2021 Nursing Annual Report by Independence Health System

EMPOWER

ENCOURAGE

ACTION

ENVISION

NURSING

EXCELLENCE

EXCELLENCE IN

COMPASSION

A LETTER FROM THE

CHIEF NURSING OFFICER Helen Burns, PhD, RN, NEA-BC, FAAN Reflecting on my years in nursing and particularly the past two years, one of my most valued realizations has been that the majority of meaningful improvement and impactful successes are gained through a collection of small, pivotal and defining moments along the way. Just one new idea, one unexpected partnership, or one growing realization has the power to create a ripple effect ----encouraging others, empowering oneself, demonstrating compassion…..each leading to the attainment of excellence. The ingenuity, passion and perseverance of the extraordinary individuals featured in the following pages illustrate the potential and possibilities present in every one of us. It reflects the influence of the Excela Nursing Team, one that extends across the entire Excela Health organization. When people, as individuals and as a group, envision a better way of doing and a better future state, they can overcome the frustration, remove the obstacles and see the opportunities beyond the challenges. Every year, this report acts as a reflection and a celebration of accomplishments that have been achieved. This past year, as the previous year, has been incredibly unique. Many people took on a variety of different roles, switched projects in mid-stream and guided initiatives despite great challenges. Our progress this year is measured not only in the quantity of accomplishments but also in their quality and the creative ways in which they were achieved. Together, each team discovered resourceful ways to stay the course, sometimes discovering unexpected improvements and innovative methods to drive excellence. As you read through the pages and find inspiration in these stories, I urge you to take a step back and ponder the last year, reflecting on what we’ve learned and on the positive difference nursing is making at Excela Health. If big improvements are a collection of small defining moments, what will be…what can be…. our next defining moment? With gratitude and respect,

Table of Contents Quotes from our Nursing Leaders EMPOWER Strides in Evidence-Based Practice and Research Efforts Inspire Positive Change 7th Annual EBP & Research Forum: Trauma and Resilience Nurse Resident Evidence-Based Practice Projects 2021 Excela Health Nurses Disseminate Work Impacting Relevant Issues Tackling Workplace Safety Excela Partners with UPMC Western Psychiatric Hospital Crisis Training Institute for CCM Training Celebrating Excela Health Safety Heroes Personal Safety Alarms Effectively Penetrate Noise Reducing Isolation Barriers Elevated Shared Decision-Making Through Professional Governance New CNO Advisory Cabinet Professional Development Council Introduces New Nursing Profesional Advancement Program ENCOURAGE Support for New Nursing Graduates Customized Nursing Education in Response to Pandemic Nurse Residency Programs More Important than Ever New Residency Voices Emphasis on Well-Being Blessing of the Hands Ceremony The Art of Team Building EXCELLENCE Nurses Play Key Role in New Heart, Lung and Vascular Institute Analytics Team Commitment to Quality New Heart Failure Clinic Offers Much Needed Support New Surgical Institute Opens Doors of Opportunity Spotlight on Behavioral Health Excela Behavioral Health Nurse Provides Crisis Intervention Training for First Responders Successful Reduction in Behavioral Health Acute Care 30-Day Readmsiion Rates Nurse-Driven Protocols to Decrease Hospital Acquired Pressure Injuries (HAPI) Internal Wound Care Nurse Drives HAPI Prevention Protocol HAPI Prevention Protocol Clinical Nurse Coordinators Introduce Skin Assessment Tool Effective in Decreasing HAPI ENVISION Creative New Pathways Meet Evolving Demands High Demand for Monoclonal Antibody Treatments Changes in Workﬂow and Expanding RN Schedules Promote Increased Number of Patients Receiving Surgical Procedures PACU Nurses Lead Interdisciplinary Approach Allowing Select Orthopedic Procedures to be Performed as Same Day Surgeries In the Spotlight Spotlight on Weekend Night Shift Home Care and Hospice Clinicians COMPASSION Socially-Sensitive Care for Homeless and Marginalized Hands of Hope: Volunteer Support for Community Outreach Beneﬁtting Local Homeless Population Teams Rally Around Patient Experiencing Homelessness to Eliminate Barriers to Receiving Necessary Surgery Long-Standing Commitment to Improving Food Access for School-Aged Children Compassionate Care Inspires Positive Patient and Family Experience A Wedding An Anniversary Emotional Support for Isolated Patients Excela Nurses Implement Evidence-Based Trauma-Informed Strategies for Mothers of Infants with NAS Accomplishments

One Person Inﬂuencing Another Traci Fick, DNP, RN, NEA-BC Vice President | Patient Care Services Frick Hospital and Westmoreland Hospital

EMPOWER Excela Health nurses lead with a purpose, demonstrating passion and optimism as they apply wisdom in pursuit of excellence. They demonstrate resiliency, enthusiastically taking action to overcome challenges in pursuit of excellence.

Maryann Singley, RN, MSN, NE-BC Vice President | Patient Care Services, Latrobe Hospital

ENCOURAGE Thank you for the courageous behaviors displayed over the last year. Your courage, commitment, care, compassion, and connection as a team is an inspiration. We believe in you!

Mary Mantese, DNP, RN, CENP Director | Professional Practice & Care Transformation/Associate Chief Nursing Ofﬁcer

ENVISION Nurses are leaders. They embrace professional governance to promote positive change and are unwilling to be satisﬁed with the status quo. They build upon the knowledge of experience in the ever-changing healthcare environment. They envision the future and inspire others to achieve extraordinary outcomes. Congratulations and thank you to every Excela Health nurse for making a difference, for leading with a passion for our profession to achieve our vision of nursing excellence.

Lydia King MSN, RN, PHRN Clinical Nurse Coordinator | Excela Frick Emergency Department Leadership Council Chair

COMPASSION It takes a strong person to handle the stresses that have been placed upon the hospital system. Excela Health nurses showed hope, strength and selﬂessness to every life they touched. They have given compassion, courage and a caring hand not only to their patients, but also their fellow colleagues. They have shown purpose and passion for the work they do every day.

Mary Mogle MSN, RN Emergency Department Case Manager | Latrobe Hospital Professional Governance Chair

EXCELLENCE It has been said, " Excellence is never an accident...”. The work being done by nurses shows purposeful creation and implementation of processes; caring and advocating for patients; and the drive and participation to change obstacles into opportunities resulting in Excela Nursing excellence.

EMPOWER

Excela Health is committed to fostering an environment where nurses from all levels and departments are empowered to not only ask questions but to take steps to ﬁnd answers to pertinent issues related to the job they do as well as to disseminate their ﬁndings to elevate nursing practice.

Nurses from all across the Health System convened for the 7th Annual Evidence-Based Practice and Research Forum focusing on Trauma and Resilience. The keynote address entitled, Sexual Assault Forensic Examination Telehealth (SAFE-T) Center: Using Telehealth to Enhance Access, Quality and the Provision of Trauma-Informed Care was presented by Sheridan Miyamoto, PhD, FNP, RN, Associate Professor at Penn State’s Nese College of Nursing and Child Maltreatment Solutions Network.

Golden Hour: Improving Exclusive Breastfeeding Rates • Kelly Craig, BSN, RN, WH Family Additions Maternity Center • Jennie Halula, RN, WH Family Additions Maternity Center • Jennifer Beckering, MBA, BSN, RN, IBCLC, WH Family Additions Maternity Center Evidence-Based Practice Beliefs at Excela Health • Jessica Love, MSN, RN, CNL, FH PCU • Tammy Vogel, MSN, RN, Director Nursing Services and Quality • Deborah Lewis, DNP, RN, CNE, WH Senior Educator

Neurological Manifestations of COVID • Elizabeth Crago, PhD, RN, FH ED and Associate Professor, University of Pittsburgh School of Nursing

Implementation of Project Red Heart Failure • Debra Moffa, DNP, RN, MEDSURG-BC, LH Education Acknowledging Our Strengths and Skills with Guided Imagery • Elizabeth Minerva, RN HSMI, CWHC, Excela Health Well-Being Center

COMPASSION

Latrobe ICU Quality Improvement Project with Bar Code Medication Administration (BCMA) • Jamie Kimmick, BSN, RN, CCRN, CNC, LH ICU • Heather Mascarello, MSN, RN, CNC, LH ICU • Tammy Vogel, MSN, RN, Director, Nursing Services and Quality

ENVISION

Post Arterial Access • Melissa Anderson, MSN, RN, CCRN, FH Nursing Pool • Virginia Iscrupe, BSN, RN, PCCN, WH 2D

EXCELLENCE

In addition to Dr. Miyamoto’s presentation, several Excela Health Nurses presented their work, including:

ENCOURAGE

7th Annual Evidence-Based Practice and Research Forum: Trauma & Resilience

EMPOWER

Strides in Evidence - Based Practice and Research Efforts Inspire Positive Change

Nurse Resident Evidence Based Practice Projects 2021 Throughout the year, new nurses enrolled in the Nurse Residency Program are mentored to develop and present evidence-based projects addressing real-time opportunities for improvement in their respective departments. This year’s projects include:

Implementing Interdisciplinary Morning Huddles in Non-Critical Care Units Alyssa Barnett, RN, WH SDU Natalie Forsythe, RN, WH L&D Briana Hozak, RN, WH SDU

Chlorhexidine Bathing vs. Soap and Water in Med-Surg Patients Ashley Cassatt, RN, WH 3DE Denver Orner, RN, WH ICU

Repositioning in the Critical Care Setting Courtney Peddicord, RN WH ICU Faith Hornak, RN, WH ICU Amy Biller, RN, FH ICU

Disposable vs. Reusable Blood Pressure Cuffs Marque Piper, BSN, RN, LH ICU Ashley Barberich, RN, LH ICU Amy Biller, RN, FH ICU

Appropriate Technique for Blood Pressure Cuff Sizing and Placement

Bariatrics and Early Mobilization Libby Cataldo, BSN, RN, WH 4AB Christina Tetkoskie, RN, LH ED Josie Barnicle, RN, WH 4D Rebecca Lytle, BSN, RN, WH 4AB Nicolia Sheaffer, RN, WH 4D

The Use of Emoticons in Second Lactate Collection Annalee Cardiff, RN, WH ED Jessica Steffey, BSN, RN, LH ED

Best Practice for Assessing Nasogastric Tube Placement Kylie Luke, RN, LH OR Faith Leiford, RN, LH PCU Sydney Henning, RN, LH PCU Julie Davis, RN, LH 3N Dana Sylvester, RN, LH 3N

Weighted Blankets in Patients Faced with Anxiety Joanna Gravely, RN, WH 3AB Grace Ostroski, RN, LH 3N Liz Ragan, RN, LH PCU Baylee Riggle, RN, LH 3N

Johnathan Klorczyk, RN, FH ED

Perineal and Indwelling Foley Catheter Care and Prevention of CAUTI Taylor Jones, BSN, RN, LH 3N

Music Therapy for Critical Care Patients John Durbin RN, WH ICU

Sarah Milliron, RN LH PCU

Meds to Beds Safe Nurse Stafﬁng Ratios Based on Patient Acuity

Kacey Koontz, RN, FH PCU Brianna Hoover, RN, WH 4D

Decrease in HAPIs Through Cueing Gabrielle Gardner, RN, BSN, WH PCU

Noise Reduction in Acute Care Settings Victoria Knopsnider, BSN, RN, WH 1D Melissa Martin, RN, WH 1D

Immersion Bathing in Newborns

ENCOURAGE

Lyndzey Busovicki, BSN, RN WH 1D Anji Zlater, RN, WH 1D Ava Kurtz, RN, WH 1D

EMPOWER

Utilizing Translators for Hard-of-Hearing and Deaf Patients

Alesia McFadden, RN, WH L&D

Abigail Gillis BSN, RN, WH 2D Brittany Bergman, RN, WH 2D

Door to ECG, Why the First 10 Minutes are Critical

Post Cardiac Cath Patient Ratios Sarah Bouchard, RN, BSN, WH 1D/E Laura Nemeth, RN, BSN, LH 3NS Brett Fess RN, WH Nursing Pool Savannah Rohrabaugh RN, WH 3AB

Julia Slusser, RN, WH 2D/E Savanna Houser RN, WH SDU

Cardiac Medication Administration in a Timely Manner Natalie DiPaolo, RN, LH PCU Sidney Painter, RN, LH PCU

Proactive v. Reactive: Violence Education and Prevention Trey Carr, RN, LH ED Jessica Aiello, RN, WH ED

COMPASSION

Probiotics to Prevent Antibiotic Associated Diarrhea

Jordan Evanko, RN, LH 4S Marissa Butler, RN, FH ICU

ENVISION

Samantha Wagner RN, WH ED Kari Naggy, RN, LH ED Elias Dorinsky, RN, FH ED

Central Line Associated Bloodstream Infection (CLABSI) Prevention

EXCELLENCE

VasoStat vs TR Band Radial Artery Compression Device

Excela Health Nurses Disseminate Work Impacting Relevant Issues One of the most important goals of conducting quality improvement projects is to expand the profession of nursing by disseminating or sharing the results. Several EH nurses had their work published or presented in a variety of local, state and national forums.

