Volume 27 Number 19 September 16, 2016
Hospital of the University of Pennsylvania
Aromatherapy A New Addition to a Nurse’s “Toolbox”
When these therapies are integrated into nursing practice, patients rest and are more comfortable, which make families happier as well.
`` Tim Rowan uses an aromatherapy hand massage to help patient James Zogbaum relax.
A new aromatherapy program at HUP is helping patients manage their symptoms … without the use of drugs. “It’s a part of integrative medicine, viewing the patient as a whole,” said Christin Reddy, MSN, RN, OCN, of Rhoads 3, an oncology unit. The nurse-driven program does not take the place of treatment; rather, it is complementary. “It’s something else in a nurse’s toolbox to manage symptoms without the side effects commonly seen with pharmacologic interventions.” Aromatherapy uses small doses of extremely concentrated essential oils from plants. Nursing created an educational handout to help patients and families better understand aromatherapy and how it might help with specific symptoms. For example, lavender can help reduce pain, stress or trouble sleeping, while peppermint oil or ginger oil can help with nausea or an upset stomach. Knowing when to use which essential oil is important but it’s crucial to know when not to use certain oils. “Not having good information can lead to unsafe uses,” said Susan Kristiniak, DHA, MSN, associate director of Palliative Care for Penn’s Health System.
INSIDE The Patient’s Surprise was Phabulous..........................2 IS Kudos.....................................3 Nursing Outreach Promotes Breastfeeding.............................3 Hossain Appointed to First Philadelphia Commission for Women.......................................3 A “Mountain of Donations” for Penn Transplant House.............4 HIPPA Refresher Course...........4 Free Continuing Education Training in LGBTQ-centered Care.............................................4
HUP offers patients both self-inhalers and lavender lotion used in hand massage. The “sniffers,” which patients are taught to use, provide more control over symptoms while in the hospital and at home. The hand massage, performed by nurses, elicits a relaxation response but also has a positive impact on the nurse/patient relationship. “Nurses are present in the moment, talking with patients as they massage their hand and making a connection,” Reddy said. “This is a great intervention. It allows us to give the patient our full attention.” And, when it works, “relief comes quickly,” she said. It takes about .5 seconds for a smell to register in our brain, almost twice as fast as pain. Nurses have been enthusiastic about bringing this practice onboard, said Kristiniak, who is also a nurse aromatherapist and leads the program. “When these therapies are integrated into nursing practice, patients rest and are more comfortable, which make families happier as well.” Initially used on HUP’s oncology units, the program has expanded to help transplant patients and patients receiving outpatient treatment. (Continued on page 2)
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Jon Crosier had been re-admitted to Rhoads 3, an oncology unit, in July and was like a part of the family there, said Kristen Bink, MSN, RN. “We wanted to do something really special for him on his birthday.” So they started planning a celebration … but weren’t telling him anything about it. On the big day, the staff filled their conference room with birthday decorations and goodies. They had even figured out a way to get Jon to the room without explaining why. Ray Lemon of Physical Plant was happy to do his part. He went into the patient’s room to “check” the room’s air vent and told him that it needed a cleaning and that Jon would need to leave the room while he did it. “He told me he’d be back in about 15 to 20 minutes,” Jon said, so when his nurse came to his door shortly thereafter, encouraging him to leave the room for the necessary work, “I told her I’d move when the guy came back. After all, he might not be on time and I didn’t want to leave earlier than I had to,” he said. “I was grumpy and half asleep and didn’t want to move!” She left but another nurse appeared and said, in a brisk voice, “Just get up…now!”
The Patient’s Surprise was
Jon said he had suspected something was up — especially after overhearing an earlier conversation about a party — but this unexpected “order” confirmed it. Still, when arriving at the conference room, “I acted surprised,” he said, smiling. But when the Phillies Phanatic came into the room, his look of surprise was real. “We knew he was a big Phillies fan,” Kristen said. So, with the help of the Headstrong Foundation, the Phanatic joined the celebration. Donna Crosier, his mom, said, “It lifted his spirits and took his mind off everything.”
(Continued from cover)
“He told me it was his best birthday yet!” Kristen added.
Aromatherapy A New Addition to a Nurse’s “Toolbox” Patient Reactions Tell the Story
Patients are asked to self-rate aromatherapy’s impact, both before and after the therapy, on the Edmonton Symptom Assessment Scale, which nurses document in the electronic medical record. “They rate symptoms like anxiety, nausea, and fatigue on a scale of 1 to 10,” said Melissa Trolene, BSN, RN, CMSRN, of Silverstein 11. Kristiniak said that, based on patient self-reports, aromatherapy has decreased nausea and lessened anxiety. But their reactions to the therapy tell the real story. Rachel Mcfadden, BSN, of Silverstein 11, described a Filipino patient who was suffering from liver failure and experiencing a great deal of pain and nausea. “Unfortunately for our `` Patient Robert Houdeshel manages symptoms through patients with compromised livers, the medications that most effectively treat these maladies the use of an aromatherapy self-inhaler. are either off the table or only safe in very small doses,” she said. During a bout of nausea, she offered the patient one of the ginger sniffers. “She smiled as she told me that ginger was a staple of Filipino cooking and she loved the smell.” While it wasn’t a cure, it did bring this patient some comfort. “I think this moment really captures the essence of aromatherapy. It’s an effective intervention because of the neurochemical pathways our olfactory sense stimulates, but the memories and feelings of comfort and pleasure triggered by our sense of smell run much deeper than the physiology.” Transplant recipients often suffer from anxiety, pain, and nausea due to frequent complications. In tandem with pharmacologic treatment, Tom Shluger, RN, BS, BSN, of Silverstein 11, offered a patient who was hospitalized for lung transplant rejection both ginger and lavender essential oil inhalers. “She was so happy to have a new tool to help calm her nerves and her stomach that didn’t come with any side effects and didn’t involve adding on another medication,” he said. “She used both oils many times throughout the days I cared for her. It felt great to be able to empower her to take control of that part of her treatment.”
