HOUSTON
METHODIST NURSE FEBRUARY 2014 | A Magazine for Nurses
Leaders in Nursing
BROTHERS
Sharefor Fight their
LIVES
Page 8
Two CHRISTUS Hospitals
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Houston Methodist
Page 12
A Message from
A
Ann Scanlon McGinity
Senior Vice President and Chief Nurse Executive
Our Journey in 2014
As winter begins to disappear and the first signs of spring arrive, our nursing organization also continues to unfold and evolve. All years present unique challenges, and it is our ability to master change that makes us successful. I continually witness the unfolding of our nursing environment as one that empowers our nurses to become leaders in the quality and patient safety arenas. Each of you has played an integral part in the development and implementation of significant
2014 EDITORIAL BOARD MEMBERS Rosario Alvarado ShuntĂĄ Fletcher Donna Esposito Elizabeth Gigliotti Elizabeth Himes
Beverley Lamoth Robert Morehead Carlette Patterson Joy Shiller Robyn Washington
MAGAZINE EDITOR Kelli Gifford
GRAPHIC DESIGNER/PHOTOGRAPHER Phyllis Gillentine
patient care standards: protocols that address hourly rounding, bedside report, preventing of BSIs and UTIs, VAPs, glucose control and delirium and sepsis. This year you have managed to markedly increase the numbers of patients along with increased acuity and have managed their care successfully. We have published in nursing journals, participated in evidence-based practice activities, attended and presented at national and international conferences: all speaking to our evolution into an academic nursing environment. We have successfully implemented care coordination rounds, and our leaders, along with each of you, have led this interdisciplinary initiative. Our patients always remain our singular focus. Your energy, enthusiasm and commitment confirm my great belief and optimism in each of you and your individual and collective contributions. Our journey continues to unfold‌
Do you have a
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METHODIST NURSE MAGAZINE? Please submit your articles or ideas to Kelli Gifford at kagifford@houstonmethodist.org
NURSING CAREER FAIR DRAWS HUNDREDS
THE NURSING CAREER FAIR held on Feb. 13 was a resounding success. Approximately 300 GNs and experienced Registered Nurses attended; there have been approximately 60 offers made so far. “The collaboration and partnership between nursing leaders and HR really made a difference,” said Sheila Coggins, MA, SPHR, Director of Human Resources, Houston Methodist Hospital. “We had a great turnout of both applicants and nursing management. I really appreciate the time commitment nursing leadership made to spend the day with us and interview the applicants as they came in. This timely and personal experience was appreciated by the candidates.” RN recruitment has been a great opportunity for Houston Methodist, said Coggins. “The job market has opened up and become highly competitive for top talent, not only here in Houston but across the country. The advantage Houston Methodist has is the excellent quality of care we provide to our patients — nurses want to work here.” During the career fair, nursing directors and leaders spent time with the candidates to tell them about the job and about their units, and also had someone take them to tour the units. “Providing candidates with the opportunity to see where they could be working and talking to some of their potential coworkers leaves a positive impression on them,” said Coggins. Houston Methodist is planning a systemwide career fair in May, and dates are being finalized. Each entity will host its own fair with a joint advertising campaign.
RN REFERRAL BONUS
Houston Methodist Hospital is offering a $2,000 BONUS for successful referrals of experienced RNs. Current employees are eligible when a referred candidate is hired. Referral bonuses are dispersed in 2 payments – 1st payment at 90 days of employment/2nd payment at 12 months of employment. Both employees must be employed on both pay out dates to receive both payouts. The applicant must list the current employee’s name on the application under referral information.
For questions, email tmhnurserecruiting@gmail.com.
Houston Methodist San Jacinto News
Jane DeStefano
Vice President and Chief Nursing Officer
Change is on the HORIZON! HOUSTON METHODIST SAN JACINTO HOSPITAL is happy to announce two newcomers this month! Charyl Bell-Gordon, DNP, RN, CEN, FNP-C, will be joining the management team of Houston Methodist San Jacinto Hospital as Director of Emergency Services. Along with diverse nursing experience in emergency nursing, leadership, and as a Family Nurse Practitioner, Charyl has recent experience as a Director of the Nurse Practitioner Program at Houston Methodist Hospital. She also is adjunct faculty for Graduate studies at Vanderbilt University. Angelica G. Hermosillo will be joining the HOUSTON METHODIST SAN JACINTO nursing staff as the manager of 2 South. Angelica is joining us from El Paso where she was a Medical-Surgical unit Director. She has extensive experience as a nursing director, manager, clinical coordinator, charge nurse and critical care nurse.
