Nursing Annual Report - Wake Forest Baptist Health

Transcription

Nursing Annual Report
2011 – 2012
From the Chief Nursing Officer
Dear Friends and Nursing Colleagues,
I want to take a moment to observe with
awe all that our astounding team of nurses is
accomplishing.
• WakeOne training and Go-Live, with new
workflows and processes to master that will
lead to even better patient care.
• Nursing’s expanding focus on the continuum
of care rather than episodes of care, and the
patient-focused innovation this is generating
in our ambulatory and procedural areas.
Our nurses’ dedication is making a significant
and measurable difference for our patients.
For example, our rates of falls and hospitalacquired pressure ulcers are the lowest we have
ever measured. Our patients’ perception of
nursing care continues to rise. I am proud that
our nurses will continue to lead the way in the
Medical Center’s patient safety initiatives. I have the greatest confidence in the awesome
nurses of Wake Forest Baptist Health, and have
deep gratitude for all that they do.
Sincerely,
• Our nurses’ essential readiness for the
challenge and scrutiny that our 2013 Magnet
Award application (our fourth) will involve.
• And their leadership in our new
co-management structure, which is improving
communication and care.
Maureen Sintich, MSN, MBA, RN, WHNP-BC, NEA-BC
Vice President Operations, Chief Nursing Officer
I see Wake Forest Baptist Medical Center’s core
values reflected in everything our nurses do.
They strive always for excellence. They care for
patients and families with sincere compassion.
Their work shows the highest principles
of service and integrity. They welcome
diversity. Their relationships reflect warmth
and collegiality. They are proud to advance
innovation, the hallmark of academic medicine.
“Knowing is not enough; we must apply.
Willing is not enough; we must do.”
— Johann Wolfgang von Goethe
Magnet Model
The American Nurses Credentialing
Center’s Magnet designation is conferred
on organizations which demonstrate
excellence in nursing in five component
areas including Transformational Leadership,
Structural Empowerment, Exemplary
Professional Practice, New Knowledge,
Innovations & Improvements and Empirical
Outcomes, which is infused throughout
the prior four. Wake Forest Baptist Medical
Center received Magnet designation first
in 1999 and was the first hospital in the
Carolinas and the 14th in the nation to do
so. Subsequent designations were in 2003
and 2009. There are currently 395 Magnet
hospitals recognized in this international
program. Multiple designations only occur
in 2% of that group. Approximately 6.61% of
all registered hospitals in the United States
(AHA, Fast Facts on U.S. Hospitals, 2011)
have achieved ANCC Magnet Recognition®
status. Magnet status is not a prize or an
award; it is a credential of organizational
recognition of nursing excellence. A
growing body of research indicates that
Magnet hospitals have higher percentages
of satisfied RNs, lower RN turnover and
vacancy, improved clinical outcomes and
improved patient satisfaction.
Nursing & He
ues in
alth
s
s
I
al
Ca
b
o
re
l
G
Empirical
Outcomes
Innovations and
2 | 2011 – 2012 Nursing Annual Report
S t a n d a rd
CA
RI
D e l i v e ry
li
ua
Q ut
O
s
e s
C ar Sy
Exemplary Professional Practice
t
on
en a l
t
s si
Profe opm
D e v el
Ac
Re rogr
om
p Div
ers
In a
ity
n
y
iali
t
Co
lle
g
nt
Ex
c
n
io
n
ss vatio
o
2011 – 2012 Nursing Annual Report | 3
ce
Servi
I
om
pa Div
ers
In
ity
n
C
ce
n
le
el rity
eg
n
Ex
c
nt
eg
Co
lle
gia
lity
ce
Servi
I
y
n
io
n
ss vatio
o
ce
len y
rit
n t a bi l i t
C
el
Shared
Governance
P
amition
s
P
cou
rk
iew
ev
og
Recrogr
Peer
R
Tea m wo
Peer
R
ev
cog
ry
Inte
r i s c i p l i n as
Reld
at i o ns hi p
Shared
Governance
ua
co l i t y
me
s
Q ut
O
ni
m
T
EN
am t i o n
s
M
to nomy
te
s
The fruits of the tree include
autonomy, peer review, teamwork,
recognition and rewards, quality
outcomes and the standards of care.
Au
S t a n d a rd
The strength of the tree is found
in the trunk and is reflected in
decentralized decision making or
Shared Governance from which
branch the Care Delivery System,
Accountability, Collaboration, and
Professional Development.
-H
G
e s
C ar Sy
The Caritas Processes of the Theory
of Human Caring (Dr. Jean Watson)
informs an environment in which
nurses grow, mentored and nurtured
by nursing leadership.
The tree shape of the Professional
Practice Model depicts the theme of
Service Excellence, “I CARE”, in which
the trunk is the collective “I”. The
canopy of the tree is shaped like a
heart, depicting caring.
D e l i v e ry
The Nursing Professional Practice
Model at Wake Forest Baptist
Medical Center exists in a caring,
healing environment created by the
Model of Care (sun) and finds its
roots in the values of the Medical
Center’s Strategic Plan. These include
Excellence, Compassion, Service,
Integrity, Diversity, Collegiality and
Innovation.
i
s
s
Profe opm
D e v el
A
ry
Inte
a
rdisciplinG EsN
Rela ALsINhip VIRO
tioEn
N
CA
RI
N
Nursing Professional Practice Model
on
e al
A u changing tributeem
The Professional Practice Model is a living,
to and
t oNursing
illustration of nursing professional practice.
n o m ycontinues to
develop, apply, evaluate and adapt the model through program
changes, education and research.
