2017 Nursing Outcomes Report by Independence Health System

2017 2017 NURSING NURSING outcomes report outcomes report

Nursing

â&#x20AC;&#x153;How

wonderful it is that no one need wait a single moment to start improving the world.

â&#x20AC;&#x153;

- Anne Frank

Letter from CNO Infographic/Statistics #ExcelaPride

INTERPROFESSIONAL COLLABORATION Firstnet: A Tool for Improved Communication Among Different Hospital Settings Advanced Practice Providers: Together is Better Spotlight Evidence Based Practice Forum: A Team Approach to Outcome Driven Practice A Smart Department: The Intensive Care Department Remodel Utilizing Simulation Technology to Change the Face of Nursing Education Staffing Support and Care Support Services: Together is Better Spotlight The Impact of Delayed Newborn Bathing on Breastfeeding Outcomes Trading Places: A Together is Better Spotlight Itâ&#x20AC;&#x2122;s A Group Effort! The Excela Technical Partner Training Program Standardization of Bedrest after Cardiac Catheterization Improves Patient Satisfaction Without Increasing Risk of Complications

CONNECTING TO OUR COMMUNITY Meet Your Nurse: Using FaceTime Technology to Connect Patients and Nurses in the Community Setting Loan Forgiveness Program: Working Together too Alleviate the Burden of Debt Home Care Fleet Program: Driving into the Future of Community Nursing Providing Christmas Dinner for a Community in Need: A Together is Better Spotlight Health and Wellness: A Marriage of Mind and Body for the Working Nurse

TABLE of contents

Nurse Navigation: Guiding Patients Through Their Healthcare Journey Nightingale Volunteer Program: Together is Better Spotlight

PROFESSIONAL ACCOMPLISHMENTS HCAHPS Domain Outcomes NDNQI Nurse Sensitive Quality Outcomes Certifications (by specialty) Nurse Residency Outcomes Nursing Accomplishments/Professional Presentations and Publications Shared Governance Councils/Committees Cameos of Caring Daisy Award 40+ Years of Services Evening with the Stars/ Photos and Awards Nurses Week Observances

Dear Friends & Colleagues, It is my privilege to present the Excela Nursing 2017 Annual Report. In our increasingly complex and changing healthcare work environment, one constant remains: our patients and families, our community, and our organization need us. They need us to be practicing at the top of the profession. They need us to be a contributing member of the interprofessional team. They need us to assure quality care. They need us to be ever vigilant about, and to advocate for, patient safety. They need us to make human caring connections with our patients. They need our expertise and our interprofessional collaboration, they need our passion and our compassion, and they need us to constantly strive to improve our practices. In short, they need us to be the best nurses and the best team members we can be. At Excela Health, we are doing just that. We know we are better together! There has never been a better time to be an Excela nurse. Working together with our colleagues to ensure our work translates to excellence at the point of care, regardless of setting. We have learned that high-level leadership is not role dependent. It is often visible when nurses, working with others, respond to specific issues, difficult situations and crises. We know full well there are more mountains to climb and we must stay engaged, think strategically. I am excited for our future and for the contributions Excela nurses are making which is evident every day across our hospitals and variety of ambulatory settings.

Letter

My thanks goes to each of you, for your commitment to interprofessional collaboration and for how you practice our profession in extraordinary ways with servant hearts for the care and improvement of the lives we touch. I am honored to be part of the team. With deep gratitude,

from the

CNO

Helen Burns, PhD, RN, NEA-BC, FAAN Senior Vice President, Chief Nursing Officer

Data through January 22,2018

Nursing

BY THE NUMBERS Age Distribution of RNs

Employed At Excela Health

2 7 4 FEMALES MALES

1151 123

20-29 30-39

226

17.74%

258

20.25%

40-49

264 20.72%

50-59

340 26.69%

60-69

181

14.21%

70 +

0.39%

RN/CNC Education

Generation Chart

Diploma

14%

Associate

34%

Bachelor

37%

Traditionalists

<1945

Baby Boomer

1946-1964

Master

14%

GenX

1965-1976

Doctorate

GenY (Millennials)

1977-1995

ADVANCED PRACTICE NURSES

GenZ

1996-2014

CRNA

CRNP

Turnover FY17 (July 2016 – June 2017)

% of RN's w/BSN or Higher Nursing Degrees

11.96% FYTD

Bedside RN/CNC Voluntary Turnover

51.41%

2017 Licensed Staff

<14.9% FY17

Target

50.00%

2017 Organizational Goal

<13.68% FY17

Saratoga

% of Eligible RN's w/National Certification

Turnover FY18 (July 2017 – June 2018)

(less two years’ experience)

7.18% YTD

Bedside RN/CNC Voluntary Turnover

18.38%

2017 Licensed Staff

<14.76% FY18

Target

12.00%

2017 Organizational Goal

<13.2% FY18

Saratoga

Staff by Length of Service

Top 5 Reasons of Termination (RN/CNC) VOLUNTARY

INVOLUNTARY

Other Employment Relocation School Retirement Resigned-No Notice/Reason

Casual Requirement Not Met LOA Expired Discipline

<1 year

1-5 years

371

6-10 years

276

11-15 years

166

16-up years

396

Traci Fick, MSN, RN, NEA-BC

How has Nursing benefited from an Interprofessional approach to patient care? How has this approach benefited the patient?

Utilizing a team approach to patient care ensures that each discipline takes responsibility for having a part in the care of each individual patient. This approach promotes a group effort to holistic care so that each patient’s needs are met and each patient’s concerns are being addressed by the appropriate expert. The nurse’s role is to coordinate the care among members of the Interprofessional Care Team and communicate the most current status and needs for the patients they have been assigned. This model increases efficient, quality care and decreases missed opportunities to go above and beyond for the community we are proud to serve.

INTERPROFESSIONAL COLLABORATION

FIRSTNET:

Improving Communication within the Emergency Department and various Hospital Settings

Excela Health implemented FirstNet as the electronic documentation system for the Emergency Department (ED) with a goal to facilitate an improved flow of information collected from the point of Triage (initial assessment) in the ED through the Admission process to the floor. FirstNet is a documentation application made specifically for the Emergency Department. The ED is one of the main doorways to the Excela Health system so the project design focused on safe, efficient movement of patients, enhanced flow of documentation, and fiscal responsibility. Work groups from many disciplines of Excela Health were created with key people that had the knowledge to work through current and future state. These work groups were focused on workflow, orders, downtime, integration, hardware, charges, reporting, communications, and education and training. The ED impacts almost every department in the health system. For this reason, interprofessional teams were established and a Workflow work group was formed to assist in the introduction of the FirstNet software. The group used real patient examples to talk through the average customer care experience from the door to the floor. The group brainstormed to determine best practice and how it would impact the workflow in their departments. The members of this group were shown visual tools from the product website so they were better able to identify advantages and concerns with the application. Shirley Brandon, MSN,RN, Coordinator Clinical Informatics and Gregory Harbaugh, DO Assistant Director, Frick Emergency Department were key leads in the project. One focus of the workgroup was how the ED could best communicate with other departments such as Registration/Admission, Radiology, Lab, Emergency Medical Services (EMS), Nursing Supervisors, The Crisis Team, and Clinical Resource Management while preserving the goal to decrease phone calls among departments. This workgroup decided to utilize icons (small figures) as a communication tool on the departmentâ&#x20AC;&#x2122;s Tracking Board. These icons were uniform throughout the Excela system for all departments utilizing the tracking board. When orders were placed, the icons would appear improving interprofessional communication. A goal to reduce the amount of unnecessary time spent on clarification of orders through the use of the tracking board and icons was key to the decision-making process.

Choosing icons for alerts such as stroke, sepsis, suspect heart attack, and others were designed with the workflow of the physicians as its focus. The icons alert the provider, thus allowing for prioritizing the evaluation of the patients, placing orders timely so care can begin, and finally tying it all together with documentation in the physician note. This helps expedite care to the patient and improves communication from the ordering physician to the nurse and ultimately to the patient. Streamlined documentation allows the admitting clinician to identify interventions that have been completed and/or needs to be completed thus eliminating repeated processes that have already been performed. This leads to a better patient experience by reducing the frustration of the patient that can transpire when tasks may be repeated out of an abundance of caution. The implementation of FirstNet allows all viewers to see what tasks have been done and what still needs to happen. FirstNet was phased in at all three ED sites (Westmoreland, Latrobe, and Frick). The phased Go Live implementation system helped to ensure an appropriate level of support staff at each hospital. Troubleshooting post Go Live was anticipated with a staffed Command Center that could address issues quickly and note staff suggestions for workflow.

Advanced Practice Providers:

Together is Better

Each year, as the challenges facing health care evolve, so does the role of the Advanced Practice Provider (APP). The demand for accessible health care has expanded the movement to employ more APPs to help narrow the discrepancy that exists between demand for services and the number of available providers to provide those services. Due to this demand, there is a strong likelihood that patients, whetherreporting for an outpatient office appointment, presenting to the emergency department, or being admitted to the hospital, will find an APP as an integral part of their healthcare team. Excela Health employs more than 150 APPs in fields such as Anesthesia, Hospitalist, Pediatrics, Cardiology, Internal Medicine, Family Medicine, and other specialties. Studies have shown the positive effects on patient outcomes include: increased access to care in primary, acute, and tertiary settings; decreased hospital admission rates; decreased length of hospital stay; and decreased infection rates. The APPs work with the nursing staff during Collaborative Care Rounding to ensure quality patient care for each patient encouraging open discussion and goal setting with the patient and family. How does one become an Advance Practice Provider? APPâ&#x20AC;&#x2122;s have undergone comprehensive specialized education, training, certification and licensure that allows her/him to provide healthcare related services with varying degrees of independence. Additionally, through advanced and vigorous training, APPs have the authority to perform certain procedures as well as prescribe medications. This collective group of healthcare providers also participates in medical evaluation, mentoring, clinical research, and serve as caregivers and advocates for all patient populations. An Advanced Practice Registered Nurse (APRN) is a registered nurse with advanced didactic and clinical education, knowledge, skills and scope of practice. There are four APRN roles: Certified Registered Nurse Anesthetist (CRNA), Certified Registered Nurse Practitioner (CRNP), Certified Nurse-Midwife (CNM), and Clinical Nurse Specialist (CNS). A Physician Assistant (PA) is a healthcare professional who providers health care within the medical model as part of a team with physicians and other providers. In the United States, Physician Assistants are nationally certified and state licensed to practice medicine under the supervision of a physician. In 2017 Excela Health established the Advanced Practice Provider Council. A group of CRNPs, CRNAs and PAs collaborated to create a unified body to represent all the APPs within the system. Through the shared governance model, the goals of the APP Council include development of attractive recruitment and retention strategies with active engagement in hiring, improving onboarding and orientation, offering input into opportunities and delivery of APP-specific educational opportunities including seminars and conferences, collaborative staffing model recommendations, and creation of a shared knowledge base on credentialing of APPs. Perhaps most importantly, and in accordance with Excela Healthâ&#x20AC;&#x2122;s patient focused mission, the APP Council advocates being an effective conduit among physicians, nurses and all allied health professionals to facilitate and improve patient care and outcomes.