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Houston Methodist Sugar Land News
Janet Leatherwood RN, MSN, VP / Chief Nursing Officer
FEBRUARY– The Month for a Heart Check When you think of the month of February, does the symbol of a heart or perhaps the thought of Valentine’s Day come to mind? If Valentine’s Day came to mind, did you think of flowers, candy, or those cute little cards that you may have exchanged as a child? When thinking of the heart, most of us are interested in keeping our bodies healthy and search for words of wisdom to assist in this lifelong search for health. According to the Journal of the American Heart Association, there are seven simple steps to take to achieve ideal cardiovascular health for adults: never smoke or quit smoking; maintain physical health by exercising at least 150 minutes a week; maintain blood pressure below 120/80; keep fasting blood glucose at less than 100 milligrams/deciliter (ml/dl); maintain total cholesterol at less than 200 mg/dl; and of course eat a healthy diet. So, have you ever wondered about the health of your child’s heart? Are there additional steps to take for children or newborns? What you might not know is that nearly 30 percent of all infant deaths are due to Critical Congenital Heart Disease (CCHD). Some defects of the newborn are immediately recognized after birth on the basis of assessment alone. However, the following seven conditions are not determined immediately: main CCHD, including hyperplastic left heart; pulmonary atresia with intact septum; Tetralogy of Fallot; total anomalous pulmonary venous return; transposition of the great arteries; tricuspid atresia and truncus arteriosus. If identified, these congenital heart diseases will require further medical and/or surgical intervention to prevent serious complication or even death. In May 2013 at Houston Methodist Sugar Land Hospital, our nurses began to ask how they might help in identifying infants who are at risk for CCHD. Our nursing staff and other professionals reviewed
the literature regarding CCHD and searched for best practices in their quest to address these concerns. The interprofessional group identified studies that showed a newborn’s pulse oximetry screening consistently identifies the majority of these seven disorders and is a relative low-cost opportunity to identify structural heart defects. By providing neonatal echocardiograms and pediatric cardiac consultation, the nursing leaders submitted a request for the appropriate testing equipment for CCHDS, which included a pulse oximetry monitor and disposable probes. The multidisciplinary group developed policies and procedures for the routine screening of all newborns and educational information for the parents as well as a learning module for the nursing staff. In July 2013, the nursing staff began to take steps to screen all newborns for CCHD with follow-up testing for positive screens. Since the initiation of the screening, two septal defects and one patent ductus arteriosus defect have been identified by a failed screen followed by further testing performed by the pediatric cardiologist. At the present time, no critical congenital heart defects have been identified. Hippocrates is credited with saying, “A wise man should consider that health is the greatest of human blessings, and learn how by his own thought to derive benefit from his illnesses.” The proactive approach of the nurses and staff of the Women’s Center at Houston Methodist Sugar Land Hospital should be congratulated for taking steps to identify early structural heart defects and provide excellent care through the loving hands and hearts of staff to the communities that we serve. Thank you for making a difference that supports health for the body and soundness for the mind. LEADERS NURSING 5 LEADERS ININNURSING
Houston Methodist Willowbrook News
Sheila Fata
Vice President & Chief Nursing Officer
Celebrating Hearts
T
his February marks the 50th year that our country has recognized American Heart Month! Since it was first observed in 1964, American Heart Month has helped to raise awareness of heart disease and heart healthy living. According to the Centers for Disease Control and Prevention, heart disease is the leading cause of death for both men and women in the United States and has been described as a national health crisis, contributing to one of every four deaths. Given these facts, it’s great to know Houston Methodist Willowbrook Hospital is doing its part to save lives impacted by heart disease. We care for patients affected by heart disease each day in many of our patient care departments —whether in ER, surgery, critical care, cardiac cath lab, surgical services, cardiac imaging or rehab, our patients are receiving high-quality cardiovascular care within the walls of our hospital. And since the beginning or our open heart surgical program in 2010, we have provided surgical and post-operative care to almost 300 heart patients in our community. Our cardiovascular program continues to grow and improve. We have outstanding outcomes with our acute MI patients who come to the cath lab from ED: 100 percent of our STEMI patients received PCI in less than 90 minutes and our median door-to-balloon time was 54 minutes — outstanding! Our open heart program is outperforming STS National Adult Cardiac Surgery Database benchmarks for major complications and the NDNQI benchmarks for nurse sensitive indicators; we have achieved zero CAUTI, CLABSI or VAP for these patients. Sheelu Joseph, BSN, RN, CCRN, and manager of the CVCU, credits these outcomes to the team’s commitment to superior quality the multidisciplinary, patient-centered approach. The nursing staff in our cardiovascular care unit adopted improvement projects to ensure the best care to this patient population. For example, an early mobility initiative in critical care seeks to get post-operative patients out of bed and moving sooner, further reducing the risks of postsurgical complications.
