University of Louisville Nursing Annual Report 2011 by Louis Defreeze III

A N N U A L

R E P O R T

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University of Louisville Hospital | James Graham Brown Cancer Center

MESSAGE FROM THE

CHIEF NURSING OFFICER

Greetings, Our Nursing Vision Statement at UofL Health Care charges us to be leaders in patient care, education and research. Each year we review our strategic plan to determine if we are on the right track. Do we need to eliminate a strategy that isn’t providing the proper outcome, add a new strategy or stay the course? Looking back at 2011, we saw significant improvements in our quality and operational outcomes. The educational level and certification of our nurses continued to climb, while nursing satisfaction improved and, consequently, turnover decreased. This all puts us on target with our goal to be a nationally recognized healthcare organization, but we still want and need to do more if we are to continue delivering first-rate care to the community. One of our goals is to increase the number of BSN direct care RNs. Today 60 percent of our direct care nurses have BSNs. While this average is better than most academic medical centers, the Institute of Medicine’s report, “Future of Nursing: Leading Change, Advancing Health,” encourages hospitals to have 80 percent of their direct-care nurses holding BSNs by 2020. Our strategy to increase this percentage each year is on target. We also have seen our nurses continue their educations by obtaining advanced degrees as well as certification in their specialties. Our new Nursing Professional Development Program (NPDP) demonstrates how we support our direct-care RNs in advancing their careers. Professional nursing certification enhances the quality of patient care and contributes to the overall professionalism and dedication of our staff. That’s why we encourage and sponsor review courses for nurses to pursue professional certification, and that is why we implemented a certification reimbursement policy and included certification in our NPDP. This past year we also began a BSN Nurse Residency Program for new RN graduates. This yearlong initiative helps ease new graduates’ transition from the classroom to the bedside. It provides them an opportunity to see how our organization works and the impact of their contributions on our success. At the end of the program, each participant completes a project focused on quality improvement in his or her area. These projects are also presented to nursing leadership and many have been instrumental in improving patient care. While all of our quality metrics continue to improve, we strive to do better. Each unit has specific measurements posted to show how it is performing. This is important, as it enables us to compare where we’ve been with where we are today. Soon the Centers for Medicare and Medicaid Services will no longer reimburse hospitals for errors and “never events.” Our metrics also will be publicly available. We want to ensure these scores are exemplary and that they tell the public that our facility is a safe place where they will receive the highest quality of care. As such, it is imperative that we continue to focus on quality, safety, efficiency and eliminating waste. Along with initiatives to treat acute illnesses and injuries, we have broadened our focus to address chronic conditions, the aging population, a more diverse population, health disparities and the limited English proficiency of our patients, too. We also continue to find more ways to partner with patients and families, engaging them as much as possible in their own treatment regimens and in helping us create policies and strategies designed to improve the overall health and quality of life for area residents. I want to thank each one of you who is helping us achieve this vision through your extraordinary efforts and selfless commitment to Excellence Defined. Working together, we are taking it to the next level in a transformation that is fully preparing us to meet the healthcare needs of the 21st Century. Sincerely,

Mary Jane Adams, MSN Chief Nursing Officer and Senior Vice President

UofL H E A LT H C A R E N U R S I N G

Nurses are the heart and soul of the day-to-day, high-quality care that we provide our community at University of Louisville Hospital and the James Graham Brown Cancer Center. We have a passionate commitment to caring, healing, teaching and learning. We see, hear and feel that passion every day through our interactions with patients, family members and one another. This year we have continued to define our passion for excellence, continually working together to improve our processes and advancing our journey toward Magnet designation.

Nursing Vision Our nursing vision is to be nursing leaders in patient care, education and research.

Nursing Mission Statement Our nursing mission at University of Louisville Hospital and the James Graham Brown Cancer Center is to provide patients exceptional care by integrating evidence-based knowledge, integrity and compassion.

Nurse Theorists Caring: Jean Watson, RN, PhD Cultural Competence: Josephina Campinha-Bacote, PhD Communication: Bonnie Duldt-Battey, RN, PhD

Philosophy As members of an interdisciplinary healthcare team, we welcome the challenge of providing exceptional nursing care to patients in a dynamic, complex and culturally-diverse environment.

Values

Excellence Professionalism Evidence-based knowledge Integrity Compassion

Nursing Delegation Attends National Magnet Conference A group of our nurses learned more about defining our excellence at the National Magnet Conference, October 4-6, 2011, in Baltimore, Maryland. The conference theme was “Honoring the Past. Creating the Future.” The conference reflected on “A Visual History of the Modern Nurse,” the shifting healthcare delivery system and how it will impact our role as nurses. The following ULHC nurses attended:

Tonya McGill, RN Leslie Lauterwasser, RN Cynthia Logsdon RN, PhD Suzanne Luzama, RN Roxanne Perucca, RN Neika Powers, RN Amber Smith, RN Libby Smith, RN Chris Thompson, RN Kim Williams, RN

EX C EL L E N C E

At the heart of all we do is a dedication to excellence and outstanding patient- and familycentered care. Our nurses lead the way in seeking out ways to improve processes that continually improve patient care. These a just a few stories that showcase the compassion and commitment exhibited by our nurses each and every day.

S P O T L I G H T

CWI Tightens the Bonds The Center for Women and Infants at University Hospital takes a personal approach when it comes to caring for newborn infants and their mothers. The Center was created by leaders in the field of maternal-fetal medicine, high-risk obstetrics and gynecology. But along with keeping patients healthy, it offers programs designed to help new parents and infants get off to a great start and to tighten the bond between mother and child. “Last year we added or expanded several initiatives with this goal in mind,” said Libby Smith, RN, MSN, PHN. Smith is the Center’s Nursing Director. “Our new outpatient Lactation Center, which opened May 2011, was among them.” The Lactation Center includes three International Board Certified Lactation Consultants and 32 Certified Lactation Counselors. They are there to provide information and assistance to mothers who want to breastfeed but need help. “The Kangaroo Care program also took great leaps in 2011,” Smith said. This unique program, begun in 2007, emphasizes skin-to-skin contact between parent and infant, something that research shows enhances bonding and helps babies adapt better to life outside the womb. In a partnership with WIC, the Kangaroo Care program sent staff statewide in 2011 to give Kangaroo Care Workshops in every Kentucky birthing hospital. “Our staff worked tirelessly all year to open the Lactation Center and to make Kangaroo Care a standard of care,” Smith said. “Their efforts in these, as well as in all the other services and programs that help us maintain our leadership role in women and infant care, epitomize our nursing vision of Excellence Defined.”

Care 6

S P O T L I G H T

The Multidisciplinary Approach of the JGBCC The nurses and other staff at the JGBCC have a simple philosophy: Because every patient is unique, their treatment plan needs to be tailored to their individual needs. To achieve this, the center employs a multidisciplinary approach that is truly a differentiator for the JGBCC. “When people go to seek treatment, it is generally surgeon-driven but with the multidisciplinary approach, the team as a whole acts as the driver for the treatment plan, not just the surgeon,” said Barb Kruse, Director of Multidisciplinary Clinics for the JGBCC. That team reflects the combined expertise of many physicians and clinical staff across the spectrum to address the breadth of clinical, physical, emotional and mental needs of the patient. These can include a surgeon, radiation oncologist, medical oncologist, radiologist, pathologist, behavioral medicine staff (psychiatrist, psychologist), nurse navigator, nutritionist, oncology-certified nurses, physical therapist, social worker and chaplain.

“In an academic setting, the nurses are truly collegial partners with the physicians. They bring that respect, integrity and teamwork that’s so necessary to give exceptional care. And they do it with passion and with evidence-based knowledge and practice. They are dedicated solely to spending time on an individual’s specific diagnosis and treatment so the nurses feel ownership for following up on that care.” Some key accomplishments for the multidisciplinary clinics for 2011 included:

Establishing a pulmonary nodule clinic through lung clinic

Establishing and adding new positions to multidisciplinary clinics and supportive services

Adding new physicians to GI group

Expanded head and neck screening outreach

Started full conference for brain and spine tumor clinic

Received grant from Hats for Hope to support full-time social worker for breast clinic

The patient-centered approach of the multidisciplinary team includes characteristics that are key to its success: the weekly conference, team decision-making, integration of all disciplines, targeted therapy and patient navigation through diagnosis, treatment and recovery.

