Christiana Care 2017 Nursing Annual Report

Engaged Experienced Essential

Extraordinary Empathetic Evidence-based Exceptional

Nursing Annual Report 2016

01 2 0 1 6 N U R SI N G A N N UA L RE P OR T

Christiana Care Welcomes First Chief Nurse Executive TL “Nursing practice is important work, with unique rewards and challenges,” said Ric Cuming, Ed.D., RN, NEA-BC, FAAN, a highly experienced and nationally recognized nursing leader who has been an RN for more than three decades. “I have tremendous respect for the work our nurses do and the impact they have on the patients and families we serve.”

Cuming joined Christiana Care on August 1, 2016 as the health system’s first chief nurse executive. He describes the decision to remodel the position from a traditional chief nursing officer reporting up through operations and responsible for hospital-based nursing practice to an executive overseeing all nursing practice systemwide, both inpatient and ambulatory, and reporting directly to the president and chief executive officer, as both strategic and visionary on the part of President and CEO Janice E. Nevin, M.D., MPH. “Dr. Nevin realizes how essential nurses — those who work in the hospitals and those who care for patients and their families out in the community — are in successfully achieving health care reform, both locally and nationally,” Cuming said. “Her vision in remodeling this position was to make sure the nurse’s voice was well-represented in the boardroom and in the executive decision-making arena.”

“Spectacular” level of engagement One of the first things Cuming discovered about Christiana Care’s clinical nurses was what he described as a “spectacular” level of engagement among the shared governance councils. “Christiana Care nurses are actively engaged in the dialogue, making important decisions with their nurse leaders about how they will practice nursing,” he said. “It’s a keystone of their success as twice-designated Magnet nurses.” continued

Christiana Care’s first chief nurse executive says the most important word in his job title is neither chief nor executive — it’s nurse.

And although Cuming is as likely to wear a suit to work as he is his nursing “blues,” he sees himself, first and foremost, as a nurse.

02 C H RI S T I A N A CA RE

Christiana Care Welcomes First Chief Nurse Executive

Essential partners in serving patients and families “In an era of great change in health care, nurses are essential partners in both strategy and operations,” said Dr. Nevin. “Ric is leading our extraordinary nursing staff in setting strategic imperatives and guiding change to ensure evidence-based care is translated into daily nursing practices through the health system to best serve our patients and families.”

Cuming is helping nurses at every level in the system review the current shared governance model, making sure it is as current as it should be — patient-centered and data-driven. He is leading a review of workforce demands to ensure the appropriate level of people — both in number and in levels of expertise — to provide exceptional quality care. He also plans to build on the energy driving the clinical ladder, which allows nurses to continually improve their skill set and, ultimately, patient outcomes by practicing at the top of their license.

He was immediately impressed with Christiana Care’s “remarkable” prepaid tuition benefit resulting in a 71 percent BSN or higher rate.

A great time to be a nurse The new chief nurse executive describes the level of commitment to professional nursing practice by his Christiana Care colleagues as “outstanding.” Every day, he said, he sees his nurse colleagues living out a favorite insight from Lillian Wald, founder of the American community nursing movement: “Nursing is love in action.”

“It is a gift — a blessing — to be able to come to work every day as a nurse and be a positive force, to make a positive difference in the life of someone you have just met,” Cuming said. “I am exceptionally grateful to serve the extraordinary Christiana Care nursing staff as their chief nurse executive.” n

Extraordinary People Engaged. Experienced. Essential. Empathetic. Evidence-Based. Exceptional. Extraordinary!

Christiana Care’s nursing team has been twice Magnet-designated and includes Beacon Award winners for Excellence; DAISY honorees for extraordinary, compassionate care; nationally elected professional leaders; lifelong learners; pioneers in innovative research and performance improvement; and tireless community health advocates and educators.

Christiana Care nurses exemplify the very best in Transformational Leadership, Structural Empowerment, Exemplary Professional Practice and New Knowledge, Innovations and Improvements. These valuable members of our interdisciplinary care team work at the top of their license and competency as essential partners in both strategy and operations, ever demonstrating The Christiana Care Way in a professional, compassionate manner with special attention to cultural competency, inclusion and diversity. In this era of great change in health care, the work our extraordinary nurses accomplish every day delivers ever-greater value for our patients and their families through service and clinical practice designed to achieve optimal health and exceptional experiences. n

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Nurse-driven ideas help advance stroke care Empowered nurses like Kaci Rainey, MSN, RN IV, CEN, of the Emergency Department (ED) trauma team, are applying their enthusiasm for new knowledge and exemplary professional practice to drive advancements in clinical care throughout the system. Prompted by observed delays in written orders for CT scans for patients exhibiting stroke symptoms, the trauma nurse proposed a move to verbal imaging orders to shave precious minutes off the time before stroke treatment is administered, an accomplishment that saves lives and reduces long-term disability for hundreds of patients who seek treatment here.

She also performed a literature search to find that moving patients more quickly out of the ED to the Neuro Critical Care Unit for incremental neurological testing significantly improves outcomes and allows ED nurses to focus on other patients. Preparing critical care nurses to transport patients has decreased ED length of stay for stroke patients by 78 percent.

Treating more than 2,000 patients a year places Christiana Care among the nation’s 10 busiest stroke centers.

Impressive collaboration by interdisciplinary stroke team colleagues has contributed to landmark Joint Commission certification and top marks from the American Heart Association, placing Christiana Care among the elite in stroke care for shaving 10 minutes off of the nationally recommended door-to-needle standards.

Rainey describes health system leadership’s willingness to listen and embrace suggestions — and allow nurses time off from their regular duties to research ideas — as transformative. “They show us they value nurses,” she said.

This nurse-initiated patient transport process has decreased ED patients’ length of stay by 78 percent.

78%

04 C H RI S T I A N A CA RE

Extraordinary People

The CVCCC (above) and SCCC (left) teams are in good company. The Medical Intensive Care Unit at Christiana Hospital has won three top Beacon honors and the Wilmington Intensive Care Unit earned silver in 2015.

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Beacon Awards signal excellence in critical care The Cardiovascular Critical Care Complex (CVCCC) achieved its second consecutive gold-level Beacon Award for Excellence and the Surgical Critical Care Complex (SCCC) earned silver Beacon honors in 2016 from the American Association of Critical-Care Nurses (AACN).

The CVCCC team focuses on providing a restraint-free environment and extubating patients from ventilators as soon as medically appropriate. In March 2016, the unit won Christiana Care’s Zero Harm Award for achieving 12 consecutive months without a Methicillin-resistant Staphylococcus aureus (MRSA) infection, and they have marked significant sustained periods without central-line-associated bloodstream infection (CLABSI) or catheter-associated urinary tract infection (CAUTI) occurrences. The SCCC also won a 2016 Zero

Harm Award in the MRSA category and is recognized for very low CLABSI rates. In welcoming them to Beacon status, the AACN cited the unit’s comprehensive approach to continual quality improvement for exceeding key performance measures, including ventilator-associated events, CAUTIs, Clostridium difficile infections, unit-acquired pressure ulcers, patient falls and patient/family satisfaction.

Chief Nurse Executive Ric Cuming, Ed.D., RN, NEA-BC, FAAN, applauded both units for sustaining success in delivering care experiences that are patient-centered, data-driven and evidence-based. “The Beacon Award for Excellence signals the delivery of exceptional critical care and provides an assurance to families that no greater professional nursing care is available in their loved ones’ most critical hours,” he said.

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Extraordinary People TL

Magnet ambassadors keep the conversation going Far from just a redesignation process every four years, Magnet defines every patient encounter, clinical activity and staff interaction at Christiana Care. An enthusiastic team of Magnet Ambassadors — more than 100 strong, representing every inpatient and outpatient area within Christiana Care — was chartered in 2016 to keep the Magnet conversation going systemwide. Led by Magnet Program Director Michelle L. Collins, MSN, APRN, CNS, RN-BC, ACNS-BC, LSSBB, ambassadors meet bi-monthly for Magnet updates, then share with colleagues how Magnet model components reflect their professional practice and The Christiana Care Way, supporting clinical excellence and adherence to national standards for the highest level of care for patients and their families. Ambassadors serve as liaisons between patient care units and system-level shared governance councils, the Magnet Steer and nursing leadership; provide Magnet education; serve as Magnet mentors for staff and new hires; and help colleagues incorporate Magnet model components into clinical activities and foster interdisciplinary relationships.

SE

Commitment to nursing education advances nursing excellence Christiana Care’s ongoing commitment to nursing education supports lifelong learning, develops core competencies and advances skills in critical thinking, leadership, care management and health promotion across inpatient and ambulatory settings. It also leads to professional benefits for our extraordinary nurses, including greater nurse satisfaction, accountability and increased confidence in decision making. From ongoing professional development activities to improve skills, knowledge and practice, to prepaid tuition assistance for degree programs and specialty certification support for professional excellence and mentorship relationships pairing the expert and the novice nurse, Christiana Care is a leader in supporting nursing excellence through education.

Nurses who are specialty certified

51%

252

MENTORING PARTNERSHIPS between novice nurses or emerging nurse leaders matched with experienced, proficient nurse mentors support transitions to a new role or unit, progress on the clinical ladder or pursuit of advanced degrees or specialty certification.

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Extraordinary People SE

Nursing education Advancing to 80 percent BSN or higher by 2020 Thanks to Christiana Care’s generous prepaid tuition program, nurses continue to advance on the clinical ladder earning BSNs, MSNs and doctoral degrees. Christiana Care is well on the way to achieving 80 percent of nurses BSN-prepared by 2020 in keeping with standards as a Magnet organization and aligned with the education goal endorsed by the National Academy of Medicine.

Prepaid tuition program accelerates BSN advancement Research demonstrates that care provided by nurses with a BSN or higher contributes to better outcomes for patients. Christiana Care’s current number of 71 percent of nurses with a BSN or higher is expected to grow as newly hired nurses now commit to obtain their degree within three years. Nurses already employed at Christiana Care who wish to transfer to another department and do not have a BSN also commit to earning a BSN degree.

Christiana Care offers a full-tuition prepaid program for qualified nurses pursuing bachelor’s, master’s and doctoral degrees in nursing at Drexel University, Immaculata University, University of Delaware and Wilmington University, and tuition reimbursement for nursing degrees at other designated schools.

Scholarship funding is available through the Nursing Scholarship Fund, supported by individual Annual Fund gifts designated to nursing scholarships. In 2016, gifts included nearly $40,000 from the Junior Board of Christiana Care Health System from the Ruth T. Shaw Memorial Fund, of which the Junior Board is a beneficiary, and a generous show of support from members of Christiana Care’s leadership.

Future support for nurses will be made available through two new gifts in 2016. A fund established by grateful patient Elwood Rice will help nurses who face financial challenges while pursuing clinical residencies.

Trustee Cathi Hodgins joined Christiana Care’s 1888 Society, naming Christiana Care in her estate plans to provide future tuition support and professional development opportunities to nursing staff, as well as nursing residencies and externships to student nurses.

1888 Society member Cathi Hodgins (center) meets with nurses who are advancing their education.

Learn about ways to support nursing education at christianacare.org/donors

CHRISTIANA CARE NURSES WHO ACHIEVED DOCTORAL DEGREES IN 2016 Joseph Cipriano, D.N.P., APRN — Rutgers University. “Increasing Parental Knowledge Related to the Human Papillomavirus (HPV) Vaccine.”

Kandie Dempsey, D.B.A., MS, BSN, RN, OCN — Wilmington University.

“Evaluation of a National Oncology Clinical Audit Workshop.”

Kathy Gallagher, D.N.P., ARPN — Wilmington University. “Utility of Web-Based Support for Acute Surgical Wound Care.”

Jill Jensen, D.N.P., APRN — University of Alabama. “Decreasing Length of Stay in Emergency Department Observation Units: One Unit’s Experience.”

