UMMC Nursing Annual Report by UMMS

OUR

EXTR ORDINARY NURSES

UMMC NURSING Annual Report FY16

Lisa Rowen, DNSc, RN, CENP, FAAN Senior Vice President and Chief Nursing Officer Nursing and Patient Care Services Chief Nurse Executive University of Maryland Medical System Associate Professor University of Maryland School of Nursing

Dear Colleagues, I am always so surprised when we are nonchalant about the amazing work accomplished every day by UMMC nurses. The cases and stories that people call out as extraordinary are frequently accepted by us as the ordinary. “Extraordinary” doesn’t just magically become manifest, it occurs after careful planning, exquisite implementation, vigilant monitoring, and constant improvement. “Extraordinary” is brought to life through the care, commitment, and efforts of individual nurses, teams of nurses, and interprofessional colleagues. Our aim is that every patient, every family member and every colleague will understand that each nurse feels privileged to care for patients, interweaves incredible care with superb practice, and has a passion for unwavering service. Again this year, we want to take the opportunity to celebrate the many talented, skilled, and committed nurses who work at the Medical Center. These nurses exemplify our values and help us to achieve our vision in a daily, consistent, and extraordinary way. Please join me in recognizing some of the extraordinary work and outcomes achieved over the past year highlighted in this Annual Report. As you read about the accomplishments, I hope you are inspired by the quality and quantity of the outcomes-both patient and staff centered -and it gives you pause to reflect on why we became members of this challenging, fulfilling, humbling, and inspiring profession. Sincerely,

Lisa Rowen, DNSc, RN, CENP, FAAN

U MMC NU R SI NG Annual Re p o r t | FY 2 01 6

OUR

EXTR ORDINARY NURSES

Table of Contents

Governance Structure

page 4

Innovations

page 9

Quality

page 11

Professional Development

page 14

Recognizing the Extraordinary

page 19

Community Outreach

page 26

U MMC NU R SI NG Annual Report | FY 2 01 6 |

self-governance structure Nursing and Patient Care Services (PCS)

Nursing & PCS Governance Council Structure FY1 Nursing Coordinating Council

UMNursing

Ongoing Education Subgroup

Advanced Practice Council Orientation Subgroup Graduate Nurse Advisory Committee

Clinical Education Council

Clinical Information Council

Med -Surg/Critical Care Value Analysis and Technology, Equipment, & New Products

Skin Care Committee Falls Subgroup

Clinical Practice Council

Pain Taskforce

Medication Management Committee

Medication Oversight Council

Nursing Research and Evidence-Based Practice Council Patient & Family Education Council

Perioperative Medication Process Improvement Committee

Patient Education On-Demand Subgroup

Performance Improvement Council Professional Advancement Review Team

Professional Advancement Council

Certification Committee Subgroup Charge Nurse Subgroup

Staff Nurse Council

Magnet Champion Subgroup

Pa g e 4

U MMC NU R SI NG Annual Report | FY 2 01 6 |

Pa g e 5

self-governance structure

Nursing & PCS Self-Governance Councils – Summary of Charge and FY16 Accomplishments

Nursing Coordinating Council NCC Chair: Greg Raymond, MS, MBA, RN CPPD Facilitator: Traci Morris Charge: The Nurse Coordinating Council (NCC) is charged with coordinating the work of the Nursing & PCS Governance councils based on the Nursing Strategic Plan and nursing and patient outcomes. The NCC provides a mechanism for enhancing inter-council communication and collaboration, while incorporating process measures and data into work plans. FY16 Accomplishments: • Coordinated Nursing & PCS Governance structure • Support & involvement in EPIC Portfolio implementation

Advanced Practice Council APC Co-Chair: Shari Simone, DNP, CPNP-AC Co-Chair: Julia Dunning, MSN, CRNP CPPD Facilitator: Precious Grant, BA Charge: The Advanced Practice Council (APC) is charged with providing strategic direction and innovative ideas for developing, implementing and evaluating Advanced Practice Nurse (APN) practice models, as well as for suggesting solutions to APN related clinical issues at UMMC. This Council assists senior leadership in setting the practice environment by providing an advisory role for operational issues that affect clinical practice, and a collaborative role with the University of Maryland School of Nursing. FY16 Accomplishments: • Restructured the Council to develop a shared governance council structure. The goal was to create different subgroups/committees to focus on key goals and drive practice changes. • All UMMC APPs were surveyed in 12/2015 in order to get their feedback, as well as encourage participation in the APC. The goal of the survey was to determine what key subgroups/committees were felt to be important to help influence and shape issues related to AP practice at UMMC, as well as encourage participation in these subgroups. • The results of the survey, as well as the description of the new subgroups and committees, were presented at the NP quarterly meetings, as well as APN Grand Rounds.

Clinical Education Council CEC Chair: Sandy Lovelace, BSN, RN, CCRN-CSC Chair-Elect: Lisa Malik, MS, RN, OCN Clinical Nurse Specialist: Karen McQuillan, MS, RN, CNS-BC, CCRN, CNRN, FAAN CPPD Facilitator: Maureen Archibald, MS, RN, RGN, RMN Charge: The Clinical Education Council (CEC) is charged with creating educational and professional developmental strategies to: • Define, implement, and maintain educational standards that promote professional growth and ongoing clinical competency • Address and develop programs and training strategies which are responsive to staff and manager training needs and clinical practice requirements • Explore innovative solutions to meet the educational needs of nursing students, new graduate and experienced nurses • Promote UMNursing partnership education and clinical practice priorities FY16 Accomplishments: • Included representation from the EPIC Portfolio team and incorporated EPIC Portfolio updates as a standing item • Preparations for preceptor conference to be held in FY17: Planning team identified, dates selected, agenda planned • Shared innovative education strategies: Presented at one local and one national conference on the education bundles

U MMC NU R SI NG Annual Report | FY 2 01 6 |

Pa g e 6

summary of charge and fy16 accomplishments

Clinical Information Council CIC Chair: Timothy Jones, BSN, RN, CCRN Chair Elect: Julia Prokic, BSN, RN Clinical Informatics Representative: Brian Burke, MS, RN-BC, CPN Facilitator: Sara Jacoby, BA Charge: The Clinical Information Council (CIC) is charged with improving the current process of electronic and manual documentation to support evidence-based best practice, professional standards, innovation, and regulatory requirements while enhancing the patient care delivery process and provider workflow. FY16 Accomplishments: • Implantation of meaningful use of initiatives and updates – Changes and updates presented to Council for further dissemination at unit level, as well as initial evaluation of presented information • Prepared for implantation of EPIC Portfolio at UMMC – Clinical readiness – selected topics presented to Council to increase adoption of these workflows at Go-Live – Super-user development – Go-Live adoption preparation • Downtime Preparation – Formalized strategy to minimize the impact of system downtimes – Post downtime reviews were undertaken to evaluate new strategies

Clinical Practice Council CPC Chair: Visitacion “Bing” Casal-Calingacion, BSN, RN Chair Elect: Mindy Ralls, BSN, BS, RN CPPD Facilitators: Tanya Ross, MSN, RN and Kimmith Jones, DNP, RN, CCNS, RN-BC Clinical Nurse Specialist Co-Chair: Christine Dawson, MS, RN CCNS, ACNP-BC Charge: The Clinical Practice Council (CPC) is charged with monitoring and continuously evaluating care delivery data and implementing strategies to maximize quality of care and patient safety. FY16 Accomplishments: • Developed standards of care and policy related to tracheostomy/mouth care • Reviewed evidence-based practices related to intravenous phlebitis and implemented standards of care related to outside intravenous access sites • Assisted with EPIC Portfolio implementation and reviewed practice concerns related to documentation standards leading to collaboration with the ICU/IMC documentation task force

Medication Oversight Council MOC Co-Chair: Mary Jo Simke, MS, BSN, RN Co-Chair: Barbara Brannan, PharmD CPPD Facilitator: Susan Carey, MS Charge: The Medication Oversight Council (MOC) is charged with understanding and coordinating work related to medication management and processes to ensure patient safety and overall quality of care. FY16 Accomplishments: • Engaged in support of Barcode Administration process and implementation