Patient’s Prefe
rred Name
A Caring Leadership Curriculum
Pain scale
Room #
Based upon the Caring Leadership Model (developed by McDowell and
Williams) and blending Watson’s Caring Theory with the Leadership Theory
of Kouzes and Posner, the Caring Leadership Curriculum expanded to
include 42 nurse managers, 30 assistant nurse managers, 25 charge nurses
and 10 department heads from the Patient Services Division of Wake Forest
Baptist Health – Lexington Memorial Center. The group presented capstone
projects that included titles: Manager Self Care and Teambuilding, the
Value of a Bedside Nurse, What Does a Caring Leader Look Like to Staff?,
Developing a Caring Environment through Co-Creation, the Nurse in the
Mirror, You Are How You Say It, Hope in the Future of Nursing, Changing
the Reflection, Caring Through Communication and Innovation, and
Footprints of Leadership.
Room Phone #
Date
Today is
MTW
TFSS
Nursing Assistan
t
4
6
8
Family Contact
Information:
Phone #
Phone # 702-
Discharge Picku
Name
Doctor
p
Phone #
Secretary
Expected Disch
arge
Date
Goals
Caring Practice Team
“The Model of Care Committee” transitioned into the “Caring Practice
Team” after a daylong retreat at Wake Forest Baptist Health – Lexington
Medical Center in September 2011. The retreat was attended by members of
the health system. The group’s mission is to deepen and expand the caringhealing experience one person at a time through dissemination of the core
aspects of Caring Science. The Caring Practice Team has two Watson Caring
Science Institute Caritas coaches who help to increase the awareness of how
current care giving can be affected by Caring Science. In February 2012 the
group sponsored its annual Caring Conference, “Caring, Coming of Age:
Practice, Research, and Education.” Speakers included Dr. Kathi J. Kemper,
Donald Kautz, PhD, RN, CRRN, CNE,
and Gayle L. Casterline, PhD, RN,
CNE. Staff presentations included
“Caring Comes Alive in a Community
Hospital,” “The Effects of Paws,”
“Caring Hearts,” “Quilts of Hope,”
and “Healing Touch.” The day ended
with a presentation from the “Carrot
Toss Players,” with skits that demonstrated a range of caring behaviors
interacting with families and patients.
2
Name
Nurse
Day
(Lynn M. Priddy, RN, BSN, RN-BC, Watson Caring Science Institute Caritas Coach)
0
Notes
Stay
Patient-centered Care Boards
Care Boards were installed in June 2012 in 626 inpatient rooms through
collaboration with Nursing and Performance Improvement. The boards
were vetted through Nursing Shared Governance Councils, the NET-T
Educational Forum, Resident Quality Council, Quality Management
Team and the Medical Center Pain Committee. Care Boards foster
communication with our patients and families and enhance teamwork
and care coordination. By engaging patients and their families in care,
identifying team members and increasing awareness of daily goals and
plans, the Care Boards will assist in discharge planning and enhance
patient satisfaction and patient-centered care.
10
Hands of Hope
Medical Clinic
The Hands of Hope Medical Clinic
is a voluntary effort of health professionals, private citizens, businesses,
churches, foundations and other
human service agencies. It is a
community effort in Yadkin County
to provide free medical care and
resources to the sick and needy in a
loving and compassionate manner.
It was founded by Mike Williams,
BSN, RN, who worked in 4 RT ICU.
Several staff nurses from Wake
Forest Baptist Health now volunteer
for Tuesday evening clinics. Scott
West, RN, CCRN, described what
Williams did in getting the clinic
off the ground. “Last July we hired
a graduate of the Winston-Salem
State Accelerated program, Michael
Williams. During his interview, I was
amazed when he began speaking of
his interest in starting a free medical
clinic for the uninsured residents of
Yadkin County. Mike made it happen.
I am amazed with the time, energy,
and dedication it took for Mike to
put this dream into action. Mike also
recruited many of our staff nurses to
volunteer their time several hours
each Tuesday night. … (he) was
featured on News 14 Carolina.”
For more information about
Hands of Hope Medical Clinic,
go to www.hohclinic.org.
Pediatric Hematology
Oncology Nurses and a
Wedding in Scrubs
Xavier was diagnosed with acute
myeloid leukemia (AML) two weeks
after his second birthday. He began
chemotherapy treatment in May
2011 and responded very well. He
went into remission, and finished
his treatment in November 2011.
In January 2012, his mom noticed
some bruising and brought him to
the Pediatric Hematology/Oncology
Clinic, where it was discovered that
the leukemia had returned. Intense
chemotherapy was started again,
but after two rounds of treatment,
Xavier’s bone marrow showed that
the leukemia was still there. His
parents decided not to participate
in clinical trials. Rather, they wanted
his remaining days spent as relaxed
and peaceful as possible. Xavier’s
parents had been a couple for
seven years, and were engaged in
his hospital room during his first
course of treatment. At the end of
February, his mother told one of
the nurses that it was their wish to
“get married while Xavier is still with
us.” With that request, the wedding
planning began.
The nurses, along with Xavier’s
mother, became the wedding
planners. They knew
time was limited. So
they helped the bride
with every part of the
wedding, including
the dress, the rings,
the flowers, the cake,
the decorations
and the photographer. One nurse
went shopping to
help her find the
perfect wedding
dress. Another nurse
contacted her own
wedding photographer to take
pictures of the event.