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IS Kudos Penn Medicine’s Information Services team has been recognized by Health & Hospital Networks with the Most Wired Award for the eighth time in the last decade. The award recognizes Information Services for its work in positioning Penn Medicine as an innovator in the fastmoving health care IT field. IS was also named among CIO magazine’s list of 100 organizations to be honored for innovative use of information technology. IS received this recognition for combining Apple’s new HealthKit tool with Penn Medicine’s electronic medical record system. This novel approach allows Penn Medicine’s clinical staff to better detect, monitor, manage and reimagine patient care. And, for the second year in a row, Penn Medicine was ranked in the top 10 in this year’s InformationWeek Elite 100, an annual list of U.S. businesses from all industries that use innovative and leading information technology to run their business. Penn Medicine placed fourth this year across all industries and is being recognized for the implementation of Penn Signals, a real-time big data platform used to generate multiple predictive applications delivered to clinical teams.
Hossain Appointed to First Philadelphia Commission for Women Farzana Rashid Hossain, MD,
`` Participating in the Latch On event were (from left): Makady Rinn, Maria DiSciullo, and Megan Pape.
Nursing Outreach Promotes Breastfeeding HUP was one of several organizations that took part in last month’s Latch On event held at Franklin Square Park to promote breastfeeding. Maria DiSciullo, BSN, RN, IBCLC, certified lactation consultant, Makady Rinn, RN, of Silverstein 8, and Megan Pape, RN, of Labor and Delivery, handed out educational information to the nearly 150 moms who registered for the event. “It was very nice to attend any event in the community which helped promote breastfeeding and provide a comfortable atmosphere where breastfeeding is natural for the mothers,” said DiSciullo. Back at HUP, the hospital’s Lactation Team gifted breastfeeding moms who delivered during World Breastfeeding Week with a beverage cup as a reminder to stay hydrated while breastfeeding.
of Gastroenterology, has been appointed to the Philadelphia Commission for Women to build key relationships and help create equitable opportunities for women at all levels of the Philadelphia workforce. There have been previous Mayor’s Commissions for Women established by executive order, but this is the first such permanent body. “I am committed to helping women achieve equal opportunities and contribute to the local economy. I hope to empower girls to follow their scientific passions and take an executive pathway from the lab to the boardroom and look forward to working with my new colleagues to demonstrate that capable women are essential in strategizing and executing long-lasting government policy matters that will enable equal rights for women.”
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F R E E Continuing Education Training in LGBTQ-centered Care Penn Medicine was named a 2016 “Leader in LGBTQ Health Care Equality,” and as part of our continued efforts to better serve our LGBTQ patients, families, and community members, Penn is partnering with the Healthcare Quality Index and Human Rights Campaign Foundation to offer free CME/ CEU educational opportunities to our employees. More than 60 different free, online training courses are currently available. Topics include:
A “Mountain of Donations” for Penn Transplant House Earlier this summer, the Clyde F. Barker Penn Transplant House received thousands of non-perishable food items and toiletries, thanks to HUP’s Support Services. “It was a mountain of donations! Our pantries were nearly bare and now they’re overflowing,” said Kirsten King, Transplant House Operations manager. And even though the donation was made in early July, “people from Support Services continue to call about bringing in more items. It’s more of a long-reach effect than a one-time event.” According to Chris Cullom, assistant executive hospital director, their initial goal when they started the drive was 500 donated items. “We tried to keep everyone motivated by really pushing the concepts of team and purpose,” he said. They also used a goal thermometer that was regularly updated with results. Staff clearly rallied around the effort, donating close to 2000 items! While the department engaged in the activity to do something for the Penn community, it was also part of its “One Team. One Mission” program to increase unity among the different areas of the Support Services team. “If we can get people fully engaged and functioning as one, it will help our patients tremendously,” Cullom said. Meanwhile, thanks to the Support Services deliveries, life is a little easier for guests at the Transplant House. “It was incredible generosity,” King said. To learn more about helping patients and families at the Penn Transplant House, go to http://bit.ly/2c91lRo.
HIPAA Refresher Course At Penn Medicine, our patients trust us to provide quality health care and to act responsibly when collecting and sharing Protected Health Information. A HIPAA Refresher Training has been launched and assigned to all employees’ Knowledge Link Learning Plan. This eLearning course addresses the most common HIPAA situations and privacy issues experienced at Penn Medicine and in health care generally. We ask everyone to schedule 15–20 minutes to log into Knowledge Link and complete the module by December 31.
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• An Introduction to your LGBTQ Patients • Introduction to LGBTQ Health • Expanding LGBTQ Cultural Competency • LGBTQ Healthcare for Clinicians • Transgender Health • Working with Trans Youth • Behavioral Health Care • LGBTQ Youth • LGBTQ Older Adults • HIV and STI Treatment and Prevention • Lesbian and Bisexual Women • Gay and Bisexual Men You may also request on-site training for your team. For more information, email lgbthlth@med.upenn.edu or call 215.573.8499.
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ADMINISTRATION
Susan E. Phillips Senior Vice President, Public Affairs Holly Auer Director of Communications CONTACT HUPDATE AT: 3535 Market Street, Mezzanine Philadelphia, PA 19104 phone: 215.662.4488 fax: 215.349.8312 email: sally.sapega@uphs.upenn.edu HUPdate is published biweekly for HUP employees. Access HUPdate online at http://news.pennmedicine.org/inside/hupdate.