St. Francis Hospital The Heart Center
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A Member of Catholic Health Services of Long Island
St. Francis Hospital 2009 Nursing Annual Report
Our Unwavering Contents 03 Message from the Chief Nursing Officer Empirical Outcomes 04 Our Nursing Philosophy 05 Patient Satisfaction 06 Making the Grade 07 Quality Outcomes and Initiatives 08 S.K.I.N. Champions Transformational Leadership 09 Dedicated Education Unit 09 The Joint Commission 10 Greeter Initiative in the Emergency Department Structural Empowerment 11 Financial Accountability Council 11 R.N. Advisory Council 11 Professional Development Council 12 Unit Based Councils 12 E-Decision Making
13 Shared Governance Awards 13 Participation on National Committees 13 Higher Education 14 Documentation Committee 14 By the Numbers Exemplary Professional Practice 15 Palliative Care 15 Intermediate Care Unit 16 Heart Failure 16 Hospice 17 Professional Nursing Practice Model New Knowledge and Innovations 18 Research Boot Camp 19 Emergency Cooling Therapy 19 Neurosurgery 20 Tandem Heart and the Impella 21 Certified Nurses
Cover (clockwise): Lisa Sperling, BSN, R.N.; Peggy Louis, AAS, R.N.; Steven Sweeney, BSN, R.N.; Fanny Ngai, AAS, R.N.; and Donna Franco, BSN, R.N.
Message from Ann Cella, MA, MEd, R.N., NEA-BC, Chief Nursing Officer
At St. Francis Hospital, our commitment in the Patient Care Services Division is to provide the ideal healing experience for our patients.The 2009 Nursing Annual Report is proof of our commitment, which is rooted in the values set by our founders, the Sisters of the Franciscan Missionaries of Mary, nearly nine decades ago.Today, those values continue to be a reflection of who we are at St. Francis and the pages of this report will highlight just that.You will meet nurses who lead, who manage and whose top priority is compassionate quality care at the bedside. Our nurses are unrivalled in dedication and spirit. They are guided by our nursing philosophy and the St. Francis Hospital Professional Nursing Practice Model which recognizes the patient and family as the center of patient care. The nurses are committed to their practice and to the values of Honesty, Empathy, Authenticity, Respect and Trust. They promote a healthy work environment and have the unique role of touching every department at the hospital and playing an extremely important role in the lives of our patients. I am constantly hearing from our patients how supportive our nurses are and how comfortable the nursing staff makes them feel. I believe that this is an important reason we received the Magnet Award for Excellence in Nursing Services. And even now, as we seek Magnet re-designation, we endeavor daily to remain worthy of the most coveted and prestigious honor a hospital and its nursing staff can achieve. It is because of the entire St. Francis staff that the Hospital’s overall rating of care has been consistently in the 99th percentile ranking, nationally and on Long Island. We have enjoyed many accolades over the past year: • The only hospital on Long Island to be ranked by U.S. News & World Report for heart and heart surgery, digestive disorders and geriatrics • Ranked by AARP as one the best hospitals in the U.S. • Rated by Consumer Reports as one of the top hospitals in the NYC metro area for patient satisfaction • Selected by Modern Healthcare magazine as one of the best places to work in healthcare in the nation It is an exciting time to be a part of St. Francis Hospital. Everyday, I find myself surrounded by exceptional, hardworking men and women, each of whom plays a pivotal role in the success of urses at St. Francis have the Hospital. To the entire nursing staff, I say thank you. You have made the past year so incredible and I know that the upthe unique role of touching every coming year will be even better. department in the Hospital and I would also like to thank our entire healthcare team, parplaying an extremely important role ticularly our superb medical staff, our dedicated partners in in the lives of our patients. I am patient care. For their continual support, guidance and leadership, I would also like to thank the Board of Trustees, our constantly hearing from our patients President and CEO, Alan D. Guerci, M.D., and James Harden, how supportive our nurses are.” President and CEO of Catholic Health Services of Long Island. –Ann Cella, MA, MEd, R.N., NEA-BC, I am especially thankful for the Sisters of the Franciscan MisChief Nursing Officer sionaries of Mary and our Bishop, the Most Reverend William F. Murphy, whose prayers, compassion and inspiration have touched and blessed us all.
Commitment
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2009 St. Francis Nursing Annual Report 3
Empirical Outcomes At St. Francis Hospital, nurses pay close attention to numerous measures of quality and performance. From research to training to the implementation or introduction of new lifesaving treatments and procedures, our nurses consistently engage multiple strategies to improve effectiveness and care at every level.
Our Philosophy of Nursing The Nursing Philosophy at St. Francis Hospital stems from a commitment to excellence in patient care based not only on the principles of Christian charity, but also on nursing theory and scientific knowledge. At St. Francis, the professional nurse is dedicated to total patient care and assessing and meeting the needs of the individual patient. The goal of the nurses at the Hospital is to restore patients to their optimal level of function and well-being by promoting good health practices, identifying potential problems and preventing further illness. The commitment is also concerned with respecting the terminally ill patient’s right to die with dignity. Here at St. Francis, nursing is at all times patient centered. Patient independence is fostered with both the patient and family actively participating in the planning and administration of care. This philosophy forms an ongoing process of vital importance in the continuum of care that reaches beyond the Hospital in restoring the patient to the community. As a member of the health team, the professional nurse unifies and coordinates inter-departmental patient services and functions as a role model to this team in the practice of nursing diagnosis and intervention. The nurse keeps abreast of new trends and concepts within the profession through continuing education and is expected to innovate, initiate and effect change.
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Leanna Contino, AAS, R.N., and Susan Casey-Bernstein, BSN, R.N., NE-BC,
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are two veteran nurses at St. Francis who know this philosophy by heart. They say that many of the nurses consider St. Francis their “home away from
have been to many hospitals on Long
home” and neither Leanna nor Susan can see themselves working anywhere
Island and we are definitely the best.
else. “At St. Francis, we are always asking ourselves, ‘How can we make
Everyone here is treated with dignity. I could
things better?’” says Leanna, who joined St. Francis in 1975 and then returned
not see myself working anywhere other than
in 1988 after taking a break to raise her four children. “I really believe we de-
St. Francis Hospital.”
liver the best practice, which leads to the best outcomes.”
–Susan Casey-Bernstein, BSN, R.N., NE-BC Susan Casey-Bernstein, BSN, R.N., NE-BC (right) with Leanna Contino, AAS, R.N. (left)
2009 St. Francis Nursing Annual Report 4
Patient Satisfaction Among facilities both nationally and on Long Island, St. Francis Hospital consistently ranks in the 99th percentile for overall care giving. Patient satisfaction is paramount at St. Francis Hospital and we believe in going the extra mile to ensure our patients are comfortable and delighted from the moment they walk through our doors until they are discharged. Patient satisfaction actually starts with recruitment. It is the reason potential candidates are asked during their inter-
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view to share an example of how they’ve gone “above and
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beyond” in a previous position, or as a recent student. It is important for St. Francis Hospital to hire individuals whose
atient satisfaction is our top priority. Our goal is to be
recognized as a provider of exceptional service. We are continuously identifying where we are doing well and
values are in alignment with ours in order to give the patient the best possible experience during their short time with us. “Our patients indicate a high level of satisfaction and we are committed to continuous improvement and want our patients
where we have opportunities for improvement.”
to have the ideal patient experience,” said Donna Rebelo,
–Deborah Harabedian, BSN, RN-BC
MS, R.N., NE-BC, Assistant Vice President of Nursing/Cardiac Catheterization Lab.