A nurse whose mom
is a baker was able to
get a custom wedding
cake. As no wedding
is complete without a
shower, a surprise one
was planned. There
were several nurses in
attendance, as well as
nursing assistants, attending physicians, residents and housekeepers.
On March 3, 2012, six days after
Xavier’s mom made the request;
she and his father were married in
the chapel at Wake Forest Baptist
Medical Center. The nursing staff
wore their scrubs, and Xavier wore a
matching blue outfit. He rode down
the aisle in a little red wagon, with
a sign that said “Just Married” on
the back. Xavier spent the last two
months of his life in the hospital, and
this is a very special memory that
his parents will hold forever in their
hearts. (Brittany Davis, BSN, RN, CPN)
About our Daisy Award Winners
want to highlight a profoundly awesome thing that Lynn
“ IChambers
did for a family and all of us in the ICU. We had
a patient who died unexpectedly, but not surprisingly, in the
early morning hours. We could not get in touch with the wife
for some time and because of bed crunch and policy issues,
the body had to be moved to the morgue. The wife eventually
arrived and wanted to see her husband for closure. The
morgue, for obvious reasons, does not allow families to view a
body there, so we had to come up with a way to bring the body
back for the wife to see him. Needless to say, this was a major
undertaking that Lynn personally became involved with and
went above and beyond her duty for. She made sure the patient
appeared peaceful and not “morgue-ish.” The family was so
delighted and thankful. This truly was a big deal for them and I
cannot express to you the enormous effort
it took to accomplish this. This was true
human love and compassion in a very
busy, sterile world. Lynn’s efforts, in
addition to the staff that assisted, made
the world a better place.
”
Submitted by Steve Zanders, DO,
FCCP, Assistant Professor of
Medicine, Pulmonary/Critical Care,
Allergy and Immunology
was called as a team member of the Healing Touch Consult team to the
“ IBone
Marrow Transplant Unit by Jorge Garcia to see a young male patient on
the unit. This man was very ill and this particular day was not a good one. The
patient was struggling to breathe and would not calm down. I worked with the
patient for 10 minutes and was unable to help calm him. Jorge put his face down
to the patient’s face to talk and listen to him. He explained what might help and
the things he would need to do to make the patient feel better. Eye to eye, Jorge
asked for this patient to trust him, to accept the help he promised, Jorge tenderly
held the patient for a moment, then immediately began to do the work. He gave
IV medication, turned the oxygen higher, and communicated to the family and
physician, all the while talking and explaining to the patient.
We pride ourselves in being I CARE — that is “being” with another and actively
listening. Jorge did both of these without question. He was the voice for a young
man who is losing his personal fight and he was strong enough to stay and just
“be” with this young man who was beginning his transition journey. Jorge remained
calm and never strayed from the truth of what was in store for this young man, but
communicated to him in ways that he understood. It was obvious this patient and
his nurse had developed a relationship founded on mutual trust and care. I was
never more proud of the nursing profession as I was watching the two of them
interacting. I am proud of Jorge and all the nurses who work in the high-intensity
care setting. He truly demonstrated to me the finest and best of our hospital and
our profession.
”
Submitted by Julie Jones, MSN, RN, CHTP
Nursing Shared Governance Councils
Nursing Executive Council
New Uniforms Address the Patient Experience
(Janice Draughn, RN; Maureen Sintich, MSN, MBA, RN, WHNP-BC, NEA-BC)
For most hospital patients, keeping track of the numerous members
of their health care team can be like learning a hotel’s television
channel lineup — difficult to do without a printed guide. To address
the confusion of many patients, families, visitors and even staff, the
Medical Center transitioned to a new professional look. The new
policy affects about 5,000 employees, or 40 percent of the main
campus workforce. Nursing, the largest group of employees, was
given first choice of colors. The members of the Nursing Executive
Council (NEC) narrowed choices to two colors for RNs, LPNs, CMAs
and CNAs. A fashion show featuring
both colors and several styles was
held and nursing staff voted on
their choice. Although employees
initially receive, at no cost, enough
scrubs or uniforms to cover their
typical weekly shifts, they have
the option of purchasing
additional uniforms
through the Gift
Shop, which has
partnered with the
uniform supplier,
Scrubwagon, a
Winston-Salembased company.
NEC addressed
individual nurses’
concerns and
feedback through
The VOICE at regular
Council meetings.
The Nursing Executive Council (NEC) provides leadership and direction to
all Nursing Shared Governance Councils. It serves as a clearinghouse for
issues being presented and disseminates them to the appropriate Council
for action.
The VOICE is a mechanism that provides staff with an electronic means
to anonymously communicate important issues and concerns. The VOICE
concerns lead the agenda of the NEC. There were 106 requests submitted to The VOICE, with topics ranging from
clinical practice issues and suggestions
to the need for increased services
from other departments. The
council discussed and
assigned questions related
to uniforms, equipment
and supplies, scheduling
and education to
the membership. A
tracking and feedback
mechanism was
developed.
Nursing Leadership Council
Patient Family Education Documentation (Kimberly Stanbery, BSN, RN, OCN, Heather Freeman, RN, BSN, CPN)
100%
Management/Leadership Council is a forum for information
sharing with representation from each Housewide Shared
Governance Council and RNs representing all levels of nursing.
The emphasis is on vertical and horizontal communication
between the bedside nurse and the Chief Nursing Officer.
Key responsibilities include:
90%
•Forum for recognition (Daisy Award, CNO recognition,
Nursing Unit Recognition).
•Updates related to pertinent process-related issues.
