University of Maryland Shore Regional Health Nursing Annual Report FY 2016

NURSING ANNUAL REPORT FY 2016

HEALING HANDS

Patient Safety, Experience and Quality

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Nursing Annual Report • FY 2016

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From the Chief Nursing Officer

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From the Chief Executive Officer

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From the Chief Medical Officer

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About University of Maryland Shore Regional Health

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Highlights

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Nursing Awards and Honors

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UM Shore Regional Health Nursing Certifications

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Nursing Research

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Nursing Executive Committee

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Nursing Management

Nursing Annual Report • FY 2016

Table of Contents

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From the Chief Nursing Officer

Ruth Ann Jones, EdD, MSN, RN, NEA-BC Senior Vice President, Patient Care Services, and Chief Nursing Officer

The past year was marked with several significant organizational changes. I am incredibly proud of how nurses at University of Maryland Shore Regional Health embraced these changes.

Even though this has been a challenging year, the nursing team has once again stepped to the plate and continued to strive to transform nursing at Shore Regional Health. Through it all we have made enormous strides, both clinically and educationally, providing a supportive and innovative environment for nursing professionals.

Nursing plays a pivotal role in the achievement of clinical outcomes by working in collaboration and partnership with our physicians and other members of our health care team.

We continue to raise the bar on safety, quality and patient experience.

This report highlights some of the advances achieved in the past year. I am honored to have been selected last May as UM Shore Regional Health’s senior vice president of Patient Care Services and chief nursing officer. It is my privilege to share our FY16 Nursing Annual Report.

Nursing Annual Report • FY 2016

Sincerely,

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From the Chief Executive Officer

Kenneth Kozel, MBA, FACHE President and CEO

Nurses are the front line of health care throughout our nation, our state and especially within the five-county region served by University of Maryland Shore Regional Health. I am so proud that our reputation for excellent nursing care continues to grow. Throughout our acute care and outpatient programs and facilities, the leadership and innovation of our nurses and their unwavering dedication to providing outstanding patient care are in evidence every day.

Our nurses play a strong role in helping UM Shore Regional Health achieve our mission, Creating Healthier Communities Together. This report describes varied nursing initiatives that have improved patient outcomes through the development of new care models, the adoption of new technologies, the creation of new protocols and ongoing collaboration with other health care professionals to overcome obstacles in the changing landscape of health care.

On behalf of the leadership team of UM Shore Regional Health, I extend my deepest appreciation for our nursing team’s ongoing focus on enhancing the patient experience and patient safety in every unit, department, service and specialty.

Sincerely,

From the Chief Medical Officer

work William Huffner, MD, MBA, FACEP, FACHE

Chief Medical Officer and Senior Vice President, Medical Affairs

Nursing Annual Report • FY 2016

This report reflects the outstanding care, commitment and professionalism that characterizes UM Shore Regional Health’s nursing team.

Physicians and allied health care professionals count on our nurses as key collaborators in the delivery of quality health care and in the advancement of our programs and services to meet evolving care needs in our communities. Our vision, to be the Region’s Leader in Patient Centered Health Care, will be realized as we continue to work together in the interest of enhancing patient outcomes.

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About University of Maryland Shore Regional Health Formed in 2013, University of Maryland Shore Regional Health is a regional health care organization serving Caroline, Dorchester, Kent, Queen Anne’s and Talbot counties. It includes three hospitals – UM Shore Medical Centers at Chestertown, Dorchester and Easton – and a host of outpatient facilities: UM Shore Emergency Center at Queenstown; the Cancer Center; the Clark Comprehensive Breast Center; UM Shore Medical Pavilions at Dorchester, Chestertown, Easton and Queenstown; urgent care centers operated in partnership with Choice One in Denton and Easton; UM Shore Nursing and Rehabilitation Center at Chestertown; UM Shore Rehab Centers at Cambridge, Denton, Easton and Queenstown; and the Diagnostic and Imaging Center at Easton.

Services of UM Shore Regional Health address the general, emergency and acute care needs of the 170,000 residents in the five-county region and provide specialized care for patients living with heart disease, stroke, cancer, joint replacement, sleep disorders, diabetes, breast disease, pain management and wound healing.

commu UM Shore Medical Center at Easton

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UM Shore Medical Center at Dorchester

UM Shore Medical Center at Chestertown

UM Shore Regional Health at a Glance • Three community hospitals with a combined 222 inpatient beds, as follows: 26 at Chestertown; 46 at Dorchester (including behavioral health); and 150 at Easton (including newborn and acute rehabilitation).

• Affiliation with University of Maryland Community Medical Group (UM CMG), which includes more than 54 physicians and 25 advanced practice providers practicing in the five-county region served

by UM Shore Regional Health

UM Shore Emergency Center at Queenstown

• Comprehensive surgical capabilities, including a full range of general surgery, ambulatory surgery, and some of the most complex brain, spine and joint procedures • A broad outpatient network of primary care complemented by behavioral health, diabetes and endocrinology, rehabilitation, wound healing and diagnostic services • Active participation in Maryland Patient Safety Center and Institute for Healthcare Improvement quality initiatives focused on patient safety • Family-friendly Birthing Center that welcomes more than 1,000 newborns each year

UM Shore Medical Pavilion at Queenstown

• MIEMSS certified emergency care in our three hospitals and UM Shore Emergency Center at Queenstown • MIEMSS designated Primary Stroke Center including Target Stroke Honor Roll designation

• IAC accredited Noninvasive Vascular Laboratories • Recognition as a community leader through volunteerism and growing partnerships with diverse business, healthcare, social services and educational organizations

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Nursing Annual Report • FY 2016

• CARF accredited Requard Center for Acute Rehabilitation

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Nursing Annual Report • FY 2016

Critical Care Nursing Enhanced by Unit Renovation in Chestertown

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University of Maryland Shore Regional Health celebrated the completion of the newly renovated critical care unit (CCU) on the second floor of the north wing of UM Shore Medical Center at Chestertown on Thursday, April 21, 2016. The highly anticipated renovation project had been a dream for several years, but thanks to $233,000 in support from members of the community through donations to Chester River Health Foundation, the dream became reality.

A grand opening celebration for the unit attracted approximately 75 guests from the community as well as many hospital staff who enjoyed touring the unit and viewing ceiling lift demonstrations provided by Sandy Prochaska, BSN, RN, inpatient nurse manager, and Mickey Roderick, MS, RN, CCRN, clinical nurse specialist.

Nursing staff at the hospital were very involved in the design and renovation project, says Mary Jo Keefe, MSM, RN, director of Nursing Services, UM Shore Medical at Chestertown. “Our goal was to improve and enhance the delivery of quality, efficient care in the CCU. We felt this could best be accomplished by opening up and reconfiguring the unit, making room for modernized and centralized work stations and providing a better line of sight to all the patients in the unit,” she explains.

The CCU renovation gave staff members at all levels the opportunity to provide input into the environment of care for patients. Every decision required input from front line staff members and the approval, understanding and insight of the nursing leadership.

Christine Dayton, Architect, met with nursing leadership and staff on several occasions to create a design of the unit that would accommodate the nurses’ expectations for providing quality care. Their first priority was for the nurses to be able to view all patients on the unit, and to have a wide, open area where all team members communicate, collaborate and complete documentation on the care of the patients. The WhitingTurner Construction Company was chosen for the project and their team met with nursing staff on a regular basis to ensure that goals for the unit redesign renovation were being realized.

The dramatically transformed unit, which received patients within days of the opening event, includes: • • • •

modernized nursing and physician work stations. a newly renovated isolation, airborne infection room that includes a private bathroom. ceiling-mounted patient lifts, and freshly painted rooms and hallways of the north corridor.

“Quality health care requires collaboration and integration of teamwork and respect, and this newly renovated unit has provided a stronger foundation for this work,” says Prochaska.

Ken Kozel, far right, is shown with several of the nurses who were on hand to celebrate the opening of the renovated CCU at UM Shore Medical Center at Chestertown: from left, Steven Jacobson, Linda Callahan, Mickey Roderick, Peggy Roca, Kathy Elliott, Mary Jo Keefe, Cassandra Price and Sandy Prochaska.