Expanded art therapy hours and opened program to children

According to Barb Kruse, the nurse navigators are truly the catalyst that help the patient to understand the process and then help to guide them through their continuum of care - from diagnosis to surgery to radiation therapy to chemotherapy.

Developed psychosocial “distress thermometer” with established

For the nurse navigator, her role on the team and responsibilities include the five core components of the multidisciplinary approach – Leadership, Coordination, Communication, Marketing and Research. That focus on key goals has established the nurses as vital to ensuring excellence for the multidisciplinary clinics, said Barb Kruse.

Continued American Cancer Society Grant for patient transportation, applied for Komen grant for Resource Center and continued previous Komen grant for Resource Center products and materials

interventions for patient care in each clinic

Began discussions on survivorship tool to measure survivorship issues – (concentration on helping patients “define a new normal” post treatment

Expanded community partnership with Gilda’s Club and now serving dinner quarterly

Working with Kentucky Cancer Program on community projects including Race for Cure, Colon Cancer Initiative and head and neck screenings.

COM MU N I C AT I O N

During the past year, we have focused on building a supportive practice environment through increase involvement and engagement from our nursing staff. We believe in the shared decision-making process. We encourage and value the input from all nurses at the unit, department and hospital level. The following are some examples of how direct care nurses through shared decision-making exemplify Excellence Defined.

S P O T L I G H T

A Strong Voice for Direct-Care Nurses Rena Bennett finds great satisfaction in being a direct-care nurse and a leader within our organization. Bennett, BSN, SANE, who works on 7 WEST, CCU, spent a great deal of time in 2011 working to ensure that direct-care nurses were well represented in our shared-decision making approach. Her accomplishments included:

Assisting with the bedside report initiative and education in the clinical quality and practice

Helping with the 30-minute no-transfer of patients (with the exception of stat patients) to facilitate bedside report.

Working to encourage the use of a standard form for Unit-Based Council meetings

Encouraging the use of unit-based websites

Starting the inclusion of a broader interdisciplinary team approach to Clinical Quality and Practice Council (these teams included: Information technology, pharmacy, clinical labs, supply chain, respiratory therapy, physical therapy/occupational therapy/speech, and wellness)

“The things that I find most rewarding about my job are 1. Things are always changing. It is never boring. 2. I can see the impact of my accomplishments this year. 3. We work in a wonderful facility with great people every day. 4. With all my new experiences I see that the opinions of the bedside nurse matter and are starting to be utilized,” she said. Bennett is grateful for the opportunities she’s had to help others while growing as a leader amongst her peers, Rena validated her leadership by completing Level 2 of the Nursing Professional Development Program “Teamwork and accomplished clinical staff have helped me define excellence at University Hospital,” she said.

S P O T L I G H T

Sharing Our Story with the Public in Innovative Ways In 2011, we worked with our marketing team to expand our reach in telling our nursing story. In addition to our internal nursing newsletter, we shared our information and successes externally through our UofL Health Care Nursing Facebook page, as well as our popular nursing website at uoflnursing.com.

Below are just a few of the many comments we’ve received:

In addition, we also receive numerous accolades and expressions of gratitude from former patients and family members who submitted their stories to our blog at stories.uoflhealthcare.org, as well as to our JGBCC and ULH Facebook pages.

Eugenia Woodard of Austin, Ind., who struggled with a life-and-death battle against painful flesh-eating bacteria

“We’ve found that the public has enthusiastically embraced our social media and web endeavors. What’s been so exciting is that they’ve turned to these avenues to say ‘thank you’ to our nurses in very public, poignant and powerful ways that weren’t available to them before we expanded the way we communicate,” said Melissa Deaver, Marketing and Communications Manager for University Hospital and the JGBCC. “I love sharing these messages with members of our leadership team and nursing staff. These comments from the heart are tangible ways to see the difference our nurses are making in the lives of those they care for day in and day out.”

The nurses were very dedicated to my healing and sympathetic to my pain. Eleven days after I was admitted, I was sent home to finish my recovery.

I still can’t stop talking to people about the utmost care and compassion I received from the entire staff of nurses, assistants, doctors and other stroke team staff. My son even made a few nurse friends while there. I felt the utmost confidence in the care I received while at University Hospital and would recommend them to anyone. Kristen Copis, a 31-year-old wife and mother of a 3 year old from Glasgow, Ky., who suffered a stroke

I cannot tell you how comforting all the staff was. The nurses were kind and understanding of me as a patient, as well as a nurse. My experience there has helped me become a better nurse myself. Melissa Braden, a Registered Nurse in the emergency room at Norton Hospital and a wife and mother of five who was treated for anal melanoma by our team members at both the JGBCC and ULH

I cannot thank everyone enough for saving my husband’s life. I am now trying to pursue my nursing career so that I can give back to University Hospital for giving back my family! 11

Christa Speagle, wife of former trauma patient Christopher Michael Speagle, who received numerous injuries in a motorcycle wreck

In addition to our social media and web outreach efforts, our nursing program was spotlighted on several high-profile local media outlets in 2011.

S P O T L I G H T

Promoting Nursing Excellence on Wave 3 On May 24, 2011, several nursing personnel were interviewed by local television personality Cindi Sullivan on the noontime talk show WAVE 3 Listens. The segments promoted how we are defining excellence at University Hospital and the JGBCC. Betsy Wise, APRN, told viewers about the hospital’s Stroke Program, while Mary Jane Adams, CNO, and Roxanne Perucca, director of Magnet/ Nursing Excellence, shared information on the recent Department of Nursing strategic initiatives and the Magnet Recognition Program. Kimberly Williams, a nurse in Acute Pain Service, discussed the Pain Management Program and what being named the 2010 Nurse Excellence Award Winner meant to her.

S P O T L I G H T

University Hospital Nurses Featured on Public Radio Program University of Louisville School of Nursing Dean Marcia Hern, along with University Hospital Trauma Nurse practitioner Kimberly Broughton-Miller and Cathy Velasquez, the program coordinator in the Nursing Education and Research Department, were featured on 89.3 FM WFPL’s State of Affairs. The veteran nurses were asked to share their thoughts on the evolution of nursing and how the economy has affected today’s profession and nursing education. The program aired in early March 2011.

PR O FES SI O N A L I S M

The professionalism of our nurses is reflected in the respect and trust patients, physicians and other hospital staff place in them. Our nurses constantly seek ways to expand their skills and knowledge. We are proud of our nurses and the positive image they portray for our hospital and the nursing profession.

S P O T L I G H T

Making a Difference Through Education University Hospital and the JGBCC take great pride in supporting and nurturing nursing professionals as they develop into leaders dedicated to excellence. Mark Spivak, RN, BSN, CEN, offers a prime example of how leadership is dedicated to helping the nurses in their units move ahead in their careers. As an advanced practice educator in University Hospital’s Emergency Department (ED), he worked on numerous professional development projects. They included revising the department’s critical care course for new nurse graduates, becoming a PALS instructor, helping several ED nurses prepare and pass their certification exam, plus a great deal more. Spivak also gave a presentation on the department’s Community Assistance Program (CAP) to Agency for Healthcare Research and Quality (AHRQ). CAP is an innovative program begun by Anna Smith in which patients who come to the Emergency Department with acute alcohol intoxication are offered a safe alternate treatment at the Healing Place. Substance abuse is a serious problem in the community, and many intoxicated individuals were taking up limited bed space in the ED with no other diagnosis than acute intoxication. Historically, the individual was allowed to sober up and then be discharged, beginning the cycle all over again. “Anna saw an opportunity for improvement to both the individual and the community,” Spivak said. “The partnership included University Hospital purchasing a van for the Healing Place. Once an individual was deemed safe for discharge, the ED staff would contact the Healing Place. They would come get the patient and take them back there for an opportunity to start the recovery process.” Today the program has expanded so that anyone in the community (other hospitals, libraries, public places, etc.) can call CAP to pick up an intoxicated individual looking to get help from the Healing Place. To date thousands have benefited from the program.