U MMC NU R SI NG Annual Report | FY 2 01 6 |

Pa g e 7

summary of charge and fy16 accomplishments

Nursing Research and Evidence-Based Practice Council

NRC

Co-Chair: Lisa Petty, BSN, RN, CCRN, HNB-BC Co-Chair: Danielle Evans, BA, BSN, RN, CCRN Charge: The Nursing Research Council (NRC) is charged with creating educational and developmental strategies to develop and sustain a partnership with the University of Maryland School of Nursing, enhance PCS direct-care staff research competency, and introduce evidence-based practices approaches to the development of clinical policies, procedures, and care strategies. FY16 Accomplishments: • Held a successful Clinical Practice Summit – Thirty-eight high-quality posters were presented. ˚ Nine Evidence-Based Practice posters ˚ Twenty-six Performance Improvement posters ˚ Three Research posters – Initiated four poster awards ˚ People’s Choice poster ˚ Best Process Improvement poster ˚ Best Evidence-Based Practice poster ˚ Best Research poster • Revised the Council charter – Charter included the inclusion of the Director of Translation to Nursing Practice – Clarified other roles and responsibilities • Renamed the Council to the Nursing Research and Evidence-Based Practice Council

Patient and Family Education Council PFEdC Chair: Jean Ludwig, MS, RN, CCRN Chair-Elect: Crystal Jefferson, BSN, RN CPPD Facilitator: Gena Stanek, MS, RN, CNS-BC Charge: The Patient and Family Education Council (PFEdC) is charged with creating, developing and identifying patient educational materials, resources and strategies that are population-specific, culturally sensitive, and address “universal health literacy” needs for our patients and families with the goal of improving patient outcomes (health and satisfaction), while meeting or exceeding regulatory requirements. • Support patient care areas to provide individualized, population, disease specific education using a variety of teaching materials & resources • Ensure staff-friendly electronic documentation resources • Promote staff satisfaction regarding educational resources available • Ensure quality, culturally sensitive, population-specific, educational materials to provide a “universal precautions for health literacy” approach to patients and families education • Ensure compliance with patient and family education, regulatory and documentation standards • Track and trend data and develop implementation strategies to improve patient satisfaction with education • Identify, promote, and refine educational materials and technologies available to internal customers • Fully develop and improve the use of the innovative, On-Demand video education system while targeting its use to improve regulatory and patient outcomes FY16 Accomplishments: • 38 Total videos added • Assisted with system health literacy video • Updated orientation blue print – literacy focus • Goal met: Increased total video use: Your Care/Speak-up and our overall monthly video usage to > 1000.

117%, Fall

233%, Pain

27%, and

55% Relaxation Guided Imagery videos > 25%

U MMC NU R SI NG Annual Report | FY 2 01 6 |

Pa g e 8

summary of charge and fy16 accomplishments

Performance Advancement Council (Elevated to Council status in late FY16)

Professional Advancement Council PAC Chair: Julie Busseau, BSN, RN Chair Elect: Mark Wieber, BSN, CNOR CPPD Facilitator: Erin Barnaba, MS, RN, OCN, CNL Charge: The Professional Advancement Council (PAC) is charged with advancing and supporting ongoing professional growth opportunities for the registered nurse with emphasis on development, mentorship, certification, stewardship and organizational involvement of our professional nursing staff. The charge is accomplished by. • • • • • • •

Enhancing of professional growth and development Providing recognition for professional contributions Encouraging involvement of direct care nurses in decisions that support and enhance patient care outcomes Providing motivation for direct care nurses to pursue higher education, certification, and other professional achievements Recruiting and retaining the highest caliber of nurses at UMMC Providing an environment that suports professional nursing practice Empowering “the nurse to make decisions and build professional accountability, and allow nurses to practice in an environment in which innovation, creativity, and scholarly productivity are encouraged, recognized, and rewarded.” (UMMC Professional Pracctice Model)

Staff Nurse Council SNC Co-Chair: Christine Byerly, BSN, RNC-NIC Co-Chair: Lisa Rowen, DNSc, RN, CENP, FAAN CPPD Facilitator: Kimmith Jones, DNP, RN, CCNS, RN-BC Charge: The Staff Nurse Council (SNC) is charged with identifying and implementing strategies to improve patient safety and overall quality of care in collaboration with the Senior Vice President and Chief Nursing Officer. Additional topics addressed pertain to professional nursing practice and the relationship with nursing support services.

U MMC NU R SI NG Annual Report | FY 2 01 6 |

Pa g e 9

innovation Routine HIV Testing and Linkage to Care at UMMC

Epic /Portfolio News & Views, Winter 2015

n Saturday, November 7, 2015, the UMMS Portfolio electronic health record (EHR) went “live” at UMMC, UMMC Midtown, UM Rehabilitation & Orthopaedic Institute, and in several outpatient settings. A number of outpatient areas and several UMMS hospitals had already implemented all or parts of the Portfolio system. The Portfolio EHR is a tool designed to increase patient safety, improve the patient experience and enhance communication among providers. Use of Portfolio will also improve the translation of evidence-based care to the bedside and the coordination of care between both the inpatient and outpatient settings, throughout UMMC and across the UMMS system. Every staff member working in these sites was impacted. Nursing and the Patient Care Services (PCS) teams at UMMC were instrumental in the successful launch of our new EPIC/Portfolio EMR.

Critical Care Resuscitation Unit News & Views, Winter 2015

he innovative Critical Care Resuscitation Unit (CCRU), possibly the first unit of its kind anywhere, continues the pioneering spirit of the R Adams Cowley Shock Trauma Center (STC), and applies the concept of the “golden hour” to other time-sensitive critical illness. The CCRU opened on July 18, 2013, and is based on STC’s highly effective model that is now the world standard for trauma care: the concept that patients need to be seen in a specialized center within one “golden hour” of a critical injury or illness. The CCRU’s mission is to support a regionalized approach to critical care for patients with time-sensitive critical medical or surgical illness who require transfer, allowing them immediate access to the University of Maryland Medical Center (UMMC).

Early Mobility Program News & Views, Winter 2015

ollowing full implementation of the Early Mobility Program paired with the safety briefs, the Neuro IMC and Neuro Acute Care units went 75 and 29 days respectively without a fall. During the Comprehensive Stroke Center Certification visit, representatives from The Joint Commission referred to the program as “best practice” and encouraged moving the project forward to publication. The Early Mobility Program has since been implemented in the Cardiac Care Unit with good results and is set to systematically roll out house-wide throughout 2015.

News & Views, Winter 2016

n response to the National HIV/AIDS strategy and the high prevalence of HIV in Baltimore, a Routine HIV Testing and Linkage to Care program (RTP) was developed in 2013 as a partnership between University of Maryland Medical Center (UMMC) and The JACQUES Initiative at the Institute of Human Virology of the School of Medicine (JI). Identifying HIV infection early and linking a patient to treatment reduces disease morbidity and mortality, as well as disease transmission. The RTP was piloted and eventually expanded more broadly at UMMC, resulting in significantly increased numbers of inpatients being tested for HIV and linked/ relinked to outpatient HIV care. Organizational participation was realized when UMMC was building and implementing the new electronic health record (EHR). A Best Practice Advisory (BPA) was built into nursing workflow documentation to screen patients for HIV test eligibility and prompt testing. The BPA uses logic and EHR data to determine if a patient meets eligibility criteria for testing. A systematic, electronic workflow for routine HIV testing and linkage to care has increased the number of screening tests and identified more linkage to care opportunities in the community. By implementing an EHR-driven workflow, UMMC was able to implement the RTP house-wide in all acute and intermediate care units. As a result of this innovation, the RTP is reaching more patients in need of testing and/or linkage to care services. Utilizing and studying the EHR’s ability to drive inter-professional processes, such as the RTP, has implications for other hospital-based initiatives within the public health arena and beyond.

HIV Tests Pre and Post EHR Changes

U MMC NU R SI NG Annual Report | FY 2 01 6 |

Pa g e 1 0

innovation

Toward a High Reliability Organization

Resilience in Stressful Events (RISE) News & Views, Winter 2015

n emotional response to adverse clinical events is referred to as a “second victim” phenomenon in the literature. When unanticipated medical errors result in harm to a patient, the event also shakes health care professionals to their core. Sometimes their lives, like the lives of their patients, are forever changed. An emotional response to adverse clinical events is referred to as a “second victim” phenomenon in the literature.

