N U R S E S O F C I N C I N N AT I C H I L D R E N ’S Cincinnati Children’s Nursing Annua l Report
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Dear Colleagues and Friends, Please join in my excitement as I share with you the 2012 Nursing Annual Report from Cincinnati Children’s Hospital Medical Center. The theme of this year’s report, “24/7: Nurses of Cincinnati Children’s,” highlights the round-the-clock care our nurses give to change the outcome for our patients and families. The pages that follow are just a glimpse into the minutes, accomplishments and many responsibilities of our nurses. As clinicians, patient advocates, researchers, educators and numerous other roles, nurses
While they care for our patients 24 hours a day, seven days a week, Cincinnati Children’s nurses make each minute count.
seamlessly work together to help the medical center become the leader in improving child health. Whether that be rounding with the interprofessional team to ensure concerns are addressed, or acting as the impetus of change for a new research project, Cincinnati Children’s nurses do not measure their work in 8- or 12-hour shifts. They measure it in outcomes and quality of life indicators; in easing the suffering and concerns of patients and their families; and in the smiles of the kids they care for every day. And while they care for our patients 24 hours a day, seven days a week, they make each minute count.
Sincerely,
Cheryl Hoying, PhD, RN, NEA-BC, FACHE, FAAN Senior Vice President of Patient Services
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0700 | SAFET Y
“S afet y fir st.” T he mot to has been embedded in the Cincinnati Children’s culture as we strive to become a high reliability organization. In doing so, the medical center has t wo strategic safet y-related goals: to eliminate all serious patient harm, and achieve and maintain the lowest rates of hospital employee injur y by June 30, 2015.
Our nurses are at the frontlines of this safet y work— leading rounds, implementing huddles and executing handof fs—to ensure both patient and employee are safe.
07:00 Jeffrey Schroer, RN, and Jana Cook, RN, huddle about their patients on A7.
At-Risk RNs Change the Nature of Their Work Bruises were just part of the job, thought Judith Imhoff,
saw a 70 percent reduction after our first adopted
RN II, and the other caregivers on P3SW at Cincinnati
intervention, and as time went on, have sustained
Children’s College Hill campus. The unit cares for
a 65 percent reduction in employee injuries.”
children with developmental disabilities and acute psychiatric challenges, a patient population which
Interventions that were implemented include unit
often demonstrates intense and frequent behavioral
huddles, risk identification and assessment with
challenges. Such behaviors increase risk associated
families, mitigation planning, learning from system
with employee injury, and nurses just believed that
failures, protective equipment and adaptation to
was the nature of their work.
work flow.
That was until Adam Hill, MSN, RN-BC, CPN, clinical director of P3SW, and psychologist Mike Lind, PhD, created a formal improvement team to identif y interventions that would help reduce employee injuries. The team members in direct care positions were skeptical, but willing to try new tests of change in attempt to lower the rates. “When we started this work and were setting goals, our staff thought I was unrealistic for suggesting we could lower our rates by 50 percent. They said maybe 10 percent was doable,” Hill says. “But we immediately
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07:15 P3SW staff use a whiteboard in the shift report room to keep every shift, every staff member aware of which kids are at-risk.
07:30 Clinical Director Adam Hill, MSN, RN-BC, CPN, and an improvement team have helped staff on P3SW sustain a 65 percent reduction in employee injuries.
07:45 Julie Klare, RN, reviews daily treatment goals with a patient
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while wearing arm pads and Kevlar to reduce risk of injury from scratching and hitting.
Before May 2011, the unit averaged 2.2 employee
As with all improvement work, the efforts are
injuries per week related to aggressive patient
ongoing as the team continues striving to eliminate
interactions. About every 26 days, an occupational
employee injuries.
injury or illness would occur, resulting in medical treatment beyond first aid (referred to as an
“I believe that through changing behaviors, we’ve
Occupational Safety and Health Administration
changed our culture. When people show up to work
(OSHA) recordable injury).
and plan their shift, they’re thinking differently about what types of problems they might have,” says Hill. “They are acting and behaving differently because we have built a system that’s reliable.”
“I believe that through changing behaviors, we’ve changed our culture.”
As of December 2012, the unit currently stands at an average of 128 days between OSHA recordable injuries, with zero OSHA recordable injuries occurring between August 21, 2011 and March 22, 2012. The weekly injury median has also shifted to zero as of July 2012.
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12 0 0 | PAT I E N T C A R E
2012 has been a year of accolades for nurses at Cincinnati Children’s with a spotlight on the excellent care we give to our patients. Perhaps most telling is that this year’s award winners aren’t clustered into one discipline; excellent patient care at Cincinnati Children’s spans the entire spectrum of patient care from outpatient clinics and the emergency room to our pediatric intensive care unit.
12:00 Melissa Robers, RN, PICU, gives an update to a patient’s grandfather.