Information about CAP spread after Spivak’s presentation to AHRQ, leading to interviews by the media and invitations to co-author a journal paper on CAP with Smith and others involved in the initiative. Spivak also made time to coordinate a community health fair with Dr. Kay Roberts of the Harambee Clinic. “Our role in the community as a safety net hospital is something to be very proud of,” Spivak said of why he dedicates so much time both inside and outside his normal work day to advancing the profession. “I think that being an academic medical center drives everyone to continuously learn. I can’t tell you how many people I know that are either enrolled in school right now or recently graduated while working at ULH. If they’re not in school, they are studying for their certification or looking for the newest best practices to bring to the bedside. “I believe this constant need to know what the best evidence practice dictates translates to better patient care and outcomes. The entire building is literally buzzing with new knowledge, and I find that extremely exciting.”

S P O T L I G H T

Opportunities Abound Through New Professional Development Program The Nursing Professional Development Program (NPDP), launched in 2011, is an essential component of Excellence Defined. NPDP recognizes direct care RNs for their contributions to excellence in nursing practice and patient care through formal recognition and a monetary award for their accomplishments. It also promotes lifelong learning and establishes individual accountability for one’s professional growth and clinical advancement.

Congratulations to the following RNs who successfully completed the inaugural NPDP program in 2011: Level 3

Joni Crusott, RN, BSN – Mother/Baby Complex

Kim Williams, BSN, RN-BC – Pain Clinic

Level 2

Karen Gividen, RN – OR

Amy Augustine, RN, BSN, CCRN – Burn Unit

Leah Ashby, RN, BSN – 5 South

Meghan King, RN, BSN, PCCN – 5 South

Rena Bennett, RN, BSN, SANE – CCU

Susanna Bowen, RN, BSN – L&D/Mother Baby Float Pool

Tara Garris, RN, BSN – L&D/Mother Baby Float Pool

All NPDP applicants must have actively participated in either a quality improvement initiative, evidence-based project or a research study. Amy Augustine, BSN, RN, CCRN of the Burn Unit was the first RN to complete the Nursing Professional Development Program application process for the Spring Cohort of 2011. She successfully applied for Level 2 of the program and was granted this distinction in April 2011. In an interview for the ULH nursing newsletter Destination Nursing Excellence, Augustine expressed surprise that more people were not applying to the NPDP. “I know many nurses who are already going above and beyond the job description to elevate patient care and their nursing practice in our hospital. The majority of these extra activities and projects can be used for points in the NPDP,” she said.

The Nursing Professional Development Program is essential in defining nursing excellence at ULHC. It offers RNs the opportunity for reward and recognition of their efforts to improve themselves professionally without the need to leave the area of bedside care. The opportunities afforded by the NPDP support increased engagement in the nursing profession and in clinical practice at this facility. Increased nursing engagement has been shown to reflect positively on patient outcome indicators. Pamela Smith Elzy, RN, BSN, MA, CNOR Director, Nursing Education, Research and Clinical Informatics

ULH | BCC RN EDUCATION

Goal

60 Professionalism is promoted through our commitment to life-long learning. In 2011, the number of direct care nurses with a BSN continued to increase. Tuition reimbursement is available to our many

45 30

nurses who are pursuing an advanced nursing degree.

15 0

ULH | BCC RN CERTIFICATION

2009

2010

2011

ULH | BCC

Goal

20 In addition, we strongly encourage and offer financial support to our

nurses to become certified in their specialty area. In 2011, many nursing certification prep courses were sponsored by our hospital. As a result,

the number and variety of certifications steadily increased. Professional

nursing certification enhances quality patient care and professionalism. We nurture and support our nurses to be leaders dedicated to

excellence. 2009

2010

2011

ULH | BCC

Goal

S P O T L I G H T

BSN Nurse Residency Program has Successful First Year Our BSN Nurse Residency program enables new nurses to get off to a great start. The program provides nurturing, guidance and encouragement to graduate nurses in their first year of practice and enhances their critical thinking, problem solving, interpersonal and clinical skills. All newly hired BSN graduates with less than a year of experience are enrolled in the program. They are supported in their transition from academics to complex clinical practice in an academic medical center with a Level 1 trauma center. During the year they spend in the program, they meet regularly with peers to learn about our hospital culture and to professionally grow together. Each Nurse Resident also participates in an evidence-based practice project specific to his or her unit quality and safety initiatives. To date, 22 first-year nurses have successfully completed our BSN Nurse Residency Program, including 14 in May and eight in December. The initial cohort of Nurse Residents was part of a collaborative project with the University of Louisville School of Nursing. Cathy Velasquez, RN, DNP, CPHM, is the hospitalâ&#x20AC;&#x2122;s professional development coordinator in Nursing Education and Research. She also served as Nurse Residency Program facilitator.

The Nurse Residency Program is essential in defining excellence at ULHC. Both the Joint Commission (2002) and the Institute of Medicine (2010) advocated for the development of nursing residency programs, which have proven to dramatically reduce the number of RNs who leave the profession within the first 12 to 24 months of practice. Helping new graduates transition into practice in a supportive environment allows them time to develop an understanding of the complexities of patient care in a Level One Trauma Center and develop confidence in their ability to appropriately care for those patients and families. Pamela Smith Elzy, RN, BSN, MA, CNOR Director, Nursing Education, Research and Clinical Informatics

CARING

It takes a special kind of person to be a nurse. But it takes a special kind of nurse to be part of an academic medical center. We define caring by the personal connection that our nurses make with patients and their families. Our nurses are the well-known faces of caring. Intentional caring is listening from the heart. Our nurses are committed to providing more than the physical aspects of healthcare by also taking into consideration the psychosocial, cultural and spiritual concerns of the patient/family. The following examples exemplify our commitment to caring for the whole person, patient and family.

S P O T L I G H T

Expanding Patient- and Family-Centered Care for Better Outcomes The nurses, physicians and staff at University Hospital and the JGBCC collectively embrace and commit to providing patient- and family-centered care (PFCC). This concept recognizes the vital role families play in ensuring the health and well-being of patients of all ages. As part of this commitment, the organizations are a Pinwheel Sponsor of the Institute for Patient- and Family-Centered Care. Pinwheel Sponsors are dedicated to advancing the understanding and practice of PFCC, to making a significant difference in promoting this philosophy of care and to serving as a role model of PFCC. Linda Ritter, RN, MBA, BSN, is a Nursing Director and our Patient- and Family-Centered Care Committee Chair. She reports several ways in which PFCC was expanded in 2011. “Among the new initiatives,” she said, “was the transition from a very restrictive visitation policy to one that emphasizes that families are a core part of the patient’s healthcare team and encourages a 24-hour presence. We also developed ‘partner in care’ bands to identify the people in a patient’s life the patient deems integral to his or her care.” A computer tracking system that documents the patient’s partner-in-care, plus details the education provided on PFCC to the patient and family, also was implemented in 2011. Yet another milestone came through the expansion of the Care Advisory Team. The team is made up of former patients and their families along with staff representatives. Its mission is to promote the culture and ideas of PFCC; to advise hospital leadership, faculty and staff on patient needs and hospital priorities from a patient and family perspective; and to educate and empower families about their role in their loved ones’ care.

“Integrating former patients and families as members of our organization enables us to effectively use their wisdom and experience to redesign and improve our care system,” Ritter explained. “This team has been instrumental in helping us implement numerous PFCC initiatives, such as bedside shift reporting, updating white boards, developing our family presence policy and redesigning our lobby to be more family friendly.” One of the organization’s proudest accomplishments in 2011, Ritter said, was the “Promise” poster, which every hospital employee signed to demonstrate their commitment to PFCC. “This has been instrumental in making our organization more attuned to PFCC,” she explained, “and keeps us connected to our mission of nursing excellence enhanced by patient- and family-centered care.”

S P O T L I G H T

EPS Renovation Redefines Excellence in Unit Design Some say it takes a village to succeed when working for a common goal. But, just sometimes, it takes a modular home. University Hospital’s Emergency Psychiatric Services (EPS) is the region’s only specialty emergency room dedicated to the care, treatment and stabilization of patients with psychiatric disorders. The staff serves as a crisis intervention team to stabilize patients in emergency situations. Recently the unit was temporarily located in a triple-wide modular facility while its permanent space underwent renovation. Though not the most modern facility, the modular did have an advantage, according to Kathy Cox, RN, MSN, Director of Psychiatric Services at University Hospital. “It taught us about increased teamwork among disciplines and the effect of a more open unit on patient agitation, restraint and seclusion episodes and wait time,” she observed. The staff used what they learned in “the trailer” to work closely with architects and University Hospital’s Engineering, as well as Risk Management and Clinical Quality and Patient Safety Departments to create a safe, welcoming space that shows patients respect. The newly renovated unit, opened in June 2011, features 20 beds, including eight private and six semi-private rooms. Numerous safety features have been implemented to provide a secure environment for patients, visitors and staff. Returning to the beautifully renovated unit with its increased space and visibility reinforced the staff’s experiences in the temporary quarters, Cox said.

