Nursing Annual Report 2020
SERVING TOGETHER ChristianaCare Nurses at the Front Lines
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CHR IST IA
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To be the transformative and intellectual force improving health through the evolving art and science of nursing.
Professional Governance
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VISION STATEMENT
We, the nurses of ChristianaCare, provide a high-quality, exceptional care experience for every patient, every day, by partnering with our neighbors, colleagues and each other.
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MISSION STATEMENT
S ta co nd pe ard s
The ChristianaCare Way
Contents Beacons of Light in a Year Like No Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Serving Together at the Front Lines: Magnet in Action . . . . . . . . . . . . . . . . . . . . . . . . . 4 Three Times Magnet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Exemplary Professional Practice. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Empirical Quality Results. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Transformational Leadership. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Structural Empowerment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Awards and Recognition. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Publications and Presentations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
ChristianaCare Nursing Annual Report 2020 | 1
Beacons of Light in a Year Like No Other A Q&A with Ric Cuming, Ed.D., RN, NEA-BC, FAAN, ChristianaCare chief nurse executive and president of ChristianaCare HomeHealth During a year unprecedented in modern history, nurses have provided hope and healing to millions of people. Ric Cuming reflects on how nurse caregivers across ChristianaCare and HomeHealth made all the difference.
How did the extraordinary circumstances of 2020 make it a year truly about nursing? The World Health Organization couldn’t have predicted a global public health crisis when it designated 2020 the Year of the Nurse and Midwife. When COVID-19 hit, the pandemic put nurses center stage, and now the world sees what those of us in health care have known for a long time—nurses are true superheroes. ChristianaCare and HomeHealth nurses and nurse partners have put their training, expertise and experience to work caring for patients, each other and our community in ways they likely never expected to. The year 2020 also marked Florence Nightingale’s 200th birthday. It was incredible to celebrate the mother of modern nursing during a year when nurses embodied everything Nightingale stood for: evidence-based, patient-focused care, leadership and collaboration. And I am proud that so many of our nurses were featured on 2020nurseandmidwife.org/ stories, a website celebrating the Year of the Nurse and Midwife.
How did ChristianaCare nurses meet the moment? With exceptional grace, skill and courage. Even as they feared for their families’ health, grappled with shifting family responsibilities and more, our caregivers never wavered in serving everyone with love and excellence. Most amazing to experience was the all-hands-on-deck mentality. Nurses took on new roles to optimize care delivery and meet capacity during surges. For example, nurses were reassigned to provide telehealth consultations and COVID-19 monitoring, serve as visitor and employee entry screeners and work in COVID-19 units and testing centers.
2 | Beacons of Light in a Year Like No Other
In addition to a pandemic, the U.S. heard widespread calls for social and racial justice. How did ChristianaCare nurses respond? ChristianaCare has committed to being an anti-racism organization. Our caregivers recognize their unique role in promoting health equity and upholding ChristianaCare’s promise to advance actions that dismantle racism. I’m glad that many nurses joined a systemwide silent protest in remembrance of George Floyd and too many other Black lives lost to violence.
Of course, extraordinary national and global events ushered in the new decade, but they weren’t all that happened last year. What else stands out for you about ChristianaCare Nursing and HomeHealth in 2020? It was a remarkable year. Our caregivers showed in so many other ways they are exceptional today, even better tomorrow and Magnet® every day. First and foremost, ChristianaCare earned our third Magnet redesignation for our Newark and Wilmington campuses, Ambulatory Services and HomeHealth. Like almost everything else in 2020, the end of our Magnet redesignation process was virtual, and our caregivers adapted with style. ChristianaCare also welcomed Maryland’s Union Hospital to the family when we integrated it — our first Maryland hospital — into the health system early in the year. Known now as our Cecil County campus, the campus’s nurses wasted no time in integrating ChristianaCare’s Nursing Professional Practice Model. And our home health agency — the largest accredited home-health agency in Delaware and a trusted resource for generations of families — celebrated a milestone when it rebranded from the Visiting Nurse Association to ChristianaCare HomeHealth. This inclusive new name and a vibrant, colorful visual identity are the result of a yearlong rebrand journey with our caregivers. Our goal was to better reflect the agency’s full spectrum of holistic, patientfocused services—from skilled and private duty nursing care to home health assistance, medical social work, rehabilitation and more. All told, in 2020 our nurses and nurse partners shone brightly, embodying what it means to be Magnet.
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SERVING TOGETHER
Serving Together at the Front Lines: Magnet in Action Magnet recognition speaks to an extraordinary partnership among all ChristianaCare caregivers. Our third consecutive Magnet designation is proof that when we commit to serving our community together, guided by our values of love and excellence, the result is outstanding clinical care and an exceptional patient experience. Never has this commitment been more obvious than during the COVID-19 pandemic. Inpatient, ambulatory and HomeHealth nurses pivoted to serve in this crisis, showing every day what it means to be part of a Magnet institution.
CODE Blossom Nurses were led the cheerleaders who sent recovered COVID-19 patients home with joyous send-offs during CODE Blossom goodbyes.
“It was just so great to take a moment and celebrate one of our patients’ victories. We are so happy.” Kelin Stanley, BSN, RN-BC
4 | Serving Together
COVID-19 testing
In March, ChristianaCare established two COVID-19-focused ambulatory care centers in Delaware—one each in Newark and Wilmington—and scaled virtual care to safely screen and support people who test positive for COVID-19, have significant exposure or work in high-risk professions. Nurses played a major role in COVID-19 care and hosted widespread testing events for our neighbors at our hospitals and in the community.
Called to serve, with love and compassion ChristianaCare caregivers immediately heeded the call to serve when Newark’s Jeanne Jugan Residence, a long-term care facility run by the Little Sisters of the Poor, became a COVID-19 hotspot. Nurses from our Acute Care for the Elderly units and float pool volunteered at the residence, helped by ChristianaCare’s Environmental Services team. And HomeHealth nurses assisted with vascular access. Our caregivers found creative ways to help residents and staff feel more connected during the challenging and lonely preventive isolation. Patients received Easter baskets filled with candy, games, books, puzzles and walkie-talkies so they could talk to each other and nurses.
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Two shots seen round the world Nurses have led the health system’s vaccine rollout. They helped design and implement the vaccination program and have lovingly vaccinated priority communities — including President of the United States Joe Biden, two shots receiving worldwide media coverage.
“In 2021, we’re going to beat COVID. We’re going to wash up, we’re going to mask up, we’re going to separate [6 feet], and we’re going to vaccinate. Let’s do it!” Tabe Mase, MSN, MJ, FNP-C, CHC, COHN-S, who administered the initial Pfizer-BioNtech vaccine to President Biden
6 | Serving Together
ChristianaCare Nursing Annual Report 2020 | 7
Three Times Magnet Always flexible and creative, caregivers didn’t miss a beat when ChristianaCare’s spring 2020 Magnet survey visit was pushed to the summer and made virtual because of the pandemic, based on nurse input. By computer, iPad and other videoconferencing technology, some 800 nurses, several hundred collaborative caregivers, community partners and nursing school representatives joined our four Magnet appraisers for more than 50 sessions. These caregivers knocked the virtual three-day visit out of the park, capping a journey that resulted in the health system’s third consecutive Magnet designation. The designation includes Christiana and Wilmington Hospitals, Ambulatory Services and ChristianaCare HomeHealth.