RISE

Expected Signs and Symptoms of Distress • • • • • • • •

Shock Depression and/or anxiety Guilt Self-doubt, feelings of inadequacy Poor concentration Social avoidance Intrusive thoughts Re-experiencing the event

RISE

News & Views, Spring 2016

ur journey towards becoming a High Reliability Organization (HRO) continues. To become an HRO, all who work in the organization are engaged and empowered. To this end, we have created and implemented a “Patient Safety Net” – groups of professionals who are passionate about ensuring the care we provide is both quality-driven and safe. These individuals are from interdisciplinary backgrounds, with a passion surrounding safe care and for their demonstrated independent initiatives on their respective units/areas of specialty. The Patient Safety Net includes five distinct groups which function both independently and collaboratively on larger system safety and quality issues. These groups include the Council for Hospital and Ambulatory Patient Safety, Patient Safety Risk Mitigation Group, Quality Improvement and Patient Safety (a resident-led group), and the Unit-Based Safety Clinicians (UBSCs) – all closely working with the Department of Quality.

RISE Team Qualifications

• Identified resource to peers • Team-oriented practice • Three years of experience in health care preferred • No history of disciplinary action • Attendance record in good standing • Application submission • Recommendation from current supervisor • Two recommendations from peers/co-workers

AvaSys TeleSitter Solution for UMMC and Beyond

RISE

Psychological First Aid Components in RISE Voluntary Pressure-free opportunity to talk Active listening and “presence” Compassion and caring Acknowledgment of concerns Explanation of normal reactions and responses to extreme stress • Coping strategy discussion • Connection and re-connection with social supports • Follow-up, linkage, referral information • • • • • •

The RISE Program was developed by our colleagues at Johns Hopkins to provide timely peer support to any staff member who encounters a stressful, clinically related event, in order to facilitate staff resilience and recovery. The objectives of RISE are to: • Increase awareness of the second victim phenomenon; • Provide interdisciplinary peer support in a non-judgmental environment; • Equip managers and employees with healthy coping strategies to promote well-being; and, • Reassure and guide employees to continue thriving in their professional roles. We believe this is an ethical imperative and demonstrates our support of each other in many ways, with the implementation of RISE being our next venture.

mplemented this calendar year at UMMC, the AvaSys TeleSitter Solution is a method of providing remote monitoring to a group of patients (located in a predetermined area) by a safety observation technician. When a patient meets the criteria for remote observation, an iterative process starts between the nurse and the safety observation technician to continually assure appropriateness of the remote observation solution. A mobile cart is placed in the patient’s room and an audiovisual connection is formed via our wireless system. The safety observation technicians are trained to anticipate patient behaviors, verbally redirect patients, and alert clinical staff of potentially high risk behaviors. A stat alarm is used if staff presence is immediately required in the room to avoid or mitigate patient harm. Unit staff are educated prior to the implementation of this program in their areas. The patients and families are also educated about the remote observation program. In-room privacy can be requested by the nurse for beside procedures and bathing. There is a safety observation technician (‘runner’) who rounds on the patients on an hourly basis, checking in on them and viewing the physical surroundings. The TeleSitter solution was implemented to expand in-house, continuous observation of patients, decrease falls and increase patient safety. The program is slowly being disseminated throughout UMMC, while the planning work has started for implementation of the AvaSys TeleSitter Solution to other UMMS hospitals.

U MMC NU R SI NG Annual Report | FY 2 01 6 |

Pa g e 1 1

quality Patient Experience

Communication with Nurses

100 90 80 70

Percentile Rank

60 50 40 30 20 10

Nurses Listen Carefully

4 FY

3 16

Nurses Listen Carefully

Q 16

FY/Quarter

ommunication with Nurses is the “Rising Tide” ™ measure for patient satisfaction. No other domain has greater influence on overall patient experience. UMMC has elevated Communication with Nurses as our top strategic priority. FY16 scores in 3 of 4 quarters reflect achievement in the top decile among hospitals in our Maryland peer group. UMMC nurses provide world-class clinical care and remain focused on our patient’s physical comfort, educational, emotional, and spiritual needs. UMMC continues to partner with patients to exceed expectations every patient, every time.

PercentileRank RankininMaryland Maryland Database Participants (Press Ganey) Percentile Database Participants (Press Ganey)

UMMC top topbox boxscore score

100 90 80 60 50

Percentile Rank

40 30 20 10

4 FY

3 FY

2 Q 16 FY

FY/Quarter

Nurses Treat with Respect

FY/Quarter Percentile Rank in in Maryland Maryland DatabaseParticipants Participants(Press (PressGaney) Ganey) Percentile Rank Database

UMMC box score score UMMC top top box

Nurses Treat with Respect

100 90 80 70

Percentile Rank

60 50 40 30 20 10

Nurses Explain So You Understand

UMMC UMMC top Top box Box score Score

100 90 80

Percentile Rank

70 60 50 40 30 20 10

UMMC box score score UMMC top top box

Percentile Rank in (Press Ganey) Percentile in Maryland MarylandDatabase DatabaseParticipants Participants (Press Ganey)

Q 3 FY

Q 2 16 FY

16 FY

FY/Quarter

Q 1

Q 16 FY

2 Q 16 FY

FY/Quarter

Percentile Rank Rank in in Maryland MarylandDatabase DatabaseParticipants Participants (Press Ganey) (Press Ganey)

U MMC NU R SI NG Annual Report | FY 2 01 6 |

Pa g e 1 2

quality

Baby Friendly designation journey

ecognizing the benefits of breastfeeding as the best nutritional source for healthy infants, leadership in Women’s and Children’s Services conducted a thorough assessment of our clinical practices to evaluate our effectiveness in supporting the initiation and continuation of breastfeeding. With core measure rates well below the Joint Commission benchmark and the challenges of serving a patient demographic with the lowest breastfeeding rates in the country, UMMC applied for and was awarded a grant through the Centers for Disease Control (CDC) to embark on the two-year Baby Friendly designation journey. UMMC entered the first of four phases of the Baby Friendly designation process in July of this year and hosted a site visit that began a thorough assessment of our compliance with best

practices for breastfeeding. Over the last year, an interdisciplinary team of staff from the maternal-child inpatient and ambulatory care units have focused efforts on evaluating our current practice, policies and procedures and began to align such with the WHO (World Health Organization) and UNICEF’s (United Nations Children’s Fund) “10 Steps to Successful Breastfeeding” (WHO, 1991). The work of this past year completed the second of the four Baby Friendly phases. With the acceptance of UMMC’s plan for staff education, competency validation, data collection and monitoring, the Medical Center has successfully been approved to move to phase three of the Baby Friendly Journey. Our target for final designation status will be late summer, 2017.

Barcode Medication Administration

arcode Medication Administration (BCMA) was implemented house-wide in November 2015 with the conversion to Portfolio. Staff readily adopted this patient safety technology as evidenced by patient and medication scanning compliance consistently exceeding 95%.

BCMA Compliance

U MMC NU R SI NG Annual Report | FY 2 01 6 |

quality

Catheter-Associated Urinary Tract Infection (CAUTI)

AUTI remains a high priority for the Medical Center. Significant strides have been made to reduce the CAUTI rate within the organization. Kimmith Jones, DNP, RN, RNBC and Karen McQuillan, MS, RN, CNS-BC, CCRN, CNRN, FAAN, in collaboration with Mala Filippell, BSN, RN, CIC (Infection Prevention), have co-chaired a nursing task force to assist ICU and IMC bedside staff in implementing CAUTI best practices. Staff share successes that can be translated into other clinical areas and areas of opportunity.

UMMC Aggregate CAUTI Rate FY16

Central Line-Associated Blood Stream Infection (CLABSI)

LABSI has been a major focus for the medical center. Kimmith Jones, DNP, RN, RN-BC and Karen McQuillan, MS, RN, CNS-BC, CCRN, CNRN, FAAN, in collaboration with Mala Filippell, BSN, RN, CIC (Infection Prevention), have co-chaired a nursing task force focusing on this issue. Staff nurses from all the ICUs and IMCs meet monthly to discuss the data and strategize innovative ways to implement CLABSI best practices. Members share their facilitators and barriers to accomplishing positive outcomes for patients.