Neurological Manifestations of COVID Elizabeth Crago, PhD, RN, Clinical Nurse, Emergency Department, FH and Assistant Professor, University of Pittsburgh School of Nursing

• In her role at the University of Pittsburgh, Dr. Crago worked on a team conducting research for an international study on the Global Incidence of Neurological Manifestations of Hospitalized Patients with COVID-19. She presented the results at the 7th Annual Excela Health Evidence- Based Practice and Research Forum. • In the study of 3,744 patients, neurological manifestations were found in 80% of hospitalized COVID patients. The study revealed most common symptoms as headache (37%) and loss of taste or smell (26%). Most common signs/syndromes included acute encephalopathy (49%), coma (17%) and stroke (6%). • Dr Crago’s presentation outlined many applicable aspects of the study providing pertinent information related to the care of patients with COVID, particularly surrounding the increased risk for stroke.

A complete listing of publications, posters and presentations developed by Excela Health nurses in 2021 can be found in this report in the ACCOMPLISHMENTS section.

Nicole Komenda, DNP, RN, PHRN, CEN, Clinical Coordinator, Emergency Department, FH

• In November of 2021, Dr. Komenda attended the prestigious Sigma 46th Biennial Convention in Indianapolis, IN to present work completed for her DNP project. She collaborated with local EMS and pre-hospital staff to increase pre-hospital stroke recognition and ultimately decrease the time it takes to administer interventions to treat patients suffering from stroke.

Deb Lewis, DNP, RN, CNE, Senior Nurse Educator

COMPASSION

• Dr. Lewis was also invited to be a moderator at the Sigma conference for a quick moving group of Pecha Kucha style presentations. Pecha Kucha allows the exciting innovations from a number of projects to be highlighted in a very short period of time. Effective moderation is key to the success of this style of presentation.

ENVISION

• Dr. Lewis presented her work on EBP implementation in a community hospital at the November 2021 Sigma Conference. Excellence in nursing practice requires that nurses throughout the system are empowered to introduce new evidence-based strategies to improve patient care. Dr. Lewis’ work surveyed EH nurses to measure belief in, implementation of and organizational culture related to Evidence-Based Practice. Dr. Lewis’ work has markedly inﬂuenced the culture of excellence at EH.

EXCELLENCE

EBP Implementation Within a Community Hospital System: A Comparative Analysis

ENCOURAGE

• Dr. Komenda recently presented the Caring Cabinet project aimed at improving food access for local school- aged children at the 12th Annual McGinley-Rice Symposium, a national forum organized by the Duquesne University School of Nursing, focusing on critical issues in health care practice and policy through the lens of social justice. The project is coordinated by the EH Nursing Professional Development Council, for which Dr. Komenda is the Chair.

EMPOWER

Caring Cabinet AND Implementation of EMS Feedback to Improve Stroke Identiﬁcation

Tackling Workplace Safety Excela Partners with UPMC Western Psychiatric Hospital Crisis Training Institute for Comprehensive Crisis Management (CCM) Training Safety is an organizational strategic priority at Excela Health. In addition to the many efforts directed toward patient safety, staff safety is of equal priority. Employee feedback following internal Workplace Violence Training revealed that in addition to the existing crisis management training material, staff requested that training include physical restraint and escape techniques. Western Psychiatric Hospital, part of the University of Pittsburgh Medical Center, has been a nationally recognized leader in mental health clinical care, research and education for more than 70 years and their Crisis Training Institute provides specialized training on a variety of topics, including a train-thetrainer Comprehensive Crisis Management (CCM) Training for healthcare providers.

for Excela Health staff in the Emergency, Behavioral Health and Security Departments. The initial training for staff is eight hours and consists of: • Verbal de-escalation techniques • Physical restraint and escape techniques • Understanding violent behavior • Suicide prevention • Trauma informed care Staff are required to attend a four -hour refresher class annually and instructors must attend a 16 hour refresher course each year. Staff have shared that CCM training has empowered them to approach a violent or potentially violent situation with the necessary knowledge and skills to minimize the risk of injury and to in many cases avoid an escalation to violence altogether.

The goal of CCM training is to provide staff with the knowledge and skills, including hands- on physical emergency management techniques, necessary to prevent the occurrence of crisis situations in clinical settings as well as safe practice techniques to reduce the number of injuries to staff and the individuals they serve. Speciﬁcally, program objectives include: • To promote the safety of individuals receiving and providing care • To reduce the use of seclusion and restraint • To provide an environment of partnership and collaboration • To eliminate the use of aversive and coercive interventions. Kelly Bedner, MSNEd, RN, CEN, Education; Lois Noonan, M.Ed, BSN, RN, NPD-BC, Education; Aaron Kelly, RN, Behavioral Health; and Tim Holler, RN, Behavioral Health became system instructors for Excela Health by attending a 40 hour train- thetrainer program. CCM Training is currently required

“

Staff seem to appreciate the class and have voiced that the education has been helpful. Lois Noonan, M.Ed, BSN, RN, NPD-BC, Education and CCM Instructor

EMPOWER

ENCOURAGE

EXCELLENCE ENVISION

COMPASSION

Celebrating Excela Health’s Safety Heroes The award-winning Excela Health Safety & Occupational Health Department defines “Excellence in Action”. They strive for zero harm for all employees, patients and visitors on all Excela Health properties. They work diligently to ensure that all employees, patients & visitors go home in the same, or better condition than when they came through our doors. As a result, Excela employees experience far fewer work-related injuries. The Excela Health OSHA Recordable Incident Rate of 1.61 per 100 employees, is well below the national average. The most common work- related injuries or incidents include: blood and body fluid exposures, contact with objects, and slips/trips/falls. Excela staff rely on the Safety and Occupational Health teams for countless items, including but not limited to: employee health initiatives, nurse on call service, fit testing, fire training, flu shots, workplace violence training, ergonomics support, safety committees and safety fairs. Throughout the pandemic, these teams owned the added responsibility of coordinating COVID testing for all employees and medical staff as well as communicating test results and offering personalized guidance for each individual who was exposed to or tested positive for COVID-19. The latter months of 2021 saw record high numbers of employees affected by COVID. The large numbers of staff requiring isolation or quarantine coupled with the critical staffing crisis, resulted in the need for this team to provide immediate responses to the hundreds of phone calls daily from staff seeking guidance and the critical need to eliminate any potential delay in facilitating testing or communicating results. The Excela Health Safety and Occupational Health team accepted each additional burden with grace and efficiency. Their efforts were heroic and appreciated by all.

The nurse found the patient unresponsive and as she attempted to arouse him, the patient grabbed her and refused to release her. The patient appeared to be suffering from delirium related to his hypoxic state and was unable to understand that he was hurting the nurse. With the door closed and the P100 mask and other personal protective equipment in place, no one could hear the nurse call for help.

The Unit Based Council discussed potential solutions to this problem and devised the plan to have staff carry personal alarms at all times when behind closed doors alone with patients. The alarms are easily activated and the sound made when activated is loud enough to penetrate all safety barriers and doors. These simple alarms are just one example of the innovative efforts nurses conceive to ensure that all remain safe while at work. The alarms are in use throughout Frick Hospital.

EXCELLENCE

Geared in her gown, gloves, P100 mask and eye protection, the nurse entered the room of a patient in the Intensive Care Unit at Frick Hospital to assess her patient and closed the door behind her as per COVID safety protocol. The patient had been struggling with hypoxia despite oxygen therapy.

For this nurse, her co-worker noticed changes in the patient’s heart rate via the telemetry monitor and promptly went into the room to assist and together they were able to calm the patient and restore safety. The nurse sustained a minor injury; however, the event raised the concern that closed doors and PPE, while necessary, result in potential risk to those caring for patients in COVID isolation.

ENCOURAGE

COVID isolation created an uncharted challenge for direct-care staff and the need for creative innovations to maintain the level of workplace safety to which Excela Health staff are accustomed. It became apparent that the necessary safety practices in place to prevent the spread of COVID-19 posed a different form of safety hazard as evidenced by one nurse’s experience.

EMPOWER

Personal Safety Alarms Effectively Penetrate Noise Reducing Isolation Barriers

ENVISION COMPASSION

Elevated Shared Decision-Making Through Professional Governance NURSING PROFESSIONAL PRACTICE EVALUATION (NPPE) COMMITTEE

PRACTICE EXCELLENCE COUNCIL EVIDENCED-BASED PRACTICE & RESEARCH COMMITTEE

ADVANCED PRACTICE PROVIDER (APP) COUNCIL PROFESSIONAL GOVERNANCE COMMITTEE

ERSHIP COUNC AD IL LE ED PRAC BAS TIC ITE N U

PATIENT

& FAMILY

STAFFING COMMITTEE

PROFESSIONAL DEVELOPMENT COUNCIL

MANAGEMENT COUNCIL RETENTION & RECOGNITION COMMITTEE

C O U N CILS

INNOVATION, TECHNOLOGY & INFORMATICS COMMITTEE

CNO ADVISORY COUNCIL Chairs and facilitators from all ll committees report to this council

NURSE EXECUTIVE COMMITTEE Direct communication to all clinical nursing

New CNO Advisory Cabinet

Professional governance is the voice of frontline nurses, empowering them to use their clinical knowledge and expertise to identify opportunities for improvement and to coordinate initiatives to address those topics head-on. The individual councils and committees making up the Excela Health Nursing Professional Governance Structure implement measures or take action to achieve measurable outcomes on a variety of topics. In evaluating the efﬁcacy of professional governance at Excela Health, it was noted that while the individual groups tackled various projects, the key opportunity was to strengthen communication among the individual councils and committees.

In response, the CNO Advisory Cabinet was launched. The chairs (and facilitators) of each of the ﬁve councils convene every six months providing updates on the work underway in each of their individual councils as well as the efforts of the associated committees. Additionally, they advise the CNO and other Excela nurse leaders on issues of importance to frontline nurses and offer recommendations. In the coming months, there are plans to distribute to all nursing staff a Professional Governance Newsletter to communicate the work being done across the Health System. The goal is to elevate shared decision-making at Excela Health to new levels through increased collaboration and communication among professional governance leadership.