•Multidisciplinary presentations related to process outside of
nursing that affect nursing or that nursing can affect.
•Forum for managers to discuss and resolve management issues
to improve consistency throughout.
80%
84
87
88
Overall Scores
90
91
70%
60%
50%
40%
30%
20%
10%
0
2QT 11
3QT 11
4QT 11
1QT 12
2QT 12
Nursing Practice Council
(Jennifer Montgomery, BSN, RN, Warren Bost, BSN, RN, Jennifer Holthof, RN)
The Nursing Practice Council is responsible for changes in policies and
procedures and collaborative practice with the interdisciplinary team.
Members worked to complete monthly Patient and Family Education
(PFED) audits, validated the Central Line Associated Blood Stream Infection
insertion and maintenance bundles, completed bimonthly CLABSI bundle
audits and updated the central venous catheter policy to follow Centers for
Disease Control and Prevention guidelines. 2011 – 2012 Nursing Annual Report | 9
Nursing Quality Council
(Brandy Edmiston, RN; Kate L Przybylowicz, BSN, RN, FCCS)
Nursing Quality Council focused
on several best practices this year,
including its continued quarterly
skin monitors, support of the falls
prevention program, and using
evidence-based practice to develop
a Catheter Associated Urinary Tract
Infection (CAUTI) program. The
council participated in ongoing
CAUTI audits that improved
overall practice of interdisciplinary
discussions of foley necessity, care
and early removal. The council
continued to team with pharmacy
to minimize issues related to
work flow, feedback on policy
and practice and developed the
Good Catch program to recognize
nurses instrumental in preventing
medication errors and near misses.
Traci Kirkner
Michelle
Howell
Carolyn Fulton
Leslie Butcher
Debbie Smith
Stacey Snow
Stephanie
Plattel
Nancy Bennett
Photo not
available
Aileen
Malimban
Angela Yancey
Rebecca King
LeStarr
Hannah
Good Catch Recipients, 2011
Good Catch Recipients, 2012
July: Traci Kirkner, RN, CPN
August: Michelle Howell, BSN, RN, CPN
September: Aileen Malimban, RN
October: Angela Yancey, RN
November: Rebecca King RN
December: Erin Heller, RN
January: Carolyn Fulton, RN
February: Leslie Butcher, RN
March: Debbie Smith, RN
April: Stacey Snow, BSN, RN, CPN
May: Stephanie Plattel, RN
June: Nancy Bennett, BSN, RN, CPN
July: LeStarr Hannah, BSN, RN
Advanced Practice Nurse Council
(Melissa Coble, RN, NNP)
The Advanced Practice Nurse Council expanded
to include Physician Assistants in addition to Nurse
Practitioners and Certified Nurse Anesthetists,
Certified Nurse Midwives and Clinical Nurse
Specialists. The Council finalized a peer review
document that was incorporated into the credentialing
process for APNs. It reviewed the process for
collaborative practice agreements and established
a goal to create a forum/structure for the growing
number of advanced practitioners in the Medical
Center (currently 312 credentialed providers).
Professional Development Council
(Suzanne Breedlove, RN, CCRN, Brittany Davis, BSN, RN, CPN)
The Professional Development Council (PDC) defines, implements and
maintains educational standards that promote professional growth
and ongoing clinical competency. The council promotes recognition of
nursing achievements and supports specialty certification.
Critical Care Divisional Council
The PDC facilitated the following activities this year:
(Cheryl Bullins, RN)
•Developed annual clinical competencies for RN, NA and US positions.
The Critical Care Divisional Council works to bring
forward practice and workplace issues from the
adult intensive care units. Nurses brought to the
meeting an issue with hydraulic arms for the portable
computers within the ICU environments. There were
reports of nurse injuries as well as broken hydraulic
arms. Nursing Clinical Systems has an ad hoc position
on the council and, together with staff nurses, set
up with stakeholders including Information Services.
A walk through of the units was completed to gain
an understanding of the depth of the problem.
Temporary measures were put in place and meetings
were scheduled with potential vendors for nursing
to review for safety and workability with the input of
Information Services. A new arm was selected and
trialed in 5A ICU. The new arm was an improvement,
so it was purchased and installed.
•Nursing Excellence Awards: 56 nurses were recognized for their
commitment to excellence, innovation, compassion, integrity, caring
and collegiality within their practice area.
•Nurses Week: Activities included a unit poster contest, nurses rally,
Caring for the Caregiver Conference, and Munchies with Maureen,
Chief Nursing Officer.
•Certified Nurses Day: Council members hand-wrapped cupcakes,
attached a thank you card and delivered each of the cupcakes to
more than 500 certified nurses.
•Concluded the Career Advancement Program (CAP).
•Developed the New Clinical Ladder to replace CAP.
The Clinical Ladder provides a program for RNs at the bedside to
receive recognition for the knowledge, quality performance and level
of experience they bring to their chosen field of practice. Career
advancement, financial compensation and professional growth are
enhanced as a result of involvement in the program. This program
provides eligible RNs the opportunity to progress on a clinical career
ladder consisting of a number of four-position levels.
2011 Education Fair
The Professional Development
Council held the Education
Fair in November 2011 and
more than 130 attendees
obtained information about
the opportunities available for
education. Twelve schools of
nursing were represented and
included distance learning
and traditional programs. The
Armed Forces were represented by the U.S. Army and a
Kaplan Test Prep person was
available to answer questions
regarding GRE Test Prep.