Magnet Masters Liaisons between 160 Magnet ambassadors and ChristianaCare’s director of Nursing Professional Excellence/Magnet Recognition, Michelle Collins, DNP, APRN, CNS, ACNSBC, NPD-BC, NEA-BC, LSSBB, Magnet Masters are the pillars of ChristianaCare’s Magnet program. They steer Magnet culture systemwide. And over the past three years, they have guided ChristianaCare through our redesignation journey. Kenneth Anderson, BSN, RN, CCRN Transitional Medical Unit Maria Brown, MSN, RN IV, PCCN, CNL Transition Surgical Unit Elaine Farr, BSN, RN III-BC 2B Transitional Neuro Unit Ashley Jackson, BSN, RN 3B/3C/4B Postpartum Karen Karchner, ADN, RN, OCN Cancer Research Samantha Lewis, BSN, RN 6S Wilmington Intensive Care Unit Kara Welcher, BSN, RN ChristianaCare HomeHealth Rochelle Williams, BSN, RN Ambulatory Infusion
8 | Three Times Magnet
Magnet Commission Exemplar Recognition The ANCC’s news that ChristianaCare earned our Magnet redesignation came with an extra special surprise and additional proof of excellence: ChristianaCare was also awarded four exemplars. The 2019 Magnet® Application Manual defines an exemplar as “a concept, practice or program worthy of imitation.” The ANCC Commission on Magnet® Recognition awards hospitals and health systems exemplars for extraordinary components of the application document and site visit. We are deeply grateful for the exemplary caregivers behind ChristianaCare’s four Magnet exemplars: Off-shift Support Council and Support The ANCC upheld the Off-shift Support Council as an exemplary instance of how ChristianaCare Chief Nurse Executive Ric Cuming, Ed.D., RN, NEA-BC, FAAN has implemented structural change systemwide. Taking an integrative approach, the council meets monthly to address the needs of night, weekend and evening caregivers. This council implemented numerous changes, such as post-shift wellness and fitness activities, off-shift nurse education opportunities and grand rounds and improved food options at night. Virtual Reality Magnet Prize Continued Interprofessional Work and Enculturation The ANCC awarded the 2018 Magnet Prize to the Helen F. Graham Cancer Center and Research Institute for its virtual reality (VR) positive distraction therapy. Since then, ChristianaCare has expanded the program to other units. Our 2020 Magnet appraisers noted three VR program-related practices as exemplary: integrating volunteers into the
program; lending 360-degree cameras to Cancer Center patients to create personally meaningful videos, with help from our Health & Technology Innovation Center; and making our virtual reality software open source to allow other health care institutions to develop similar programs. Nursing Practice Bundle for Exceptional Experiences A nursing team focused on improving six patient experience components of the Nursing Practice Bundle: purposeful hourly rounding, bedside shift report, exceptional experience leadership rounds, patient education and Teach-back, quiet environment and service recovery. This team incorporated the bundle into huddleboards, helping improve shift hand-off, communication, patient safety concerns, problem-solving and caregiver recognition. This initiative contributed to an impressive increase in ChristianaCare patient experience scores and improved communication between patients and nurses. Advancing Nursing Workforce Formal Education The ANCC acknowledged ChristianaCare’s exemplary approach to building, developing and retaining a clinically competent and educated nursing workforce. From 2019 to 2020, the health system’s bachelor of science in nursing (BSN) rate increased from 72.2% to 80%, exceeding our goal. ChristianaCare’s current BSN rate is now 81% and its master of science in nursing (MSN) rate is 21%. This achievement is the result of our exceptional commitment to professional development and advancement.
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EXEMPLARY PROFESSIONAL PRACTICE
Exemplary Professional Practice Exemplary Professional Practice within nursing is the essence of a Magnet institution. It stems from a comprehensive understanding of the role of nursing, the application of this role with patients, families, communities and across interdisciplinary teams, and the pursuit and adoption of new knowledge and evidence. Exemplary Professional Practice is about being exceptional today and even better tomorrow.
Preventing cancer readmissions Can medical record data help lower emergency department (ED) visits and hospital readmissions for some cancer patients? Yes, according to a new study by our Organizational Excellence, Oncology Nursing and Cancer Care Management teams. They’ve joined forces to create a computer model based on variables from patients’ individual medical records to identify at-risk patients prior to discharge. During the 13-month study, caregivers focused interventions on these patients. The 30-day readmission rate saw a steady decline for patients classified as high-risk (by 16%) as well as for the total population (by 10%). And in the pilot phase for the total population, the average length of stay decreased to 5.9 days and the number of ED visits dropped by 3%.
Special delivery Nursing caregivers were front and center in the 2020 opening of ChristianaCare’s new Center for Women’s and Children’s Health. They helped keep the project on track, despite the challenges COVID-19 presented. A stateof-the-art facility, the Center for Women’s and Children’s Health is one of 13 nationwide to offer “couplet care” in the NICU, keeping mother and baby together even if they both require medical care. More than bricks and mortar, the center supports and enhances the most current, evidence-based models of care, with improved integration of services and the space to offer innovative, patient-centered care for mothers, babies and families.
10 | Exemplary Professional Practice
Home Care Coach™ among Amazon’s first HIPAA-eligible skills
ChristianaCare’s vision is that all care that can be digital will be digital, and all care that can be done in the home or in the community will be done in the home or in the community. HomeHealth’s new Home Care Coach™ advances this vision. Designed by HomeHealth caregivers and ChristianaCare’s Health and Technology Innovation Center, the voice assist tool uses Alexa Skills and allows caregivers to customize patients’ care plans. Patients can also ask Alexa questions about their own care and receive personalized answers in return.
Teach-back moves forward In 2020, thousands of ChristianaCare caregivers received training on Teach-back, an evidence-based approach for improving patient understanding designed and led by nurses. In addition, representatives from ChristianaCare’s Virtual Education and Simulation Training Center trained leaders from Nursing and other disciplines in Teach-back observations. These leaders observe staff and provide feedback to encourage use of and improve Teach-back techniques. Our Patient and Family Health Education and Patient Experience teams also developed a Teach-back Toolkit to serve as a readily available resource for ongoing training and reinforcement. The two teams continue to collaborate to reach more caregivers and support sustaining and fostering of the Teach-back skill.
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Stepping in and stepping up When COVID-19 hit, our Nursing leadership team developed the Capacity Assistance Program (CAP) to meet coverage needs. CAP is designed for any type of emergent crisis that threatens to overwhelm day-to-day acute care operations. The program provides guidelines for scheduling an adequate number of nursing caregivers with the competencies needed to provide exceptional care. It redeploys non-bedside clinical nurses to assist with unit needs and patient care as needed. The emergency plan outlines levels of severity response in ensuring adequate nursing care when normal operations are exceeded. In addition, it calls for daily staffing huddles to discuss elevating care delivery needs to the next levels.
CareVio™ COVID-19 monitoring For eight years, ChristianaCare’s award-winning CareVio care management system has monitored patients at home to help them manage their health all the time, not just when they are at the doctor or the hospital. With its unique technology platform, specially trained caregivers and one-to-one access to care, CareVio became the foundation of the health system’s COVID-19 virtual response. Using CareVio monitoring, CareVio nurses were able to provide key information like the results of COVID-19 tests, directly to patients. For COVID-19 positive patients, they offered twice daily phone or text check-ins to monitor symptoms and recovery. This essential service helped primary care providers focus on seeing patients rather than fielding calls for test results or other nonurgent care questions.
12 | Exemplary Professional Practice
Annual wellness during crisis At the beginning of the COVID-19 emergency, ChristianaCare’s primary care caregivers pressed pause on annual wellness visits to identify a safe way to meet the needs of their high-risk patient population—mostly Medicare patients age 65 and older who were anxious about in-person visits. In a just a few weeks, the health system set up a vast telehealth infrastructure for annual wellness visits and other primary care services, outfitting nurses and physicians with laptops and training them in video, phone and portal protocols. By the end of 2020, the primary care community of practice had reached its pre-pandemic target for number of annual wellness visits for the year.
