Newsletter January 2014
MONL Leader You Should Know! NAME: Keri Brookshire-Heavin MHA, BSN, RN-CNML
Inside This Issue
MONL Leader You Should Know!
President’s Corner
News
Upcoming Programs and Conferences
2014 Board Members
Welcome New Members
HOMETOWN: Rolla, Missouri CURRENT JOB: Chief Nursing Officer at Phelps County Regional Medical Center BEING IN A LEADERSHIP POSITION ALLOWS ME THE OPPORTUNITY TO: Being in a leadership role allows me to be instrumental in the change process. I love to see positive changes in healthcare. I still feel like I am able to directly impact the satisfaction of patients and employees and that is why I do this. I am also able to work with a group of excellent leaders and staff members. This leadership position allows me to be part of their growth and achievements. FIRST JOB IN NURSING: My first job in nursing was as a nursing assistant in a home for developmentally disabled children. It was one of the most rewarding jobs I have ever had and taught me compassion. As a new graduate nurse my first job was in a small rural hospital in Salem, MO. It was a terrific learning experience and allowed me to realize how important a strong team was. When working in a rural setting you have to depend on your teammates because there are fewer resources available to you. MOST PEOPLE DON’T KNOW THAT I: I live on a farm and love the outdoors. MY BEST ADVICE TO ASPIRING LEADERS IS TO: Surround yourself with a strong team and realize that putting great effort into growing and developing that team will strengthen you as a leader and a person.
MONL VISION: Promote Nursing Leadership Today, Prepare Nurse Leaders for Tomorrow.
BIGGEST CHALLENGE I FACED AS A NURSE LEADER WAS: I feel like I am facing that challenge now in the current healthcare environment. It is a constant struggle to find a balance between the financial and clinical aspects of nursing. INTERESTED IN LEARNING MORE ABOUT: I am always interested in learning more about ways to improve the quality of patient care. I think there are so many innovative approaches available and nursing as a profession has to start thinking “out of the box” to achieve what is expected. I am also always interested in learning more about ways to motivate and inspire others. ONE WORD TO SUMMARIZE ME: Driven Keri has worked her way up the ladder at our facility beginning with an IT position for nursing, working to Director of Medical Telemetry, obtaining her MHA and securing a position of Chief Nursing Officer. Her ability to multi task and build team concepts is amazing. Her focus is on improving all processes while enhancing relationships. ~Nominated by Cindy Butler
www.monurseexec.org Login: monl Password: leader
President’s Corner MONL LEADER YOU SHOULD KNOW! Nominate a MONL member for "MONL Leader You Should Know!" Recognize a co-worker for their contribution to nursing leadership. Nominating someone is easy...just send name, title and one sentence describing why they are a nursing leader we should know to ptaylor@mail.mhanet.com.
January 2014
When I see the word “bullying” I think of what is happening in our schools between children or teens. I recently attend a seminar on Lateral Violence in healthcare settings which is described as bullying. Can we be talking about the same thing? After reading one definition of Lateral Violence, I believe we are talking about the same thing: “……repeated unreasonable actions of individuals (or a group) directed toward an employee or a group of employees, which are intended to intimidate, degrade, humiliate, or which create a risk to the health or safety of the employee (s).” Washington State DLI, 2011 What are the effects of lateral violence? Physical effects – stress, depression, insomnia, shame or suicidal behavior Moral distress – frustrated employees may lash out against a newer less assertive co-worker What are the hidden costs of lateral violence? Lost time due to worry and stress Targets cut back on work efforts Greater than 50% of staff who are bullied contemplate leaving their job and 12% doing so What do we do about it? Education on topic to staff and physicians Safety huddles system-wide – recognize the “Great Catch” Encourage reporting Focus on physician/nurse communication As tight as we are all staffing, we cannot afford to lose one more employee to bullying. Wishing each of you a wonderful New Year, Patti Muxlow, President Reference: Brooks, A.T., & Phillips, E., (March, 2013); Lateral Violence: The Nurse Leader Role in Moving from Willful Blindness to a Culture of Safety and Accountability
“Be kind, for everyone you meet is fighting a hard battle.”
Plato
LinkedIn You should have received an invitation to join the MONL LinkedIn group. Once you accept the invitation, you are automatically connected to the group. If you don’t already have a LinkedIn profile, you may need to create one first before you can join. Here are a few helpful links to help you get started: How to set up a profile Starting a discussion group Commenting on a discussion 10 Essentials of LinkedIn Etiquette
www.monurseexec.org Login: monl Password: leader
News
January 2014
New Rule Requires Nurses To Report Name, Address Changes Within 30 Days A rule change finalized today requires Missouri nurses to report to the Missouri State Board of Nursing any changes in their names or addresses within 30 days. The rule, 20 CSR 2200-4.020 Requirements for Licensure, is effective Friday, Feb. 28.