Shared Governance Chair Support Group
Nursing Education and the NET-T Forum
(Judy McDowell, MSN, RN,CCRN)
Nursing Education, in collaboration with Nursing Research and the
Simulation Program Coordinator, Mechelle Mumford, MSN, RN, CMS, developed new hire simulations called “I CARE Exchange.” The simulation
is attended in the first 90 days and included scenarios addressing changes
in patient condition, bedside reporting and measures to decrease hospital
acquired conditions (HAC). With a focus on quality and safety, the first HAC
classes were developed and included in several programs in collaboration
with Nursing Quality and Compliance. I CARE classes with simulation labs
were offered to Certified Nursing Assistants (CNAs). The CNA Skin College
simulations were implemented as part of the Save our Skin Program. Foley
skills labs included tips and tricks for insertion and maintenance of Foleys
in a collaborative project with urology residents to decreased CatheterAssociated Urinary Tract Infections (CAUTI). Other interdisciplinary projects
included those addressing SEPSIS, C Diff and Central Line Associated
Bloodstream Infections (CLABSI).
The Shared Governance Chair Support Group has met on a monthly
basis with attendance from across the Medical Center. This meeting
includes a sharing of successes and opportunities presented by each chair
in attendance, as well as leadership development based upon Kouzes
and Posner’s leadership theory. The meetings are themed and include
examples for openings and closings, reference material and takeaways
for all. Chairs are encouraged to use these concepts and materials in their
own individual SG meetings. Themes were: 2011
July: Leadership Lessons from our Founding Fathers
August: A New Breed of Leader
September: Lessons from a Deck of Cards
October: The Power of Storytelling
November: The Power of Thank You
December: Encouraging the Heart
2012
January: The Power of Appreciation
February: The Power of Please
March: The Power of Pause
April: The Power of Words
May: The Power of Purpose
June: The Power of Positivity
The Novice to Educational Transformation Team (NET-T Forum) increased
its meetings to twice monthly to cover the increased initiatives in nursing
education this year and timely dissemination of information. The group is
comprised of staff development instructors, Nursing Practice Specialists
and Clinical Educators. Meetings included topics related to professional
development of the nurse educator as well as clinical content related to
initiatives such as CAUTI, competency development, Blood Administration
and Restraint Education. Numerous clinical practice updates were rolled out
through the group.
ONE STOP, the education communication tool that was the result of a VOICE
request to Executive Council, transitioned to a new look and continued to
update nurses throughout the Medical Center on “payday Thursdays.”
The Nursing Academy was developed for the newly licensed registered nurse
to participate in orientation activities on several units before completing
their 90-day probationary period and as a strategy to decrease time to fill.
Rather than hiring directly into one nursing unit, many nurses oriented on
two medical/surgical units or combined with work in the Intermediate Care
Unit before choosing a home base. A total of 46 nurses participated in the
Nursing Academy.
Nursing Quality and Compliance
Staffing and Scheduling Initiatives
Nursing Quality and Compliance was involved in three
successful surveys with The Joint Commission this past year.
WakeOne training
Lexington Medical Center
The Joint Commission conducted a triennial accreditation survey
of Lexington Medical Center the week of Thanksgiving. The
surveyors praised the Medical Center for several of its patient
care practices and especially commented about the maintenance
of the Medical Center. There were no conditional findings cited
and all required responses were submitted and approved.
Re-accreditation was awarded for a three-year period, with the
cycle effective beginning Nov. 24, 2011.
Wake Forest Baptist Medical Center
The Joint Commission conducted a triennial accreditation survey
of Wake Forest Baptist Medical Center during the first week of
December 2011. The survey was a tremendous success, with the
Survey Leader extolling the excellent practices found throughout
the Medical Center during the survey. There were no conditional
findings cited and the majority of the cited findings were corrected
before the surveyors left. All required responses were submitted
and approved. Re-accreditation was awarded for a three-year
period, with the cycle effective beginning Dec. 10, 2011.
Davie Hospital
The Joint Commission conducted a triennial survey of Davie
Hospital on Aug. 23 – 24, 2012. The surveyors praised the Davie
staff on their desire to learn and grow. There were no conditional
findings cited and all required responses are being prepared for
submission and approval. Granting of an accreditation decision is
expected in November 2012.
In preparation for development and training, staff nurses moved out
of their primary positions to assume roles as developers, credentialed
trainers, and superusers for the new Electronic Health Record system.
To ensure a safe environment for patients, contract nurses were oriented
and participated in caring for patients. Many other initiatives were
implemented to address staffing and scheduling in the inpatient and
outpatient settings.
Cross-training staff
Several areas have developed cross-training initiatives for staff. The
Hematology/Oncology areas developed a cross training program for
staff in 9 RT, 9 NT, BMT, 9 AE, 10 RT, II NT and 4A ICU. All staff received
orientation on sister units when hired and can float to any unit as the need
arises. Nurses work in teams or have varied assignments when floated
to a higher level of care to ensure patient safety and that work is within
competencies.
5A ICU and 5 RT have a voluntary program for cross training those nurses
who exhibit readiness to care for stable ICU patients. Nurses in 5 RT
attended all appropriate specialty classes for ICU training and worked
with a preceptor taking care of table heart surgery patients and patients
with lung surgery. The 5A ICU staff floats to the floor during high acuity
and to provide support and act as resources for new staff, especially on
the night shift.