Evidence-Based Practice Forum: A Team Approach to Outcome Driven Practice Excela Health continues to showcase growth in evidence-based practice activities. The 3rd Annual Evidence Based Practice (EBP) Forum was held in September 2017. Eighty-one nurses and 10 ancillary staff attended the forum held at the Westmoreland campus to learn more about the projects completed by their coworkers and the latest research in the field of nursing and medicine. The morning keynote speaker, Richard Henker, PhD, RN, CRNA, FAAN, a professor in Nurse Anesthesia at the University of Pittsburgh, discussed findings from his work related to pain and pain management. He provided strategies for the rollout of Enhanced Recovery After Surgery (ERAS) to facilitate pain relief and decreased surgical complications.

Kathy Lindell, PhD, RN Research Assistant, Department of Medicine University of Pittsburgh

There were a variety of speakers for the breakout sessions throughout the day. Excela Health pharmacist Nick Zaksek, Pharm D, who holds certification in Advanced Antibiotic Stewardship and Infectious Disease, discussed the success of the antibiotic stewardship program. Wendy Shaffer, BSN, RN, Clinical Coordinator in the Heart Center and Howard Grill, MD, FACC, Director of the Cardiac Cath Lab, presented their research project by which they were able to decrease the amount of hours of bedrest after a diagnostic heart catherization without increasing complication or infection rates. This research project led to changes in current practice. Sandra Hartman, BSN, RN, CWOCN, Excela Health Wound-Ostomy Specialist, provided an overview of her research study examining the effectiveness of a new wound debridement product on wound cleansing and pain management. Staff of Excela’s Family Additions Maternity Center – Brenda Lenz, MSN, RN, Staff Nurse; Kathy Kepple, BSN, RNC-MNC, Clinical Coordinator; Ann Kremer, BSN, RN, IBCLC, Lactation Consultant; and Amy Medved, CRNP, Neonatal Nurse Practitioner – showcased their study illustrating an increase in breastfeeding rates of new moms by delaying the timing of the “first bath” after delivery. The final speaker was Kathy Lindell, PhD, RN, Research Assistant, Department of Medicine at the University of Pittsburgh. She discussed the educational program that she developed, "The Clock is Ticking: Strategies to Enhance Quality of Life in Interstitial Pulmonary Fibrosis Patients”, which helps patients and families increase their knowledge and understanding of their disease process and quality of life indicators. A variety of posters, many of which had been showcased externally at local and national conferences, were on display with the poster presenters, Nursing and Ancillary staff alike, immediately available to answer questions.

Richard Henker, PhD, RN, CRNA, FAAN Professor in Nurse Anesthesia University of Pittsburgh

a smart department:

INTENSIVE CARE department remodel To enrich patient safety, to improve staff efficiency, to enhance the patient experience and to empower the patient and family to be a more active care team partner, Excela Health embarked upon a journey to renovate and modernize the sixth floor of Westmoreland Hospital. The critical care environment prior to the start of this project was outdated. The typical room size was 135 square feet and most rooms were separated by a cloth curtain. For the patient, there was a lack of privacy and a minimal floor space, which reduced mobility and increased slip, trip, and fall risk. The lack of an in room bathroom forced the patient to utilize a bedpan or a bedside commode. The aftermath would then be carried by the nurse to a centralized hopper (toilet like device) for disposal. Supplies and computers were located in a centralized nursing station requiring the nurse to leave the bedside to obtain needed supplies, review charts, document, interpret monitoring data, and interact with other care team members. The project began with an extensive literature search to determine what other organizations were doing. Then, clinical staff visited fourteen sites, including the 2009 Intensive Care Unit Design Award recipient-Memorial Sloan Kettering Cancer Center. The clinical staff completed a survey at each site they visited to determine what they liked, what they didn’t like, and what they thought would be a necessity in the new environment. After the site visits, 52 interdisciplinary team members attended an eight hour workshop with the intent on turning concept into design. A multidisciplinary advisory group was then formed and used as a focus group throughout the schematic design process. This group helped to refine design decisions with emphasis on functionality, workflow efficiency, and evidence-based practice.

There was great debate on how and where to put the medical gas connections in the room. It became apparent that the team would need to decide between three concepts: having movable booms in each room, utilizing a headwall medical gas delivery system, or using a combination of a headwall and column design. Using the concept of shared governance, the decision was made to use a combination of the headwall and column design. The money saved by this decision was used to purchase ceiling mounted lifts and other technology to enhance the nursing workflow. In February 2017, the first unit of the new sixth floor, the Step Down Unit, opened with 12 beds. Another fourteen beds were opened on the 6E side of the Intensive Care Unit in August of 2017. The final 8 beds (the 6D side of the Intensive Care Unit) are slated to open in February 2018. The rooms are much bigger, at around 360 square feet in the Intensive Care Unit. The rooms are now big enough to be divided into zones: the patient zone, the family zone, and the staff zone. One of the technologies that was installed in each room is referred to as a Nurse Server. This is a shelving system that opens from both the hallway and the patient room, allowing it to be stocked without disturbing the patient, but having the ability to access the supplies from inside the room when they are needed. Another technology that the team was able to include revolves around an Interactive Patient Care Technology. This technology works through the TV in the patient room to help educate, engage, and empower the patient and their family. The team also installed a technology to send life threatening alarms from the patient physiologic monitoring system (EKG and Pulse-Ox) to the mobile device carried by the nurse. This secondary alerting system not only includes textural information about the alarm, but it also includes the waveforms as seen on the physiologic monitor. With the upgrades, the team was also able to send call bell requests to the nurse’s mobile device. This allows the nurse to talk to the patient before entering the room, so that they ensure they have the needed supplies to take care of the patient’s needs. One last piece of technology that was implemented to enhance the nursing workflow is referred to as a Roomlink Device. This is a tablet like device that provides electronic signage outside of the patient’s room. Important information, like isolation precautions, fall risk, and allergies, flows from

the Electronic Medical Record (EMR) to this device automatically. In the past this had to be manually done by the nurse. The nurse also was responsible for ensuring the information was up-to-date in both the EMR and the manual signage. Now if it is correct in the EMR, it will be correct on the signage. Overall this project has improved not only the look and feel of Westmorelandâ&#x20AC;&#x2122;s sixth floor; it has also improved the nursing workflow and helped to improve the patientâ&#x20AC;&#x2122;s experience.

QUIETNESS OF ENVIRONMENT HCAHPS Improvement: Quietness of Environment Excela Health Westmoreland Hospital, ICU and SDU ! Post-Intervention

Pre-Intervention 100 90 70

Intervention

HCAHPS Score

80 60 50 40 30 20 10 0 HCAHPS Score

Jan 2017 33.3

Feb 2017

March 2017

Apr 2017

May 2017

June 2017

50.0

60.0

85.7

88.9

Utilizing Simulation Technology to Change the

Face of Nursing Education

In 2017, the Education Department created a series of live simulation scenarios as a method to verify initial and ongoing competency in chemotherapy administration for Registered Nurses (RN) at Excela Health. Current evidence supports the use of simulation training with live actors and/or mannequins to introduce, reinforce and verify clinical decision-making and skill competence. Simulation scenarios offer learners the opportunity to display competency with clinical skills within a structured, controlled learning environment. There were three simulation scenarios in each chemotherapy administration session. The sessions were two hours in length and included debriefing. The scenarios used a live actor as the ‘patient’. Learners were placed in groups of five. Objectives for completion of the session were that RN would be able to: 1. Demonstrate the safe administration of a chemotherapeutic agent 2. Engage in therapeutic interactions with the ‘patient’ 3. Practice troubleshooting techniques during chemotherapy administration 4. Manage complications related to chemotherapy administration. At the conclusion of each simulation scenario, participants were queried about strengths and opportunities identified during each scenario. After attendance at the initial Chemotherapy Administration Session, RNs are required to attend two additional simulation sessions annually to maintain competency. Prior to each Chemotherapy Administration session, participants received a pre-assessment tool that measured their confidence in, preparation for and understanding of chemotherapy administration. At the completion of the session participants completed a post assessment tool and course evaluation. In 2017, nine simulation sessions were conducted with 37 RNs successfully completing the three scenarios. Post-assessment evaluations indicated that the majority of nurses rated their understanding and confidence in the preparation and administration of chemotherapy as excellent and good.

! !

Staff Support Team:

Together is Better The Staffing Support Team (SST) is comprised of several disciplines that include Registered Nurses, Licensed Practical Nurses, Technical Partners, and Patient Safety Associates. The SST is responsible for providing staffing coverage to care for our patients in the clinical setting who are awaiting admission, as well as providing care to patients on the inpatient clinical units during high census when additional support is needed. The team also provides staffing in the event of callâ&#x20AC;&#x201C;offs. The SST has several nurses trained to work in specialty areas of nursing such as the Emergency Departments, Critical Care Units, as well on Telemetry and Med-Surg areas. More than 170 staff members work out of the SST Pool within our three Excela Hospitals. Many of the Technical Partners and Patient Safety Associates are pursuing a career in health care. The SST Pool provides an excellent opportunity for nurses and support staff to work throughout the hospital in a variety of units and gain indepth experience. The SST staff care for a diverse range of patients and enjoy the advantage of working in a variety of settings.

