Houston Methodist Nurse November 2013

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Houston

METHODIST NURSE NOVEMBER 2013 | A Magazine for Nurses

Celebrating

Leaders in Nursing

MAGNETat Houston Methodist Willowbrook Page 8

i care in action

World Food Day

Page 11

November

Diabetes

Awareness Month

Page 13


I

A Message from

Ann Scanlon McGinity

Senior Vice President and Chief Nurse Executive

Congratulations to Houston Methodist Willowbrook!

2013 Editorial Board Members

I would like to extend my congratulations to Houston Methodist Willowbrook Hospital for earning their Magnet designation. Sheila Fata and her team at Willowbrook have put forth a superb effort on their journey toward Magnet and should definitely be commended for a job well done. Houston Methodist Willowbrook is the first of our community hospitals to earn this prestigious honor. As our nursing excellence continues to grow at each of our Houston Methodist locations, our other community hospitals continue to make progress toward Magnet designation. I am confident that they too will see their hard work reach its fruition in the near future.

Elizabeth Himes Beverley Lamoth Kathy Materre Denise McNulty

Earlier this month we celebrated both National Nurse Practitioner Week and Perioperative Nurses Week. Our nurse practitioners at Houston Methodist do a great job working with physicians and other members of the health care team to provide comprehensive, quality care to our patients and families. We depend on our NPs to be present around the clock as they lead several essential clinical programs such as our CERT and sepsis teams. Our perioperative staff provides a broad spectrum of patient care services—showcasing their clinical skills through preoperative, intraoperative and postoperative patient care. If you haven’t already, be sure to share your thanks with members of our outstanding nurse practitioner and perioperative teams.

Phyllis Gillentine

I hope that you all have been attending our Leadership Conversations Series. Since we began this monthly initiative in July, staff members have had an excellent opportunity to meet and converse with dynamic leaders from many fields of health care. This month, our very own Dr. Mauro Ferrari, president and CEO of the Houston Methodist Research Institute shared his remarkable story with us. Immediately following the event, attendees learned even more about Dr. Ferrari as he surprisingly entertained the crowd with his musical talents on the saxophone. Our next and final Leadership Conversations event for this year will take place on December 17, 2013, at noon, in the Houston Methodist Research Institute Auditorium. Our guest speaker will be Dr. Osama Gaber. Everyone is invited to join us for what promises to be another enlightening discussion.

It’s hard to believe that one of my favorite holidays, Thanksgiving, is fast approaching. As we enter the holiday season, it is always a time to reflect on everything we have to be thankful for in our personal and professional lives. I would like to personally thank each of you for the countless contributions you bring to our nursing community each and every day. Recently, as I rounded on several units, I witnessed staff members that were heavily invested in the care of patients. It was also very comforting to chat with many patients and family members who were so happy with the care they were receiving. These experiences serve as a testament to our stellar team members and the passion you each have for your profession. Please know that I, along with our nursing leadership team, appreciate all that you do to make Houston Methodist the great place that it is for our patients and our staff! My very best wishes for a Happy Thanksgiving to you and your loved ones!

Carlette Patterson Joy Shiller Maria Steele Robyn Washington

Magazine Editor Trevor Mitchell

Graphic Designer Photographers Phyllis Gillentine Trevor Mitchell

Do you have a

STORY

that you would like to post in the

Methodist Nurse Magazine? Please submit your articles or ideas to Trevor Mitchell at tmitchell2@houstonmethodist.org


THE DEPARTMENT of NURSING

Houston Methodist Hospital presents its...

Day in the LIFE PROGRAM

T

he Houston Methodist Hospital Department of Nursing’s newly created Day in the Life Program offers staff members an opportunity to observe, learn, and gain exposure to other professional hospital careers, roles, departments or specialty areas they may be

interested in. The program creates unique job shadowing and hands-on learning experiences by matching participants with experienced mentors— who allow interested colleagues to get a glimpse into their work environment and the day-to-day job responsibilities required in their chosen fields.

If you would like to register to participate in the Day in the Life Program and schedule some time with an individual working in a specific role at Houston Methodist Hospital, or if you would like to serve as a Day in the Life Program mentor and share details about your job, please visit the program’s webpage which can be found under the Workplace Environment tab on the nursing intranet.