Emergency Department Wins Lantern Award The Burnet Emergency Department (ED) received the
Penny Eggemeier, RN, agrees. “Winning the Lantern
Lantern Award from the Emergency Nurses Association
Award validates the nursing care we provide every day.
in September. The award recognizes the department’s
The evidence-based practice and research that goes
commitment to quality, safety, a healthy work environment,
on every single day in the Emergency Department is
and innovation in nursing practice in the core areas of
shown through the quality of our nursing care, great
leadership, education, advocacy and research.
clinical skills, work environment and innovation. It enhances why CCHMC’s Emergency Department is
Recent efforts in the ED have focused on patient flow,
a remarkable place, changing the outcome for our
patient experience, evidence-based care and safety
patients’ lives every day.”
to lead continuous improvement. Specifically, the flow team recently revised how non-urgent patients are seen in the ED. A fast-track area, staffed in part by nurse practitioners, helps to expedite non-urgent visits and alleviate the main emergency department to care for more critical patients. Other outcomes include a significant reduction in the time to administer antibiotics for immuno-compromised cancer patients who visited the ED with fevers. Only four pediatric institutions hold the distinction of receiving the Lantern Award. Liberty’s ED was honored with the designation in 2011, making Cincinnati Children’s the only hospital to have earned Lantern
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Awards for two campuses. “We work at this outstanding level all the time, but I think it’s hard for staff in the midst of it every day to recognize
12:15 The Emergency Department (ED) Burnet campus staff
what a great job they’re doing,” says Julie Shaw, MBA,
celebrate their new Lantern status from the Emergency Nurses Association.
MSN, RN, CEN, former senior clinical director, Emergency Services. “This external recognition from our professional organization adds validation for the
12:30 PICU staff: (Front, L to R) Dena Clark, MSN, RN; Jennifer Rice,
staff that the work they do is important and exceptional.”
BSN, RN, CCRN; Nicole Harris, PCA; and Julie Kulhanek, BSN, RN, CPN. (Back, L to R) Jerry Schwartz, RN, BSN, MHHA; Kelly Brinkman, RN, BSN; Erik Martin, RN, MSN, CNML; Mary
“Being a Lantern ED is honorable and displays how great clinicians and staff can work together to provide the best pediatric care possible,” says Jennifer Oehler, RN III, who helped write the application.
Porter, RN, BSN, CCRN; and Colleen Oliver, RN, BSN, CCRN.
12:45 Cincinnati Children’s Pediatric Intensive Care Unit (PICU) attains the Gold Status Beacon Award for exceptional care and evidence-based practices that improve patient outcomes.
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PICU Takes Home Beacon Award Cincinnati Children’s became the first pediatric hospital
“Being recognized as a gold award winner of the
in the state of Ohio to receive the Gold Status Beacon
Beacon award justifies the high quality of work and
Award. The award recognizes hospital critical care
compassion that is provided in our PICU by our
units in the U.S. that demonstrate exceptional care
whole multi-disciplinary team. Even though it stems
and employ evidence-based practices to improve
from a nursing association, the award reflects our
patient and family outcomes.
entire team in the PICU and hospital,” Porter says.
“When I looked at the criteria for the award I kept thinking, ‘We do this all the time,’” says Mary Porter, RN, BSN, CCRN, clinical manager, Pediatric Intensive Care Unit (PICU) and member of the American Association of Critical Care Nurses (A ACCN). “We have always provided excellent care to our patients and families, and have strived to be the front runners
“When I looked at the criteria for the award I kept thinking, ‘ We do this all the time.’ ”
in new initiatives to improve patient outcomes for pediatric critical care.” With the unit continually working to reduce hospital-
“We applied for the Beacon Award to evidence our
acquired infections and incorporate family input, a
excellent clinical practice in the PICU,” says Tena Pham,
group of bedside nurses, charge nurses, unit council
RN II. “I am proud to be part of the PICU that provides
members and the leadership team applied, confident
an excellent level of care and that has been recognized
of earning bronze, silver or gold status. They were right.
by the AACCN.”
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CCHMC Wins Big on Patient Satisfaction Cincinnati Children’s received 13 National Excellence
The Five-Star Award Plaque is given to facilities that perform
in Healthcare Awards from the Professional Research
in the top 10 percent of the PRC database. Cincinnati
Consultants, Inc. (PRC), an organization utilized to gather
Children’s units that received this award included:
information regarding patient satisfaction. • Outpatient – Overall Quality of Care Two areas received the Top Performer Award for
• Home Care; Home Health – Overall Quality of Care
Overall Quality of Care—PACU Liberty for Outpatient
• B5CA – SD; Inpatient Pediatrics – Overall Quality of Care
Surgery and Outpatient. This award is given annually
• A6C – SD; Inpatient Pediatrics – Overall Quality of Care
to healthcare facilities, outpatient service lines and
• B6HI – CICU; Inpatient Pediatrics – Overall Quality of Care
inpatient units for performance at or above the 100th
• Outpatient Surgery – Overall Quality of Care
percentile of the PRC national client database.
• PACU – Liberty; Outpatient Surgery – Overall Quality of Care • PACU – Main; Outpatient Surgery – Overall Quality of Care • SDS – Liberty; Outpatient Surgery – Overall Quality of Care • SDS – Main; Outpatient Surgery – Overall Quality of Care Overall inpatient units received the Four-Star Award Certificate, which is given to facilities in the top 25 percent.