The SST creates the perfect environment for someone who enjoys continuous change, especially for nursing students who are unsure where they would like to begin their nursing career. Being part of the SST gives new graduates a chance to learn about our healthcare system and explore specialty departments where they may want to work in the future. Our team enjoys collaborating with other healthcare team members. The constant exposure to new patients and coworkers can be very satisfying as we work toward improving the health and well-being of every life we touch. We look forward to contributing to the optimum patient experience.

The Impact of Delayed Newborn Bathing on

BREASTFEEDING OUTCOMES staff in the first two to three hours of life. During the trial, the bath was done on the postpartum unit when the infant was approximately 12 hours of age. Barriers encountered during the project included staff concern to the change in standard work, timing of the bath when the 12-hour period fell in the middle of the night, monitoring the infant’s temperature after the bath, and the increased use of baby linen on the postpartum side of the unit.

Kelly Gavin, Tracey Downs, Ann Kremer Lacation Consultants, IBCLC Certified Excela Heath Family Additions Maternity Unit aspires to incorporate evidence-based practices from the womb to the home. Delayed Newborn Bathing was a project that was developed to improve exclusive breastfeeding rates for our hospital system and community. The Association of Women’s Health, Obstetric and Neonatal Nursing (AWHONN) and the World Health Organization (WHO) recommend delaying the first newborn bath as a means to increase exclusive breastfeeding during the hospital stay. Objectives were to provide evidence-based research supporting the benefits of delayed bathing on the exclusive breastfeeding rate in the neonate. This project took place during a six-week time frame. Participants were healthy, fullterm newborns. The hospital's protocol prior to this study was to bathe the newborn within the first two hours of life. There is a lack of consistency in the literature as to the optimum amount of time to “delay” the bath, but the consensus was a bath in the first two hours of life was not best practice. This Evidence-Based Practice (EBP) project was to investigate the impact on exclusive breastfeeding when the first bath was delayed for at least 12 hours after birth. Exclusive breastfeeding rates were gathered before and during the trial. Exclusive breastfeeding is defined as the number of infants at discharge that have not been given any formula during their hospital stay. According to the data at the time the concept was adopted, it was clear that a change from the current practice had to take place. The Uni-Based Council offered a design on how delayed bathing could be initiated which included an opportunity for staff feedback. A total of 100 infants met inclusion criteria. Prior to this trial, the infant was bathed by the labor room

These barriers were resolved through staff education, flexibility of the bath time, and encouraging skin to skin contact with the parents to stabilize the infant’s temperature after the bath. Linen volume was adjusted on the postpartum unit. Parent education was also a key part of this project. Another concern was identifying unbathed infants for infection control purposes. This was resolved by placing a yellow card behind the infant’s crib card with the birthdate and time and the earliest time the bath could be completed. Once the bath was completed, the yellow card was removed from the crib. This was a visual sign to staff that the first bath had been given. Prior to this trial, the exclusive breastfeeding rates for 2017 ranged from 42% to 45%. By the end of trial the exclusive breastfeeding rates increased to 54%. In addition, there was an unexpected result in delayed bathing. It was the positive feedback from parents. Mothers and other family members expressed delight with their involvement in the first bath. Now they had an opportunity to participate in the bath of their newborn. In the first two hours after giving birth, mothers are seldom ready to “take in” new information. They are much more likely to retain this information after some time to recuperate. This hands-on approach is more effective for helping them gain confidence in caring for their infant. As a result of this project, a change in practice has occurred. We have adopted delayed bathing for all healthy full-term newborns. It is now part of the standard work.

“

Trading Places:

An Interprofessional Journey

“

One of the deep secrets of life is that all that is really worth doing is what we do for others. - Lewis Carroll

Our journey to Magnet Designation includes Excela Health employees dedicated to facilitating education about the Magnet Recognition Program and generating staff enthusiasm on each of their respective units. These Magnet Maestros, as we call them, meet monthly and discuss ways to encourage our journey to excellence. At one of the meetings a few of the Magnet Maestros felt it would be a good idea for individuals of different departments throughout the health system to “trade places” in order to gain a better perspective of each other’s daily routines, day to day challenges, and point of view. The goal of the project was to build respect and understand the role of members of the patient care team throughout the Excela Health system. The experience of “trading places” with other departments gave the opportunity for the teams to recognize new coworkers or friends and put a face to the Excela Health family. This mutual goal helps make a positive change for the patient and the staff within the hospital environment. Three Magnet Maestros, Matt Yarkovich, BSN, RN; Ann Kremer, BSN, RN, IBCLC and Susan Goodnight, MLT (ASCP), BSTM, met for several weeks prior to getting the project started. The discussion included how to handle the visits and/or what possible questions or concerns needed to be addressed within the departments. The project would focus on positivity and improving the communications between different professions. The departments included in this project were the Laboratory, a Medical Surgical Nursing unit (1D) and the Obstetrics unit (5th floor). The Laboratory agreed to send a member of its team to both 1D and the 5th floor to attend the daily huddle for three days of the same week making sure it was convenient for all parties involved and keeping patient care first. The daily huddle is a great forum to be able to discuss daily activities, concerns, accomplishments, and goals of each unit. It also allows

the unit staff to ask any questions they might have about a particular topic. The Laboratory graciously offered a tour after the daily huddle so team members could see the dynamics of the various aspects of Laboratory function. The Laboratory’s large outreach business was a surprise to many team members. This experience ran for two weeks. The Maestros discussed the benefits of the project, worked out any issues and planned for its expansion to other departments. Some of the benefits found by ‘Trading Places” was that smaller groups of staff could reach out to solve or help eliminate some of the current struggles faced by staff. As a result of the initial “Trading Places” success, the Maestros decided to expand this project to other departments ensuring a positive and respectful environment. In addition to the involvement of the previously named departments, the Emergency Department is getting involved to work toward a better working environment and patient experience. As a team member of Excela Health and Magnet Maestros we are proud to be a part of this journey to Excellence.

It's a Group Effort! THE EXCELA TECHNICAL PARTNER TRAINING PROGRAM The Excela Health Leadership Team and the Excela Education Department teamed up to provide a practical solution to a problem that is crippling hospital systems nationwide. Staffing and shortages are increasingly becoming an issue with an influx of patients and a decrease in workers. At Excela Health we strive for staff satisfaction and retention to try to meet this demand. In 2017 it was identified that there were numerous open positions for Technical Partners at the three Excela Health Hospital campuses. Due to the large number of open positions and the difficulty in recruiting qualified candidates for these positions, Excela Health Leadership developed the “Earn While You Learn" Program. This program teaches the principles and mandatory skills to those interested in becoming a Technical Partner. The program was initially offered to employees within the Excela family but has since been open to outside applicants as well. Through the efforts of the Nurse Educators, a 40-hour training program was developed. The program consists of skills training in the Clinical Education and Simulation Center at the Frick Hospital campus. This is followed by two weeks of training on the clinical setting. Technical Partner “trainees” work alongside preceptors as they continue to learn and develop their skills. During classroom instruction, participants learn how to provide care to patients including bathing, feeding, toileting, and assisting with mobility. They are instructed on how to obtain vital signs including measuring blood pressure, pulse, respiration and temperature. They are educated on the care of patients who have diabetes, patients who are experiencing respiratory problems, and learn how to effectively care for the elderly population. Other skills include learning how to perform blood glucose monitoring, inserting of Foley catheters, recognizing reportable conditions and responding to emergencies on the unit.

The program is intended for individuals who have an interest in working as a Technical Partner but lack the formal education or experience to qualify for the position. Candidates may be hired from outside of the organization or recruited from other departments within Excela Health. The first class was held in June 2017 with only two participants. Subsequent classes were held in July, August, September and November with gradually increasing enrollment in each of the classes. A total of 39 individuals participated and completed the program in 2017. The program will be offered on a quarterly basis in 2018.

The

Heart Vascular and

Center at

The Heart Center and Bedrest Post Cardiac Catheterization

For decades, Interventional Cardiologists have all had personal preference for the number of bedrest hours after diagnostic cardiac catheterizations. The bedrest order ranged anywhere from 2 to 6 hours. The Heart Center staff at Excela Health noted in their practice that there was no appreciable increase in vascular complications for patients with a 2-hour period of bedrest versus those who maintained bedrest for up to 6 hours. This varied length of bedrest had the potential to increase patient discomfort and to prolong length of stay. The Heart Center staff decided to initiate a study to safely standardize the number of bedrest hours after diagnostic cardiac catheterization without an increase in vascular complications. The study included tracking site complications (defined as bleeding, hematoma, or pseudoaneurysm) and number of hours of bedrest. The coordinated effort of The Heart Center Unit-Based Practice Council along with a member of the Evidence-Based Practice Committee began in February 2017. A literature search was conducted and six research articles reviewed for statistical analysis of randomized trials to explore the effect of bedrest duration after diagnostic catheterization and the incidence of vascular complications, back pain, and urinary complications. A summation of the literature review was presented to the Director of Interventional Cardiology, Howard Grill, MD, FACC, by Wendy Shaffer, BSN, RN, Clinical Coordinator in the Heart Center. It was determined that a Heart Center pilot of 3 hours bed rest for all femoral diagnostic cardiac catheterization procedures with a 7 Fr catheter or smaller would be performed over a 6-week period. If the results indicated no increased risk of complications, the department would standardize the post-procedure bedrest time frame to 3 hours. The study ran over 6 weeks beginning March 1, 2017 and concluding April 7, 2017. A total of 53 diagnostic cardiac catheterizations were monitored with data collected including but not limited to: size of the arterial sheath, who pulled the arterial sheath and the number of manual compression minutes to the site, closure device type, number of hours of bed rest, blood thinning agents ordered post procedure, follow-up for complications, and follow-up for patient satisfaction. After analysis of the data it was determined that there was no increase in the incidence of vascular complications for patient undergoing diagnostic cardiac catheterization with 3 hours of bed rest compared with greater than 3 hours bed rest. The findings were presented at the Cardiology meeting in April 2017 and the physicians adopted the recommendation that the post procedure order sets be revised to implement a standard maximum of 3 hours of bed rest after all diagnostic cardiac catheterizations that utilized a 7 Fr catheter or smaller.