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EMPIRICAL QUALITY RESULTS
Empirical Quality Results Magnet-designated organizations serve as pioneers of future care, developing and demonstrating solutions to numerous problems that are part of today’s health care systems. As caregivers at a three-time designated Magnet institution, ChristianaCare nurses value data collection and use outcomes data to inform improvement and quantify excellence.
Perfecting care, one process at a time Perfect care process monitoring To achieve highly reliable care, the Nursing Quality and Safety Council identified the need to establish a standardized process for monitoring compliance with evidence-based practices for harm prevention. The council engaged key stakeholders in creating Perfect Care Bundle process monitoring tools for achieving zero preventable harm in catheter-associated urinary tract infections (CAUTI), hospital-acquired pressure injuries (HAPI), central line–associated bloodstream infections (CLABSI), and falls. The evidence-based process monitoring strategies help identify areas for improvement in nursing practices with the goal of perfect care. As a direct result of the initiative, since the initiative began in July 2019: •
Hospital-acquired infections have decreased by 41%.
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Overall hospital-acquired pressure injuries have decreased by 12%.
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Falls with major injuries have decreased by 20%.
14 | Empirical Quality Results
All hands in to reduce hospital-acquired pressure injuries (HAPIs) Among the improvements that led to a 44% reduction in Patient Safety Indicator PSI-3 HAPIs that include stages 3 and 4 and unstageable injuries: •
Introduced education, training and a hands-on competency assessment for nurses and patient care technicians.
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Improved pressure injury prevention processes, practice and documentation for all areas of care, including perioperative services and the Emergency Department.
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Increased interprofessional engagement, awareness and practice related to skin integrity, pressure injuries, care planning, documentation and coding.
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Developed and implemented a nursing practice accountability toolkit.
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Hired a wound ostomy continence (WOC) nurse certified pressure injury preventionist focused on pressure injury prevention, and a medical director for the WOC team.
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Implemented a virtual process for WOC nurse-verification of all pressure injuries using Cerner Camera Capture technology that resulted in a significant increase in validated pressure injuries, including injuries that were present on admission.
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Developed a standardized process monitoring pressure injury prevention through the Perfect Care tool and interactive dashboard.
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Zero Harm Awards ChristianaCare’s Zero Harm committee awarded a total of 86 Zero Harm Awards across our three campuses and HomeHealth in 2020. The awards are for areas with zero cases of preventable patient harm for 12, 24, 36, 48, 60 or 72 consecutive months. Our patients are safer because of our caregivers’ commitment to zero harm, and we are proud to acknowledge all 2020 Zero Harm awardees at our Wilmington (W), Newark (N) and Cecil County (C) campuses and HomeHealth (HH).
Catheter-Associated Urinary Tract Infection (CAUTI) 12 months: C Intensive Care Unit, C PCU, C MSU, C SSU, N Surgical Critical Care Complex, HH CD Team 1, HH PDN 24 months: N 5E, W 4W, N 2C, W Wilmington Intensive Care Unit, N 6A, W 6W 48 months: N 3A 60 months: N Transitional
Central Line-Associated Bloodstream Infection (CLABSI) 12 months: C Intensive Care Unit, C PCU, C MSU, C SSU, HH CD Team 2, HH NC Team 6, N Transitional Neuro Unit, W 6W, N 4D, N 6B, W 8S 24 months: HH CD Team 1, HH CD Team 3, HH NC Team 2, HH NC Team 3, HH NC Team 4, HH NC Team 6, HH NC Team 7, HH PDN, N 5D 36 months: W Wilmington Intensive Care Unit, W 3M
Methicillin-Resistant Staphylococcus Aureus (MRSA) 12 months: C Intensive Care Unit, C PCU, C MSU, C SSU, N 5A, N 5D, N 6B, N 5E 24 months: N Transitional Medical Unit, N BMT 36 months: N Transitional Surgical Unit, W Wilmington Intensive Care Unit 48 months: N 4D 60 months: N 4B
Clostridium Difficile (C. Difficile) 12 months: N 3A, W 7N, C Intensive Care Unit, W 5N, N 5A, N BMT, N Medical Intensive Care Unit, N 4E, N Surgical Critical Care Complex, W 6S 24 months: N Transitional Neuro Unit, W Wilmington Intensive Care Unit
16 | Empirical Quality Results
Falls With Major Injury 12 months: C BHU, C CDU, C Emergency Department, C Intensive Care Unit, C MIC, C SSU, N 5B, W 6W 24 months: N Neuro Critical Care Unit, N ED, W 8S 36 months: N 4A, N 6C 48 months: N 5A, W 4W, N 6B, N Surgical Critical Care Complex, N 3A
All Falls 12 months: N Transitional Surgical Unit 60 months: N Neonatal Intensive Care Unit
Antenatal Steroids 12 months: N 2M, N OB Triage
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TRANSFORMATIONAL LEADERSHIP
Transformational Leadership
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18 | Transformational Leadership
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ChristianaCare nurses lead with vision, influence, clinical knowledge and strong expertise in professional nursing practice. Working with a leadership team that holds a vision for the future of health care delivery and provides the environment necessary to achieve this vision, our nurses are creative, innovative, inquisitive knowledge-seekers who contribute to the health system’s values, behaviors and models of care.
Council highlights Administrative Council Chair: Lynda Huselton, MSN, MSM, RN-BC, NE-BC •
Prepared for a successful Magnet site visit.
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Provided ongoing support of the Nursing bundle.
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Collaborated with patient experience to transition to NRC Health from Press Ganey and on the service recovery launch.
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Helped reduce HAPI and drive the initiative for zero harm.
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Worked in conjunction with the Workforce Connection Council on the nurse staffing collaboration that focuses on retaining, onboarding and recruiting nurses, including new-to-practice nurses.
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Supported the Teach-back initiative.
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Supported the reinvigoration of the discharge lounge.
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Created and implemented the Nursing Practice Accountability toolkit in the
Workforce Connection Council Chair: Lisa Markiewicz, MSN, MSM, RN IV, CCRN •
Executed strategies to advance practice environments that result in increased caregiver retention.
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Implemented alternatives for nurses eligible to retire.
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Applied a comprehensive workplace violence mitigation program.
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Identified barriers and designed solutions that will improve nurse-to-nurse collaboration and communication.
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Identified and addressed gaps in Capacity Management Plan.
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Created and disseminated education resources for the new capacity plan to managers and charge nurses through the charge nurse workshop.
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Quality and Safety Council Chair: Tania Dossantos, BSN, RN III, RN-BC •
Partnered with key stakeholders to provide feedback and encourage decision-making to improve nursing practice and patient outcomes quality and safety initiatives.
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Established a sub-committee for the Event-Based Nursing Peer Review.
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Increased access to Patient Care Monitoring for clinical nurses to include ambulatory settings, revised perfect care monitors as needed to better identify opportunities in perfect care, and encouraged units to review dashboard data to identify and address any areas of opportunity.
Education Development and Advancement Council Chair: Marykate McGurk, BSN, RN, TCRN •
Interviewed and promoted 52 system nurses to RN III and RN IV on the Clinical Ladder.
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Promoted certification by hosting the annual Certified Nurses Day Bulletin Board Contest in March 2020 and developed a “Certification Spotlight” in Nursing’s newsletter to highlight nurses committed to excellence in their specialties.