Deborah Harabedian (left) with patient
What Our Patients Say The treatment I received at St. Francis Hospital from your staff was superb. Every member of your staff was instrumental in my recovery. They were caring, conscientious, capable and competent. The nurses would always identify themselves and explain the purpose of their presence. As a retired administrator, it’s quite obvious that you have an excellent selection process and training program in place to ensure such stellar employees. They are highly trained, gentle and reassuring. I came to St. Francis based on the recommendation of my wife, a physician for five decades who considers your facility the best in cardiac care. As usual, she was right! With sincere gratitude, Nicholas A. Neuhaus, Howard Beach, NY We want to express our heartfelt appreciation and sincere gratitude to you and your exceptional staff for the unparalleled level of care provided to our father. He dedicated his entire life to his family, students and community and is revered throughout the Jewish world as a great sage and a man of exceptional piety. It is therefore fitting that he received his care at an institution with similar values.The kindness, skill and sensitivity exhibited by your outstanding staff was truly remarkable. It was a great source of comfort to watch the doctors, nurses and technicians in the Critical Care Unit provide the highest level of care, for which St. Francis is deservedly famous. Sincerely, Anonymous I was completely delighted and pleased with my hours spent at St. Francis Hospital. Your staff proved that your hospital is truly a world class health institution. The staff’s professionalism allowed me to receive the best care possible. From the beginning, several nurses and technicians were at my bed side. I was most impressed with how they repeatedly double checked my name and date of birth for accuracy while performing their required tasks.Your staff’s constant courtesy, sensitivity to my requests, and eagerness to answer all my questions demonstrated the meaning and importance of good bedside manner. Sincerely, Howard Linden, Syosset, NY 2009 St. Francis Nursing Annual Report 5
Empirical Outcomes continued
Making the Grade In 2006, St. Francis Hospital earned the prestigious Magnet designation for excellence in nursing services, joining only 320 other medical institutions across the country. Magnet designation recognizes quality patient care, nursing excellence and innovations in professional nursing practice. As the Hospital currently seeks redesignation, obtaining outstanding patient satisfaction continues to be a primary goal. As you can see from Overall Rating of Care Given the graphs below, our patients value the professional100 ism, skill and compassion of our nurses. For each quar80 ter of 2009, St. Francis nurses received high rankings 60 40 in courtesy, skill and collaboration with all members of 20 the healthcare team. 0
1Q09
2Q09
3Q09
4Q09
Overall Nursing Care 100 80 60 40 20 0
1Q09
2Q09
3Q09
4Q09
Friendliness/Courtesy of the Nurses 100 80 60 40 20 0
1Q09
2Q09
3Q09
4Q09
Skill of the Nurses 100 80 60 40 20 0
1Q09
2Q09
3Q09
4Q09
Staff Worked Together to Care for You 100 80 60 40 20 0
1Q09
2Q09 SFH Mean Score
3Q09
SFH LI Ref, Grp. Rank
4Q09
SFH Nat’l %-tile Rank
2009 St. Francis Nursing Annual Report 6
Quality Outcomes At St. Francis Hospital, Quality Outcomes are measured and compared to national benchmarks in many areas, including central-line infections and pressure ulcers. Following the protocols established in 2008 to reduce central line-associated bloodstream infections (CLAB), all patient care units are monitoring results closely. Through these efforts, MICU 2 has demonstrated a significant reduction in CLAB rates that have been sustained over successive quarters. In 2008, MICU 2’s baseline was 6.6 with a target of 1.9. At the end of 2009, this was achieved with an annual rate of 1.1. These results are a reflection of our nurses’ tireless commitment to patient safety and quality outcomes.
Quality Initiatives
At St Francis Hospital there is a high use of anticoagulants ment effort. St. Francis Hospital utilizes Hillrom’s benchmark for evaluating over- which presents a continually high risk for patient safety. The all hospital acquired pressure ulcer rates in comparison to like acute care Medication PI Team, which includes nurses at all levels, refacilities. Hillrom’s data base includes data collected from over 700 facilities in viewed the National Patient Safety Goal (NPSG.03.05.01: Rethe United States and abroad on an annual basis. Analysis of St. Francis’ over- duce the likelihood of patient harm associated with the use of all hospital acquired pressure ulcer rates from the first quarter of 2009 through anticoagulant therapy) and provided evidence based research to guide each department’s education and form changes. Staff the fourth quarter of 2009 shows a steady linear decline in hospital acquired was educated on: pressure ulcer rates. Quarterly data demonstrates that St. Francis has achieved 1. Types of anticoagulants and their dosing, indications, pre a steady linear decline to 0.73 percent of patients surveyed with a hospital accautions, and side effects quired pressure ulcer in the fourth quarter of 2009. The Hospital attributes the 2. Monitoring of therapeutic levels and recognition of under success in achieving these results with the process change in our pressure ulcer and overdosing prevention program. The program was overhauled and redesigned with use of 3. New forms and proper documentation, including adminevidence based practice. Staff education, systematic data collection process, istration of anticoagulants and the related dosing guidelines, and changes in policy and procedure have contributed to the great success we laboratory tests, and patient education have achieved and are managing to sustain. Among all the anticoagulants, the Medication Safety PI Team considered Heparin the most dangerous and the most complicated for the nurses to administer. It took on center stage of the education for nurses.To assure safety, weight based dosing charts on a new Heparin nomogram, along with standardized Heparin drip concentration, and new nursing flow records were all implemented. These dosing charts mitigate errors in math calculations for the nurse.The Medication Safety PI Team monitors our compliance with the safe and effective use of Heparin and has shown the nomogram to be very successful. As part of St. Francis and Catholic Health Systems commitment to quality and patient safety, St. Francis is entering the final stages in the implementation of bar code medication administration, known as Admin Rx. Bar code technology is a wireless point-of-care application that improves medication safety through scanning bar-coded medications and intravenous fluids at the point of administration, automating the documentation process and ensuring the “7 rights” are followed.The nursing staff has been involved in all phases of this project.As members of the Shared Governance Admin Rx Group, nurses accompanied the team on site visits to hospitals which have implemented this system.They also participated in the design sessions and assisted in the decisions made regarding the type of computers and carts to purchase. The implementation of Admin Rx will begin on 1 West, following training sessions for the clinical nurses and managers. It is anticipated the pilot on 1 West will be successful, leading to full implementation of this system throughout the patient care areas. Prevention and treatment of pressure ulcers is a key performance improve-
2009 St. Francis Nursing Annual Report 7
Empirical Outcomes continued
S.K.I.N. Champions In the fall of 2008, St. Francis Hospital proudly introduced the S.K.I.N. Champion Program. This new program utilizes both ancillary staff and clinical nurses to conduct a monthly prevalence study for pressure ulcers, which are an established indicator used to measure the quality of nursing care delivered. St. Francis nurses have made combating pressure ulcers a top priority. Nurses participating in the program undergo intensive training to develop the skills necessary to differentiate multiple types of skin impairments. Proper identification leads to proper course of care, resulting in positive outcomes for patients. Characteristics of the program are spelled out using the S.K.I.N. acronym: Support surface; Keep turning and repositioning; Incontinence and moisture management; Nutrition and hydration. The S.K.I.N. Champion Program is connected to a wider research project conducted by the National Data Base of Nursing Quality Indicators. On each prevalence day, approximately 300 patients participate in the study. There are 10 teams conducting the S.K.I.N. Champion study. Each team is comprised of a Clinical Nurse Specialist, an R.N., and a PCA or CCP. A data-collection work sheet is utilized to provide a systematic gathering of clinical information while nurses are evaluating patients for pressure
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K.I.N. Champions is a fantastic program that
allows us to bring to our nurses the best practices for
reducing pressure ulcers. As a result, we have already
ulcers. The team also looks at the patient’s environment to ensure their overall safety as part of the prevalence day surveillance. When a problem is identified, there is an immediate assessment of severity and nurses evaluate the interventions which were in place and the effectiveness of those interventions. “On the day of the study, we carefully look at every patient from head to toe,” says Chenel Trevellini, BSN, R.N.,
seen a steady decline in our incidence rates, putting us
CWOCN. “The S.K.I.N. Champion Program is adding to the pro-
well below the national benchmark. When I came to St.