SHEA Issues Guidance on Health Care Personnel Attire The Society for Healthcare Epidemiology of America recently issued voluntary guidelines for health care personnel attire in non-operating room settings. The guidance was published online in the February issue of Infection Control and Hospital Epidemiology. “Institutions considering these optional measures should introduce them with a well-organized communication and education effort directed at both HCP and patients,” the authors said.
The What, Why and How of Acute Inpatient Rehabilitation This is the first in a series of monthly MONL articles that will provide an overview of different types of specialized hospitals and services. This article, written by Bruce Eady, CEO and Amy Vieth, Director of Therapy Operations Rusk Rehabilitation Center first appeared in The Missouri Nurse, a publication of MONA. In today’s dynamic environment healthcare providers must work together to transition patients across a continuum of care, while maximizing quality and minimizing costs. Developing a sound knowledge of various options that can benefit patients and families is critical to patient centered care. Rehabilitation services play a very important role in meeting this objective, the expectation of keeping patients as healthy as possible and in their homes longer. There are several venues for a patient to receive physical, occupational and speech therapy services, and each setting holds a vital spot on the continuum of care. Acute care, home health, outpatient, skilled nursing and inpatient rehabilitation settings are the most common environments to receive these services. In all of these settings, the basic expectations are that patients meet certain criteria for admission, are able and willing to participate in therapy and have the expectation for improvement. Acute inpatient rehabilitation is available in two forms — free-standing inpatient rehabilitation hospitals and hospital based inpatient rehabilitation units. In Missouri there are five freestanding inpatient rehabilitation hospitals and 24 hospital-based inpatient rehabilitation units. While acute inpatient rehabilitation is often confused with therapy and ancillary services provided at SNFs, there are some very distinct differences, which are outlined in the table on the next page.
Page 3
www.monurseexec.org Login: monl Password: leader
News
January 2014
The What, Why and How of Acute Inpatient Rehabilitation (continued)
REQUIREMENTS Physician
Nursing
ACUTE REHAB
SNF
Training
Physiatrist (specialty trained rehab physician)
Any physician
Visits
Daily
Minimum every 30 days
Coverage
Round daily, 24 hour availability
Emergency coverage
Training
Specialized for rehab, (CRRN potential)
Not mandated
Availability
24 hour RN staffing
Not mandated, minimum 1 nurse per 40 residents and 1 CNA per 20 residents
Therapy Intensity Pre-Admission Screening
Minimum 5 days/week, dependent on patient tolerance, standard is 3+ hours/day Licensed clinician (RN) evaluator, reviewed by physiatrist
Not mandated Not mandated
Interdisciplinary Approach
Physician, registered nurse, physical, occupational & speech therapist, psychology, dietician, case manager
Not mandated
Plan of Care
Coordinated by team upon admission, rehab needs identified and addressed by the team. Patient/family involved in goals, focus on training and preparing for discharge to home. At minimum weekly review, team conferences.
Every 30 days
Pharmacy
On-site pharmacist, consults with team on med use and dosing
Off-site services
Discharge Back to Acute Care
Average 10%
Average near 25%
Who is Appropriate for Inpatient Acute Rehabilitation? Patients who have experienced any of the following would benefit from an acute inpatient rehabilitation stay and may meet criteria for admission:
Page 4
Stroke Traumatic brain injury Spinal cord injury Multi-trauma Burns Amputation Chronic condition with recent decline in function or acute exacerbation – cardiac, pulmonary, oncology are just a few examples Acute injury, surgery, or illness that has led to a decline in functional mobility or self-care Failing at home but do not meet criteria for acute inpatient admission
www.monurseexec.org Login: monl Password: leader
News
January 2014
The What, Why and How of Acute Inpatient Rehabilitation (continued) How are Patients Admitted to Acute Inpatient Rehab?
Referral is received from a healthcare provider (acute hospital, physician/physician extender clinic, social worker, skilled nursing or long-term care facility, or case manager), or a patient and/or family member self-refers Clinical liaison completes preadmission screening assessment and presents to physiatrist for approvalthat can be done at a facility or in the patient’s home A three day inpatient stay is NOT required. Fifteen percent of all Rusk admissions are admitted from home. Insurance approval is obtained, if needed. Medicare patients who meet admission criteria do not require pre-authorization.
When choosing the best post-acute service for your patient, knowing the facts can make all the difference in how well a patient progresses and is able to get back home and to community activities.
Upcoming Programs and Conferences Nurses at the Table Webinar Presented by the Missouri Action Coalition OPTIONS FOR VIEWING THE PRESENTATION: Attend a live webinar. Webinars are scheduled for: February 5, 2014 at 3 p.m. February 10, 2014 at 4 p.m.