Rachel Joseph, Ph.D., RN, CCRN — Duquesne University. “Quality of Life of Parental Caregivers of Children with Tracheostomy at Home.”

Cheryl-Lynne Kitts, D.N.P., APRN — Wilmington University. “Improvement of Care Coordination for Patients with Sub-massive and Massive Pulmonary Embolism Through Implementation of a Pulmonary Embolism Response Team Model.”

Denise Lyons, D.N.P., APRN — West Chester University. “Measuring Staff’s Knowledge, Attitudes and Perceptions Regarding the Care of the Hospitalized Older Adult.”

Rebecca Douglas MacIntyre, D.N.P., ARPN — Drexel University. “Implementing an Infection Control Bundle for the Reduction of Ventriculostomy-Related Infections in a Neurologic Critical Care Unit.”

Tammie Moore, D.N.P., ARPN — Wilmington University. “Managing Follow-Up Care for Inferior Vena Cava (IVC) Filter Retrieval Through Development of an IVC.”

07 2 0 1 6 N U R SI N G A N N UA L RE P OR T

Extraordinary People SE

Climbing the clinical ladder Christiana Care nurses demonstrate their commitment to nursing excellence and professional development by climbing the four-tiered clinical ladder in growing numbers. Based on nursing legend Patricia Benner’s landmark “Novice to Expert” and the American Association of Critical Care Nurses Synergy Model, the Nursing Professional Advancement Program recognizes the unique relationship between nurses and patients, and demonstrates the direct correlation between years of experience and patient safety. See page 24 for a complete listing of nurses who advanced to the highest levels in 2016.

RN I / NOVICE A six- to 12-month first step on the clinical ladder for all newly hired RNs with less than six months’ experience. Focus is on skill development and education, mentoring and nursing excellence.

RN II / COMPETENT Demonstrates a focus on evidence-based practice and mentoring.

A nurse may choose to remain at this level or continue to advance on the clinical ladder.

RN III / PROFICIENT Holds a BSN or MSN and three years of acute or subacute nursing experience; has advanced knowledge and skills; and is viewed as a mentor, resource and leader.

RN IV / EXPERT CLINICIAN Served as an RN III for at least two years; has five years of acute or subacute nursing experience and at least three years in a specialty; holds a master’s degree; has chaired or served as project leader of a council or task force; is acknowledged as a role model to peers, active in a relevant professional organization and volunteers in community activities; is recognized for clinical expertise and leadership at the bedside; and demonstrates community involvement and the ability to direct, support and influence nursing practice.

We are here to support our nurses in their professional development.

It’s the best thing to do — the right thing to do.

Jennifer Painter, MSN, APRN, CNS, RN-BC, OCN, AOCNS Director of Nursing Professional Development and Education

Nurses achieving BSN, MSN or higher and climbing

71%

08 C H RI S T I A N A CA RE

Extraordinary People

SE

Nurses leading the way through shared decision-making Through our shared decision-making unit- and system-level council structure, nurses hold both participatory and leadership roles in all decisions and processes directly affecting professional nursing practice. They are integrally involved from the start in identifying issues to be addressed, gathering information and making decisions, educating colleagues and evaluating the effectiveness of change.

2016 system-level highlights include:

Nursing Coordinating Council Christopher Otto, BSN, RN II, CHEN, PCCN, staff nurse on the Cardiovascular Critical Care Complex and past chair of the Professional Nurse Council, assumed the chair of the Nursing Coordinating Council in 2016, succeeding Kim Eckerson, BSN, RN III-BC (pictured right) who led the council since 2008.

As the shared governance steer, Coordinating Council brings together system council chairs, nurse leaders and frontline staff to collaborate on nursing practice initiatives and systemwide projects.

Council Chairs from left to right: Lorie Meck, BSN, RN-BC, RN III, Professional Advancement Council; Shannon Collins, MSN, RN, OCN, LNCC, Nursing Research Council; Christopher Otto, BSN, RN II, CHEN, PCCN, Nursing Coordinating Council; Jennifer Schulak, BSN, RN, CCRN, Quality & Safety Council; Maria Brown, BSN, RN, PCCN, Professional Nurse Council; Kristina Manners, BSN, RN, CPN, VA-BC, Education Council; and Tina Hendler, APRN, NNP, Advanced Practice Registered Nurse Council.

Pictured on page 9, Marowena Reyes-Rigor, BSN, RN II, CCRN, Evidence-Based Nurse Practice Council.

09 2 0 1 6 N U R SI N G A N N UA L RE P OR T

Extraordinary People

Education Council

Professional Nurse Council

• Created BSN & Beyond and certification tool kits to guide nurses through the process.

• Awarded monthly DAISY Awards to recognize outstanding nurses and introduced first DAISY Leader and DAISY Team Award to be presented in 2017.

• Communicated educational offerings identified by the learning needs assessment and spotlighted various departments through internal nursing communications.

• Coordinated Nurses Week celebration honoring our extraordinary nurses.

• Organized Certification Day celebration in March to recognize nurses with specialty certifications.

• Partnered with Textiles and Purchasing departments and the Patient and Family Advisory Council on design of a custom patient gown.

Evidence-Based Nurse Practice Council

Quality & Safety Council

• Collaborated with an integrated team of staff nurses, advanced practice nurses and nurse leaders in implementation of the Christiana Care Early Warning System (CEWS) technology to reduce patient harm and improve outcomes.

• Promoted unit-based data transparency and endorsed new electronic data dashboards.

• Collaborated with clinical practice guideline content experts to ensure nurses are practicing with the most current evidence-based literature from Lippincott Procedures.

• Created and implemented the Care Practice Guidelines/Care Management Algorithms Plan of Care Question and Request Form to promote nurse inquiry for clinical practice questions.

Nursing Research Council • Co-hosted 11th Annual Research Conference with Nemours Alfred I. duPont Hospital for Children, University of Delaware, West Chester University and Wilmington University. Of 39 abstract submissions, 16 were selected as posters and 10 for podium presentations. This encourages vital research projects that improve patient care outcomes and influence the quality and scope of nursing practice.

• Educated nurses on how to critically evaluate research articles, including quantitative, qualitative and performance improvement projects through “Tell It in a Poster” workshops as part of National Nurses Week.

• Presented monthly Nursing Grand Rounds to interdisciplinary audiences on topics including wound care, ostomy patients, coagulopathy of trauma and early extubation.

• Expanded database of nurse accomplishments, including projects, posters, presentations and publications.

• Acknowledged the increase in hospital-acquired pressure ulcers and collaborated with Wound Ostomy Continence team to bring a nationally recognized expert to the annual retreat to address pressure ulcer prevention, strategies to improve quality outcomes and the impact on patients.

• Collaborated with Patient Escort and ancillary departments (including MRI, X-Ray, CT) to improve safe patient handoff when traveling without a nurse. Currently revising the process, educating and piloting implementations on multiple units.

• Partnered with the Systemwide IV Safety Team to modify practice related to changing peripheral IVs only when clinically indicated.

10 C H RI S T I A N A CA RE

Extraordinary People

Nurses leading the way in decreasing harm Christiana Care nurses are helping to drive the journey to zero harm. By embracing tools such as the Comprehensive Unit Safety Program (CUSP), simulation training, toolkits, checklists, daily huddles and standardized practices, Christiana Care has reduced the incidence of preventable harm by 66 percent over the past five years.

Reduction in the incidence of harm by 66 percent over the last five years.

66%

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Extraordinary People EPP

Zero Harm Awards recognize ongoing commitment to patient safety Christiana Care’s Zero Harm Awards recognize the achievement of successfully reaching 12 consecutive months without patient harm in key patient safety measures. In 2016, the following units achieved Zero Harm Awards — several for more than 24 consecutive months — a true mark of Exemplary Professional Practice and a commitment by nurses and interdisciplinary partners to a culture of safety.

Central-Line-Associated Bloodstream Infection (CLABSI) W IL MIN G TO N HOS PI TA L 3N Extended Stay Unit* 4N Medical 5N Acute Care for the Elderly Unit* 7S Center for Advanced Joint Replacement* Wilmington Intensive Care Unit CH RIS T IAN A HOS PI TA L 2C Surgical* 3A Antenatal Stepdown* 3B/3C/4B Well Mom and Baby 4A Pediatrics 4D Surgery Stepdown 5C Medical 5E Heart Failure 6A Acute Care for the Elderly Unit* 6C Stroke Treatment and Recovery Unit 7E Spine/Joint Replacement Surgery* Neuro Critical Care Complex

Catheter Associated Urinary Tract Infection (CAUTI) W IL MIN G TO N HOS PI TA L 3N Extended Stay* 4N Medical* 4W Surgical* 5N Acute Care for the Elderly Unit 7S Center for Advanced Joint Replacement* Wilmington Intensive Care Unit*

5A Medical 5C Medical 5D Medical 6A Acute Care for the Elderly Unit 6E Medical* 7E Spine/Joint Replacement Surgery*

Clostridium difficile (C. difficile) WIL M IN GTON HOS PI TA L 7S Center for Advanced Joint Replacement* Extended Stay Unit C HRIS T IA N A HOS PI TA L 2B Transitional Surgical Unit 3A Antenatal Stepdown* 3B/3C/4B Well Mom and Baby* 4A Pediatrics/GYN* 7E Spine/Joint Replacement Surgery*

Falls WIL M IN GTON HOS PI TA L 4W Surgical* 5N Acute Care for the Elderly* Extended Stay Unit Wilmington Emergency Department* Wilmington Intensive Care Unit* C HRIS T IA N A HOS PI TA L 2B Transitional Surgical Unit* 2E/Cardiovascular Critical Care Complex* 3A Antenatal Stepdown* 3D Transitional Medical Unit* 4A Pediatrics* 4C Surgery/GYN* 4D Surgery Stepdown* 4E Cardiac Stepdown* 5A Medical* 5E Heart Failure* 6B Oncology* 6C Stroke Treatment and Recovery*

CH RIS T IAN A HOS PI TA L 3A Antenatal Stepdown* 3B/3C/4B Maternity* 3D Transitional Medical Unit 4C Surgery/GYN 4D Surgery Stepdown 4E Cardiac Stepdown

7E Spine/Joint Replacement Surgery* Medical Intensive Care Unit* Surgical Critical Care Complex*

Hospital Acquired Pressure Ulcer (HAPU) W I L M I N G TO N H OSPI TA L 4W Surgical 7S Center for Advanced Joint Replacement* CH RI S T I A N A H OSPI TA L 4C Surgery/GYN* 6E Medical

Methicillin-resistant Staphylococcus aureus (MRSA) W I L M I N G TO N H OSPI TA L Extended Stay Unit* 4N Medical* 4W Surgical* 5N Acute Care for the Elderly Unit* 7S Center for Advanced Joint Replacement* Wilmington Intensive Care Unit*

CH RI S T I A N A H OS PI TAL 2B Transitional Care Unit 2C Ortho/Neuro/Trauma Surgery* 2E Cardiovascular Critical Care Complex 3A Antenatal Stepdown* 3B/3C/4B Maternity* 3D Transitional Medical Unit 4A Pediatrics/GYN* 4D Surgery Stepdown* 5A Medical 5B Medical* 5C Medical Teaching 5D Medical 6B Oncology 6C Stroke Treatment and Recovery* 6E Medical 7E Spine/Joint Replacement Surgery* Medical Intensive Care Unit* Neonatal Intensive Care Unit Surgical Critical Care Complex n *24 months or more

NURSING INITIATIVES HELP DECREASE HARM

19.7 5 %

REDUCTION IN CLABSI

CALENDAR YEAR 2016

%

REDUCTION IN CAUTI

2.7

%

REDUCTION IN C.diff

81

%

REDUCTION IN MRSA

Innovative Tools

Nurses involved in innovations like Google Glass (top) and virtual patient visits are improving patient experience. Here, a VNA nurse works with a patient and his Care Link case manager using an iPad.