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Heart disease and open heart procedures are physically (and sometimes emotionally) difficult for the patient and their families as they recover after their hospital stay. The cardiac rehab unit supports their physical recovery and has grown 14 percent year over year. And in 2013, Adrienne Joseph, RN, helped relaunch the Mended Hearts support group, a community initiative that offers heart disease survivors both peer support and education from Houston Methodist caregivers and our physician partners. We plan to expand this program in 2014 to include home visits by a Mended Hearts volunteer during recovery. Mended Hearts is an important part of helping our surgical patients establish heart healthy lifestyles and sustained recovery of their health. Speaking of heart healthy lifestyles, I would be remiss if I did not mention that Houston Methodist is committed to supporting heart health not only in patients, but employees as well! Heart disease and related death is largely preventable through healthy lifestyle choices. We’re fortunate that Houston Methodist offers several benefits and incentives to support heart health, such as our tobacco cessation incentive, BMI weight loss challenge and on-campus fitness facilities. This Heart Month, let’s all be reminded to make choices that will ensure a heart healthy life for ourselves and our loved ones!
Houston Methodist West News
Vicki Brownewell
Vice President & Chief Nursing Officer
rse Do? u N b a L th a C a es o What D
d not know what to ess for February, I di en ar Aw t ar He t ou b nurse, and I write an article ab doing. I am a Cath La at st be am I When I was asked to at wh t ou having a hit me, I will write ab th Lab. However, I am Ca e th in s nt tie pa write about. Then it c for cardia rse does. opportunity to care s what a Cath Lab nu les h uc am blessed with the m is, rse nu b ng what a Cath La en asked a difficult time describi gs, Wikipedia and ev blo d rea I s. er sw an e and made for som ere quite humorous toward the Internet k wh s loo er to sw ed an e cid Th de . I at So RNs on a ch ce of a foley catheter ion about Cath Lab sertion or maintenan in th wi friend to post a quest als de o wh , but it is nses consisted of a RN ese characterizations th th wi s rse nu me laugh, most respo b La Cath y you would describe (ha, ha). I can see wh es. do Cath Lab nurse ICU nurse, furthest from what a same standards as an to ld he is o wh rse nu ical Cath Lab a highly skilled techn tient care during all pa e th for e ibl ns A Cath Lab nurse is po rse is res ER nurse does rse. The Cath Lab nu nt’s care much like an tie pa e th ER nurse and OR nu e ag tri d an cal caring as a s have to prioritize the same level of criti es id ov pr rse procedures. The nurse nu b La th h like an OR uma patient. The Ca g in a procedure muc in lat cu cir of n when caring for a tra tio ra orchest a Cath Lab nurse tient in the ICU. The of the responsibilities few a cardiogenic shock pa ly on est gg su ds of critical thinking, ery. These standar t display a high level us m rse nu nurse does in a surg b La th Ca e th Lab procedure. Th executes in every Ca . a.m 2 at es y procedur even during emergenc r-known specialized nurse has with bette b La th Ca a ies rit at a Cath Lab g some of the simila t important part of wh os m e th r, ve I hope that illustratin we Ho . do ck. It is being e clarity as to what we riencing a heart atta pe ex nt tie pa a for nurses provides som t vironmen ening. The nurse is g a calm, peaceful en lize what is now happ rea ey th nurse does is creatin as rs tea e th illness. We give nd and wipe away expect next with the to at wh dd there to hold their ha an rst de un aintain foley family and help them yes, we insert and m d an es, on ed lov there to educate the d ily an d hugs of sorrow to fam hugs of happiness an oviding the best catheters, too. n Methodist West, pr to us Ho at re he rse her nu cause we are small in are nurses like any ot t in a unique role. Be bu All humor aside, we — ily fam d an nt e here every day (and g for every patie ticed. However, we ar no un go environment of carin n ca we , ea s. Thank you for a rather isolated ar re to cardiac patient ca al vit , nt lle number and work in ce ex g idin role we play g many hats and prov y passion about the m e ar sh e m g tin many nights) wearin let rses and d about Cath Lab nu taking the time to rea . on the cardiac team
Joe Ray, RN, BSN
LEADERS IN NURSING 7
BROTHERS SHARE UNCERTAIN FUTURE
Both diagnosed with Becker muscular dystrophy By: George Kovacik and live with heart pumps
It is not unusual for brothers to fight, tease, love and support each other. But what is unusual is that Tyler Wertz, 18, and his 16-year-old brother, Austin Tucker, both have a debilitating disease that requires heart assist devices to keep them alive. As young boys, Tyler and Austin were diagnosed with Becker muscular dystrophy, a disease that slowly weakens the arms and legs and damages the heart. “Sometimes I’ll be walking and I’ll fall down for no reason,” Tyler said. “It can be scary and embarrassing, but it’s just something I have to deal with.” In 2010, Tyler’s heart condition became so grave that doctors at the Methodist DeBakey Heart & Vascular Center implanted a left ventricular assist device (LVAD), a battery-run device that assists the pumping of the heart, in an attempt to improve his quality of life. Austin received one in 2012.