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A Familiar Face Patient satisfaction scores may be excellent, but
A6N and has continued this work after her promotion
Cincinnati Children’s nurses continually look for new
to clinical manager.
ways to improve the experience. In 2011, a Rapid Cycle Improvement Collaborative (RCIC) was formed on four
“It’s important for families to have an excellent stay
inpatient units to increase satisfaction rates on the
while they’re here, including a comfortable environment
Intelliq Survey.
where they are safe,” says Lichner. “Research also shows how better patient experiences link to better
Kelli Lichner, RN, MSN, became involved with the RCIC
patient outcomes.”
patient satisfaction work while she was still an RN II on One tested project was “Faces on A6N,” which used a whiteboard to feature a photograph and name of each caregiver and manager on the unit. To further familiarize patients with the caregivers, pictures were printed, laminated and put in patients’ rooms. Feedback was positive from families, staff and physicians.
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12:15 Mom Linda Cobb jokes with Liberty PACU nurses Matt McConnell, RN II, BSN, and Mary Margaret Garrison, RN II, BSN. Liberty PACU and Outpatient were both recognized as Top Performers for Overall Quality of Care by Professional Research Consultants, Inc.
12:30 Clinical Manager Kelli Lichner, RN, MSN, huddles with Patty Shipp, RN; Amanda Carota, RN II; Christa Easton, RN, BSN; and Lindsay Grimes, RN, MSN, about patient satisfaction.
12:45 The “Faces on A6N” whiteboard helps patients and families understand who their caregivers are and their
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roles on the care team.
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14 0 0 | Q U A L I T Y I M P R O V E M E N T
With their primar y role dedicated to taking care of patients, nurses quickly become aware of gaps in care or inef ficient processes. Seeing this as a challenge to improve, nurses get involved and transform the deliver y of care. Their insights, integral to qualit y improvement ef for ts throughout the medical center, result in nurses acting as drivers of change.
14:00 Nathaniel Bohn, BSN, RN III, CPN, CCRN, TNCC, of the SRU Months Team, participates in the Inpatient Combined Cluster Council shared governance meeting.
Ending the Power Struggle and Making the Care Environment Shift Kathleen Hautman, RN II, recalls the ineffective power
beforehand about what to expect; it makes it easier
dynamics on A6N when working with eating disorder
for them to follow the plan of care, and it makes their
patients. “The patients would exercise in their rooms
stay here less worrisome,” says Hautman.
and not eat when they were supposed to.” Positive about improving patient care, the team on Patients and families were frustrated about the
A6N continues to monitor and expand on Hautman’s
restrictions placed on them. Nurses were frustrated
initial efforts.
about the lack of adherence with their plan of care, a common challenge among nurses. Then Hautman learned about the Point of Care Scholars program, a nurse- and allied health-specific program that promotes the use of evidence and research to improve patient, family and organizational outcomes. She immediately applied. The program allowed Hautman to dedicate eight hours a week to improving the care environment. After she defined her project goals, Hautman completed a literature review, and piloted a test of change for nurses on A6N based on research that information awareness and empowerment could impact the care environment.
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Hautman incorporated new patient and family education materials for the nurse to share with the patient, including a care plan brochure and parent education resources. A daily schedule was also placed in the patient’s room. A6N also tested empowering patients to make certain decisions since they were unable to alter their structured diet plan.
14:15 Kathleen Hautman, RN II, is changing the outcomes for
Though the sample size is small, initial data shows
eating disorder patients through her involvement in the
favorable outcomes for the population. “Discharge surveys are showing that the patients are receptive. They seem to like the explanations
Point of Care Scholars program.
14:30 Charlene Cureton, RN, MSN, FNP-BC, keeps a close eye on her patients at one of the monitoring stations on the Transitional Care Center unit.
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Extra Eye on Safety: Unit Goes High Tech to Monitor Patients Nine months after moving into their new high-tech
unit coordinators and environmental coordinators
space on A3S, the Transitional Care Center (TCC) team
could write down their ideas,” says Van Romer, BS,
successfully mitigated 131 potential safety issues,
BSN, RN, CPN, RN II. These ideas were used to
such as patients pulling on critical tubes or getting
develop key features on the unit.
their feet caught in the ventilator tubing. The smartly designed space helped make the difference.
Nurses unanimously requested glass-paneled doors instead of the standard wooden doors to increase
Most TCC patients have tracheostomies and are
visual checks on patients as they walk by. “They found
chronically ventilated, putting them at risk for
a way to do it. I love that on our new unit, I can have
respiratory failure if a tube is accidentally dislodged.
eyes on my patients at all times,” says Romer.
Many patients have multiple tubes and lines, all of which present a considerable challenge to keeping
Decentralized charting cubbies, closer Pyxis machines,
them safe during their three-week average stay.
and enhanced communications via intercom and cell phones were also included in the design to help keep
Before the unit opened in December 2011, nurses,
nurses in touch with their patients.
other staff, physicians and families set out to design their new home with technological features to improve
TCC also created a new monitor technician role to aid
efficiency and patient safety.
in the surveillance of the patients. This key member of the team watches displays of all 18 patients on the
“In the break room, there was a large flipchart with the
unit, and monitors EKG, ETCO2 and blood oxygen
question: If the sky is the limit, what would your perfect
levels. In addition, the monitor tech observes 24/7
unit look like? Nurses, respiratory therapists, health
video streaming of each patient and can direct the camera in each room to zoom in on the smallest detail if necessary. Depending on the algorithm, the monitor tech will call the nurse and, using SBAR (Situation, Background, Assessment, Recommendation), will review the situation with the nurse, who is then responsible for responding to the safety catch. “The monitor tech functions very much like an air traffic controller,” says TCC Senior Clinical Director Kathy Dressman, MS, RN, NEA-BC. “The more sets of eyes on each patient lessens the chance of missing something.”