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Innovative Tools

Working in one of the nation’s “most wired” hospitals positions Christiana Care nurses to connect with patients and their families in ways unimaginable when most first began their nursing education. From comprehensive data and predictive analytics to help align the right patient with the right care at the right time, to early warning and virtual monitoring systems that improve patient outcomes, to lifesaving diagnostic and treatment advancements and bedside innovations that engage patients and increase access to care, the integration of care and technology is an ever-increasing part of today’s nursing profession. Yet, despite the indisputable sophistication of these tools, their true power awakens only when employed by highly skilled and compassionate professionals to care for patients in new and better ways. In the hands of a nurse, the power of technology is transformative. n

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Care Link nurse care coordinators link patients to optimal health As anyone who has cared for a chronically ill family member knows, coordinating appointments, ensuring information is shared among primary care providers and specialists, and following up on details like tests, transportation, prescriptions and appointments can be a full-time job. Getting it all right can make the difference between better health or a return to the hospital.

To help address complications before they escalate to medical emergencies, 35 inpatient and community-based care coordination nurses partner through a virtual hub with social workers, pharmacists, physicians, respiratory therapists and community social service providers in a whole new approach to population health through Christiana Care’s innovative Care Link program.

Care Link is driving greater coordination of care for patients diagnosed with or at risk for chronic disease. And by reducing unnecessary variation in care to ensure consistent quality and safety for defined procedures, Care Link is helping to lower costs and provide greater value to patients, promoting true partnership between individuals and their health care providers in the quest for optimal health.

The goal: to improve outcomes, provide better patient experiences and ensure the best use of resources.

In the last two years, Care Link has supported more than 2,500 Medicare beneficiaries. Fewer than 8 percent were readmitted to the hospital within 90 days after discharge, compared to 14 percent before Care Link. In 2016, the program served more than 45,000 patients, including those requiring continued pre- and post-operative care.

35 Care Link registered nurses help patients navigate care to better manage chronic conditions.

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Innovative Tools

Care Link (continued) Population care nurses are the backbone of Care Link’s care coordination team.

They perform assessments and educate patients in a holistic way to identify Care Link barriers, education gaps, physical, served more than social and emotional needs, and 45,000 patients work closely with physicians, social in 2016. workers, pharmacists and a wide range of medical and social service professionals to promote safe, quality care through the optimal use of resources. They also participate in perioperative outreach to patients in episodic care (such as bundled care for surgery) by performing pre-assessments and preparing patients to ensure optimal post-surgical clinical outcomes.

The VNA is an important partner in Care Link as VNA nurses assess patients’ needs to be successful in the community once discharged from the hospital.

The VNA nurse, the Care Link case manager and the patient review the discharge plan over Lync technology.

This facilitates a smooth transition of care and reinforces the relationship among the VNA, the Care Link case manager and the patient. Trained on specialized equipment, VNA nurses also can conduct virtual visits.

These innovations provide patients and families with optimal care and education so patients can return to their highest level of independence.

C AR E C OOR DIN AT OR NUR S E S

PH YS IC I ANS

C OM M UNI T Y SER V I CE S

PH AR M AC IS T S

S OC I AL WOR K E R S

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iRound drives performance improvement The same iRound technology that helps nurse leaders enhance the patient experience through real-time feedback and immediate response to patient needs is now driving performance improvement at the unit and system levels. Nurse managers are now using iRound capabilities to assess unit compliance with Joint Commission standards. The system is also used to document and track compliance with assessing and reassessing patient pain levels.

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Innovative Tools EPP

Data boards support transparency in quality and safety

Large monitors located on 41 units chart performance data in key areas of quality, safety and patient experience.

The electronic data boards

To increase awareness of quality and safety measures among staff, provide transparency of quality patients and visitors, Nursing Quality and Safety led an initiative to develop informational data displays for units at Christiana and safety data and information for and Wilmington hospitals. “The electronic data boards provide staff, patients and families. Improving transparency of quality and safety data and information for staff, patients and families,” said Susan Mascioli, MS, BSN, RN, transparency of data drives engagement of NEA-BC, CPHQ, LSSBB, director of Nursing Quality and all members of the health care team and Safety. “Improving transparency of data drives engagement of all members of the health care team and patients in improving patients in improving outcomes. outcomes.” A slide show on plasma screen monitors located prominently on 41 units continuously scrolls an introduction Susan Mascioli, MS, BSN, RN, NEA-BC, CPHQ, LSSBB to the unit and data on the unit’s performance in quality and Director of Nursing Quality and Safety safety priorities such as falls prevention, infection prevention and adherence to hand hygiene; pain management, staff communication and responsiveness; and patient experience initiatives including Quiet at Night. Partnering with Nursing on the project were Data Acquisition, External Affairs, Information Services, Patient Experience and the Patient and Family Advisory Council. Christiana Care is recognized as a national leader in quality and safety, with Magnet redesignation in 2015 and as one of the 100 Top Hospitals® in the U.S. and as an Everest Award winner for the second consecutive year in 2016. n

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Strategic Partnerships At every level — on interdisciplinary teams within the health system’s hospitals and ambulatory settings, partnering with community and state leaders and on prominent national boards and committees — Christiana Care nurses forge strategic partnerships to create greater value in care. Our nurses work directly with community-based groups to provide education and screening, collaborate on longterm plans to respond to community health crises, and give colleagues a voice in how care is best delivered through participation in shared decision-making councils.

The power of partnership plays a deciding role in improving clinical outcomes, enhancing the patient experience and strengthening organizational vitality. Each alliance leads back to the most fundamental, strategic partnership of all — the relationship of trust between patients and the nurse heroes who care for them.

n

17

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Nurses take the front line against the threat of emerging infections Today’s nurses are strategically partnering in innovative and intensely important ways to lead preparations for the emerging possibility of biohazards and pathogenic infections such as Ebola, Middle East Respiratory Syndrome (MERS) or the Zika virus.

Christiana Care’s emerging infections response team was put to the test — and rose to the occasion — last spring when triage nurse Linda Biggs, BSN, RN III, CEN, of the Middletown Emergency Department, recognized a potentially life-threatening situation. continued

18 C H RI S T I A N A CA RE

Strategic Partnerships

Nurses take the front line (continued) Her patient, who had recently traveled to West Africa, presented with symptoms characteristic of the Ebola virus. Biggs swiftly isolated the patient and activated the response plan. The patient was transported to a special isolation unit at Wilmington Hospital and cared for by a highly trained nursing and infection prevention team who had participated in months of intensive, voluntary preparation with personal protective equipment for just such a moment. Tests eventually ruled out Ebola, but thanks to intensive simulation training and preparation, frontline and behind-the-scenes nurses and other response team members exhibited the talent, knowledge and experience needed to protect the patient, health care providers and the community.

Such a high level of readiness doesn’t happen overnight, or in a vacuum. It’s a well-coordinated strategic partnership that involves rigorous simulation training procedures focusing on epidemiology and transmission of emerging infections, infection prevention and control principles, personal and environmental safety, and principles of clinical care and management of the patient with an emerging infection.

More than a year of intense planning, preparation and fine-tuning by nurses representing departments and specialties throughout the health system culminated in a level of readiness that has earned Christiana Care designation as the official Ebola Assessment Center for the state of Delaware.

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Outcomes soar with VNA nurse pilots Every successful flight team needs a capable pilot at the controls.

The same can be said for coordinating the many interdisciplinary team members involved in delivering exceptional home health care for increasingly complex and higher acuity patients. Office-based nurse “pilots” Kelly Tibbitt, RN, and Kara Welcher, BSN, RN, of Christiana Care’s Visiting Nurse Association (VNA) are sitting in the pilot seats helping to improve communication, care transitions and interdisciplinary care planning among physicians, home health nurses, direct care clinicians, aides and social workers caring for patients in the home.

The new model also makes shifts more efficient for nurses in the field. With the office team handling calls to physician offices and durable medical equipment providers, nurses in the field can focus on providing skilled patient care.

A combination of pre-admission calls focusing on person-centered goals, clinical support and case-conferencing for high-risk patients and more coordinated communications with both the clinical team and patient by these highly experienced nurse case managers led to improvements in both clinical outcomes and patient experience scores.

Nurse “pilot” program impact by the numbers

26 10 %

IMPROVEMENT IN ACUTE CARE HOSPITALIZATION

%

IMPROVEMENT IN CLINICAL OUTCOMES

5

%

IMPROVEMENT IN PATIENT EXPERIENCE

7.5

%

IMPROVEMENT IN PRODUCTIVITY

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Strategic Partnerships

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Nurses partner with physician and operations colleagues to lead service lines, implement clinical pathways At every level, nurses are strategic partners in advancing Christiana Care’s new operational structure that replaces traditional siloes of care with a more robust, collaborative approach organized around nine clinical service lines and an array of essential services. The executive division of each service line includes a nurse leader serving alongside physician and operations colleagues to help guide teams in achieving optimal health and an exceptional experience for every patient, while

reducing the cost of care. As the structure enters its second year and emphasizes reducing unnecessary variation in care through evidencebased clinical pathways, clinical nurse leaders bring valuable expertise and perspective to the integrated practice teams charged with creating medical road maps. Clinical pathways support care teams in achieving optimal health and an exceptional experience for every patient, while eliminating waste and reducing the cost of care.

Nurses play an essential role in creating — and implementing — clinical pathways to ensure safer, more consistent care.

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Nurses partner with teens in school-based wellness centers In partnership with local school districts and the Delaware Department of Health and Social Services Division of Public Health, Christiana Care operates 15 high-school wellness centers that help teens overcome obstacles to receiving good health care — lack of transportation, inconvenient appointment times and worries about cost and confidentiality. Working with each student’s health care provider, parents and school nurse, nurse practitioners partner with licensed clinical social workers and registered dietitians to provide comprehensive medical and mental health care, treatment and health education.

High-School Centers: 15 Nurse Practitioners: 15 Student Visits in 2016: 24,183

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Celebrating 20 years of statewide trauma care in Delaware

A celebration at Legislative Hall in Dover recognized the 20th anniversary of Delaware’s statewide trauma system and honored the trauma nurses, trauma surgeons, paramedics, social workers and other health care professionals who have contributed to its success.

For the past two decades, Christiana Care trauma nurses have played a key role in creating and enhancing Delaware’s statewide trauma care system. From critical care air-medical transports to emergency stabilization in trauma bays in Christiana Care’s three emergency departments, to life-saving surgeries and expert care on critical care units, Christiana Care’s advanced practice and advanced-trained trauma nurses offer the highest level of trauma readiness, 24 hours a day, every day of the year. Trauma nurses also regularly educate community groups on injury prevention and partner strategically with community-based Emergency Medical Services response personnel. n

The following pages highlight the honors, awards and accomplishments — both within our own health system and in national, industry-wide nursing forums — that set the extraordinary nurses of Christiana Care at the top of their profession.

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The Christiana Care Way Awards The Christiana Care Way Awards, formerly the Focus on Excellence program, highlights the best team efforts, improvements and successes achieved during the past year. Nurses were actively involved in nearly every one of the 145 projects submitted to this year’s competition, their efforts leading to significant reductions in length of stay, enhanced patient experiences, improved clinical outcomes and nearly $2.7 million in estimated cost savings. Special congratulations to the following gold-level, nurse-led winning teams.

Magnet Structural Empowerment Award – Gold CLABSI PREVENTION: AN EDUCATOR’S APPROACH Acute Medicine Service Line staff development specialists developed competency sessions to enhance nurse awareness and skill in managing central venous catheters to reduce the rate of central-line-associated bloodstream infections (CLABSI) on six medical units at Christiana Hospital: 5A, 5B, 5C, 5D, 6A and 6E. More than 300 nurses completed central-line usage competency sessions at the VEST Center. CLABSI incidence on the six units decreased 70 percent, from 10 to three.