fessional development of the nursing staff, resulting in im-
Francis, I felt Santa Claus had given me a big present.
proved patient outcomes.”
Here there is a sense of professionalism, ownership and accountability at all levels.” –Chenel Trevellini, BSN, R.N., CWOCN Chenel Trevellini, BSN, R.N. CWOCN (right) with Theresa Orecchio, BSN, R.N. (left)
Transformational Leadership Nursing leaders at St. Francis Hospital recognize the importance of providing an environment that blends timetested standards, with the values, beliefs and behaviors required to move our staff forward.
Dedicated Education Unit During the fall semester of 2009, St. Francis teamed with Adelphi University to launch a Dedicated Education Unit (DEU), an exciting and innovative approach to teaching tomorrow’s nurses. The program was implemented to provide students with a clear picture of what a nurse does, day in and day out. Training with the DEU has been shown to boost confidence for the students, as well as enhance communication with patients, and provide professional skills as they make their transition to the workforce. St. Francis, one of the first hospitals in the United States to establish a DEU, now has eight students per semester study on-site on 2 West, a 35bed medical/surgical and cardiac telemetry unit. Two students are paired with one St. Francis nurse, who is known as an Education Ambassador, and assigned to four patients. The intense and consistent learning relationship between the student and his/her ambassador gives students the opportunity to experience the practical realities of a nursing career early on. The students’ first two shifts are eight hours long, followed by six 12-hour shifts. In their first weeks on the unit, student nurses care for a patient firsthand while learning about different disease processes and medication management. The program has garnered much enthusiasm from the nursing department and the students.
Joint Commission Nurses at St. Francis Hospital always strive for excellence, which is why the Hospital has received glowing results by the Joint Commission in the
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last few accreditation cycles. Though accreditation is tri-annual, meeting performance standards is a daily requirement at St. Francis Hospital. The Joint Commission is an independent, not-for-profit group that ac-
he students in DEU are getting a leg up on
credits and certifies more than 17,000 health care organizations and pro-
students who are being trained in the classroom with
grams in the United States. Joint Commission accreditation and
traditional clinicals. As a nurse, I would have loved an
certification is recognized nationwide as a symbol of quality that reflects
opportunity like this. The students become more confident in caring for and interacting with the patients.” –Jean Braegelmann, BSN, R.N. (From l to r) Genevieve Higgins, BSN, R.N.; Jean Bragelmann, BSN, R.N.; and Ildiko Kutasi, BSN, R.N., CMSRN
an organization’s commitment to meeting certain performance standards. The organization’s objective is to evaluate health care organizations and inspire excellence in providing safe and effective care of the highest quality and value. Our nurses are one of the main reasons that St. Francis Hospital consistently receives excellent reviews from the Joint Commission. Because they touch every facet of the Hospital, from the accounting and admissions to pharmacy and discharge, they are continuously striving for excellence and improvement. “Performance improvement is the backbone of our hospital,” says Anna Baracchini, MA, R.N., CPHQ, who leads the team responsible for preparing the hospital for Joint Commission evaluations. “If you rest on your laurels, you are not going to achieve future success.”
2009 St. Francis Nursing Annual Report 9
Greeter Initiative in the Emergency Department St. Francis Hospital’s mission includes providing an environment where excellence of patient care in its totality is emphasized. One measurement of our efforts to uphold this mission is our level of patient satisfaction, reflected by our Press Ganey scores. Press Ganey provides patient satisfaction surveys, management reports, and national comparative databases for the integrated health care delivery system. These scores (along with the HCAHPS scores), provide vital feedback regarding experiences and areas needing improvement. For the Emergency Department, these surveys reflect responses of patients that were treated and released. Patient
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satisfaction in the Emergency Department is directly impacted by
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the effectiveness and efficiency of the care delivered. An estimated 21,000 people are seen in the Emergency De-
ne of the biggest developments in the Emergency
partment at St. Francis Hospital annually. Patient arrival concerns were identified during several staff and leadership meetings
Department redesign is the involvement of security guards at
where it was decided that there was not a consistent process of
the ED entrance. As triage nurses, we are so appreciative of
acknowledging, greeting and triaging patients. Many activities
security being here. They greet the patients and punch in the
occurring in triage were also competing with efficient and effec-
patients’ arrival time. To me, it makes a big difference. Patients
tive patient flow. This included: 12 lead EKG, medication reconcil-
feel that they are immediately being taken care of.”
iation, booking, and labeling of charts. Several changes needed
–Christine Pinto, AAS, R.N.
to occur in order to improve patient safety and patient flow. Ann Cella, MA, MEd, R.N., NEA-BC, Chief Nursing Officer (CNO),
(From l to r) Catherine Vicari, AAS, R.N.; Christine Pinto, AAS, R.N.; and Gerard Urick
championed the use of hospital security guards to serve as formal greeters in the Emergency Department. These greeters would document the accurate arrival time for all Emergency Department patients 24 hours a day, 7 days a week. This innovative initiative ensured that each patient be seen and greeted upon entrance into the department. The CNO collaborated with the director of the Security Department, and along with the Executive Leadership Team, approved allocation of this full time position. In August 2009, St. Francis introduced this redesign initiative in which security guards were asked to partner with the Emergency Department staff to improve the arrival experience of the patient. The purpose of this initiative was to expedite patient access and to support St. Francis’ goal of getting emergency patients from door to stretcher in 20 minutes. This program addresses a key element of concern for patient safety and satisfaction as well as assists with providing efficient triage. Currently, the arrival process includes identifying and welcoming the patient, stamping arrival time and having the patient document name and reason for visit (on a temporary form). The security guard then passes the stamped triage record and the temporary form to the triage nurse. Both the Emergency Department and security staffs have expressed how much the program has successfully benefited the patient and triage nurse. The following Press Ganey data further validates the success of this program.