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15 0 0 | S H A R E D G O V E R N A N C E
The shared governance structure is embedded in the nursing culture at Cincinnati Children’s. Nurses become involved in councils because they want to use their professional voices to change practices and policies, and advocate for patient outcomes. The opportunities gained far exceed the perceived cost of being away from the bedside— enhancing leadership skills, traveling to conferences, at tending board meetings, visiting legislators, trailblazing the safet y culture and more.
15:00 Deneshia Smith, RN III, BSN, engages her colleagues in a shared governance meeting.
Magnet ® Conference Advances
Up the Chains: Nurses
Practice
Participate at Board Meetings
Cincinnati Children’s is well represented at the annual
As past chair of the Nursing Coordinating Council,
Magnet conference. A group of at least 30 nurses and
Brenda Williams, BSN, RN, CPN, CCRN, education
allied health professionals from Cincinnati Children’s
specialist II in the Cardiac Intensive Care Unit, has the
attend the yearly meeting to gain knowledge, then
opportunity to attend a Cincinnati Children’s Board of
return to the medical center to share their findings.
Trustees meeting and represent her council.
Before attending the Magnet ® conference in
Monthly, Williams attends the Patient Care Committee
Los Angeles, Calif., on Oct. 9, the group of attendees
and participates in discussions related to the strategic
devised a strategic plan.
goals about patient care activities with board members,
®
senior vice presidents and CEO Michael Fisher. “We were purposeful in dividing up into dif ferent groups to make sure that Children’s would learn
“It’s a great connection to have bedside staff sitting
about everything that was presented. We had
in at that level and knowing what’s going on
someone in every session so we could optimize
organization-wide,” Williams says. “Those not involved
learning in what we could bring back,” says Angela
in shared governance may not realize that the board
Aull, RN III, MSN, CPN.
does want to know what’s going on at the point of care. By having me and the Patient Care Governance Council
Upon their return to the medical center, the attendees
chair attend these meetings, it helps with open and
were expected to summarize their biggest takeaways,
honest communication. The board wants to know
and share that information with their colleagues in
honestly how the staff feels.”
different venues. Furthermore, they were asked to develop an action plan and follow-up in relation to
Williams tries to empower her fellow nurses by urging
what they learned during the conference. Topics
them to join shared governance.
included using technology to increase awareness and communication in shared governance, linking nursing
“I want people to recognize that the councils make a
advancement to Magnet goals, and developing a
difference, and by getting involved, you get to make
mentoring program to increase retention of new nurses.
decisions that affect you. This is your practice; you
®
should know it and speak about it by getting involved “It was an amazing experience,” says Aull. “It gave us
and making a difference.”
the opportunity and challenge to see what’s outside Children’s, and empowered us to bring it back,
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implement, and transform nursing.”
Brenda Williams, BSN, RN, CPN, CCRN, attends the Patient Care Committee (PCC) with Board of Trustees member and PCC Chair Lee Carter.
15:30 Jane Garry, RN, reviews safety information from the monthly Safety Operations meeting she attends as part of her shared governance role with the Nursing Professional Coordinating Council.
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Nurses Oversee Safety Improvements When the monthly Safety Operations meeting began in
awareness and ask for input. Council members
2011, Jan Jacob, senior director of Patient Safety, visited
suggested making the bundles more efficient and were
the Nursing Professional Coordinating Council (NPCC) to
responsible with developing an action plan on their
share important improvement efforts and request a
units to increase compliance.
representative from the council attend the meetings. “As bedside nurses, she knew we were working day-today at the bedside to keep our patients safe, and she wanted to make sure our voice was heard,” says Jane Garry, RN, NICU, and chair-elect of the NPCC. The group agreed to have the chair-elect attend the
“It makes me a better nurse, knowing that our leadership wants input from us, and vice versa.”
safety meetings. Garry began attending in July 2012 when she was elected. “It’s just another way we nurses are making a difference hospital-wide,” Garry says.
“This is what shared governance is really about,” Garry says. “It makes me a better nurse, knowing that our leadership wants input from us and vice versa; we are
In recent collaboration, Garry helped oversee involved
willing to give input to our practice to improve patient
expectations of bundle usage. Safety leaders saw
outcomes. Recognizing that our voice is heard and
confusion among bedside staff about bundles, so
acted upon is huge.”
they attended cluster council meetings to spread
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19 0 0 | O F F T H E C L O C K
Nurses at Cincinnati Children’s aren’t just changing the outcomes for our patients and families during their regular shif ts. Whether it’s volunteering to sing in a choir or spending their Saturdays painting neighborhood houses and schools, our nurses dedicate their time of f to making a difference in the community.