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Sepsis Response Team Saves Lives in Emergency Departments Sepsis is the body’s life-threatening defensive mechanism against an infection. According to the Center for Disease Control and Prevention (CDC), over one million cases of sepsis occur each year in the U.S., and 275,000 of these cases are fatal.

UM Shore Regional Health’s Sepsis Response Team was initiated in March 2015 to facilitate early recognition of patients with sepsis upon presentation to the Emergency Departments (ED). Upon arrival in the ED, patients are evaluated for specific signs and symptoms that may indicate the sepsis process. These include: At least two of the vital signs meeting the following measures: • • • •

Temperature < 96.8 or > 100.4 F Heart rate greater than 90 beats per minute Respiration rate greater than 20 breaths per minute Systolic blood pressure less than 90 mmHg

When a patient meets the criteria, the Sepsis Response Team is alerted. This team consists of the ED physician, ED nurse, and staff from respiratory therapy and laboratory. The goal of this team is to provide appropriate medical treatment – IV fluid administration, antibiotics and other necessary treatment – in a fast, safe and effective timeframe. The Sepsis Response Team is activated on average of 90 times per month across all four Emergency Departments – UM Shore Medical Centers at Chestertown, Dorchester and Easton and the Emergency Center at Queenstown.

The CDC has linked 50% of all hospital deaths to sepsis.

By initiating the Sepsis Response Team process, UM SRH has significantly improved the quality of care provided to patients presenting with sepsis. This multi-disciplinary, regional approach has provided safe, efficient and evidenced based care to the community we serve.

And one potential source of an infection: • • • •

Dysuria, wound drainage, foul smell, cough or fever Unexpected post-operative pain Current symptoms associated with pneumonia Currently on an antibiotic or antifungal

A few years ago, the concept of a “bridge clinic” was introduced by Jaclyn Crawford, BSN, BA, RN-BC, manager, Behavioral Health Services. This concept arose during a meeting in which the most recent Community Health Needs Assessment (CHNA) was being discussed. The CHNA report identified mental health as a major issue in the region served

by UM Shore Regional Health. Based on her own observation and conversations with members of the community, Crawford recognized the need to fill gaps in treatment so often experienced by patients with behavioral health issues, including substance use disorders and mental illness.

Crawford broached the idea with nurses and staff on Shore Behavioral Health’s inpatient unit. The staff reported a growing trend – patients who had been discharged from inpatient behavioral health care returning to the hospital emergency departments (and ultimately, being readmitted to the inpatient unit) due to lack of follow through in obtaining outpatient

treatment or lack of timely and available resources in the community. Their vision was to provide continuity of care for individuals who are stepping down from the inpatient unit by connecting them with mental health counseling and psychiatric resources.

Early in 2016, that vision became a reality as Shore Behavioral Health (SBH) launched the Bridge Clinic at UM Shore Medical Center in Dorchester. The Bridge Clinic provides coverage for up to 90 days – “bridging the gap” between a patient’s discharge and his or her first connection with a permanent mental health care provider in the community.

The connection begins with a follow up phone call to verify that the patient is safe, has an understanding of his or her treatment plan and was able to get prescriptions filled.

Some patients are brought in to continue therapy or to address prescription issues; others’ needs are met by simply reviewing their plan.

Nursing Annual Report • FY 2016

Bridge Clinic Helps Behavioral Health Patients Transition to Outpatient Care

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Nursing Annual Report â&#x20AC;˘ FY 2016

Nurses play a key role in assessing patients who enroll in the Bridge Clinic and in their care plan. Based on the patientâ&#x20AC;&#x2122;s health and medical history, the nurse evaluates whether or not he or she needs additional or specialized health care from a community-based provider. If that is the case, the nurse helps the patient navigate the system to connect with the appropriate provider in the community.

The Bridge Clinic also offers a monthly support group that provides encouragement and education for individuals discharged from the inpatient unit at SBH. Former inpatients use the time in group to flesh out concerns about their medications, find ways to accept and manage their difficult diagnoses, and address the issues that didnâ&#x20AC;&#x2122;t change while they were hospitalized. Family members typically use the time to vent frustrations and learn strategies to better support the family member who was hospitalized.

The goal of the Bridge Clinic is to help patients transition successfully from inpatient care to life in the community with outpatient care by giving them the information, resources and support they need. In just the first six months of operation, it proved highly beneficial for the approximately 275 patients served.

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Merry Webb (left), who works in the Bridge Clinic, with Jaclyn Crawford (right), nurse manager for Shore Behavioral Health.

inno UM SRH Nurses Adopt Early Warning Score Program

Early Warning Score (EWS) Programs have been implemented nationwide as a method of improving recognition of deteriorating patient conditions. The Office of Healthcare Quality identified adverse events related to delay in treatment as the second most reported event, of which 75% were fatal. To help detect patient deterioration more quickly, EWS programs respond to subtle changes in multiple patient parameters. Used in conjunction with Rapid Response (RRT)/ Medical Emergency Team (MET) programs, EWS programs facilitate identification of patient deterioration, provide timely interventions and reduce the incidence of Code Blue for cardiac arrests.

In collaboration with University of Maryland Medical System, UM Shore Regional Health performed a retrospective chart review of prior Code Blue and MET activations using an Early Warning Score Program. This review, which suggested that implementing an EWS program could reduce Code Blue and MET activations by as much as 75 and 35 percent, respectively, prompted the formation of an interdisciplinary EWS Taskforce, including a physician, staff nurses, nursing techs, and staff from information technology (IT) and patient safety. The EWS Taskforce collaborated with IT to build the EWS program into the current electronic documentation, thereby minimizing the impact on the nursing workload. An innovative PowerPoint presentation with embedded video demonstrating the documentation flow served to educate staff on how the EWS system works.

The program was piloted at UM Shore Medical Center at Chestertown in early June, 2015, and expanded to UM Shore Medical Centers at Dorchester and Easton in September, 2015. Several metrics were used to ensure success of the new program. Checking vital signs as ordered and documentation of complete vital sign sets were implemented above 90% consistently across three quarters.

ovation The implementation of the EWS program resulted in a reduction of Code Blue calls from eight to three over a threequarter period on units performing EWS measurements.

The success of the EWS program is directly related to the dedication and commitment of the nursing staff and nursing leadership to improve patient outcomes related to the rapid identification of patient deterioration.

EWS Taskforce Members Jo Anne Thomson, MN, RN-BC, Facilitator Mandy Bounds, MSN, RN, CCRN Lisa Eisemann, BSN, RN Ludwig Eglseder, MD, Ad Hoc Barbara Etchison, RN Samantha Fitzhugh, RN Elexes Howard, NT Sherrie Hunter, NT Patty MacDougall, DNP, RNC Ashley Macer, NT Jennifer Miles, MSN, RN Kitty Neff, BSN, RN Amy Stafford, DNP, RN, CMSRN Lauren Webster, RN

Nursing Annual Report â&#x20AC;˘ FY 2016

Process metrics and pre-program data also had indicated that an average 120-minute delay was occurring between the time vital signs were obtained and the time they were documented. This delay was reduced to 26 minutes following EWS education and implementation of the EWS program; however, the EWS Taskforce in conjunction with Nursing Leadership wanted to find innovative solutions to further reduce the time.

New technology was emerging that allowed for the calculation of the EWS scores at the patient bedside. This technology would allow staff to identify patient deterioration immediately and intervene without waiting for vital sign documentation to occur within the electronic medical record. The Nursing Leadership Team presented a proposal for the purchase of EWS programming for the vital sign machines to calculate EWS scores at the patient bedside, and senior leadership supported the proposal. The new programming was implemented in March 2016.

Once implemented, the 26 minute average to obtain the EWS score was reduced to between two and three minutes, which reduced by one-third the time it took nurses to document on the EWS assessment.

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Nursing Annual Report • FY 2016

Implementation of Telemetry Guidelines Promotes Patient Throughput

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Many patients are admitted to UM Shore Regional Health hospitals after being seen in the Emergency Department (ED).

Moving patients from the ED to inpatient units – known as “throughput” – can be delayed for many reasons. Having a smooth transition for patients from the ED to inpatient units prevents long wait times for emergency care and patients being held in the ED. It also improves patient satisfaction.