Houston Methodist San Jacinto News

Jane DeStefano

Vice President and Chief Nursing Officer

Houston Methodist San Jacinto Cancer Center

Honors Breast Cancer Survivors

E

ach October, Houston Methodist San Jacinto Hospital honors local breast cancer survivors with our annual Pink Rose Survivors Celebration and Balloon Launch. In addition to taking place during National Breast Cancer Awareness Month, the event is also held in conjunction with National Mammography Day, to underscore the importance of early detection through mammograms. This year’s 11th Annual Pink Rose Survivors Celebration and balloon launch included a reception, program, and fashion show featuring survivors and patients of the HMSJ Cancer Center. The fashion show highlighted support services available at the Cancer Center, such as the American Cancer Society’s “Look Good…Feel Better” program. Local businesses donated makeover services, including hair, make-up, manicures and clothing, to the models. To round out the royal treatment, the survivors were escorted down a pink runway by Baytown Fire Department and EMS personnel. Following the program,

4 Methodist Nurse

attendees launched 500 pink balloons in honor of survivors and in memory of loved ones lost to breast cancer. HMSJ continued to think pink into November, when the Pink Heals Tour kicked off its inaugural National Pink Heals Day on November 1 in Baytown. For the past four years, our hospital has been fortunate to have this outstanding group partner with our Cancer Center and the Baytown Fire Department to raise awareness for cancer through our Pink Heals event. On National Pink Heals Day, the group visited the homes of several patients across our service area, and made its last stop at HMSJ to visit with inpatients. The following day, the pink fire trucks rolled back through town in support of our 4th Annual Pink Heals Event – a day of education, fun, and activities for the entire family. These events are very moving to experience first-hand and serve as a reminder of our role in providing hope and healing to everyone we encounter.


Houston Methodist Sugar Land News

Janet Leatherwood RN, MSN, VP / Chief Nursing Officer

Bonnie Riley, Sally Shen, Harry Chen, Tricia Lewis

Pretty in

PINK

On October 11, 2013, as Sugar Land Town Square was bathed in pink light, I was reminded of the song, “Pink is my favorite color” and at that moment I couldn’t have agreed more with Aerosmith; pink was officially my favorite color along with many other attendees that night. October has, in the last few years, been cleverly coined as “Pinktober,” and this year the term “Pink Out” was used to describe the color pink as it relates to the official month for national breast cancer awareness activities.

Left: Sugar Land Towne Square “Pretty In Pink” event with City Hall glowing pink!

M

any events focusing on breast cancer occur nationally as well as internationally in October to heighten public awareness of the sheer magnitude of people who are diagnosed. These events promote the positive attributes of early detection and treatment. The latest statistics reflect that one in eight women will be diagnosed with breast cancer in their lifetime. Approximately 182,000 new cases of breast cancer are diagnosed each year. It’s been said everyone knows someone who has had breast cancer or is currently battling breast cancer. Once again and back by popular demand, “Pretty in Pink” returned to raise breast cancer awareness while having family fun and raising funds. For the second year in a row Sugar Land Town Square was aglow in pink lights in honor of all cancer survivors. This “Pink Out” event allowed Houston Methodist Sugar Land Hospital in association with Fort Bend Junior Service League, and breast surgeons Dr. Kelly Dempsey and Dr. Sandra Templeton, an opportunity to reach out to our community and provide education, raise charity funds, and still turn it into a night of fun for the entire community. In fact, many were asking if “Pretty in Pink” was going to be an annual event so they could look forward to participating next year.

What was the impact of this event for those who are fighting for their survival? Last year, the inaugural “Pretty in Pink” in Sugar Land’s Town Square raised a total of $110,000. This year’s grand total was even higher at $114,000. The fundraiser not only provided an avenue to raise funds, but also allowed our employees and hospital to maintain a strong community presence that supports improved patient outcomes and the health of our community. One hundred percent of the funds raised are used to assist those with cancer who find themselves in a financial crisis meeting their living expenses and medical bills while fighting for their own survival and recuperation. Houston Methodist Sugar Land looks forward to extending that assistance at a time when it is so greatly needed. In closing, for all of those who served and donated in any way to this event, thank you for your support and generous giving to this significant outreach. Thank you for making a difference in the lives of our patients and their families and in our very own community. As always, your generous support and assistance reflects the hands and heart of a caring community. Leaders in Nursing 5


Houston Methodist Willowbrook News

Sheila Fata

Vice President & Chief Nursing Officer

We Have Arrived – Destina tion Magnet! We did it!