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While most teenagers carry a backpack with books and other items, Tyler and Austin carry a small computer-controlled device powered by two batteries that always have to be charged.
“We are always there for each other and stay strong for each other,” Austin said. “When I’m feeling bad he encourages me, and vice versa. That’s what brothers do. We are going through this together and trying to make the best of it.” “Sometimes I’ll be in public and people will stare and ask me about it,” Tyler said. “It’s overwhelming at times, but I know that it gave me a second chance at life and for that I am grateful.” “Tyler and Austin are the first people in the world with this condition who have received this type of treatment to stop the
progression of heart disease and improve the quality of their lives,” said Dr. Jerry Estep, a cardiologist with the Methodist DeBakey Heart & Vascular Center. “We are using this as a ‘bridge to transplant’ in the hopes that somewhere down the road they will be able to receive a heart transplant. It all depends on how the underlying disease progresses.”
WHAT IS AN LVAD? The left ventricular assist device, or LVAD, is a mechanical
Becker muscular dystrophy is a genetic and milder form of muscular dystrophy that affects mainly males. The boy’s mother, Jennifer Banks, has had to deal with the heartache of this disease most of her life.
pump that is implanted inside a person’s chest to help a
“Two of my brothers had it,” Banks said. “One of them died a decade after receiving a heart transplant and the other never lived long enough to receive a new organ. It’s heartbreaking to watch my boys go through the same thing.”
Unlike a total artificial heart, the LVAD doesn’t replace
“Before they received the heart pump, the boys did not have the energy to do any kind of physical activity and it was making their muscular dystrophy worse,” said Dr. Matthias Loebe, chief of division of thoracic transplant and assist device at the Methodist DeBakey Heart & Vascular Center and director of thoracic transplantation at the Methodist J.C. Walter Jr. Transplant Center. “The pump gives them the ability to perform every day activities and move around because they are no longer in heart failure.” For now, Tyler and Austin go to school and play video games and continue to fight the disease that threatens them. They know the pump will not stop the progression of their muscular dystrophy, but it has given their family hope. “We are always there for each other and stay strong for each other,” Austin said. “When I’m feeling bad he encourages me, and vice versa. That’s what brothers do. We are going through this together and trying to make the best of it.” “I love them more than life itself, and without the LVADs I know they probably wouldn’t be here,” Banks said. “It’s a blessing to have doctors who will find the proper technology to save lives. I’m just happy they have been given a chance to enjoy their lives.”
weakened heart ventricle pump blood throughout t he body.
the heart. It just helps it do its job. This can mean the difference between life and death for a person whose heart needs a rest after open-heart surgery, or for some patients waiting for a heart transplant. LVADs may also be used as destination therapy, which is an alternative to transplant. Destination therapy is used for long-term support in some terminally ill patients whose condition makes them ineligible for heart transplantation.
HOW DOES AN LVAD WORK? Like the heart, the LVAD is a pump. The LVAD is surgically implanted just below the heart. One end is attached to the left ventricle — that’s the chamber of the heart that pumps blood out of the lungs and into the body. The other end is attached to the aorta, the body’s main artery. Blood flows from the ventricles into the pump which passively fills up. When the sensors indicate it is full, the blood is ejected out of the device to the aorta. A tube passes from the device through the skin. This tube, called the driveline, connects the pump to the external controller and power source. The pump and its connections are implanted during open-heart surgery. A computer controller, a power pack, and a reserve power pack remain outside the body. Some models let a person wear these external units on a belt or harness outside. The power pack has to be recharged at night.
Source: Medicinenet.com Left Ventricular Assist Device (LVAD)
LEADERS IN NURSING 9
As a lifeline in our quest to bring evidence to the bedside, the Iowa Model of EvidenceBased Practice is an anchor in the mist of uncertainty.