“The team had become comfortable there with more openness and visibility, plus we learned that patients appreciate being able to see staff work hard to help them,” she explained. Along with space and better visibility the renovated unit features small things like etched glass windows that allow a feeling of the outside and a break room for staff which are very much appreciated by the team. Cox said, “Barriers, literally and figuratively, have been taken down in EPS, with a decrease in violent episodes despite an increasing number of visits.” Nursing was not always a part of the EPS team at University Hospital. In fact, it wasn’t until the mid-90s that the value of nursing clinical skills became evident. Today, however, EPS nurses play a key role in identifying behaviors, disease processes and risks, and the life stories that patients bring to the hospital. “We continually evaluate our operation to ensure we are applying sound evidence to our practices,” Cox said. “In 2011 this led us for the first time to allow a service animal to remain with a patient during her time in the unit.” She said they also began a trial study of an evidence-based violence assessment tool in order to apply early interventions. And, in another new initiative begun in 2011, they are piloting a high-reliability, high-validity suicide risk assessment that may eventually be carried out to medical/ surgical units. “Every effort we undertake, whether trial study or carefully planned facility design, has the goal of better supporting those who need our services and compassion,” Cox said.

B E F O R E

A F T E R

S P O T L I G H T

Q UALI TY & PATI EN T S A F E T Y

Improving the quality and safety of patient care is our top priority, and there are dozens of quality improvement initiatives and evidence-based projects under way across the hospital. Our outcomes are compared to external databases and national benchmarking sources. Each nursing unit posts its individual quality goals and results on a unit-designated bulletin board. Many of our quality and safety initiatives begin at the grassroots level with those closest to the patient â&#x20AC;&#x201C; our nurses. The following demonstrate some of our successes in 2011, ranging from basic quality and patient safety initiatives to improving our processes to achieve exceptional patient care.

S P O T L I G H T

Outpatient Surgery Team Rises to the Challenge CNO Mary Jane Adams continually challenges the nursing staff at University Hospital and the JGBCC to embrace their profession. That leads to a lot of self-evaluation, says Christina Thompson RN, BSN, MHA, CNOR, Director of Outpatient Surgery. “For each nursing intervention we perform, we must ask ourselves if we are basing our care on evidence and best outcomes. As we acknowledge our nursing mission and vision, we will begin to turn away from taskoriented practices and move into a more thought-provoking method that will enhance patient outcomes,” Thompson said. As a leader in the Outpatient and procedural arenas, Thompson said she initially felt challenged to help her staff identify meaningful ideas and processes to improve patient outcomes. “With the passing of time, and with more involvement in the Unit Based Practice Councils and other nursing programs offered within the hospital, the team is definitely rising to the challenge,” she noted. For instance, Pam Cox, RN, the Charge Nurse in the Interventional Nephrology Department (IND), housed in UofL’s Health Care Outpatient Center, or HCOC, led the startup of a journal club. To date, the articles selected for publication have been evidence-based research relevant to patients in their area and in general. Though the IND team is small (four RNs, two radiology technicians and two physicians), they practice patient care using a multidisciplinary approach. The unit’s patient satisfaction scores stay between 97 percent to 100 percent, and patient- and family-centered care is practiced consistently. IND is a relatively new specialty that does not yet have a national professional organization. University Hospital’s IND team is helping to change that.

Thompson said, “We’re fortunate to be at the ground level of creating this organization, and some have just returned from a national ASDIN (American Society of Diagnostic and Interventional Nephrology) meeting in New Orleans. Pam and her group are planning on creating a poster presentation for the 2013 meeting.” Finally, Thompson said, the vision of the Magnet program and what it means to be a part of this initiative provides a catalyst for the unit. “In this everevolving healthcare environment,” she said, “nurses must be prepared to accept the changes and move forward. Becoming involved in the Magnet journey and all that it encompasses is a great way to begin!”

S P O T L I G H T

5 South is a Team Focused on ‘Always’ The Nursing teams at UofL Health Care continually work toward excellence in their practice — and it’s paying off. Those in 5 South, University Hospital’s Progressive Care Unit, exemplify the dedication, hard work and teamwork being exerted in order to provide the highest level of patient care. The 5 South nurses have incorporated into their routine the philosophies of Patient- and Family-Centered Care along with hourly rounding, bedside shift reports, rounding with physicians and the use of white boards in the rooms. This better involves patients and families in their treatment plan while simultaneously increasing communication among every one participating in the patient’s care. In 2011, these practices not only helped 5 South accomplish the goals set by the hospital, but to exceed many of them, too. This included attaining five out of five National Database of Nursing Quality Indicators (NDNQI) each quarter encompassing patient falls, pressure ulcers, restraints, catheter associated urinary tract infections and central line bloodstream infections. The 5 South nurses also met or exceeded their patient satisfaction goal of 85.2, plus five out of eight HCAHPs each month with a score of greater than 50 percent. Clinical manager Melissa Burchett, RN, BSN, CCM, explains how they accomplished this. “To be successful in meeting or exceeding the goals, 5 South first and foremost works together as a team, focused on always when it comes to meeting the needs of patients and families in a positive manner,” she said.

We strive to be caring and compassionate, to have a strong work ethic and to openly communicate. We also want to be role models and mentors. Finally, we take full responsibility and accountability for our actions. The staff cares for each patient and family as if they were their own family member. Melissa Burchett, RN, BSN, CCM 5 South Clinical Manager

COM MUN I T Y

Nurses are drawn to serving and to using their knowledge and skills to help others. Our nurses are also natural teachers who are committed to sharing their knowledge and expertise to further patient care. Along with the patients who enter our hospital doors, we care for the people in the communities where we live. The following examples show how our nursesâ&#x20AC;&#x2122; influence extends far beyond our hospitalâ&#x20AC;&#x2122;s walls.

S P O T L I G H T

Putting Volunteerism to Work for the Public UofL Health Care nurses are far more than caregivers. They are mentors, educators and advocates for their patients and families. They also are active partners with other healthcare providers. Community outreach is a major catalyst for these efforts, as demonstrated by the volunteer work of the nurses in Inpatient Blood and Marrow Transplant/Oncology ICU unit (6 East). One of the unit’s goals in 2011 was to compile and educate patients on services that are available to them out in the community along with those offered at the hospital. “We wanted to enrich patients’ support base as they work through their cancer treatments,” explained DenEllen Coldiron, RN, MSN, OCN, CHPN, and Director for Inpatient Oncology and Palliative Care Services at University Hospital. As such, the 6 East nurses teamed up with Gilda’s Club Louisville last June to prepare and serve a Mexican fiesta. A month later they were back at the club to cook up an Italian feast that was enjoyed by about 50 families. Gilda’s Club is an organization that provides social and emotional support to anyone touched by cancer, whether it’s their own diagnosis or that of a loved one. This volunteer participation provided the nursing team a firsthand opportunity to learn about the benefits Gilda’s can offer patients, complementing what is already offered through the hospital and the JGBCC. “This is the type of project that has a lasting impact on patients and their families as well as the nursing staff on 6 East,” Coldiron said. “Participating in volunteer activities together, outside the regular scope of work, increases our nurses’ camaraderie, cohesion and respect for one another. “Our nurses were also able to identify acute patients they had taken care of on the unit to those patients now reconnecting to their homes and community settings through Gilda’s Club. This could have lasting

implications on the patient’s and family’s ability to reintegrate back into the community.” The success of the Gilda’s Club collaboration motivated the Unit Based Practice Council (UBPC) on 6 East to implement a designated activity night. The goal is to encourage families on the unit to support one another through fellowship similar to that demonstrated by Gilda’s Club. The UBPC hopes that families who experience long-term stays on 6 East will, upon discharge from the hospital, naturally gravitate toward community-based support systems similar to that which Gilda’s Club offers, Coldiron explained, adding, “It is truly exciting to see nursing promote this level of excellence in patient- and family-centered care.”