UMMC Aggregate CLABSI Rate FY16

Pa g e 1 3

U MMC NU R SI NG Annual Report | FY 2 01 6 |

professional development Promotions to Senior Clinical Nurse I Jennifer Arrington, MS, RN, CPN, CNL Pediatric Intensive Care Unit

Abigail Gatch, BSN, RN, CCRN Medical Intensive Care Unit

Brian Le, MS, RN, CCRN Medical Intensive Care Unit

Kristin Bailey, BSN, RN NeuroCare Acute Care

Michelle George, BSN, BS, RN, FCCS, CCRN Medical Intensive Care Unit

Daniel Mesfin, BSN, RN, CMSRN Orthopaedics

Monique Barrow, BSN, RN General Operating Room

Theresa Gerrity, MS, RN, CNL Medical Telemetry Unit, 13 East/West

Hara Oyedeji, MSEd, MSN, RN Psychiatric Emergency Services

Christina Boord, BSN, RN, OCN Hematology/Oncology

Annie Grace, BSN, RN, CPN Otorhinolaryngology Outpatient Clinic/PICU

Sandy Penn, MS, RN Adult Emergency Department

Sara Broumel, BSN, RN NeuroTrauma Intermediate Care Unit

Christina Grow, BSN, RNC-NIC Neonatal Intensive Care Unit

Julia Prokic, BSN, RN Medical Telemetry Unit, 13 East/West

Patrick Brown, MS, MA, RN Psychiatric Emergency Services

Heidi Halterman, BSN, RN Trauma Resuscitation Unit

Sylvia Rose, BSN, RN, CEN Adult Emergency Department

Christine Cascio, BSN, RN, OCN Hematology/Oncology

Shannon Hansen, BSN, RN Cardiac Cath Lab

Megan Smith, BSN, RN, OCN Hematology/Oncology

Cheryl-Ann Daley, MS, RN, CMSRN, CNL Vascular Surgery Progressive Care Unit

Ashley Hernandez, BSN, RN Psychiatric Emergency Services

Lindsey Stanton, BSN, RN Orthopaedics

Jeanne Delaney, BSN, RN, CNOR General Operating Room

Clare Howard, BSN, CNOR Perioperative Services

Jamie Stowe, BSN, RN, CMSRN Medical Telemetry Unit, 13 East/West

Brooke Donlon, BSN, RN, CNOR Perioperative Services

Susan Huppmann, BSN, RN Cardiac Cath Lab

Valerie Streeb, BSN, PCCN Cardiac Progressive Care Unit

Lynmarie Dudley, BSN, RN, BS, PCCN Multi Trauma Intermediate Care 6

Laura Joseph, MSN, MBA-HCM, RN, CCRN-CSC, CPPS Lung Rescue Unit

Cara Sullivan, BSN, RNC-MNN Inpatient Perinatal/Gyn

Amanda Fabian, BSN, RN, CCRN Multi Trauma Critical Care 5 Stacy Foertsch, BSN, RN Cardiac Surgery Intensive Care Unit

April Joynes, BSN, RN, CNOR Trauma Operating Room Cathy Karska, BSN, RN, BMTCN Blood and Marrow Transplant

Shoshana Yudkowsky, BSN, RN, CCTN Transplant Intermediate Care Unit Hannah Young, BSN, RN, PCCN Multi Trauma Intermediate Care 5

Promotions to Senior Clinical Nurse II Richard Bell, BSN, RN, CCRN-CSC University of Maryland eCare

Danielle Evans, BSN, BA, RN, CCRN Medical Intensive Care Unit

Rachel Maranzano, BSN, RN, CCRN Surgical Intensive Care Unit

Samantha Dayberry, BSN, RN, PCCN Multi Trauma Intermediate Care 6

Jessica Farace, BSN, RN, PCCN Multi Trauma Intermediate Care 6

Kristen Rouse, BSN, RN Perioperative Services

Mylene De Vera, BSN, RN, OCN, BMTCN Blood and Marrow Transplant

Deborah Guzik, BSN, RNC-OB Labor and Delivery

Hannah Entwistle, BSN, RN, CCRN, FCCS Medical Intensive Care Unit

Cheryl Mack, MPA, BSN, RN Adult Emergency Department

Pa g e 1 4

U MMC NU R SI NG Annual Report | FY 2 01 6 |

Pa g e 1 5

professional development

New Graduate Nurse Residency Program

Benefits of our program include, but are not limited to: • Participating in orientation that provides education, mentorship, and peer support; • Engaging with a mentor to help identify and achieve short- and long-term goals on one’s journey to becoming a confident, professional nurse; • Developing effective clinical judgment and critical thinking skills; • Becoming empowered to improve and lead through evidencebased practice and research; and • Encouragement to embrace a healthy work environment that promotes teamwork and socialiation.

e are very familiar with the needs and difficulties faced by new graduate nurses as they undergo role transition in their first year of practice. As a result, UMMC has incorporated a 12-month Nurse Residency Program (NRP) designed to build upon knowledge and skills obtained in previous undergraduate learning and during one’s unit-based individualized orientation. Core curriculum topics include: • Critical thinking • Patient safety – minimizing risk • Leadership • Communication • Evidence-based practice • Professional development

New Graduate Nurse Residents by School FY16

N = 336 4%

3% 2%

University of University of Maryland Maryland

2%2%

Other * Other* 33%

Towson University University CC of Baltimore County Community College of Baltimore County

Johns Hopkins University University

Stevenson University University of Delaware Delaware University of

Howard CC Community College 6%

Salisbury University University 7%

Anne Arundel Arundel CC Community College 21%

Coppin State James Madison University York College of of PA Pennsylvania Harford Community College Harford CC

* Represents schools of nursing with only one representative.

U MMC NU R SI NG Annual Report | FY 2 01 6 |

Pa g e 1 6

professional development

Clinical Scholar Program

ur Clinical Scholar Program is an innovative scholarship opportunity designed to recruit outstanding nursing students entering their last semester of study, affording them the opportunity to complete their clinical practicum in their future place of employment. Objectives of the program: • Provide on-the-job training that will optimize the time for orientation needs while enhancing the educational experience. • Ease the new graduates’ transition from student to independent practicing nurse. • Decrease Medical Center recruitment efforts for new graduate nurses. • Improve new graduate retention at six months and one year post-hire. Students are awarded $5,000 in educational assistance for their last semester of school and have a two year commitment to UMMC as a new graduate nurse. For Spring 2016, 51 students were selected and placed as new graduate nurses on 22 different in-patient units at UMMC, including eight critical care areas.

Visibly Unified

he University of Maryland Medical Center is aligned as a single care team committed to patient-centered care. The standardization of scrubs was established with three areas of focus: minimize infection risk to our patients, maximize safety for our patients and staff, and raise the level of professional appearance. Our appearance is a reflection of UMMC and a well-dressed health care professional indicates that we know that the hospital and the people here are important. Inspired by the alignment of our Shock Trauma colleagues in pink, we created a visibly unified care team by reaching across departmental lines and implementing a scrub standardization policy for all others in non-sterile environments. We are all elevated by the navy scrubs with our UMMC logo displayed. Moreover, the addition of role-specific badge backers clearly identifies each member of the team for our patients and families.

The new standardized scrub policy creates a visibly unified care team.