1Q & 2Q 2009
3Q 2009
4Q 2009
Mean Score
Large PG DB Rank
Mean Score
Large PG DB Rank
Mean Score
Large PG DB Rank
Waiting time before noticed arrival
86.8%
45% tile
86.2%
35% tile
94%
95% tile
Helpfulness of the first person
89.4%
86% tile
89%
78% tile
92.2%
97% tile
2009 St. Francis Nursing Annual Report 10
Structural Empowerment At St. Francis Hospital, proven structures and processes are combined every day with strong leadership, resulting in professional partnerships at every level that aim to improve patient health outcomes and community relations. It is called the St. Francis Hospital Professional Nursing Shared Governance Model. At St. Francis, Shared Governance provides a structure that supports decentralized decision-making and encourages collaboration on clinical outcomes, professional practice, performance improvement, education, and evidenced-based practice.
Professional Financial Accountability Council Development Council
Responsible spending is a component of the Shared Governance Model and is taken very
seriously at every level at St. Francis Hospital. The Financial Accountability Council mem-
The Professional Development Council’s mission is to
bers are committed to cost-saving initiatives and promoting staff education on effective
promote and support the personal and professional
cost-reduction, as well effective resource utilization. We believe improved awareness leads
growth and development of the registered professional
to an improved bottom line.
nurses at St. Francis Hospital. The council members work hard to recognize and celebrate the nursing profession and create an energetic, compassionate workplace where everyone is committed to providing quality patient care.
From L to R: Stephanie Ajudua, BSN, R.N., CCRN; Patricia O’Connor, AAS, R.N., CCRN; Frances Breeze, BSN, R.N.; Patricia Lupski, MSN, R.N., NE-BC; Kathleen Peppard, BSN, R.N., CMSRN; Marilyn Piliere, AAS, R.N.; Karen Prashad, BSN, R.N.; Kathleen Gilligan-Steiner, MA, R.N., NE-BC; and Tanya Louis, BSN, R.N.
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his council is a group of dedicated
members that work together to recognize the achievements of the professional nurse
R.N. Advisory Council Our diligent nurse leaders continuously maintain a healthy work environment at St. Francis Hospital. Ann Cella, MA, MEd, R.N., NEA-BC, the Chief Nursing Officer (CNO), seeks constant feedback from the staff in many forums. One popular forum for the nurses is the R.N. Advisory Council, the essence of the Nursing Shared Governance Model and the interchange of information to and from the other Shared Governance Councils. These meetings are structured to generate the opportunity for open constructive ex-
and create an environment that supports
changes among nurses and the CNO about decisions impacting their work environment,
professional growth.”
and patient care. The monthly meetings, which are consistently well-attended, are con-
–Christine Spitz, BSN, R.N.
ducted by members and focus on several important topics that keep nurses informed and allows them to actively participate in decision-making at St. Francis.
2009 St. Francis Nursing Annual Report 11
Structural Empowerment continued
Unit Based Councils Clinical nurses practicing on each patient care unit at St. Francis Hospital are represented by individual unit councils. Nurses volunteer to represent their colleagues through active participation on the councils. The common goal of each unit based council is to provide an avenue where information and suggestions can be discussed, promote a positive work experience, as well improve clinical outcomes and R.N. satisfaction through active decision making at the
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unit level. The concept of unit based councils empowers the clinical
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nurses’ ability to participate in decision making, provide them with authority, enhance collaborative skills and autonomy to problem
nit Based Councils make a big difference. It gives
solve, and create a healthy work environment. The voice of the nursing staff can be heard through the unit based
nurses a voice and make the unit more effective. It also shows
how much our opinion counts and how much respect we get.
St. Francis nurses always offer a helping hand to each other – you are never alone. And that translates into better care for our patients.”
council members who are comprised of both day and night nurses from different levels of nursing experiences. Each unit based council member has their finger on the pulse of the unit and are the primary decision makers responsible for bringing positive outcomes to their units.
–LaToya Bucknor, BSN, R.N.
Last year, each unit council addressed nursing concerns such as se-
(From l to r) LaToya Bucknor, BSN, R.N.; Marianne Hill Day, BSN, R.N., CCRN; Antoinette Jordan, BSN,
lecting a unit-specific scrub uniform for the clinical nurses, acquiring
R.N.; Richard Crudo, BSN, R.N.; Denielle Lawtum, BSN, R.N.; and Donna Rebelo, MS, R.N., NE-BC
equipment/supplies to enhance patient care, and improving nurse/physician collaboration. Additional examples of the impact Nursing Leadership Council
Finance Accountability Council
RN Advisory Council
Evidence Based Practice Councils
Unit Councils
Patient
Professional Development Council
Hospital PI Teams/ Committees/Task Forces
the unit based councils have had include: • SICU developed a plan for caring for the neurosurgery (a new service at St. Francis) patient population • MICU 2, in conjunction with the Emergency Department, developed the plan for use of emergency cooling therapy • K1 introduced a program to support new nurses • K2 developed a new peer review process • 1 West significantly reduced the number of falls in their unit in 2009 through their “I Make a Difference Program”
Quality Outcomes Council
Nursing Shared Governance Online Survey/E-Decision Making
E-Decision Making Whether it’s a discussion about the color of nursing uniforms, nursing certifications, or locating lost telemetry monitors, St. Francis Hospital is now utilizing information technology to engage more nurses in decision making. Created in 2009, this initiative is an opportunity for all clinical nurses to participate in shared governance at the Hospital. Here’s how it works: Twenty-four hours, seven days a week, for a designated period of time, nurses can use the St. Francis intranet to access the web based survey. Here, the nurses can review a summary of each shared governance council minutes and participate in decisions by responding to council specific questions. The results are downloaded and an analysis is provided to the leaders of each shared governance council for review with their members. 2009 St. Francis Nursing Annual Report 12
Participation on National Committees The sharing of ideas and knowledge by committee participation on a local or national level promotes growth among the nursing
The 2009 Shared Governance Awards winners with Ann Cella, MA, MEd, R.N., NEA-BC (cen-
staff – directly for the participant and indirectly for peers. In 2009,
ter): From L to R: Laura Costa, BSN, R.N., CMSRN; Ruth Reed, BSN, R.N., CEN; Beth Ann Grady-
two nurses at St. Francis Hospital, Lita Au, BSN, R.N., CCRN, and
Acker, BSN, R.N., CDE; and Judith Morrison, BSN, RN-BC
Benzy Thomas, MSN, R.N., CCRN/ANP-C, served as “ambassadors” to the American Association of Critical-Care Nurses
Shared Governance Awards
(AACN). Their role was to promote certification in critical-care
nance Awards. Four clinical nurses are recognized by staff nurses for their
among their peers. Upon returning from a national conference, the
achievements that reflect a positive image of nursing. Every year it is al-
nurses shared literature and ideas with their nursing colleagues.
ways an arduous task to select only four outstanding nurses from such
Bobby-Jo Ward, AAS, R.N., CMSRN, and Angela Tainter, AAS,
a large pool of talented and noteworthy professionals. Each specialty,
R.N., CMSRN, members of the Academy of Medical Surgical
Medical-Surgical, Critical Care, Procedural and Outpatient, have the op-
Nurses’ national and Long Island chapter, attended the national
portunity to showcase their accomplishments through the awardees.
Congratulations to the recipients of the annual Nursing Shared Gover-
convention in September 2009. Bobby-Jo presented a poster on S.K.I.N. Champions, while Angela presented a poster on an Assessment for Falls Risk.