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Developed and disseminated the annual Department of Nursing Continuing Education Assessment. Council members worked directly with practice areas to deliver the results and assist with identifying educational needs unique to the nurses in their areas.
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Developed the RN III and RN IV Maintenance Checklists, to assist nurses in their professional goals as advanced clinical nurses and collect information about their ongoing project work and professional accomplishments.
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Recognized exceptional nurses as Rising Stars for working diligently in their areas with great potential for promotion up the Clinical Ladder.
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Presented 14th Annual Dot Fowler Award, given annually to an exemplary RN III or RN IV who demonstrates commitment to excellence in their practice area.
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Awarded the Preceptor Excellence Award, given annually to nurses providing a supportive environment for new employees to learn and transition to their new roles, to five system nurses.
20 | Transformational Leadership
Professional Nurse Council Chair: Nathalie Miller, MSN, RN III RNC-NIC •
Created and implemented the ROSE Award—Raising Our Standard of Excellence—to recognize nursing partner caregivers who help deliver exceptional, compassionate care to patients and families.
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Hosted first “We Serve Together Week” to honor nursing partners—clerks, technicians, medical assistants, behavioral health specialists and others—across the health system.
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Created the Nursing Honor Guard to honor deceased nurses.
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Presented the DAISY Lifetime Achievement Award.
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Nominated Annamarie Flick, MSN, RN-BC, NE-BC, for inaugural Health Impact DAISY Nurse Leader Award for Advancing Compassion Through Policy.
Research and Evidence-Based Practice Council Chair: Lisa Wallace, MSN, APRN, FNP-BC •
Appointed APRN representative to the Medical Dental Staff Credentialing Committee.
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Adopted several means of improving communication between the council and all APRNs in the system.
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Conducted Grand Rounds on: Optimizing our use of the Delaware Prescription Monitoring Program. Update on SGLT2 inhibitors. Virtual APC appreciation event, planned by the APC Leadership Committee. COVID-19 and its impact on mental health.
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Launched an APC Mentoring Program.
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Continued to publish a quarterly newsletter, now named “APRN Connection.”
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Off-Shift Council Chair: Alexandra Kaminski, BSN, RN •
Launched “Nocturnal News” digital newsletter to open a line of personal communication with off-shift staff, addressing areas such as night shift wellness, nurse-provider communication, cleanliness and quiet at night and systemwide communication.
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Offered ACLS and BLS classes off-shift for the second consecutive year.
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Implemented survey regarding off shift education needs.
Technology and Innovation Council Chair: Thomas (TJ) Byrnes, BSN, RN, CCRN •
Implemented Camera Capture to document wound photos in patients’ medical records.
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Added an “unchanged from previous assessment” option to iView to reduce the number of clicks nurses must make during a shift.
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Launched Connect Nursing, a mobile digital application used on smartphones to barcode scan medication during medication administration, and Bridge Medical to scan patients ID bracelets and transfusion products prior to hanging blood products.
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Implemented individualized plans of care for pain management, pressure injury prevention in the Neonatal Intensive Care Unit.
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Launched an electronic patient handoff to reduce paper use.
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Implemented RoomLink to eliminate the need for paper signage on patient room doors.
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Developed and deployed Nursing Handoff, a new Cerner tool that aims to do away with all paper handoffs slips
22 | Transformational Leadership
Systemwide promotions to nurse leadership Vikki Benson, RNC-OB, assistant nurse manager, ChristianaCare LDR/High Risk OB/ OB Triage Paul Danao, BSN, RN, CDN, nurse manager, Wilmington Campus Hemodialysis Center Jillian Foster, MSN, RN, PCCN, assistant nurse manager, Christiana Surgery Center Joshua Gorman-Zolochik, BSN, RNC-NIC ANM, assistant nurse manager, Neonatal Intensive Care Unit Timothy Heckman Jr., MSN, RN-BC, nurse manager of 3D TMU/3C Lindsey Hoosty, BSN, RN, assistant nurse manager, Medical Intensive Care Unit, Newark Campus Denise Lottero, MSN, MSM, RN, NE-BC, CNOR, nurse manager, patient care unit 4C, Surgery, Newark Campus Melissa MacMurray, BSN, RN, PCCN, BC, CHR PACU, P&H, CSA, assistant nurse manager, Post-Anesthesia Care Unit, Newark Campus Jennifer Painter, DNP, APRN, CNS, NEA-BC, RN-BC, OCCN, AOCNS, LSSBB, vice president, Nursing Professional Development and associate chief learning officer Ashley Pezzullo, MSN, RN, PCCN, CPAN, Phase II Wilmington Campus, Prep Hold/PostAnesthesia Care Unit Joan Pirrung, MSN, APRN, ACNS-BC, vice president, Patient Care Services-Nursing for ChristianaCare, Cecil County Campus George Potts, MSN, APRN, AGACNP-BC, nurse manager, Ortho/Trauma/Neuro unit on 2C, Newark Campus Allison Steuber, MSN, RN, CAPA, nurse manager, Cardiovascular Critical Care Complex at, Newark Campus Danielle Weber, MSN, MSM, RN-BC, NEA-BC, chief nursing officer, Wilmington Campus
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STRUCTURAL EMPOWERMENT
Structural Empowerment ChristianaCare nurses work in an innovative environment where strong professional practices flourish and the ChristianaCare mission, vision and values come to life in service. Through strategic planning, system and structures, policies and programs, the health system promotes strong relationships among colleagues and partnerships with community organizations to improve patient outcomes and community health.
Nursing scholarships Nursing Advancement Scholarships ChristianaCare’s Nursing Advancement Scholarships support the career growth of nurses and provide an opportunity for nurses interested in roles that require advanced degrees. Currently, 113 nurses are enrolled in the program, including the 2020 scholarship recipients.
Nurse Practitioner Scholarships Kiera Dortch, BSN, RN-BC April Hall, BSN, RN-BC, WTA-C Ejike Ibekaku, RN, BSN, CRRN Jenine McCloskey, BSN, RN, CEN, ANM Kendall McDowell, BSN, RN-BC Alicia Press, RN, BSN, CEN
Clinical Nurse Specialists, Direct Care Ashley Connell, BSN, RN-BC
Master of Science in Nursing, Nurse Leadership Jana Dean, BSN, RN Denny Quinones, BSN, RN, CNOR Rochelle Williams, BSN, RN
Master of Science in Nursing, Nurse Educator Kiersten Edmondson, BSN, RN, PCCN Carley Griscom, BSN, RN, SCRN
Hayley Sweetser, BSN, RN-BC
Supporting diversity and inclusion in nursing ChristianaCare Nursing Scholars Program provides scholarships to full-time pre-nursing students at Delaware State University (DSU), one of the nation’s premier Historically Black Colleges and Universities. Students must plan to attend DSU’s BSN program. Scholarship recipients are awarded a student nurse extern position upon completing one semester of clinical training and accepted into ChristianaCare’s Nurse Residency Program after finishing DSU’s program. Since starting in 2019, the Nursing Scholars Program has awarded scholarships to nine students, including the following future nurses receiving scholarships in 2020: Melissa Blake, DSU freshman
Tionne Henson, DSU junior
Saniya Harris, DSU freshman
Ny’Asia Lea, DSU junior
24 | Structural Empowerment
Delaware Aspiring Nurse Leader Scholarship Kristin Macey, BSN, RN-BC, received the 2020 Delaware Aspiring Nurse Leader Scholarship. The $1,500 educational scholarship is presented to two nurses in the state who are actively pursuing a graduate degree in Nursing Leadership or Health Care Administration.