ANNUAL REVIEW:
Iowa Model of EvidenceBased Practice
T
he Iowa Model [1] is a “cookbook” approach to conducting an evidence-based practice (EBP) project. It utilizes the problem-solving steps in the scientific process to provide a logical framework for conducting an EBP project. Widely utilized in multiple clinical settings and interprofessional teams, the Iowa Model is intuitive and easy to follow. Application of the model maximizes the clinician’s time and resources and prevents incomplete implementation of the practice change[2]. In summary, by integrating the Iowa Model into all EBP projects, new evidence is readily adopted into practice and ultimately embedded into the foundation of our nursing organization and culture[3]. (See Appendix A)
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The Iowa Model begins by encouraging clinicians to identify a question that is a priority for the organization. Problem-focused (e.g., financial data, clinical problem, process improvement data) or knowledge-focused (e.g., new research data, new guidelines, philosophies of care) are used as catalysts to encourage clinicians to critically think about the efficiency and effectiveness of their clinical and operational work environment and seek a scientific basis for decision-making[1]. Considering then how a topic fits within the organizational priorities will facilitate garnering support both from leadership and other disciplines in order to complete the project. Higher priority topics to consider may address: 1) high-volume, high-risk or high-cost procedures; 2) topics that align with the organization’s strategic plan, and; 3) topics driven by other institutional or market forces (e.g., changing reimbursement)[4].
There are three decision points within the Iowa Model delineated by a diamond. The first decision point asks the question, “Is this topic a priority for the organization?” If the answer is “no,” then the model prompts the clinician to consider other triggers and returns them back to the problem — and knowledge-focused triggers for consideration of a different topic (feedback loop). The second decision point on the model asks, “Is there a sufficient research base?” Determining if there is enough research to guide clinical practice is a critical step in the EBP process; implementing a practice change on limited or poorly conducted studies will not produce the intended outcome and can be potentially dangerous. When evaluating the evidence the following criteria are useful to consider: (a) consistency of findings across research studies; (b) the level and quality of the research; (c) clinical relevance of the findings to practice; (d) similarity of sample characteristics; (e) feasibility of implementing the findings; and (f) the risk-to-benefit ratio[1]. If after a thorough literature review and synthesis, high-quality research evidence is not available, the project team may either recommend use of lower level evidence (e.g., case reports, expert opinion) or conducting a research study in order to generate the knowledge needed to base practice decisions[4]. When evidence is deemed sufficient, the practice change is piloted to determine feasibility and effectiveness of the change in the actual clinical setting. Pre- and post-pilot data will determine the appropriateness of adopting the change into practice. If the desired outcomes are not achieved in the pilot study, adopting the change is not appropriate (third decision point) and the EBP team should refocus on ongoing quality monitoring and consider a new problem- or knowledge-focused trigger (feedback loop). If the pilot data show positive outcomes the practice change is implemented into practice. Integrating a practice change is facilitated by leadership support, staff education and continuous monitoring of outcomes[4]. Implementing a practice change can be a challenge. Effective, sustained implementation requires multiple reinforcing and interactive strategies. The final stage of the Iowa Model that is likely the most significant entails disseminating the EBP change results internal and external to the organization through presentations and publications. Results dissemination is important for professional learning and ensures the growth of an EBP culture, expands our knowledge, precludes duplication of work and encourages positive EBP changes in other organizations[4]. The Iowa Model outlines a pragmatic approach to changing practice by melding quality improvement with timely translational science. The ultimate goal is always improvement in patient outcomes. Through the use of the Iowa Model, clinicians can effectively manage EBP projects and gain confidence in the fact that the best available evidence has been translated into practice at the bedside. For further assistance please contact: Houston Methodist Hospital: Shannan Hamlin Houston Methodist San Jacinto: Kathy Arthurs Houston Methodist Sugar Land: Betty Gonzales or Tricia Lewis Houston Methodist West: Kahla LaPlante or Laura Espinosa Houston Methodist Willowbrook: Robin Howe References 1. Titler MG, Kleiber C, Steelman VJ, Rakel BA, Budreau G, Everett LQ, Buckwalter KC, Tripp-Reimer T, Goode CJ: The Iowa Model of Evidence-Based Practice to promote quality care. Critical care nursing clinics of North America 2001, 13(4):497-509. 2. Gawlinski A, Rutledge D: Selecting a model for evidence-based practice changes: A practical approach. AACN advanced critical care 2008, 19(3):291-300. 3. Dearholt SL: The johns hopkins nursing evidence-based practice model and process overview. In: Johns Hpkins Nursing Evidence-Based Practice: Model and Guidelines. Edited by Dearholt SL, Dang D, 2nd edn. Indianapolis: Sigma Theta Tau International; 2012: 33-53. 4. Ciliska D, DiCenso A, Melnyk BM, Fineout-Overholt E, Stetler CB, Cullen L, Larrabee JH, Schultz AA, Rycroft-Malone J, Newhouse RP et al: Models to guide implementation of evidence-based practice. In: Evidence-Based Practice in Nursing & Healthcare a Guide to Best Practice. Edited by Melnyk BM, FineoutOverholt E, 2nd edn. Philadelphia: Wolters Kluwer/ Lippincott Williams & Wilkins; 2011: 241-275.