Recognizing an opportunity to improve ED throughput, reduce ED wait times and improve patient satisfaction in its three hospitals, UM SRH sought out innovative solutions to improve throughput within the hospital. One major barrier identified was the overutilization of telemetry monitoring.

A literature review identified a telemetry protocol that was implemented at another hospital. The protocol included indications and durations for telemetry monitoring for specific medical diagnoses derived from the American Heart Association (AHA)/American College of Cardiology (ACC) Practice Standards for electrocardiographic monitoring in hospital settings. The protocol included physical assessment parameters completed by the RN one hour prior to discontinuation of telemetry monitoring. If the assessment met the clinical parameters established, the telemetry monitor could be discontinued; if it is outside the clinical parameters, the telemetry monitoring is continued. The hospital implementing this protocol was able to decrease telemetry monitoring by 70%, which promoted throughput of patients from the ED to the inpatient unit and resulted in improved care quality and patient satisfaction.

This information was discussed with Tim Shanahan, DO, medical director, Cardiology Services for UM SRH, who endorsed the concept. The Cardiac Steering and ED Throughput committees also supported implementing the protocol.

An interdisciplinary Telemetry Monitoring Protocol Taskforce was formed, including physicians, staff nurses, nurse educators, nursing management, the director of Cardiopulmonary Services and staff from Information Technology (IT). The first task was to determine if telemetry orders could be built in the electronic medical record system; the challenge was establishing rules to accommodate the various lengths of time telemetry monitoring is recommended depending on the diagnoses. The IT team worked diligently to build a system that would automatically notify the nurse when the 24- or 48-hour assessment was required.

Streamlined and automated documentation, along with comprehensive staff education, was pivotal to the success of the program. Mickey Roderick, RN and Marilyn Herridge, RN took the lead in developing and educating both the nursing staff and physicians. The Telemetry Monitoring Protocol was implemented at UM Shore Medical Center at Easton in January, 2016 and then further expanded to UM Shore Medical Center at Dorchester; ultimately, it will be adopted at UM Shore Medical Center at Chestertown.

Bobbi Simkins, RN and Adam Weinstein, MD, vice president, Medical Affairs, monitored the telemetry protocol following implementation and reported that over a four-month period, there was a 50% reduction in the number of patients held in the ED. This great improvement in patient flow from ED to inpatient units should help to further reduce ED wait times and improve patient satisfaction.

Throughput Committee Diane Walbridge, MSN, RN, NEA-BC and Adam Weinstein, MD, Co-chairs Walter Atha, MD Gary Bigelow, BSRT, R, CV Teresa Blem, PT Robert Carroll, MBA, CPHQ, MHP Deborah Davis, MD Dennis DeShields, MD Jessica Denny, PT Rachel Howard, PA Ruth Ann Jones, EdD, MSN, RN, NEA-BC Mary Jo Keefe, MSM, RN Gabe Martinez, MD Korah Pulimood, MD Terri Ross, LCSW-C, C-ASWCM, ACM Bill Roth, MS, NHA Bobbi Simkins, MSN, RN Cardiac Services Steering Committee Gary Jones, RCP, FACCA and Tim Shanahan, DO, Co-chairs Mandy Bounds, MS, RN, CCRN-CMS Juan Cordero, MD Ryan Foster, MSN, RN, CNML, NEA-BC Iris Giraudo, BSN, RN Mary Jo Keefe, MSM, RN Jen Nutley, BSN, RN George Panas, MD Pamela Pardun, BSN, RN, CCRN Brendon Paltoo, MD Laura Ross, MD Mary Alice Vanhoy, MSN, RN, CEN, CPEN, NREMT-P Bobbi Simkins, MSN, RN

Fast Communication Facilitates Mass Casualty Response in Emergency Departments Weber and Foster immediately notified the UM SRH administrator on call, administrative supervisors and Emergency Department (ED) charge nurses at the Dorchester and Easton hospitals. The charge nurses advised the nursing and physician staff of the situation and began making preparations for the incoming surge of patients. ED staff worked together to process and discharge all patients currently in the department who met discharge criteria to make room for the incoming patients. Ancillary departments, such as laboratory, radiology and respiratory therapy were notified to be prepared for the surge of incoming patients. All staff on duty made plans to extend their shift until the incident was considered clear.

Communication between the Dorchester and Easton hospitals was maintained by ED charge nurses and administrative supervisors via Spectralink phones. As the incident occurred in Dorchester County, Shore Medical Center at Dorchester was the first facility to receive notification of the impending arrival of patients. This information was immediately communicated to the administrative supervisors and the Easton ED charge RN. Soon thereafter, information was received that a medical bus would be transporting the remaining patients to Shore Medical Center at Easton. Communication continued between the hospitals until all patients had received care.

At the close of the evening, Dorchester had treated and released six patients; Easton had treated and released 18 patients.

It was through exemplary teamwork and communication between campuses that the multiple patients involved in this event were treated in a calm, safe and caring manner.

Cathy Weber and Ryan Foster, nurse managers for the Emergency Departments of UM Shore Medical Centers at Dorchester and Easton, respectively, managed ongoing communications during the mass casualty incident caused by a boating accident.

Nursing Annual Report â&#x20AC;˘ FY 2016

During mass casualty events, the emergency department plays a vital role in facilitating organization-wide communication to ensure that staff members in direct care positions are supported and safe patient care is provided.

June 1, 2016 was a beautiful Eastern Shore evening with warm, sunny skies and calm waters. At approximately 1800 hours, UM Shore Medical Center at Dorchester and Easton Emergency Department managers Ryan Foster, BSN, RN, CEN and Cathy Weber, MSN, RN, CNML, NEA-BC were notified by Michael Boldosser, emergency preparedness manager for UM Shore Regional Health, that a boating accident had taken place in southern Dorchester County. The initial report received from the County Emergency Operations Center was that there were approximately 24 victims, mostly children, with the severity of injuries unknown.

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safety Nursing Annual Report • FY 2016

Online Perioperative Documentation Established

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After years of hard work and dedication, including the collaborative efforts and support of the Medical Staff as well as colleagues in inpatient care and informatics, online documentation for the Perioperative area was finally realized during FY 16.

The process began with the development of a multidisciplinary Operating Room Module (ORM) Steering Committee. The team decided to move systematically through the process as a patient would, implementing online documentation at each area of contact. The project required financial investments and some space renovation to allow appropriate access for physicians in Same Day Surgery.

Today, anywhere a surgical patient may present in the UM Shore Regional Health network, his or her information can be accessed electronically. An example would be a patient who was being prepped for an elective surgery but presented first in the Emergency Department (ED) and was unable to provide his or her medical history. Thanks to online documentation in the Pre-Anesthesia Testing (PAT) office, the ED physician could see invaluable information – the patient’s baseline nursing assessment, consults, medication list and diagnostic workup that was intended for surgery. Likewise, a planned outpatient surgery that became emergent would already have in place the necessary preoperative work up required to safely provide anesthesia.

This approach to documentation also enables all patient information to be viewed from a secure location by anesthesia providers in all locations. Questions from PAT nurses to the anesthesiologists take on more meaning when everyone is looking at the same information during the discussion.

The transition to electronic medical records began with PAT, but quickly moved into Same Day Surgery where nurses prep patients for surgery, endoscopy, interventional radiology and the cath lab. Electronic documentation allows all the providers involved in the patient’s care to access the same information at once. In the past, the single, hard-copy chart meant only one provider could view the detail at a time. The

electronic access allows for a more efficient response to patient issues and preparation because several people can review the patient’s chart at once. This also created one source of truth – the Electronic Medical Record (EMR).

There are a number of ways a patient can actually present to surgery, and each one of these ways had to be documented and tested by the team to ensure that all aspects of any patient’s care could be communicated effectively. An added bonus of PAT being online was the ability to have Chestertown residents who were scheduled for surgery in Easton choose the Chestertown location for their pre-op visit. Again, documentation completed online during the pre-op visit is immediately accessible and doesn’t have to be faxed or delivered.

Once past the prep stage, the team tackled the challenges of electronic documentation in the Operating Room (OR); in particular, the administration of medication. As they worked through the process of medication, the OR went live with perioperative documentation. Once the Endoscopy Department became involved, the issues surrounding incremental dosing of narcotics for conscious sedation procedures were resolved. This process is also applied in other departments that administer medication incrementally.