We have arrived at DESTIN ATION: MAGNET! Now time to pause, reflect and cel is the ebrate, taking pride in Houst on Methodist Willowbrook Hospital and the world class nursing tea m that brought us to this day. As I think back on our journey, it is evident tha t it truly took “a village” to attain this design ation. Numerous staff nurse s and our entire leadership team worked col laboratively to lead the wa y. Though smaller teams worked on our applica tion documents and site sur vey preparations, literally every nurse has bee n part of this journey! There are a few individuals who stand out, deserving spe cial recognition. First, thanks to Dana Sco tt, BSN, RN, our Magnet Pro gram Coordinator who championed the Magn and tenacity to ensure we et ideals since 2010. Her kno meet the standards was cen wle dge of Magnet tral to our success. Many but special thanks goes to hands contributed to our wr Robin Howe, MSN, RN, itten documents, RNC-OB, Julie Peterson who wrote and rewrote doc , MHA, and Nick Hough, uments that highlighted our project manager best nursing practice and to Tammy Walrath, who inter-professional collabora designed and built our web tion. Thanks also document. I also want to thank Mona Cockerham, MSN, RN, Nu rsing Quality Coordina infrastructure and sifted thr tor, who developed our nu ough voluminous NDNQI rsing quality data to create meaningful Denise McNulty, MS, BS inf ormation for each nursing N, RN-BC and Carol La unit. Thanks to Monica Way, MSN, RN amounts of information to C-OB, our educators who our writing team and suppor provided incredible ted process changes in nume Froedge, MSN, RN, CCRN rous ways. Thanks also to for leading our Magnet Ch Wendi ampions, and to each Magn principles and culture to life et Champion for bringing in each nursing unit. the Magnet Thank you to the members of shared governance and the hundreds of nurses wh tours with the Magnet app o took part in interviews, me raisers during our site sur als and unit vey , and to the three staff nurse which WOW’d the survey escorts for their charm and team. And finally, a very spe congeniality cia l thanks to all of our nu commitment to the long, som rsing leaders, whose unwa etimes arduous process of vering becoming Magnet reinforce s the excellence we celebrate Now that we have arrived today. at Destination Magnet, we will continue to look forwa members of the prestigious rd at HMWB. We are among Community of Magnet and the newest now we will contribute to challenged us to share our this community. Our apprai practices and outcomes and ser team to publish findings that will enable other hospitals to reach higher standards of quality. We are committed to meeting that challenge. As a matter of fac t, in February two of our nurses will presen t at the national ANA Qu ality Conference. Additionally, we have new research studies and EBP projects underway that will grow the body of nursing knowledge. Achieving Magnet designati on is a new height for nursi ng at our hospital, yet not our climax. Our bes t days are still ahead as we continue to raise the standard of exceptional nu rsing practice and continue to create our future! Congratulations, my esteem ed colleagues, Sheila

6 Methodist Nurse


Houston Methodist West News

Vicki Brownewell

Vice President & Chief Nursing Officer

October Nursing Grand Rounds

Resilience H

ouston Methodist West Nurse Scholar Anila Simon, RN and Steve Spidell, Chaplain, described the importance of resilience for both patient recovery and as an essential personal resource for nurses.

They shared that resilience is the ability to come through traumatic experiences and maintain one’s basic grounding in life without being overwhelmed. Traditional thinking has been that persons are normally emotionally disabled by trauma. Stress is the usual reaction to major traumatic events requiring months of working through to emotional stability. To the contrary, studies by George Bonanno of Columbia University have demonstrated that upwards of 50% plus of the population have resilience factors that will see them through to successful outcomes without becoming overwhelmed. (Bonanno, 2012) Furthermore they shared that patients who have resilience factors such as optimism, flexibility, gratitude, and are willing to participate actively in their own health care plan are better prepared and more successful in dealing with the trauma of illness than those who are less resilient. Nurses who have resilience are better able to overcome compassion fatigue and burnout – a major concern of healthcare. Along with those mentioned, other resilience factors are selfconfidence, the ability to think through options, to be more in control of one’s emotions, and seem to have a strong support system. Resilience training should be an important part of nursing training according to McAllister and McKinnon (2009). The Grand Rounds participants had the opportunity to take the Connor-Davidson Resilience Scale. Though not a scientific survey, the experienced nurses did have higher resilience totals in general than their student trainees. Recognizing resilience and providing ways to build up resilience is a well justified concern of hospital and nursing