19:00 Cindi Bedinghaus, RN, senior clinical director, Perioperative Services, hones her painting skills at Bethany House.
Keeping Time with the Music
Live United
Cincinnati Children’s hosted an internal Choir Games
Frisbee golf, potato sack races, pizza parties and
in February, a friendly staff competition to raise money
Segway competitions: Cincinnati Children’s employees
for ArtsWave, a Cincinnati organization that supports
know how to get creative when it comes to raising
the arts throughout the community. The choir games
money for the United Way. In 2012, RNs participated
also raised awareness and excitement for the World
in bake sales, Adopt-a-Class, Cooking for a Cause at
Choir Games, which was hosted by Cincinnati and
the Ronald McDonald House and various other events
brought more than 15,000 participants from 64
to help the medical center reach its $1.1 million goal.
countries to the Queen City in July. Julie Schletker, RN of A4S, helps lead efforts for Adopt-aNursing staff in the Cincinnati Children’s version of the
Class. At the holiday party, she learned firsthand the
choir games were split into two teams—Hoying A and
difference the program and her involvement is having
Hoying B. Hoying A took home the gold with their
when one student showed her the ticket stub from the
gospel rendition of “I Go to the Rock,” followed by a
Adopt-a-Class Reds game. The event was held nine
fun, tie-dyed version of the “Aquarius/Let the Sun Shine
months prior. She carries it with her every day.
In” medley from the musical “Hair.” “This program allows the staff members of A4S to give Cincinnati Children’s raised almost $162,000 for
back to the community surrounding the hospital.
ArtsWave in 2012.
Examples such as this one only break the surface of the impact that this program has on the children involved,” says Schletker. “At Cincinnati Children’s, a nurse is not just someone who clocks in and out for a shift. Nurses are visible within the community and provide a positive example of the use of knowledge, drive and caring for humanitarian purposes.”
19:15 John Gennett, RN, BSN, NICU, sings his solo during “Let the Sunshine In” at the Cincinnati Children’s Choir Games on February 17. When asked why he wore a Rastafarian hat for Hoying A’s performance, he responded, “Because I couldn’t find my mullet wig.”
19:30 Julie Schletker, RN, BSN, decorates cookies with a South Avondale School student at the Adopt-a-Class holiday party.
19:45 Melissa Kimball, RN II, MSN, threw out the first pitch at
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the Cincinnati Reds game against the Chicago Cubs on August 17, 2012. The Reds won 7-3.
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Take Me Out to the Ball Game Melissa Kimball, MSN, RN II, has been given many
“I was so delighted and immediately nervous,” Kimball
opportunities since she began participating in shared
says. “It was an honor to stand on the field not only
governance five years ago—but perhaps none of
representing Cincinnati Children’s, but also the
them can top Aug. 17, when she represented Cincinnati
profession of nursing at Cincinnati Children’s. It was
Children’s by throwing the ceremonial first pitch at the
a proud moment and once-in-a-lifetime opportunity.”
Cincinnati Reds game. As for the pitch, she ended up making it over home As chair of the Nursing Professional Coordinating
plate—but credits the catcher with fast reflexes for
Council, Kimball was approached by Cheryl Hoying,
catching the ball as it almost flew over his head.
PhD, RN, NEA-BC, FACHE, FAAN, senior vice president of Patient Services, and asked if she would like to throw out the first pitch.
“It was an honor to stand on the field not only representing Cincinnati Children’s, but also the profession of nursing at Cincinnati Children’s.”
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2 10 0 | P R O F E S S I O N A L D E V E L O P M E N T
Learning doesn’t stop after passing the NCLE X. Nurses at Cincinnati Children’s dedicate many hours a year to continuing education, including cer tifications, par ticipating in professional nursing and health care organizations, or earning advanced degrees. Their commitment to lifelong learning earns them internal and ex ternal accolades and enhances the patient care experience.
21:00 University of Cincinnati College of Nursing 2012 Nightinga le Award winner Anne Blackmore, RN, MSN, MEd, Hematolog y (second from right), with Susan Allen, PhD(c), RN-BC, assistant vice president of Patient Services, and College of Nursing board members Shannon Carter and Trudi Fullen. Photo courtesy of the University of Cincinnati College of Nursing.