Student Nurse Residency Program

or nursing students ready to enhance their clinical competence and prepare for the challenging role ahead, UMMC’s Student Nurse Residency Program offers the in-depth training that can put their career on the fast track. This paid ten-week summer program typically runs from the first week of June through the first week of August. Students work one-on-one with a nurse preceptor, attend education classes, present a poster project at the end of the program, and keep bi-weekly journals. To be considered, all students must be a BSN or CNL candidate with a GPA of 3.0 or higher and graduating in December of the application year or the following May. All applicants are Maryland state residents. Program Objectives: 1. Utilize critical thinking skills and apply knowledge in clinical and simulation-based scenarios. 2. Demonstrate effective and professional styles of communication as evidenced by preceptor and mentor feedback. 3. Formulate and demonstrate realistic expectations of self and medical staff as evidenced by student journals and verbal mentor feedback. 4. Demonstrate professional and leadership qualities by participating in a poster presentation at the end of the residency. 5. Increase recruitment and retention of new graduates. Summer 2015 – 45 student nurse residents; 82% hired as new graduate nurses in 2016 Summer 2016 – 53 student nurse residents representing 15 different BSN programs, with 28 from University of Maryland, School of Nursing

U MMC NU R SI NG Annual Report | FY 2 01 6 |

Pa g e 1 7

professional development

Publications and Presentations Notifications of Acceptance July 1, 2015 through June 30, 2016

Publications Connolly, M. E. & Buckley, K. M. (2016). A Quality improvement project to increase breast milk expression. Journal of Pediatric Surgical Nursing, 4, (4), 128-134. Corbitt, N. (2016, June 6). Transparency Makes a Difference When Creating a Culture of Safety [web log post]. http://connect.ons.org/ons-connectblog/transparency-makes-a-difference-when-creating-a-culture-of-safety. Glenn, D. (2015). Promoting the Safety and Dignity of Patients who have DNR orders. Clinical Journal of Oncology Nursing, 1;19(6):667-9. Kapu, A. N., McComiskey, C.A., Buckler, L. Derkazarian, J., Goda, T., Lofgren, M.A., McIlvennan, C. K., & Wells, N. (2016). Advanced practice provider patient ratios and workload: Results of multi-institutional survey. Journal of Nursing Administration, accepted for publication, March, 2016. Lardieri, A., Fusco, N.M., Simone, S., Walker, L.K., Morgan, J.A., Parbuoni, K.A. (2015). Effects of Clonidine on Withdrawal from Long-Term Dexmedetomidine in the Pediatric Patient. The Journal of Pediatric Pharmacology and Therapeutics, 20(1), 45-53. McComiskey, C. (2015). Preparation for Practice: Interprofessional Practice: Certification, Licensure, Credentialing Documentation, Billing, and Coding; “Documentation, Billing and Coding”. In Kline-Tilford, A., & Haut, C. (Eds.). Wolters Kluwer Health. McComiskey, C. (2015). Pediatric Nursing: Scope and Standards of Practice, (2nd Ed.) Published by the American Nurses Association, National Association of Pediatric Nurse Practitioners and the Society of Pediatric Nursing. Mignano, J., Miner, L., Cafeo, T., Spencer, D., Gulati, M., Brown, T, Borkoski, R., Gibson-Magri, K., Canzoniero, J., Gottleib, J., Rowen, L. (May/June, 2016). The Routinization of HIV Testing in an Inpatient Setting: A Systematic Process for Organizational Change. Journal for Healthcare Quality, 38(3), 10-18. Moss, M. & Simone, S. (2015). Physical Design and Personnel Organization of the PICU. In Rodgers Textbook of Pediatric Intensive Care, 5th Edition. Philadelphia: Wolters Kluwer & Lippincott, Williams & Wilkins. Russo-McCourt, T., Bauman, M. (2016). Caring for patients with spinal cord injuries. American Nurse Today, 11(5), 18-23. Schofield, D. & McComiskey, C. (2015). Post-graduate nurse practitioner critical care fellowship: Design and implementation, and outcomes at a tertiary medical center. Journal of Nurse Practitioners, 11, (3), e19-e26. Simone, S. Metabolic Disease. In Tilford A. & Haut C. Lippincott Certification Review: Acute Care Pediatric Nurse Practitioner. Textbook. Philadelphia, MA: Wolters-Kluwer/Lippincott. 2015. Simone, S. & Sorce L. Pain and Sedation. In Tilford A. & Haut C. Lippincott Certification Review: Acute Care Pediatric Nurse Practitioner Textbook. Philadelphia, MA: Wolters-Kluwer/Lippincott. 2015. Sorce, L & Simone S. (2015). Pain and Sedation Management in Mechanically Ventilated Children. Journal of Pediatric Intensive Care, 4(2).

Presentations Arrington, J., Masters, J., Spillman, K., Szekley, D. (2015). Think Outside the Heart: Pediatric Cardiac Surgery Post-Operative Complications. Poster Presentation at the 2015 Northeast Pediatric Cardiology Nurses Association Annual Conference, Washington, DC. Ball, C., Cysyk, B., Woltz, P. (2016). Improving DTN Time in Maryland: Results from the Stroke Rapid-Treatment Readiness Survey. Oral Presentation at the Maryland Institute for Emergency Medical Services System bi-monthly meeting, May 13, 2016, Baltimore, MD. Bell, R., Espeso, L., Foertsch, S. (2015). Nurses leading the change to educate the staff about CALS and no I didn’t misspell ACLS! Poster Presentation at the 2015 Maryland Nurses Association Conference, Linthicum Heights, MD. Corbitt, N., Latsko, J., Navada, S., Weinstein, B. (2016). Latest Developments in Treating MDS – An Update on Molecular Testing, Low-Risk and High-Risk MDS Therapies, and Disease Management. Oral Presentation at the 2016 Oncology Nursing Society 41st Annual Congress, San Antonio, TX. Corbitt, N. (2015). Chapter Communications. Oral Presentation at the Oncology Nursing Society Leadership Weekend, Pittsburg, P.A. Corbitt, N. (2016). Infusion Reactions. Oral Presentation at the 2016 Oncology Nursing Society 41st Annual Congress. San Antonio, Texas. DeVera, M., Malick, L., Ruehle, K., Miller, K., Rutter, M., Nickel, J. (2016) Stem Cell Infusion Education: A Creative Approach. Poster Presentation at the 2016 BMT Tandem Meetings. Honolulu, HI. DiNardo, T. & Doyle, K. Pre-Conference (six-hour session). “I Didn’t Sign Up For This: Workplace Violence.” May 15, 2016. NTI. American Association of Critical Care Nurses. DiNardo, T. & Doyle, K. Three-hour Podium Presentation. “Workplace Violence: Do You Have a Plan.” (May 16, 2016). NTI, American Association of Critical Care Nurses. Dougherty, R. and Cascio, C. (2015). Battling Cancer Related Fatigue: Designs and Implementation of the Cancer Warrior Exercise Program. Poster Presentation at the 2016 Oncology Nursing Society 41st Annual Congress. San Antonio, TX. Graves, J., Choiniere, D. (2016) Do no harm: Making the case for a nurse led sustainability program. Oral Presentation at the 2016 ANCC National Magnet Conference, Orlando, FL. Hoffman, S. B., Terrell, N., Driscoll, C. H., & Davis, N. L. (2016). Impact of High-Flow Nasal Cannula Use on Neonatal Respiratory Support Patterns and Length of Stay. Respiratory Care. Huffer, D. and Gorman.K.(2015). Optimizing Preceptor Resources: Retool for a brighter future. Oral Presentation at the 2015 Maryland Educators Collaborative, Maryland. continued on next page.

U MMC NU R SI NG Annual Report | FY 2 01 6 |

Pa g e 1 8

professional development

Presentations, Kaiser, K., McGuire, D., Shanholtz, C., Haisfield-Wolfe, M., Deeley, M. (2015). Implementing an Evidence-based Tool for Assessing Pain in Non-communicative Palliative Care Patients: Challenges and Solutions. Poster Presentation at the 2015 American Academy of Hospice and Palliative Medicine and Palliative Nursing Association Annual Assembly, Chicago, IL. Kapu, A. N., McComiskey, C.A., Raaum, J.W., & Selig, P.M. (2015). Advanced Practice Patient Ratios and Workload: Results of Multi-Institutional Survey. Oral Presentation at the 2016 ANCC Magnet Conference, Orlando, FL. McComiskey, C.A. (2016). The Role of the Pediatric Nurse Practitioner: A 50 year history. What is our future? Keynote Address, National Association of Pediatric Nurse Practitioners (NAPNAP) Maryland Chesapeake Chapter, Baltimore, MD. McComiskey, C.A. (2016). Academic-Practice Partnerships for Preparing the NP of the Future. Panel Discussion, National Organization of Nurse Practitioner Faculties Special Topics Conference, Crystal City, VA. McComiskey, C.A. (2015). Leading Leaders: Keys to Creating an Advanced Practice Structure. Panel Discussion, Children’s Hospital Association Executive Leadership Webinar. McComiskey, C.A. (2015). Research, Evidence-Based Practice or Quality Improvement – That is the Question. Keynote Address, Nursing Research Conference Shore Health Medical Center, Cambridge, MD. Minas, N. and Ruehle, K. (2015). The Process of Choosing the best match for BMT Informatics Software. Oral Presentation at the 2016 CRPDM Conference BMT Tandem Meeting, Honolulu, HI. Miner, L., Mignano, J., Cafeo, C., Lemkin, D., Gulati, M., Rowen, L. (July 2022, 2016) Utilizing the HER to overcome barriers of a Routine HIV Testing and Linkage to Care Program. Poster Presentation, 2016 Summer Institute in Nursing Informatics, Baltimore, MD Miner, L., Mignano, J., Cafeo, C., Brown, T., Gulati, M., Lathan, V., Borkoski, R., Rowen, L. (October 22-23, 2015). Increasing access to HIV Care through Institutional Policy in the Acute Care Setting. Poster Presentation, 2015 Maryland Nurses Association 113th Annual Convention, Linthicum Heights, MD Miner, L., Mignano, J., Cafeo, C., Brown, T., Gulati, M., Lathan, V., Chance, G., Rowen, L. (October 22-23, 2015) Transitions in Care for Persons Living with HIV Accessing the Acute Care Setting. Poster Presentation, 2015 Maryland Nurses Association 113th Annual Convention, Linthicum Heights, MD