Higher Education There are 970 registered nurses at St. Francis Hospital. Of those, 646 are Bachelors prepared and 91 are Masters prepared, bringing the total to 737 or 76 percent of the nursing complement. Of the staff of registered nurses, 705 are full time, 238 are part time and 27 are per diem. The average years of service are 10 years and four months. Years of Service Range 0-5 years 6-10 years 11-15 years 16-20 years 21-25 years 26-30 years 31-35 years 36-40 years 41 or more years
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t. Francis nurses are highly skilled and
willing to go the extra mile. It was a very proud moment to be at a national conference with 400 other nurses making a presentation on ulcer and falls prevention. It lets everyone know we are proactive for our patients.”
–Bobby-Jo Ward, AAS, R.N., CMSRN Bobby-Jo Ward, AAS, R.N., CMSRN (left) with Angela Tainter, AAS, R.N., CMSRN (right)
2009 St. Francis Nursing Annual Report 13
Total 356 206 134 109 81 48 26 8 2
Structural Empowerment continued
Documentation Committee With the introduction of a Document Redesign Project in 2009, a 20-person inpatient committee and 10-person procedural committee discussed ways to reduce paperwork overload. For each one of the 18,433 patients admitted to St. Francis last year, there is a corresponding collection of 14 required admission forms. In addition to that, it is estimated that one inch of paperwork is collected for each day a patient is hospitalized. Greeley HCPro, a hospital consulting firm, was brought in by the nursing department to address the issue. Clinical, education and administrative nurses who formed the committee found their task challenging yet creative; maintaining legal requirements while whittling down the burden on staff. Newly designed forms will be introduced to
SFH’s Patient Care Services Leadership Team (from L to R): Donna Rebelo, MS, R.N., NE-BC;
staff as each is completed. A complete overhaul is expected by
Kathleen Gilligan-Steiner, MA, R.N., NE-BC; Ann Cella, MA, MEd, R.N., NEA-BC; Kathleen Engber, MA, NE-BC/R.N. Informatics; Margaret Ochotorena, MSN, R.N., NE-BC; Anna Baracchini, MA,
the summer of 2010.
R.N., CPHQ; and Diane Mamounis-Simmons, MSN, R.N., NEA-BC/CNOR
By the Numbers 2009 St. Francis Hospital Statistics SERVICES TO PATIENTS Operating Room Procedures (Including Cardiac Surgery) • Open-Heart Surgery • General Surgery • Ambulatory Surgery • Other Cardiothoracic Surgery
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t. Francis feels like a family. You are proud to be part of it
16,879 1,597 3,485 7,136 4,674
Cardiac Catheterization Patients • Inpatient Catheterizations • Outpatient Catheterizations • Coronary Interventions
12,331 5,413 3,326 3,592
Non-Invasive Cardiac Lab Procedures
13,251
Cardiac Rehabilitation Visits
61,388
and to see your successes. I serve on a committee to revamp medical documentation. We are focused on increasing speed and decreasing paper so we have more time for patient care. The
PATIENT CARE Number of Beds Patient Admissions
committee gives us a voice to make positive changes.”
Days of Patient Care
–Kim Chang, BSN, R.N.
Bed Occupancy Rate Emergency Room Visits
2009 St. Francis Nursing Annual Report 14
319 18,087 104,295 90% 21,073
Exemplary Professional Practice
Individually and collaboratively, nurses consistently work to promote professional values and a healing environment aimed at meeting the exemplary standards established in the Professional Practice Model.
Palliative Care Intermediate Care Unit In October 2009, 1 East became the Intermediate Care Unit While palliative care is a
(IMCU)/Stroke Unit. It was successfully transitioned from a
relatively new term in
medical surgical unit to a 24-bed IMCU/Stroke Unit, with an
health care delivery at St.
additional 14 medical surgical beds, under the leadership of
Francis Hospital, we be-
Barbara Colligan, AAS, R.N., CMSRN, Nurse Manager; Erin
lieve it reaches back to
Markey, MA, R.N., ANP-C, Clinical Nurse Specialist; and As-
the heart, or core, of
sistant Nurse Managers, Linda Mendick, AAS, R.N., CMSRN;
nursing–taking time for
Patricia Carroll, BSN, R.N., CMSRN; Jennifer Ryan, BSN, R.N.,
each person. Not to be
CMSRN; and Celeste Koske, BSN, R.N., CMSRN. The profes-
confused with hospice,
sional development of the staff was essential to meet the
palliative care focuses on
needs of the patient population. Each nurse was required to
the relief of symptoms at
attend a five-hour neurosurgery class which included: the
any stage of a disease
pathophysiolgy of the brain, Massey Swallow Screen, TPA ad-
uring a palliative care
process. It not only ad-
ministration, antithrombotics, NIH Stroke Scale, RRT, and DVT
consultation I try to slow the pace
dresses physical needs,
prophylaxis. Twelve nurses attended the Critical Care class for
but it also considers the
clinical development.
D
“
down for the patients and their
spiritual, emotional and
1 East also welcomed 23 staff nurses from P2, one nurse
families. I give them time to talk,
social aspects of life for
from MICU 1, and one PACU nurse to the unit, in addition to hir-
think, and reflect not only about their
patients and their fami-
ing eight new PCAs and two new CCPs. The staff is very ex-
illness and hospitalization, but also
lies. Our Palliative Care
cited about developing new clinical skills and embracing their
about their lives.”
Program offers a team
new patient population. They are also enjoying all of the chal-
approach to communica-
lenges that arise in the IMCU/Stroke Unit.
–Maria Vitsentzos, MSN, R.N., ANP-C
tion, compassion, comfort and quality of life.
Since it was initiated in August 2005, the Palliative Care Program at St. Francis Hospital has seen an upward trend in referrals. In 2009, the department received 513 referrals for palliative care, an increase from the 48 referrals in the inaugural year. On any given day, the needs of 15 to 20 patients are addressed. The Palliative Care Nurse Practitioner often calls on peers in other disciplines, including social work, pastoral care, dietary and medicine, to meet individualized patient plans of care. Once involved, they meet regularly to discuss patient needs and treatment. When patients find themselves caught in the fast-paced world of doctors and hospitals, providers of Palliative Care at the Hospital help slow it down for them. 2009 St. Francis Nursing Annual Report 15
Exemplary Professional Practice continued
Hospice Hospice is the philosophy of care designed to give support to people in the final phase of a terminal illness. The focus is on comfort and quality of life, rather than cure. The goal is to maximize patient comfort and relief from pain and other distressing symptoms. Although hospice care does not aim for cure of a terminal illness, it does treat potentially curable conditions such as pneumonia and bladder infections, with brief hospital stays if necessary. In 2008, St. Francis Hospital, in collaboration with Good Shepherd Hospice (GSH) contracted for four inpatient hospice beds on 2 West. The staff received an extensive in-service by the GSH staff on the philosophy of care and symptom management in end-of-life issues. A hospice referral can be initiated by the patient and family members, as well as St. Francis Hospital’s interdisciplinary health care team and Palliative Care Service. The GSH staff reviews the patient’s medical record, and discusses the referral with the primary care practitioner and with the patient and/or family. Once the criteria for admission are met, the goals of care are established. The competent, dedicated, and compassionate staff of 2 West, with the guided support of GSH has cared for over 85 patients and their families since the inception of the Hospice Program. Here is our motto:
H
To Cure Sometimes
“
To Relieve Often To Comfort Always –Sir Walter Osler
ospice care is really
being attentive to the emotional, spiritual and psychological needs of
Heart Failure
patients and their families as the end
Congestive heart failure (CHF) affects
of life approaches. The staff at St. Francis has a history of providing compassionate and empathetic care
over 6 million people in the United States. The disease is the second most common cardiac diagnosis requiring hospitalization at St. Francis
at this time of life, very similar to
Hospital–preceded only by coronary
palliative care, but more intense.”