Committed to excellence, two key aims for Excela Health Nursing are to:

The NPAP is designed to: • Value all nurses for excellent patient care

2. Increasing the number of RNs earning a specialty certiﬁcation. In an effort to inspire nurses to work toward achieving these aims, the Professional Development Council (PDC), responding to feedback from Excela Health nurses, created and introduced the Excela Health Nursing Professional Advancement Program (NPAP).

• Establish opportunities for nurses to grow professionally through meaningful contributions to their unit/department, hospital, and the System or through community involvement • Increase ﬂexibility in the choice of activities which align the interests and talents of staff with the needs of the organization • Support the Institute of Medicine (IOM) Future of Nursing Report (2010) recommendation for an increased number of nurses with advanced degrees, ensuring that nurses are able to lead critical changes in health care and nursing education, now and in the future

I’m excited for the opportunity to grow professionally ... and to be rewarded for it. I think this is motivating for others as well.

ENVISION

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• Provide opportunities for advanced positions at the bedside that will retain, recognize and compensate clinical staff

EXCELLENCE

The program was created to promote the attainment of outstanding patient and organizational quality outcomes. It deﬁnes the performance standards for four levels of nursing practice and offers a means of providing direct care/bedside clinicians an opportunity to earn ﬁnancial compensation and recognition for professional development while advancing the leadership, art and science of nursing.

• Support new graduate nurses, nurses who are new to Excela Health, and experienced Excela nurses to demonstrate accountability, innovation, and leadership from the bedside

ENCOURAGE

1. Meet standards set forth by the Institute of Medicine (IOM) Future of Nursing Report (2010) that recommend an increase in the number of nurses in the RN workforce holding a BSN degree or higher.

EMPOWER

Professional Development Council Introduces New Nursing Professional Advancement Program

Anna Furnival, MSN, RN, C-EFM, WH Family Additions Maternity

COMPASSION

ENCOURAGE

Customized Nursing Education in Response to Pandemic A customized education program at Excela Health is successfully transitioning into practice nursing graduates in 2020 and 2021 who faced unique challenges due to the pandemic.

• A simulation on standard work, where orientees walk through a typical “day in the life” of a new nurse • Hands-on time for a variety of clinical skill sets • An escape room simulation

COMPASSION

Among the most popular components of the program is the development of a four-hour day of simulation and skills stations.

• Patient education and communication techniques simulation

ENVISION

Nursing educators use the graduate’s learning needs assessment to individualize and guide the new nurse through the orientation process, which includes biweekly meetings and input from a consistent preceptor, clinical director, and educator. This allows special learning needs for each orientee to be communicated throughout the orientation. A strong focus on patient/family engagement, communication skills, SIBR rounds, NKE at the bedside, and white board updates is utilized since graduates missed so much clinical time. And then, additional wrap-around supports are created for the ﬁrst few weeks following the orientation period to complete the transition for new nurses.

Simulation and Skills Stations

EXCELLENCE

“We need to be aware of and responsive to their unique needs since their ﬁnal semester was disrupted by the pandemic and classroom and clinical time became virtual. Exceptional onboarding is more important than ever,” commented Deborah Lewis, DNP, RN, CNE, Senior Educator for Excela Health.

ENCOURAGE

COVID-19 prevented students from participating in traditional hands-on clinical experience. Mindful of this disruption in clinical education, Excela’s Nursing Educators forwarded a learning needs assessment to every new grad offered a job at Excela Health. They then worked with nursing leaders and preceptors to develop a customized curriculum based on individual needs identiﬁed as a result of the assessments.

EMPOWER

Support for New Nursing Graduates

Nurse Residency Programs More Important than Ever New nurse residency programs help bridge the existing gap between academic preparation and professional role expectations. They impact retention, job satisfaction and clinical performance acclamation into the organizational structure. Robust nurse residency programs can go a long way in alleviating some of the “reality shock” new nurses experience. Newly licensed nurses in 2021 entered environments burdened by chronic stress related to a critical nursing stafﬁng crisis coupled with the global pandemic. Additionally, often their school clinical experience was truncated due to COVID-19 restrictions.

The Excela Health Nurse Residency program is evolving constantly to meet the speciﬁc needs of each cohort of new nurses joining the Excela Health team. The foundation of the program is structured around key competencies including patient-centered care, communication and teamwork, evidence-based practice, quality improvement, informatics, and patient safety, as well as elements of the Quality and Safety Education for Nurses (QSEN, 2010) and The National Council of State Boards of Nursing’s Transition to Practice Model.

Newly added components in 2021 include: • Trauma Informed Care • Nearly one-in-six persons have experienced four or more traumatic events that increases their risk of numerous adverse health outcomes, including cancers, cardiovascular disease, and depression. • This training aims to increase the effectiveness of interventions with patients and decrease the risk of burnout and secondary trauma for staff. • Nurse Residency Simulation Session Changes • AIDET Communication • Critical Thinking Escape Room (based on quality core measures of sepsis) • Multi-Patient Standard Work • Open Discussion

• Charge Nurse Communication Strategies: TeamSTEPPS • Seven Steps for Having Difficult Conversations • Team Building Strategies • Nursing Professional Advancement Program (NPAP) • Voluntary professional development program for registered nurses who deliver patient care. • Defines the performance standards for four levels of nursing practice and offers a means of providing direct care/bedside clinicians an opportunity for financial compensation and acknowledgment for professional development while advancing the leadership, art and science of nursing.

• Charge Nurse Leadership • Over 45% of new graduates enter the role of charge nurse in the ﬁrst year of employment

• Wellness Resources • Opportunities for social networking

• Charge Nurse Leadership Styles

• Excela-based peer support program Caring 4 You

• Standard Work

• Washington EAP Services

Trey Carr, RN, Latrobe Hospital Emergency Department From being a housekeeper, to a technical partner, then a nursing student, and now a registered nurse, the Nurse Residency Program helped make the transition seamless and comfortable.

A major shout out and “thank you” to my nursing preceptor, the educators, and the Nurse Residency Program team for my early success as a new nurse.

Tyler Miller, Frick Hospital, PCU

The Program has shown me we are a jack-of-all-trades. We are the shoulder that family's cry on, and the hand shake while they are walking out the door. The Nurse Residency Program has given me opportunities for research and innovation. It empowers me to help facilitate a response to our patients needs with the backing of research and evidence-based practice. It allows me and my colleagues to be able to make a difference for not only Frick hospital but for the whole Excela Health community.

I am thankful for the opportunities, support, and encouragement that the Nurse Residency Program has provided me. This program is operated by an exceptional team of nurse educators who strive to provide nurses a variety of opportunities. This program assisted me in ﬁnding my place within the system and nursing ﬁeld. The Operating Room is where I was meant to be. If it was not for the Nurse Residency program, I would not have had the courage to take a chance in a new nursing unit within Excela Health.

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I owe my preceptors and educators the most heartfelt “thank you” for their patience and guidance to become the nurse I am today. I have grown into a nurse I am proud of and know that with the assistance of Excela Health’s educators and preceptor programs, I will continue to improve my nursing practice I will always remember and cherish the encouragement that led me to where I am now and the support to strive for future goals within the system.

COMPASSION

From the ﬁrst day working at Excela, they coordinated education to prepare us new nurses…they offered opportunities to practice skills and discuss the nursing practice.

ENVISION

Kylie Luke, BSN, RN, Latrobe Hospital Operating Room

EXCELLENCE

The Nurse Residency Program here at Excela Health has allowed me to see the bigger picture of being a nurse. A nurse just isn’t someone who gives medicine, or takes someone’s blood pressure.

ENCOURAGE

This program equips the nursing workforce with a strong foundation to become critical thinkers, ambitious leaders, and lifelong learners within the healthcare setting and community.

EMPOWER

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Nurse Residency Voices

Emphasis on Well-Being Blessing of the Hands Ceremony The Nursing Retention and Recognition Committee facilitated a “Blessing of the Hands” ceremony at each hospital campus to kick off National Nurses Week. Earl Gardner, D.Ed., MSN, RN, CCRN, Nurse Educator and ordained minister, along with the Reverend Jeffrey Wylie ofﬁciated the ceremonies, designed to recognize the work Excela staff members have done during the pandemic to care for and comfort the ill.

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The event was open to all Excela Health staff and as each participant approached one of the ministers, the following blessing was shared:

Through this pandemic, you have had the strength and the courage to carry out your duties with care, concern, compassion and commitment. May the work of your hands bring healing to every life that you touch.

Luminaries honoring the personal and community losses during the pandemic shined in the hallways during the ceremonies, representing the lamp Florence Nightingale carried as she worked her way through the battleﬁelds of the Crimean War caring for fallen soldiers. These ceremonies were a wonderful step in facilitating the healing process for staff, who like Nightingale, have battled heroically in the war against COVID-19. The response was so positive that there are plans to conduct this event annually.

EMPOWER ENCOURAGE EXCELLENCE

The Art of Team Building

“Our team has to be very adaptable and ﬂexible. We have limited services and resources but that does not limit the care we give to our patients. We sometimes need to think out of the box and value what each team member has to offer. This helps build trust, respect and appreciation for each other.” Kim Miller, BSN, RN, Clinical Nurse Coordinator, Progressive Care Unit Frick Hospital

COMPASSION

Extended periods of chronic stress related to crisis stafﬁng and surging COVID-19 prompted nursing teams to uncover strategies to reinforce the troops. Wellness and resilience became the focus of national discussion. At Frick Hospital, nursing teams on both the 3rd ﬂoor and in the Emergency Department brainstormed ways to help reset and reconnect their teams.

Nurses from both areas engaged in several opportunities at work to celebrate teamwork and they also joined together outside the hospital for a night of “artful” team building, laughter and comradery.

ENVISION

A strong sense of community on nursing units is critical because how well a group of nurses communicate, respect and understand each other ultimately affects patient outcomes, care coordination and turnover. In 2021, nurses faced unprecedented challenges and, in many scenarios, the most valuable resource available… the glue that held everything together… was the team.

EXCELLENCE

This expansion gives Excela Health the ability to provide progressive procedures such as the WATCHMAN implant to reduce the risk of stroke

Amanda Urosek, BSN, RN, CVBC As patients present to the hospital for a cardiac procedure, the Clinical Specialty Coordinators Wendy Shaffer, BSN, RN and Beth Dell, RN, RCIS, lead the care teams that prepare the patient from arrival, through the procedure, and into recovery. The team of valued nurse practitioners contribute to various aspects of patient care throughout the Heart, Lung and Vascular Institute in both inpatient and outpatient settings.

HEART, LUNG & VASCULAR INSTITUTE

COMPASSION

“(They) are the glue that holds everything together,” remarks Addis.

“

Patients prefer to receive their care in the community hospital where they don’t feel like a number.

ENVISION

One exciting component to the expanded cardiovascular service line is the newly designed Hybrid Cath Lab that began offering two complex procedures and added Structural Heart Nurse Navigators, Amanda Urosek, BSN, RN, CVBC and Joni Powell, MSN, RN. Those individuals guide and support patients during every step of their care before, during, and after their procedure. Urosek and Powell help to curate the relationship between patients, physicians, and the interdisciplinary team, helping patients to build trust, especially when disease progression calls for more complex treatments.

