses) Nursing Management Conference 2018 (1 nurse) STAR 7th Regional Stroke Management Symposium (1 nurse) 2018 ANCC National Magnet® Conference (4 nurses) Association of Rehabilitation Nurses Conference 2018 (1 nurse) Nursing Management Conference 2018 (1 nurse) Perioperative AORN Global Surgical Conference & Expo (3 nurses) Pre-Surgical Evaluation World of Hurt - A Guide to Classifying Pain Course (1 nurse) Pulmonary Rehab New York State Association of Cardiovascular and Pulmonary Rehabilitation State Conference (2 nurses) Radiology Probiotics, Food, and the Immune System (1 nurse) Surgery AORN Global Surgical Conference & Expo (2 nurses)

Nursing impacts patient falls

Falls with Injury 2 West, 3 East, 2 East/2 South Adult Med-Surg 2.5

Fall prevention requires an interprofessional approach to create a safe patient environment and to reduce injuries related to falling In 2018, Kenmore Mercy’s medical-surgical areas outperformed the national average in “Falls with Injury” eight out of twelve times in four quarters and the MRU did so four out of four times.

Injury Falls per 1,000 Patient Days

Inpatient falls are a major safety concern for hospitalized patients. They may lead to increased length of stay, reduced quality of life, and increased costs to patients and hospitals alike.

1.5 1 0.5 0

1Q17

2Q17

3Q17

4Q17

1Q18

2Q18

3Q18

4Q18

2 West

0.45

0.99

1.36

0.83

2.06

0.95

3 East

0.53

0.55

0.48

0.94

0.48

2E/2S

0.34

0.36

0.34

0.31

0.36

0.64

0.6

0.65

0.62

0.58

0.59

0.6

4Q18

NDNQI Mean

2 West

3 East

What has helped to reduce the risk of falls at Kenmore Mercy?

NDNQI Mean

Falls with Injury MRU Adult Rehab

It’s important to ensure that patients feel comfortable using and can reach their call lights.

1.8 1.6 1.4

Injury Falls per 1,000 Patient Days

Chair alarm sensor pads are also successful. They distract patients so they stop and wait for help. They also prompt nurses to assist patients. Seeing nursing staff frequently in the form of hourly rounding to address patient needs using the “four Ps” (pain, potty, position, and possessions) engages patients in care.

1.2 1 0.8 0.6 0.4 0.2 0

1Q17

2Q17

3Q17

4Q17

1Q18

2Q18

3Q18

MRU

1.66

0.88

0.74

0.83

NDNQI Mean

0.99

1.07

1.13

1.06

0.95

0.84

0.97

0.98

Thank you to our entire nursing team for your dedication to preventing harm to our patients by reducing falls.

I’m proud to be a nurse at Kenmore Mercy because

“we work great as a team and provide quality patient care.” ~ Emergency Department

2E/2S

MRU

NDNQI Mean

Pressure ulcer or injury prevention remains one of the most common and significant tasks in healthcare for decreasing harm. Preventing pressure ulcers is accomplished through interprofessional teamwork and leadership, including ongoing education and collaboration.

10 8 6 4 2 0 ICU NDNQI Mean

In 2018, the Intensive Care Unit and medicalsurgical areas outperformed the national average in all four quarters with zero pressure injuries, stage 2 and above.

Our skin champions, certified wound care nurses, and the dedicated wound and ostomy nurses continue to provide monthly education to make sure the latest evidence is at the bedside. The hospital’s Move with Care program, new mattresses and positioning devices in the nursing units, and in the Operating Room have helped to prevent pressure ulcers.

1Q17

2Q17

3Q17

4Q17

1Q18

2Q18

3Q18

8.33

1.64

1.75

2.34

2.65

3.07

1.89

2.01

1.91

ICU

1.4

4Q18

NDNQI Mean

Hospital-Acquired Pressure Injury Stage 2 and Above 2 West, 3 East, 2 East/2 South Adult Med-Surg

1.2

Percent of Patients Surveyed

According to Mary Applegate, BSN, RN, CWON, “Prevention begins the minute a patient comes through the door of the Emergency Department throughout their visit on patient care floors, in the Operating Room, or the Intensive Care Unit.”