Nursing Team Members: Christine Brown, BSN, RN-OCN; Barbara Feeny, MSN, RN-BC; Michele McHugh, MSN, RN-VA-BC; Cheryl Muffley, MSN, RN-BC; Kendall Scott, MSN, RN-BC; Amy Spencer, MSN, RN-BC and Ann Wright-Glover, MSN, RN-BC.

Magnet New Knowledge, Innovations & Improvements Award – Gold ENGAGING FRONTLINE STAFF IN REDUCING DISCHARGE TIMES ON MOTHER/BABY UNIT A Lean Six Sigma team decreased the wait time from discharge order to hospital departure for obstetric postpartum patients on 3B/3C/4B from 12 to 3.75 hours by standardizing and streamlining key processes: discharge tasks, availability of the pediatrician to discharge babies, vaccinations and car seat education.

Nursing Team Members: Sherry Monson, MSN, MBA, RN, CENP; Marilyn Sherman MSN, RNC, CPHQ, LSSGB; Mary Stirparo, MSN, RN, NE-B; Kathy Simpson, MSN, RNC-OB; Linda Louie MS, RNC-MNN; Cheryl Scott, MSN, RNC-MNN; Mary Lavoie, MSN, RNC-MNN; Eileen Krapf, RNC-MNN and Melissa Detweiler, RN II. continued

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145

performance improvement projects submitted to the 2016 competition.

Ramatoulaye Bah, PCT; Katie Heller, BSN, RN; Michelle Maurer, BSN, RN-BC, RN II; Sharon Simeone, BSN, RN-BC; Lisa Stoltz, BSN, RN II and Lenore Porter, PCT, discuss the care of patients during a shift change brief, an initiative that came out of a Black Belt project known as “Transform Nursing Care Delivery.”

Magnet Exemplary Professional Practice Award – Gold IMPROVING BARCODE SCANNING ON 4D Patient care unit 4D increased the bar code medication administration scanning rate from 93 to 97.5 percent by eliminating non-value-added process steps, collaborating with Pharmacy to fix unscannable bar codes and standardizing nurse training.

Nursing Team Members: Diane Talarek, MA, RN, NE-BC; Gwen Ebbert, MSN, BA, RN-BC; Karen McCloud, RN; Lindsay Sanderson, RN; Jessica Hellstern, RN III; Kim Christopher, RN; and Jan Gibson-Gerrity, MS, BSN, RN.

Magnet Transformational Leadership Award – Gold COLLABORATING FOR CLABSI PREVENTION IN HEMATOLOGY & ONCOLOGY PATIENTS The 6B/Bone Marrow Transplant Value Improvement Team implemented evidence-based standards of care for centralline management and infection prevention, developed a tool to monitor central lines three times weekly and conducted deep dives into each central-line-associated bloodstream infection (CLABSI). CLABSI decreased by 42 percent, from a baseline of 5.7 infections per 1000 line days to 3.3.

Nursing Members: Courtney Crannell, MSN, RN-BC, OCN; Angela Ross, BSN, RN, OCN; Christine Brown, BSN, RN, OCN; Krystle Becraft, BSN, RN, OCN; Tracy Curry, MSN, RN, OCN; Lisa France, ADN, RN, OCN; Lori Randla, BSN, RN, OCN; Trudy Thomas, BSN, RN, OCN; Lorraine Adkins, BSN, RN, CIC; Mary Susan

MacCord, BSN, RN, CEN; Michele McHugh, MSN, RN, VA-BC; Dan Dougherty, MSN, RN, CEN; Sharon Vickers, MSN, RN, CEN; Dannette A. Mitchell, MSN, APRN, CNS, ACNS-BC, CCRN; Maureen Seckel, MSN, APRN, CNS, ACNS-BC, CCNS; Susan Mascioli, MS, BSN, RN, NEA-BC CPHQ, LSSBB; and nursing teams from Vascular Access, the Emergency Department, Intensive Care, and Nursing Quality and Safety.

Extraordinary People Award TRANSFORMING NURSING CARE DELIVERY To ensure that Christiana Care’s nursing model supports the nursing top-of-licensure focus, a deeper look into the nursing care delivery process by this nurse-led project team decreased the percent of nurse’s time spent in non-value-added activities from 34 to 28 percent and the percent of nurses’ time spent in documentation from 15 to 10.4 percent.

Nursing Team Members: Diane Talarek, MA, RN, NE-BC; Janet Cunningham, MHA, RN, NE-BC, CENP; June Estock, MSN, RN, CPHQ, LSSBB; Megan Bastianelli Sungail, BSN, RN-BC; Kristen Callaghan, RN II; Kathy Davidson, MSN, RN, BC; Katie Heller, BSN, RN; Barbara Marandola, MBA, RN; Michelle Maurer, BSN, RN-BC, RN II; Bonnie Osgood, MSN, RN-BC, NE-BC; Amy Spencer, MSN, RN-BC; Joanne McAuliffe, D.N.P., MSN, BA, BSN, RN, OCN, NEA-BC and Beth Fraticelli, MSN, RN.

Initiatives resulted in a cost savings of:

$

2.7

MILLION

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2016 DAISY Award for Extraordinary Nurses The DAISY Award for Extraordinary Nurses recognizes nurses who exceed the needs and expectations of their patients and families by displaying exceptional clinical skills, compassion, respect and partnership. “Excitement for the DAISY Award continues to flourish as the Professional Nurse Council (PNC) completes the second full year of celebrating our extraordinary nurses at Christiana Care through the internationally recognized program,� said Maria Brown, BSN, RN, PCCN, chair of the PNC, which selects monthly DAISY winners from nominations by patients, families and colleagues.

Christiana Care will add two new annual award categories in 2017: the DAISY Nurse Leader and DAISY Team awards.

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Honors, Awards & Accomplishments

2016 DAISY Award recipients Megan Smakulski, MSN, MBA, RN, PCCN

Stefanie Desiderio, ADN, RN II

3D Pulmonary Stepdown

Erin Brennan, BSN, RN III, CCRN

Stephanie Forester, BSN, RN III

Neuro Critical Care

Labor & Delivery

Karen Minard BS, RN-BC

Brie Crabill, MSN, RN II

5D Medical

6S, Wilmington Intensive Care Unit

Megan Cronshaw, RN II

Phillip Scott, RN, NRP

Labor & Delivery

Wilmington Intensive Care Unit

John Keichline, RN

Julie Mullins, RN

Middletown Emergency Department

5C Medical

Angela Goodale, BSN, RN, CCRN

Katharine Potter, MSN, RN III, BC

Surgical Critical Care Complex

Christiana Emergency Department

5B Medical

We have been truly touched by this angel of a nurse and have no doubt all his other patients that night felt the same level of expertise, compassion and kindness.

Sharon Urban, MSN, RN-BC, CNML

As written in her nomination of DAISY Award-winning nurse John Keichline, RN, for the care given to her son Kyle.

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Nursing Professional Advancement Program’s clinical ladder rewards clinical and professional excellence Advancement on the clinical ladder provides greater opportunity for nursing professional advancement, allowing frontline nurses to continually improve their skill set and, ultimately, impact patient outcomes by practicing at the top of their license. Research reveals that each additional year of nursing experience on a clinical unit corresponds to improved patient outcomes. Levels III and IV offer increasingly greater opportunity for recognition and compensation for nurses who wish to remain at the bedside. Congratulations to the following colleagues who achieved RN III and RN IV status in 2016.

RN III 60 nurses advanced to the RN III “Proficient” level in 2016: Kate Armstrong, BSN, RN III, CCRN

Brent Hastings, BSN, RN III, CEN

Kelsey Petrusky, BSN, RN III, RN-BC

Christiana Emergency Department & Critical Care Transport Team

Medical, Christiana

Wilmington Intensive Care Unit

Jodi Hayden, BSN, RN III, CEN

Labor and Delivery

Susan Atkison, BSN, RN III, RN-BC

Middletown Emergency Department

Renee Lynne Platt, BSN, RN III, RN-BC

Medical, Wilmington

Alexis N. Herbein, MSN, RN III, PCCN

Acute Care for the Elderly, Christiana

Megan Bastianelli Sungail, MSN, RN III, RN-BC

Christiana Post Anesthesia Care Unit

Nicole Possenti, BSN, RN III, CEN, FNE, TCL

4D Surgical Stepdown

Jennifer Holveck, MSN, RN III, CEN

Christiana Emergency Department

Tracy Bell, BSN, RNC-NIC, RN III

Christiana Emergency Department

Margaret Ann Rafal, MSCC, RN III, RN-BC

Neonatal Intensive Care Unit

Tamie Hotchkiss, BSN, RN III, RN-C

Behavioral Health

Ines Boado, BSN, RN III, CMSRN

Neonatal Intensive Care Unit

Dana Roncagliolo, RN III, CNOR

Surgical

Kristen Hover, BSN, RN III, CCRN

Christiana Surgicenter

Mark J. Caldwell II, BSN, RN III, CCRN

Medical Intensive Care Unit

Jennifer Schulak, BSN, RN III, CCRN

Cardiovascular Critical Care Complex

DeLea Jacobs, BSN, RN III, CEN

Post Anesthesia Care Unit

Alana Coppol, MSN, RN III, RN-BC, FNP-C

Wilmington Emergency Department

Elizabeth Shearon, BSN, RN III, RN-BC

Medical, Christiana

Kathleen Jamison, BSN, RN III, CPAN

Medical Stepdown

Catherine Corbett, BSN, RN III, PCCN

Christiana Surgicenter

Jennifer Sliney, BSN, RN III, CEN

Transitional Medical Unit

Nora Jingeleski, BSN, RN III, RN-BC

Christiana Emergency Department

Arwen Craig, MSN, RN III, OCN, RN-BC

Surgical, Wilmington

Erin Taylor, BSN, RN III, CCRN, CEN

Hematology/Oncology

Kaitlin Johnson, BSN, RN III, PCCN

Christiana Emergency Department

Kathrine Crawford, MSN, RN III, CCRN

Stepdown Intensive Care Unit, Wilmington

Kelley Vanhorn, BSN, RN III, CNOR

Medical Intensive Care Unit

Jaclyn Kerezsi, BSN, RN III

Christiana Operating Room

Stephanie C. Daneshgar, BSN, RN III, BSN, CNOR

Neuro Ortho Trauma

Barbara Vogel, BSN, RN III, PCCN

Cardiothoracic Surgery

Amy Llewellyn, BSN, RN III, CCRN

Cardiovascular Stepdown

Jacqueline Day, BSN, RN III, PCCN

Medical Intensive Care Unit

Joe Walsh, BSN, RN III, CEN

Transitional Surgical Unit

Paula Loder, BSN, RN III, RN-BC

Sharon J. Dietzel, BSN, RN III, CCRN

Medical, Christiana

Heart & Vascular Interventional Services, Interventional Radiology/Cath Lab

Surgical Critical Care Complex

Donna M. Lougheed, MSN, RN III, CEN, SANE-A

Eric Wickersham, BSN, RN III, CCRN

Lauren Duddy, BSN, RN III, CEN, PCCN

Wilmington Emergency Department

Medical Intensive Care Unit

Cardiology Short Stay Unit

Kimberly M. Malcom, BSN, RN III, CEN

Amanda Williams, BSN, RN III, BC

Greta Endres, BSN, RN III, PCCN

Critical Care Transport Team

Medical, Wilmington

Cardiovascular Critical Care Complex

Jerry Mench, MSN, RN III

Lelia Williams, BSN, RN III, ONC

Sara Fetters, BSN, RN III, CCRN, PCCN

Middletown Emergency Department

Medical, Christiana

Cardiovascular Critical Care Complex

Tara Miles, BSN, RN III, CCRN

Traci Williams, BSN, RN III, RN-BC

Blyss Galizia, BSN, RN III, CNOR

Neuro Critical Care Unit

Behavioral Health

Christiana Operating Room

Serah Muhoro, BSN, RN III

Daniel E. Zirolli, BSN, RN III, CCRNe

Darlene Glazier, BSN, RN III, RN-BC

Center for Rehabilitation at Wilmington Hospital

eCare Virtual Intensive Care Unit

Medical

Jaime Murray, MSN, RN III, CNN

A. James Grant, IV, BSN, RN III, CPEN

Hemodialysis

RN IV

Christiana Emergency Department

Jane Njuguna, RN III

Kathleen Hackett, BSN, RN III, CCRN

Obstetrics/Gynecology/Urology

Medical Intensive Care Unit

Eric Oberle, BSN, RN III, CCRN

Ann K. Hallstrom, MSN, RN III, CEN

Medical Intensive Care Unit

Kaci Rainey, MSN, RN IV, CEN, of the Christiana Emergency Department, reached the highest rung on the clinical ladder in 2016 — RN IV / Expert Clinician — making her the fourth Christiana Care nurse to achieve this highest clinical standing.