management. According to Lee Lightfoot, a clinical instructor of nursing for the local campus of the University of Houston Victor said that resilience awareness would become a regular aspect of nursing training for her students. Resilience comes out of the positive psychology movement and provides a hopeful complement to the more problem-focused, stress-management focus of professional support according to Chaplain Spidell. Ms. Simon highlighted the challenges of patient care and how her own resilience factors saw her through to high quality patient care.

What are your resilience factors? Positive emotions Belief that life has meaning

Support of family, friends, and/or social resources

Awareness of one’s Optimism own feelings and the ability to control one’s emotions

Flexibility

Spirituality

Sense of humor

Independence

Overly high Pragmatic, self-assurance and problem-solving approach self-confidence

High adaptability

Mastery

Resourcefulness

Sense of control of one’s life

Belief one can make a difference

Equanimity

Perseverance

Effectiveness Self-reliance

Determination

Invincibility

Positive responsiveness

Superior cognitive skills

to others

[Bonanno, Jacelon, Mancini, Jackson, McMurtrie, Friedman]

Chaplain Steven Spidell Department of Spiritual Care and Value Integration Houston Methodist West Hospital

Leaders in Nursing 7


Houston Methodist Willowbrook Hospital

Celebrates Magnet Recognition ®

Houston Methodist Willowbrook Hospital (HMWB) is carrying on a proud Houston Methodist tradition of Magnet recognition

by recently earning this prestigious designation from the American Nurses Credentialing Center’s (ANCC) Magnet Recognition Program. Bestowed on less than seven percent of our nation’s hospitals, Magnet status provides consumers with the ultimate benchmark to measure the quality of care they can expect to receive. “Magnet is important to us on many levels. It is an elite designation that awards professional nurses for their stellar quality outcomes that they are able to achieve when working in a collaborative environment that allows them to put into practice both “We now have a culture autonomy and innovation that celebrates nursing to the full extent of their professionalism, a licensure,” said Sheila Fata, comprehensive nursing MBA, BSN, RN, NEA-BC, vice quality and strategic president and chief nursing officer at Houston Methodist plan, and sustained Willowbrook Hospital. “We quality results that started this journey to create an routinely outperform environment where nurses can established benchmarks.” work and excel as professionals. said Sheila Fata We now have a culture that celebrates nursing professionalism, a comprehensive nursing quality and strategic plan, and sustained quality results that routinely outperform established benchmarks.” 8 Methodist Nurse

Early phases of the designation process started more than three years ago with staff nurses and nursing leaders diligently building processes and structures that met the rigorous expectations of the Magnet program. These processes were fully described in the 3,000 page document that was submitted February 1, 2013. The efforts continued once documentation was approved and preparations were in place for the ANCC’s three-day site visit in early September. The culmination of these efforts was reached on Thursday, October 24 at 9 a.m. with a call from the ANCC Magnet Commission, giving the news that the hospital had earned the highest level of international recognition in nursing for health care organizations. A large group of HMWB hospital leaders, nurses, and Magnet Champions were present for the call, which many staff nurses on units listened to via conference call. Balloons and cake were brought to the Conference Center after the call took place and cupcakes were then served during lunch to


all employees in the Pathway Café. Sheila Fata personally delivered cupcakes to the night shift on units that evening. A hospital-wide celebration is planned in mid November with Texans cheerleaders, a football player and Toro, the team mascot, rounding on units and barbecue being served to staff members.

Benefits of Magnet Designation

“While this is a nurse-centric designation, it wouldn’t have happened without the support of the entire hospital. It required intradepartmental collaboration,” said Fata. “We had to show full compliance in meeting 87 different standards, and present numerous empirical outcomes relating to improvements gained through the work of nursing. To achieve this, we retooled infrastructure, enhanced quality processes, and streamlined our nursing plan. Our nursing team has created a culture within our organization that is focused on the highest levels of quality, healing and making a difference in the lives of our patients and their families.”