S P O T L I G H T

Where Compassion and Empathy Come Together University Hospital has a long-time commitment to patients and families who experience end-of-life decisions. The Legacy of Life is an initiative to honor our organ, tissue and eye donors from the hospital. In 2010, a group of nurses, donor families, Kentucky Organ Donor Affiliate (KODA) staff, the hospital’s marketing department and its planning department developed plans for a memorial to commemorate patients and families who choose to give the gift of life and sight. The memorial will serve as a place of reflection and inspiration for guests, patients and staff. The annual Legacy of Life 5K event, held at Iroquois Park, provides an opportunity for staff, donor families and transplant recipients to come together in celebration of those who saved lives through donation. The 2011 event was attended by more than 250 participants to help raise funds for the memorial. “During the event, two donor families met their loved ones’ transplant recipients for the very first time,” said Stephanie Perna, RN, MSN, CCRN. Perna is clinical nurse manager of Surgical ICU on 8 West. “It was a special time for a mother who lost her daughter in a car accident in 2009. She was able to hear her daughter’s heart beat in the chest of her daughter’s transplant recipient. Staff members who cared for her daughter were there as well. It was truly an awesome moment,” Perna recalled. She added, “I have been at University Hospital for nearly 13 years in Critical Care. It is a great honor to care for patients and their families, especially during trying times when death is imminent. The art of nursing is where compassion and empathy come together to offer patients and families solace. That is our job.”

S P O T L I G H T

Taking Pain Management Knowledge to a New Level The summer of 2011 was a very exciting time for increasing ULHC nurses’ knowledge of pain management. Our Pain Committee was honored to host the First-Annual Pain Conference with a nationally acclaimed guest speaker – Chris Pasero, MS, RN-BC, FAAN. Pasero lectured on a variety of pain issues to 200 nurses from ULHC, as well as other hospitals throughout the community and region. “The pain conference was an important piece of education that has been ongoing, as nurses here take ownership of their patients’ pain management needs,” said Lindsey Siewert, RN, MSN, ARNP, CCRN, CCNS, Critical Care Clinical Nurse Specialist. She helped coordinate this event with Cindy Foote, RN, BSN, Clinical Nurse Manager for Pre-Op/PACU/Pain Clinic, and Kim Williams, RN, BSN, RN-BC, Charge Nurse for Acute Pain Service and the ULHC 2010 Nurse Excellence Winner. “We have been excited and honored to participate in this movement towards excellence in pain management,” Foote added. This event was so successful that the three are making plans for another one in 2012. “It is our vision for this program to make every patient as pain free as possible,” Williams said. “We feel it is very important to educate and inspire other nurses to take up this vision as their own.”

S P O T L I G H T

Trauma and Emergency Medicine Conference Best Attended in Kentucky The annual Kentucky Trauma and Emergency Medicine Conference has become the best attended conference statewide. Planning this big event in 2011 was ULHC Nurse Theresa Baker, RN, BSN, who is University Hospital’s Trauma Outreach and Injury Prevention Coordinator. Orchestrating such an effort took a great deal of effort on Baker’s part to make it happen. “The magnitude of people it takes to pull it off is tremendous,” said Ben Hughes, RN, MSN, MS, CMTE, CCRN, who is the Director of our Trauma Institute and Cardiopulmonary Services. “While we were the sponsoring organization and primarily responsible for the 2011 event, it is a team effort with the University of Kentucky, Norton Healthcare, and Kosair Children’s Hospital.” Word-of-mouth endorsements have led to this conference being a great success every year, Baker said.

Our faculty presenters are physicians, nurses and emergency responders who remain in active practice and continue in the trenches day after day, night after night, dealing with the most complex trauma challenges. Theresa Baker, RN, BSN University Hospital’s Trauma Outreach & Injury Prevention Coordinator

Each year, Baker said, hundreds of health care professionals from all service lines gain the newest evidenced-based practices that can be applied to their everyday practice. “Providing advanced trauma education for both nurses and physicians helps University Hospital be the leaders in nursing excellence across the Commonwealth of Kentucky,” she said.

S P O T L I G H T

Sharing our Excellence with International Delegations On May 25, 2011, University Hospital and the JGBCC were honored to host visitors from Thailand and China. The visitors were made up of a group of international nursing delegates who were attending the Infusion Nurses Society (INS) Annual Meeting held in Louisville. We welcomed the opportunity to share with both groups all of the many ways we are serving patients and families, as well as furthering nursing knowledge, throughout our region and beyond.

NE W K N O W L E D G E AN D I N N O VAT I O N

Our nurses are committed to building and sustaining a research environment that promotes excellence in nursing care, new knowledge and innovation. Here, we showcase some of the ways we share our new knowledge and innovation within our organization and beyond.

S P O T L I G H T

Research Champion Program Bridges the Gap Through our Research Champion Program, we encourage nurses to develop a spirit of clinical inquiry, question the status quo and focus on finding innovative solutions to questions and problems. Our research champions hold unit-based journal clubs that encourage direct care nurses to become involved in utilizing the last evidence in clinical practice and the nursing research process. In 2011, our nursing research infrastructure continued to advance from a collaborative partnership with the UofL School of Nursing. Associate Chief for Nursing Research Cindi Logsdon, PhD, APRN, FAAN, and our Nurse Scientists mentor and assist nurses with their projects. At the 2011 Nurse Practitioners in Women’s Health Annual Conference, Dr. Logsdon, Diane Eckert, RN, MSN, and Rosalyn Tomasulo, RN, MSN, received the Research Podium Award for their study, “Preferred Health Resources and Use of Social Media to Obtain Health Information by Adolescent Mothers.”

S P O T L I G H T

Adding to the Base of Nursing Knowledge UofL Health Care Nursing continues to be a leader in advancing research among our own nurses as well as those practicing in the community. Our participation in Research!Louisville each year offers just one example of how we work to this end. This annual citywide conference has the goals of promoting excellence in and public awareness of health sciences research along with generating additional funding for such research and promoting the Louisville Medical Center. This all adds up to make the conference an excellent vehicle for bringing recognition to our nurse scientists, whose discoveries are adding to

the base of knowledge in the profession and who are inspiring other nurses to engage in their own investigative studies. In 2011, UofL Health Care played host to the nursing symposium section of Research!Louisville. University Hospital’s Reetta Stikes, RN, MSN, RNCNIC, CLC. served as chair of the planning committee. She is an Advanced Practice Educator for the Center for Women and Infants, Along with UofL Health Care, the committee included members from Baptist Hospital East, Jewish Hospital & St. Mary’s HealthCare and Norton Healthcare. “There are many benefits to this type of collaboration, most importantly the opportunity to work with other organizations in the city to support the professional development of nurses at all levels,” Stikes said. The symposium, titled “Unit-Based Nursing Research: Making it Happen!,” broke attendance records with 185 people. It focused on the facilitation of nursing research by clinicians. Numerous examples of clinician research projects were detailed throughout the day, emphasizing the use of practical strategies to facilitate nursing research in the service setting. The symposium was capped by keynote speaker Marianne Chulay, RN, PhD, FAAN. Dr. Chulay has been guiding the conduct of nursing research for more than 30 years. Her presentation focused on introducing nurses to the “how to’s” of successful identification and completion of a clinical research project, and how this research impacts patient care. Stikes is a prime example of the value research brings to the nursing profession and one’s career. “I found the Research!Louisville experience both rewarding and beneficial to my own professional growth as a leader,” she said. “Leading this project allowed me to establish multiple networking relationships and to expand my knowledge of project management and organizational effectiveness. I also had the pleasure of reviewing research, evidence-based practice and quality improvement projects submitted by nurses throughout the city. Finally, I was afforded multiple opportunities to have conversations with and glean knowledge from a nationally recognized expert in nursing research. Opportunities such as this are what help us define excellence in nursing at UofL Health Care.”

Our nurses share the knowledge obtained from their research with others through posters and presentations throughout the global community.

S P O T L I G H T

Burn Unit’s Innovation Showcased at Conference

Poster Profiled on AHRQ Innovation Exchange Site

Dale Rae Miller, RN, RN,BSN, and Sarah Bishop, RN, BSN, CCRN, Burn Unit Clinical Manager, attended the Southern Medical Association 24th Southern Regional Burn Conference.