Awards 2 0 12 D A I S Y R E C I P I E N T S
2 0 12 S P O R C K AWA R D N O M I N E E S
Sara Baker, RN II
Virginia Bossman, RN II
Melissa Bowman, RN III
Elizabeth (Liz) Fleckenstein, RN II
Erin Butt, RN II
Mary Ann Groeschen, RN III
Bethany Hoffman, RN II
Michelle Kyle, RN III
Lauren Krebs, RN
Eric Mills, RN II (Winner)
Vicky Minning, APRN
Erin Sandfoss, RN
Randy Peck, RN Christina Rub, RN III Roma Sant, RN
2 0 12 P E A S E AWA R D N O M I N E E S
Julie Schletker, RN
Kathy Bilz, RN II
Rachael Schrand, RN
Jennifer Gold, RN
Micole Vaughn, RN
Alvin Jeffery, RN (Winner)
Tony Zaya, RN
Grace McIntyre-Patton, RN III Christy Miller, RN Julie Stark, RN
2 0 12 C A R E S AWA R D R E C I P I E N T S
Brenda Williams, RN
Beth Higgins, RN II
Nancy Zahradnik, RN
Regina Smith, RN
2 0 12 N I G H T E N G A L E AWA R D N O M I N E E S Angela Aull, RN III
21:15 The Pease Award finalists: (L to R) Julie Stark, RN, Gastro-
Jane Beischel, RN II
enterolog y; Christy Miller, RN, A7 Central/Diabetes/ Endocrinology/CTRC; Jennifer Gold, RN, Home Care;
Anne Blackmore, RN (Winner)
Grace McIntyre-Patton, RN, Same Day Surgery; Alvin
Penny Bowden, RN
Jeffery, RN, Pediatric Intensive Care Unit; Brenda Williams, RN, B6/Heart Institute; Kathy Bilz, RN, Children’s
Lee Ann James, RN II
Outpatient Northern Kentucky; Nancy Zahradnik, RN,
Elizabeth LaTulippe, RN III
Emergency Services; and William Pease, MD.
I-Chun Lin, RN Nancy Morgan, RN III
21:30 Alvin Jeffery, RN, Pediatric Intensive Care Unit, with William Pease, MD. The Pease family established the Burton R. Pease Award for Excellence in Nursing Leadership as a thank-you for the outstanding nursing care received by Burton Pease’s daughter, Sally, when she was hospitalized at Cincinnati Children’s many years ago with a traumatic brain injury.
21:45 Eric Mills, RN, Specialty Resource Unit, beams as he holds up his B. Robison-Sporck Outstanding Nurse Award.
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Publications AGRICOL A , K A REN D.
Pediatric Neurology
Vigabatrin for Childhood Partial-Onset Epilepsies
Journal of Child Neurology
Everolimus for Tumor Recurrence After Surgical Resection for SEGA
BLACKMORE, ANNE C.
APHON
Anticoagulation Education for Pediatric and Adolescent Patients
CASH, MICHELLE C.
Pediatric Research
Everolimus for Tumor Recurrence After Surgical Resection for SEGA
HOYING, CHERYL L.
AONE Voice of Nursing
AONE’s Participation in Global
Leadership
Nursing Events Provides New Perspective for U.S.
JOHNSON, CARA B.
APHON
APHON Counts: Chemo RN Role
KOLL AR, LINDA M.
Bariatric Nursing and Surgical
Web Resources for Adolescent Obesity
Patient Care
Meeting the Unique Needs of Adolescents in Surgical Weight Loss
MOTTES, THERESA A.
Intensive Care Medicine
Implications of Applying Different Fluid Overload Definitions in Pediatric Stem
Critical Care Medicine
Fluid Overload and Fluid Removal in Pediatric Patients on Extracorporeal Membrane Oxygenation Requiring Continuous Renal Replacement Therapy
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MUELLER, ROBIN L.
Pediatric Blood and Cancer
Endocrine Phenotype of Children and Adults with Fanconi Anemia
Pediatric Blood and Cancer
The Clinical Phenotype of Children with Fanconi Anemia Caused by Biallelic FANCD
MYERS, CHRISTINE M.
Pediatrics
Prevention of Tracheostomy-related Pressure Ulcers in Children
NIE, ANN MARIE
Pediatrics
Prevention of Tracheostomy-related Pressure Ulcers in Children
PIERCE, TIFFANIE R.
T I E R N E Y, C A R O L C .
Journal of Pediatric
Access to Care for the Adolescent
Orthopaedics
Athlete
Journal for Nurses in Staff
Presentation Skills for the Nurse
Development
Educator
RNs who gave oral or poster presentations in 2012
172
29
Nurses who Received Advanced Nursing Degrees in 2012: Rachel Adleta Miranda Agin Diana Agoston Leah Aho Jamie Ahrmann Amy Andrews Tiffani Anglin Wilma Anthony Katherine Aponte Jane Arbogast Kathryn Ard Kristy Atkinson Keyna Austin Vivian Bachman Julie Baker Mallory Baker Shirley Richelle Baker Alexandra Bauer Deah Behler Jennifer Beitz Jessica Bell Jennifer Bergen Alexandra Bertke Ramona Bezold Rachael Birkley Rebecca Blackman Christa Boone Kristen Borchelt Monica Borell Annamarie Borich Stacey Bova Nicole Brabender Datosha Brigger Stacey Brock Kristin Broering Tina Brooks Sharon Brown Laura Buckley Melissa Burbrink Jenna Burgei Katie Burleson Summer Burton Angela Byrne Rhonda Cable Mary Cabrera Rodolfo Canos III Kimberly Carpenter Michelle Carter William Caruso
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Debra Chandler Tonya Chaney Amanda Christian Stephanie Cmehil Shannon Cofer Theresa Cole Jennell Collins Marci Conroy Rebecca Sue Cook Susan Council Jessica Cox Lisa Crosby Lisa Curtis Amy Daniel Pamela Daniels Julie Davis Neva Davis Joy Deer Bethany Dendler Lisa Devoto Kimberly Dietrich Mary DiRuzzo Danielle Dixon Casandra Dobrowolski Lindsay Doellman Shannon Downs Amy Dressman Mica Lynn Dulle Joseph Dunn Elizabeth Dupont Sarah Durham Ashley Earhart Marcia Early Christa Easton Cassie Edens April Egbert Paula Eichmann Paula Eldridge Renee Fages Anna Fahey Angelina Fiszlewicz Elizabeth Fleckenstein Merry Jo Ford Kelsey Fritsch Amy Garcia Rebecca Gawronski Jillian Gehlfuss Amanda Geiger Lyndsey Geiser