continued

Rowen, L. (2016). Nursing: The Art of the Science. 2016 June Staff Nurse Council. University of Maryland Medical Center. Baltimore, MD. Rowen, L. (2016) Nursing: The Art of the Science. 2016 Nursing Grand Rounds, University of Maryland Medical Center. Baltimore, MD. Rowen, L. (2016). Nursing: The Art of the Science. 2016 Nursing Grand Rounds, University of Maryland Medical Center Midtown Campus. Baltimore, MD. Rowen, L. (2016). Strengthening Leadership Skills. 2016 Leadership Retreat, for Rehabilation Therapy, Respiratory Therapy and Dietitian Leaders, University of Maryland Medical Center. Baltimore, MD. Simone, S.L. (2016). Dazed and Confused: Assessment and Management of Delirium in the Pediatric Intensive Care Unit. National Teaching Institute. New Orleans, LA. Simone, S.L. (2016). Medical and Surgical Management of Pediatric Pneumonia. National Association of Pediatric Nurse Practitioner Conference. Atlanta, GA. Simone, S.L. (2016). Case Studies in Acute and Chronic Ventilation. National Association of Pediatric Nurse Practitioner Conference. Atlanta, GA. Simone, S.L. (2016). Unmasking and Managing Pediatric Vasculitis: Case Study Analysis. National Association of Pediatric Nurse Practitioner Conference. Atlanta, GA. March 2016. Simone, S.L. (2016). “Interprofessional Collaboration for Delirium Management in a Pediatric Intensive Care Unit.” Oral Research Snapshot presentation at SSCM Critical Care Congress, Orlando, FL. Simone, S.L. (2016). “Aint Got No Rhythm: Pediatric Case Studies of Sudden Cardiac Arrest.” AACN National Teaching Institute. San Diego, CA. May 2015. Simone, S.L. (2015). Sudden Cardiac Arrest in Children and Adolescents. Baltimore NAPNAP Chapter Symposium. Baltimore, MD. Simone, S.L. (2015). Synaptic Overload: Refractory Status Epilepticus. National Association of Pediatric Nurse Practitioner Conference. Las Vegas, NV Tumulty, J., Woltz, P., Rowen, L. (2016). Alarm identification and response simulation (AIRS). Podium Presentation at the 2016 ANCC National Magnet Conference, Orlando, FL.

Nair, P., McComiskey, C., Zeller, J. (2016). Transitional Surgery Center: An innovative multidisciplinary approach in reducing 30-day hospital readmissions. Oral Presentation at the 2016 ANCC National Magnet Conference, Orlando, FL.

Woltz, P., Ellis, C., Nahm, E., Everhart, L., Stanek, G., Anderson, S., Sagherian, K. (2015). Application of the Rapid Cycle Research Framework in an Integrated Health IT System Implementation. Poster Presentation at the 2016 Society of Behavioral Medicine Annual Meeting, Washington DC.

Noll, C. and Doyle, K. (2015). Behavioral Emergency Response Team: Implementing a Performance Improvement Strategy to Address Workplace Violence. Poster Presentation at the 2015 ANCC Magnet Conference, Atlanta, GA.

Yu, T., Mignano, J., Brown, T., Garcia, M., Lathan, V., Chance, G., Seidl, K., Cafeo, C., Miner, L., Gulati, M. (March 6-9 2016). Implementation of a Routine Inpatient Hepatitis C Virus (HCV) Screening and Outpatient Linkage to Care Program. Poster Presentation, 2016 Society of Hospital Medicine, San Diego, CA

Poynter, S., Arrington, J., Heishberger M., Mansai, L., & Ruoff, C. (2015). ALCAPA and Left Ventricular Dysfunction: A Podiatric Case Study. Poster Presentation at the 2015 Northeast Pediatric Cardiology Nurses Association Annual Conference, Washington, DC. Roane, L. and Novak, D. (2015). Impact of building design on medication error rates in the ICU setting. Poster Presentation at the 2015 ANCC National Magnet Conference, Atlanta, GA.

Zimmer, M., Woltz, P., Barnaba, E., Raymond, G. (2016). Professional Advancement Model Outcome Evaluation Fosters Organization Changes to Increase Nurse Engagement and Advancement. Poster Presentation at the 2016 ANCC National Magnet Conference, Orlando, FL.

U MMC NU R SI NG Annual Report | FY 2 01 6 |

Pa g e 1 9

recognizing the extraordinary CNO Award for Team Excellence

MICU

atient care in the Medical Intensive Care Unit (MICU) requires being a jack-of-all-trades and master of most; the breadth and depth of the knowledge and skills necessary for this unit are remarkable. Immersed in a continuously active learning environment, the MICU nursing team is extraordinarily innovative. Over the past year, the MICU team has shown excellence in all of our C2X pillars.

People

• Continued to grow the Senior Clinical Nurse group – now 14 strong!

• Implemented a unit-based Senior Clinical Nurse Mentor Program

• Continued a unit-based Novice Nurse Support Group

• Implemented a unit-based PCT/RN Committee

• Implemented a unit-based Unit Secretary Committee

Service

• Implemented a unit-based Rewards and Retention Committee

• Created a “Come See How Cool I Am” board to get to know each other better

• Recognized a unit-based Employee of the Month and Employee of the Quarter

• Created a “MICU Stars” board to thank and recognize staff members

• Implemented the Pause Project, in which a provider or clinician initiates a 30-second or longer pause to honor the life of a patient who has just passed away

• Initiated a Patient Experience Committee

• Created a Quiet Time initiative using images of staff members’ sleeping pets

• Implemented a unit-based Charge Nurse Committee

Julie Ann Griffith BSN, RN, CCRN Clinical Nurse II

Adam Taylor, BSN, RN Clinical Nurse I

Front row, left to right:

Back row, left to right:

Kristin McAleer, BSN, RN, Clinical Nurse I Christian Gragasin, BSN, RN Clinical Nurse I Martin Maier, BSN, RN, Clinical Nurse I Molly Hutchins, BSN, RN, CCRN Senior Clinical Nurse I

Shelby Murphy, BSN, RN, Clinical Nurse I Jessica Grandier, Unit Secretary Tara Stocksdale, BSN, RN, Clinical Nurse II Katherine Shaw, RN, Clinical Nurse II Melissa Wagner, BSN, RN, CCRN Clinical Nurse II Brittany Ingram, Unit Secretary D. Seth Taylor, MSN, ACNP, CCRN Nurse Practitioner Kerry Sue Mueller, MBA, BSN, RN, CCRN Nurse Manager

Middle row, left to right: Kirstyn Hasson, RN, Clinical Nurse I Doresia Porter, Patient Care Technician Kim Bowers, MS, ACNP-BC, CCRN Nurse Practitioner Rachael Goucher, BSN, RN, Clinical Nurse II

Cassy Crowder, BSN, RN Clinical Nurse II

U MMC NU R SI NG Annual Report | FY 2 01 6 |

Pa g e 2 0

recognizing the extraordinary

CNO Award for Team Excellence,

continued

The incredible innovation, teamwork, spirit, enthusiasm, and interprofessional collaboration demonstrated on the MICU makes this team, hands down, the perfect honorees for the CNO Award for Team Excellence. This award is presented to the area of patient care that has consistently shown excellence in teamwork to provide extraordinary care to patients and families. Congratulations to Kerry Sue Mueller, MBA, BSN, RN, CCRN, and the amazing MICU nursing team for setting the standard so high.