Hospital-Acquired Pressure Injury Stage 2 and Above ICU Adult Critical Care

Percent of Patients Surveyed

Pressure injury prevention a high priority

1 0.8 0.6 0.4 0.2 0

1Q17

2Q17

3Q17

4Q17

1Q18

2Q18

3Q18

4Q18

2 West

3 East

2E/2S

1.24

0.84

0.9

1.04

1.09

0.76

0.9

0.84

NDNQI Mean

2 West

3 East

2E/2S

NDNQI Mean

Awards and Honors Kenmore Mercy Hospital is proud to have earned awards and honors, which recognize the quality of care we give our patients and families, and the supportive work environment we provide for our nurses and other healthcare professionals. I’m proud to be a nurse at Kenmore Mercy because

“I’m proud to work with great staff.” Kenmore Mercy is the only hospital in the Buffalo area currently with Magnet® Recognition. This honor is bestowed by the American Nurses Credentialing Center (ANCC), sponsor of the Magnet® Recognition Program. Magnet® designation lasts four years, during which time the ANCC monitors the hospital closely to ensure it maintains high standards of care. ANCC is the world’s largest and most prestigious nurse credentialing organization, and a subsidiary of the American Nurses Association.

~ Emergency Department

2017 Kenmore Mercy Hospital was the only hospital in New York State to be named a Top Hospital by The Leapfrog Group in 2016 and 2017.

Our Intensive Care Unit was granted the Beacon Award for Excellence Silver Level originally in 2012 and again in 2016 from the American Association of Critical Care Nurses. For nurses, a Beacon Award signifies a positive and supportive work environment with greater collaboration between colleagues and leaders, higher morale and lower turnover.

Kenmore Mercy Hospital is accredited by The Joint Commission, the nation’s leading accrediting body for hospitals and healthcare providers.

In the Fall 2018 score update, Kenmore Mercy Hospital was honored again with an “A” Hospital Safety Grade. Scores range from A, B, C, D, and F, and are released every six months. The hospital has accomplished the difficult task of being awarded straight “A’s” since 2014.

Applicants are judged in the areas of leadership, appropriate staffing, use of evidence based practices, outcome measurement, effective communication, and a focus on learning and development of nursing staff. The ICU resubmitted their document for the Beacon Award in 2018.

Kenmore Mercy earned Western New York’s only Disease-Specific Care Certification for both total knee and total hip replacement from The Joint Commission (2011, 2013, 2015, and 2017).

Kenmore Mercy Hospital was named a Blue Distinction Center + for Spine by BlueCross BlueShield of Western New York (2016). Kenmore Mercy Hospital was named a Blue Distinction Center for Knee and Hip Replacement by BlueCross BlueShield of Western New York (2016).

Kenmore Mercy Hospital’s pulmonary rehabilitation program received certification from the American Association of Cardiovascular and Pulmonary Rehabilitation (20172020).

Hospital’s nurses newsworthy in 2018 Kenmore Mercy Hospital received the American Heart Association and American Stroke Association Get with the Guidelines® Stroke Gold Plus Award, recognition for achieving 85% or higher adherence to award’s Indicators for two or more consecutive 12 month intervals.

Kenmore Mercy is a New York State Department of Health - Designated Stroke Center (2006).

Kenmore Mercy’s nurses proved to be quite newsworthy this past year with several of them featured in stories and local commercials. Samantha Belter, RN, BSN, from 2 East, was interviewed by WKBW-7, during Nurses’ Week, showing a day in the life of a nurse.

Daughter and mother nurse team Maria Richardson and Kitty Scribner.

Kitty Scribner, RN, BSN, and Maria Richardson, RN, BSN, were featured as the cover story in the Buffalo News’ Refresh section, focusing on mother/daughter relationships in the nursing field. In addition, Catholic Health’s Marketing Department chose Kenmore Mercy as the filming site for three different commercials - stroke services, orthopedics, and Leapfrog Group - SAfer Care. Catholic Health President & CEO Mark Sullivan (center, back row) took a moment while filming the Leapfrog commercial to pose with associates who were also actors on the set.

Kenmore Mercy earned DiseaseSpecific Care Certification as a Primary Stroke Center with capabilities to treat the most complex stroke cases.

OUR VALUES Reverence: Nursing reflects our values and mission by the acknowledgement of the sacredness of human life and the individuality of their needs and goals. Compassion: Nursing provides compassionate care by identifying the connectiveness of each person through the relationship with each other and their environment. Justice: Nursing advocates for our patients to achieve their personal goals, respecting and recognizing the differences in each individual. Excellence: Nursing continually strives for quality and excellence through the care we deliver through communication to our patients, families and the interprofessional team.

Nursing strives to interact with our patients to achieve their goals, promote, maintain and sustain health and to ensure satisfaction of the care the patient receives.

OUR MISSION We are called to reveal the healing love of Jesus to those in need.

OUR VISION Inspired by faith and committed to excellence, we will lead the transformation of health care in our communities.