 Advance nursing standards and practice

Among the many notable accomplishments realized throughout the Magnet process were: revitalization of shared governance, which encourages nurses to be engaged in leading nursing practice at the hospital; increasing the number of baccalaureate prepared nurses at the bedside; increasing the number of nurses pursuing advanced degrees and certification; implementing unit-based dashboards that allow nurses to be actively involved in the analysis of unit data and the action planning process; the development of a research program and creation of original research studies; and organization of the Magnet Champions, a group of highly engaged staff nurses across departments who were crucial to the roll-out of Magnet education and the understanding of the Magnet culture across all of the units. “The credit for earning this Magnet recognition goes to our entire nursing team and our leadership team, and we are indebted to our medical community and our entire hospital staff for their great support,” said Fata. “This shows how strong intra-professional efforts can have such meaningful effects that culminate in providing high quality care, which truly reflects our I CARE Values.”

 Attract and retain top talent  Improve patient care, safety and

satisfaction  Foster a collaborative culture

MAGNET recognition program

The Magnet Recognition Program® recognizes health care organizations for quality patient care, nursing excellence and innovations in professional nursing practice. Consumers rely on Magnet designation as the ultimate credential for high quality nursing. Developed by ANCC, Magnet is the leading source of successful nursing practices and strategies worldwide.

 Grow your business and financial success  National Recognition of Magnet  US News & World Report utilizes Magnet

designation as a primary competence indicator in its assessment of almost 5,000 hospitals to rank and report the best medical centers in 16 specialties. Magnet requires organizations to develop, disseminate and enculturate evidencebased criteria that result in a positive work environment for nurses and, by extension, all employees.

Goals & Guiding Principles The Magnet Recognition Program® advances three goals within health care organizations:  Promote quality in a setting that supports

professional practice  Identify excellence in the delivery of

nursing services to patients/residents  Disseminate best practices in nursing

services. *Courtesy of ANCC American Credentialing Nursing Center

Leaders in Nursing 9


I CARE in ACTION Last month, in recognition of World Food Day, over 30 Houston Methodist nurses helped fight hunger in our local community by volunteering at the Houston Food Bank. Making a great impact through our organization’s I CARE in Action program, our nurses worked both morning and afternoon shifts to help pack 11,748 pounds of food, which will help to feed 9,790 people! “The Houston Methodist service project at the Houston Food Bank was a great example of our organization and our nursing staff giving back to the community,” said Robin Washington, RN, CNOR. “Volunteering to benefit those in need was also an awesome way of demonstrating our I Care values. I was honored to be able to participate in such a rewarding experience!”

10 Methodist Nurse


Physician Panel (L to R): Drs. Barbara Bass, Aldona Spiegel, Hailey Hall, Bin Teh, Tejal Patel, & Mary Schwartz (not pictured)

Pink Pride

Houston Methodist Cancer Center recently hosted a patient education event for a

celebration of breast cancer awareness, education, and empowerment. The event featured a multidisciplinary physician panel of breast cancer specialists. Attendees were able to ask questions and interact with physicians. This event was well attended with over 100 patients, caregivers, nurses, and support staff in attendance.

M7SW Nurse Selected as RN Spirituality Award Winner The Institute for Spirituality and Health at the Texas Medical Center presented its 21st Annual Nursing Conference on October 18. This year’s theme was entitled “Cultivating a Heart of Compassion for Patients and Their Caregivers.” Each year, a nurse is recognized for serving as an outstanding spiritual asset to their patients, department and organization. It was with great pleasure that I was invited to present Houston Methodist nurse Merly Notarte, R.N., from Main 7SW, with the 2013 RN Spirituality Award.

Leaders in Nursing 11


Driving Patient Progression in the Right Direction Top Care Crews OCTOBER 2013

Houston Methodist Hospital recently kicked off its Patient Progression Recognition Campaign entitled Readiness, Set, Go! This month, we congratulate our Top 3 Care Crews for driving patient progression in the right direction and ensuring that patients are discharged in a safe, efficient and effective manner.