Safety & Quality

Stewardship

• Designed an education simulation

• Created an Epic Quick Start Guide for

process that presents real-life arrest scenarios on acute units (Arrest Pager Training Pilot)

• Focused on two safety projects for the Medical/Surgical Division related to the AHRQ Safety Survey

• Led by the unit-based Infection Control Committee, reduced CLABSI and CAUTI

• Completed a project to increase RL6 reports

• Promoted certification through the unitbased Certification Committee – and at last count had 36 certified nurses!

the Portfolio Go-Live

• Led a Working Together Civility Project for the unit

• Participated in a pilot to study chlorhexidine-impregnated Tegaderm dressings for central lines. This trial is currently happening in the MICU and involves a pre-assessment about the Tegaderm/Biopatch lines dressings. The trial is CHG impregnated Tegaderm and the staff are evaluating the effectiveness of the dressing.

Innovation

• Completed an evidence-based performance improvement project on positioning patients in a prone position for improved ventilation

• Initiated an End-of-Life Committee designed to help grow the end-of-life care practices for patients, families, and caregivers

• Initiated a Healthy Work Environment Committee

Left to right: Alyssa Robinson, BSN, RN Clinical Nurse II Shelby Murphy, RN Clinical Nurse I

Melanie Schutt, BSN, RN Clinical Nurse I

Front row, left to right:

Back row, left to right:

Shelby Murphy, BSN, RN, Clinical Nurse I Julie Ann Griffith, BSN, RN, CCRN Clinical Nurse II Nicole Hodski, BSN, RN, CCRN Senior Clinical Nurse I

Lindsay Jones, BSN, RN, Clinical Nurse II Melanie Schutt, BSN, RN, Clinical Nurse I Rachael Goucher, BSN, RN Clinical Nurse II Katherine Shaw, RN, Clinical Nurse II Sharnette Wells, Unit Secretary Rebecca Stecher, MS, RN, CCRN Senior Clinical Nurse II Chad Copeland, BSN, RN, CCRN Clinical Nurse II

Left to right: Katherine Shaw, RN Clinical Nurse II Ashley Trentzsch, RN, CCRN Clinical Nurse II

U MMC NU R SI NG Annual Report | FY 2 01 6 |

Pa g e 2 1

recognizing the extraordinary

Expanded Role Lisa Rowen, DNSc, RN, CENP, FAAN, was named System Chief Nurse Executive for the University of Maryland Medical System.

Media Recognition Baltimore magazine, Excellence in Nursing 2016

Lisa Rowen, DNSc, RN, CENP, FAAN Chief Nurse Executive University of Maryland Medical System Senior Vice President of Patient Care Services & Chief Nursing Officer University of Maryland Medical Center Associate Professor University of Maryland School of Nursing

s System Chief Nurse Executive, Dr. Rowen adds a senior nursing voice at the System level for strategic planning, nursing workforce development and continuous clinical improvement initiatives. She provides input and leadership for patient care issues to ensure integration of services and alignment with the Systemâ&#x20AC;&#x2122;s strategic goals and objectives. Dr. Rowen has oversight for more than 5,000 nurses, advanced practice nurses, and other health professionals. She continues in these roles while dedicating a portion of her time and effort to this new System role. Under her leadership, UMMC was awarded MagnetÂŽ designation by the American Nurses Credentialing Center in 2009 and was recredentialed in 2014. Approximately five percent of all hospitals across the United States have achieved this prestigious designation, which recognizes hospitals that demonstrate excellence in nursing practice and adherence to national standards for nursing care. Dr. Rowen is a strong champion and advocate for nurses. Her passion for patients, leadership abilities and dedication to nursing research and education are demonstrated daily. An associate professor at the University of Maryland School of Nursing, Dr. Rowen has formulated innovative relationships with the SON to advance education and training of nurses from beginning of the career through advanced nursing practices.

Chona Rizarri, BSN, RN, PCCN Clinical Nurse II Cardiac Surgery Stepdown Unit Christina Purificato, BSN, RN, CCRN Clinical Nurse II Surgical Intensive Care Unit Jasmine Noronha, BSN, RN Clinical Nurse II Pediatric Progressive Care Unit Donna Audia, RN, HN-BC Senior Clinical Nurse I Integrative Care Team

International Recognition Sigma Theta Tau International Research Congress Rising Stars of Scholarship and Research Poster Program Award Recipeint Andrea M. Smith, DNP, CRNP, FNP-BC Clinical Program Manager for NP Emergency Services

U MMC NU R SI NG Annual Report | FY 2 01 6 |

recognizing the extraordinary

National Recognition Fellow American Academy of Nursing (FAAN) Inductee Carmel A. McComiskey, DNP, CRNP, FAANP, FAAN Director Nurse Practitioners and Physician Assistants

FAAN Inductee Karen Doyle, MSN, MBA, RN, CNE, FAAN Senior Vice President Nursing & Operations R Adams Cowley Shock Trauma Center

2016 Improving Patient Care and Health Delivery Award from the Intelligent Health Association (IHA) and the 2016 IHA GRAND Award Neonatal Intensive Care Unit (NICU)

Nominated by the Oncology Nursing Society (ONS) and served as a delegate to Vice President Biden’s Cancer Moonshot Summit on June 29 in Washington, D.C. Nancy Corbitt, BSN, RN, OCN, CRNI Senior Clinical Nurse ll Oncology 46th President of the American Association of Critical-Care Nurses (AACN) Karen McQuillan, MS, RN, CNS-BC, CCRN, CNRN, FAAN Lead Clinical Nurse Specialist R Adams Cowley Shock Trauma Center

Left to Right: Sami Gurmu, BS Clinical Engineer Treza James, MS, NNP-BC, CPES Clinical Practice and Education Specialist Inhel Rekik, MS Clinical Engineer Dina El-Metwally, MD NICU Medical Director Colleen Driscoll, MD Associate Professor of Pediatrics Joan Treacy, MS, RN-NIC Nurse Manager George Reed, MBA Director, Clinical Engineering

Silver-Level Beacon Award for Excellence Multi-Trauma Intermediate Care – 6

Pa g e 2 2

U MMC NU R SI NG Annual Report | FY 2 01 6 |

Pa g e 2 3

recognizing the extraordinary

Regional Recognition

The Science of Nursing

2016 Nurse.com Nursing Excellence GEM Awards – Regional Finalist for the Mid-Atlantic Region

Excellence in Innovation through Research Jacqueline Christian, MS, RN Clinical Nurse II Medicine Telemetry, 10 East

Priya Nair, MS, RN Nurse Manager Surgery Subspeciality Clinic, Digestive Health Center & Oral-Maxillofacial Clinic

Excellence in Innovation through Evidence-Based Practice Left to right: Kirsten Tomaschefsky, BSN, RN, CCRN Senior Clinical Nurse I

State Appointment and Recognition

Medical Intensive Care Unit

Maryland State Board of Nursing Appointee

Hannah Entwistle, BSN, RN, FCCS, CCRN Senior Clinical Nurse I Medical Intensive Care Unit

Greg Raymond, MS, MBA, RN Director of Nursing and Patient Care Services for Clinical Practice, Professional Development, Neuroscience, and Behavioral Health

Maryland Hospitals for a Healthy Environment (MD H2E) Award for Environmental Health in Nursing Justin Graves, MS, RN Interim Director for Materials Management, Logistics, and Sustainability

Excellence in Publication or Presentation

Team from Pediatric Intensive Care Unit

Front row, left to right: Jennifer Arrington, MS, RN, CPN, CNL Senior Clinical Nurse I Susie Park, MS, RN Clinical Nurse II

Back row: left to right: Colleen Ruoff, BSN, RN Clinical Nurse II

2nd photo: left to right: Diana Szekely, BSN, RN Clinical Nurse II Katherine Spillman, MS, RN Clinical Nurse II

Not pictured: Sarah Poynter Keaney, BSN, RN, CPN Clinical Nurse II

Lauren Manrai, RN, CCRN Clinical Nurse II Jessica Masters, BSN, RN Clinical Nurse II Excellence in Leadership – Manager Cynthia O’Carroll, MS, RN Nurse Manager Transplant IMC and Transplant Transitional Care Center