EXCELLENCE

Denise Addis, MSN, RN, CPHQ, Vice President, Cardiovascular Service Line; Jessica Stack, MSN, RN, Director, Cardiovascular Services and Interventional Radiology; and Melissa Kinneer, BSN, RN, Supervisor, Non-Invasive Cardiology, lead nursing care across the continuum of cardiovascular care.

in patients with atrial fibrillation (AFib) and transcatheter aortic valve replacement (TAVR), a minimally invasive procedure to replace a narrowed aortic valve. Now, patients who previously would have been referred for these procedures outside the Health System to hospitals in Pittsburgh, some 45 miles away, are able to receive quality care closer to home, thus reducing additional difficulties for patients with atrial fibrillation or aortic stenosis who are at a higher risk for a cardiovascular event.

ENCOURAGE

When Excela Health Westmoreland Hospital opened its newly established Heart, Lung and Vascular Institute in September 2021, the role of nursing was vitally important to the success of the program.

EMPOWER

Nurses Play Key Role at New Heart, Lung and Vascular Institute

Analytics Team Commitment to Quality Another facet of nursing within the Heart, Lung and Vascular Institute is the role of the Quality Analytics team. Carrie Horner, MSN, RN, CPHQ, Manager, Quality Analytics/VBP and her team of RN quality experts help drive excellence through patient outcomes data. Micaela Hough, RN, Quality Abstractor, enters data extracted from patient records into a variety of professional registries that focus on key metrics related to speciﬁc topics, such as heart failure, myocardial infarctions, and vascular and cardiothoracic surgeries. These registries analyze the data and compare EH patient outcomes with those reported by other national organizations. The ability to compare internal data trends with national benchmarks is an excellent way to identify opportunities for improvement as well as system strengths, including EH cardiothoracic surgery patients who experienced fewer post-surgical complications as compared to national averages. Bridget Rafferty-Himler, BSN, RN, CCRN, Coordinator, Quality Analytics, validates and analyzes the data to help identify trends and communicates ﬁndings with clinical teams. Rafferty-Himler shared that the acute-care or critical-care bedside experience that nurses on the quality team have often affords them the opportunity to examine the outcomes and identify nuances of the treatment or medication regime that can lead to improving patient outcomes. “My job is wonderful,” Rafferty-Himler comments. “I can use my bedside experience to add perspective to analyzing the patient outcomes data. My experience in caring for patients as they prepare to go home after a procedure or come to terms with the disease process, combined with reviewing the outcomes data, allows me to see where we can make suggestions for improvement within the institute and Health System.”

Robin Weyandt, BSN, RN, CCRN, Quality Specialist oversees all aspects of quality for procedures performed in the Cath Lab. She works closely with physicians and other care-team members to explore speciﬁc opportunities for improvement based on the patient outcomes data collected, reported and analyzed by the quality team. Weyandt recently completed a project where she worked with Abbott, cardiologists and clinical informatics to create a robust power plan for the Impella left ventricular assistive device, which she lauds as a life saver.

“

It’s amazing to realize how many pieces of the puzzle contribute to the success of the team. Without one piece, it doesn’t work as it’s not complete, I really enjoy seeing how we are evolving. - Robin Weyandt, BSN, RN, CCRN

EMPOWER ENCOURAGE Excela Health opened the Heart Failure Clinic in 2021 as a support for patients who are diagnosed with systolic or diastolic heart failure. Jennifer Barrick, MSN, RN, NE-BC, Nurse Navigator shares that the opportunity to be a part of this new clinic from its inception has been extremely rewarding. Barrick and the team, consisting of cardiology providers, pharmacy, and a nurse practitioner, Chantal Trice, CRNP, have seen remarkable growth in recent months.

EXCELLENCE

New Heart Failure Clinic Offers Much Needed Support

The clinic is yet another support Excela Health offers to patients as part of the Heart, Lung and Vascular Institute, according to Barrick. And the goal is to prevent hospitalizations and Emergency Department visits through education and medication management.

“We encourage them to do daily weights, adhere to a low sodium diet, ﬂuid management, and maintain a balance between activity and rest,” said Barrick. “We teach them to recognize signs and symptoms of heart failure and encourage them to contact us early if they get in trouble so we can make recommendations.”

Barrick shared that the team has developed relationships with patients and families as well as with providers across the inpatient and outpatient teams, which has contributed to the success of the program. The team also engages on community outreach efforts to provide education on how to prevent heart failure.

COMPASSION

Patients receive follow- up phone calls from Barrick at 24 and 48 hours post discharge as well as 10 and 30 days later. She states that the purposeful outreach has proven beneﬁcial in preventing both Emergency Department visits and hospital admissions or readmissions.

ENVISION

Barrick assists patients referred to the program, often beginning during a hospitalization, to navigate the continuum of healthcare services and offers support upon discharge. She and the team offer personalized assistance with medication management and recommend lifestyle changes to support heart health.

New Surgical Institute Opens Doors of Opportunity Excela Health demonstrated the continued commitment to excellence by opening a new Surgical Institute at Latrobe Hospital in the fall of 2021 specializing in thoracic surgery. Monica Krinock, BSN, RN, Clinical Nurse Coordinator for the program, played a key role in collaborating with the unit’s lead surgeons, the program’s outpatient clinic and various departments throughout the Health System to map out an efﬁcient workﬂow for patient care, specialty equipment and supplies, as well as comprehensive education for patients, families and staff. Planning began months prior to the unit’s opening. Krinock met with the staff on unit 2D/E at Westmoreland Hospital, where these patients had previously been admitted postoperatively as well as with Drs. Szwerc and Lace to determine expectations for the physical layout and daily schedule. Details like generous showers on the unit, a mobile thoracic cart containing preferred equipment to insert chest tubes designed to be a time saver for staff and stocking particular items

that patients need upon discharge to empty their chest tubes were addressed early in the planning process. The standard was set at Dr. Szwec’s request, that patients presenting to the unit from surgery walk from the surgical cart straight to a recliner in the room. Early ambulation for the patients on the unit was identiﬁed as a priority. Krinock shared that they were able to evaluate what worked well and opportunities for improvement. For instance, in order to avoid discharge delays, they arranged for 4:30 a.m. chest x-rays as a standard procedure. The early schedule allowed the results to be analyzed during morning rounding where treatment recommendations could be made using the most recent test results and allowing discharge planning to proceed without delay. Additionally, Krinock worked to adjust the day certain surgeries are performed to alleviate the need for patients to be transferred to another unit over the weekend when this unit is typically closed. Krinock worked with Educators to create comprehensive training for nursing teams, students, technical partners, patient transport staff and others. The education covered a vast array of topics, including the surgical procedures many of the patients would be receiving as well as comprehensive training on the care of chest tubes. The education was made available to all EH nursing teams. Krinock shared that the experience has been extremely rewarding.

“

It has been wonderful to be a part of this program from the ground up and I know we are making a difference for our patients.

Excela Behavioral Health Nurse Provides Crisis Intervention Team Training for First Responders A person suffering a behavioral heath crisis can pose a threat to themselves and those responding to assist in emergency situations.

ENVISION COMPASSION

Excela Health Westmoreland Hospital and the Behavioral Health staff posthumously honor Miller for her service to her community and her commitment to behavioral health causes.

EXCELLENCE

Heather Miller, MSN, RN, PMH-BC, a Clinical Nursing Coordinator with Excela’s Community Psychiatric Nursing, volunteered her expertise to provide 1.5 hours of training on psychotropic medications and their side effects during the 40-hour in-depth training sessions offered through Westmoreland County Behavioral and Developmental Services and Southwest Crisis Intervention Teams.

Several emergency personnel including Emergency Management Services, Pennsylvania State Police, Park Police, Departmental and Township Police, School Resource Officers, and Correction Officers were able to benefit from the CIT training and Miller’s important information.

ENCOURAGE

Across the nation, Crisis Intervention Team (CIT) training programs are put in place to create connections between law enforcement, ﬁrst responders, behavioral health providers, hospital emergency services and individuals with mental illness and their families to give police and ﬁrst responders the tools to perform their jobs safely and effectively.

Communities that have implemented CIT training have reported signiﬁcant reduction in injuries to police and community members, decreased arrests, increased health referrals, and a dramatic reduction in the need for intensive police interventions. CIT training consists of numerous topics including behavioral health symptoms and diagnoses, suicide prevention, substance abuse services and resources, and de-escalation tactics.

EMPOWER

Spotlight on Behavioral Health

Successful Reduction in Behavioral Health Acute Care 30-Day Readmission Rates The Beacon Select Clinical Department recognized the Behavioral Health (BH) Department at Excela Health for successfully decreasing acute-care hospital readmission rates. Beacon Select are provider health partners for the BH Department at Westmoreland Hospital with 55% of clientele covered by Beacon’s insurance. Through identifying the most common causes of recidivism and how to tackle those issues, hospital readmission rates were dramatically reduced in 2021 from 18.74% to 11.95%, earning the Excela Westmoreland Hospital BH Team the Beacon Award for Excellence. In order to ensure success, the Westmoreland team first joined forces with the Pittsburgh Regional Healthcare Initiative and a root-cause analysis was done to identify issues that affected readmission: • Patient unable to fulfill having prescriptions filled • Patient not remembering follow up appointments • Patient experiences difficulty finding transportation to follow up appointments Interventions engaged at Excela to prevent readmissions included: • Follow-up phone calls from nursing or social work to ensure patient appointment compliance and arranging transportation as needed • Meds to Beds Program secured with funding to assist patients with copays • Monthly team meetings regarding high-risk individuals

Chris Kravetsky, MBA, BSN, RN, Clinical Director, Inpatient Behavioral Health and Nursing Home Support; Rachel Jackson, Manager, Outpatient Behavioral Health Services; George Mizikar, Director, Behavioral Health Services; and Donna Harshell, Ofﬁce Supervisor, accepted the honor on behalf of the entire BH team.

According to a 2021 report by the National Pressure Injury Advisory Panel (NPIAP), in the Unites States:

EMPOWER

Nurse Driven Protocols to Decrease Hospital Acquired Pressure Injuries (HAPI) • There are 2.5 million cases of hospital acquired pressure injuries (HAPI) each year

• HAPI account for 25% of all “wasteful spending” related to failures in healthcare delivery, according to U.S. CMS Director’s Ofﬁce and $26 Billion in acute costs Patient safety is a strategic priority at Excela Health and nursing teams in all hospital nursing units track the incidence of HAPI for patients under their care.

Internal Wound Care Nurse Drives HAPI Prevention Protocol

Johnson piloted the Pressure Injury Prevention Protocol on unit 4AB with all patients aged 65 years and older who were admitted with a diagnosis of hip fracture (speciﬁc ICD 9 codes identiﬁed). Interventions included the following preventative measures:

Considering the successful results of the project, Johnson presented the protocol to the Excela Health Orthopedic Group, a team of orthopedic providers, to propose that the HAPI Prevention Protocol be approved as a nurse driven protocol not requiring a physician signature. The protocol was approved and with the help of Nursing Informatics, in July of 2021, the protocol went live in the electronic medical record for all three hospitals across the Health System.

COMPASSION

Johnson compared the incidence of HAPI six months following the implementation of the protocol with the same six months in the previous calendar year. The data analysis revealed that the project successfully decreased the incidence of HAPI in patients meeting criteria from 21.4% (6 of 28 admissions) to 2.8% (1 of 35 admissions).

ENVISION

• Application of a Mepilex border foam dressing to the sacrum and bilateral heels on admission • Air mattress attached to bed frame on admission • Reminders to turn and position patients every two hours • Elevate heels off bed at all times • Consult Wound Care Nurse for each patient meeting the criteria • Consult Nutritionist

EXCELLENCE

Abby Johnson, BSN, RN, CWON, Inpatient Wound Care, noted an uptick in the number of patients admitted to inpatient units with a primary diagnosis of hip fracture. Upon reviewing the data and recent literature, she worked with nurse educators and nurses on unit 4AB at Westmoreland Hospital to initiate a quality improvement project and revised protocol with several preventative measures to decrease the incidence of HAPI in this speciﬁc patient population.