Sitter Pilot 5 RT
The staff on 5 RT engaged family members as sitters when one of the
elderly patients complained about privacy because of the constant
presence of a stranger in her room. After assessment of appropriateness,
the nurse manager or charge nurse discussed the goals and guidelines
with a family member. The pilot lasted two months and family provided
370 sitter hours for a savings of $3,012. Patient and family satisfaction
were enhanced. There were no falls among these patients. The pilot is
currently being considered for housewide implementation.
Wound Care Team 10 NT/Burn ICU
A dedicated wound care team allows staff to maintain consistent level of
service during lengthy wound dressing changes (two to three hours).
Level I Trauma and Emergency Department
A Level I Trauma patient comes to the Emergency Room and goes
to the CT scanner (total body) and then either goes to the Operating
Room directly or to the Trauma Intensive Care Unit for fluid resuscitation,
blood, traction application, etc., rather than returning to the Emergency
Department. In addition to improving patient outcomes, this process
allows the Emergency Department staff to care for their current volume of
patients, without diverting staff to a patient with intensive needs.
MICU Palliative Care Nurse Specialist
The Medical Intensive Care Unit (MICU) is currently piloting an MICU
Palliative Care Nurse Specialist position. It is already receiving positive
feedback and praise from staff members from all disciplines as well as
family and patients related to the positive effect on the patient-family
experience in the MICU.
Caregiver Stress
The Caregiver Stress Task Force, renamed Nurses for Integrative Therapies,
sponsored quarterly Healing Touch sessions for staff, families and visitors.
Healing Touch, a gentle, relaxing energy therapy, helps to balance the
physical, mental, emotional and spiritual well-being. Members of the task
force provided Healing Touch for night staff. In collaboration with Action
Health and Pastoral Care, the group has sponsored Integrative Therapy
Conferences in which attendees sample caring modalities. The task force is
also working with pastoral care to address Compassion Fatigue.
The following categories demonstrate
accomplishments of our nurses in being
published, making presentations and
winning grants.
Publications
Hubbartt, B., Davis S.G. & Kautz, D. (2011, September – October). Nurses’ experiences with bed exit alarms may lead to
ambivalence about their effectiveness. Rehabilitation Nursing,
36(5): 196 – 199.
Butner, Stephanie, BSN, RN. (2011). Rapid response team effectiveness. Dimensions of Critical Care Nursing, 30(4):201/205.
Rash, Wendy, BSN, CEN. (2011). Hyoid/thyroid fracture. Journal of Emergency Nursing, 37(2):182 – 3.
Kemper, K., Bulla, S., Krueger, D., Ott, M.J., McCool, J.A. & Gardiner, P.
(2011, April). Nurses’ experiences, expectations, and preferences
for mind-body practices to reduce stress. BMC Complementary
and Alternative Medicine, 11;11:26.
Thomson, S. (2011). Transition into practice: a comparison of outcomes between associate- and baccalaureate-prepared nurses
participating in a nurse residency program. Journal for Nurses in
Staff Development, 27(6), 266 – 271.
Hubbartt, B., Corey, D. & Kautz, D. (2012). Prayer at the bedside. International Journal for Human Caring, 16(1), 42 – 47.
McLean, S.A., Soward, A., Ballina, L., Rossi, C., Rotolo, S., Wheeler, R.,
Foley, K., Batts, J., Casto, T., Collette, R., Holbrook, D., Goodman,
E., Rauch, S., & Liberzon, I. (2012, June). Acute severe pain is a
common consequence of sexual assault. Epub.
Danhauer, S.R., Tedeschi, R., Jesse, M., Vishnevsky, T., Daley,
K. & Carroll, S. (2012, June). A longitudinal investigation of
posttraumatic growth in adult patients undergoing treatment
for acute leukemia. Journal of Clinical Psychology in
Medical Settings.
Presentations/Lectures
Dinkins, Laura, RN (2012, July). All about
Me: Getting to the Heart of Knowing Your
Patient. Poster presentation at the Watson
Caring Science Institute and World Caring
Conference in Boulder, CO.
Butcher, Wendy, BSN, RN, CCRN (2012,
May). Mobility matters: Get up off of
that bed. Evidence-based practice and
technology to improve surgical ICU patient
mobility and outcomes. Poster presentation
at National Teaching Institute and Critical
Care Exposition, Orlando, FL.
Mumford, Mechelle, MSN, RN, CMSRN
(2012, March). Lesson learned: Bringing the
simulation to life. Podium presentation at
health care conference, Fort Lauderdale, FL.
Blake, P., MSN, RN, NEA-BC, CENP &
Boles, K., BS, RD, LDN, NACHRI (2011,
October). FIT: Telemedicine Adaptations
for Pediatric Weight Management in Rural
Populations at the National Association
of Children’s Hospitals and Related
Institutions. Poster presentation at Annual
Leadership Conference, Washington, DC.
Krueger, D.L., MSN, RN, NE-BC, CNRN,
CHTP, Bulla, S., RN, PhD & Madden, P., RN,
ANCC (2011, October). The art and science
of caring. Podium presentation at National
Magnet Conference, Baltimore, MD.
Mumford, Mechelle, MSN, RN, CMSRN
(2011, August). Lessons learned: Bringing
the simulation to life. Podium presentation
at 3rd Annual You Bought the Manikin, Now
What? Best Practices in Simulation Training
Conference, Greensboro, NC.
Krueger, Deborah L., MSN, RN, NE-BC,
CNRN, CHTP (2011, June). Addressing
caregiver stress through healing touch.
Poster presentation at American Holistic
Nurses Association Annual Meeting,
Louisville, KY.
Awards/Grants
Watters, Carol, EdD, ACNS-BC (2011, May).