“

It has been extremely gratifying to be able to work side by side with my nursing colleagues in a variety of areas. From one on one Palliative Care issues with bedside staff to system-wide performance improvement efforts with members of the nursing executive team, I have learned from each one of these professionals. Their passion and compassion for their work and their patients is palpable and makes me a better physician.

We have seen many positive outcomes due to our close interactions with the nursing staff. Our working relationship has led to improvements in Point of Care testing implementation, early lab intervention for Stroke patients, and labeling of pathology specimens to name a few.

Carol J. Fox, MD, FAAFP, Senior Vice-President and Chief Medical Officer Excela Health

I have the good fortune of working on the outstanding care team at Diagnostic Associates. The clinical leader and staff are invaluable assets. Staff are recognized by our patients as knowledgeable and trusted professionals. The positive impact of the Clinical Leader is evidenced by the professionalism and quality care given to our patients.

“

David Richards, MD, MMM, CPE, Executive Medical Director, EHMG

Barb Day MT(ASCP), SBB, Director Laboratory

“

“ Better

together

As Respiratory Therapists, we are afforded the opportunity to work closely with the nursing staff providing care to our patients. Excela Health nurses are intelligent, dedicated, caring, and compassionate. They have an undeniable focus on the wellbeing of their patients. Through all of the challenges that they face throughout their day, they maintain a positive attitude and strive to provide the best care possible. I am proud to be part of such an amazing team. Jeff Oliver, RRT/RPFT, System Director, Respiratory Care

Clinical Resource Management is appreciative of the teamwork from the exceptional nurses at Excela Health that help facilitate the transitions of care for our patients

I am a better doctor because of the nurses that I work with. The nurses in the ED are the ultimate patient advocates. They challenge me to be a better and more compassionate practitioner. They make me a better educator. William Jenkins, MD, FAAEP, Director Emergency Medicine, Frick

John Dolan, MBA, BSN, RN, Director, Clinical Resource Management

How does Excela Health Nursing best serve our Community and what are some ways the inpatient and outpatient setting work together to provide continued care to the patient?

Maryann Singley, MSN, RN, NE-BC

As a Health System, Excela understands its role in the changing landscape of healthcare today. As the demand for efficient, cost effective, and quality care increases, Excela has focused on community care. Excela Nursing participates in numerous fund-raisers, community outreach programs, and benefits annually. We have also added several positions (see Nurse Navigator article) specifically designed to transition patients from the acute setting to the home setting to improve the discharge process and ensure follow-up care is provided and equipment is obtained as ordered. In addition, we are focused on providing quality care in our outpatient centers such as Excela Square at Norwin, Laurel Surgical Center, and our many physicians offices in the area to improve the convenience of access to care. Another great face of Excela Nursing is the Excela Health Home Care & Hospice division coupled with our recently acquired Private Duty. Our nurses are providing the same excellent care in patientsâ&#x20AC;&#x2122; homes that they are accustomed to receiving in the acute care environment. Excela is proud of our commitment to Westmoreland County and dedicated to the patients we serve.

CONNECTING TO OUR

COMMUNITY

Meet Your Nurse

Using FaceTime Technology to Connect Patients and Nurses in the Community Setting Excela Health started a new initiative to improve our handoff process between Skilled Nursing Facilities and our three hospitals, Westmoreland Hospital, Latrobe Hospital, and Frick Hospital. A trial in early 2017 with Transitions Healthcare in Irwin was initiated to improve Nurse Knowledge Exchange for patients using FaceTime technology (live video feed). This process was then implemented at St. Anne Home in Greensburg and Hempfield Manor later in the year. The process was developed to give the receiving facilities the ability to visually see the patient prior to being admitted to their facility. Nurse Knowledge Exchange using FaceTime enhances the handoff process between the admitting and sending facilities. The receiving Skilled Nursing Facility can visualize the patientâ&#x20AC;&#x2122;s current condition, mental status, dressings, IV lines, and any other assessment needs pertinent to the patient. Additionally, the receiving nurse at the Skilled Facility has the benefits of asking any questions concerning the patientâ&#x20AC;&#x2122;s care while the patient is in visual sight of them. This process also alleviates the patientâ&#x20AC;&#x2122;s anxiety by allowing them to communicate and meet with the receiving nurse at the Skilled Nursing Facility before arriving. The process begins with the Excela RN making contact with the nursing supervisor at the Skilled Nursing Facility to give FaceTime report. The Excela RN then enters the patient room and accesses the FaceTime application on an iPad to initiate Nurse Knowledge Exchange with the receiving nurse at the facility. The receiving facility nurse, the acute care setting nurse, and the patient all participate in this exchange of information. After the exchange is complete, arrangements for transportation are completed and the transfer process is initiated. If ambulance transport is needed, Care Support staff make the arrangements. This has helped to improve patient care communication between the hospital and community facilities, which in turn improves patient care and enhances the patient experience.

LOAN FORGIVENESS PROGRAM

Working Together to Alleviate the Burden of Debt Working together for the best possible outcomes of the patient is our aim at Excela Health and that mission starts by hiring the best possible candidates for the job. Excela Health Human Resources takes careful consideration to hire highly trained individuals who display compassion, caring, critical thinking, empathy, and possess strong clinical skills. Oftentimes, this comes in the form of a new nurse. Though training is required, there is a special kind of excitement that comes with embarking on a new adventure and realizing your dreams. But, this can quickly become overshadowed by the debt that follows after graduation. In an effort to assist and retain new nurses, Excela Health has partnered with them to help alleviate this burden. The Loan Forgiveness Program was designed to reduce the stress that the new nurse feels related to mounting debt from school loans by assisting with \payments once the nurse has completed the probationary period with Excela. After this period, monthly loan payments would be made directly to the student loan institution of the employeeâ&#x20AC;&#x2122;s choice for up to 50 consecutive monthly payments. All RNs are eligible who have not already received the Educational Assistance benefits (Another program that works with in-house nurses to reimburse payments up to $5,000 per year to obtain an advanced degree). The employee must meet the objectives set forth on yearly performance reviews to maintain eligibility. The expectation is that Excela and the new nurse will be partners to create an environment of growth and job satisfaction. The nurse must also be an active employee and remain on staff with Excela for 12 months or one year after the final payment is made. This ensures the dedication of all parties to invest in the future of Excela and its staff. The Loan Forgiveness Program is one of many programs that Excela Health utilizes to promote retention and recruitment. We are confident that programs like this and others that we are currently implementing will help to build a staff that is well rounded and competent. Seven nurses participated in this new program in 2017 with more involvement anticipated next year.

HOME CARE FLEET PROGRAM Driving Into The Future of Community Nursing As the needs of health care changes, so must Excela Health. We strive to stay current and relative in the face of the constantly evolving medical field. The new generation of patients poses some serious challenges to the way we deliver health care. As a result, we see care from the home as a viable option to meet the needs of the patients we are serving in this diverse population. With a growing census of Home Care patients, recruitment and retention are vital to the success of that model. One way in which Excela is devoted to staff satisfaction and retention in Home Care is through a recently developed Car Leasing Program. Excela Health Home Care clinicians drove more than 1.6 million reimbursable miles while caring for patients in their communities in 2015. Staff expressed dissatisfaction with the wear and tear that it put on their private vehicles. Upon this discovery, Erica Shaffer, BS, Executive Director of Excela Health Home Care & Hospice, introduced the concept of car leasing and the Fleet Program. A survey completed that year showed significant interest with almost 80% of employees expressing interest in such a program. After researching and testing the market, the program was rolled out. Initially, the process of signing employees up, choosing one of three available leasing options, ordering the cars, and shipping them took some time. The options to lease averaged in cost between $250-$300 a month that would be deducted from the employeeâ&#x20AC;&#x2122;s paycheck that would cover the cost of the vehicle, gas, maintenance/repairs, as well as insurance and registration. The employee would receive a new car every three years and Excela would gain a small profit on the exchange. By early 2017, employees received their new vehicles and Excela began tracking the data. The goals

of the program were to improve safety/maintenance, decrease cost and reimbursable mileage, and improve staff satisfaction. It did not take very long to see results. Out of 130 staff, 49 opted in to the program during the first year. For FY 2017, a reduction in reimbursable mileage was realized by 100,000 miles. No safety or maintenance issues were reported. According to informal feedback from the clinicians, they are satisfied with the program and are, overall, happy they have chosen to participate in the program. Formal data shows a decrease in turnover by more than 2% from FY 2016 to FY 2017. The data strongly suggests a correlation between the Fleet Program and staff satisfaction. Excela Health is hoping this trend continues in FY 2018. Since the inception of this program, costs have decreased, clinician satisfaction appears to have increased, turnover rates have decreased and retention has improved. The safety of the Excela Home Care & Hospice clinicians and patients has remained a priority. As this program continues to grow, Excela hopes that it will continue to contribute to the success of Excela Home Care and assist in delivering the best care possible in our community we love to serve.

I enjoy the Fleet program because I never have to worry about paying for maintenance, gas or insurance. In Home Care we frequently need tires and brakes, and that is all covered by this program. Iâ&#x20AC;&#x2122;m thankful for the opportunity to have a Fleet car! Christine Ambrose, BSN, RN

Providing Christmas Dinner for a Community in Need

Together is Better The Professional Image and Community Partnership Committee, part of Shared Governance at Excela Health, has a goal of helping those in need within our community. When the idea was presented to the committee to assist the Derry Area School District with their annual Christmas Dinner Project, the vote was unanimous. Kennette Grohal, MSN, RN-BC, Coordinator Clinical Informatics, met with school officials to discuss the program and the needs of the district. The committee worked to create a list of non-perishable food items, such as stuffing, potatoes, gravy, beans, corn, and cranberry sauce, to create a Christmas dinner. Additional items were collected to supplement the familiesâ&#x20AC;&#x2122; food needs over the long Christmas break. The 150 participants of the Christmas Dinner Project are eligible for free/reduced lunches during the school year and there was a desire to fill the void during the break. Staff from 18 departments at Latrobe Hospital, including Information Technology located at Corporate Services, collected 150 of the assigned items. The Christmas dinner items were collected during the month of November and on December 14, five vehicles were packed full of food for delivery to the school. In addition to the Christmas dinner meal, personal hygiene items, such as soap, hand sanitizer, toothbrushes, and toothpaste also were donated. Once the items were delivered, high school students organized the food into stations to make packing easy. On Saturday, December 16, district officials handed out the boxes of food and delivered to those who were unable to make it to the school. The generosity of the Excela Health staff led to 150 families having a Christmas dinner and additional food to sustain them for the long break. You may ask, what about the turkey? The turkeys were provided by the school from donations they received. The success of the project has led to a desire to continue the program in 2018.