Nurse residencies ChristianaCare’s paid Nurse Resident program at our Wilmington and Newark campuses supports all newly graduated nurses in their transition to practice. The health system is set to onboard nearly 220 nurse residents in FY 2021, hiring residents from the following tracks:
Acute Care Nurse Residency tracks in 2020/2021 •
Float Pool Nurse Residency
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Medical Nurse Residency
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Surgical Nurse Residency
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Transitional Care Nurse Residency
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Postpartum Nurse Residency
Critical Care Nurse Residency tracks in 2020/2021 •
Critical Care Nurse Residency
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Emergency Department Nurse Residency
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Labor and Delivery Nurse Residency
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Neonatal Nurse Residency
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Perioperative Nurse Residency
Also, in 2020, our Critical Care, Medical, Surgical, Float Pool, Postpartum and Progressive Care residencies earned accredited with distinction from the ANCC Practice Transition Accreditation Program®. Currently, our Cecil County Campus uses the Vizient Nurse Residency Program, which provides a different structure. In 2021, the campus’s nurse residency program will integrate into the larger ChristianaCare Nurse Residency program.
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Advanced Practice Clinician Fellowships ChristianaCare offers numerous fellowships for Advanced Practice Clinicians (APCs). The nine-month Primary Care APC Fellowship is for newly graduated nurse practitioners and physician assistants with fewer than 18 months of experience. There are currently four Primary Care APC fellows, all nurse practitioners—once finished, they will interview for open primary care positions. ChristianaCare has retained 90% of the 21 providers who have already completed the primary care fellowship, enabling the health system to fill open primary care positions. ChristianaCare also launched a one-year NICU fellowship for physician assistants to work as providers in the NICU. The first cohort of two fellows graduated in 2020 and now work as providers in our NICU. Additionally, two APCs—one nurse practitioner and one physician assistant—are the first cohort of ChristianaCare’s one-year Psychiatry Fellowship.
ChristianaCare HomeHealth Nurse Fellowships In 2020, HomeHealth launched Nurse Fellowships for experienced RNs to receive professional development in home health care. The 24-week program provides a comprehensive, structured combination of didactic and clinical experiences that equip new HomeHealth nurses with knowledge and tools to become successful in this specialty area. Clinical experiences include chronic disease management for adult patients, post-op care, IV infusion management, wound/ostomy, tracheostomy, drains/tubes, central venous catheters, urinary catheters and more. The first group of fellows graduated in March.
Four nurses earn doctoral degrees ChristianaCare appreciates the dedication and determination of our four nurses who persevered through a public health crisis to earn their doctoral degrees in 2020. Jacqueline Armstrong, DNP, NP Behavioral health nurse University of Delaware Connie Crane, DNP, NP-C, RN Flight nurse University of Delaware Kristyn Keller, DNP, FNP-C, RN, CEN, WTA Emergency department nurse University of Delaware Esther Oteng, DNP, FNP-BC Surgical nurse University of Delaware
26 | Structural Empowerment
Rising on the Clinical Ladder in 2020 On the path to being exceptional today and even better tomorrow, ChristianaCare offers a four-tiered Clinical Ladder for nurses in outpatient and ambulatory settings. The Clinical Ladder is a professional advancement model that recognizes and rewards experience, knowledge and clinical expertise, allowing clinical nurses to continually improve their skills and to practice at the top of their nursing license. The model, the first of its kind in Delaware, includes nurses in primary care practices, specialty care practices and ChristianaCare HomeHealth.
RN IV
Caitlin Foster, BSN, RN-BC
Maria Brown, MSN, RN, PCCN
Stephanie Fulton, BSN, RN, CCRN
Stacey Byam, MSN, RN, AGCNS-BC, PCCN
Lyrae Graham, BSN, RN-BC
RN III
Greg Gupiteo, BSN, RN-BC
Kenneth Anderson, BSN, RN, CCRN
Kyle Hatfield, BSN, RN-BC
Naomi Anderson, BSN, RN, CNOR
Jennifer Huebner, BSN, RN, CCRN
Carly Baity, BSN, RNC-NIC
Kelli Lynn Krause, BSN, RN, CEN, TCRN
Nicole Bell, BSN, RN, CCRN, SCRN Kathleen Booker, MSN, PCCN Marlo Bowser, BSN, RN-BC
Kristen Graney, BSN, BS, RN, CEN
Alexander Krenz, BSN, RN, CCRNCSC
Jessica Bull, MSN, CCRN Megan Byrne, BSN, RN, CCRN
Christie Lynn Lion, BSN, CCRN
Nyree Cephas, MSN, MSM, RN-BC
Mary Manglass, BSN, RN-BC, CEN
Lindsey Clark, BSN, RN, PCCN
Jennifer Marschalok, MSN, RN-BC
Emily Colonna, BSN, RN, SCRN
Brionna Masterson, BSN, RN, PCCN,
Shelby Crawford, BSN, RN, CCRN
Giana Claire Patton, MSN, RN CEN Jannelle Ransome, MSN, RN, CAPA Ashley Rufe, BSN, RN, CCRN Lauren Rutecki, BSN, RN-BC
Judith Lind-Mahoney, MSN, RN, CCRN
Jasmine Cook, BSN, RN-BC
Edward Okonowicz, MSN, RN, CHRC
Megan Scofield, MSN, RN-BC Christine Schrei, BSN, RN-BC Kathryn Shady, BSN, BA, RN, OCN, CCLS Jessica Toner, MSN, RN-BC, WTA-C Lauren Turner, BSN, RN-BC, CAPA Gina Waithe, MSN, RN, CNOR Rochelle Wright, BSN, RN-BC Mason Leon Wurzburger, BSN, RN, CEN Aleksandra Wyatt, BSN, RN, CAPA Kerri Zippe, BSN, CCRN-K
Shelly McVey, BSN, RN-BC
Darlene Deel, MSN, RN-BC, CLC
Alexis Morris-Williams, MSN, RN, CCRN, WTA-C
Kristina DiCarne, BSN, RN-BC
Amanda Myron, MSN, CCRN
Brianna Dix, BSN, RN, CCRN
Stephanie Neifert, BSN, RN, CNOR
Joseph Fiorelli, BSN, RN, PCCN
Melissa Neri, BSN, RN, TCRN
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AWARDS AND RECOGNITION
ChristianaCare Way Awards
The annual ChristianaCare Way Awards recognize outstanding performance improvement work by nurses and other caregivers, demonstrating our commitment to being exceptional today and even better tomorrow. This year, 90 teams submitted entries. Award-winning initiatives with nurse leads, co-leads or team members are listed here.
President’s Award
Value Award
The Wilmington Cardiac Care Unit: The Right Care in the Right Place
From Program Offering to Best in ClassTransforming the Structural Heart Program
(Award presentation pictured above.)