Wilmington Emergency Department

Jennifer Piaskowski, BSN, RN III

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Honors, Awards & Accomplishments NK

Value Institute Nursing Scholars translate discoveries into practice The following nurse leaders serve as Value Institute Scholars for the Christiana Care Value Institute.

Lynn E. Bayne, Ph.D., ARNP, NNP-BC Nursing Research Facilitator

Michelle L. Collins, MSN, APRN, CNS, RN-BC, ACNS-BC, LSSBB Director, Magnet Program

Susan Mascioli, MS, BSN, RN, CPHQ, NEA-BC, LSSBB

Joanne McAuliffe, D.N.P. MSN/BA, BSN, RN, OCN, NEA-BC

Director, Nursing Quality and Safety

Vice President, Patient Care Services, Wilmington Hospital

Rachel J. Joseph, Ph.D., CCRN Registered Nurse, Neonatal Intensive Care Unit

Denise Lyons, D.N.P., APRN, AGCNS-BC, FNGNA Gerontological/Adult Clinical Nurse Specialist and WISH/NICHE Program Coordinator

Rebecca Walker, Ph.D., JD, MSN Chief Operating Officer, Division of Forensic Sciences, Delaware Department of Safety & Homeland Security Emergency Medicine Nurse and Trustee, Christiana Care Health System

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Improving Quality with Lean Six Sigma Christiana Care’s Lean Six Sigma program trains employees as quality improvement experts who can recognize opportunities, identify root causes of problems and develop quality improvement interventions to deliver meaningful, sustained value in health care.

Nurse-led projects in 2016 were: Reduce 30 Day Readmission Rates for Global AMIs

BLACK BELT PROJECTS

GREEN BELT PROJECTS

Decrease the DPMO of Specimen Originating from Women’s and Children’s within Christiana Hospital

Performance of the Diabetes Case Bundle Valerie Rebmann Schimpf, RNP-BC Cheryl Tuohy, FNP-C, CEE

Greg O’Neill, BSN, RN, CCRN Jennifer Leonovich, MSN, MBA, RN, CCCC, CCRN

Champion: Elizabeth Igboechi, MSN, RNC-OB, FNP, NEA-BC Process Owner: Lisa Renée Malm, BSN, RN

Wound Vac Equipment Loss Avoidance

Reduce Safety Companion Utilization

Transforming Nursing Care Delivery Project June Estock, MSN, RN, CPHQ, LSSBB Janet Cunningham, MHA, RN, NE-BC, CENP

Daria Barksdale, MSN, MBA, RN, CCM

Denise Lyons, D.N.P., APRN, AGCNS-BC, FNGNA

Reduce the Percent of Long-Stay Patients on 6E

Reduce the Percent of Medication Requests on 5B

Thomas Desper, RN-BC, CCM

Jennifer Painter, MSN, APRN, CNS, RN-BC, OCN, AOCNS

Reduce Length of Stay for Observation Status Patients on 5B Medicine Unit

Reduce Percentage of OB Post-Partum Discharges that Occur After Twelve Noon

Patti McGraw, MS, RN

Marilyn Sherman, MSN, RNC, CPHQ, LSSGB

ED Patient Paper Record Optimization

Optimization of Breast Cancer Nurse Navigation

Heather Panichelli, MSN, APRN, AGCNS-BC, CEN, CPEN

Darcy Burbage, MSN, RN, AOCN, CBCN Kathy Coward, BSN, RN, OCN

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Nursing research

RE S E A RC H B Y T HE NUM BE RS

47 107 167

PEER-REVIEWED PUBLICATIONS

POSTERS / PRESENTATIONS

GRADUATE -LEVEL RESEARCH PROJECTS

Publications Prolific researchers, Christiana Care nurses were lead or contributing authors on a number of journal articles, including: Cynthia Arslanian-Engoren, Ph.D., RN, ACNS-BC, FAHA, FAAN, Linda LaskowskiJones, MS, APRN, ACNS-BC, CEN, FAWM, FAAN, et al. “Admit to Observation Status: Policy Brief.” American Academy of Nursing on Policy Nursing Outlook journal http://dx.doi.org/10.1016/j.outlook.2016.09.002.

Holly Bechard, BSN, RN II, Jennifer Singley, Vanessa Estrada, BSN, RN-BC, Catherine Corbett, BSN, RN III, PCCN. “Focus on Safety: Creating a Culture of Safety.” Critical Care Nurse. 36:40. April 2016.

Tracy Bell, BSN, RNC-NIC, Barbara Dean, BSN, RNC, Amy Mackley, MSN, APN, Gina Moore, Cheryl Swift, Dina Viscount, David A. Paul, M.D., Stephen A. Pearlman, M.D., MSHQS, et al. “A Quality Improvement Initiative for Delayed Umbilical Cord Clamping in Very Low-Birthweight Infants.” BMC Pediatrics BMC series.

Elisabeth Bradley MS, APRN, AGPCNP-BC, ACNS-BC. “Million Hearts Delaware: A First State Coalition to Prevent Heart Attack and Stroke.” Journal of Cardiovascular Nursing. Vol. 31. January 2016.

Patricia Briggs, MSN, RN IV, CCRN, HTCP, HTCI, Helen Hawrylack, BSN, RN III, CCRN, Ruth Mooney Ph.D., MN, RN-BC. “Inhaled Peppermint Oil for Postop Nausea in Patients Undergoing Cardiac Surgery.” Nursing. 2016;46(7):61-67.

Darcy Burbage, MSN, RN, AOCN, CBCN. Book Chapter on Breast Disorders in the Textbook Medical Surgical Nursing: Assessment and Management of Clinical Problems. Lewis, Bucher, Heitkember, & Harding (Eds). Elsevier: pp. 1204-1226 and “Survivorship Care Planning. Supportive Cancer Care.” Chapter 6. Springer International Publishing. Switzerland 2016.

Michele Campbell, MSM, RN, CPHQ, FABC. “A Nurse’s Obligations to Patients with Ebola.” The Joint Commission Journal on Quality and Patient Safety. Vol. 1.

2016.

Michele Campbell, MSM, RN, CPHQ, FABC, and Gwen Ebbert, MSN, BA, RN, RN-BC, LSSGB. “Improving Infusion Pump Safety through Usability Testing.”

Journal of Nursing Care Quality. pp. 1-9. August 2016.

Publications as of February 2017. Listing may not be complete.

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Honors, Awards & Accomplishments

Michele Campbell, MSM, RN, CPHQ, Kristen Miller, Dr. PH., MSPH, and Kathleen W. McNicholas, M.D., “Post Event Debriefs: A Commitment to Learning How to Better Care for Patients and Staff.” The Joint Commission Journal on Quality and Patient Safety. January 2016.

Joshua Davis, Ellen Justice, MLIS, AHIP, Mark D. Cipolle, M.D., Ph.D., Cathy L. Bailey, Joan M. Pirrung, MSN, APRN, ACNS-BC, Erin M. Meyer, D.O., Edmondo J. Robinson, M.D., MBA, and Glen H. Tinkoff, M.D. “Embedding a Trauma Hospitalist in the Trauma Service Reduces Mortality and 30-Day Trauma-Related Readmissions.” The Journal of Trauma and Acute Care Surgery. July 2016.

Laura Dechant, MSN, APRN, CCRN, CCNS. “Care of Patients with Acute Coronary Syndrome,” “Care of Patients with Cardiac Problems,” “Care of Patients with Dysrhythmias” and “Catheter Directed Thrombolysis.” Medical Surgical Nursing: Patient Collaborative Care. Vol. 8. Chapters within Text. Ignatavicius & Workman. 2016.

Kandie Dempsey, DBA, MS, BSN, RN, OCN. “Clinical Trial Assessment of Infrastructure Matrix Tool to Improve the Quality of Research Conduct in the Community” and “Decreasing Sedation for Pediatric Head CT Imaging.” Journal of Oncology Practice. Vol. 1: 63-64. January 2016.

Elizabeth A. Donovan, MSN, RN, Christine J. Manta, BS, MS(c), Jennifer C. Goldsack, MChem, MA, MS, MBA, and Michelle L. Collins, MSN, RN-BC, ACNS-BC. “Using a Lean Six Sigma Approach to Yield Sustained Pressure Ulcer Prevention for Complex Critical Care Patients.” Journal of Nursing Administration. January 2016.

Robert Felte, M.D., Kathy Gallagher, D.N.P., APRN-FNP, BC, CWS, WCC, CMC, UMC, FACCWS, Glen H. Tinkoff, M.D., Mark Cipolle, M.D. “A Case Review Series of Christiana Care Health System’s Experience with Negative Pressure Wound Therapy Instillation.” Cureus Journal of Medical Science. Vol. 8:11.

November 2016.

Jennifer C. Goldsack, MChem, MA, MS, MBA, Christine DeRitter, BSN, RN-BC, Michelle Power, BMST(ASCP), CIC, Amy Spencer, MSN, RN-BC, Cynthia L. Taylor, MS, BSN, RN, CRN, Christine J. Manta, BS, MS(c), Ryan Kirk, Marci Drees, M.D., MS. “Increasing the Efficiency of a Targeted Methicillin-Resistant Staphylococcus Aureus Screening Program” and “Increasing Value to Medical Practices and Public Health: Adding Embedded Registered Dietitians and Diabetes Educators to Improve Team-Based Care.” American Journal of Infection Control. Issue 1. 2016.

Jacqueline Grau, BSN, RN, CCRN-e, Daniel Zirolli, BSN, RN, CCRNe, Nancy Galbreath, BSN, RN, CCRN, and Kellie Kessler, MSN, RN, CCRN. “Extubate Patients When Ready.” Critical Care Nurse. 36:40. April 2016.

Timothy Heckman, BSN, RN-BC, Samantha Kelley, Sonya Stover, RN, MSN, CCRN, NE-BC, and Jennifer Papi MSN, RN, PCCN. “Ventilator-Associated Pneumonia: Prevention in the Midst of Change.” Critical Care Nurse. Vol. 36:21.

April 2016.

Stacie Holdinsky, MSN, FNP-BC. “Bedside Shift-to-Shift Handoffs: A Systematic Review of the Literature.” Journal of Nursing Care Quality. May 2016.

Nancy Homan, RN, MSN, MBA, MHS, APRN-BC and Melanie Chichester, BSN, RNC-OB, CPLC. “Peer to Peer Education: OB Visits the ED.” Journal of Emergency Nursing. Vol. 42: 125-127. March 2016.

Rachel A. Joseph, Ph.D., MSN, MA, CCRN, et al. “Placentophagia: Benefit or Myth?” Nursing for Women’s Health, October/ November 2016. “Global Health Perspectives: Undergraduate Student Experiences in India.” Neonatal Network Academy News. July 2016. “Health literacy: A Cross-Disciplinary Study in

American Undergraduate College Students.” Journal of Information Literacy.