ENCOURAGE

• HAPI contribute to 60,000 deaths per year and are the 8th most frequent cause of death based on CDC reporting

Clinical Nurse Coordinators Introduce Skin Assessment Tool Effective in Decreasing Hospital Acquired Pressure Injuries (HAPI) The nursing team on unit 3AB at Westmoreland Hospital routinely reviews nurse sensitive clinical indicator data and noted an opportunity to decrease the incidence of Hospital Acquired Pressure Injuries (HAPI). After discussion at the Unit Based Council, Clinical Nurse Coordinators Sarah Guzik, BSN, RN and Rebecca Zolocsik, BSN, RN proposed the implementation of a skin assessment tool consisting of a diagram of a human body from both posterior and anterior points of view.

In the ﬁrst two quarters of 2021, there were a total of 23 reported HAPI on unit 3AB. After the introduction of the Skin Assessment Tool, the number of HAPI for patients hospitalized on unit 3AB decreased to four in the last two quarters of 2021. Internal audits revealed that at least one of the HAPI recorded post intervention was on a patient for whom the skin assessment tool was not utilized.

They proposed that the tool or “body sheet” be completed as part of the initial skin assessment on each patient as they are admitted or transferred to the unit. The initial skin assessment is conducted by two persons, either two nurses (RN or LPN) or one RN/LPN and a technical partner. In addition, a laminated copy of the “body sheet” is hung on each patient’s white board in their room. The tool effectively communicates the patient’s skin integrity status with members of the interdisciplinary team, calling attention to areas of concern. The tool hanging in the patient room also serves as a reminder to turn and position patients and to keep in mind all skin care and HAPI prevention techniques.

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Guzik and Zolocsik also initiated internal audits to assure that the tool is being used consistently and effectively.

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EMPOWER

ENCOURAGE EXCELLENCE

ENVISION

ENVISON

COMPASSION

Creative New Pathways to Meet Evolving Demands In 2021, Excela Health nurses were instrumental in adjusting workﬂows, expanding schedules, leading interdisciplinary opportunities to map new and creative pathways to meet the needs of the community and the Health System.

High Demand for Monoclonal Antibody Treatments As COVID-19 continued to spread, the demand for monoclonal antibody infusions grew dramatically, bringing staff together to overcome the challenges with the goal of preventing disease progression and hospitalization for high risk individuals. Monoclonal antibody infusion treatments mimic the body’s natural antibodies designed to enhance the ability to ﬁght infection and offered encouraging results in decreasing hospitalization rates and preventing serious infection and death for non-hospitalized individuals diagnosed with mild to moderate COVID-19 deemed at high risk of becoming seriously ill based on speciﬁc risk factors. Each person tested for COVID-19 through Excela Health was screened for eligibility and those meeting selection criteria were contacted by Leah Fontana, PA-C, with the opportunity to schedule an infusion.

Perioperative staff, led by Karen Soltez, MSN, RN, Director, Perioperative Services, accepted responsibility for coordinating the infusions. The Short Procedure Unit (SPU) at Frick Hospital was chosen as the initial location for monoclonal antibody infusions for the health system. Soltez and her team collaborated with various departments to design a safe workflow and made recommendations for alterations to the physical site to accommodate COVID positive members of the community presenting to the busy Frick SPU to receive a monoclonal antibody infusion. In order to meet the increased staffing demand, perioperative staff from Frick Hospital, Excela Square Norwin, and Laurel Surgical Center were cross-trained to administer the infusions at Frick Hospital and schedules were expanded to accommodate the growing demand. Eventually monoclonal antibody infusions were moved to a larger space within Frick Hospital to allow for a greater number of patients to receive the infusions safely and efficiently.

• PACU and Heart Center staff extended their schedules to stay later into the evening to accommodate recovering patients, which in many cases, offered sufﬁcient support to allow the procedure to occur while avoiding an inpatient admission.

ENVISION

• PACU and Heart Center staff were willing to care for select patients overnight in their areas, when clinically appropriate, allowing surgeries to take place while diverting inpatient admissions when the inpatient census was too high to accommodate post-surgical patients.

EXCELLENCE

• Surgical schedules were amended to perform select procedures, such as hysterectomies, earlier in the morning thus allowing sufﬁcient time postoperatively for monitoring and care throughout the day. This schedule change, in most cases resulted in the ability for the patient to be discharged home that same day, where previously, these patients would have been admitted to the hospital overnight.

ENCOURAGE

Due to extraordinarily high patient volumes and the stafﬁng crisis throughout the pandemic, elective surgeries requiring a hospital admission were often canceled or postponed. Excela nurses across the Health System initiated various adaptations to allow surgical procedures to take place, if at all possible, by overcoming the need for an inpatient admission.

EMPOWER

Changes in Workﬂow and Expanding RN Schedules Promote Increased Number of Patients Receiving Surgical Procedures

COMPASSION

PACU Nurses Lead Interdisciplinary Approach Allowing Select Orthopedic Procedures to be Performed as Same Day Surgeries As the months of 2021 progressed, elective surgeries requiring hospitalization following the procedure continued to be postponed. In the summer of 2021, perioperative nurses worked with various inpatient and outpatient teams to create a protocol to provide sufficient support for patients undergoing total knee replacements and minimally invasive hip surgeries to allow them to be safely discharged home on the same day as the procedure thus avoiding a 2 or 3- day hospital stay as was traditionally the standard. While not all patients were candidates for discharge the day of surgery, perianesthesia staff worked with physicians and orthopedic office staff to identify potential candidates and those individuals were screened for eligibility and provided education on the revised process. On the day of surgery, these cases were performed first thing in the morning utilizing a modified anesthesia regimen and held in the recovery room for a prolonged period of time for sufficient observation for any potential bleeding or anesthesia related complications. Karin Yesho, BSN, RN, Supervisor, Perianesthesia, Latrobe Hospital, shared, “thought processes completely changed to get patients what they needed. It took everyone working together to make this happen.”

Throughout their recovery, arrangements were made to feed these patients in the PACU and when they were feeling well enough, they met with PT and OT teams to assess their progress and ability to get dressed, ambulate and get into a vehicle for discharge. Outpatient pharmacy coordinated fulfilling prescriptions. If at any point in the nursing or therapy assessments the patient was deemed not ready for discharge, steps were taken to admit the patient to the hospital. In October of 2021, the new protocol went live and during that month there were 17 patients with hip or knee surgery identified as candidates for discharge on the same day as their surgery. Fifteen of the seventeen, or 87% of the patients were successfully discharged home with no readmissions within 30 days. Yvonne Hunter, BSN, RN, Manager, Perioperative Services, shared that the team was motivated to find ways to allow patients suffering from knee or hip pain to receive the treatment aimed at providing increased comfort and mobility. “We found ourselves doing things we’ve never done before and it’s working”, remarked Hunter.

Spotlight on Weekend Night Shift Home Care and Hospice Clinicians

The clinicians who cover the night shift in home care and hospice are not only challenged by an unconventional schedule, though. They shoulder remarkable responsibilities. They are on call for approximately 1,000 patients in several counties, with some patients residing up to an hour away in good weather, yet alone in a blizzard or ice storm.

In these times, “I know I made a difference in someone’s life and even though it’s not always an emergency, to them it provides a sense of relief,” said Burkholder. “My job is to be available so our patients know they are not alone.”

COMPASSION

Both Miller and Burkholder share that they enjoy the challenge that this level of autonomy provides. “There is always a supervisor available for us to call, but for the most part it’s me in my car on the road to whoever needs me”, Miller said. Whether it is a wound vac machine or an IV pump beeping, a clogged catheter causing pain and discomfort, or a hospice patient who is in pain they can’t bear, these clinicians are available to help. “I’m the last chance IV person,”

Miller and Burkholder shared that the emotional support that they are able to offer is often times the most rewarding aspect of the job. Whether a family member comes home and ﬁnds a loved one has passed and they don’t know what to do, a child or infant is receiving hospice care and the parents are struggling, or someone simply forgot to tell the treatment team something and wants to tell someone so they don’t forget, they are there to help.

ENVISION

They are called to care for patients ranging from infancy through old age in both home care and hospice programs and thus must be prepared to lend their expertise in a variety of specialty areas to meet the vast and varying needs of the entire home care and hospice caseload.

“At 2 or 3 in the morning, the people who are calling really need you,” said Miller. “They call crying and some might have family there with them but for others, you’re it.” Miller went on to say that “sometimes I don’t even feel like I did anything special, but they are so grateful to have someone to call.” Miller shared that sometimes “you’re their only hope” to get through the night and at the end of the phone call or visit patients or families share their appreciation, citing that now they can sleep.

EXCELLENCE

“This can be the job that no one else wants”, Miller chuckled. He shared that for many, being available every Saturday night holds little appeal; however, for him it afforded the opportunity to be available for his young son.

Burkholder stated. “If I can’t get the IV inserted, they have to go to the hospital.”

ENCOURAGE

For anyone who has ever cared for an ailing loved one, it comes as no surprise that some of the most overwhelming moments occur outside of ofﬁce hours on the weekend or in the dark of night. In those moments, having someone to reach out to can mean so very much to patients and those caring for them. For Randy Miller, RN and Charles Burkholder, RN, working the night shift, including weekend nights, creates work-life balance. For those they care for, they provide a service that is immeasurable in value.

EMPOWER

In the Spotlight

COMPASSION

Excela Health nurses consistently evidence a passion for delivering socially-sensitive care both in the hospital setting as well as in the community.

Homelessness is a complicating factor in healthcare, where some diseases contribute to homelessness, others are a result of homelessness, and many diseases are complicated by the effects of homelessness itself. Diseases such as diabetes are nearly impossible to treat without access to regular meals, refrigerators for storing vital medications, and a safe place for syringes/needles is nonexistent. Excela Health Frick Hospital services many communities in its southern neighbor, Fayette County, which has a poverty rate of 18.8%, and a consistent homeless population.

Patterson, like many other Excela Health employees, values the ability to share her time and talents in local community programs. After joining Hands of Hope, she identiﬁed the need in the homeless population for more than just meals on the weekends and brainstormed how she could maximize her volunteer experience with her nursing education and expertise.

First-aid care packages included: • Hard candies

• Triple antibiotic ointment

• Hand warmers

• Acetaminophen

• Hand sanitizer/sanitizer wipes

• Ibuprofen

• Snacks

• Hydrocortisone cream

(chips, pretzels, crackers,

• Lip moisturizer

fruit gummies)

The PCU staff and the Hands of Hope organization have formed a lasting relationship and their efforts continue to support the Hands of Hope mission seasonally with hundreds of baskets and hours of education.

COMPASSION

• Band-aids

ENVISION

Patterson was joined by Frick Hospital Director of Patient Care Services, Brandi Hall, MSN, RN, NE-BC and together they expanded the volunteer opportunity to their peers on the Progressive Care Unit (PCU), forming a group of volunteers to create and distribute ﬁrst-aid themed care packages to the homeless community and using the care packages to educate the population on promotion of healthy hygiene practices and simple wound care.

EXCELLENCE

In an effort to impact the community that Excela Health serves, as well as align efforts with the overarching goals of Healthy People 2020 to prevent disease, achieve health equity, and promote quality of life and healthy behaviors, clinical nurse Charity Patterson, BSN RN-BC formed a relationship with Hands of Hope: Help Feeding the Homeless in Uniontown, Fayette County.