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Welcome Aboard
TWO HOUSTON CHRISTUS HOSPITALS BECOME PART OF HOUSTON METHODIST
T
he transfer of majority ownership of CHRISTUS St. John Hospital and CHRISTUS St. Catherine Hospital to Houston Methodist is now complete,
with the two hospitals officially joining Houston Methodist. Under this new agreement, CHRISTUS St. John Hospital in Clear Lake will now be called Houston Methodist St. John Hospital, and CHRISTUS St. Catherine Hospital will now be Houston Methodist St. Catherine Hospital. Houston Methodist St. John Hospital will continue providing comprehensive care to the greater Clear Lake area. Houston Methodist St. Catherine Hospital soon will be repurposed to a long-term acute care hospital to complement the services Houston Methodist already offers the West Houston/Katy
Ernie Sadau, left, president and CEO of CHRISTUS Health, and Dr. Marc Boom, president and CEO of Houston Methodist, shake hands after signing final documents completing the transfer of majority ownership of CHRISTUS St. John Hospital and CHRISTUS St. Catherine Hospital to Houston Methodist. Looking on is Sr. Lillian Anne Healy, CCVI, congregational leader of Sisters of Charity of the Incarnate Word of Houston. (Photo courtesy of Houston Methodist)
community. Under this agreement, Houston Methodist has retained CHRISTUS Continuing Care, a division of CHRISTUS Health, to manage St. Catherine. “I cannot emphasize enough what a good fit the two organizations are for each other,” said Marc Boom, MD,
president and CEO of Houston Methodist. “This brings together two faith-based organizations that share common missions and values. We are especially excited about the opportunity to expand our services to the Clear Lake area, and to work with CHRISTUS to open our first continuing care facility.” Houston Methodist has 15,000 employees caring for patients in seven hospitals, stand-alone emergency departments, imaging centers, physical therapy clinics and a top-ranked research institute. “We are delighted that St. Catherine and St. John will continue providing high-quality, compassionate care to the Katy and Clear Lake communities as part of a faith-based system,” said Ernie Sadau, president and CEO of CHRISTUS Health. “This completed transition creates a new, innovative partnership, and ensures that Gulf Coast residents will have access to a full continuum of care right in their own backyard.” The partners will work together to find new opportunities to serve, innovate and enhance the health care provided throughout the Gulf Coast area. In addition, the CHRISTUS Foundation for Healthcare will continue serving the Houston community through its clinics, school-based centers and services for the poor and underserved, which are not part of the transition. “We welcome the CHRISTUS employees to the Houston Methodist family,” Boom said. “Through this business process it became very clear: CHRISTUS employees are wholeheartedly dedicated to their patients and their care. This partnership will be a benefit to the entire community.”
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INFECTION CONTROL SPOTLIGHT Last month you met an ICP at Houston Methodist Hospital. This month, let’s find out what ICPs do for you. By Robert Morehead, RN, ICP Infection Prevention and Control Houston Methodist Hospital
What is an ICP (or IP)?
ICP stands for “Infection Control Practitioner.” Another title is IP, for “Infection Preventionist” or “Infection Prevention Specialist.”
Do ICPs have a professional organization?
There are several professional organizations that ICPs can join. One is APIC, The Association For Professionals in Infection Control and Epidemiology. The APIC website is www.apic.org, and you don’t have to belong to check it out. You’ll find lots of great infection prevention information there for you and your family.
What do ICPs do?
APIC describes its members as nurses, physicians, public health professionals, epidemiologists, microbiologists or medical technologists who: Collect,
analyze and interpret health data in order to track infection trends, plan appropriate interventions, measure success and report relevant data to public health agencies. (Determine HAIs, Healthcare Associated Infections)
Establish
scientifically based infection prevention practices and collaborate with the health care team to assure implementation. (Infection Prevention Bundles/Daily Care Checklists for Central Line and Foley Catheters)
Work
to prevent health care-associated infections (HAIs) in health care facilities by isolating sources of infections and limiting their transmission. (Isolation)
Educate
health care personnel and the public about infectious diseases and how to limit their spread. (Hand Hygiene, Disinfection of Rooms and Equipment, Isolation)
Further, ICPs plan facility construction, repair and remodeling projects. Construction barriers, airflow, and traffic patterns are determined before projects begin to protect patients, staff, and visitors from dust, germs, and mold that may be dislodged or introduced during construction. ICPs perform environmental rounds and unit inspections, looking for unsafe conditions and practices that could pose a risk to patients and healthcare workers. Some ICPs, especially in community hospitals, may serve in employee health and quality (Core Measure) roles.
How do ICPs help you?