Katherine Geraci April Gieske Erin Giordano Heather Goettke Karen Goodman Tiffany Grammer Janice Grant Elam Lomalouise Gray Lindsay Grimes Jennifer Gripshover Lucy Gruen Stephanie Guenther Mary Guilfoyle Melanie Gulla Lauren Haake Elaine Haddix Amy Haering Keeley Harding Rebecca Harper Kimberly Hartley Moira Hecker Michael Hegman Christie Heinzman Stephanie Herber Christina Hernandez Linda Herrick Meghan Hewitt Rita Hill Stephanie Hodapp Lauren Holzschuh Erin Hosty Samantha Huneck Annie Hyberger Kaitlyn Igel Melissa Jackson Nishi Jani Lisa Jarmon Cindy Jennings Danielle Johnson Kelly Johnson Amanda Jones Brittany Jones Sean Jones Holly Karches Brooke Keene Jodi Kelley Christine Kenning Patricia Kern Seth Kidwell
Melissa Kimball Chris Kopras Tamera Kopser Kathi Kramer Jessica Kretzer Nicole Kuhlenberg Sharon Kwiecinski Rebecca Leach Lisa Leesman Stacy Lehman Emily Leisge Lisa Levernier Jennifer Lewis Mark Lewis Michelle Lewyckyj Emily Licata Katherine Limbach Courtney Little Katrina Lock Ashlee Lonnemann Ashley Lonsbury Leslie Lopez Shari Lotspeich Tricia Luckhaupt Connie Lunsford Eileen Lynch Laure Mack Lisa Mack Eric Mailloux Jennifer Mangino Malgorzata Manning Rasheeda Marshall Alexandra Mathes Cathryn Maurer Elizabeth Mayerle Julie McCarthy Ryan McCarthy Colleen McGuine Mary McLaughlin Stefani McMahon Jamie Meister Jodi Meister Jill Meriweather Jennifer Margaret Merritt Allison Millard Christy Miller Mary Miller Teresa Miller Vicky Minning
Donna Minor Alyssa Mohr Sally Monahan Heather Morath Hal Morgan Melissa Morris Mueller, Katie Chelsea Muenzer Chelsey Mullins Milton Munro II Roxanne Munson Rachel Murray Autumn Naegele Teresa Nasser Angela Neidich Tessa Neiheisel Diana Nguyen Anthony Nkwor Carie Norris Patricia Norton Paige Nugent Josie O'Toole Amber Overly Mayfred Owusu Meagan Pachuta Gail Patten Cristy Payne Erin Petrovic Ashley Pollard Terri Ann Price Molly Proctor Jennifer Prows Emma Pruss Jennifer Pulskamp Angelia Radcliffe Mark Raguz Sarah Rank Austin Rankin Michael Reffitt II Danielle Rielag Amy Ritter Andrea Roberts Amber Rodencal Michelle Rodgers Ashley Roeding Julie Roell Carrie Romano Elizabeth Rompies Stephanie Rosekopanke
Amy Beth Ross Kristen Ruehlmann Cindy Rutschilling Jessica Sanchez Tyler Sandfoss Monica Savoti Brenda Scales Anna Schank Lauren Schoenfeld Christina Schrand Cadee Schumacher Kimberly Schwartz Lauren Seither Jessica Shaw Heather Sheehan Jeffrey Shoemaker Alyssa Shuber Jacquelin Sidley Kara Silagy Jill Skladany Christopher Smith Roddale Smith Laura Snow Andrea Songer Zachery Sparks Ann Spears Jacole Spriggs Jill Springmyer Rebecca Stern Joshua Stetson Emily Stolz Jessica Strasser Tamara Supe Diana Swisshelm Trisha Taylor Kelly Terry Christina Thomas Caitlin Trentman Kristi Trogden Wendisha Turnage Ronald Tyson Stefani Vander Zwaag Rachel Vanderhorst Emily Vehr Lisa Vormohr
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2012 in Review HOSPI TA L FAC T S A ND FIG URES Number of beds licensed
587
Number of beds staffed
527
Number of ambulatory clinic visits Number of Admissions Number of RN FTEs RN Skill Mix
462,040 17,843 2,225 88.9%
RN turnover rate
5.9%
RN vacancy rate
4.1%
PROFESSIONAL DEVELOPMENT Percentage of certified direct care RNs
34.4%
Percentage of certified RNs serving in leadership positions
79.1%
Total number of RNs who have nationally recognized certification
1,077
Total number of RNs who are members of at least one professional nursing organization
575
STUDENT INFO Cohort groups Undergrad students completing clinicals
164 1,099
Graduate students completing clinicals
128
Role transition and leadership students
214
CONT INUING EDUC AT ION INFO # of Nursing Grand Rounds (NGR) live presentations # of nurses who attended NGR # of nurses who attended NGR online
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12 620 2,007
CONT INUING EDUC AT ION Highest Nursing Degrees for RNs ADN/Diploma
829
BSN
1814
MSN
677
Doctorates
27
Highest nursing degree for RNs who provide direct care ADN/Diploma
29.8%
BSN
63.1%
MSN
7.0%
Doctorate
0.1%
Highest nursing degree for RNs in leadership positions ADN/Diploma
1.7%
BSN
36.8%
MSN or other master’s degree
58.7%
Doctoral degree
1.8%
Number of Employees who received Nursing Degrees in 2012 ADN
34
BSN
174
MSN
105
Doctorate Total
10 323
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Becoming the leader in improving child health does not mean Cincinnati Children’s can only look inward for innovations and transformations of care. It requires we look outside to the local community, participate in statewide and national dialogue, and spread our practices globally to change the outcome for pediatric patients. Nurses continue to do their part to expand the reach of Cincinnati Children’s.