Operating Room Steering Committee Members Lisa Eisemann, BSN, RN Bee Fish, MBA John Haines, BSN, RN Renee Jeffries Khalid Kurtom, MD Kim Marks, RPh Sydney Milligan, MSN, RN Jacquie Mowbray, BSN, RN, MHA James Palumbo, MD Penny Pink, MS, RN, NEA-BC John Snell, MD Susan Walbridge, MSN, RN, NEA-BC Douglas Wiseman, MD

Stroke Center Team Earns Silver Plus and Target Stroke Honor Roll Awards UM Shore Medical Center at Easton has remained a Certified Primary Stroke Center since 2007. This certification demonstrates that UM Shore Regional Health is committed to providing the most up to date, evidence based care to all stroke patients. In fiscal year 2016, the Stroke Center provided care to more than 190 ischemic stroke patients, 80 transient ischemic attack (TIA) patients and more than 25 intracerebral hemorrhage patients.

Of the ischemic stroke patients, 19 were treated with Alteplase, the only approved drug for acute ischemic stroke.

Alteplase is a strong clot buster that can be given to stroke patients if they arrive at the hospital within 3.5 hours of symptom onset. Studies have shown that Alteplase decreases mortality and increases functional independence after a stroke.

Being a Certified Primary Stroke Center requires maintaining a team approach to stroke treatment and care, and UM SRH Primary Stroke Center is measured on specific performance criteria. The Centerâ&#x20AC;&#x2122;s team is required to meet these measures at least 85% of the time in order to be recognized as one of the top performing stroke centers in the United States.

In 2015, UM Shore Medical Center at Easton was recognized as meeting these measures and was awarded the Silver Plus Award for stroke from the American Heart and Stroke Association (AHA/ASA). In addition to the prestigious Silver Plus designation, the hospital received the Target Stroke Honor Roll, which signifies that the hospital administered Alteplase in all eligible patients within 60 minutes of arriving at the hospital.

These awards were presented at an event in May, 2016 that recognized the excellent work of the Stroke Center and all that the team has accomplished in advancing quality care for stroke patients and their families in the five-county region.

Jessica Fluharty, neuroscience specialist and stroke coordinator, and Terry Detrich, MD, Stroke Center medical director, accept the Silver Plus Award from the American Heart Association/ American Stroke Association. At right is AHA/ASA representative Noella Lang.

Nursing Annual Report â&#x20AC;˘ FY 2016

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Nursing Annual Report • FY 2016

Birthing Center Welcomes New OB-GYN Practice and Promotes Breastfeeding and Skin to Skin Contact

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In early 2016, University of Maryland Shore Regional Health’s Birthing Center celebrated its 20th year of service – and more than 20,000 deliveries – since it opened its doors in January, 1996. Along with members of the nursing team and several members of the leadership team of UM Shore Regional Health, the celebration was attended by members of the new OB/GYN practice – University of Maryland Community Medical Group (UM CMG)-Women’s Health. Formed initially with the arrival of OB/GYN specialist Aisha Siddiqui, MD and two nurse midwives, Michell Jordan, RN, DNP, CNM, FNP, BC and Brittany Krautheim, MSN, CNM, WHNP, the specialist practice group was later joined by Barbara Kierns, MD and midwife Rebecca Ailstock, MSN, CNM. The new practice operates on a primary midwifery model of care. The midwives are responsible for a majority of the on-call shifts at the Birthing Center, located in UM Shore Medical Center at Easton, with their physician partner always available for immediate consultation or interventions. Jordan, Krautheim and Ailstock are members of UM CMG, a multihospital, multi-specialty network of University of Maryland Medical System providers serving the people of Maryland.

The midwives specialize in encouraging natural methods of childbirth, including but not limited to a minimal or medication free labor and delivery, the promotion of ambulation during the labor process, and access to fluids and food. Midwives help with labor discomforts by encouraging laboring moms to use the Jacuzzi tubs that are located in each labor suite. They also promote natural movement and position changes that facilitate the rotation of the baby’s head for a successful vaginal delivery.

The Birthing Center is working on a number of new initiatives. The first is the ongoing promotion of exclusive breastfeeding – “breast is best.” UM Shore Regional Health is a participant in the Maryland Breastfeeding Friendly initiative.

Mothers are encouraged to breastfeed their newborns without supplementation, to room-in with their newborns during the hospital stay and to notice the cues their babies show when they are ready to nurse.

The Birthing Center’s two lactation consultants cover 40 hours every week to provide individualized care for nursing mothers. There are also several midwives who specialize or are certified in lactation to assist a new mom, and a free breast-

feeding support group is offered twice monthly. The Birthing Center also offers childbirth and parenting education classes, including a breastfeeding class, throughout the year free of charge.

The second initiative involves the encouragement of skin to skin contact as soon as possible after the birth has occurred to promote bonding between mother and newborn; skin to skin contact also improves breastfeeding success. In the fall of 2015, the Birthing Center staff began offering this service to mothers having a cesarean delivery as long as the mother and baby are healthy. These initiatives help to promote “Creating Healthy Families Together.”

Michell Jordan

Brittany Krautheim

Rebecca Ailstock

Lactation Consultant Carol Leonard is shown with members of the Breastfeeding Support Group, which is part of the ongoing promotion of exclusive breastfeeding promoted by the Maryland Breastfeeding Friendly initiative.

Emergency Departments Earn Five-Year Designations from Maryland Institute for Emergency Medical Services System self-assessments with site visits to follow. The process was new due to the regionalization of UM SRH facilities and the adoption of system-wide policies and procedures that had occurred since the original designation. The new, regionalized approach was identified as a best practice that will be shared with other facilities.

An additional best practice identified by the group was the collaborative Quality Improvement Program. This includes two processes. In Easton, there are quarterly meetings with Talbot County EMS, at which five 911 calls and responses are randomly selected and reviewed. This QI program is unique in the state and will be shared with other EMS programs in the state.

A second Quality Improvement Program is coordinated with Caroline, Dorchester, Queen Anne’s and Talbot County.

The counties send a list of the highest priority patients and receive feedback related to their impression and interventions and the findings of the Emergency Department during assessment and interventions. Again, this is a best practice that is unique to UM Shore Regional Health.

UM Shore Emergency Center at Queenstown and the Emergency Department Base Stations at UM Shore Medical Centers in Chestertown, Dorchester and Easton exceeded the MIEMSS standards and expectation and therefore received five year designations, which is the highest designation offered.

At UM Shore Emergency Center at Queenstown, Mary Alice Vanhoy, Emergency Department manager, mans the EMS radio while Walid Hammad, MD, emergency physician and Anne George look on.

Nursing Annual Report • FY 2016

The Maryland Institute for Emergency Medical Services Systems (MIEMSS) oversees and coordinates all components of the statewide Emergency Medical System (EMS) in accordance with Maryland statutes and regulations. UM Shore Regional Health participated in two different types of re-designation surveys in 2016.

First surveyed was UM Shore Emergency Center at Queenstown, which had become the first Maryland-designated Freestanding Emergency Department in 2010. In the winter of 2016, Shore Emergency Center at Queenstown staff completed a self-assessment that was followed by a site visit from a MIEMSS representative who spent a day in the Emergency Center reviewing processes, interviewing staff and reviewing policies and documentation. Upon completion of the site visit, the re-designation group made recommendations for a full five-year designation.

The second type of re-designation was the three Base Stations located in the emergency departments of the UM SRH hospitals in Chestertown, Dorchester and Easton. Maryland’s designated EMS Base Stations provide quality on-line medical direction to the State’s EMS providers. This includes operations and evaluation of emergency departments as well as the medical oversight that occurs between emergency departments and the field EMS provider though radio communications, quality improvement and education.

In the spring of 2016, the MIEMSS designated Base Station coordinators at UM Shore Medical Centers at Chestertown, Dorchester and Easton completed

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Nursing Annual Report • FY 2016

Recognizing and Rewarding Clinical Nursing Expertise

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The UM Shore Regional Health Professional Advancement Program (PAP) is a clinical advancement system that develops, recognizes and rewards clinical nursing expertise throughout UM SRH hospitals and outpatient facilities. Inaugurated at UM Shore Medical Centers at Dorchester and Easton several years ago and extended to include nurses at UM Shore Medical Center at Chestertown in 2013, PAP supports and encourages career advancement for nurses – from novice to expert – through professional growth, competence, experience and education.