Members of the Professional Image and Community Partnership Committee:

Amy Berger

BSN, RN

Nursing Supervisor

Courtney Boord

BSN, RN

Clinical Nurse

Sarah Burlas

BSN, RN

Clinical Nurse

Those who assisted with packing/delivery on December 14th:

Kristen Browe

BSN, RN

Clinical Nurse

Sally Backus

MSN, RN-BC

Coordinator Clinical Informatics

Cathy Choby

Manager, Customer Service

Katie Crovak

MSN, RN

Clinical Director

Tracey Gilbert

BSN, RN

Clinical Nurse

Earl Gardner

D. Ed, MSN, RN

Educator

Kennette Grohal

MSN, RN-BC

Coordinator Clinical Informatics

Jennifer Gregory

BSN, RN, CPPS

Patient Safety Officer

Kelly Neubauer

MSN, RN

Clinical Director

Kennette Grohal

MSN, RN-BC

Coordinator Clinical Informatics

Jane McManigle

BSN, RN

Clinical Nurse

Carrie Horner

MSN, RN

Quality Analyst

Katie Paul

BSN, RN

Clinical Nurse

Pam Korchok

Lisa Roth

Clinical Nurse

Kate Rosatti

MSN, RN

Director

Ranae Splendore

MS, BSN, RN

Director

Jeff Siegel

BSN, RN

Nursing Supervisor

Linda Sopher

Clinical Nurse

Renee Stiffey

Natalie Wickham

Clinical Nurse

Tammy Vogel

Administrative Assistant

Administrative Assistant MSN, RN

Director

Health and Wellness

A Marriage of Mind and Body for the Working Nurse While nurses care for and respect their patients’ needs, they devote little time to meeting their own needs, particularly for self-care. Data supports nurses’ experiences of self-reported stress and lack of self-care and its impact on suboptimal physical, mental, and spiritual health. An interdisciplinary team of nurses and mind-body practitioners met to create an introductory learning session for nurses to sample mind-body interventions. This team, which included Sheila Farina, MSN, RN; Elizabeth Minerva, RN, HSMI, CWHC; Nancy Urick, MSN, RN; and Lisa Marie Bernardo, PhD, MPH, RN, collaborated to identify nurses’ learning experiences with mind-body practices by measuring their interest in learning about and using mind-body practices and their response to a 10-minute experience of mind-body practice.

There was a statistically significant difference in the self-reported Bio-Dot colors before and after the session. Pre-Session, 98% of the participants were noted as Stressed/Tense. Post-Session less than 1% of the participants were noted as Stressed/Tense. Over half of the participants were interested in attending a training on Mind-Body Practices. The majority of participants noted that they were interested in using the techniques of Mindful Moment, Breathing/Calming Techniques, and/or Mindfulness Meditation in their practice. Moving forward, the interdisciplinary team is using data from this Evidence-Based Practice project to develop, implement and evaluate a mindful moment curriculum using multi-media learning approaches.

Staff were introduced to Breathing/Calming Techniques, transitioned to Mindfulness Meditation, and concluded with Guided Imagery. Over a fivemonth period, 626 staff attended the sessions. Pre and post-session, staff completed a Bio-Dot card. The Bio-Dot card measures staff stress levels which can range from stressed, tense, calm, to relaxed. Staff also completed a survey post-session about their interest in learning about and using mind-body practices.

Introducing Mind-Body Practices to Nurses: A Team Approach Sheila Farina, MSN, RN; Elizabeth Minerva, RN, HSMI, CWHC; Jyl Glunt, BS, CHAC; Nancy Urick, MSN, RN; Lisa Marie Bernardo, PhD, MPH, RN

Background

Methods: Practice Sessions

•

• •

While nurses care for and respect their patients’ needs, they devote little time to meet their own needs, particularly for self-care. Data support nurses’ experiences of self-reported stress and lack of time to devote to their own selfcare. Lack of self-care may lead to suboptimal physical, mental, and spiritual health.

Purpose •

The purpose of this EBP project was to identify nurses’ learning experiences with mind-body practices by measuring their: interest in learning about (cognitive domain) and using (psycho-motor domain) mind-body practices, and their response to a 10-minute experience of a mind-body practice (affective domain).

Methods: Teamwork •

•

An inter-disciplinary team of nurses and mindbody practitioners met to create an introductory learning session for nurses to sample mind-body interventions. The team met bi-weekly and pilot-tested the intervention, making adjustments as needed. They created the project survey and obtained the Bio-Dot cards. This 10-minute learning intervention of mind-body practices was delivered during the annual Professional Development Forums (PDF’s) February-June, 2017. After each session, the project team met and discussed their experiences. The project team leader (SF) entered all project data into an electronic database for analysis.

• •

• Experiential learning of mind-body practices shows promise for integration into self-care. • An inter-disciplinary team committed to staff enrichment for mind-body practices is crucial for project success. • Regular team meetings, timely communication among team members, ongoing data analysis and openness to modify the sessions based on data resulted in a successful project outcome. • The project team is using data from this EBP project to develop, implement and evaluate a mindful moment curriculum using multi-media learning approaches. • Nursing leadership can support self-care practices by encouraging team efforts to promote these practices during work time.

Staff were introduced to Breathing/Calming Techniques, transitioned to Mindfulness Meditation, and concluded with Guided Imagery. Pre and post session, staff completed a Bio-Dot card and described their responses to the session (psychomotor and affective domains). Post session, staff completed a survey about their interest in learning about and using mind-body practices (cognitive domain). Over a 5-month period, 626 staff attended the sessions. There was an even age distribution across the participants, and all campuses were represented.

Learning Outcomes Mind-Body Practices: Very Interested in Attending a Training • Mindful Moment (n=388) • Yoga (n=386) • Mindfulness Meditation/Breathing-Calming (n=364 tie) Mind-Body Practices: Very Interested in Using the Practice • Mindful Moment (n=445) • Breathing-Calming Techniques (n=434) • Mindfulness Meditation (n=420) Benefit Derived from the 10 Minute Practice • Benefit/great benefit (n=343, 54.8%) • Some/no benefit (n=130, 20.8%) • Missing data (n=153, 24.4%) Bio-Dot Feedback Session Stressed/Tense Pre-Session (n=599) 356 Post-Session (n=603)

Calm/Relaxed 243 555

There was a statistically significant difference in the selfreported Bio-Dot card colors before and after the session (Wilcoxon rank sum, p=.000).

 The team analyzed the written survey comments; 115 participants reported positive experiences with the practice sessions.  The team conducted their own formative and summative evaluations: • All staff required to attend the PDF’s attended the mind-body practice session. • Having the session at the beginning of the PDF set the tone for the remainder of the day. PDF educators found the staff to be more relaxed and attentive in their learning. • Additional survey questions could include staff interest in the use of mind-body practice ‘boosters’ to promote the use of mind-body practices (staff iPhone applications, online learning system links, etc.) • More time to introduce and practice other mindbody techniques would have been desirable.

Acknowledgment : Melissa Wybiral, Excela Health Volunteer Services

NURSE NAVIGATION “Guiding the Patient Through Their Healthcare Journey” Marcie Slivka, BSN, RN

Pam Kacmarkiewicz MSN, RN

Health care is a complex and difficult world for patients to navigate, particularly when needing to have surgery, deal with a chronic illness, or receiving a potentially life altering diagnosis. Having a qualified and competent healthcare professional, particularly a nurse, assigned to educate you on your options, answer questions, provide education, remove barriers and NAVIGATE you thru the process is “priceless”. Starting in August 2017, in response to the Comprehensive Joint Replacement (CJR) established by the Centers for Medicare and Medicaid Services (CMS), Excela Health started the first Nurse Navigator program for the system. While the goal of the CJR program is to assure that patients receive high quality and safe care in the most appropriate setting for the most cost effective price. Additional goals of the Orthopedic Nurse Navigator program are to enhance the patient experience, maximize appropriate spend, and assure achievement of the excellent patient outcomes that already existed for the Joint Works Program at Excela health. The Orthopedic Nurse Navigator program, assigns a nurse navigator to each patient that is scheduled for either a total knee or hip replacements. Nurse Navigators Marcie Slivka, BSN, RN and Pam Kacmarkiewicz MSN, RN, are responsible for navigating approximately 1,200 patients annually for six orthopedic surgeons at four physician office settings. The Nurse Navigators are bachelor prepared Registered Nurses who possess good communication skills, have a thorough understanding of the healthcare system, and work well with all members of the healthcare team. The Nurse Navigator is responsible for providing information, education, and emotional support to patients and their families. The Navigator facilitates the shared decision making process and connects them with community resources and other providers as necessary. In Orthopedics, the Nurse Navigator meets the patient in the office, or shortly thereafter, when the decision is made to proceed with total joint replacement. The Navigator provides the patient with a business card, which includes their picture and a direct dial phone number. The Navigator is responsible for

Sheila Farina, MSN, RN-BC

providing initial education on the procedure and post-operative recovery period, as well as schedule the patient for the formal “Joint Works” class. At the Joint Works class, additional detailed education is provided to the patient and the “coach, or family member” related to pre and post-operative care and expected outcomes. The Navigator works with the patient to assure the pre-operative testing and medical clearances are obtained and the patient’s condition is maximized prior to surgery. Post-operatively, the Navigator may see the patient at the initial post visit and / or reach out to the patient after surgery to address any concerns, as well as work with Home Care Agencies and other community care facilities to assure the patient has the best experience and outcome possible. Throughout the process (up to one year after the procedure), the patient has a single individual to whom they can reach out at any time to answer questions, provide information, and assist them through the process. From July to December 2017, we have navigated 637 patients. With 62-81% of uncomplicated elective joint patients discharged directly to home. The average length of stay for uncomplicated elective joint replacement is 1.76 to 3.0 days. Medicare bundled payment metrics have been achieved and an excellent quality score has been assigned by CMS for both facilities for CJR program year one. Based on this experience and feedback from the patients served, Excela Health in spring 2018 will begin a Nurse Navigation program for patients who are diagnosed with breast cancer at our Breast Cancer Center. In 2018, the Breast Cancer Center will be seeking national accreditation from the National Accreditation Program for Breast Centers (NAPBC), part of the American College of Surgeons quality program.