U MMC NU R SI NG Annual Report | FY 2 01 6 |

recognizing the extraordinary

The Science of Nursing,

continued

Excellence in Leadership â&#x20AC;&#x201C; Clinical Fatemeh Jorshari, MSN, RN Senior Clinical Nurse I Surgical Intermediate Care

The Art of Nursing Art of Caring Kelly Watts, RN, CCRN Clinical Nurse II Lung Rescue Unit

Excellence in Nursing Practice

Personifies Professionalism

Rowell Lomat, BSN, RN Clinical Nurse II General OR

Kristen Dizon, BSN, RN, PCCN Clinical Nurse II Cardiac Surgery Step-down

Excellence in Advanced Practice Nursing Cheryl Cline, MS, CRNA Manager Nursing Anesthesia

Personifies Professionalism Leah Smith, BSN, RN Clinical Nurse II EMS Nursing

Excellence in Advanced Practice Nursing JoAnn Sikora, MS, CRNP Senior Nurse Practitioner Cardiac Surgery

Personifies Professionalism Martina Patricio, BSN, RN, CNRN Nurse Coordinator Interventional Radiology

Excellence in Quality Barbara Bosah, BSN, RN, PCCN Senior Clinical Nurse I Surgical Intermediate Care

Contagious Positive Attitude Ashley Loftice, RN Clinical Nurse II Stoler Pavilion

Excellence in Safety Abigail Gatch, BSN, RN, CCRN Clinical Nurse II Medical Intensive Care Unit

Bellwether Amy Brown, RN Clinical Nurse II Labor and Delivery

Pa g e 24

U MMC NU R SI NG Annual Report | FY 2 01 6 |

Pa g e 2 5

recognizing the extraordinary

The Art and Science of Nursing Excellence in Precepting, Mentoring, and Education Ashley Hernandez, BSN, BA, RN-BC Senior Clinical Nurse I Psychiatric Emergency Services

Our Extraordinary Health Care Partners University of Maryland School of Nursing Colleague Joan Davenport, PhD, RN Assistant Professor, Organizational Systems & Adult Health (OSAH)

Excellence in Community Service Debbie Guzik, BSN, RN, RNC-OB Senior Clinical Nurse II Labor and Delivery

Physician Colleague – Attending Sam Galvagno, DO, PhD, MSm, FCCM Department of Anesthesiology, Surgical Intensive Care Unit

Physician Colleague – Resident/Fellow

Daisy Award

Ravishankar Shivashankar, MD, MBBS Interventional Radiology

1st Daisy Award Recipient (May 2016) Tya Schoppe, BSN, RN Clinical Nurse II NeuroTrauma Critical Care Unit

Our Extraordinary PCS Partners Daisy Award Recipient (June 2016) Rachael Martin, BSN, RN, CPN Clinical Nurse II Pediatric Acute Care

Outstanding Nursing Support Staff Paul Jefferson Patient Care Technician NeuroCare Acute

Special Friend of Nursing Sherrie Stephens-Hunt, MBA Business Management Patient Care Services

U MMC NU R SI NG Annual Report | FY 2 01 6 |

Pa g e 26

community outreach Improving Population Health and Care Coordination News & Views, Winter 2015

program assistant

pharmacist

ne of the initiatives in the current strategic plan for the University of Maryland Medical Center (UMMC) is to improve population health. The transitional care program at UMMC provides care coordination for high-risk patients as they are discharged from the hospital. The team includes nurse care coordinators, a social worker, pharmacist, and program assistant. A member of nurse care coordinator the team sees the patient prior to discharge to establish the patient relationship. The pharmacist ensures the discharge medication reconciliation is accurate and works with the medical team on any needed interventions. A program assistant works with the

social worker

pharmacist and patient to provide the patient with their filled prescriptions prior to discharge. During the past year, each of the ambulatory clinics developed programs to serve their patient populations. This year, the ambulatory clinics have begun expanding their care coordination programs with additional structural supports and tools. Clinical staff, including medical directors, nurse managers, and the ambulatory medical and nursing directors have been working together to define the population served for care coordination in each clinic. Information on top diagnoses, readmissions, and other quality data on potentially avoidable utilization (PAU) assist in this determination. Once the population is defined for each clinic, a patient list is entered into the secure Chesapeake Regional Information System Portal (CRISP) so that the clinic can receive reports of their patients who have had an emergency room visit or admission to any hospital in Maryland.

Transitional Surgery Center News & Views, Spring 2016

n February 2015, the Transitional Surgery Center (TSC) at UMMC was Readmission Rate Transitional Surgery Center established as a collaborative between surgical nurse practitioners (NPs) and nursing leadership and staff nurses in the Surgery Subspecialty clinic. An evidencebased process improvement project was Baseline CY13 undertaken and aimed at improving care Baseline CY14 and decreasing emergency department Jan – June 2015 (ED) visits and hospital readmissions July – Oct 2015 among the post-operative population by improving access. Baseline CY13 The TSC received notification on Baseline CY14 October 29, 2015 that the HSCRC Jan – June 2015 approved TSC as a new hospital-regulated July – Oct 2015 clinic. The TSC program is housed in the regulated Surgery Subspecialty Clinic on the ground floor of the North Hospital. Current specialty practices included are surgical oncology, vascular, urology, and general surgery, in addition to the Digestive Health Center on 8 North. The TSC continues to grow and is working on providing service to more surgical patients. Recently the TSC team had an abstract accepted for the 2016 Magnet conference.

U MMC NU R SI NG Annual Report | FY 2 01 6 |

Pa g e 27

community outreach

Annapolis 2016: Nurses Influence Legislation News & Views, Spring 2016

or years, nurses in the Trauma Resuscitation Unit (TRU) and emergency departments have been subpoenaed by attorneys to testify to their competence to draw blood from impaired patients. As a background to this issue, in any given quarter, approximately 30-40 TRU nurses are issued subpoenas to testify to their competence to perform blood collection to determine blood alcohol levels. Drawing blood is a basic skill within the scope of practice of all licensed nurses in the state of Maryland. For the nurse to have to travel to a court of law to attest to their level of competence to perform this fundamental skill is wasteful to both the judiciary and health care system. Valuable time, effort and resources are continually diverted from patient care to no practical, useful end. Recognizing the burden this places on our nursing staff and on the Medical Center, legislation was drafted eliminating the need for nurses to testify to this basic core competency. Ultimately, two bills that were introduced during the 2016 session in Annapolis provided that a nurse who performs a blood draw does not have to testify in court if a law enforcement officer who witnesses the blood draw attests to the fact that the blood was drawn by a qualified individual and that proper procedures were followed. Karen Doyle, MBA, MS, RN, NEA-BC, FAAN, representatives from the Maryland Nurses Association and the Maryland State Police, and several State’s Attorneys provided strong support for the bills during public hearings in both the Senate and the House of Delegates. Another example of the Trauma nurse’s influence on legislation at the state level can be seen in the role that Tara Carlson, MS, RN holds as chair of TraumaNet, a statewide advocacy group for the Maryland trauma system. Carlson testified in support of legislation for stricter ignition interlock requirements in both the House and Senate. House Bill 1342 and Senate Bill 945 Drunk Driving Reduction Act (Noah’s Law) increased the suspension periods for the driver’s license of a person who is convicted of offenses relating to driving under the influence and driving while impaired and increased the categories of offenses for which participation in an ignition interlock program is mandatory. The Senate version of the bill was passed during the 2016 legislative session.

Nurses make a substantial difference in the political process in a variety of ways. We can impact our profession by paying attention to legislation that is introduced and by contacting our elected representatives to voice our opinions, whether they are positive or negative. Those who make laws have power, but so do we. Let’s not forget that we as nurses are the most trusted profession in the country. Our voice matters.

Produced and edited by: Greg Raymond, MS, MBA, RN Director, Nursing and Patient Care Services Clinical Practice and Professional Development, Neuroscience and Behavioral Health Susan Santos Carey, MS Manager, Operations Clinical Practice and Professional Development Managing Editor, News & Views Cyndy Ronald, BA Manager, School of Nursing Partnership Programs Clinical Practice and Professional Development