F i rs t P l a c e

Main 7SW 45 points

Jones 11 44 points S e co n D

P l ac e

T h ir d

P l ac e

12 Methodist Nurse

D10W

43 points


November is Diabetes Awareness Month Nearly 26 million children and adults in the United States have diabetes. Another 79 million Americans

have prediabetes, which puts them at risk for developing type 2 diabetes. Recent estimates project that as many as one in three American adults will have diabetes in 2050 unless steps are taken to stop this challenging disease, which is also the nation’s leading cause of kidney failure. If you are living with diabetes or have a loved one with the disease, effectively managing diabetes is vital to preventing serious health problems from occurring. It is also important to know that if you have a family history of diabetes. This November, during National Diabetes Month, ask yourself if you’re at risk for type 2 diabetes and take the necessary steps to prevent it.

Staff Resources

A few small changes in your lifestyle such as eating healthier, increasing your physical activity or shedding a few pounds can help to prevent diabetes. And, during Diabetes Awareness Month is a great time to start. For Houston Methodist staff members currently battling diabetes as well as those who may be at risk, our organization has several resources to help make your life easier and help you avoid serious health complications. If you feel you need any help with managing your diabetes or would like more information on the disease, below are a few great programs that are offered through our Houston Methodist Wellness Services team.

use of hospital  The glucometers or any

other medical equipment by staff members for personal reasons is prohibited. For employee

medical concerns occurring on Monday – Friday, between the hours of 7:00 a.m. -4:30 p.m., staff members should contact Employee Health at 713.441.1391. For medical attention beyond those hours, employees should proceed directly to the Houston Methodist Hospital Emergency Department. Employees are also encouraged to access their personalized Healthy Directions WebMD accounts to record and track their blood glucose levels and access FAQs, recipes and more.

 Did you know

Wellness Services offers freeAccucheck® glucometers for Houston Methodist employees? Glucometers come with 10 free test strips and a lancet pen so that recipients have time to get a prescription for more strips from their doctor. Please contact employee dietitian Kristen Van Sickel at kvansickel@ houstnmethodist.org or at 713.441.5922.

 Wellness Services

WHAT DO THE NUMBERS MEAN? Normal 70-110 mg/dl Impaired glucose tolerance 110-126 mg/dl Diabetes >126

also runs a free program called Well Managed Diabetes for Methodist employees or spouses who have diabetes or pre-diabetes. Well Managed consists of twelve 30-minute individual sessions focusing on diabetes control. Please contact employee dietitian Kristen Van Sickel at kvansickel@ houstnmethodist.org or at 713.441.5922.

 Exercise is an

important way to manage blood glucose. Did you know there is a free employee fitness center in the Outpatient Center that is open 24-hours a day every day of the year? The fitness center even has showers, lockers, and complimentary towel service. For access, please contact Wellness Services at WellnessTMH@ houstonmethodist. org or 713.441.5936.

 Through insurance,

staff members with diabetes are eligible for diabetes education whether you are a newly diagnosed diabetic or someone who just wants continued diabetes education. Contact the Houston Methodist Diabetes and Metabolism Institute at 832.667.5673.

Tips for Improving Your Number  Eat a variety of foods everyday

 Eat high fiber foods such as fruits, vegetables, grains and beans  Use less added fat, sugar and salt

 Eat meals and snacks at regular times everyday

 If you want to lose weight, cut down your portion size

 Fill about ¼ of your plate with carbohydrate foods such as bread,

noodles, rice, corn and fruit

 Fill about ¼ of your plate with main-dish (protein) foods such as

meat, poultry, fish or meat substitute

 Fill at least ½ of your plate with vegetables such as carrots,

broccoli or spinach

Leaders in Nursing 13


DIABETES MYTHS There are many myths about diabetes that make it difficult for people to believe some of the hard facts – such as diabetes is a serious and potentially deadly disease. These myths can create a picture of diabetes that is not accurate and full of stereotypes and stigma. Get the facts about diabetes and learn how you can stop diabetes myths and misconceptions.

Myth: If you are overweight or obese, you will eventually develop type 2 diabetes. Fact: Being overweight is a risk factor for developing this disease, but other risk factors

such as family history, ethnicity and age also play a role. Unfortunately, too many people disregard the other risk factors for diabetes and think that weight is the only risk factor for type 2 diabetes. Most overweight people never develop type 2 diabetes, and many people with type 2 diabetes are at a normal weight or only moderately overweight.