In October 2011, the Agency for Healthcare Research and Quality (AHRQ) Innovation Exchange profiled on its website a poster by Lindsey Siewert, RN, Mark Spivak, RN, and Anna Smith, RN.

At this event, they had the honor of presenting two posters: “Incorporating Patient- and Family-Centered Care into an Adult Burn Unit” (authored by Dale Rae Miller and Sarah Bishop)

“Hospital Partners with Residential Treatment Facility to Offer Alternative Setting to Intoxicated Patients, Reducing Emergency Department Length of Stay” detailed an innovative project called the Community Alcohol Program in which patients coming to the Emergency Department with acute alcohol intoxication were offered a safe alternate treatment at the Healing Place.

“Utilizing Benner’s Novice to Expert in Burn Unit New Graduate Nurse Orientation” (authored by Sarah Bishop, Anna Smith and Mandi Walker)

The poster, “Utilizing Benner’s Novice to Expert in Burn Unit New Graduate Nurse Orientation,” received the 3rd place award for best poster.

This represents just one of many research initiatives in which our nurses are working to improve the quality of care by sharing best practices, new knowledge and innovations.

“Dale and I were very excited to have this opportunity to share our unit’s innovations with our peers in burn care,” Bishop said. “We look forward to opportunities to disseminate at future conferences. This experience has ignited a spark of excitement within us.”

She added: “It was an honor to be able to represent University Hospital at the Southern Regional Burn conference. It feels great to do something for your patients but to contribute to the knowledge of nursing feels amazing!”

Many times we care for patients who have experienced life-altering events. They come to us with broken bones as well as broken hearts. Our nurses are committed to embracing them and their needs. We build caring relationships, recognizing that we have their lives in our hands. Nursing is not just a career. It is our life. These are the ways we are Excellence Defined each and every day. Roxanne Perucca, RN, MS, CRNI Director of Magnet/Nursing Excellence

2011 NURSE EXCELLENCE A W A R D

W I N N E R

S P O T L I G H T

Kimberly Phillips When thinking of Kim Phillips, I think of HCAHPS. The HCAHPS questions are framed around ‘always,’ ‘usually,’ ‘sometimes’ or ‘never.’ Kim Phillips is an “always nurse.” She is constantly learning, searching for better ways to deliver patient care, using best evidence and practice. She is a teacher to the many nursing students she has precepted, as well as an invaluable resource to less experienced nurses at the bedside. She is confident and conscientious. She includes the patient and family in their care; in the planning and delivery of that care. She promotes accountability and engagement among her peers, often holding others to her high standards by gentle reminders and conversation. She delivers great care to every patient. She is an “always” kind of nurse.

Chassidy Bibb, RN, BSN Clinical Manager Nursing Support Services

2011 A YEAR OF A C C O M P L I S H M E N T S

It was a year of incredible success and progress for the Department of Nursing at the University of Louisville Hospital and the James Graham Brown Cancer Center. The following are a few additional highlights as we continue our journey of Excellence Defined.

Winter 2011

Conducted our third NDNQI RN Engagement

Medicine Service to enhance patient-and family-

Published the first Nursing Education and

RNs responding to achieve an overall 81 percent

centered care throughout the care continuum

Research Course Catalog listing classes and

response rate

Introduced the “Patient- and Family-Centered

quality care and life-long learning

Care Promise” describing the principles of

Opened the new 8-South Unit to enhance our

PFCC and commitment expectations of

care for patients requiring progressive care

healthcare providers

Introduced UofL Health Care’s online blog for patients, families, employees and physicians to

Fall 2011

Implemented a new BLS recertification program,

quality patient care

Summer 2011

trauma care to our community

to enhance staff education and training for our

format and greater flexibility for staff

clinical documentations systems, as well as

Pain Conference with more than 150 regional

working toward an integrated electronic medical

nurses attending

record

Sponsored our first UofL Health Care Regional

Hosted city-wide Research!Louisville between

Implemented the Family Presence policy along

area hospitals and universities to promote new

Celebrated Certified Nurses Day recognizing

with the Partner in Care Identification Bands

knowledge and innovation

more than 200 UofL Health Care nurses who are

to promote safety and patient- and family-

nationally certified

centered care

Symposium in collaboration with area nursing

Initiated in collaboration with the UofL School of

departments to support nursing research and

Annual Report, Excellence Defined, to celebrate

Nursing a 12-month Nurse Residency Program

evidence based practice with more than 200

our contributions and recognize nurses during

that included more than 80 Nurse Residents

nurses attending

Published the inaugural edition of our Nursing

national Nurses Week

Established the Clinical Information Department

Health Stream, to provide a more user-friendly

Celebrated 100 years of Trauma Service, providing Level One expertise and advanced

Spring 2011

Implemented new Patient Safety Net (PSN) occurrence reporting system to ensure safe,

“Share Your Story” at stories.uoflhealthcare.org

Implemented Nurse Clinicians for the Internal

Survey in May with more than 656 direct care

courses for the entire year to promote safe,

Reopened the newly renovated Emergency

Sponsored Annual Nursing Research

Celebrated “30 Years of History and Hope”

Sponsored third Nursing Town Hall Meetings,

Psychiatric Services Unit (EPS) to promote

of the James Graham Brown Cancer Center

with Mary Jane Adams, Senior Vice President

quality and patient safety

providing groundbreaking research and patient

and Chief Nursing Officer, to celebrate National

treatment outcomes

Nurses Week

OUR NURSING A C H I E V E M E N T S

The information presented here was obtained from the 2012 RN Educode Demographic Survey. PRESENTATIONS

Reetta Stikes, RN, Pauline Hayes, RN, et al. – National Institute for Nursing Research Conference, “Umbilical Artery Catheters in Pre-term Neonates May Contribute to Tissue Hypoxia in the Kidney and Brain,” Washington, D.C., October 2011 (poster)

International Leigh Ann Bowe-Geddes, RN – Canadian Association for Vascular Access, “Ultrasound Guided PICC Insertions,” Toronto Leigh Ann Bowe-Geddes, RN – Skype Broadcast Series, “Vascular Access Device Indications, and Complications; Building Your Own PICC Team; Upper Extremity Deep Vein Thrombosis (DVT) Awareness,” Amsterdam National Leigh Ann Bowe-Geddes, RN – CCIP Conference, “Ultrasound-Guided PICC Insertions,” Kansas City Association for Vascular Access, Kansas City, Mo. Leigh Ann Bowe-Geddes, RN – Association for Vascular Access Annual Meeting, “Ultrasound Guided PICC Insertions,” San Jose, Calif. Leigh Ann Bowe-Geddes, RN – Baton Rouge Chapter, Infusion Nurses Society, “Antimicrobial Stewardship,” Baton Rouge, La. M. Cynthia Logsdon, PhD, Diane Eckert, RN, Roselyn Tomasulo, RN – National Association of Nurse Practitioners in Women’s Health, “Preferred Health Resources and Use of Social Media to Obtain Health Information by Adolescent Mothers,” Austin, Texas, October 2011 Deanna Parker, RN, Mandi Walker, RN – University HealthSystem Consortium Webinar, “Hospital-Acquired Infections,” location? August 2011 Roxanne Perucca, RN – Infusion Nurses Society Annual Meeting and Industrial Exhibition, “Developing Infusion Alliance Programs to Improve Outcomes,” Louisville, Ky., May 2011 Lindsey Siewert, RN, Anna Smith, RN – “The Use of a Community Based Alcohol Treatment Program to Reduce ER Length of Stay at a Level-1 Trauma Center,” (abstract posted on University of Texas Health Science Center website)

State, Regional & Local Sarah Bishop, RN, Anna Smith, RN, Mandi Walker, RN – Southern Regional Burn Conference, “Utilizing Benner’s Novice to Expert in Burn Unit New Graduate Nurses Orientation,” Winston-Salem, NC, December 2011 (poster) DenEllen Coldiron, RN – End-of Life Nursing Education Consortium, “Quality Palliative Care,” Louisville, Ky. Dale Rae Miller RN, Sarah Bishop, RN – Southern Regional Burn Conference, “Incorporating Patient- and Family-Centered Care into an Adult Burn Unit,” Winston-Salem, NC, December 2011 (poster) Deanna Parker, RN, Mandi Walker, RN – Southern Regional Burn Conference, “Hospital-Acquired Infections,” Winston-Salem, NC, December 2011 (poster) Elizabeth Wise, APRN – Nursing Symposium, “Neuroanatomy,” presented quarterly, Louisville, Ky. Poster Presentations: 2011 Research!Louisville, Unit Based Nursing Research: Making It Happen!