artery disease. Last year, in an effort
–Sr. Katherine Murphy, MSN, RN-BC/CCRN/CHPN
to streamline medical care for congestive heart failure patients and reduce repeated emergency admissions, the
Hospital created a new unit dedicated to treating this chronic cardiac condition. Located on 2 East of the DeMatteis Pavilion, the 38-bed unit has a staff specially trained and focused on taking a multi-disciplinary approach in caring for patients whose principle diagnosis is CHF. This highly dedicated team is comprised of nurses, MLP’s, dieticians, pharmacists and care managers who have completed a four-hour class on CHF treatment, documentation and medication management. Upon discharge, patients are referred to the
“
T
o be effective with heart failure
patients, you need collaboration between departments, so our approach is interdisciplinary. You don’t find Congestive Heart Failure Units everywhere. We
Hospital’s CHF Outpatient Program located at the DeMatteis Center. The ultimate goal is to
are totallyfocused on bringing together
keep them well balanced on a diet and medication regimen aimed at preventing episodes
developed expertise, with an emphasis
of worsening CHF requiring recurrent hospitalizations.
on quality care and patient safety.”
The outpatient program had 253 unique patients participate in 2009, of which 191 (75%) did not require any hospitalizations for CHF exacerbations throughout the year. The dedicated CHF floor began its specialized focus last fall. Between October and December 2009, 79 patients with CHF were assigned to and treated on 2 East. 2009 St. Francis Nursing Annual Report 16
–Patrice Keenan, BSN, R.N., CMSRN (From l to r) Patrice Keenan, BSN, R.N., CMSRN; Patricia Krug, MA, R.N., RN-BC; and Mary Gallagher, MA, R.N.
The Professional Nursing Practice Model Unveiled in 2009, the Professional Nursing Practice Model is a system that depicts how nurses practice, collaborate, communicate and develop professionally to provide the highest quality care for those served by the organization. The model incorporates Jean Watson’s Theory of Human Caring, which was developed in 1979 and melds human aspects of nursing with scientific knowledge. By using the practice model, St. Francis ensures that its professional nursing practice is consistent, regardless of where it occurs or who is providing the application. Applying our practice model also minimizes practice variations that can create risks, gaps in care, missed or overlooked needs and incomplete care.
2009 St. Francis Nursing Annual Report 17
New Knowledge and Innovations
At St. Francis Hospital, nurses play a critical role in bringing clinical innovations and improvement to patients.
TempaDOT The clinical environment often presents challenges when obtaining patient temperature measurement consistent with St. Francis Hospital’s policy, but the 3M TempaDOT single-use clinical thermometer allows for proper and accurate use. Right now, St. Francis routinely employs the TempaDOT thermometer for oral temperature measurement. St. Francis Hospital’s clinical nurses questioned whether the axillary route recommended by the manufacturer was a viable option for temperature measure. As a result, the nurses developed a research protocol to examine the mean difference between the oral and axillary route when using the TempaDOT thermometer. Using very controlled methods, a total of 100 healthy subjects were enrolled. The
Research Boot Camp
nurse researchers designed the research questions, inclusion/exclusion criteria, and
Staying true to our commitment to education and research
study procedures including writing and obtaining the research consent. The excitement
at St. Francis, a series of workshops were held at the Hos-
was palpable as the team awaited the study results reported by the statistician. The in-
pital in 2009, matching nurses with an expert in research.
teresting results lead
Kathleen O’Connell, Ph.D., R.N., FAAN, Coordinator of the
to more questions
Nursing Education Program for the Teacher’s College at Co-
and the distinct pos-
lumbia University, held research workshops in August and
sibly of continued
November. Nurses who were at various phases in research
TempaDOT research.
projects at the Hospital participated, gaining valuable insight during the one-on-one interactions.
I
“
t was an honor and privilege to be a part
of the TempaDOT research team and compare axillary and oral temperatures. As nurses, our goal is to always ensure quality patient care at St. Francis Hospital.”
–Judith Morrison, BSN, RN-BC
Among the nurses who participated were: • Ruth Reed, BSN, R.N., CEN; Erica Hassan, BSN, R.N.; Judith Morrison, BSN, RN-BC; and Jeanette McLaughlin, BSN, R.N., CCRP – TempaDOT • Karen Venice, MA, R.N., CCRN, and Bessy Abraham, BSN, R.N. – The Use of Basic Knowledge Assessment Test in Critical Care Orientation • Jane Billian, BSN, R.N.; Karen Venice, MA, R.N., CCRN; Sue Seiberlich, MA, R.N., CCRN; and Joan Wallace, R.N., CCRN – Exploring Patient Interest in Pet Therapy/Visitation • Michele Sena, MSN, R.N. and Mary Gaglione, MSN, R.N., CPAN – Patient Comfort Level Related to the Use of Warm Blankets in the Procedural Area • Elizabeth Haag, MPA, R.N., CCRP and Suzanne Palo, MA, RN-BC – Cardiovascular and Lifestyle Habit Survey • Shoshana Scholem, BSN, R.N. and William Peabody, MSN, R.N., CCRN – Sense of Belonging and the Process of Socialization in the Novice Nurse • Mary Jane Glander, MSN, R.N. – Atrial Fibrillation and Blood Pressures • Patricia Krug, MA, RN-BC – Patient Education and Heart Failure • Elizabeth Cotter, MSN, RN-BC – Staff Satisfaction and the Dedicated Education Unit.
Judith Morrison, BSN, RN-BC (left) with Ruth Reed, BSN, CEN (right)
2009 St. Francis Nursing Annual Report 18
“
T
he SICU nurses were very excited to be part of the
development and implementation of the neurosurgery service at St. Francis. The educational seminars played an integral role in developing effective surgical policies and procedures for our staff nurses.”
–Karen Venice, MA, R.N., CCRN
Emergency Cooling Therapy St. Francis was one of the first hospitals on Long Island to adopt a
Karen Venice, MA, R.N., CCRN (left) with Amy Devine, AAS, R.N. (right)
new cooling technique that can revive unconscious patients who have suffered cardiac arrest and restore their normal cerebral func-
Neurosurgery
tion. This lifesaving concept, called induced therapeutic hy-
One of the goals of St. Francis Hospital is to continually strive to expand and develop new and innovative initiatives and services.The expansion of the Hospital’s surgical services in relation to the implementation and integration of neurosurgical services is an example of the continued efforts to meet all the needs of our patients and to provide them with quality care. KarenVenice, MA, R.N., CCRN, worked collaboratively with interdisciplinary team members to develop the educational plan, policies, standards of care and competencies of the expansion of the neurosurgical services for St. Francis nurses.The integration of staff nurse champions allowed the staff to participate in each step along the way.The champions agreed with the developed educational plan and encouraged their colleagues to attend educational seminars. In addition, two staff champions, Asha Phillips, BSN, R.N., CCRN and Maria Meyers, BSN, R.N., taught the Intracranial Pressure Monitoring portion of the classes offered. Development and implementation of the neurosurgery service generated effective and appropriate support and resources to the patients and staff, as well as development of collegiate relationships with neurosurgeons, MLP’s, and product representatives.