23:00 Flags outside Cincinnati Children’s represent the various countries we serve through our diverse, international patient population.
APRNs Collaborate to Change Legislation Advanced Practice Registered Nurses (APRNs) at
National Association of Pediatric Nurse Associates
Cincinnati Children’s have been working on the
and Practitioners (NAPNAP). Through her role there,
frontlines for more than six years on legislation
she was able to take a “Nurse in Washington”
involving their expanded prescribing rights of Schedule
internship in 2011 and have face-to-face meetings
II controlled substances. And on June 8, 2012, Ohio
with aides for Ohio Senators Rob Portman and
Senate Bill 83 was signed into law by the government,
Sherrod Brown.
allowing APRNs to prescribe certain controlled substances without restrictions—a right that before required physicians to handle the initial prescription.
“It is important to educate our legislators about barriers to practice. They need to know that patients and families are impacted by these obstacles and that
Mandi Cafasso, RN, MSN, CPNP, pediatric nurse
they impede care that is provided to their loved ones,”
practitioner, describes the barriers: “Say we had a
says Cafasso.
family coming to clinic from a different area and they drove two to three hours to refill their ADHD medication.
While obstacles still exist, Cafasso is proud that
Because it’s a controlled substance, the prescription
Schedule II passed in Ohio.
needed to be handwritten and from a physician. These medications cannot be called in. If the APRN was
“It feels wonderful to be recognized as a provider that
working without a physician the day the family was
can make the judgments to write for these medications,
seen in clinic, they would have to come back to the
especially in a society where controlled substances
facility and get the prescription when the physician
are abused. To know that we’re a trusted profession
was available.”
and know we can care for our patients appropriately is huge,” adds Cafasso.
When Cincinnati Children’s APRNs began advocating for Schedule II rights, they quickly realized the shared governance structure would need to be utilized to become more efficient and effective. So APRNs and physician assistants (PAs) formed the Health Policy Council in 2010, with the goal to monitor the impact of legislation and policy as it relates to APRN/PA practice. In 2011, the council focused on passing the legislation around Schedule II medications. Cafasso was one of the APRNs driving legislative change. She visits the Ohio State House with other Cincinnati Children’s nurses during the annual Nurses Day for open dialogue with legislators and lobbyists, and also serves as the Ohio legislative chair of the
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23:15
RN Goes Global to Teach, Change Lives When Sarah-Ross Tolin, RN, CPN, was invited to go to Ghana, she didn’t hesitate before saying yes. The mission was comprised of a team of 34 individuals, including six Cincinnati Children’s surgeons and anesthesiologists and eight surgical staff. The team ran three operating rooms for five days and completed 34 complex surgeries for rare colorectal and gynecological
“I was truly honored to be part of such a meaning f ul collabor ation.”
conditions in March 2012. Perhaps as equally important, the team provided three shipping containers with donated medical equipment, supplies, bedding and gifts for the Korle Bu Teaching Hospital in Accra. They renovated a 124-bed hostel for visiting families. And they provided advanced training to dozens of doctors and nurses so that many more Ghanaian children will benefit in years to come. “We were able to complete quite a few surgeries, but we were also teaching the staff there to do the surgeries. The surgeons were teaching surgeons, and nurses were teaching nurses,” Tolin says. “The team was amazing,” she continues. “I was truly honored to be part of such a meaningful collaboration.”
23:15 Mandi Cafasso, RN, MSN, CPNP, (second from left) stands with other members of the National Association of Pediatric Nurse Practitioners: Susie Newton, RN, MS, AOCN, AOCNS; Terrie Stewart, RN, MSN; Jill BeaversKirby, DNP, MS, CCRN, ACNP-BC; and Michelle Wilson, MS, CNP, APRN-BC, CPNP-AC.
23:30 Sarah-Ross Tolin, RN, CPN, takes a break from one of the 34 surgeries she helped complete on Cincinnati Children’s
23:30
mission trip to Ghana.
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