Cindy Foote, RN – “Nurse Pain Champions: Changing an Organizational Culture Related to Pain Management” Karen Gividen, RN – “On Your Mark, Get Set, Go Live!” Linda Goss, RN, Pam Nolting, RN, Crystal Heishman, RN, Amber Sexton, RN? – “Critical Communication: A Non-bundled Intervention for Prevention of Healthcare Associated Infections (HAI’s)” Susan Rothbauer, RN, Melissa Streeter, RN, Cambridge Kaufman, RN, Nicole Chapman, RN – “Opening Doors and Opening Minds … Relaxing Visiting Hours on an Inpatient Psychiatric Unit – A Quality Improvement Initiative” Kristin Skeens, RN, Janine Diaz, RN, Carlotta Keltner, RN, Phyllis Stribling, RN, Cathy Thompson, RN, Kimberly Ross Wilson, RN, Pauline Hayes, RN, Reetta Stikes, RN – “From Bathing to Breathing: Journal Club Sparks Spirit of Inquiry in NICU Nurses” ULH IN-HOUSE POSTER PRESENTATION CONTEST, OCT. 27, 2011 Research 3rd place Linda Goss, RN, Pam Nolting, RN, Crystal Heishman, RN, Amber Sexton, RN? – “Critical Communication: A Non-bundled Intervention for Prevention of Healthcare Associated Infections (HAI’s)”

Kim Bagby, RN, Denise Barbier, OTR/L, Susanna Bowen, RN, Jonetta Crusott, RN, Amy Pacyga, RN, Reetta Stikes, RN, Roselyn Tomasulo, RN, Lisa Wright, RN – “Kangaroo Care Increases Breastfeeding Rates”

Evidence-Based Practice 2nd place Kim Bagby, RN, Denise Barbier, OTR/L, Susanna Bowen, RN, Jonetta Crusott, RN, Amy Pacyga, RN, Reetta Stikes, RN, Roselyn Tomasulo, RN, Lisa Wright, RN – “Kangaroo Care Increases Breastfeeding Rates”

Sarah Bishop, RN, Anna Smith, RN, Mandi Walker, RN – “Utilizing Benner’s Novice to Expert in Burn Unit New Graduate Nurse Orientation”

3rd place (tie) Amanda Corzine, RN, M. Platt, MD, R. Coleman, MD – “Implementing Toluidine Blue Dye Use in Sexual Assault Forensic Exams”

Amanda Corzine, RN, M. Platt, MD, R. Coleman, MD – “Implementing Toluidine Blue Dye Use in Sexual Assault Forensic Exams”

3rd place (tie) Cindy Foote, RN – “Nurse Pain Champions: Changing an Organizational Culture Related to Pain Management”

Kena DeSpain, RN, Regina Doan, RN, Kristin Eiland, RN, Linda Ritter, RN – “Partnering with Patients and Families to Promote Family Presence at the Bedside” Regina Doan, RN, Eileen Grigutis RN, Debra Dougherty, RN – “Catheter Associated Urinary Tract Infection (CAUTI) Prevention Initiative”

Quality Improvement 1st place Regina Doan, RN, Eileen Grigutis, RN, Debra Dougherty, RN – “Catheter Associated Urinary Tract Infection (CAUTI) Prevention Initiative” 2nd place Kristin Skeens, RN, Janine Diaz, RN, Carlotta

Keltner, RN, Phyllis Stribling, RN, Cathy Thompson, RN, Kimberly Ross Wilson, RN, Pauline Hayes, RN, Reetta Stikes, RN – “From Bathing to Breathing: Journal Club Sparks Spirit of Inquiry in NICU Nurses” 3rd place Sarah Bishop, RN, Anna Smith, RN, Mandi Walker, RN – “Utilizing Benner’s Novice to Expert in Burn Unit New Graduate Nurse Orientation” PRESENTATIONS FROM THE 2011 NURSE RESIDENCY PROGRAM, RESEARCH DAY CELEBRATION, DEC. 14, 2011 Oral Presentations Joshua Capps, RN – “Nurses’ Perception of Bedside Shift Reporting” Karin Martin, RN – “Utilization of Bedside Shift Report in the Emergency Room” Tara White, RN – “The Affect of Spontaneous Breathing Trials and Sedation Vacation on Vented Patients in the MICU”

Tara White, RN, 6 West – “The Affect of Spontaneous Breathing Trials and Sedation Vacation on Vented Patients in the MICU”

Infusion Nurses Society (INS), Roxanne Perucca, RN, Nomination Committee Member PUBLICATIONS *In many cases, the Department of Nursing Staff partnered with other authors, listed here as et al. Their contributions are greatly appreciated. Jessica Massouda, RN, and M. Cynthia Logsdon, PhD, et al. – Maternal Sensitivity: A Concept Analysis. In: Davis, D.W. & Logsdon, M.C. (Eds.) Maternal Sensitivity: A Scientific Foundation for Practice. Nova Science Publishers, 2011. David Morrison, RN, M. Cynthia Logsdon, PhD, et.al. – Emotional Availability of Mothers to Children Across the Developmental Period. In: Davis, D.W. & Logsdon, M.C. (Eds.) Maternal Sensitivity: A Scientific Foundation for Practice. Nova Science Publishers, 2011. Mark Spivak, BSN, Anna Smith, MSN, M. Cynthia Logsdon, PhD, - Developing Clinical Nurses: How to Grow Them, Hold Them, and Let Them Walk Away Journal of Nursing Management, January 2011.

Poster Presentations Shizuka Buckner, RN, 5 West – “Decreasing the Risk for Inpatient Falls in NeuroScience Units” Joshua Capps, RN, 9 West – “Nurses’ Perception of Bedside Shift Reporting” Anthony Carpio, RN, Emergency Department – “Hypothermia Protocol for Post Cardiac Arrest Resuscitation in the Emergency Department” Jessica Eckhoff, RN, 9 West – “Music as Adjunct Therapy for Pain Management in the ICU”

EDITORS & REVIEWERS Pamela S. Elzy, RN – Editor, Designation: Nursing Excellence Eileen Grigutis, RN – Reviewer, Society of Urologic Nurses and Associates 2012 Core Curriculum Roxanne Perucca, RN – Editorial Review Board, Journal of Infusion Nursing PROFESSIONAL ORGANIZATIONS

Karin Martin, RN, Emergency Department – “Utilization of Bedside Shift Report in the Emergency Room”

National

Courtney Bowling, RN, Emergency Department – “The Need for a Pocket-Sized Reference Book for New Graduate Nurses in the Emergency Department”

Association for Vascular Access (AVA), Leigh Ann Bowe-Geddes, RN, President, September 2009 – 2011; Presidential Advisor 2011 – current

Jessica Williams, RN, Emergency Department – “Effectiveness of Appropriate and Timely Antibiotic Administration to Pneumonia Patients”

American Nurses Association (ANA), Congress on Nursing Practice and Economics, (CNPE), Roxanne Perucca, RN, Appointed Member

Commission on Collegiate Nursing Education (CCNE), Eileen Grigutis, RN, Program/School Accreditation Reviewer

State, Regional & Local Bridgehaven Board of Directors, Secretary Executive Committee, Member Program Committee, Member Kathy Cox, RN Business First 2011 Health Care Partner Honoree Mary Jane Adams, RN, MSN, CNO Hospice and Palliative Care of Kentucky Secretary DenEllen Coldiron, RN Hospice and Palliative Nurses Association State Ambassador – Political Action Committee DenEllen Coldiron, RN Kentucky Hospital Association (KHA) CNO/Dean Committee Mary Jane Adams, RN, MSN, CNO Kentucky Consortium for Health Care Professions Board Member Mary Jane Adams, RN, MSN, CNO Oncology Nursing Society (ONS) Greater Louisville Chapter Board Member, Director-at-Large Rosemary Wafford, RN Sigma Theta Tau, Lambda Psi Chapter Treasurer Sarah Puckett, RN UofL School of Nursing Advisory Committee Board Member Mary Jane Adams, RN, MSN, CNO