Innovative Tools Award How Images and Electronic Workflow Improve Pressure Injury Identification
Organizational Vitality Gold Award Reimagining Diabetes Patient Education Throughout the Continuum of Care
Magnet New Knowledge, Innovations and Improvements Award Decrease the Cycle Time from Discharge Order Entered Until Room Ready
28 | Awards and Recognition
Magnet Transformational Leadership Award Promoting Nurse Driven Mobility of Patients with Spinal Cord Injuries in the SCCC
Health Equity Gold Award Reducing Racial Disparity in Postpartum BP Readmissions Through Care Standardization
Exceptional Experience Gold Award Timeliness of Service at ChristianaCare HomeHealth
Optimal Health Quality Gold Award The International Dysphagia Diet (IDD): Patient Safety Speaks a Common Language
Optimal Health Quality Bronze Award Forward Thinking: Innovative Strategies for an LVO Protocol
Resident’s Award
Transformation Silver Award
Postpartum Diabetes Screening
The CANDOR Program: We Tell the Truth with Courage and Empathy
Magnet Exemplary Professional Practice Award Pediatric Passport: Safe Passage Through Improved Documentation
Transformation Gold Award Zero to 62 in 3.9 Months: How 62 Teams of Caregivers Launched Virtual Care
Optimal Health Safety Gold Award OB Emergency Response Team (OBERT) Simulation Training Improves Patient Outcomes
Exceptional Experience Silver Award
Magnet Structural Empowerment Award Reduce Urinary Tract Infections (UTI) in HomeHealth
Extraordinary People Silver Award The Pandemic Playbook: A Strategic Walk into the Unknown
Optimal Health Quality Honorable Mention Award Improving Compliance to the Wake Up and Breathe Protocol
Health Equity Silver Award
Ambulatory Infusion Improving Patient Access to Ambulatory Infusion Care
Addressing Social Determinants Improves Overall Health
Population Health Award
Organizational Vitality Bronze Award
Innovative Tools and Effective Care Coordination Reduce Heart Failure Admissions
Eliminating Mom’s Delay and Decreasing Length of Stay
Optimal Health Safety Silver Award
People’s Choice Award
NEWS Alert: Getting Ahead of Patient Harm
Caring for Our Caregivers During COVID- 19
Strategic Partnerships Award CareVio COVID-19 External Business Employee Monitoring Program
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Excellence in Nursing Awards The annual Excellence in Nursing Awards spotlight exceptional ChristianaCare nurses. To adhere to social distancing during COVID-19, the awards were presented individually in 2020 to 90 nurses.
National and regional nursing-specific awards Ric Cuming, Ed.D., RN, NEA-BC, FAAN, chief nurse executive of ChristianaCare and president of ChristianaCare HomeHealth, was named to the board of the DAISY Foundation. Dannette Mitchell, MSN, APRN, ACNS-BC, CCRN, clinical nurse specialist on Wilmington Campus Intensive Care and Transitional Care units, was awarded the 2020 Circle of Excellence Award from the American Association of Critical-Care Nurses. Leslie Verucci, MSN, RN, CNS, CRNP, APRN-BC, was honored with the 2020 Advocate State Award for Excellence from the American Association of Nurse Practitioners.
Delaware Today magazine’s 2020 list of Top Nurses included 95 nurses from ChristianaCare. The list represents the full spectrum of care areas, from acute to ambulatory to rehabilitation and HomeHealth, at all levels of nursing practice.
30 | Awards and Recognition
Jefferson Awards recognize caregiver passion for service ChristianaCare recognized some of its most extraordinary caregivers in a virtual Champions of Service Awards celebration, coordinated with participation in the Jefferson Awards community service program. These caregivers received 2020 ChristianaCare Jefferson Awards for their passion for service in our community. Annamarie Flick, MSN, RN-BC, NE-BC Raquel Spencer, MSN, RN, CPHRM
Champions of Service Awards In concert with the Jefferson Awards, ChristianaCare honors individuals and groups each year with Champions of Service Awards. This year’s ChristianaCare nurses receiving an award were: Elizabeth (Beth) Acton, MSN, RN, VA-BC Alexandra Colin, MSN, RN, CCRN-K Christopher Otto, MSN, RN, CHFN, PCCN, CCRN Sonya Stover, MSN, RN, CCRN, NE-BC
ChristianaCare Magnet Nurse of the Year A big shoutout to Stacey Byam, MSN, RN IV, AGCNS-BC, PCCN, in Newark Campus’s Transitional Surgical Unit. Byam is ChristianaCare’s 2020 Magnet Nurse of the Year. A member of ChristianaCare’s Interprofessional Ethics Committee and consultation service, Byam is a determined advocate for health equity for LGBTQ patients, leadership in ethical clinical practice and improvements in surgical patient throughput and handoff.
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DAISY Awards The international DAISY Awards for Extraordinary Nurses acknowledge nurses who meet and exceed patient and family needs and expectations by displaying exceptional clinical skills, compassion, respect and partnership. ChristianaCare’s Professional Nurse Council selects ChristianaCare awardees from patient, family and colleague nominations. Congratulations to our 2020 DAISY Awards recipients. Corinne Banter, BSN, BS, RN Surgical Unit, Newark Campus Megan Bastianelli Sungail, MSN, RN III-BC 4D Surgical Stepdown Unit, Newark Campus Karla Hasben, ADN, RN-BC Inpatient Psychiatry Unit, Wilmington Campus Laura Klein, BSN, RN-BC 4D Surgical Unit, Newark Campus Taylor Murphy, BSN, RN, CCRN Cardiovascular Critical Care Complex Kelin Stanley, BSN, RN-BC Center for Advanced Joint Replacement
Gillian Tilley, BSN, RN, CEN, TCRN Heart and Vascular Interventional Services Virtual Interventional Labs Jenna Townsend, RN Labor and Delivery Team, Newark Campus Inaugural 2020 HealthImpact DAISY Nurse Leader Award Annamarie Flick, MSN, RN-BC, NE-BC 5B Medical Unit, Newark Campus 2020 DAISY Nurse Leader Award Dennis Harris Jr., MSN, MA Ed., RN-BC, NE-BC Acute Care of the Elderly Unit
Melanie Sweeney-Smolka, LPN ChristianaCare HomeHealth
2020 DAISY Lifetime Achievement Award Nora Katurakes, MSN, RN, OCN Community Health Outreach and Education
Elsa Szczerba, BSN, RN Surgical Critical Care Complex
2020 DAISY Team Award Surgical Critical Care Complex
32 | Awards and Recognition
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Beacon Award for Excellence The American Association of Critical-Care Nurses’ Beacon Award for Excellence recognizes caregivers in outstanding units whose consistent and systematic approach to evidencebased care optimizes patient outcomes. In 2020, ChristianaCare’s Transitional Medical Unit (TMU) earned a Silver Beacon Award for excellence in professional nursing practice, optimal patient outcomes and exceptional experiences for critically ill patients and their families. Of the seven Beacon Award winning patient care units in Delaware, six are at ChristianaCare. They are the Transitional Medical Unit, Transitional Surgical Unit, Neuro Critical Unit, Cardiovascular Critical Care Complex, Medical Intensive Care Unit and Cardiology Short Stay Unit.
Development Support Helping health care heroes Nearly 800 ChristianaCare neighbors supported the ChristianaCare Caregiver Relief Fund. The Fund supported ChristianaCare nurses and other caregivers who faced unexpected challenges—such as school and daycare support, meals and temporary housing— while protecting and healing our community during the COVID-19 crisis. In total, the Fund raised more than $360,000, thanks to a matching $100,000 pledge from generous donors Dan and Susan Katzin (pictured).
Junior Board supports the healing power of touch Healing Touch therapy is a form of energy healing used to decrease pain, nausea, anxiety and more in patients. ChristianaCare’s Systemwide Pain Committee worked with Stacy Noel, BSN, MSN, nursing professional development specialist, to start a Healing Touch program in the health system. To help get it off the ground during a pandemic, ChristianaCare’s Junior Board made a generous gift of $3,600. The gift supported the Healing Touch training of 24 nurses, helping to drive ChristianaCare’s longer-term plan to implement Healing Touch and other integrative therapy across all campuses and practice settings.
34 | Awards and Recognition
NEW KNOWLEDGE, INNOVATIONS AND IMPROVEMENTS
New Knowledge, Innovations and Improvement ChristianaCare Nursing and HomeHealth caregivers never rest with the status quo. They continuously seek new knowledge and pursue innovations and improvements, using evidence to build new models of care, change policies and drive outcomes.