Clinical nurses interested in obtaining a Level III or Level IV through PAP must submit an application for professional advancement, which requires evaluating their level of practice at the bedside and providing evidence of the skills they have achieved. The application is evaluated by the PAP Nursing Review Board. Nurses at UM Shore Medical Center at Chestertown became eligible for the PAP program in July 2013, just as the hospital began its journey to Magnet® designation.

In April 2015, Danielle Pierzynski, BSN, RN, CRNI, became the first nurse at UM Shore Medical Center at Chestertown to be awarded the distinction of Level III. A year later, she earned the honor of being the first nurse in Chestertown to be awarded the Level IV. With Pierzynski’s encouragement, two other RNs at the hospital achieved the advancement merit in April, 2016.

“The Professional Advancement Program gives registered nurses the opportunity to advance their careers and the incentive to stay active in their units and current in their practice,” says Pierzynski. “I was eager to attain the status of RN Level III and further motivated to obtain a certification to advance to RN Level IV. Change occurs very quickly in the oncology field, so I appreciate how the Professional Advancement Program encourages me to keep up with the latest evidencedbased research and seek new education opportunities.”

Anne North, RN, CMSN, and Mary Ann Scott, RN, CCRN, both achieved Level III in the past year. Says North, a 20-year veteran of UM Shore Medical Center at Chestertown, “PAP enables me to use my certification and CEUs to advance my career. I enjoy teaching, especially new nurses, and it gave me an opportunity to do so. Because of the annual CEU requirements, I’ll be able to stay on top of best practices, which is important in the Infusion Clinic where we provide chemotherapy and IV outpatient treatments.”

Anne North, Mary Ann Scott and Danielle Piercynski were among the first nurses working at UM Shore Medical Center at Chestertown to participate in UM Shore Regional Health’s Professional Advancement Program.

Scott, who has worked at the Chestertown hospital for 25 years and maintained her critical care nursing certification since 1993, found participating in the Professional Advancement program to be a logical choice. As she explains, “With my CCRN certification comes the CEU requirement needed for the RN III. Mentoring and teaching also is a regular aspect of my job, so I just needed to take that to a more documentable level.”

Notes Kathy Elliott, UM Shore Regional Health’s director of professional nursing practice and Magnet® program, “The Professional Advancement Program supports our Magnet® journey as it promotes nursing excellence, and it is exciting to see Chestertown nurses taking advantage of the opportunity to advance their expertise and professionalism.”

PAP Nursing Review Board Members Connie Edwards, BSN, RNC-OB, CCE - Level IV, Chair Theresa Bosworth, RN - Level IV Kimberly Brice, MSN, RN, CCRN - Level IV Katherine Cvach, MS, RN-C Renee Edsall, MSN, RN, CCRN Kathy Elliott, MSN, RN RN Danette Everngam, BSN, RN - Level III Kathy Freund Rita Holley, MS, BSN, RN Jeannine Le Mieux, BSN, RN, PCCN - Level III Susan Lewis, BSN, RN - Level II Danielle Pierzynski, RN - Level III Stacy Smith, BSN, RN-BC - Level IV Tara Smith, RN - Level III Amy Stafford, DNP, RN, CMSRN Amanda Sutton, RN - Level II Carolyn Timms, RN-BC, CNN - Level III

Surgical Services Team Redesigns Custom Packs for Efficiency and Cost Savings

Lauren Wade, perioperative business manager, holds one of the newly designed custom packs created for Surgical Services.

The end results were impressive – a total of 14 custom packs, eight of them new. Says Wade, “Throughout the process of this redesign, staff gained a new appreciation for the cost of items used in daily practice and were pleased with the efficiencies achieved – which netted a significant savings of nearly $50,000 annually – as well as with their involvement and decision-making.”

Surgical Specialties Team Leads Lisa Asplen, RN Carol Dickerson, RN Tyler Gogoll, RN Katherine Jones, RN, CNOR Jackie Milledge, BSN, RN Claudia Tilley, MSN, RN

Nursing Annual Report • FY 2016

University of Maryland Shore Regional Health operating rooms, like many all over the country, use custom packs to pull together supplies needed for a surgical case. The custom pack contains all of the items common to a particular procedure and creates efficiencies in the processes around the gathering and opening of supplies.

In 2014, Surgical Services at UM SRH began to receive requests for changes to custom packs that had been in place for more than three years. Surgical Services reached out to the custom packs vendor, who worked closely with the operating room materials team as well as with the surgical specialties team leads to modify existing packs and create new ones.

“Efficiency was the primary goal – creating packs that would meet the needs for varied surgical cases and also reduce waste,” says Lauren Wade, BSN, RN, CIC, OR, perioperative business manager, Surgical Services. Wade worked with the surgical team leads on the project.

The first step was to have multiple items included in one sterilized pack that can be opened quickly, rather than having each item in individual wrappings that must be opened one at a time. The single pack can be opened much more quickly and the added benefit is less packaging waste.

A second goal, cost effectiveness, proved to be a greater challenge. The team spent many hours poring over the content list for each pack. They eliminated items that would not be used in at least 90% of cases and evaluated generic versions of requested items to avoid unnecessary expense for name brands.

They debated the “need to haves” and the “nice to haves” and presented the rationale for items to be eliminated to the rest of the team. Finally, they compared the cost of the custom pack to the cost of pulling the single items from shelves. Most packs were found to be cost effective, but some provided only soft savings in terms of time and effort (as opposed to cost).

The team went back to the drawing board to look for greater savings.

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Nursing Awards and Honors

Awards Presented for Nurse Excellence

Nursing Annual Report • FY 2016

University of Maryland Shore Regional Health’s Nurse Excellence Awards Presentation and Graduate University (GU) and Critical Care University (CCU) Graduation was held on Monday, May 9, 2016 at the Todd Performing Arts Center at Chesapeake College.

Leading the event presentations, Ruth Ann Jones, EdD, MSN, RN, NEA-BC, senior vice president of Patient Care Services and chief nursing officer, noted that the 2016 honorees were selected from a total of 43 nominations, the greatest number submitted since the awards were established five years earlier. “This awards program was established by nurses, for nurses as a way to recognize those who go above and beyond for our patients and their families, and for their communities,” said Jones.

Ken Kozel, president and CEO, spoke glowingly of the key role that the 533 UM SRH nurses play in achieving the organization’s mission, Creating Healthier Communities Together, and its vision, to be the Region’s Leader in Patient Centered Health Care. “This evening we are surrounded by nurse leaders who believe in excellence, and they achieve it by focusing on relationship based care, evidence based care and professionalism,” he said.

Kozel also encouraged the 2016 CCU and GU graduates to continue their professional development as the next generation of nurse leaders who will help the organization continue to thrive in the coming decades.

John Dillon, chairman of the Board of UM Shore Regional Health, stated, “Board members often hear from people in the community about how wonderful our nurses are. In my opinion, our nurses have played a key role in helping us become one of the best community hospitals in the nation.”

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Ruth Ann Jones, senior vice president, Patient Care Services and chief nursing officer (far left), pauses with Easton and Dorchester PACU team members who were on hand to receive the 2016 Unit Award for Empirical Outcomes: Colby Robbins, Holly Frase, Leslie Mansfield, Sara Rissolo, Brittany Gowe, Jamie Riley and Sydney Milligan, PACU manager.

Ruth Ann Jones, UM SRH senior vice president, Patient Care Services and chief nursing officer (far left), with Nurse Excellence Individual Award winners Steven Jacobson, Kimberly Kral and Beverly Greaves. (Not shown is Mary Collins.)

Jean Volz, MSN, RN, CCRN, Critical Care and Graduate University faculty, led the certificate presentations to the 28 novice nurses who were honored for completing the UM SRH CCU and GU advanced nursing education programs, after which the 2016 Shore Regional Health Nurse Excellence Awards were presented, as follows: Outstanding Achievement in Care Delivery: Commitment to Others Beverly Greaves, RN, CEN, Clinical nurse, Emergency Department, UM Shore Medical Center at Chestertown

In attendance to receive their certificates were 2016 GU graduates, l. to .r, Ashley Higgs, Shelby Wheatley, Susan Price and Jessica Pretzler.