ENCOURAGE

Hands of Hope: Volunteer Support for Community Outreach Beneﬁting Local Homeless Population

EMPOWER

Socially-Sensitive Care for the Homeless and Marginalized

Teams Rally Around Patient Experiencing Homelessness to Eliminate Barriers to Receiving Necessary Surgery While nurses at Frick Hospital worked to provide first aide kits to homeless individuals in Fayette County, nurses at Latrobe Hospital advocated to assure that a patient experiencing homelessness was able to receive a necessary surgery. • While working to assure that all pre-procedural requirements were met for a patient recommended for surgery, PAT (Pre-Admission Testing) staff uncovered that one particular patient was currently homeless and living in her car. • Current guidelines recommend that patients having outpatient surgery refrain from driving for 24 hours following surgery and that they leave the facility accompanied by a responsible adult for the first 24 hours to assist with any potential complications. • While the patient was willing to accept the possibility of not being eligible for surgery due to her current social circumstances, the nursing staff was determined to find a solution to each presenting challenge. • In order to assure that this patient could indeed have her surgery and remain safe post discharge, perianesthesia staff at Latrobe Hospital worked with staff in a variety of departments, including the outpatient physician’s office, inpatient case management, legal, and nursing administration. • Seventeen phone calls later, the patient had a plan for discharge customized to her unique situation thanks to Excela Health staff who refused to allow her lack of resources to prevent her from accessing healthcare. “It takes a village to get patients the care they need,” shared Karin Yesho, BSN, RN, Supervisor, Perianesthesia, Latrobe Hospital.

• In 2019, 10% of Westmoreland County residents lived at or below the poverty level (Data USA) • In 2020, 13,375 Pennsylvanians experienced homelessness on any given day (Continuums of Care to the U.S. Department of Housing and Urban Development (HUD) • Addressing the medical issues of individuals who are homeless is a serious health equity challenge • Those experiencing homelessness face many barriers to accessing health care and complying with health care directives, such as taking prescribed medications, obtaining diagnostic testing and surgical/procedural interventions (American Public Health Association). • People who are homeless die, on average, 17 years earlier than those who are housed (American Public Health Association).

In 2014, the Nursing Professional Development Council (PDC) chose to support the Excela Health mission “to improve the health and well-being of every life we touch”, by focusing on improving food access for vulnerable school-aged children.

The “Backpack Program” was a success and would continue in years to come.

COMPASSION

In the 2017 school year, Excela Health nurses purchased a cabinet and ﬁlled it with bulk food items monthly, which students and parents utilize on a regular basis on site at the school. The project has evolved from the “Back Pack Project” into the “Caring Cabinet” and continued its mission in the 2021 school year.

In October of 2021. PDC chair Nicole Komenda, DNP, RN, PHRN, CEN, Emergency Department, Frick Hospital presented the Caring Cabinet Project at the 12th annual McGinley-Rice Symposium on Justice for Vulnerable Populations sponsored by Duquesne University School of Nursing.

ENVISION

During a 39- week period in the 2015 school year, Excela Health nurses delivered approximately 100 bags of food and logged 900 hours of volunteer time. The PDC has continued the project annually and has delivered thousands of dollars of donated food and supplies.

In addition to reassessing the needs of local communities, the PDC evaluated and reinforced program logistics to align with COVID restrictions. Despite challenges related to crisis stafﬁng and the COVID-19 pandemic, nurses and healthcare staff in nursing units across Excela Health never failed to collect food and supplies and deliver them on a monthly basis to the Jeannette School District for distribution.

EXCELLENCE

In the 2014 school year, nursing units collected two bags of food/week, for a total of 400 bags of donated food. On a weekly basis, nurses packed 100 backpacks with food and delivered them to the Jeannette school district for distribution.

The data search conﬁrmed that the children and families in the Jeannette School District continued to display the greatest risk for food insecurity.

ENCOURAGE

Research revealed that residents in the city of Jeannette had the highest poverty level in Westmoreland County (18.2% poverty rate, median household income of $33,000). Therefore, the PDC collaborated with the Jeannette School District’s school nurse and principal, investigated food banks, and secured donations of backpacks that could be ﬁlled with food and supplies.

To ensure that the donated supplies were still meeting the families in Westmoreland county who were most in need of support, in 2021 the PDC examined data from a variety of local resources ranking economic need of local communities.

EMPOWER

Long-Standing Commitment to Improving Food Access for Local School-Aged Children

Compassionate Care Inspires Positive Patient and Family Experience Excela Health received initial Magnet designation in 2019 by providing evidence to support standards of nursing excellence. But perhaps what “wowed” the Magnet appraisers most was the very evident culture of compassion fostered and maintained by our staff.

A Wedding On April 8, 2021, staff on unit 4 Surgical at Latrobe Hospital received a call requesting special visitation privileges for a pastor who planned to perform a wedding ceremony involving a patient on the unit later that same day. The team jumped into action to create a wedding environment complete with cake, decorations, crystal lite “champagne”, ﬂutes on a shiny platter, ﬂowers, balloons, the wedding march music, and a wheelchair-ready “Just Married” sign. Physicians, Unit Directors, Nursing Supervisors, Unit Clerks, Administrate Assistants, Therapists, Transport Team members, Nurses, Technical Partners, and other members of the hospital staff offered support as Pastor Lola performed a touching ceremony for the couple. The couple shared their sincere and heartfelt gratitude for the warmth they felt from everyone around them. The groom even called one of the technical partners into his room to ask him to be his ring bearer. The couple voiced plans to repeat the ceremony later in the year and heartfelt appreciation to staff for working a little Excela magic to pull together the special day.

EMPOWER ENCOURAGE Courtney Kubovcik, MSW, Social Worker, 3AB WH, approached Megan Shearer, MSN, RN, NE-BC, Clinical Director, 3AB WH, with the notion to do something special for a patient and his wife as it was their 37th wedding anniversary and they had faced an array of difﬁcult challenges thus far in 2021. The patient was dependent on a tracheostomy and tube feedings, but the team contacted Food and Nutrition Services to request a special lunch and dessert for the patient’s wife. The entire team signed a card with congratulatory sentiments.

“

Our wonderful medical and support staff don’t get the credit they deserve. They sure did make my day with their thoughtfulness!! Thank you all so much again!!

COMPASSION

I just want to thank the staff at Westmoreland Hospital. My husband was in a horriﬁc accident a year and a half ago and had been in and out of hospitals and nursing facilities since then. Unfortunately, my husband is in the hospital again today on our 37th wedding anniversary. The staff all signed an anniversary card for us and also brought me lunch!

ENVISION

The patient’s wife shared emotionally that she was extremely hungry and that this meal was exactly what she needed. She later expressed on social media her appreciation for the efforts the team took to extend their care beyond her husband’s clinical needs to be thoughtful of her as well.

EXCELLENCE

An Anniversary

Emotional Support for Isolated Patients For the many hospitalized in 2021 with COVID-19, beyond the challenges resulting from the disease process and the need for hospitalization, patients often suffered emotionally due to limited social interactions brought on by the need for isolation. Infection prevention precautions often increased the prevalence of fear, loneliness and anxiety in patients, which often resulted in the frequent and often demanding use of patient call bells. Nursing staff, on the other hand, faced crisis staffing for weeks and months on end and a level of patient acuity higher than usual. The two conditions were a recipe for frustration. At Frick Hospital, staff consistently managed to find creative ways to support isolated patients despite heavier than usual patient assignments and consistently working short staffed. Charity Patterson, BSN, RN-BC, Frick Hospital PCU, shared that throughout the pandemic it has been a challenge to find time to do any of the little extra things that make such a difference to patients, especially for those in isolation. Patterson shared that “most often caring for basic needs—combed hair, clean faces and teeth and simple conversation seems to matter to many patients much more than even their medication.” She shared that many times the satisfaction patients feel with just a few minutes and a personal touch can go a long way toward a smoother day. While nurses across the world struggled to overcome mountainous challenges, the kindness and compassion Excela Health nurses displayed throughout the difficult days of 2021 did not go unappreciated as evidenced by this patient’s note of gratitude.

“

As a result of having COVID, I was admitted to Frick Hospital. I spent my time there in isolation on the 3rd ﬂoor. I was there for 3 weeks. The entire staff made my stay extremely pleasant. Not only did they care for my medical needs but treated me as a person who needed encouragement as they worked to heal me of my pneumonia. All the staff stayed and talked to me and made me feel as comfortable as possible. I give them all a 10 out of 10. I could say more but don’t have the words to express it.

The article relates that: • Opioid use/abuse among adults and pregnant women has increased dramatically over the last decade

• 50% to 90% of infants exposed to opioids during pregnancy will develop neonatal abstinence disorder (NAS) after birth • Infants with NAS are more likely to suffer low birthweight, prematurity, feeding difﬁculties, and respiratory distress

Neonatal Abstinence Syndrome (NAS) is a group of behavioral and physiologic signs and symptoms in the newborn caused by the abrupt withdrawal of various pharmacologic agents following birth.

• Average length of stay decreased signiﬁcantly from 6.5 days prior to the implementation of the new education to 5.1 days after • The project’s ﬁndings suggest that implementing these strategies with new mothers with substance abuse disorders can improve outcomes with infants with NAS

COMPASSION

Lewis worked in conjunction with a student from Waynesburg University and the Excela Health Westmoreland Hospital Family Additions Maternity Team to develop and implement evidence-based education to support mothers of infants with NAS. The education provides clear, consistent information for families about neonatal

• Of the 461 women admitted to the maternity unit at Westmoreland Hospital during the implementation period, 37 tested positive for opioids

ENVISION

• These complications often result in longer hospital stays requiring specialized care, higher costs of hospitalization, and increased demands on professionals who provide care for them

The study results revealed that:

EXCELLENCE

• The number of infants in the US exposed to illicit substances prenatally has increased by 333% over 15 years

opioid withdrawal symptoms and nonpharmacologic interventions designed to reduce its severity. An Excela Health interdisciplinary team developed an education module for neonatal team members about the importance of providing compassionate, non-judgmental care to parents with substance abuse disorders, including elements and principles of trauma-induced care (TIC) to reduce adverse maternal and neonatal health outcomes.

ENCOURAGE

Deb Lewis, DNP, RN, CNE, Senior Educator, collaborated with colleagues to publish work entitled, “Implementing Trauma-Informed Strategies For Mothers of Infants With Neonatal Abstinence Syndrome” in the American Journal of Maternal/Child Nursing July/August 2021 July/August 2021 - Volume 46 - Issue 4 pg. 211-216.

EMPOWER

Excela Nurses Implement Evidence-Based Trauma-Informed Strategies for Mothers of Infants with Neonatal Abstinence Syndrome (NAS)

2021 | Nurses Earning Advanced Degrees BACHELOR’S DEGREE Baker, Tina M.

Nelen, Tessa N.

WH 3AB

Barnicle, Josie M.

WH 3D/3E

Nolan, Samantha M.

WH 4AB

WH INTENSIVE CARE UNIT

Blair, Tanya E.

WH EMERGENCY DEPARTMENT

O'Donnell, Kathleen A.

Borelli, Tyler L.

FH PROGRESSIVE CARE UNIT

Orndorff, McKinley

Bowser, Alicia

WH BEHAVIORAL HEALTH CRISIS CENTER

Palko, Ashley M.

Burns, Carly M.

WH EMERGENCY DEPARTMENT

Patterson, Charity A.