Bisphosphonate therapy: The potential risk of
subtrochanteric fractures. Podium presentation
at NAON Congress, Baltimore, MD.
Gena Near, BSN, RN, CPAN, was awarded
the American Society of PeriAnesthesia
Nurses President’s Award. Gena has been
an active member of ASPAN since 1990.
Kemper, K.J., MD, MPH. Bulla, S., RN, PhD,
Krueger, D.L., MSN, RN, NE-BC, CNRN,
CHTP, Ott, M.J., MN, MA, APRN-BC, McCool,
J., RN, PhD, AHN-BC & Gardiner, P., MD,
MPH (2011, May). Nurses’ experiences,
expectations, and preferences for mind/
body practices to reduce stress. Poster
presentation at 6th International Congress
on Complementary Medicine Research,
Chengdu, China.
The Community Training Center for
American Heart Association (AHA)
Emergency Cardiac Care Program’s staff
completed update sessions highlighting
the AHA’s 2010 resuscitation guidelines
revisions for more than 700 affiliated
instructors from across North Carolina.
Krueger, D.L., MSN, RN, NE-BC, CNRN, CHTP
& Bulla, S., RN, PhD (2011, April). Addressing
caregiver stress through healing touch. Poster
presentation at Women’s Health Research
Day, Women’s Health Center of Excellence for
Research, Leadership, Education, Wake Forest
Baptist Medical Center, Winston-Salem, NC.
Freeman, Heather, RN, BSN, CPN (2011, March).
Pediatric patient satisfaction: Utilizing Six Sigma
as a quality initiative. Poster presentation at
National Association of Children’s Hospitals
and Related Institutions Creating Connections
Conference, Baltimore, MD.
Adamski, Sharon, MSN, RN (2011, March).
Providing comprehensive palliative care
in your community. Panel presentation at
National Association of Children’s Hospitals
and Related Institutions Creating Connections
Conference, Baltimore, MD.
Sintich, M., MSN, RN, MBA. Developing a
Care Delivery System; From Deficiency to
Innovation. Podium Presentation 2011 ANCC
National Magnet Conference, October, 2011.
Baltimore, MD.
Sintich, M., MSN, RN, MBA. Co-Management
in a Caring Environment — Nurses Effecting
Change Throughout the Academic Medical
Center. Poster Presentation 2011 American
Organization of Nurse Executives National
Conference, April, 2011. San Diego, CA.
Kim Hutchinson, EdD, RN, was appointed
as a representative of the North Carolina
Nurses Association. Hutchinson will serve
a four-year term to the Nursing Advisory
Committee for Drug Monitoring Programs
for the North Carolina Board of Nursing.
She is board certified in psychiatric mental
health nursing and addictions nursing.
Marcy Poletti, MSN, RN, and Kim Stanbery,
MSN, RN, OCN, were chosen for one
of the 40 competitively selected teams
from cancer institutions across the nation
to attend the “Improving Quality of Life
and Quality of Care for Oncology Family
Caregivers,” in Anaheim, CA, in July 2011.
Steve Davis, RN, and Denise Tate, AS, CS,
Nursing Clinical Systems Administrative
Project Coordinator, received awards from
the North Carolina Triad affiliate of Susan
G. Komen for the Cure®.
Lynn M. Priddy, RN, BSN, RN-BC,
completed the prestigious Watson Caring
Science Institute (WCSI) Caritas Educational
Program and is now a Caritas Coach.
Life Support Education has received grant
money from the Childress Institute for
Pediatric Trauma to conduct Pediatric
International Trauma Life Support provider
and instructor courses. The grant objective is
to improve the quality and capability of EMS
systems’ management of pediatric trauma,
thereby ultimately improving outcomes
for pediatric trauma victims through the
provision of a sustainable program of EMS
pediatric trauma care training.
The Center for Nursing Research received
an educational $4,000 grant from Wake
Forest School of Medicine alumna
Dr. Caryl Guth. Guth has long been a
supporter of integrative therapies, and
this educational grant is her second
contribution to Healing Touch. The money
will be used to assist in the education
and implementation of Healing Touch
in the Medical Center. Nurses awarded
scholarships from this money include:
Tamatha Adkins-Ford, BSN, RN, Deborah
Hord, BSN, RN, Misty Cheesman, BSN,
RN, Katherine Kruppenbach, BSN, RN,
Sharon Rodriguez, BS, RN, Elizabeth
Brown, BSN, RN, Eileen Tague, BSN, RN,
Jeannie Leggett, RN, Tracy Brumbeloe,
RN, Jody Cuellar, BSN, RN, Joyce, Koskey,
BSN, RN, Sharon Humston, BS, RN and
Drema Britt, RN.
The Center for Nursing Research received
a grant from the Daisy Foundation to
study the Efficacy of Healing Touch
versus Guided Imagery on Pain, Fatigue,
Nausea and Anxiety in Patients’ Receiving
Outpatient Chemotherapy. The study
team is: Principal Investigator, Lisa
Hodges, RN; study team member, Sally
Bulla, PhD, RN, Deborah Larrimore, BSN,
RN, LMBT, Deborah Krueger, MSN, RN,
NE-BC, CNRN, CHTP, Ashley Fleetwood,
LMT, CHTP and Kathleen Siegel, MSN,
RN, CHTP. The objective is to determine if
the provision of Healing Touch or Guided
Imagery during outpatient chemotherapy
when compared to standard practice is
associated with decreased pain, fatigue,
nausea and anxiety.