Nightingale Volunteer Program

TOGETHER IS BETTER

The Nightingale Nurse Volunteer designation was initiated in May 2017. This program was operationalized at Westmoreland and Latrobe Hospitals. It also operates out of Excela Square at Frick, Excela Square at Latrobe and Excela Square at Norwin. The designation is given to retired Registered Nurses (RN) who utilize their nursing knowledge as well as their interpersonal communication and other skills to provide comfort measures, support, and information, both patient specific and general, to patients and other identified individuals. The volunteers also offer support to staff in the area of assignment. The goal of the Nightingale Nurse Volunteer Program is to enhance the patient experience from the time of entry into the health care environment to the time of discharge. Today 35 Nightingale Nurse Volunteers are working throughout the Excela Health system. This number represents an increase of seven nurse volunteers since the designation’s inception May 2017. Nightingale Nurse Volunteers currently serve in the Emergency Department, Heart Center, Surgical Area (Open Heart), Short Procedure Unit, Outpatient Surgery, Nursery, and Inpatient Care Units. They may also serve in non-clinical areas such as Education, Volunteer Services, Quality, Human Resources and Mall Walkers-Community Outreach. Some of the Nightingale Nurses serve as a community representative on select Excela committees. Regardless of the area of assignment, they bring a unique skill set to the individuals with whom they interact and the projects in which they participate. Their overall focus is to support the Excela Mission “To improve the health and well-being of every life we touch.” The RNs who serve as Nightingale Nurse Volunteers find it to be a rewarding experience and are pleased with the opportunity to serve in this unique role. Melissa Coffman, a Nightingale Nurse Volunteer at Excela Square at Frick stated, “I am happy to be able to give back to a community that gave me such support in my professional life. Volunteering has helped me stay connected to the health system and it is a good feeling.” The response to the Nightingale Nurse Volunteers has been positive from patients, family members and staff. Going forward, to further evaluate the programs, a brief survey will be conducted giving more specific data in regards to patient satisfaction. Dr. Mark Suzuki, Cardiothoracic Surgeon, stated “The volunteers that participate in the Open Heart Communicator Program are truly incredible. They provide warmth, comfort and support to the patient’s family during a stressful time. The genuine embrace for families by the Open Heart Communicator Volunteers promotes a calming environment for my conversations with family members following the surgery.”

PROFESSIONAL

ACCOMPLISHMENTS

HCAHPS domain ourcomes

Excela Health considers patient satisfaction a key indicator of organizational success. Excela measures a patientâ&#x20AC;&#x2122;s perception of care using the Hospital Consumer Assessment of Healthcare Providers and Systems or HCAHPS survey issued by the Centers for Medicare and Medicaid Services. Nursing has many opportunities to impact the survey domains positively. Based on the many initiatives advanced over the past few years, it is clear Excela Nursing is trending upward on key survey questions.

HCAHPS continued

NDNQI clinical indicators The National Database of Nursing Quality Indicators (NDNQI) was established in 1998 by the American Nurses Association (ANA) and is a leading quality improvement program that analyze relationships between nursing and patient outcomes. NDNQI consists of a comparative national database of nursing-sensitive quality indicators at the unit level.

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CERTIFICATIONS (by specialty) Advanced Diabetes Management

Acute/Critical Care Nursing

Kristen L. Hauger

Melissa E. Anderson Kaitlin L. Balchik Benjamin L. Collins Jaime L. Culley Kala S. Hutchinson Deborah B. Jenkins Brittany L. Lubinsky Danielle L. Pavlik Kathleen A Radocaj Bridget M. Rafferty-Himler Glenn M. Repko Chelsea A. Long Karen K. Scanlan Christen M. Stercho Chad T. Toth Robin D. Weyandt William M. Widmann Bridget M. Matthews

Certified Diabetes Educator Kristen L. Hauger David C. Hinzman Michele L. Axelson

Certified Infection Control Suzanne M. Mamrose-Hunt Mary J. Bellish Deborah M. Schotting

Registered Nurse Board Certified Jacquelyn M Crowe- Medical Surgical Rhiannon E. May- Mental Health Katie M. Brant- Mental Health Kacie S. Klimchock- Medical Surgical Rebecca E. Breegle-Medical Surgical Patricia J. Hobaugh-Medical Surgical Donna L. Ross- Medical Surgical Deborah A. Barricklow-Mental Health Heather L. Miller-Mental Health Rachel R. Prettiman-Medical Surgical Dawn M. Henry-Gerontology Patricia A. Yorko-Mental Health Kortnee M. McGinnis-Medical Surgical Cari A. Reidmiller-Medical Surgical Randy D. Pritts-Mental Health

Certified Documentation Specialist Rebecca J. Fello

Certified Childbirth Educator Susan K. Patula

International Board Certified Lactation Consultant Tracey M. Downs Ann Kremer Roseann Rudy

Certified Nurse Educator Deborah Y. Lewis

Lactation Consultant Mandy M. Emmick

Registered Cardiovascular Invasive Specialist Elizabeth A. Dell Amanda Urosek

Certified Nurse Case Manager Joyce A. Hodczak Susette J. Lasher Rosanne R. Maticko Edith K. Spinneweber

Certified Emergency Nurse Kelly J. Bedner Laurie G. Dearmitt Nicole M. Komenda Deborah Y. Lewis

Certified Hospice Palliative Care Gretchen W. Peske

Certified Nurse Operating Room

Certified Professional Patient Safety

Leann Kaltenbaugh Chad T. Toth

Jennifer M. Gregory

Nurse Executive, Advanced Certified Wound Care and Ostomy Nurse Patricia Hutchinson Kimberly L. Strashensky Sandralee Hartman Sarah M. Vanderelli Abby E. Johnston Sue E. Zezzo Lori E. Crawford

Traci M. Fick Helen K. Burns

Nurse Executive Maryann Singley Michelle D. Lewis Brandi B. Hall

Progressive Care Nursing Certified Wound Specialist Darlene M. Brottish

Virginia R. Iscrupe Elizabeth A. Stefano

Occupational Health Nursing

Nursing Professional Development Certification

Susan E. Bainbridge Megan B. Kapolka

Sheila M. Farina

Maternal Newborn Nursing Certified Occupational Health Nurse Case Manager Eileen M. Kantorik Patricia L. Vomish

Kathryn L. Kepple Jessie N. Hall

Inpatient Obstetrics Nursing Certified OASIS Specialist Jennifer B. Faris Cheryl A. Johnson Particia A. Lebin Jacqueline J. Peterson Laura J. Davis

Barbara A. Bumar Waynette C. Reynolds Darla J. Klein Susan K. Patula

Vascular Access BD Allison M. Squires

Nursing Informatics Kennette A. Grohal Sally E. Backus Karen M. Edmunds W. Mike Widmann

Certified Professional Health Quality Denise D. Addis Bonnie E. Barnhart Carrie A. Horner AnneMarie Scekeres Jessica L. Spiker Christine A. Wentzel

Certified Professional Risk Management Denise A. Smail

Certified Registered Nurse Practitioners Family: Diane Navarre Dawn Repak Mary Augustine Sally Cline Victoria McIlnay Anna Kay South Lauren Love Randolph Wadsworth Leanne Wiltrout Mandee Mikeska Kayla Ellis Mallory Gergely Kristina Smouse Tami Judy Kelly Snively

Erin Dieter Rene Smail Chantel Trice Brittan Brown Marian Hazy Megan Reed Marybeth Farina- Mazur Shawnaa Rutkowsky Laurie Christner Ashley Batsa Amanda Connors David Geiger Emily Titel Maryann Dowling Rebecca Heinle Janine Meneghini Vicki Beal Jennifer Penrose

Neonatal: Jeanine Doyle Regina Oâ&#x20AC;&#x2122;Leary Susan Barbossa Amy Medved Kathleen Campbell Paula Urban Kathleen Eisensmith Karen Ewing Mary Kish Merry Kruger

Womenâ&#x20AC;&#x2122;s Care: Judy Svidron Cathy Piper

Acute Care: Kari Halaut

Gerontology: Jerod Smith

Certified Registered Nurse Anesthetists Amy Acie Michele Bailey Gabrielle Beltz Danielle Cooley Michael DeBroeck Terry Doney Jennifer Ellena Danielle Gray Joseph Hermen Brian Holt

Christopher Kolowitz Stephan Miller Donna Ross Kristen Schnauber Stephan Taylor Renee Wilson Staci Alexander Terri Baker Lisa Berdar Linette Copelli Ann DeLattre Joseph Dorazio Diane Fair Lisa Groft Deborah Hill Todd Hrtyanski Rae Kozinko Beverly Nickelson Joelle Sabatine Nicholas Shinsky Susan Tranchine William Antonucci Melissa Barras Brian Berry Melissa Cuningham Ruth DiLello Cynthia Gladora Davis Guidry Jillian Hodczak- Coffey Julie Hutchinson Patricia Kuster Tammy Nuzzo Victor Sansing Megan Spivak Vicki Vecchiolla Jessica Angelichio Robin Bell Richard Burkey Carol Curry Cynthia Donatelli Patricia Eisner Amy Graham Cara Haines Elizabeth Hollar Mark Kantola Leslie McClarren Theodore Oshie Heather Scanlon Rebecca Sullivan Lisa Vittone

CERTIFICATIONS continued ...