UofL School of Nursing, Adjunct Faculty Mary Jane Adams, RN, MSN, CNO UofL School of Nursing, Mark Spivak, RN, Ex-officio President, Alumni Board

COUNCILS AND COMMITTEES Advanced Practice Nurses Council Kim Meyer, RN, Chair Eileen Grigutis, RN, Co-Chair Care Advisory Team Linda Ritter, RN, Chair Evidence Based Practice Council Lindsey Siewert, RN, Chair Magnet Steering Committee Mary Jane Adams, Chair Roxanne Perucca, Co-Chair Nursing Interdisciplinary Research Council Reetta Stikes, RN, Chair Nursing Policy and Procedures Committee Pamela S. Elzy, RN, Chair Practice and Quality Council Rena Bennett, RN, Chair Amber Smith, RN, Chair-Elect Professional Development Council Pamela S. Elzy, RN, Chair UNIT PRACTICE COUNCIL CHAIRS/CO-CHAIRS * Chair ** Co-chair 9 South Darlene Brown, RN* 9 East Sherra Desurne, RN* 9 West Allison Woosley, RN* Jennifer Schmitz, RN**

8 South Pam Brown, RN*

NICU Gretta Walters, RN* Dawn Dichiara, RN** Emergency Department

8 East Allison Stuller, RN* Erin Gualdoni, RN** 8 West Portia Steele, RN* Kandace Vanhoozer, RN**

Rachel Sparks, RN* Jessica McFadden, RN**

7 South Jennifer Riggs, RN* 7 East Shonte Long, RN* Tasha Sparks, RN**

Endoscopsy Ingrid Calloway, RN* Jennifer Bonner, RN** Emergency Psychiatric Service Chris Beets, RN* Cath Lab

7 West Kevin Becthloff, RN* Rena Bennett, RN** 6 South Anne Husz, RN*

Laurie McLaughlin, RN*

OPSC Lisa Fuguate, RN* Alicia Snardon, RN**

6 East Whitney Barter, RN* Amy Hirby, RN**

ODSU/PACU Suzanne Luzama* Julie LaMotte**

6 West Amy Lobb, RN* Jessica Massouda, RN** 5 South Sarah Wissemeier, RN* Tyri Petty, RN** 5 East Melissa Streeter, RN*

JGBCC Christi Schmidt, RN* Cassie Carney, RN*

Vascular Radiology Suzann Hendrickson, RN* Radiation Oncology Frances Taylor* Rosemary Wafford**

Burn Unit Dale Rae Miller, RN* Courtney Speedy, RN**

PAIN CHAMPIONS Leader: Kimberly Williams, RN

5 West Natalie Williams, RN* Danielle Robison, RN** 3 South/Newborn Nursery Therese Spurling, RN* Tammy Witsiepe, RN**

Labor & Delivery Janna Sharp **

Tasha Casey, RN Leann Dehart, RN Jan Fadel, RN Cindy Foote, RN Tara Garris, RN Donna Gray, RN

Suzann Hendrickson, RN Laurie McLaughlin, RN Cynthia Logsdon, RN, DNS Mike Middleton, RN Dale Miller, RN Lindsey Siewert, RN Sara Stein, RN Frances Taylor, RN RESEARCH CHAMPIONS Leaders: M. Cynthia Logsdon, PhD, APRN, FAAN Reetta Stikes, MSN Tammy Cadima, RN Labor and Delivery Diane Eckert, RN Mother Baby Colleen Greenwell, RN NICU Pauline Hayes, RN NICU Kimberly Phillips, RN Critical Care Float Smita Ranjan, RN 8 South Mary Beth Richardson, RN PACU Susan Rothbauer, RN 5 East Kristin Skeens, RNA NICU Gary Spaulding, RN CCU Therese Spurling, RN Nursery Christy Dianne Thomas, RN Radiation Oncology Shirley Tobe, RN PACU

Tiffany Wingate, RN 9 South Gayle Zeller, RN 7 East NURSE FELLOWS Jennie Alvarez 8 West Gabrielle Good 8 South Whitney Graves 9 West Stacy Hager 6 South Michelle Hornung Labor & Delivery (internal) Ingrid Irwin 8 South Jill Lascoe 7 West (internal) Megan Lewis NICU Sarah Olliges Emergency Department (internal) Allison Porter 9 East Casey Sullivan 6 South COMMUNITY SERVICE The Department of Nursing staff provides many hours of community service. The following is a representative sampling of groups that have benefited from the staff’s commitment to community service. 4-H Club American Heart Association American Red Cross Amyotrophic Lateral Sclerosis (ALS) Walk Coordinator

Big Brothers Big Sisters Boy Scouts of America Camp for Disabled Kids Court Appointed Special Advocate (CASA) Crusade for Children Dare to Care ElderServe Gilda’s House Habitat for Humanity Harambee Clinic Hand in Hand Ministries Hats for Hope Healthy Start House of Ruth Jefferson County Public Schools Louisville Central Community Center Leukemia and Lymphoma Society Louisville Lung Cancer Alliance Louisville Zoo Kentuckiana Girl Scouts Kentucky Humane Society Kentucky and Indiana Stroke Association Indiana Department of Natural Resources Make A Wish Foundation March of Dimes Meghan’s Mountain Mission trips: Joplin, Mo.; Haiti; Nicaragua Operation Brightside Ovarian Awareness of Kentucky Ronald McDonald House Schumann Center PROFESSIONAL RECOGNITION NURSING AWARDS John and Yvonne Mead Stroke Nursing Fellowship Betsy Wise, APRN Stroke Unit Kentucky Society for Healthcare Risk Management Risk Manager of the Year Darlene Booth, RN Director of Risk Management Kentucky Hospital Association (KHA) Consortium for Health Care Professions Sarah Olligies, CA Emergency Room Kathy Thomas, CA Stroke Unit

UNIVERSITY OF LOUISVILLE HOSPITAL & JAMES GRAHAM BROWN CANCER CENTER

Jennifer Riggs, RN Progressive Care Unit, 7 South

PHYSICIANSâ&#x20AC;&#x2122; CHOICE FIRST QUARTER AWARD

Molly Schaeffer, RN Emergency Department

Leslie Lauterwasser, RN, OCN James Graham Brown Cancer Center Blood & Marrow Transplant

Louis Snyder, RN Cardiac Care Unit, 7 West

NURSING EXCELLENCE QUARTERLY AWARDS Jana Shehan, BSN, OCN James Graham Brown Cancer Center Medical Oncology Infusion

Raymond Woods, RN Emergency Department

Andy (Robert) Sturges, BSN, CCRN Stroke Unit Lydia Copelin, RN Burn Unit Kimberly Phillips, BSN Critical Care Float Pool 2011 ANNUAL NURSE EXCELLENCE AWARD WINNER

EDITORIAL DIRECTORS

Kimberly Phillips, BSN Critical Care Float Pool

Roxanne Perucca, RN, MS, CRNI Director of Magnet/Nursing Excellence

NURSING EXCELLENCE HONOREES

Melissa Deaver Marketing & Communications Manager

Connie Hawkins, RN Progressive Care Unit, 8 South Alelea Hewitt, RN Progressive Care Unit, 9 South Jessica Meffert-McFadden, RN Emergency Department Michael Middleton, RN Medical Intensive Care Unit, 6 West Lora Nickelson, RN Surgical Intensive Care Unit, 8 West Whitney Pitman, RN Oncology Unit, 6 South

CREATIVE DIRECTOR Louis DeFreeze III Marketing & Communications Multimedia Designer WRITERS Laurel Harper & Holly Hinson PHOTOGRAPHY Marvin Young Many special thanks go to the outstanding nurses who shared their stories and photographs with us for the creation of this publication.

IN REMEMBRANCE

DEBORAH LEAKE, RN OPERATING ROOM NURSE

EXCELLENCE DEFINED

Excellence Defined to me means always being open and willing to change processes that not only improve a patientâ&#x20AC;&#x2122;s outcome but also positively impacts a familyâ&#x20AC;&#x2122;s experience while we are caring for their loved one. Suzanne Luzama, RN, BSN Relief Charge Nurse, Pre-op/PACU

University of Louisville Hospital | James Graham Brown Cancer Center

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