December 2016. “New Technology in the NICU; Challenges to Parents and Clinicians.” Neonatal Network. November 2016. “Oral Feeding in Infants After Tracheostomy.” Journal of Pediatric Nursing. December 2016. “Transition from NICU to Home: Are the Parents Ready to Manage Any Emergency? An EvidenceBased Project.” Neonatal Network.

Nora Katurakes, RN, BSN, MSN, OCN, and Charlene Marinelli, RN, BSN, OCN. “Health Info On The Go: New Innovative Approach To Cancer Awareness.”

Oncology Nursing Forum. Vol. 43. 2:26. March 2016.

Linda Laskowski-Jones, MS, APRN, ACNS-BC, CEN, FAWM, FAAN. A chapter, “The Emergency Nurse as a Professional.” Emergency Nursing. The Profession/ The Pathway/The Practice. Sigma Theta Tau International Honor Society of Nursing. 2016. Monthly editorial in Nursing: The Journal of Clinical Excellence as Editor-in-Chief of the Journal, 46(1-12). 2016. “Care of patients with common environmental emergencies.” In D. Ignatavicius & L. Workman (Eds.), MedicalSurgical Nursing: Patient-Centered Collaborative Care (8th ed., pp. 120-137).

St. Louis: Elsevier. 2016. “Concepts of emergency and disaster preparedness.”

In D. Ignatavicius, & L. Workman (Eds.), Medical-Surgical Nursing: PatientCentered Collaborative Care (8th ed., pp. 138-147). St. Louis: Elsevier. 2016.

Linda Laskowski-Jones, MS, APRN, ACNS-BC, CEN, FAWM, FAAN and Karen Toulson, MSN, MBA, RN, CEN, NE-BC). “Concepts of emergency and trauma nursing.” In D. Ignatavicius & L. Workman (Eds.), Medical-Surgical Nursing: Patient-Centered Collaborative Care (8th ed., pp. 105-119). St. Louis: Elsevier.

Tiffani Lee, MSN, RN, PCCN, Sonya Stover, RN, MSN, CCRN, NE-BC, Kimberly Mattison, MSN, RN, PCCN, and Shannon Guzman RN, BSN, RN-BC. “Relieving the Pressure: Reducing Unit-Acquired Pressure Ulcers on Medical/Pulmonary Step-down Units.” Critical Care Nurse. Vol. 36. 2:e25-e26. April 2016.

Amy Mackley, MSN, RNCR, Michael Winter, Ursula Guillien, M.D., David A. Paul, M.D., and Robert Locke, D.O., MPH. “Health Literacy Among Parents of Newborn Infants.” Advances in Neonatal Care. October 2016.

Susan Mascioli, MS, BSN, RN, NEA-BC, CPHQ, Christine B. Carrico, MSN, RN, CPHQ. “Spotlight on the 2016 Joint Commission National Patient Safety Goals for Hospitals.” Nursing2016. May 2016.

Kimberly Mattison, MSN, RN, PCCN, Sarah Smith, Sonya Stover, MSN, RN, CCRN, NE-BC, Megan Smakulski, MSN, MBA, RN, PCCN. “Crushing CLABSI: Collaborative Approach to Eliminate Center Catheter-Associated Bloodstream Infections.” Critical Care Nurse. 36:34-35. April 2016.

Kristen Miller, Dr.PH, MSPH, Carol Briody, MT (ASCP), CIC, Donna Casey, BSN, MA, RN, FABC, NE-BC, Jill K. Kane, BSN, RN, CCRN, Dannette Mitchell, MSN, APRN, ACNS-BC, CCRN, Badrish Patel, M.D., Carol Ritter, MSN, RN, CCRN, CNML, Maureen Seckel, MSN, APN, MSN, ACNS-BC, CCNS, FCCM, Sandy Wakai, MSN, RN, CCRN, Marci Drees, M.D., MS. “Using the Comprehensive Unit-based Safety Program Model for Sustained Reduction in Hospital Infections.” Journal of Infection Control. September 2016.

Joan Pirrung, MSN, APRN, ACNS-BC. “A Key to Success: Building an Internal Trauma Education Program;” and president’s message “You Are a Member of the Premiere Trauma Nursing Organization.” Journal of Trauma Nursing.

July/August 2016 and “What Is Your Superpower as a Trauma Nurse?” Vol. 23.

5:239. Sept/Oct 2016 and “Deck the Halls Safely.” Vol. 23. 6:309-310.

Nov/Dec 2016 and “Embedding a Trauma Hospitalist in the Trauma Service Reduces Mortality and 30-day Trauma-Related Readmissions.” Journal of Trauma and Acute Care Surgery. Vol. 81. 1:178-183. July 2016. continued

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Publications (continued) Maureen A. Seckel, MSN, APRN, ACNS-BC, CCNS, CCRN, FCCM, et al.

“Challenges in Sepsis Care: New Sepsis Definitions and Fluid Resuscitation Beyond the CVP.” Critical Care Nurse Quarterly. 2016.

Denise Taylor, MS, RD, Elisabeth Bradley, MS, APN, Stephen Meng, M.D., Jhapat Thapa, MBBS, and Edward Goldenberg, M.D. “Tobacco Cessation for Patients with Coronary Artery Disease.” Delaware Medical Journal. March 2016.

Megan Smakulski, MSN, MBA, RN, PCCN, Sonya Stover, MSN, RN, CCRN, NE-BC, and Jennifer Papi, MSN, RN, PCCN. “Courageous Collaborative Care: Value Improvement Teams Make a Difference on a Step-Down Unit.” Critical Care Nurse. Vol. 36. pp. 40-41. May 2016.

Wendy Wintersgill, MSN, RN, CRRN, ACNS-BC, et al. “The Competency Model for Professional Rehabilitation Nursing.” Pp. 41, 33-44. Rehabilitation Nursing Journal. 2016. n

Presentations Christiana Care nurse researchers shared their knowledge on national and international stages as lead or contributing authors of posters and podium presentations, including: Marilyn Bartley “Revaccination Compliance After Trauma Splenectomy: A Call for Improvement.” Eastern Association for the Surgery of Trauma Annual Scientific Assembly. Hollywood, Florida. January 2017.

Lynn Bayne, Ph.D., RN, APRN, NNP-BC. “I Didn’t Know It Did THAT!!!!” Best Practice in Neonatal Nursing. Wilmington, Delaware. April 2016.

Holly Bechard, “Focus on Safety: Creating a Culture of Safety.” AACN National Teaching Institute. New Orleans, Louisiana. May 2016.

Tracy Bell, BSN, RNC-NIC. “The Interview Process for the Residency Program.”

University of Delaware 50th Anniversary Celebration for the School of Nursing.

Newark, Delaware. 2016.

Bridget Bieber, MSN, CCRN, and Kathy Crawford, MSN, CCRN. “Hemodynamic Insights in Your Acute Care Patient.” 2016 National Teaching Institute & Critical Care Exposition. New Orleans, Louisiana. June 2016.

Patty Blair, MSN, APRN, ACNS-BC, CEN, and Heather Panichelli, MSN, APRN, AGCNS-BC, CEN, CPEN. “Nobody Likes Your Orange Milkshake: Decreasing Turnaround Time for Abdominal CT Scan.” National Association of Clinical Nurse Specialists Conference. Philadelphia, Pennsylvania. March 2016.

Elisabeth Bradley. “Million Hearts Delaware: A First State Coalition to Prevent Heart Attack and Stroke.” PCNA 21st Annual Symposium. Jan/Feb 2016.

Darcy Burbage, MSN, RN, AOCN, CBCN. “Survivorship Care Planning” Chapter 6. Supportive Cancer Care, Alberts, Lluria-Prevatt, Kha, Weihs, Eds. Springer International Publishing. Switzerland 2016; and “Is There a Difference Between African-American and Caucasian Breast Cancer Survivors in the Incidence and Severity of Chemotherapy Induced Peripheral Neuropathy (CIPN)?” Oncology Nursing Society 41st Annual Congress. San Antonio, Texas. April 2016.

Muge Capan, Ph.D., Stephanie Hoover, MS, Justin Glasgow, M.D., Ph.D., Susan Mascioli, MS, BSN, RN, CPHQ, NEA-BC, and Eric Jackson, M.D., MBA. “Validation and Integration of a Predictive Warning System Combining.” Society of Medical Decision Making Annual North American Meeting, Vancouver, Canada. October 2016 and “Validation and Implementation of Early Warning System to Synthesize Acuity, Clinical Judgment and Workload.” INFORMS 2016 Annual Meeting. Nashville, Tennessee. November 2016.

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Presentations (continued) Jill Carpenter, BSN, RNC, and Ann Will, BSN, RNC. “Collaboration Between NICU and Free-Standing Emergency Room to Improve Proficiency With Neonatal IV Insertion and Lab Draws.” National Association of Neonatal Nurses annual conference. Palm Springs, California. October 2016.

Nancy Courchaine, Nancy Galbreath, Jacqueline Grau and Daniel Zirolli.

“Minimizing the Noise to Maximize Efficiency.” Advancing Nursing: Developing Excellence in EBP and Research Conference 2016. Newark, Delaware. November 2016.

Donna Casey, MA, BSN, RN, FABC, NE-BC. “Courageous Care: Ethics Informed Peer Review: Why and How.” 2016 National Teaching Institute & Critical Care Exposition. New Orleans, Louisiana. June 2016 and “Ethical Issues Confronting Nurse Leaders.” AACN Delaware Chapter Annual Conference. Newark, Delaware.

October 2016.

Susan Culp, RN III. “Caring for the Substance Abuse Mother and Infant: A Case Study Presentation with Post Partum Nursing Role.” American Academy of Neonatal Nurses/Mother Baby Conference. Nashville, Tennessee. September 2016.

Melanie Chichester, BSN, RNC-OB, CPLC. “Bleeding in Pregnancy.” Delaware Academy of Family Physicians 2016 Annual Scientific Assembly and Awards Ceremony. April 2016 and “Door-to-Drug in Obstetrics —Time to Antenatal Corticosteroid Administration and Factors Which May Influence the Timing of Administration.” Advancing Nursing: Developing Excellence in EBP and Research Conference 2016. Newark, Delaware. November 2016.

Melanie Chichester, BSN, RNC-OB, CPLC and Sheryl Allston, BS, MDiv, BCC. “Pastoral Services Utilization for Perinatal Loss.” Advancing Nursing: Developing Excellence in EBP and Research Conference 2016. Newark, Delaware. November 2016.

Melanie Chichester, BSN, RNC-OB, CPLC, Barbara Dean, BSN, RNC-NIC, CPLC, and Dina Viscount, MSN, APRN, CNS, RNC. “Perinatal Loss Education: A 15-Year Reflection.” Association of Women’s Health, Obstetric and Neonatal Nurses convention. Grapevine, Texas. June 2016.

Mark Cipolle, M.D., Ph.D., Joan Pirrung, MSN, RN, ACNS-BC, Erin Meyer, D.O., Glen Tinkoff, M.D., Baily Ingraham, MS, and Edmondo Robinson, M.D., MBA. “Embedding a Hospitalist on the Trauma Service Reduces Mortality and Readmissions.” EAST Conference. San Antonio, Texas. January 2016.

Barbara A. Dean, BSN, RNC, Gina Moore, BSN, CPHQ, Tammy Search BSN, RNC, et al. “A Robust Program to Monitor Compliance with Delayed Cord Clamping.”

Poster presentation. National Association of Neonatal Nurses meeting. Palm Springs, California. October 2016.

Dan Doherty, RN, and Lynn Bayne, Ph.D., RN, APRN, NNP-BC. “Can Focused Efforts Overcome the Effects of Burnout, Compassion Fatigue, and Vicarious Trauma for Nurses?” MAGNET 2016. Orlando, Florida. October 2016.