Advancing evidence-based practice Evidence-Based Practice Fellowship ChristianaCare’s Evidence-Based Practice (EBP) Fellowship uses the Johns Hopkins Nursing Evidence-Based Practice model. The nine-month mentorship program helps clinical nurses develop their leadership, problem-solving and critical EBP competency skills. An EBP Mentor—clinical nurse specialist, educator or other expert—mentors fellows in the development, implementation and evaluation of EBP initiatives. EBP Facilitators: Michelle McHugh, MSN, RN, VA-BC and Karen Allicock, MSN, RN, NPD-BC
2020 Evidence-Based fellows’ projects include: Use of incentive spirometry in postoperative abdominal patients Fellows: Tricia Harvey, BSN, RN-BC and Natalie Roddy, BSN, RN-BC Mentor: Denise Lottero, MSN, MSM, RN, NE-BC, CNOR
Deimplementation of checking gastric residual volume in patients receiving enteral nutrition through external access devices Fellows: Lisa Markiewicz, MSN, MSM, RN, CCRN and Angela Drenth, BSN, RN Mentor: Susan Birkhoff, Ph.D., RN
Decreasing patient falls in stroke patients Fellow: Kathleen King, BSN, RN Mentor: Jamie Ayala, DNP, RN, NE-BC, RN-BC
Use of continuous noninvasive blood pressure (cNIBP) monitoring and patient outcomes Fellows: Deb Wambold, BSN, RN, CEN and Christina Hoddinott, MSN, RN, CEN, CPEN Mentor: Doreen Nord, MSN, RN, CEN, NPD-BC
Venipuncture/line placement on the side of axillary node dissection Fellow: Kristen Otlowski, BSN, RN, OCN Mentors: Kate Shady, BSN, BA, RN, CCLS, OCN and Courtney Crannell, DNP, MSN,OCN, NE-BC
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Nurse-led Lean Six Sigma Black Belt projects ChristianaCare’s rigorous Lean Six Sigma program enables nurses to advance their leadership skills using process-improvement methodologies designed to improve patient experience, clinical effectiveness and organizational vitality. In 2020, Gwen Ebbert, MSN, BA, RN-BC, CPHQ, and Carmen Pal, MSN, MBA, RN, were certified as Lean Six Sigma Black Belts for their joint project—Decrease the Cycle Time from Discharge Order Entered Until Room Ready—which also received a ChristianaCare Way Award.
Out with the old, in with the new surveys To make it as easy and efficient as possible for patients to share assessments of their care experiences, ChristianaCare Nursing and Patient Experience teams instituted digital NRC Health Patient Experience surveys and real-time feedback management for caregivers. The process begins with a brief digital survey, created in consultation with nurses, sent to a patient after an ambulatory or acute care experience. The survey collects a mix of openended and fixed feedback via Interactive Voice Response, text or email. Negative comments trigger an alert to our Patient Experience team. Since replacing non-HCAHPS patient satisfaction surveys with the NRC digital surveys in April 2020, patient response rates have increased from 18% to 40%.
36 | New Knowledge, Innovations and Improvements
Nurse-led research Impacting Oncology Patients’ Anxiety and Self-efficacy Using Virtual Reality Susan Birkhoff, Ph.D., RN, Cindy Waddington, MSN, RN, AOCN, NE-BC, Jordan Williams, BSN, RN, OCN, Leslie Verucci, MSN, APRN-BC, Maureen Dominelli, BSN, RN and Richard Caplan, Ph.D. found that after watching a virtual reality educational video, first time chemotherapy patients’ anxiety levels decreased and their perceived ability to cope with chemotherapy increased.
An exploration of characteristics and behavioral traits of DAISY honorees and nominees: A qualitative study Julie McCulloh Nair, Ph.D., RN, APHN-BC, CCRE, Paige Merring, BSN, RN, CCRN and Bradley Jones, BSN, RN-BC, with outside researcher Senem Guney, Ph.D., CPXP found DAISY nurses are highly engaged in care, create a positive environment of care and are dedicated to care and competence of care.
Barriers to Care and Root Cause Analysis of LGBTQ+ Patients’ Experiences: A Qualitative Study Julie McCulloh Nair, Ph.D., RN, APHN-BC, CCRE, Alex Waad, MA, Stacey Byam, MSN, RN, AGCNS-BC, PCCN, Madeline Maher, BSN, RN, and ChristianaCare’s Health Equity team explored the barriers to quality care faced by the LGBTQ+ communities, finding found three primary themes across the cases: lack of provider knowledge, lack of patient-centered care and lack of institutional infrastructures associated with providing affirming care to LGBTQ+ individuals.
Facilitators and Challenges in the Adoption of a Virtual Nurse Visit in the Home Health Setting Susan D. Birkhoff Ph.D., RN, Julie McCulloh Nair Ph.D., RN, APHN-BC, CCRE, Kelly Bald BS, RN, HCS-O, HCS-D, Tracey Frankum BSN, RN, Sophie R. Sanchez and Alicia L. Salvatore DrPH, MPH explored heart failure patients’ perception of facilitators and barriers influencing adoption of virtual nurse visits (VNV) during the pandemic. Four themes emerged: perceived safety during COVID-19, preferences for delivery of care, user experiences and challenges with the VNV service and satisfaction with the VNV service. The System Usability Scale results revealed over half of the participants perceived the VNV service to be usable.
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ChristianaCare nurse-led conferences 15th Annual Nursing Research Conference ChristianaCare held its 15th Annual Nursing Research Conference in partnership with regional health systems and education institutions. The theme—2020 Year of the Nurse and Midwife: Creating and Sustaining Evidence Based Practice Culture—and agenda was designed for professional nurses and students seeking to use research and evidence-based practices to improve patient outcomes.
ChristianaCare Nursing participation in national conferences National discussion with ChristianaCare “See Me as a Person” facilitators ChristianaCare and Creative Health Care Management hosted a national roundtable discussion on See Me as A Person (SMAAP) and Relationship-Based Care (RBC). Led by Mary Koloroutis, CEO of Creative Health Care Management, who wrote the books on SMAAP and RBC, the virtual roundtable featured ChristianaCare See Me as a Person facilitators sharing their experiences and what they’ve learned from SMAAP participants.