Again, APIC tells it best: Many ICPs are employed within health care institutions and also serves as educators, researchers, consultants and clinical scientists (outbreak investigations). [Most] are affiliated with acute care settings, [but also] practice in ambulatory and outpatient services, [long-term care, and home health] where they direct programs that protect patients and personnel from HAIs. All Methodist hospitals have ICPs. Outpatient facilities have access to ICPs through their affiliated hospitals.
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CAREER COACH’S CORNER
“FOLLOW YOUR HEART”
І Career Coach’s Corner
By ShuntÁ Fletcher, MSN, RN, NE-BC, CVRN-BC
With a lifelong interest in sports and helping people, Joshua Davis knew before he graduated high school that he wanted to pursue sports medicine. But it was while taking a class on “Ethics in Healthcare” his freshman year of college that he was inspired to look in another direction. That class was being taught by a nurse, and after class one day he asked her about nursing. He saw nursing as a way to have a more personal impact with the patient and soon changed his major to nursing. While in school he heard about the Houston Methodist Advancement into Professional Practice (MAPP) program and decided to apply. First was his phone interview and initial encounter with a career coach. He was pleased and hoped he would be selected.
“The Methodist Experience is real here....For now I will focus on being the best ICU nurse I can be.” Joshua Davis
And he was. After the one-year MAPP program in CVICU, Joshua fell in love with the unit and its staff and wanted to stay after graduation. He applied, and before the interview he became stressed because it was the only job he had applied for. Once again he turned to his career coach for assistance. She provided guidance and support to help relieve his stress as well as provide clear direction for all possibilities. He got the job and is currently working in CVICU. He really wanted to stay at Houston Methodist because “The Methodist Experience is real here.” He plans to continue with career coaching when he gets ready for his future education endeavors but “for now I will focus on being the best ICU nurse I can be.” If you would like greater career success or need help in solidifying your vision for the future coaching appointments are flexible and are conducted by face-face interview or telephone. For more information please contact The Center for Professional Excellence at 713.441.4546 or via email at cpecareercoaching@houstonmethodist.org.
DID YOU KNOW? February is National Cancer Prevention Month?
We know that each month has at least one type of cancer awareness that it signifies, but prevention is likely the most integral part of the fight against this disease. According to the American Institute of Cancer Research (AICR), many Americans are still unaware that simple health practices, such as 30 minutes of exercise each day, a healthy diet and maintaining proper body weight, can lower their risk of developing cancer (AICR, 2014). This particular organization
Gift Basket Giveaway Katina Smith, representative in the BMT Outpatient Infusion Center, got into the Valentine’s Day spirit and wanted to spread it to coworkers and patients. Katina decorated the front desk and put together two gift baskets – one for a patient to win and the other for a coworker to win. She placed a vase full of Starburst candy next to the baskets and whoever guessed the closest won. Chasity Norris won the employee basket, and out of 282 patients who guessed, Mr. Richard Klein, 78, got the number exactly right. He was elated to be the winner and said the gesture made him feel very special. When told they were going to post his picture in the department, he said, “Send it to Hollywood!”
funds cancer research and works to dispel myths that many Americans still hold about cancer. At Houston Methodist, the entire health care team plays a vital role in patient care for their fight against cancer, but half of that battle is educating our patients about steps they can take to prevent it For more information, including nursing resources and evidence, check out the AICR website at aicr.org and worldcancerday.org. Chelsea Davang, BSN, RN, CNOR
Katina Smith
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Richard Klein
N O
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EDUCATION BOOT CAMP: A Call to Duty
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Houston Methodist Center for Professional Excellence hosted its first Nursing Education Boot Camp, themed “Call to Duty,” for two weeks at the end of January. The boot camp was mandatory for all nurses, and each had to visit stations targeting five nursing priorities: patient satisfaction; staff satisfaction; HAI-CLABSI & CAUTI; patient throughput; and core measures. The boot camp was made possible by a grant from the Texas Workforce Commission. “We got so many positive comments from directors/managers and staff stating it was the best education event they had ever attended,” said Alicia Hernandez, director of the Center for Professional Excellence.
Of those who attended, 1,074 filled out evaluations for a chance to win an iPad. Maribel Castillo on Dunn 9 was the lucky winner! Some feedback:
“It was a great experience. It gave me a lot of updates on what we need to focus on.” “This was a great way to reinforce our clinical knowledge and give us an opportunity to ask questions.” “Very creative decoration, great enthusiasm, very informative and great participation activities.”