Outstanding Achievement in Leadership Mary Collins, RN, Clinical Nurse Coordinator, 2 East, UM Shore Medical Center at Easton Outstanding Achievement in Mentorship/ Advocacy Kimberly Kral, BSN, RN, CEN, Clinical Nurse Coordinator, Emergency Department, UM Shore Medical Center at Dorchester

Unit/Department Excellence in Clinical Outcomes Post Anesthesia Care Unit, UM Shore Medical Centers at Dorchester and Easton

2016 CCU graduates who were present to receive their certificates were, front row, l. to r., Michelle Bixler, Amy Loder-Crouch, Laura Jackson, Justine Schnaitman and Kim Seward; and back row, l. to r., Kathie Fisher, Melanie Walls, Christina Seningen, Amanda Dulin, Chelsea Lewis and Trisha Germann.

Ruth Ann Jones, far left, and Nurse Excellence Awards Committee members Kathy Elliott, Jackie Moriarty, Eden Kinser, Jane Flowers, Elizabeth Todd, Jean Volz, Hope Padilla, Bernadette Wood and Dawn Ford.

Nursing Annual Report â&#x20AC;˘ FY 2016

Outstanding Achievement in Professional Nursing Steven Jacobson, MSN, RN, CEN, NR-P, Clinical Nurse Coordinator, Emergency Department, UM Shore Medical Center at Chestertown

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Nursing Awards and Honors (continued)

Annual Conference Features Nursing Research and Spies Award Presentation

Nursing Annual Report • FY 2016

The 2016 UM SRH Nursing Research Conference, held May 13 at Chesapeake College’s new Allied Health Professions and Athletic Center, attracted the highest attendance – 75 nurses – in the seven years the conference has been held.

The keynote speaker was Karen Gabel Speroni, PhD, RN, chair of the UM SRH Nursing Research Council. Speroni has 30 years of experience in biomedical research and is a consultant for hospitals and other health care organizations on research process and infrastructure. She addressed the topic, “Connecting the Dots through Nursing Inquiry.”

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Other presentations at the conference included: • Performance Measurement, FOCUS PDSA and Change Management, by Robert Carroll, MBA, CPHQ, MHP, director, Performance Measurement and Improvement • Process Improvements and Current Practice, a panel presentation by Renee Edsall, MS, RN; Ryan Foster, MS, RN; Cathy Weber, BSN, RN; Jennifer Miles, MS, RN; Lisa Eisemann, BSN, RN; and Mandy Bounds, MS, RN • Real Life Experiences of the Nursing Research Intern,

by Mickey C. Roderick, MS, RN, CCRN, Nursing Research Intern, January-June, 2015 • Is that Really Evidence-Based Practice? Fact or Fiction, by Amy Stafford, DNP, RN, CMSRN, Clinical Specialist • Quality Improvement in Heart Failure Patients, by Sherrie Hill, MSN, RN CCRN, CHFN, Coordinator, Cardiopulmonary Rehabilitation • Root Cause Analysis (RCA), by Jean Seiler, BSN, RN, MA, CPPS, Clinical Quality Coordinator/Educator

2016 Karen Spies Award Winner Marcia Shapiro (far left) with Ruth Ann Jones, Karen Spies and Janet Andrews, who represented UM Memorial Hospital Foundation.

Keynote speaker Karen Speroni (left) with Ruth Ann Jones, senior vice president, Patient Care Services and CNO.

Ruth Sullivan (right) was on hand to be recognized for her service to Nursing Research by Ruth Ann Jones. Not shown are honorees Kim Billingslea, Barbara Bilconish and Sharon Richter.

Evidence-based Practice - Diana Cox, RN, and Sam Stevens, RN, representing UM Shore Medical Centers at Dorchester’s 2 East and Critical Care Units.

Idea: Modify patient room white-boards to improve communication and pain management with patients.

Quality Improvement - Christina Seningen, RN, and Kim Seward, RN, representing UM Shore Medical Center at Easton’s Emergency Department.

Idea: Propose the use of ER Wait-Time Monitors, which provide communication with patients and improve patient satisfaction.

A major highlight of the conference was the presentation of the 2016 Karen Spies Award to Marcia Shapiro, MSN, RN, of the UM Shore Medical Center at Easton Emergency Department, for her research study, “Relationship Between Emergency Department Patient Anxiety Level and Provision of Medication History.” Shapiro will present her research study poster at the 2016 ANCC National Magnet Conference in Orlando, Florida.

The Karen Spies Award was established in 2009 by Karin Brown in recognition of the professional service and caring demeanor shown to her parents by Karen Spies, RN. Criteria for selection to receive the award are: relevance of study to provision of care; benefit to education/research and principles of nursing practice; willingness to promote research to the larger community; use of the scientific method; potential benefits to UM SRH; and alignment with the nursing mission, “to excel in quality care and patient satisfaction.”

Special recognition for service and contributions to nursing research at UM Shore Regional Health was given to Kim Billingslea, MS, RN, past Institutional Review Board (IRB) member; Barbara Bilconish, MS, RN, past Nursing Research Executive Team member; Ruth Sullivan MS, RN, IRB, community member; and Sharon Richter, BSN, RN, past IRB member.

Nurses Honored as Everyday Heroes

by Patients, Families and Colleagues UM SRH physicians, nurses, clinical staff and volunteers are honored throughout the year by patients, families and co-workers who give donations to UM Memorial Hospital Foundation, UM Chester River Health Foundation and Dorchester General Hospital Foundation recognizing individual staff and unit staff as “Everyday Heroes.”

The following nurses were recognized in FY 2016 as Everyday Heroes: Alida Bushe, BSN, RN, BC Amanda Coate, RN Karen Denny, RN, FNE A/P Stella Hubbard, RN, PCCN Kelly Hutt, RN Eden Kinser, BSN, RN Cheryl Milewski, RN, CCU Jennifer Nutley, BSN, RN, FNE-A Victoria Spray, RN Deborah Timms, RN April Venables, RN

Nursing Annual Report • FY 2016

The 2016 Research Idea Contest winners were announced, as follows: Research - UM Shore Medical Center at Easton, 3 East Staff Nurses.

Idea: Does the use of IV acetaminophen decrease length of stay (LOS), decrease narcotic use, and improve pain control in post-operative medical surgical patients?

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Nursing Awards and Honors (continued)

Brittingham Receives Margaret Ann Gary Nursing Award Christine Brittingham, RN, CNOR, operating room coordinator at UM Shore Medical Center at Chestertown, was honored by Kent County doctors as recipient of 2016 Margaret Ann Gary Nursing Award on June 29, 2016.

The award was created and named in honor of Margaret Ann Gary, RN, by Chestertown medical staff in 2011.

Brittingham’s nominators commended her for her strong work ethic, competence, knowledge, flexibility, resilience and the respect she has earned from her colleagues.

David Knutson, MD; Christine Brittingham, winner of the 2016 Margaret Ann Gary Award; and Michael Peimer, MD.

Weber Honored by the Maryland Chapter of the American College of Emergency Physicians

Nursing Annual Report • FY 2016

Cathy Weber receiving her award from William Jaquis, MD, FAECP, on April 8 at the Maryland ACEP conference in Baltimore.

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Cathy Weber, BSN, RN, CEN, Emergency Department manager at UM Shore Medical Center at Dorchester, was named Emergency Nurse of the Year by the American College of Emergency Physicians, Maryland Chapter (MD ACEP).

The award, presented by William Jaquis, MD, FAECP, on April 8 at the Maryland ACEP conference in Baltimore, recognized Weber as a “leader who serves to motivate, inspire and challenge her team while promoting others to maximize their strengths and look at weaknesses as opportunities to grow.”

Weber joined the Emergency Department at the Dorchester hospital when it first opened and has remained there for more than three decades, now serving as nurse manager for the department. She has promoted professional and personal development for her colleagues, advanced the practice of emergency nursing at the hospital, and facilitated multiple renovations and enhancements to the department, including the incorporation of new technologies.