Myth: Eating too much sugar causes diabetes. Fact: The answer is not so simple. Type 1 diabetes is caused by genetics and unknown

factors that trigger the onset of the disease; type 2 diabetes is caused by genetics and lifestyle factors. Being overweight does increase your risk for developing type 2 diabetes, and a diet high in calories from any source contributes to weight gain. Research has shown that drinking sugary drinks is linked to type 2 diabetes. The American Diabetes Association recommends that people should limit their intake of sugar-sweetened beverages to help prevent diabetes. Sugar-sweetened beverages include beverages like:  regular soda  fruit punch

 fruit drinks

 energy drinks

 sports drinks  sweet tea

 other sugary drinks

These will raise blood glucose and can provide several hundred calories in just one serving! *Just one 12-ounce can of regular soda has about 150 calories and 40 grams of carbohydrate. This is the same amount of carbohydrate in 10 teaspoons of sugar!

Myth: If you have diabetes, you should only eat small amounts of starchy foods, such as bread, potatoes and pasta.

Fact: Starchy foods can be part of a healthy meal plan, but portion size is key. Whole grain breads, cereals, pasta, rice and starchy vegetables like potatoes, yams, peas and corn can be included in your meals and snacks. Wondering how much carbohydrate you can have? A place to start is about 45-60 grams of carbohydrate per meal, or 3-4 servings of carbohydrate-containing foods. However, you may need more or less carbohydrate at meals depending on how you manage your diabetes. You and your health care team can figure out the right amount for you. Once you know how much carb to eat at a meal, choose your food and the portion size to match. Myth: People with diabetes can’t eat sweets or chocolate. Fact: If eaten as part of a healthy meal plan, or combined with exercise, sweets and

desserts can be eaten by people with diabetes. They are no more “off limits” to people with diabetes than they are to people without diabetes. The key to sweets is to have a very small portion and save them for special occasions so you focus your meal on more healthful foods.

Myth: People with diabetes are more likely to get colds and other illnesses. Fact: You are no more likely to get a cold or another illness if you have diabetes.

However, people with diabetes are advised to get flu shots. This is because any illness can make diabetes more difficult to control, and people with diabetes who do get the flu are more likely than others to go on to develop serious complications.

Myth: If you have type 2 diabetes and your doctor says you need to start using insulin, it means you’re failing to take care of your diabetes properly.

*Diabetes facts courtesy of American Diabetes Association and the Centers for Disease and Control Prevention

14 Methodist Nurse

Fact: For most people, type 2 diabetes is a progressive disease. When first diagnosed, many people with type 2 diabetes can keep their blood glucose at a healthy level with oral medications. But over time, the body gradually produces less and less of its own insulin, and eventually oral medications may not be enough to keep blood glucose levels normal. Using insulin to get blood glucose levels to a healthy level is a good thing, not a bad one.


Left (bottom) JoAnne Gaudet, Shannan Hamlin, Gilbert Barrera, Elizabeth Gonzales, Patricia Lewis, Ellen Fineout-Overholt, Kahla LaPlante, Laura Espinosa, Kathy Authors, Mary Harris

The ARCC Model

T

The Advancing Research & Clinical Practice through Close Bernadette Melnyk & Ellen FineoutCollaboration Overholt (ARCC) model is a guide that inaugurates the implementation of evidence-based practice (EBP) as a system-wide process, conceptualized by Melnyk (2008) in 1999. Development of this mentorship framework was cultivated to assist Advanced Practice Nurses and health professionals adopt strategies for successful implementation in clinical settings. Five steps toward successful implementation of EBP include (a) conducting an organizational assessment of the culture and readiness for EBP; (b) identifying EBP facilitators and barriers; (c) support scholars through a mentorship program; (d) place scholars in “Point-of-Care” locations; and (e) provide continuous EBP knowledge and training to scholars (Melnyk, Fineout-Overholt, & Mays, 2008). The ARCC model is part of a strategic plan to integrate research findings with clinical practice. The course of