Carrie Dugan, MSN, RN. “Hepatitis C — A Refresher Education Module: Delaware Healthcare Community Providers” Hepatitis C. Wilmington University Capstone Project. Kent County, Delaware. November 2016.

Christine Ennis, M.D., Monica Castellano, MSPH, Tina Hendler, NNP, Rachel Baldwin, NNP, Lauren Walker, NNP, Lauren Kibler, RT, Mandy Pennington, RN, Robert Locke, D.O., MPH and Haritha Vellanki, M.D. “Measuring Adherence to Neonatal Resuscitation Program (NRP) Guidelines with Video Recording.” Eastern Society of Pediatric Research Meeting. Philadelphia, Pennsylvania. March 2016.

Megan Farraj, Pharm.D., Carol K. Gray, APN, FNP-BC, Sharon Jones, MSN, RN, Maureen A. Seckel, MSN, CCRN, FCCM, and Jeffrey I. Stewart, M.D. Poster: “PAH Care Management Guidelines.” Pulmonary Hypertension Professional Network Symposium. Alexandria, Virginia. September 2016.

Beth Fitzgerald. “Malignant Hyperthermia.” Association of PeriOperative Registered Nurses Conference and Expo. Anaheim, California. March 2016.

“Development of a Perioperative Simulation Program.” Association of periOperative Registered Nurses (AORN) Webinar. May 2016 and “Ebola/ Emerging Pathogens in the OR?” AORN Wilmington Chapter. Wilmington, Delaware. December 2016.

Jineen Flagg, BSN, RN, SDS, and Kelsey Bristow, BSN, RN. “Touch Touch Baby!

Overcoming Barriers to Intentional Touch in the NICU.” National Association of Neonatal Nurses annual conference. Palm Springs, California. October 2016.

Nancy Galbreath, BSN, RN, CCRN, Jacqueline Grau, BSN, RN, CCRN, Kellie Kessler, BSN, RN, CCRN, and Danael Zirolli, BSN, RN, CCRN. “Extubate Patients When Ready.” AACN. NTI, New Orleans, Louisiana. 2016.

Nancy Galbreath and Daniel Zirolli. “Optimizing Patient Care Virtually with eInterventions.” Advancing Nursing: Developing Excellence in EBP and Research Conference 2016. Newark, Delaware. November 2016.

Dominique Comer, Pharm.D., MS, Angela Parker, MSN, RN-BC, Devida Long, BA, EMPH, Emily Wunsch, Bernadette Baker, MSN, APRN, NP-C, Tamekia Thomas, MSN, APRN, ACNS-BC, PCCN, Denise Taylor, MS, RD, Brian Rahmer, Ph.D., MS, Edward Goldenberg, M.D., Ray Blackwell, M.D., Elisabeth Bradley, MS, APRN, AGPCNP-BC, et al. “Each One, Reach One! Improving Blood Pressure Awareness in the African-American Community Using Peer Education.” Academy Health Annual Research Meeting. Boston, Massachusetts. June 2016.

Kathy Gallagher, D.N.P., FNP. “Skin Grafts.” Christiana Care Health System Nursing Grand Rounds. Newark, Delaware. February 2016. “Collagen Matrix Donor Site Treatment Reduces Dressing Changes and Bleeding Complications.”

Diabetic Limb Salvage Conference. Washington, D.C., April 2016, and World Union of Wound Healing Societies Conference. Florence, Italy, September 2016.

“Medical Grade Honey As An Alternative To Surgery — A Case Series.” World Union of Wound Healing Societies Conference. Florence, Italy. September 2016.

Jacqueline Grau, BSN, RN, RN III, CCRN-e. “Minimizing the Noise to Maximize Efficiency” and “Partners in Practice Improves Outcomes.” Advancing Nursing: Developing Excellence in EBP and Research Conference 2016. Newark, continued Delaware. November 2016.

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Presentations (continued) Deborah Hassler, MSN, RN, ACNP-BC. “Improving Care by Embedding a Trauma Hospitalist onto the Trauma Service.” TraumaCon 2016. Anaheim, California.

March 2016.

Helen Hawrylack, BSN, RN III, CCRN. “Evaluation of Peppermint Oil as Alternative Therapy in Relieving Postoperative Nausea.” Current Issues in Nursing Research.

Newark, Delaware. February 2016. “Mentoring Bedside Nurses through the Research Process” “Mentoring Bedside Nurses Through the Research Process,” and “Self-Care: Setting Healthy Boundaries to Manage Stress and Anxiety.”

2016 National Teaching Institute & Critical Care Exposition. New Orleans, Louisiana. June 2016.

Florida. September 2016. “Why Become a Nurse: Factors That Influence Career Choice.” Sigma Theta Tau International Congress. Capetown, South Africa. July 2016. “Emerging Novice Nurse: A Study on Health Literacy.” Pediatric nursing conference. Philadelphia, Pennsylvania. June 2016. “Knowledge Exchange in Another Continent: Pearls and Perils.” Knowledge Crossing Borders Conference.

West Chester, Pennsylvania. May 2016.

Nora Katurakes, MSN, RN, OCN, and Charlene Marinelli, BSN, RN, OCN. “Health Info on the Go: New Innovative Approach to Cancer Awareness.” Oncology Nursing Society 41st Annual Congress. San Antonio, Texas. April 2016.

Linda Laskowski-Jones, MS, APRN, ACNS-BC, CEN, FAWM, FAAN. “Professionalism in Nursing.” Lecture to the graduating class. University of Delaware 50th Anniversary Celebration for the School of Nursing. Newark, Delaware.

Tiffani Lee, MSN, RN, PCCN. “Relieving the Pressure: Reducing Trach-Related Unit Acquired Pressure Ulcers on Medical Stepdown.” ANCC National Magnet Conference. Orlando, Florida. October 2016.

Tiffani Lee, MSN, RN, PCCN, Kimberly Mattison, BSN, RN, PCCN, Shannon Guzman, BSN, RN-BC, and Sonya Stover, MSN, CCRN, NE-BC. “Relieving the Pressure: Reducing Unit Acquired Pressure Ulcers on Medical/Pulmonary Stepdown.” AACN 2016 National Teaching Institute & Critical Care Exposition.

New Orleans, Louisiana. June 2016.

Amy L. Lembeck, D.O., Deborah J. Tuttle, M.D., Robert Locke, D.O., MPH, Pamela Jimenez, MSN, RN, CNP/CPNP, Amy B. Mackley, MSN, RNC, CCRC, and David A. Paul, M.D. “Outcome Differences in Neonatal Abstinence Syndrome Managed in the NICU Versus Pediatric Floor” and “Breast-Feeding and Formula Selection in Neonatal Abstinence Syndrome.” Eastern Society of Pediatric Research Meeting. Philadelphia, Pennsylvania. March 2016.

Tim Heckman, BSN, RN-BC, Jennifer Papi, BSN, RN, PCCN, and Samantha Kelley, BSN, RN. “Ventilator Associated Pneumonia: Prevention in the Midst.”

2016 National Teaching Institute & Critical Care Exposition. New Orleans, Louisiana. June 2016.

Cynthia Houseal, MSN, RN, CEN. “Reclaiming Nursing Fundamentals of Care to Promote Skin Care of the Elderly Patient in the Emergency Department: Avoiding Initiation of Pressure Ulcers in the Elderly Population.” Advancing Nursing: Developing Excellence in EBP and Research Conference 2016 and the 11th Annual Nursing Research Conference. Newark, Delaware. November 2016.

Sharon Jones, MSN, RN, CCM. “Pulmonary Hypertension Nurse Navigator,” and “Don’t Be in Denial — Insurance & Disability Issues.” Pulmonary Hypertension Professional Network Symposium. Alexandria, Virginia. September 2016.

Michelle Jonkiert, MSN, RN II, CCRN-E. “A Multidisciplinary Approach to Early Extubation.” Christiana Care Health System Nursing Grand Rounds. Newark, Delaware. March 2016.

Rachel A. Joseph, Ph.D., MSN, MA, CCRN, et al. “Complementary Medicine & Spirituality: Preferred Modes of Health Care Among Indian Immigrants In the United States?” and “Facilitating a Study Abroad Program: Processes and Challenges.” West Chester University Fall Research Day. West Chester, Pennsylvania. November 2016. “Placentophagia: Benefit or Myth?” and “Complementary Medicine & Spirituality: Preferred Modes of Health Care Among Indian Immigrants In The United States.” Nursing Research Conference, Christiana Care Health System. Newark, Delaware. November 2016. “Health Seeking Behaviors of Indian Immigrants in the U.S. Cincinnati, Ohio. October 2016. “Processes and Challenges.” National League of Nursing. Orlando,

Denise L. Lyons, MSN, APRN, AGCNS-BC, FNGNA. “The WISH Program: An Interprofessional Approach to Geriatric Education.” National Association of Clinical Nurse Specialists Conference. Philadelphia, Pennsylvania. March 2016. “#1 Orthostatic Blood Pressure — What Does the Evidence Tell Us? #2 A More Detailed CAM Increases Nurse’s Identification of Delirium, #3 Implementing the Dream Team to Increase the Patient Experience.” National Gerontology Nursing Association. Indianapolis, Indiana. October 2016. “Routine Orthostasis Assessment in Management of Fall Risk In Hospitalized Older Adults: An Evidence-based Practice Project.” Advancing Nursing: Developing Excellence in EBP and Research Conference 2016. Newark, Delaware. November 2016.

Amy Mackley, MSN, RNC, CCRC, et al. “Mindfulness Based Training Among Parents with Preterm Neonates in the Neonatal Intensive Care Unit (NICU)” and “Multicenter Study of Hand Carriage of Potential Pathogens by Neonatal ICU Healthcare Personnel.” Eastern Society of Pediatric Research Meeting.

Philadelphia, Pennsylvania. March 2016.

Amy Mackley, MSN, RNC, CCRC, Lauren Speakman, RN, Chris Skinner, RN, and Susann Volk, MSN, RN, CCRN, CPAN. “Green Means Go-Safer PACU Transitions.” American Society of Perianesthesia Nurses (ASPAN). Philadelphia, Pennsylvania. April 2016.

Lisa Markiewicz, BSN, RN, CCRN. “How the Wilmington ICU’s Eradication of CLABSI Led Our Beacon Journey.” National Teaching Institute and Critical Care Exposition. New Orleans, Louisiana. May 2016.

Alyssa Marshall, D.O., Ursula Guillen, M.D., Robert Locke, D.O., MPH, Amy Mackley, MSN, RNC, CCRC, and Wendy Sturtz, M.D. “Mindfulness Based Training Among Parents with Preterm Neonates in the Neonatal Intensive Care Unit (NICU).” Eastern Society of Pediatric Research Meeting. Philadelphia, Pennsylvania. March 2016.

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Susan Mascioli, MS, BSN, RN, CPHQ, NEA-BC, et al. Poster. “Bringing Early Warning Systems into the Digital Age.” 2016 Institute for Healthcare Improvement Scientific Symposium. Orlando, Florida. December 2016.

Kimberly Mattison, BSN, RN, PCCN, Sarah Smith, BSN, PCCN, Megan Smakulski, MSN, MBA, RN, PCCN, and Sonya Stover, MSN, CCRN, NE-BC. “Crushing CLABSI: Collaborative Approach to Eliminate Central Line Associated Blood Stream Infections.” 2016 National Teaching Institute & Critical Care Exposition. New Orleans, Louisiana. June 2016.

Kaitlin M. McLean, M.D., Julia D Ryan, M.D., Annette L. Rickolt, MSN, RNC, and John Stefano, M.D. “Time to First Hold: Quality Improvement Project Using Lean Six Sigma Methodology to Decrease the Time to Parents’ First Hold of Infants in the NICU.” Eastern Society of Pediatric Research Meeting. Philadelphia, Pennsylvania. March 2016.