Barr, Loren A. Barron, Mindy S. Blazowich, Kacie M. Butler, Sabrina A. Camboni, Joseph A. Columbus, Madison M. David, Gena R. Davis, Alysa R. Deluca, Alaina E. Dickey, Tyler W. Dumbaugh, Ashley N. Fabian, Alicia J. Fetsko, Lea M. Flinn, Julie A. Garber, Alicia M. Ghekiere, Jennifer C. Giacomelli, Gabrielle L. Glaser, Kelly L. Gonda, Christy L. Green, Samantha A. Gruss, Vanessa M. Harvan, Stefanie M. Jones, Anna R. Jones, Christine M. Kanala, Kimberly M. Kemp, Shelbi J. Kozak, Kaitlin M. Leasher, Kayla R. Manning, Carrie A. Marko, Kaitlyn M. Marshall, Evan J. McCallen, Janet M. Miller, Angela M. Murphy, Joanne Opfar, Jessica E. Overman, Noah M. Pastva, Marissa C. Pietrangelo, Mariah A. Pitzer, Sarah G. Predajna, Jade A. Rich, Amanda J. Rimel, Jamie A. Shannon, Samantha J. Snickles, Julia A. Staub, Matthew A. Van Der Weele, Gretchen L. Weir, Erin B. Willett, Rayannon S.

REGISTERED NURSE, RN REGISTERED NURSE, BSN REGISTERED NURSE, RN REGISTERED NURSE, BSN REGISTERED NURSE, RN REGISTERED NURSE, RN REGISTERED NURSE, RN REGISTERED NURSE, BSN REGISTERED NURSE, RN REGISTERED NURSE, RN REGISTERED NURSE, RN REGISTERED NURSE, RN REGISTERED NURSE, RN REGISTERED NURSE, RN RN, WEEKEND REGISTERED NURSE, RN REGISTERED NURSE, RN REGISTERED NURSE, RN REGISTERED NURSE, RN REGISTERED NURSE, RN REGISTERED NURSE, RN REGISTERED NURSE, RN REGISTERED NURSE, BSN REGISTERED NURSE, RN RN, PERIOPERATIVE REGISTERED NURSE, RN REGISTERED NURSE, BSN REGISTERED NURSE, RN REGISTERED NURSE, RN REGISTERED NURSE, RN REGISTERED NURSE, BSN RN, WEEKEND REGISTERED NURSE, RN REGISTERED NURSE, RN REGISTERED NURSE, RN BSN, WEEKEND REGISTERED NURSE, RN REGISTERED NURSE, RN REGISTERED NURSE, RN REGISTERED NURSE, RN REGISTERED NURSE, RN REGISTERED NURSE, RN RN, CASUAL REGISTERED NURSE, BSN REGISTERED NURSE, BSN BSN, WEEKEND REGISTERED NURSE, RN REGISTERED NURSE, RN

EMERGENCY DEPARTMENT INTENSIVE CARE UNIT PCU 1E NEURO/JOINT WORKS CCU 2 EAST MED/SURG 3AB INTENSIVE CARE UNIT INTENSIVE CARE UNIT INTENSIVE CARE UNIT PCU 2E NURSING ADMINISTRATION PCU 2D EMERGENCY DEPARTMENT PROGRESSIVE CARDIAC UNIT EMERGENCY DEPARTMENT MED/SURG 2AB MED/SURG 3D EMERGENCY DEPARTMENT PCU 1E EMERGENCY DEPARTMENT MED/SURG 2AB EMERGENCY DEPARTMENT CCU PERIANESTHESIA BH INPATIENT UNIT 1 CRITICAL CARE STEP DOWN UNIT EMERGENCY DEPARTMENT MED/SURG 4D EMERGENCY DEPARTMENT MED/SURG 2AB EMERGENCY DEPARTMENT 2 EAST OPERATING ROOM EMERGENCY DEPARTMENT PROGRESSIVE CARDIAC UNIT LABOR & DELIVERY MED/SURG 2AB PROGRESSIVE CARE UNIT INTENSIVE CARE UNIT OPERATING ROOM STEP DOWN UNIT INTENSIVE CARE UNIT EMERGENCY DEPARTMENT STEP DOWN UNIT ER HOLDS PROGRESSIVE CARDIAC UNIT

NURSE residency

professional

PRESENTATIONS and PUBLICATIONS PUBLICATIONS Bernardo, L., Burns, H.K., Noonan, L., & Jenkins, D. (2017). Using research findings to design an EBP curriculum. The Journal of Continuing Education in Nursing, 48(4), 184-189. doi:10.3928/00220124-20170321-09 Taormina, D., & Berry, B. (2017) End-tidal carbon dioxide monitoring during patient transport and handoff procedures. International Journal of Clinical Anesthesiology, 5(3), 1072. Bernardo, LM., & Becker, B.J. (2017). Integrating physical activity into cancer care: An evidence-based approach. Pittsburgh, PA: Oncology Nursing Society.

PRESENTATIONS Bedner, K. (2017, June). Use of simulation for yearly ED competencies. Podium presentation at the Pennsylvania Emergency Nurses Association Horizons, Pittsburgh, PA. Choby, C., Gilbert, T., Grohal, K., Helfferich, J., Hines, L., McManigle, â&#x20AC;Ś Splendore, R. (2017, October). The back pack project: A nurse driven community intervention for childhood hunger. Podium presentation at the Pennsylvania State Nurses Association Annual Conference, Poconos, PA. Overly, S., & Jackson, R. (2017, October). Collaborative care: Partnerships in the community. Podium and poster presentation at the 8th Annual McGinley-Rice Symposium, Pittsburgh, PA. Burns, H., & Bernardo, L. (2017, October). The nursing shared governance structure as a vehicle for advancing EBP: An evidence-based approach. Podium presentation at the 44th Biennial Convention Sigma Theta Tau International, Indianapolis, IN. Jenkins, D., Scanlan, K., & Krinock, M. (2017, November). Facilitating evidence-based practice principles through a unit-based EBP curriculum. Podium presentation at the 44th Annual National Conference of the Professional Nurse Educators Group, Pittsburgh, PA.

POSTER PRESENTATIONS Farina, S., Glunt, J., & Minerva, E. (2017, March). Nursesâ&#x20AC;&#x2122; interest in learning about and using mind-body practices for self care: Preliminary findings. Poster session presented at the Sigma Theta Tau International Scholars Night, Pittsburgh, PA. Rosatti, K. (2017, March). Nursing professional practice evaluation: Three years of progress. Poster session presented at the American Organization of Nurse Executives Annual Conference, Baltimore, MD. Burns, H., Jenkins, D., Splendore, R., & Bernardo, L. (2017, March). Correlates of evidence-based practice in a multi-hospital system. Poster session presented at the American Organization of Nurse Executives Annual Conference, Baltimore, MD. Kapolka, M., & Bellush, M. (2017, September). Sharp injury reduction: A guide to success. Poster session presented at the AOHP 2017 National Conference, Denver, CO. Farina, S., Minerva, E., Glunt, J., Urick, N., & Bernardo, L. (2017, September). Introducing mind-body practices to nurses: A team approach. Poster session presented at the Southwestern Pennsylvania Organization of Nurse Leaders Annual Conference, Farmington, PA.

Vogel, T., Hall, B., Spiker, J., & Paterline, L. (2017, September). Nurse leaders â&#x20AC;&#x201C; Managing the present, anticipating the future. Poster session presented at the Southwestern Pennsylvania Organization of Nurse Leaders Annual Conference, Farmington, PA. Lebin, P., & Shaffer, E. (2017, September). Car leasing: An innovative strategy to increase safety and staff satisfaction in home health. Poster session presented at the Southwestern Pennsylvania Organization of Nurse Leaders Annual Conference, Farmington, PA. Lewis, D., & Reynolds, W. (2017, September). Neonatal resuscitation program (NRP): From static to simulating. Poster session presented at the Southwestern Pennsylvania Organization of Nurse Leaders Annual Conference, Farmington, PA. Moffa, D., & Steiner, L. (2017, September). Nursing professional development forums (NPDF): Assessing nursing competencies through simulation. Poster session presented at the Southwestern Pennsylvania Organization of Nurse Leaders Annual Conference, Farmington, PA. Burns, H., Jenkins, D., Stiffler, T., Shaffer, W., & Bernardo, L. (2017, October). Showcasing evidence-based practice initiatives: Outcomes from annual dissemination forums. Poster session presented at the Helene Fuld Health Trust National Summit on Transforming Healthcare Through Evidence-based Practice, Columbus, OH. Katter, E., Kepple, K., & Reynolds, W. (2017, October). Community, connections, and contributions: Nurses shaping the future of healthcare. Poster session presented at the Pennsylvania State Nurses Association Annual Conference, Poconos, PA. Farina, S., Minerva, E., Glunt, J., Urick, N., & Bernardo, L. (2017, October). Nurses' interest in mind-body practices for self-care: Outcomes of an education intervention. Poster session presented at the Pennsylvania Organization of Nurse Leaders, Gettysburg, PA. Burlas, S., Browe, K., & Lewis, M. (2017, November). Situation, background, assessment and recommendation (SBAR). Poster session presented at the 44th Annual National Conference of the Professional Nurse Educators Group, Pittsburgh, PA.

HONORABLE MENTION Brian Berry, Pittsburgh Magazine Excellence in Nursing â&#x20AC;&#x201C; Honorable Mention, Advanced Practice Nurse

THE SHARED GOVERNANCE MODEL The Shared Governance model at Excela Health provides clinical professional nurses a voice in decision making that creates a positive impact on the quality of patient and family care. Shared leadership is actualized through a formalized structure of councils, committees and work groups. Clinical professional nurses have the ability to facilitate recommendations and make decisions that pertain to clinical care, quality improvement, and professional nursing practice. Under this model of shared responsibility, Excela Healthâ&#x20AC;&#x2122;s clinical professional nurses assume full responsibility for nursing practice while participating in strong collegial relationships with other disciplines in the planning and delivery of patient care.

LEADERSHIP COUNCIL AND UNIT BASED PRACTICE COUNCIL The Leadership Council and Unit Based Practice Councils are at the core of the Shared Governance model. The Leadership Council provides a mechanism for the communication, integration and coordination of the four functions of the Excela Health Shared Governance structure. The Leadership Council works within the Shared Governance structure to provide vision, direction and planning for the nursing organization in matters of patient care and professional development. The Unit Based Practice Councils (UBPC), provide a voice for clinical nursing in decision making at the unit level. The UBPC is accountable for unit operations, communication and compliance with nursing care standards for specific populations. Each unit systemwide has a UBPC. The Nursing Professional Practice Evaluation (NPPE) Committee, Shared Governance Committee, Staffing Committee and Nurse Executive Committee are part of Leadership Council.