Collaboration Among Houston Methodist Nurses By Kathy Arthurs MSN, RN-BC, RNC-OB, HMSJ Magnet Coordinator
At the heart of exemplary professional practice is the role of the nurse in patient care and the quality and service outcomes associated with the patient’s experience. A professional practice model is a visual description of nursing practice and provides a framework to define the role and impact of nursing. In 2013, members of the systemwide Houston Methodist (HM) Clinical Practice Council, led by Jane DeStefano CNO, Houston Methodist San Jacinto Hospital (HMSJ), collaborated with HM nurses throughout the system to review, evaluate and provide input into the continued development of HM’s Professional Practice Model (PPM) and RN Standards of Nursing Practice.
HM Shared Governance Councils at each hospital provided input into the refinement of the model and helped to identify generic RN Standards of Nursing Practice that support implementation of the PPM by all HM nurses. During the HM Shared Governance Conference in November, nurse colleagues participated in an activity to provide examples of RN behaviors that demonstrate the RN Standards in action. In December, DeStefano gathered a group of Magnet Coordinators and Magnet Champions to align the RN behaviors with the RN Standards and prepare next steps for developing an education plan for all nurses at HM. In 2014, nurses will have many opportunities to apply the RN Standards of Nursing that underpin HM’s Professional Practice Model. LEADERS IN NURSING 15
Nursing News
Houston Methodist Hospital is proud to have nurses who are dedicated to the nursing profession, driven to achieve growth in their professional development, and creative and always compassionate in their care for patients.
Accolades
The accolades page is an opportunity for the nursing staff to showcase a few of the many exciting tributes our nurses receive. Please submit kudos to: kagifford@ houstonmethodist.org.
Tiffany Street, R.N., M.S.N., ACNP-BC, with the Houston Methodist DeBakey Cardiovascular Surgery Associates, was recently elected to a two-year term on the board of directors of the Society for Vascular Nursing. The SVN is a not-forprofit international association dedicated to promoting excellence in the compassionate and comprehensive management of persons with vascular disease. Please join us in congratulating the nurses listed below, who have successfully met the criteria and demonstrated during an interview the traits and abilities needed to successfully fulfill role responsibilities for promotion to R.N. III. These nurses put together an application packet that included various documents, evidence of six contribution points and a written clinical narrative. The nurses were also required to pass a clinical simulation. They are Jeremy Aganon, OPC AOD, Lisa Castro, OPC OR, Tracee Kennon, CVICU, Jennifer Daniels, Jones 9, Diana Garcia Prats, Jones 11, Christie Aguirre, Main 3 AOD, Theresa Vu, Dunn 3 OR, Bernice Onyenezi, Alkek 7, Felicia Akingbola, Jones 11, and Haley Hoskinson, MICU. Congratulations to Jannah Mitchell, R.N., B.S.N., MEd, on Jones 8, for becoming Medical/Surgical certified! Congratulations to Mary Silas, R.N., M.S.N., in CPE, on passing her Nursing Professional Development certification! Kudos to Erica Mouton, R.N., on Jones 9 for becoming a Certified Progressive Care Nurse (PCCN)! Joy Shiller , R.N., B.S.N., M.S., CAPA, from Main 3 Pre-Op, was selected to serve on the Exam Review Committee for the Certified Perianesthesia Nursing Exam in San Antonio.
Congratulations to My Ton, R.N., and Shannon White, R.N., from NICU, for obtaining their Master of Science in Nursing degrees in December! My graduated from University of Phoenix and Shannon graduated from University of Texas Health Science Center. Congratulations to Sadaf Abbas, R.N., in Neurosensory 7 AOD/ PACU for getting her M.S.N and MBA degrees! Great job! Congratulations to Becky Cox, R.N., at Kirby ECC, for earning her Emergency Nurse Certification! Suzanne Cearley, Lauren Girardi, Audrey Thomas and Shelby Wileym in Case Management completed training and are InterQual Certified Trainers (IQCT). Great job! Congratulations to Jessica W. Daniel, RN III, CNOR, Charge Nurse/Surgery Coordinator at Houston Methodist Willowbrook Hospital, for receiving a 2014 Stryker Educational Grant by the AORN Foundation to attend the AORN Surgical Conference & Expo 2014 in Chicago. Congratulations to Casey McAndrew, RN, on SICU for earning her Critical Care Certification (CCRN). Great job, Casey! Mavis Quarcoo-Asimenu, team RN, achieved her CVRN-BC certificate. What a great accomplishment! The director and manager of the Inpatient Dialysis Unit presented two posters at the ANNA Texas Annual Collaborative meeting in Houston. Sana Haj-Khalil, MHA, RN, CNN. Poster presentation “Educational Illustration For ED Nurses: Best Practice—How to Collect Peritoneal Dialysis Fluid Cultures” and Gail Messner, MSN, APN, CNN, Poster presentation “Palliative Care for the Renal Dialysis Patient—An Educational Tool for Nephrology Nurses.”