38 | New Knowledge, Innovations and Improvements
PUBLICATIONS AND PRESENTATIONS
Journal Articles Emily C. Alberto, Luis Cardenas, Mark Cipolle, and Kathy E. Gallagher. (2020, June). “Level 1 Trauma Center Experience Utilizing Negative Pressure Wound Therapy with Instillation: Hypochlorous Acid Versus Normal Saline Solution in Complex or Infected Wounds.” Journal of Medical Science and Clinical Research, 8(6): 414-20. Susan D. Birkhoff and Helene Moriarty. (2020, March). “Challenges in Mobile Health App Research: Strategies for Interprofessional Researchers.” Journal of Interprofessional Education and Practice, 19. Susan D. Birkhoff, Julie McCulloh Nair, Cheryl Monturo, Dona Molyneneaux, Monica F. Rochman, Amy M. Sawyer and Helene Moriarty. (2020, September). “Role of the Nurse Scientist. Special Issue: Increasing Capacity for Nursing Research in Magnet Institutions.” Applied Nursing Research 55(1). Stacey L. Byam. (2020, May). “Healthcare Disparities in the LGBTQ Population: An Opportunity for Delaware Nurses.” DNA Reporter 45(2) 5–7. Deborah Becker, Laura M. Dechant, Laura J. McNamara, JoAnne Konick-McMahon, Cynthia A. Noe, Kristen Thomas and Lawrence J. Fabrey. (2020, March). “Practice Analysis: Adult-Gerontology Acute Care Nurse Practitioner and Clinical Nurse Specialist.” American Journal of the Critical Care Nurse 29(2): e19–30. Danielle Coyne, Amy Tuer and Julie McCulloh Nair. (2020, January). “Novice Nurse Support Group: A Pilot Study.” Nurses in Professional Development 36(1): 12–32. Senem Guney, Bradley Jones, Julie McCulloh Nair and Paige Merring. (2021, January). “An Exploration of Characteristics and Behavioral Traits of DAISY Honorees and Nominees: A Qualitative Study.” Journal of Nursing Administration 51(1): 26–32. Lisa Maxwell and Jennifer Painter. (2020, April). “Advanced Practice Clinician (APC) Fellowships: A Strategic Approach to a High Quality, Stable APC Workforce.” Delaware Journal of Public Health 6(1): e52–53. Christopher E. Otto, Leasha Roy, Kathy Price-Ward, Naomi Benjamin and Sonia B. Cooper. (2020, April). “Developing a Clinical Nurse-Led Peer Review Committee.” Nursing 2020 50(4): 1–4. Gordon D. Reed, Anita Symonds, Amy Stier, Sarah Peluso and Sarah O. Watson. (2020, May). “Prosecutor Preference for Forensic Nurse Testimony: Outcome of Expanding a Forensic Program.” Journal of Emergency Nursing 46(3): 310–17. Maureen M. Seckel. (2020, February). “Current Sepsis Research: What Nurses Need to Know.” Nursing Critical Care 15(2): 7–13. Maureen M. Seckel, Kathleen Hackett and Lauren Camposano. (2020, April). “Improving Compliance with the Wake Up and Breathe Protocol.” Critical Care Nurse 40(2): e37–8. Amy Sutor, Jennifer Painter (2020, April) “Nurse Residency Programs: Providing Organizational Value.” Delaware Journal of Public Health 6(1): 58–61. ChristianaCare Nursing Annual Report 2020 | 39
Book Chapters Karin L. Cooney-Newton. (2020). “Thinking Aloud and Expert Modelling.” In Innovation Strategies in Teaching Nursing. Springer. Laura M. Dechant and Nicole M. Heimgartner. (2021). “Concepts of Care for Patients with Cardiac Problems.” In Medical-Surgical Nursing: Concepts of Interprofessional Collaborative Care (10th ed.). Laura M. Dechant and Nicole M. Heimgartner. (2021). “Critical Care of Patients with Acute Coronary Syndromes.” In Medical-Surgical Nursing: Concepts of Interprofessional Collaborative Care (10th ed.).
Presentations – Evidence-based Practice Linda Daniel. (2020, November). Evaluation of Transcutaneous Electrical Nerve Stimulation (TENS) for Pain Management in Early Labor. Virtual poster presentation at AWHONN Annual National Convention. Kathy E. Gallagher, Richard J. Caplan, J. R. Getchell, Jennifer Bayron and Luis Cardenas. (2020, July). Use of a Collagen/Oxidized Regenerative Cellulose Dressing for SplitThickness Skin Graft Donor Site to Reduce Pain and Bleeding Complications. Virtual poster presentation at the Symposium on Advanced Wound Care. Kathy E. Gallagher, Luis Cardenas, Mark Cipolle and Emily C. Alberto. (2020, July). A Case Series Comparing Negative Pressure Wound Therapy with Instillation: Hypochlorous Acid vs. Normal Saline for Complex Infected Wounds. Virtual poster presentation at the Symposium on Advanced Wound Care. Kathy E. Gallagher, David C. Roberge and Luis Cardenas. (2020, July). Necrotizing Fasciitis of Forearms in Intravenous Heroin Users: Case Report of Advanced Wound Management Improving Dressing Tolerance and Expediting Skin Graft. Virtual poster presentation at the Symposium on Advanced Wound Care. Elizabeth G. McCarthy, Luis Cardenas and Kathy E. Gallagher. (2020, July). Management of Two Patients with Enterocutaneous Fistula After Open Abdomen Requiring Split-Thickness Skin Grafting. Virtual poster presentation at the Symposium on Advanced Wound Care. Doreen Nord. (2020, September). Elevating Emergency Department Education. Virtual poster presentation at the Emergency Nurse Association 2020 National Conference in Las Vegas, NV. Kaci Rainey. (2020, September). Keep the Beat: Metronome Implementation in ED Cardiac Arrest. Virtual poster presentation at Emergency Nurses Association 2020 National Conference in Las Vegas, NV.
40 | Publications and Presentations
Presentations – Education Karin Cooney-Newton. (2020, February). RDOS Use for Comfort Care at End of Life. Podium presentation at WISH Retreat in Newark, DE. Susan Volk, Nancy Homan and L. Douglas (2020, February). Perioperative Education and Treatment Service (POETS). Podium presentation at Perioperative Perspective, Latest Trends, and Practices in Newark, DE. Susan Volk, Terrence Wallace and Mary Pickering. (2020, February). Destination Bariatric Surgery. Podium presentation at the Chesapeake Bay Society of Perianesthesia Nursing Conference: Promoting Self Care of the Nurse in 2020 in Newark, DE. Laura Dechant. (2020, March). Class 1a Interventions: A Prescription for Successful Management of the Patient with Acute Coronary Syndrome. Podium presentation at the National Association of CNS Annual Conference in Indianapolis, IN. Tiffani Lee and Tara Miles. (2020, August). A Stroke of Genius: Developing and Implementing a Preceptor Bootcamp. Virtual podium presentation at the AANA 2020 Stroke Conference in Louisville, KY. Maureen A. Seckel. (2020, March). Reducing Patient Harm: Evidence-Based Practice Change Feeding Tubes. Lecture at the National Association of CNS Annual Conference in Indianapolis, IN. Maureen A. Seckel. (2020, March). Top Sepsis Studies 2019-2020. Podium presentation at the National Association of CNS Annual Conference in Indianapolis, IN. Maureen A. Seckel. (2020, March). Vaping Associated Respiratory Distress Syndrome Guidelines. Virtual podium presentation at the Delaware Chapter of SCCM. Maureen A. Seckel. (2020, September). Benefits of Awake Proning in Non-Ventilated COVID-19 Patients. Society of Critical Care Medicine COVID-19: What’s Next, Preparing for the Second Wave. Virtual Conference. Maureen A. Seckel. (2020, July). Top Sepsis Studies 2019-2020. American Association of Critical Care Nurses Sepsis Resources for September 2020 On-Demand Webinar. Adrienne A. Thorne. (2020, November). Development and Evaluation of a Nurse Practitioner-Directed Medication Adherence Program for Adults with Hypertension in an Academic Medical Center. Virtual poster presentation at the 15th Annual Nursing Research Conference in Newark, DE.
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The ChristianaCare Way We serve our neighbors as respectful, expert, caring partners in their health. We do this by creating innovative, effective, affordable systems of care that our neighbors value.
We Serve Together Guided by Our Values of Excellence & Love. Love
Excellence
We anticipate the needs of others and help with compassion and generosity.
We commit to being exceptional today and even better tomorrow.
We embrace diversity and show respect to everyone.
We seek new knowledge, ask for feedback and are open to change.
We listen actively, seek to understand and assume good intentions.
We use resources wisely and effectively.
We tell the truth with courage and empathy.
We are curious and continuously look for ways to innovate.
We accept responsibility for our attitudes and actions.
We are true to our word and follow through on our commitments.
ChristianaCare, PO Box 1668, Wilmington, DE 19899 | 800-693-CARE 21NUR5