Coppetti, Deanna L. Cribbs, Emma L.

WH CLINICAL RESOURCE MANAGEMENT

WH 2D

WH FAMILY ADDITIONS MATERNITY

Czernatowicz, Jacqueline L.

Ptaszkiewicz, Caprice L.

LH EPIC IP REHAB

LH EMERGENCY DEPARTMENT

Scanlon, Morgan E.

Farkas, Amy S.

WH BEHAVIORAL HEALTH NURSING HOME SUPPORT

Short, Amanda K.

FH EMERGENCY DEPARTMENT

WH BH OUTPATIENT

LH NURSING POOL

Robertson, Bridget M.

Eikenburg, Katie

Garlick, Caylee M.

FH PROGRESSIVE CARE UNIT

Ragan, Elizabeth C.

WH 2D

HH ADMINISTRATION

LH 4S

LH 3NS

LH 2 WEST

Short, Justin T.

WH NURSING ADMINISTRATION

George, Automn G.

WH INTENSIVE CARE UNIT

Stein, Emily

WH FAMILY ADDITIONS MATERNITY

Goehring, Juliene C.

WH NURSING POOL

Stouffer, Brandy

HH SKILLED NURSING

Suter, Andrea

WH INTENSIVE CARE UNIT

Grace, Amy S.

LH NEURO/JOINT WORKS

Halula, Jennie K.

WH FAMILY ADDITIONS MATERNITY

Thomas, Michael G.

Hoffman, Lisa M.

WH 3D/3E

Vomish, Patricia L.

Horner, Hanna K.

WH FAMILY ADDITIONS MATERNITY

White, Tiffany R.

WH STEP DOWN UNIT

Hunter, Yvonne E.

LH PERIOPERATIVE ADMIN

Wirt, James R.

WH INTENSIVE CARE UNIT

Ingalls, Laidyn H.

WH 4D

WH INTERVENTIONAL RADIOLOGY

WH SAFETY SERVICES

Jones, Taylor

LH 4S

MASTER’S DEGREE

Kalp, Alexis T.

LH EMERGENCY DEPARTMENT

Fiore Haines, Pauline M. WH CLINICAL RESOURCE MANAGEMENT

Leasher, Kayla R.

WH STEP DOWN UNIT

Grenda, Lindsay K.

LH INTERVENTIONAL RADIOLOGY

Lovis, Brenda L.

WP BURSCH/SELIP FAM MED-CR

Harvan, Stefanie M.

WH 2AB

Ludwick, Sydney M. Luke, Kylie

WH STEP DOWN UNIT

LH OPERATING ROOM

Manning, Carrie A. FH EMERGENCY DEPARTMENT Martray, Kensi M.

FH NURSING POOL

McClelland, Kaylee A.

LH PERIANESTHESIA

Means, Joy C.

HH SKILLED NURSING

Morrison, Marie

WH EMERGENCY DEPARTMENT

Nadeo, Nichole P.

WH NURSING POOL

Komar, Megan J.

WP ADVANCED PAIN CENTER LATROBE

Miller, Cathleen

LH CLINICAL RESOURCE MANAGEMENT

Porter, Lyndsie T.

LH 3NS

DOCTORAL DEGREE Moffa, Debra S.

WH EDUCATION

Widmann, William M.

WH NURSING INFORMATICS

2021 | DAISY Award Winners DAISY is an acronym for Diseases Attacking the Immune System. The DAISY Foundation was formed in November 1999 by the family of J. Patrick Barnes who died at age 33 of complications of Idiopathic Thrombocytopenic Purpura (ITP) to acknowledge nurses for the work they do for patients and their families every day. • Nurses may be nominated by patients, families, colleagues, physicians and other staff. • Nominees will be judged for their compassionate care, knowledge, teamwork, clinical expertise and professional collaboration.

Individual • Kacie Yokitis, BSN, RN (WH ICU)

• Martha Boyd, RN (LH ED)

• Heather Sundin, BSN, RN (LH ED)

Team • Latrobe Hospital 2 East Hospice Care

Leader • Helen Burns, PhD, RN, NEA-BC, FAAN EH Chief Nursing Ofﬁcer

2021 | Certiﬁed Nurses Accredited Case Manager

Dolan, John C.

CLINICAL RESOURCE MGMT

Adult Gerontology Acute Care Nurse Practitioner

Dodson, Stacey A. Smith, Jerod C. Toth, Chad T.

LH APRN CARDIOLOGY LH APRN

Ambulatory Care Nursing

Bush, Stacey L.

ESL FAMILY MEDICINE

Advanced Oncology Certiﬁed Nurse Practitioner

Paronish, Raymond P.

WH APRN

Certiﬁed Breast Care Nurse

Farina, Sheila M.

WH QUALITY SERVICES

Certiﬁed Childbirth Educator

Patula, Susan K.

WH FAMILY ADDITIONS MATERNITY

Certiﬁed Case Manager

Hodczak, Joyce A. Smith, Stefanie J.

LH CLINICAL RESOURCE MGMT WH CLINICAL RESOURCE MGMT

Acute/Critical Care Nursing

Anderson, Melissa E. Appleby, Madeline B. Arthur, Kahlee Delancey, Michelle C. Gardner III, Earl K. Hutchinson, Kala S. Kimmick, Jamie L. Lubinsky, Brittany L. Matthews, Bridget M. Mough, Ericka C. Radocaj, Kathleen A. Rafferty-Himler, Bridget M. Scanlan, Karen K. Walker, Terry J. Weyandt, Robin D.

FH SST ESN CARD REHAB WH ED WH ICU LH EDUCATION LH GI LH ICU WH ICU WH ICU FH SST WH NURSING ADMINISTRATION WH QUALITY SERVICES WH EDUCATION WH ICU WH HEART CTR

Acute/Critical Care Knowledge Professional

Adams, Joshua

WH QUALITY SERVICES

Electronic Fetal Monitoring

Furnival, Anna

WH FAMILY ADDITIONS MATERNITY

Certiﬁed Emergency Nurse

Adams, Joshua Bedner, Kelly J. Blycheck, Paul B. Dearmitt, Laurie G. Komenda, Nicole M. Mcclelland, Rebecca S.

WH QUALITY SERVICES EDUCATION LH ED WH CLINICAL RESOURCE MGMT FH ED LH ED

Certiﬁed Pediatric Emergency Nurse

Adams, Joshua

WH QUALITY SERVICES

Certiﬁed in Executive Nursing Practice

Mantese, Mary

NURSING ADMINISTRATION

Certiﬁed in Infection Control

Bellush, Mary Jo Schotting, Deborah M.

WH QUALITY SERVICES WH QUALITY SERVICES

Certiﬁed Medical-Surgical Registered Nurse

Estochin, Mildred A. McGinnis, Kortnee M. Reidmiller, Cari A.

WH SDU LH 5FL LH 5FL

Certiﬁed Nurse Educator

Lewis, Deborah Y.

WH EDUCATION

Clinical Nurse Leader

Love, Jessica A.

FH PCU

Certiﬁed Nurse Midwife

Smouse, Kristina N.

EH OB

Certiﬁed Ostomy Care Nurse

Hutchinson, Patricia

HOME CARE

Certiﬁed Occupational Health Nurse

Kantorik, Eileen M. Kapolka, Megan B. Vomish, Patricia L.

LH SAFETY SERVICES WH SAFETY SERVICES WH SAFETY SERVICES

Certiﬁed Professional in Health- Adams, Joshua R. care Quality Addis, Denise D. Barnhart, Bonnie E. Horner, Carrie A.

WH QUALITY SERVICES WH NURSING ADMINISTRATION WH QUALITY SERVICES WH QUALITY SERVICES

Certiﬁed Professional in Patient Safety

Adams, Joshua R. Gregory, Jennifer M.

WH QUALITY SERVICES LH PATIENT SAFETY

Certiﬁed Registered Nurse Anesthetist

Acie, Amy L. Angelicchio, Jessica L. Antonucci, William J. Bailey, Michele A. Baker, Terri L. Barras, Melissa A. Bell, Robin L. Berdar, Lisa J. Berry Jr., Brian D. Boehm, Natalie R. Cooley, Danielle M. Copelli, Linette E. Cunningham, Melissa A. Curry, Carol A. DeBroeck, Michael A. Devine, Jessica L. Donatelli, Cynthia J.

WH APRN WH APRN WH APRN WH APRN WH APRN LH APRN WH APRN WH APRN WH APRN WH APRN WH APRN LH APRN WH APRN WH APRN WH APRN LH APRN LH APRN

Certiﬁed Registered Nurse Anesthetist

Dorazio III, Joseph F. Droschak, Lori A. Eisner, Patricia M. Ellena, Jennifer L. Fair, Diane S. Ferriero, Deborah M. Forish, Lou Ann Gray, Danielle R. Griener, Sarah E. Groft, Lisa A. Guidry, David J. Haines, Cara L. Herman, Joseph H. Hill, Deborah A. Holmes, Staci A. Holt, Brian D. Hutchinson, Julie B. Kantola, Mark A. Kozinko, Rae Ann Kuster, Patricia A. Lager, Jillian M. Lazur, Megan E. Malone, Kelly Miller, Stephen P. Nickelson, Beverly A. Oshie, Theodore J. Pavlik, Danielle L. Pierce, Amanda Rafter, Yvonne M. Richards, Julie A. Ross, Donna P. Sabatine, Joelle S. Scanlon, Heather L. Schnauber, Kristen Shinsky, Nicholas L. Spivak, Megan C. Stewart, Sarah L. Sullivan, Rebecca A. Tranchine, Susan M. Vecchiolla, Vicki L. Vittone, Lisa M. Weir, Katie L. Woods, Melinda S.

WH APRN LH APRN LH APRN WH APRN WH APRN WH APRN WH APRN WH APRN WH APRN WH APRN LH APRN LH APRN WH APRN FH APRN WH APRN LH APRN LH APRN LH APRN WH APRN WH APRN WH APRN WH APRN WH APRN WH APRN WH APRN LH APRN WH APRN WH APRN WH APRN WH APRN WH APRN WH APRN LH APRN WH APRN WH APRN WH APRN LH APRN WH APRN WH APRN FH APRN FH APRN WH APRN WH APRN

Certiﬁed Rehabilitation Registered Nurse

Ihrig, Lori

LH 5th Floor

Cardiac Vascular Nursing

Urosek, Amanda N.

WH QUALITY SERVICES

Certiﬁed Wound Care Nurse

Strashensky, Kimberly L.

WH WOUND CTR

Certiﬁed Wound, Ostomy, Continence Nurse

Hartman, Sandralee Vanderelli, Sarah M.

WH INPATIENT WOUND LH INPATIENT WOUND

Certiﬁed Wound Ostomy Nurse

Johnston, Abby E.

WH INPATIENT WOUND

Certiﬁed Wound Specialist

Brottish, Darlene M. Maust, Katlin M.

WH WOUND CTR WH WOUND CTR

Family Nurse Practioner

Augustine, Mary C. Manzini, Lydia J. Mazur, MaryBeth Navarre, Diane L. Stewart, Jennifer B. Umbel, Hope E. Yanits, Jennifer L.

CARDIOLOGY MT. VIEW PRIMARY CARE WESTMORELAND GASTRO ASSOCIATES ESL CARDIOLOGY PULMONARY EH PRIMARY CARE FAMILY MEDICINE

Gerontological Nursing

Patterson, Charity A.

FH PCU

International Board Certiﬁed Lactation Consultant

Beckering, Jennifer A. Garvin, Kelly E.