Webinar invitations are sent through the MOAC listserv. Sign up at www.moactioncoalition.org
Request the presentation to present to your students, organization, or coaliation. Contact Tina Lear, MOAC Executive Director, at tina@moactioncoalition.org.
The Missouri Action Coalition is offering a presentation entitled, Nurses at the Table: Serving to Transform Healthcare through Nursing in response to the Institute of Medicine Report on the Future of Nursing completed in 2010. The goal of the presentation is to encourage and prepare nurses to become active on local boards and commissions. This goal addresses one of the key IOM recommendations: Nurses should be full partners
with physicians and other health professionals in redesigning health care in the United States.
RAI Process from Start to Finish Date: February 18, 2014 - February 19, 2014 This workshop is for individuals in long-term care who coordinate and/or code the MDS. Typically, this is an RN or LPN with the title of MDS Coordinator or Care Plan Coordinator. This is also for the DON or ADM who needs a better understanding of the complexity of the RAI process. Download information/registration form
Page 5
www.monurseexec.org Login: monl Password: leader
Upcoming Programs and Conferences
January 2014
MONL District 4 Meeting 5:30 to 7 p.m. February 26, 2014 May Center, SSM DePaul Health Center, 12303 DePaul Drive, Bridgeton, MO Register Online.
Centers for Medicare & Medicaid Services Hospital Conditions of Participation and State Licensure Regulations for Acute Care Hospitals Date: March 11-12, 2014 Every hospital that accepts payment for Medicare and Medicaid patients must comply with the Centers for Medicare & Medicaid Services Conditions of Participation and the Missouri hospital licensure statutes and regulations. Get details online now.
AONE 2014 Date: March 12-15, 2014 Location: Orlando, FL Register Online.
Nurse Preceptor Academy March 19, 2014 The Missouri Nurse Preceptor Academy is a training program for hospital registered nurses serving as preceptors to newly hired nurses. Seminar registration form
RAI Process from Start to Finish Date: February 18, 2014 - February 19, 2014 This workshop is for individuals in long-term care who coordinate and/or code the MDS. Typically, this is an RN or LPN with the title of MDS Coordinator or Care Plan Coordinator. This is also for the DON or ADM who needs a better understanding of the complexity of the RAI process. Download information/registration form
Forensic Investigations Conference May 12 - 17, 2014 Pre-conference - May 12 - 13, 2014 Kansas City Convention Center Learn about every aspect involved in prosecuting sexual assault, domestic violence, human trafficking, child and elder abuse—from the scene to the courtroom.
Page 6
www.monurseexec.org Login: monl Password: leader
2014 MONL Board
January 2014
Patti Muxlow, R.N., BSN, MHA President Lake Regional Medical Center Osage Beach, MO pmuxlow@lakeregional.com
Kathleen Bonser, R.N. District 4 Representative SSM DePaul Health Center Bridgeton, MO Kathy_bonser@ssmhc.com
Debbie White, RN, MSN, MSA, ACNS-BC, NEA-BC President-Elect Saint Luke’s Hospital of Kansas City debwhite@saint-lukes.org
Marcia Robson, R.N. District 5 Representative Ozarks Medical Center West Plains, MO marcia.robson@ozarksmedicalcenter.com
Cheri Hunt, R.N., BSN, MHA, NEA-BC Secretary Children’s Mercy Hospital Kansas City, MO chunt@cmh.edu
Lois Prost, R.N. District 6 Representative Perry County Memorial Hospital Perryville, MO lprost@pchmo.org
Sarah Fields, R.N., MSN District 1 Representative North Kansas City Hospital sarah.fields@nkch.org
Monica Smith, APRN, ACNS-BC, NE-BC Boone Hospital Center Columbia, MO Representative-At-Large mks8163@bjc.org
Andrew Loehr, R.N., MSN, CPNP District 2 Representative Children’s Mercy Hospitals and Clinics Kansas City, MO aloehr@cmh.edu
Sharon Burnett Finance Chair/Treasurer Missouri Hospital Association Jefferson City, MO sburnett@mail.mhanet.com
Tawny Sandifer, RN, MSN, NEA-BC District 3 Representative Capital Region Medical Center Jefferson City, MO tsandifer@mail.crmc.org
Welcome New Members! Debra Cochran Share Pregnancy & Infant Loss Support St. Charles, MO MHA District 4
Melissa Samuelson Poplar Bluff Regional Medical Center MHA District 6
Amy Kempf Lake Regional Health System Osage Beach, MO MHA District 3
Page 7
www.monurseexec.org Login: monl Password: leader