By: Kahla LaPlante and Laura Espinosa action of the model is to establish a cohesive EBP culture by developing EBP champions possessing an interest in research and process improvement projects, through the mentorship of expert research staff. The intent of the model is to build confidence among health professionals, improve job satisfaction, transform health care organizations to implement and sustain EBP, and to compel a conscientious approach in medical practices, through the discovery of the best evidence possible, in patient care. Provisions of the ARCC model afford health professionals, an opportunity to gain the buy-in and support of the leadership team, and create a conducive atmosphere for the clinician’s, practitioner’s and the nursing staff (Wallen et al., 2010). Central focuses of the ARCC model are components such as performance, safety, efficacy, and interdisciplinary teamwork, which are essential tools needed to sustain an evidencebased practice culture. Wallen et al. (2010) posits High Reliability Health Organizations (HRHOs) are more equip to implement and sustain an evidence-based culture (Wallen et al., 2010). Key concepts of HRHOs imply mindfulness of system processes that impinge upon patient

care, reluctance to simplification, engagement in the root-cause analysis, cognizant of the differences in expertise, resilience, and quick to respond to at-risk situations (Melnyk, 2012). Characteristics of an HRHO include the ability of leadership to identify EBP interventions, convert organizational behaviors, examine measures to improve outcomes and quality of patient care, and evaluate baseline performance of staff members (Pronovost et al., 2006). The Houston Methodist Hospital system has successfully completed two of the five steps of the ARCC model, towards successful implementation of EBP. On April 3, 2013, the Houston Methodist Interprofessional Research and Evidence-Based Practice Council began a 12-week EBP mentorship program, which successfully ended on July 31, 2013. The council held the first annual Evidence-Based Practice Symposium on September 20, 2013, featuring Victoria M. Steelman, PhD., (IOWA Model developer), and Ellen Fineout-Overholt (EBP expert and publisher). The ARCC model has been an essential instrument in leading Houston Methodist towards sustaining an EBP culture.

Leaders in Nursing 15


Nursing News

The 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: tmitchell2@houstonmethodist.org.

Kudos to the following staff from Alkek 7: Assumpta “Iffy” Iwe, R.N. – successfully completed her MSN degree from University of Texas Health Science Center Houston and is now board certified as a Geriatric Nurse Practitioner.

Congratulations to Charyl Bell-Gordon, D.N.P., R.N., F.N.P.-C., C.E.N., director of the Nurse Practitioner Program, for completing her Doctor of Nursing Practice degree. Her scholarly project was focused on the nurse’s ability to recognize clinical deterioration. Way to go!

Alina Leigh, R.N. – successfully completed her MSN degree from Texas Women’s University Houston and is now board certified as a Family Nurse Practitioner

The CMS Delirium Grant Team would like to congratulate Dunn 4 West as the top performing unit for nursing compliance in screening for delirium using the modified CAM (Confusion Assessment Method) for the month of August. Dunn 4 West nurses had an overall compliance score of 100 percent. The following units also performed well: Jones 9 IMU- 96 percent and Dunn 7 East with 91 percent.

Lixian Luo, R.N. – successfully completed her MSN from Texas Women’s University Houston and is now board certified as an Adult Gerontology Acute Care Nurse Practitioner. Nina Hawthorne, M.S.N., R.N. II – has successfully completed the criteria for promotion to RN IV on Alkek 7 Georgia Blackshire, PCA II – has successfully completed the criteria for promotion to unit secretary on Alkek 7. And, congratulations to these nurses on Alkek 8: Melinda Freeman, R.N., promoted to R.N. II; and Natalie Willis, R.N., who has passed the Medical-Surgical certification. Great work! Congratulations to Kathleen Ulanday, M.H.A., M.B.A., R.N.B.C., who has been invited to speak at The American Nursing Informatics Association’s (ANIA) 2014 Conference in Las Vegas, on March 27-29, 2014. Congratulations to Shannan Hamlin, Ph.D., R.N., who was recently invited to present her hemodynamic research at the American Association of Critical Care Nurses 2014 National Teaching Institute in Denver.

Congratulations to Sheri Baum who recently earned her certification in Emergency Nursing. Kudos to Laura Moore, R.N., Care Navigator, who recently earned her ANCC Certification in Nursing Case Management. Congratulations also go out to the following newly certified case managers who received their Accredited Case Manager (ACM) certifications: Lori Generes, Gloria Govella, Margaret Goodrich, Michelle Millender, Audra White and Audrey Thomas, R.N. A special congratulations goes out to Kelly Bria, R.N., a nurse at the Alzheimer & Dementia Clinic of the NNAC. Kelly recently fulfilled all the requirements for the Certified Neuroscience Registered Nurse program of The American Board of Neuroscience Nursing and has earned the CNRN credential. Way to go Kelly!


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