A longstanding member of the Eastern Shore Chapter of Emergency Nurses Association (ENA), Weber has served in multiple offices of the organization and as an active member of the ENA Leadership Special Interest Group.

Williams Honored by American Cancer Society

Pain Care Nurses Help ASPMNMaryland Win National Award

Michele Williams, DNP(c), NP, MSN, RN-BC, OCN, staff nurse in the Cancer Center at UM Shore Regional Health, received the 2016 Medical Professional Hometown Hero from the American Cancer Society at the annual “Colors of Cancer Gala” held April 2, 2016 in Oxford.

The award noted Williams’ commitment to the fight against cancer and her long-term involvement with the America Cancer Society and other community organizations that support area cancer patients.

As active members of the Maryland Chapter of the American Society for Pain Management Nursing (ASPMN), UM SRH Pain Care nurses Gail Shorter, CRNP, Cathy Asche, BSN, RN-BC and Linda Wilt, RN-BC, were on hand to accept this year’s National Chapter Award from the ASPM. The award was presented at the ASPMN’s national conference in Atlanta, Georgia, in September.

Julia Foxwell, American Cancer Society representative, presents Michele Williams with a certificate naming her a 2016 Colors of Cancer award recipient.

(Standing, l. to r.) Karen Snow Kaiser, Maryland ChapterASPMN president, Claudette Jacobs, 2014 president, and UM Shore Pain Care nurses Gail Shorter, Cathy Asche (chapter secretary) and Linda Wilt accept the 2015 ASPMN National Chapter Award.

Karen Denny, RN, FNE A/P, coordinator, Shore Regional Health’s Sexual Assault Forensic Examiner (SAFE) and Sexual Assault Response Team (SART) programs, received the 2016 Ruby Award for Women Helping Women from the Soroptimist International of Talbot County. The Ruby Award recognized Denny’s hard work for and dedication to the UM SRH sexual assault treatment program.

Shown above are (l. to r.): Laura Heikes, Soroptimist member; Ruth Ann Jones, senior vice president, Patient Care Services/CNO; Kay Wendowski, Soroptimist member; Pat Steele, Soroptimist member; Karen Denny, Ruby Award winner; Melissa Kelly, president, Soroptimist International of Talbot County; Diane Walbridge, regional director of Clinical/Financial Nursing Resources; and F. Graham Lee, vice president of philanthropy.

Nursing Annual Report • FY 2016

Karen Denny Honored by Soroptimist International of Talbot County

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UM Shore Regional Health Nursing Certifications

Nursing Annual Report â&#x20AC;˘ FY 2016

Governing organizations through which UM Shore Regional Health nurses have achieved certification are:

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Addictions Nursing Certification Board American Academy of Wound Specialists American Association of Critical Care Nurses Certification Corporation American Association of Neuroscience Nursing American Association of Nurse Practitioners American Board for Certification of Gastroenterology Nurses American Board for Occupational Health Nurses, Inc. American Board for Transplant Certification American Board of Cardiovascular Perfusion American Board of Managed Care Nursing American Board of Perianesthesia Nursing Certification, Inc. American Board of Quality Assurance and Utilization Review Physicians, Inc. American Board of Wound Management American College of Forensic Examiners Institute American College of Health Care Administrators American College of Sports Medicine American Council on Exercise American Holistic Certification Corporation American Legal Nurse Consultant Certification Board American Midwifery Certification Board American Nurses Credentialing Center American Organization of Nurse Executives in partnership with MCN American Registry of Radiologic Technologists American Society for Metabolic and Bariatric Surgery American Society for Quality Association for Health Care Accreditation Professionals Association of Clinical Research Professionals Baromedical Nurses Association Board of Certification for Emergency Nursing Board of Certification for Emergency Nursing/ Pediatric Nursing Board of Medical Specialty Coding Certification Board of Perioperative Nursing Certification Board of Infection Control and Epidemiology Certification Council for Medical Audit Specialists Certification Program of American Correctional Association

Certifying Board of Gastroenterology Nurses and Associates, Inc. Commission on Accreditation for Dietetics Education Commission on Nurse Certification Competency & Credentialing Institute Compliance Certification Board Council on Certification of Nurse Anesthetists Dermatology Nursing Certification Board Developmental Disabilities Nurses Association Forensic Nurse Certification Board Genetic Nursing Credentialing Commission HR Certification Institute Infusion Nurses Certification Corporation International Board of Lactation Consultant Examiners International Childbirth Education Association International Nurses Society on Addictions Maryland Board of Nursing McKesson Health Care Medical Surgical Nursing Certification Board Nursesâ&#x20AC;&#x2122; Association of the American College of Obstetricians and Gynecologists National Association of Pediatric Nurse Practitioners National Board for Certification of Hospice and Palliative Care Nurses National Board of Certification of School Nurses National Board of Diving and Hyperbaric Medical Technology National Board of Nutrition Support Certification National Certification Board for Diabetes Educators National Certification Corporation for Obstetric, Gynecological and Neonatal Nursing Specialties National Certification Corporation National Certifying Board for Ophthalmic Registered Nursing National Certifying Board of Otorhinolaryngology and Head-Neck Nursing National Commission for Certifying Agencies National Consortium of Breast Centers National League for Nursing Nephrology Nursing Certification Commission OASIS Certificate and Competency Board Ohio State University & OHIC Oncology Nursing Certification Corporation Orthopaedic Nurses Certification Board Pediatric Nursing Certification Board, Inc.

More than 208 UM Shore Regional Health nurses have achieved certification in a wide range of specialties, including: Addictions Adult Nurse Practitioner Adult Psychiatric Mental Health Clinical Nurse Specialist Advanced Practice Ambulatory Care Ambulatory Peri-anesthesia Ambulatory Women’s Health Cardiac and Vascular Care Cardiac Rehabilitation Case Management Childbirth Educator Clinical Research Coordinator Clinical Transplant Coordinator Critical Care Diabetes Educator Electronic Fetal Monitoring Emergency Family Nurse Practitioner Forensic Nurse Examiner Adult/Pediatric General Nursing Practice Gerontology Health Care Quality Management

Holistic Baccalaureate Nurse Home Care Coding Specialist Hospice and Palliative Care Infant Massage Infection Prevention and Control Informatics Infusion Therapy Inpatient Obstetrics Medical Surgical Neonatal Intensive Care Nephrology Neuroscience Nurse Executive – Advanced Nurse Manager and Leader Nurse Manager and Leader Nurse Practitioner – Acute Nurse Practitioner, Adult Nurse Practitioner, Family Nurse Practitioner Occupational Hearing Conservationist Obstetrics Oncology Operating Room Orthopedics Pain Management Pediatrics Pediatric Emergency Perinatal Post-Anesthesia Professional Development Professional in Health Care Risk Management Progressive Care Psychiatry & Mental Health Radiology Registered Nurse First Assistant Rehabilitation Risk Management Transport Emergency Wound Care Wound Specialist Wound, Ostomy, Continence

Nursing Annual Report • FY 2016

Plastic Surgical Nursing Certification Board, Inc. Prepared Childbirth Educators Radiologic Nursing Certification Board, Inc. Rehabilitation Nursing Certification Board Society of Trauma Nurses The American Academy of Nurse Practitioners Certification Program The National Association of Alcoholism and Drug Abuse Counselors Certification Commission The National Board for Certified Counselors The Pediatric Nursing Certification Board, Inc. Transcultural Nursing Certification Commission Vascular Access Certification Corporation Wound, Ostomy and Continence Nursing Certification Board

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Nursing Research MANUSCRIPTS Crouch, L., Speroni, K.G., Jones, R.A., MacDougall, E.P. and Daniel, M.G. (2016). Timing of newborn pulse oximetry screenings for critical congenital heart defect rates before discharge. Journal of Obstetric, Gynecologic & Neonatal Nursing; 45(1): 39–44. http://dx.doi.org/10.1016/j. jogn.2015.10.007; http://jognn.org Durcho, J., Speroni, K.G., Jones, R.A., Daniels, M.B., Beemer, C. & Daniel, M.G. (2016). A subjective view: Nurse satisfaction and the review process. Journal of Nursing Management, 47(2): 40-46. doi: 10.1097/01.