The body’s temperature is regulated by a computerized cooling
pothermia, lowers a patient’s body temperature to 91.2 degrees. pump which delivers water to special pads. These pads are wrapped around a patient’s legs, arms, chest, back, and abdomen. The goal is to reduce the body’s metabolism for 24 hours thus decreasing brain damage caused by hypoxia during a cardiac arrest and the reperfusion of oxygen which causes the brains cells to undergo apoptosis, or natural cell death. The cause of apoptosis after a brain is reperfused with oxygen is unknown. Statistics show that as many as one in five patients or 20 percent may benefit significantly by using this technology. Nurses in the Emergency Department and on MICU 2 received extensive training to deliver this therapy. When a patient meets the inclusion criteria, the physician orders the cooling therapy to begin. St. Francis has elected to use the Arctic Sun device to deliver this controlled cooling therapy. A trained R.N. places the cooling pads on the patient and connects the pads to the Arctic Sun to begin cooling. The patient is then transferred to critical care where the cooling therapy is continued for 24 hours. The process is then reversed to warming until the patient becomes normothermic.
2009 St. Francis Nursing Annual Report 19
New Knowledge and Innovations continued
Tandem Heart and the Impella Two ventricular-assist devices, which are in current use at St. Francis, highlight the Hospital’s continuing commitment to our cardiac patients. The Impella 2.5 was introduced in late 2009, while Tandem Heart made its debut in the third-quarter. The Tandem Heart is a percutaneous transeptal ventricular assist device, which acts to unload the right and/or left sides of the heart. For right-sided support, the cannula is placed via the femoral vein and is advanced to the right atrium. The blood is returned via the pulmonary artery. For left-sided support, a transseptal cannula inserted through the femoral vein and advanced across the intra-atrial septum into the left atrium, supplies blood from the left atrium to a centrifugal pump. Oxygenated blood is then propelled by the impeller from the outflow of the pump and it is returned to the patient via an arterial cannula placed in the femoral artery. Since oxygenated blood is withdrawn from the left atrium, the atrium has to do less work to move the blood to the ventricle. Also, the blood which flows through the pump, does not have to go through the left ventricle; the left ventricle also has to do less work to move blood to the aorta. The Impella 2.5 percutaneous cardiac assist device is designed to provide partial circulatory support to patients requiring temporary or prolonged assistance with ventricular unloading. It is indicated for any patient requiring partial circulatory support for short term duration. Tandem Heart and the Impella allow for fewer problems post-insertion than prior ventricular assisted devices. Both fill the need for a bridge from intraaortic balloon pump and high pressure support to allow for high-risk interventions to be performed or allow for recovery or other long-term support.
Tandem Heart patient Alice Wallice (center) with Harold Fernandez, M.D., who implanted the pump, and Joan Wallace, R.N., CCRN.
A “
s an OR nurse at St. Francis for 34 years, I take great pride
in working with a top notch team and assisting with leading edge procedures such as Tandem Heart, which supports a patient’s circulatory system until he or she is strong enough for surgery.”
–Barbara Kendall, R.N. Cindy Sukhoo, BSN, R.N., CNOR (left) with Barbara Kendall, R.N. (right)
2009 St. Francis Nursing Annual Report 20
St. Francis Hospital 2009 Certified Nurses Stephanie Ajudua, R.N., CCRN Bernadeth Alcott, R.N., ANP-C Meulan Amen, R.N., CCRN Kathleen Anderson-Arnopp, R.N., CPHQ Roslynn Aquino, R.N., ANP-C Juliette Arrastia, R.N., CCRN Warlita Au, R.N., CCRN Regina Bakota, R.N., CMSRN Joana Balsamo, R.N., CMSRN Anna Baracchini, MA, R.N., CPHQ Sandra Bastidas, R.N., CEN Kara Benneche, R.N., CEN Maria Benner, R.N., CCRN/ANP-C Carol Bertone, R.N., CMSRN Helen Birdsong-Abate, R.N., CCRN Kelly Bitran, R.N., FNP-C Suzanne Bove-Bast, RN-BC Erina Boyle, R.N., CCRN Mary Brady-Costello, R.N., CNOR Lori Brush, R.N., CCRN Elizabeth Busi, R.N., CEN Laura Buszko, RN-BC
Maryann Cacace, R.N., CEN Lara Caniano, R.N., CCRN Evelyn Capriotti, R.N., CNOR Theresa Caputo, R.N., CMSRN Laurence Carlin, R.N., CCRN Rosario Carlin, R.N., CCRN Christine Carman, RN-BC Lenore Carroll, R.N., ANP-C Mary Carroll, R.N., CNOR Patricia Carroll, R.N., CMSRN Susan Casey-Bernstein, R.N., NE-BC Joanne Catapano, R.N., CRN Ann Cella, R.N., NEA-BC Tiffany Chaffee, RN-BC Debra Chalmers, R.N., ANP-C Dorothy Ciano, R.N., CCRN Danielle Cincinelli, R.N., ANP-C Barbara Colligan, R.N., CMSRN Paul Conlin, R.N., CNOR Natalia Constantino, R.N., ANP-C Laura Costa, R.N., CMSRN Elizabeth Cotter, RN-BC 2009 St. Francis Nursing Annual Report 21
Rachel Cowan, R.N., CMSRN Nicole Cregan, R.N., CCRN Ellen Cummings, R.N., CNOR Novlet Davis, R.N., ANP-C Gina DePietro, R.N., CNOR John DePietro, R.N., ANP-C John Devins, R.N., CCRN Girannie Dilchand, R.N., CNOR Christine Dougherty, R.N., CCRN Miroslawa Drozdzik, R.N., ANP-C Kathleen Engber, R.N., NE-BC/RN-Informatics Deborah Feil, R.N., CMSRN Anne Fioresi, R.N., ANP-C Dawn Focazio, R.N., FNP-C Mitzi Forman, R.N., CCRN Janice Francis, R.N., ANP-C Rosalia Francucci, R.N., CCRN Mary Gaglione, R.N., CPAN Colleen Garr, R.N., CCRN Rosemary Gilligan-Holmes, R.N., CMSRN Kathleen Gilligan-Steiner, R.N., NE-BC Kimberly Go, R.N., ANP-C