WH FAMILY ADDITIONS MATERNITY WH FAMILY ADDITIONS MATERNITY

Medical-Surgical Nursing

Breegle, Rebecca E. Crowe, Jacquelyn M. Hobaugh, Patricia J. Moffa, Debra S. Pence, Kacie S.

WH EDUCATION WH 3AB WH 2DE LH EDUCATION WH SDU

Nurse Executive, Advanced

Burns, Helen K. Fick, Traci M.

NURSING ADMINISTRATION WH/FH NURSING ADMINISTRATION

Nurse Executive

Adams, Joshua Barrick, Jennifer M. Hall, Brandi B. Jellison, Vickie L. Lewis, Michelle D. Repko, Glenn M. Reynolds, Waynette C. Shearer, Megan L. Singley, Maryann West, Christy S.

WH QUALITY SERVICES WH QUALITY SERVICES FH NURSING ADMINISTRATION LH NURSING ADMINISTRATION WH NURSING ADMINISTRATION WH NURSING ADMINISTRATION WH NURSING ADMINISTRATION WH NURSING ADMINISTRATION LH NURSING ADMINISTRATION WH NURSING ADMINISTRATION

Neonatal Nurse Practitioner

Barbarossa, Susan M. Becquet, Ann M. Eisensmith, Kathleen S. Ewing, Karen Y. Haslett, Lisa A. Kish, Mary K. Kruger, Merry L. O'Leary, Regina M.

WH APRN WH APRN WH APRN WH APRN WH APRN WH APRN WH APRN WH APRN

Nurse Practitioner

Batsa, Ashley L. Beal, Vicki L. Beck, Kimberly L. Beckman, Matthew T. Bele, Emily L. Brown, Brittany E. Byers, Elizabeth A. Christner, Laurie M. Cline, Sally A. Connors, Amanda L. Cowan, Lauren E. Dalla Betta, Amanda N. Dieter, Erin Q. Dolney, Michelle Dowling, Maryann C. Ellis, Kayla M. Emerson, Kelly M. Emswiler, Kelly E. Geiger, David George, Keri L. Gergely, Mallory N. Grasmeder, Jeffrey B. Jacob, Kimberly Judy, Tami L. Keiper, Kayla Komar, Megan J. Kraly, Natalie C. Loughner, Carla J. Maline, Toni L. Mbae, Shiela O. McFeeley, Charlene M. Meneghini, Janine M. Mikeska, Mandee L. Orkwis, Maria T. Paul, Katie M. Repak, Dawn L. Rutkowsky, Shawnaa L. Schmidle, Beth Ann M. Sherman, Bernadette M. Skweres, Leslie M. Smail, Rene Smith, Danielle J. Snively, Kelly R. South, Anna K. Toth, Brenda S. Trice, Chantal E. Trybus, Stacy A. Weimann, Sara E. Williams, Brooke A. Wiltrout, Leanne

LH APRN WH APRN EHMG WH APRN WH APRN FAMILY MEDICINE LH APRN EH WOUND CARDIOLOGY FH APRN ADVANCED PAIN ADVANCED PAIN WH APRN FAMILY MEDICINE HOSPICE EH OB FH APRN HOSPICE WH APRN FAMILY MEDICINE EH OB PRIMARY CARE EH WEEKEND CLINIC NEUROLOGY WH APRN ADVANCED PAIN FAMILY MEDICINE GERIATRICS WH APRN LH APRN OCCUPATIONAL MEDICINE CARDIOLOGY EH WEEKEND CLINIC PRIMARY CARE PULMONARY CARDIOLOGY WESTMORELAND GASTRO ASSOCIATES NEURO MEDICINE GERIATRICS OCCUPATIONAL MEDICINE WH APRN THORACIC EH OB EH WOUND GERIATRICS CARDIOLOGY HEART FAILURE CLINIC PULMONARY WH APRN WH APRN

Nursing Professional Development Certiﬁcation

Jenkins, Deborah B. Noonan, Lois

FH EDUCATION WH EDUCATION

Progressive Care Nursing

Iscrupe, Virginia R. Kent, Satannia M. Kruel, Jennifer A.

WH 2DE WH NURSING POOL WH ED

Psychiatric Mental Health Nursing

Alger, Adrienne M. Barricklow, Deborah A. Brant, Katie M. Keffer, Lacie M. May, Rhiannon E. Miller, Heather L. Prettiman, Rachel R. Yorko, Patricia A.

WH BEHAVIORAL HEALTH INPATIENT HOME CARE LH BEHAVIORAL HEALTH INPATIENT WH BEHAVIORAL HEALTH INPATIENT WH BEHAVIORAL HEALTH INPATIENT WH BEHAVIORAL HEALTH OUTPATIENT WH BEHAVIORAL HEALTH INPATIENT WH BEHAVIORAL HEALTH OUTPATIENT

Registered Cardiovascular Invasive Specialist

Dell, Elizabeth A.

WH HEART CTR

Informatics Nursing

Backus, Sally E. Brandon, Shirley J. Edmunds, Karen M. Grohal, Kennette A. Widmann, William M.

LH Clinical Informatics FH Clinical Informatics WH Clinical Informatics LH Clinical Informatics WH Clinical Informatics

Low-Risk Neonatal Nursing

Bukovac, Anita M.

WH FAMILY ADDITIONS MATERNITY

Maternal Newborn Nursing

Wright, Janine P.

WH FAMILY ADDITIONS MATERNITY

Inpatient Obstetric Nursing

Andreani, Sharon E. Bumar, Barbara A. Dyche, Colleen M. Hall, Nicole R. Halula, Jennie K. Syster, Krystelle D. Wargo, Mackenzie M.

WH FAMILY ADDITIONS MATERNITY WH FAMILY ADDITIONS MATERNITY LH GI WH FAMILY ADDITIONS MATERNITY WH FAMILY ADDITIONS MATERNITY WH FAMILY ADDITIONS MATERNITY WH FAMILY ADDITIONS MATERNITY

Wound Care Certiﬁed

Crawford, Lori E. Maust, Christine D.

Home Care WH WOUND CTR

CER

RSE

IED NU F I T

The Magnet Journey Continues For our nurses it means top honors. For our patients it means top care. It’s the most prestigious distinction a healthcare organization can receive for nursing excellence and quality patient outcomes. Of the nation’s nearly 6,300 hospitals, only eight percent have achieved it. It’s Magnet Recognition® from the American Nurses Credentialing Center. The initial designation for Excela Health and it’s member hospitals – Westmoreland, Latrobe and Frick was recognized at the Magnet Conference in Atlanta, GA.

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Scholarly Endeavors Excela Health Nursing Presentations & Publications Bedner, K., & Bedner, K. (2021, January). EN20X encore sessions look at inclusivity, bias and patient care. Feature in ENA Connection. PUBLICATION Szarejko, K., Lewis, D., & Burns, H. (2021). The nurse residency education navigator: Educator, facilitator, and clinician. Feature in The Journal of Continuing Education in Nursing. PUBLICATION Anderson, M., Iscrupe, V., Shaffer, W., & Urosek, A. (2021, April). Nurses’ compliance with the hand-off process for patients post femoral arterial access before and after a standardized approach. Poster session presented at the Cleveland Clinic 16th Annual Clinical Nursing Research Virtual Conference. NATIONAL Lewis, D. (2021, July/August). Implementing trauma-informed strategies for mothers of infants with neonatal abstinence syndrome. Feature in The American Journal of Maternal/Child Nursing. PUBLICATION Szarejko, K., Lewis, D., & Burns, H. (2021, September). Using simulation to address nurse residents’ learning needs during COVID-19. Poster session presented at the Southwestern Pennsylvania Organization of Nurse Leaders Annual Conference, Farmington, PA. STATE Lewis, D., Love, J., Vogel, T., & Burns, H. (2021, September). Nurses’ EBP beliefs in a community hospital system: A comparative analysis. Poster session presented at the Southwestern Pennsylvania Organization of Nurse Leaders Annual Conference, Farmington, PA. STATE Bedner, K. (2021, September). History repeats itself: A history of worldwide pandemics, then versus now. Learning Hour presentation at the Emergency Nursing 2021 Annual Conference, Orlando, FL. NATIONAL Jenkins, D. (2021, September). Healthcare simulation standards of best practice the debrieﬁng process. Clinical Simulation in Nursing. PUBLICATION

Komenda, N., Hill, A., & Grohal, K. (2021, October) Caring cabinet. Poster session presented at the 12th Annual McGinley-Rice Symposium on Justice for Vulnerable Populations, Pittsburgh, PA. NATIONAL Bedner, K. (2021, October). History repeats itself: A history of worldwide pandemics, then versus now. Guest speaker presentation at the Western Pennsylvania Chapter Emergency Nurses Association virtual meeting. STATE Komenda, N., & Crago, E. (2021, November). Implementation of EMS feedback to improve stroke identiﬁcation. Podium presentation at the Sigma Theta Tau 46th Biennial Convention, Indianapolis, IN. NATIONAL Lewis, D., Love, J., Vogel, T., & Burns, H. (2021, November). EBP implementation within a community hospital system: A comparative analysis. Podium presentation at the Sigma Theta Tau 46th Biennial Convention, Indianapolis, IN. NATIONAL Jenkins, D. (2021, November). Healthcare simulation standards of best practice the debrieﬁng process. Poster session presented at the Association for Simulated Practice in Healthcare virtual conference. NATIONAL Reynolds, W., Lewis, D., & Beckering, J. (2021, November) The use of pasteurized human donor milk to increase exclusive breastfeeding. Poster session presented at the 19th Annual Perinatal and Neonatal Health Care Conference for Nurses and Allied Health Staff, Pittsburgh, PA. STATE

Best Maternity Hospital February 2021 Excela Health Westmoreland Hospital Family Additions Maternity

Primary Stroke Center August 2021 Highest Quality Stroke Care: Excela Health Hospitals – Frick, Latrobe and Westmoreland • Designated Primary Stroke Centers by the Joint Commission • Awarded Get With the Guidelines®- Stroke Gold Plus Achievement Awards by the American Heart Association/American Stroke Association

Cribs for Kids® September 2021 Excela Health Westmoreland Hospital Family Additions Maternity • Awarded Silver Safe Sleep Leader Hospital Certiﬁcation from Cribs for Kids®

CORE November 2021 Excela Health Westmoreland, Latrobe and Frick Hospitals awarded for cultivating a “culture of donation” by the Center for Organ Recovery & Education (CORE)

Beacon Award for Excellence December 2021 Excela Health Behavioral Health awarded the prestigious Beacon Award for Excellence • The Beacon Clinical Department recognized the Excela Health Behavioral Health Department for successfully decreasing 30-day hospital readmission rates from 18.74% to 11.95%.

Westmoreland County Community College 2021 Distinguished Alumnus Award Westmoreland County Community College (WCCC) named Glenn Repko, DNP, RN, NE-BC, Clinical Director, Westmoreland Hospital, as the 2021 Distinguished Alumnus during their 50th Commencement Ceremony. Repko graduated with honors from WCCC in 2010, earning an Associate’s Degree in Nursing and received the Excellence in Nursing Practice Award. Repko began his nursing career at Excela Health in June of 2010 and has continued to advance clinically and professionally. Repko earned a Bachelor of Science in Nursing Degree from Penn State-Fayette in 2012, followed by a Master of Science in Nursing Degree and a Doctoral in Nursing Practice Degree from Grand Canyon University. Repko is currently the Clinical Director of Stafﬁng Support, Care Support and Patient Transport at Westmoreland Hospital and a valued member of the Excela Health Nursing Leadership team.

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DEFINING MOMENT?