Kristen Miller, Dr.PH., MSPH, and Michele Campbell, MSM, RN, CPHQ. “Improving Infusion Pump Safety through Usability Testing.” National Patient Safety Foundation 18th Annual National Patient Safety Congress: The Heart of Safety. Scottsdale, Arizona. May 2016.

Kristen Miller, Dr.PH., MSPH, Sherry Monson, RN, MSN, MBA, Susan Coffey Zern, M.D., Neil Jasani, M.D., MBA, and Eric V. Jackson Jr., M.D., MBA. “Designing Health Care Facilities to Maximize Productivity and Patient Outcomes HealthCare Environments Track.” International Symposium on Human Factors and Ergonomics in Health Care. San Diego, California. April 2016.

Dannette A. Mitchell, MSN, APRN, ACNS-BC, CRN, Teresa Panchisin, MSN, APRN, ACNS-BC, and Maureen A. Seckel, APRN, ACNS-BC, CCNS, CCRN, FCCM. Poster presentation. “A CNS-Led Collaborative: Changing the Culture of Restraining Patients in the Intensive Care Unit.” National Association of Clinical Nurse Specialists Conference. Philadelphia, Pennsylvania. March 2016.

Carolyn Moffa, MSN, FNP-C, Sherry Monson, RN, MSN, MBA, et al. “Designing Health Care Facilities to Maximize Productivity and Patient Outcomes Health Care Environments Track.” International Symposium on Human Factors and Ergonomics in Health Care. San Diego, California. April 2016.

Tammie Moore, FNP. “IVC Filter Indications and Need for Retrieval.” 2nd Annual Vascular Nursing Conference. Newark, Delaware. April 2016.

Elizabeth Onesi, RN. “Nursing career and Nurse Residency Program.” University of Delaware 50th Anniversary Celebration for the School of Nursing. Newark, Delaware. 2016.

Jennifer Painter, MSN, APRN, CNS, RN-BC, OCN, AOCNS. “Student Nurse Extern Program.” Lecture to the graduating class. University of Delaware 50th Anniversary Celebration for the School of Nursing. Newark, Delaware.

Heather Panichelli, MSN, APRN, AGCNS-BC, CEN, CPEN “ED to SCCC Highway: Decreasing ED Length of Stay for Trauma Codes” and “In the STROKE of Time.”

National Association of Clinical Nurse Specialists Conference. Philadelphia, Pennsylvania. March 2016.

Crystal Pollock, RN-BC. “ICU for the Ambulatory World.” American Academy of Ambulatory Care Nurses Annual Conference 2016. Palm Springs, California.

May 2016.

Kaci Rainey, MSN, RN, CEN. “Acute Coagulopathy of Trauma: Past and Future Implications for Damage Control Resuscitation.” Emergency Nurses Association Conference 2016 and National Emergency Nurses Association Conference 2016 and “Masters of Disguise: Recognizing Neonatal and Pediatric Cardiac Emergencies.” National Emergency Nurses Association Conference 2016.

Los Angeles, California. September 2016.

Bridget Remel, MSN, APRN, AGCNS-BC, CCRN-K. “Five I’s to Success in Critical Care Education: Imagine, Innovate, Inspire, Invigorate and Improve.” 2016 National Teaching Institute & Critical Care Exposition. New Orleans, Louisiana.

June 2016.

Stephanie Rogers, MSN, RN, et al. “Building systems of support for breastfeeding moms in the city of Wilmington, Delaware: The GEM Project.”

Breastfeeding and Feminism Conference. Chapel Hill, North Carolina, February 2016, and National Association of City and County Health Officials Breastfeeding Closing Grantee meeting, Baltimore, Maryland, April 2016.

“Group Prenatal Care — Providing Obstetric Care in a Community-Based Substance Abuse Treatment Center.” Annual Meeting of the College on Problems of Drug Dependency. Palm Springs, California. June 2016. “Exploring Options for Health Service Delivery with Pregnant and Postpartum Women in a Methadone Maintenance Treatment Facility.” American Public Health Association 2016 Annual Meeting and Expo. Denver, Colorado. October/November 2016.

Michele Savin, MSN, NNP-BC. “A Holistic Nursing Approach to the Education of Vulnerable Substance-Exposed Mothers and Infants.” Academy of Neonatal Nursing 19th Annual Neonatal Nurses Conference. Nashville, Tennessee.

September 2016. “Care of Mother-Infant Opioid-Exposed Dyads: We Can Do Better.” March of Dimes National Policy Webinar on NAS. December 2016.

Maureen A. Seckel, APRN, ACNS-BC, CCNS, CCRN, FCCM. “Measure of Fluid Responsiveness: The New Preload.” National Association of Clinical Nurse Specialists Conference. Philadelphia, Pennsylvania. March 2016 and “Why Sepsis 3.0 in 2016: Breaking Down New Definitions and Criteria,” and “The New Preload: Measures of Fluid Responsiveness in Sepsis.” 2016 National Teaching Institute & Critical Care Exposition. New Orleans, Louisiana. June 2016.

Megan Smakulski, MSN, MBA, RN, PCCN, Jennifer Papi, BSN, RN, PCCN, and Sonya Stover, MSN, RN, CCRN, NE-BC. “Courageous Collaborative Care — Value Improvement Teams Make a Difference on a Stepdown Unit.” 2016 National Teaching Institute & Critical Care Exposition. New Orleans, Louisiana. continued June 2016.

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Presentations (continued)

Megan Smakulski, MSN, MBA, RN, PCCN, Sonya Stover, MSN, RN, CCRN, NE-BC, and Emily Riddick, RN-BC. “Total Knockout with CAUTI Prevention Team.” 2016 National Teaching Institute & Critical Care Exposition. New Orleans, Louisiana.

June 2016.

Susan Smola, J.D., MBA, Richard Caplan, Ph.D., Michele Campbell, RN, MSN, Christine Carrico, MSN, RN, Mitch Fawcett, MBA, and Eric Jackson, M.D., MBA. “Measuring the Impact of Culture of Safety on Patient Satisfaction.” Academy Health Annual Research Meeting. Boston, Massachusetts. June 2016.

Susan Smola, J.D., MBA, Robert Locke, D.O., MPH, Brenda Pierce, J.D., BSN, David Paul, M.D., Julie H. Silverstein, M.D., et al. “Medical-Legal Partnership: Integrating Attorneys with Clinical Teams to Address Social Determinants of Health.” Academy Health Annual Research Meeting. Boston, Massachusetts.

June 2016.

Kevin Sorce, RN, CCRN. “Courageous Cauti Reduction.” 2016 National Teaching Institute & Critical Care Exposition. New Orleans, Louisiana. June 2016.

Jacquelin Sunkler, BSN, RN III, CCRN. “Fits and Funny Turns: An Interdisciplinary Approach to Seizure Diagnosis Coming Soon to Christiana.” Christiana Care Health System Nursing Grand Rounds. Newark, Delaware. December 2016.

(Not first author).

Andrew Vincent, BSN, RN III, CCRN. “Wake Up and Breathe! A Standardized Multidisciplinary Collaborative Effort Piloting a New Communication Tool.”

National Teaching Institute – AACN. Houston, Texas. May 2016.

Brenda Walsh, MBA, MSN, RN-BC. “Case Manager Knowledge of Discharge Instructions.” Wilmington University Capstone Project. Wilmington, Delaware.

April 2016.

Yukiko Washio, Ph.D., Neal D. Goldstein, Ph.D., Richard Butler, MS, Stephanie Rogers, MSN, RN, David A. Paul, M.D., Miksha Terplah, M.D., MH, and Matthew K. Hoffman, M.D. Poster: “Prevalence of Prenatal Cigarette Smoking and Marijuana Use in North Delaware State.” Annual Meeting of the College on Problems of Drug Dependency. Palm Springs, California. June 2016. “Self-Reported Cigarette Smoking, Marijuana Use and Other Illicit Drug Use in Northern Delaware.”

College on Problems of Drug Dependence. Palm Springs, California. June 2016.

Danielle Weber, MSN, MS, RN-BC, CNML. “Acute Stroke Transfer Expedited from ED to NCCU.” AACN National Teaching Institute. New Orleans, Louisiana.

April 2016.

Judith White, MSN, RN, APRN, CEN. “TEG (Thromboelastography): Yesterday, Today and Tomorrow.” Delaware Trauma Symposium. Wilmington, Delaware.

May 2016.

Ann Will, RN III, and Jill Carpenter, RN III. “Collaboration Between NICU and FreeStanding Emergency Room to Improve Proficiency With Neonatal IV Insertion and Lab Draws.” National Association of Neonatal Nurses. Palm Springs, California.

October 2016.

Elizabeth Zadzielski, M.D., MBA, FACOG, Stephanie Rogers, MSN, RN, Stefanie Gargano, M.D., and Yukiko Washio, Ph.D. “Group Prenatal Care — Providing Obstetric Care in a Community-Based Substance Abuse Treatment Center.”

Annual Meeting of the College on Problems of Drug Dependency. Palm Springs, California. June 2016. n

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SE

Local, regional and national recognition Kathleen Boyer, MSN, RN, was awarded the Templeton Scholarship from the Eastern Association for Surgery and Trauma.

Donna Casey, D.N.P.(c), MA, RN, NE-BC, FABC, chairs the American Nurse Association’s Ethics & Human Rights Advisory Board.

Maria Cook, RN; Erin Hemple, BSN, RN; Beth Timerman, RN; Maureen Wood, LPN and their colleagues from Christiana Care’s Woodstown Family Medicine were recognized among the “Best of Salem County” in a contest sponsored by the Chamber of Commerce, the South Jersey Times and the County of Salem, New Jersey.

Linda Laskowski Jones, MS, APRN, ACNS-BC, CEN, FAWM, FAAN, was editor-in-chief of Nursing 2016.

Heather Panichelli, MSN, APRN, AGCNS-BC, CPEN, clinical nurse specialist in the Christiana Hospital Emergency Department, was the only U.S. recipient inducted as a national Society of Trauma Nurses Fellow for 2016.

Joan Pirrung, MSN, APRN, ACNS-BC, is the President of the Society of Trauma Nurses for the year 2016-2017.

Of the 90 Delaware licensed nurses chosen as Top Nurses by their peers through a poll by the The Delaware Nurses Association, Christiana Care nurses received 32 of the awards, listed in the May 2016 issue of Delaware Today magazine. Taking category top honors: • Felisha Marcus Alderson, MSN, RN, CCRN, Center for Rehabilitation at Wilmington Hospital, for Long-Term Care/Rehabilitation.

• Dot Fowler, MSN, APRN, RN-BC, professional advancement coordinator, was one of three winners in the Nursing Legend category.

• Tiffani Lee, MSN, RN, PCCN, nurse manager, 6C Star Unit, Christiana Hospital, for Advancing/Leading the Profession.

• Kimberley Mattison, BSN, RN, PCCN, Staff Development Specialist, nurse manager, 3D Stepdown and 6C, for Education and Mentorship.

• Bethany Twardowski, MSN, RN, HIV Primary Care Nurse for Public Health, Community Health or Ambulatory Care.

Lee Anne B. Powell, MSN, RN, ACNS-BC, CCM, was appointed to the Board of Directors and serves as a member of the Systems and Advocacy committees of the Trauma Center Association of America.

Sonya Stover, MSN, CCRN, NE-BC, received a Circle of Excellence Award at the 2016 National Teaching Institute & Critical Care Exposition.

Christiana Care’s Professional Nurse Council celebrated the outstanding work of nearly 100 exceptional nurses with the Excellence in Nursing Awards during National Nurses Week in May.

The Christiana Care 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.

Baby-Friendly USA™

P.O. Box 1668 Wilmington, Delaware 19899-1668 800-693-CARE (2273)

www.christianacare.org 17NURS3