PROFESSIONAL DEVELOPMENT COUNCIL The role of the Professional Development Council is to oversee the development,implementation and evaluation of professional career development programs, grounded in evidence-based practice and nationally recognized standards of nursing practice. The Professional Advancement Committee and the Professional Image and Community Partnership Committee is overseen by this council.

MANAGEMENT COUNCIL The role of the Management Council is to oversee the human, fiscal, material (space/equipment/supplies), and support resources/services within and affecting the continued operations of the Department of Nursing and that support safe, cost-effective, quality care. The role of the manager moves from controlling and directing to facilitating and integrating the function s of the unit. This council will address the accountabilities of management in shared governance. Recommendations on matters relating to the allocation, distribution, and assignment of resources to the individual units and the Nursing Department as a whole, shall be determined, defined, and proposed to the Nursing Excellence Council. The Recruitment Committee and the Retention and Recognition Committees are also a division of this council.

PRACTICE EXCELLENCE COUNCIL The role of the Practice Excellence Council is to define, implement and maintain the highest standards of nursing practice that are evidence based, meet regulatory requirements and are consistent with professional practice standards as defined by state and national nursing organizations. The Innovation, Technology and Informatics Committee and Evidence Based Practice Committee is a subset of this council.

ADVANCED PRACTICE PROVIDER COUNCIL The Advanced Practice Nursing Staff implements the standards of practice as defined by the American Nurses Association, other specialty certifying nursing organizations, Pennsylvania State Law, their specialty organization and practice/discipline specific guidelines. They work collaboratively with the physician and other members of the health care team and within the boundaries of their specialty scope of practice privileges and approved protocols.

Leadership Devon Everett Managment Kathy Radocaj Practice Excellence Brittany Lubinsky

COUNCILS

Professional Development Rebecca Breegle Advanced Practice Provider Erin Dieter

Evidenced Based Practice Taylor Stiffler Innovation, Technology, and Informatics Chan Pich Nursing Professional Practice Evaluation Rina Piper Nurse Recognition and Retention Gretchen Peske

COMMITTEES

Nurse Staffing Kathy Kepple Professional Advancement Christy West Professional Image and Community Partnership Cathy Choby Recruitment Courtney Boord Shared Governance Jaime Donahue

NICOLE KOMENDA, MSN, RN, CEN

DIANE MONTINI, RN

2017 CAMEO OF CARING NOMINATIONS: Barbara Alexander Kaylee Apel Rebecca Breegle Jaime Deloach

Timothy Hagerty Darla Hall Angela Kolenc Nicole Komenda

Darlene Levino Brandy Martz Crystal Matrisch Diane Montini

Melissa Townsend Jaime Varsafsky Randi Wichrowski Donia Wills

Lois Wozny

2017 OUTSTANDING CARE TEAM NOMINEES Ginny Harhai Sharon Mase Angela Mainini

Sally Baird Melanie Bergstrom Joshua Bickerstaff

Dee Pallottini Ruby Piccioni Madeline Rollins

Lindsey Rose Maggie Sistek Charyl Thiel

Patty Yanik

2017 OUTSTANDING NURSE RESIDENT NOMINEES Sarah Burlas

Brittany Coles

FRIEND OF NURSING AWARD 2017 Maureen Ceidro

Jaime Deloach

Excela Health recognizes nurses and nursing teams who create an exceptional patient care experience by participating in the DAISY Foundation’s awards program. Honorees are selected from nominations submitted by patients, visitors and health system staff and judged for their compassionate care, kindness, teamwork, clinical expertise and professional collaboration. The award was created in memory of Patrick J. Barnes to recognize extraordinary nursing care everywhere.

DAISY WINNERS FOR 2017 FEBRUARY 2017 NATALIE HOAG, BSN, RN - LH PCU

AUGUST 2017 KANDACE DUNLAP, RN HOMECARE/HOSPICE

APRIL 2017 MARJORIE THOMAS, MBA, BSN, RN NURSING SUPERVISOR

OCTOBER 2017 PAMELA PAINTER, RN - LH ICU

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JUNE 2017 SHAWN DITCH, BSN, RN HOMECARE/HOSPICE

2017 TEAM AWARD FH PERIOPERATIVE SERVICES

DECEMBER 2017 JEFFREY IAN WIRTH, RN - FH CCU

I am nominating the Periop team at Frick Hospital based on their contribution of time, energy, andtalent that resulted in enhanced safety practices to benefit both our patients and employees here at Excela Health (EH). In addition to promoting quality and safety, the work on this project empowered the staff to use their voices to make a difference in how they practice the art and science of nursing resulting in the team becoming empowered and engaged, contributing to a culture of excellence.This work began when it came to her attention that there were some safety concerns with students training in the Operating Room (OR). Staci Orbell MSN, RN, CPAN Nurse Educator, Perioperative Services pulled together a team determined to resolve the problem. Staci, FH OR nurse Yvonne Hunter RN, Martha Opalinski BSN, RN , Nurse Supervisor Perioperative Services, and LH surgical tech, Jodi Holtman formed a group to address the issue. Their data collection reviewed some issues of students mishandling sharps, improper passing of sutures and other safety concerns. Through their research, the team developed a curriculum that evolved into one hour classes that are mandatory for every Physician Assistant (PA), Certified Registered Nurse Practitioner (CRNP) Medical Student or resident before can work in the Operating room. This practice promotes safety on the part of the student while protecting Excela employees. The class content addresses sharps and scalpels safety, how to pass sutures, proper scrubbing, gloving, and gowning and preparing and maintaining a sterile field. The work was so important the team decided to do an Evidence Based Project to share their best practices and presented a poster at the Annual EH Evidence Based Project Conference. The work on this project has been disseminated throughout the system creating safe, sterile environments in our Peri-Op areas.

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The work was further validated when it was accepted as a poster presentation: Implementing a Scrubbing and Sharps Safety Course for Clinical Learners at the National AORN Conference in New Orleans in March. Yvonne Hunter RN, Martha Opalinski BSN, RN, and Staci Orbel MSN, RN CPAN will represent EH and the work done in their area by displaying and sharing their best practices at that national conference. Becoming engaged and creating change also contributes to a happy staff. When Yvonne Hunter RN was asked her thoughts about this project, she replied with enthusiasm, “I love my job, I love working with students, and this work really made a difference.” As EH pursues Magnet designation I believe this team needs acknowledged for exhibiting the components of Magnet. They are structurally empowered, utilizing their talents to create change, they demonstrated exemplary professional practice and sought New Knowledge and Innovation in developing strategies to address a problem that was identified. This team has significantly contributed to a culture of excellence. Sheila Farina MSN RN-BC Nurse Educator

NAME

POSITION

YEARS

Bayura, Debra S.

Registered Nurse, RN

40.5

Boyer, Kathleen A.

RN, Casual

41.7

Burns, Ruth C.

Unit Clerk

41.4

Como, Jill H.

Educator

44.5

Dovyak, Marsha J.

Registered Nurse, RN

41.1

Goldberg, Katherine M.

Registered Nurse, RN

44.7

Hair, Michelina E.

HUC

40.9

Hill, Rebecca J.

Unit Clerk

42.0

Jones, Melanie S.

Clin Nursing

41.5

Kemp, Denise

Supervisor, Home

42.8

Kepple, Kathryn L.

Clin Nursing

41.6

Kish, Wendy L.

Registered Nurse

42.8

Legas, Mary C.

Surgical Technician

45.5

Luczki, Mary A.

HUC

43.9

Lukon, Patricia

Registered Nurse, RN

44.6

Marion, Gail E.

Supervisor Patient Trans.

40.9

Melenia, Susan G.

Patient Transporter

41.5

Moffa, Rosemarie

RN, Casual

42.9

Palacki, Kathryn S.

Registered Nurse, RN

40.5

Potosky, Debbie A.

LPN

40.9

Povlik, Marianne

Clin Nursing Coord, RN

40.4

Riedman, Cynthia S.

Unit Clerk

44.4

Roebuck, Kathleen

Registered Nurse, BSN

40.5

Rudy, Roseann

RN Subsidiary

44.5

Rutter, Kathleen D.

Perioperative Scheduler

40.0

Sansing, Karen L.

Registered Nurse, RN

41.9

Scrabot, Dennis J.

ALS Technician

41.5

Shearer, Loretta A.

Registered Nurse, RN

41.3

Spinneweber, Edith K.

Lead Case

41.5

Splendore, Ranae A.

Dir, Nurs. Manager, BSN

41.8

Steiner, Joan R.

Registered Nurse, RN

41.6

Thomas, Joyce E.

LPN Subsidiary

44.3

Wallace, Bernadette

Registered Nurse, BSN

48.3

Watkins, Patricia L.

Registered Nurse, RN

40.5

Wichrowski, Randi L.

Registered Nurse, RN

41.5

Williams, Jackie L.

Case Manager, RN

40.4

THANK YOU for your service 40+ YEARS

EVENING WITH THE

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Celebrating Accomplishments

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NURSES

WEEK May 4 to 10, 2017

Nursing: Nu Nursing Nursin Nursi Nurs Nur The T Th Balance Ba Bal Bala Balan Balanc B of o Mind, Mi Min Mind M Body Bo Bod B and aan Spirit S Sp Spi Spir Spiri Evening Event 5 to 8 p.m. | University of Pittsburgh at Greensburg, Smith Hall

Thursday, May 4, 2017 Special Presentation: “Love in Action” Pippa White One's Company Production, Part Theater, Part Storytelling, Part History

Awards Presentation | Cameos of Caring, Nurse Resident, Friend of Nursing and Outstanding Care Team Members RSVP to Linda Dodds, 724-832-4091 or ldodds@excelahealth.org, on or before April 27, 2017 Courtesy of Excela Health Medical Staff

Friday, May 5, 2017 Refreshments delivered to Nursing Units Nurses Week Gift Card Give-Away Event . . . All nurses are already entered for drawing

Saturday, May 6, 2017 Refreshments delivered to Nursing Units

Wednesday, May 10, 2017 “A Nurse’s Guide to Preventing Compassion Fatigue, Morale Distress and Burnout” 1 to 2 p.m. Westmoreland Hospital - 2C Conference Room Viewing locations Latrobe Hospital - South Conference Room Frick Hospital - Board Room

Nursing

Nurses WEEK