NUMA.0000479445.12663.b8 Groton, M., Fisher, M., Stranahan, K., Higley, M., Speroni, K.G. & Daniel, M. (2015). A prospective, randomized, single-blind study evaluating the effectiveness, tolerability and cost of colonoscopy bowel preparations.

Gastroenterology Nursing, 38(1): 31-41.

Kram, S., DiBartolo, M., Hinderer, K. & Jones, R.A. (2015). Implementation of the ABCDE bundle to improve patient outcomes in the intensive care unit in a rural community hospital. Dimensions of Critical Care Nursing, 34(5): 250-258.

Nursing Annual Report • FY 2016

POSTERS/ABSTRACTS:

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Bounds, M., Kram, S., Speroni, K. G., Brice, K., Luschinski, M.A., Harte, S. & Daniel, M.G. Retrospective review of the effect of ABCDE bundle implementation on intensive care unit patients’ delirium prevalence. Presented at: Advancing Science, Improving Lives, the National Institute of Nursing Research’s (NINR) 30th Anniversary Scientific Symposium and Poster Session, October 13, 2015, Bethesda, Maryland; and Reston Hospital Center’s 12th Annual “Spring Into Nursing Research Conference,” May 13, 2016, Reston, Virginia.

Crouch, L., Speroni, K.G., Jones, R.A., MacDougall, E.P. & Daniel, M.G. Evaluation of timing of newborn pulse oximetry screenings for critical congenital heart defects rates prior to discharge. Presented at: Advancing Science, Improving Lives, the National Institute of Nursing Research’s (NINR) 30th Anniversary Scientific Symposium and Poster Session, October 13, 2015, Bethesda, Maryland; and Reston Hospital Center’s 12th Annual “Spring Into Nursing Research Conference,” May 13, 2016, Reston, Virginia. [3rd place winner].

Durcho, J., Speroni, K.G., Daniels, M.E., Beemer, C.P., Jones, R.A. & Daniel, M.G. Comparison of nurse satisfaction differences between annual review processes: Performance appraisal versus criteria based performance management.

Presented at: Reston Hospital Center’s 12th Annual “Spring Into Nursing Research Conference,” May 13, 2016, Reston, Virginia.

Kram, S., DiBartolo, M., Hinderer, K. & Jones, R.A. Implementation of the ABCDE bundle to improve patient outcomes in the intensive care unit in a rural community hospital.

Presented at the Sigma Theta Tau/Peninsula Regional Medical Center Evidence-Based Practice Conference, March 25, 2015, Salisbury, Maryland.

Westerfield, H. Transitioning to bedside shift report in a community hospital system. Academy of Medical Surgical Nurses (AMSN) Annual Convention, Poster Session, September 7, 2015, Las Vegas, Nevada [Academy of Medical Surgical Nurses (AMSN) Post-Convention Virtual Display on the AMSN Online Library (http://www.amsn.org/library) September 2015- September 2016].

ONGOING STUDIES

SUBMITTED AND UNDER REVIEW

Roderick, M. & Stafford, A. Evaluation of isolation patients’ perceptions on ability to identify types of health care workers when wearing isolation gowns.

Stagg, S., Speroni, K.G., Daniel, M.G., Eigenbrode, M. & Geisler, L. Evaluation of text messaging effects on health goal adherence in the management of participants with chronic diseases. Submitted to Professional Case Management Journal.

Durham-Pressley, C., Speroni, K.G., Kingan, M., MacDougall, P. & Williams, M. Nurse perceptions of the family violence screening process and education program in a rural healthcare system.

MANUSCRIPTS IN PRESS Bounds, M., Kram, S., Speroni, K.G., Brice, K., Luschinski, M.A., Harte, S. & Daniel, M.G. Retrospective review of the effect of ABCDE bundle implementation on intensive care unit patients’ delirium presence. AJCC. (Accepted 9/11/15) Shapiro, M., Speroni, K.G., Edsall, R. & Daniel, M.G. Relationship between emergency department patient anxiety level and provision of medication history. Nursing 2016.

(Accepted 5/25/16)

Nursing Annual Report • FY 2016

STUDIES UNDER MANUSCRIPT WRITING/ANALYSIS

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Nurse Executive Committee Ruth Ann Jones, EdD, MSN, RN, NEA-BC, Senior Vice President of Patient Care Services and Chief Nursing Officer

John Mistrangelo, ACSW, LCSW-C, Program Administrator, Shore Behavioral Health

Kathy Elliott, MSN, RN, Director of Professional Nursing Practice and Magnet® Program

Penny Aaron Pink, MS, RN, NEA-BC, CNOR, Director of Surgical and Ambulatory Services

Rita Holley, MS, BSN, RN, Director of Home Care Services

Diane Walbridge, MSN, RN, NEA-BC, Director of Acute Care and Emergency Services, UM Shore Medical Centers at Dorchester and Easton, and UM Shore Emergency Center at Queenstown

Mary Jo Keefe, MSM, RN, Director of Nursing Services, UM Shore Medical Center at Chestertown

Nursing Management UM Shore Medical Center at Chestertown Sandra Prochaska, BSN, RN, Manager, Nursing Services Peggy Roca, BSN, MBA/HCA, RN, CASA, Manager, Surgical Services Mary Alice Vanhoy, MSN, RN, CEN, CPEN, NREMT-P, Interim Manager, ED

UM Shore Medical Centers at Dorchester and Easton Martha Clark, BS, RN, Manager, Surgical Unit and Joint Replacement Center, UM Shore Medical Center at Easton Jaclyn Crawford, BSN, RN-BC, Manager, Behavioral Health Services Katherine Cvach, MS, RN-C, Regional Manager, Professional Nursing Practice Sherry Dolby, RN-BC, Manager, Requard Center for Acute Rehabilitation, UM Shore Medical Center at Easton Jane Flowers, MSN, RN, CNOR, Manager, Sterile Processing

Nursing Annual Report • FY 2016

Ryan Foster, MS, RN, CNML, NEA-BC, Manager, Emergency Services, UM Shore Medical Center at Easton

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Jennifer Miles, MSN, RN, Manager, 2 East MultiSpecialty Care Unit, Renal Unit and Neuroscience, UM Shore Medical Center at Easton Sydney Milligan, MSN, RN, Manager, Ambulatory Care Jacqueline Mowbray, MHA, BSN, RN, Manager, Shore Surgery Centers at Easton and Queenstown

Pamela Pardun, BSN, RN, CCRN, Manager, ICU and Telemetry, UM Shore Medical Center at Easton Luanne Satchell, BSN, RN, Manager, Women’s and Children’s Health Services Leigh Tomey, MSN, RN-BC, Manager, 2 East Multi-Specialty Care and Critical Care, UM Shore Medical Center at Dorchester Lauren Wade, BSN, RN, CIC, Business Manager, OR and Perioperative Services Susan Walbridge, MSN, RN, CAPA, NEA-BC, Manager, Operating Room Cathy Weber, BSN, RN, CEN, Manager, Emergency Services, UM Shore Medical Center at Dorchester

UM Shore Emergency Center at Queenstown Mary Alice Vanhoy, MSN, RN, CEN, CPEN, NREMT-P

UM Chester River Home Care Trish Focht, BSN, RN, Manager, Home Health Patricia Starkey, BSN, RN, COS-C, Regional Manager, Quality

UM Shore Home Care Amy Brockson, BSN, RN, CEN, Manager, Home Health Patricia Starkey, BSN, RN, COS-C, Regional Manager, Quality

The Magnet® Recognition Program Model of Nursing Practice

©2008 American Nurses Credentialing Center. All rights reserved. Reproduced with the permission of the American Nurses Credentialing Center.

The American Nurses Credentialing Center developed a model that guides hospitals and health systems as they apply for and maintain Magnet® designation. UM Shore Regional Health refers to the five components of the model as a guide for delivering quality patient care, for initiating process improvement initiatives and for conducting research that shapes the future of nursing practice.

UM Shore Medical Centers at Dorchester and Easton, and UM Shore Home Care achieved their first Magnet® Designation in 2008 and their second in 2014. At UM Shore Medical Center at Chestertown and UM Chester River Home Care, Magnet®-based initiatives are well in progress to establish structures, processes and outcomes so that when UM Shore Regional Health applies for redesignation in 2018, Chestertown nursing will be included.

umshoreregional.org