Certified Nurses continued Jennifer Gomez, R.N., CNOR Sharon Gordon, R.N., CNOR Beth Ann Grady-Acker, R.N., CDE Laura Gregorovic, R.N., CCRN Jill Grimaldi, R.N., CCRN Michelle Grippo, R.N., CEN Philomena Grossmann, R.N., CCRN Rose Guerin, R.N., CCM Susan Gunaydin, R.N., CMSRN Elizabeth Haag, R.N., CCRP Eileen Hague, RN-BC Donna Handle, R.N., CNOR Deborah Harabedian, RN-BC Anne Marie Helmke, R.N., CMSRN Patricia Hendershot, R.N., CMSRN Arlene Hilado, R.N., CCRN Marianne Hill Day, R.N., CCRN Donna Hobbs, R.N., CNOR Tina Hong, R.N., CCRN Linda Hosford, R.N., ANP-C Holly Hynes-Morales, R.N., CNOR Carla Intrabartola, R.N., CNOR Marcia Irving, R.N., CNOR Joan Jablonski, R.N., CCRN Lisa Jahrsdoerfer, R.N., CCRN Jan James, R.N., CCRN Barbara Johnson, R.N., ANP-C Catherine Kaestel, R.N., CPAN
Katherine Katz, R.N., CNOR Patrice Keenan, R.N., CMSRN Patricia Keller, R.N., ANP-C Eileen Kenney, R.N., ANP-C Alan Kiernan, R.N., CCRN Celeste Koske, R.N., CMSRN Nancy Kostel-Donlon, RN-BC/ CEN/CPAN/CCRN Patricia Krug, RN-BC Barbara Kunz, R.N., CNOR Joanne Kuplicki, RN-BC Ildiko Kutasi, R.N., CMSRN Danielle Lafont, R.N., CMSRN Mary Ellen Lagnese, R.N., CPAN Dakota Lawtum, RN-BC Patricia Lee, R.N., CCM Young Joo Lee, R.N., CNOR Kathy Ann Lobmeyer, R.N., CNOR Patricia Lupski, R.N., NE-BC Kathleen Lynch, R.N., CMSRN Danielle Mahon, RN-BC Jacqueline Maloney, R.N., CEN Diane Mamounis-Simmons, R.N., NEA-BC/CNOR Marand Manieram-Arjune, R.N., ANP-C Rosauro Maray, R.N., CNOR Jamie Marcello, R.N., CCRN Erin Markey, R.N., ANP-C 2009 St. Francis Nursing Annual Report 22
Jerrold Marshall, R.N., CCRN Barbara Martino, RN-BC Pamela Mason, R.N., CEN Karen Maul, R.N., CNOR Tara Mautner, R.N., CMSRN Mary Anne McCoy, R.N., ANP-C Jaime McDermott, R.N., CCRN Kathleen McGarry, R.N., CNOR Katherine McGrath, R.N., CCRP Jeannette McLaughlin, R.N., CCRP Mary Ann McNamara, R.N., CPHQ Cheryl Meddles-Torres, R.N., FNP-C Linda Mendick, R.N., CMSRN Kirsten Minerva, R.N., CCRN Donna Mohr, RN-BC Maureen Mondics, R.N., CNOR Cristi Moravec-Kossegi, R.N., CEN Dalia Mordekai, R.N., FNP-C Judith Morrison, RN-BC Irene Moser, R.N., CNOR Elaine Munoz, R.N., CNOR Kathy Muratore, R.N., ANP-C Deborah Murawski, R.N., AMSN Sr. Katherine Murphy, RN-BC/CCRN/CHPN Maria Jose Nappo, R.N., ANP-C Brenda Nickens, R.N., CNOR Theresa Nicosia, R.N., FNP-C Maria Nuzzolese, R.N., CMSRN
Certified Nurses continued Margaret Ochotorena, R.N., NE-BC Hannah O'Connor, R.N., CMSRN Patricia O'Connor, R.N., CCRN Elma Ortiz, R.N., CCRN Ann O'Shea, R.N., CCRN Lauren Ostuni, R.N., CMSRN Jillian Oswald, R.N., ANP-C Suzanne Palo, RN-BC Patricia Pane, RN-BC Lorraine Panella, R.N., CCRN William Peabody, R.N., CCRN Laura Penfold, R.N., CAPA/CNOR Kathleen Peppard, R.N., CMSRN Barbara Petrosino, R.N., CCRN Casey Pettersen, R.N., CCRN Asha Phillips, R.N., CCRN Catherine Pirolo, R.N., NE-BC/CMSRN Irene Poulimas, R.N., NE-BC Meredith Pujdak, R.N., CCRN Donna Ramharrack, R.N., ANP-C Margaret Raylman, R.N., CCRN Bliss Rayo-Taranto, RN-BC Donna Rebelo, R.N., NE-BC Ruth Reed, R.N., CEN Kathleen Regan, R.N., CCRN Christine Rice, R.N., CMSRN Elizabeth Ring, R.N., ANP-C Linda Rivenburg, R.N., CNOR
Eileen Roddy, R.N., CMCN Diane Ross, R.N., CCRN Marguerite Roth, R.N., CCRP Sandra Roth, R.N., CCRN Allison Rudkin, R.N., CMSRN Jennifer Ryan, R.N., CMSRN Kelley Ryan, R.N., CEN Yasmi Sacristan-Kramer, R.N., CCRN Lyn Santiago, R.N., CCRC Michelle Sayson, R.N., CCRN Linda Scharp, R.N., CCRN Stacy Schnell, R.N., CMSRN Susan Seiberlich, R.N., CCRN Dana Shapiro, RN-BC Jeannemarie Shore, R.N., CNOR Barbara Simek, R.N., CNOR Dolores Smoot, R.N., CNOR Mary Lou Solliday, R.N., CIC Jacquelin Squicciarini, R.N., CCRN Elaine Stevens, R.N., NE-BC Katherine Stevko, R.N., CCRN/ANP-C Theresa Strain, R.N., CCRN Carol Streppel, R.N., CMSRN Cindy Sukhoo, R.N., CNOR Teresa Sullivan, R.N., CCRN Angela Tainter, R.N., CMSRN Carol Tambasco, R.N., OCN Remedios Teston, R.N., CCRN 2009 St. Francis Nursing Annual Report 23
Benzy Thomas, R.N., CCRN/ANP-C Maureen Torpey, R.N., CCRN/ANP-C Allison Trevellini, R.N., CWOCN Patricia Trimboli, R.N., CCRN Elizabeth Vaas, RN-BC Sloan Vahldieck, R.N., ANP-C Nancy Vannostrand, R.N., CMSRN Maria Vega, R.N., ANP-C Karen Venice, R.N., CCRN Doris Villagonzalo, R.N., CNOR Maria Vitsentzos, R.N., ANP-C Joan Wallace, R.N., CCRN Anne Walsh, R.N., CEN Bobby Jo Ward, R.N., CMSRN Linda Weiner, R.N., CCM/NE-BC Christine West, RN-BC Elizabeth White, R.N., CAPA Roman Yagudayev, R.N., CCRN Marina Yusupova, R.N., CMSRN Dawn Zioba, RN-BC
St. Francis Hospital The Heart Center ® 100 Port Washington Boulevard Roslyn, New York 11576 Tel: (516) 562-6000 www.stfrancisheartcenter.com
The 2009 Nursing Annual Report is published by St. Francis Hospital, The Heart Center®. Questions or comments can be directed to St. Francis Hospital, Patient Care Services, 100 Port Washington Blvd., Roslyn, NY 11576 or (516)562-6060. Copyright © 2010. All Rights Reserved. St. Francis Hospital is a member of the Catholic Health Services of Long Island, the healthcare ministry of the Diocese of Rockville Centre.