Structural Empowerment
Nurses who make commitments to the community
they serve and to their professional development
enhance not just the care of patients, but the image
of nursing and what it can do in a broad sense.
Professional Development of Nurses
Scholarship Recipients 2012
•Donna Lynn Eaton Memorial Scholarship
– Brant Vanhoy, Nursing Student, Winston-Salem State University
– Cailin Ward, Nursing Student, Appalachian State University
•Gwendolyn J. Andrews Nursing Scholarship
– April Roberson, RN, Emergency Department
•Edna L. Heinzerling Award for Nursing Excellence
– Suzanne Breedlove, RN, ICU-5A
– Olivia Ogburn, RN, BSN, 9North Tower
2012 Great 100
All RN Certification
Maureen Sintich, MSN, MBA, RN, WHNP-BC, NEA-BC, Vice President, Operations/Chief Nursing Officer
600
Number of RN FTE certifications
Brenda Kelly, RN, MA, NEA-BC, Director of Nursing
Julie Jones, MSN, RN, CHTP, Nursing Research Associate
500
Laura Dinkins, RN, Acute Care of the Elderly
RN FTE
completed
400
Elizabeth Goodman, RN, SANE, Emergency Department
David Barber, RN, Emergency Department
Brittany Davis, RN, 9 Brenner Children’s Hospital, Hematology/Oncology
Goal
300
Robin Inabinet, RN, Dermatology Surgery Provider-based Clinic
Chantel Mayton, RN, Lexington Medical Center
200
100
0
2009
(starting point)
2010
(1st year increase)
2011
(2nd year increase)
2012
(3rd year increase)
Schools of Nursing Affiliations
Wake Forest Baptist Health provided nursing education for programs from the following institutions
in 2011: Appalachian State University, Davidson Community College, Duke University, Eastern Carolina
University, Forsyth Technical Community College, Gardner-Webb University, Johns Hopkins University
School of Nursing, Lenoir-Rhyne University, Liberty University, University of Massachusetts – Boston, Mitchell
Community College, North Carolina A&T University, North Dakota State University, Northwest AHEC,
University of South Carolina, South University, University of Southern Alabama, Stony Brook University,
Surry County Community College, Tennessee Board of Regents (six universities), University of North
Carolina (Chapel Hill, Charlotte and Greensboro campuses), Vanderbilt University, Walden University,
Western Carolina University, Wilkes Community College, Winston-Salem State University.
Nurse Excellence Awards 2011
Nurse Excellence Awards 2012
Marivic Alconaba, BSN, RN
Pamela Baldwin, BSN, RN
Jean Benton, BSN, RN
Ashley Boddie, RN
Sherry Bolinger, BSN, RN
Leslie Boyles, RN
Holly Burdette, BSN, RN
Nancy Caino, RN
Elizabeth Carter, BSN, RN
Elizabeth Casstevens, RN
Brittany Davis, BSN, RN
Melissa Dent, RN
Amber Draughon, BSN, RN
Beth Driscoll, RN, BSN
Megan Ezelle, BSN, RN
Renee Feimster, BSN, RN, CNN
Chris Gray, RN
Marlene Hairston, BSN, RN
Megan Harless, BSN, RN
Anna Harvey, BSN, RN
Lindsay Hazlip, BSN, RN
Sarah Hembree, RN
Juanice Kilgo, BSN, RN
Robert Light, RN
Jennifer Link, BSN, RN, CCRN
Anika Lyerly, BSN, RN, NE-BC,
Joy Malit, BSN, RN
Crystal M. Anderson, BSN,RN, SANE
Pamela Ascano, BSN, RN,CMSRN
Phyllis H. Ballance BSN, RN, CNN
David L. Barber, RN, FNE
Kristina Bodenheimer, BSN, RN
Sandra M. Bowman, RN
Courtne Wells Brunt, RN
Joanne Buckner, RN
Melisa Buljina, BSN, RN
Blossom R. Bullard RN-BC
Sherry C. Burleson, BSN, RNC-NIC
Pam Casey, BSN, RN
Elisabeth Chinlund Young, RN
Duffin Clark, BSN, RN, CMSRN
Nancy Jane Crouse, RN
Wanda Bean Cruise, BSN, RN
Renata G. Drake, BSN, RN
Sonja Eads, RN
Jennifer Ann Harris, RN
Lisa G. Harris, BSN, RN
Margaret H. Harrison RN
Casey J. Hodgin, BSN, RN
Robin T. Inabinet, RN
Elizabeth K. Johnson, BSN, RN
Jamie Lee Jonas, BSN, RN
Julie Marie Jones, MSN, RN, CHTP
Temple M. Kellermann, MSN, RN, CNOR
Karen W. Kiger, BSN, RN
Marwa Massry, BSN, RN, CCRN
Shelia McKinnon, BSN, RN
Lisa Montgomery, RN
Lindsey Pace, BSN, RN
Corey Paris, BSN, RN
Crystal Parks, RN
Leah Payne, RN
Patti Pepper, RN
Hanh Pham, BSN, RN,
Kristina Pietsch, BSN, RN
Leslie Regan, BSN, RN
Pedro “Joel” Resuello Jr., BSN, RN
Summer Richardson, RN
Carolyn Roberts, RN
Aimie Shipley, BSN, RN
Candice Shumate, BSN, RN
Jennifer Spencer, RN
Benjamin Steinberg, BSN, RN
Suzanne Storment, BSN, RN
Matthew Strong, RN
Amy Taylor, BSN, RN
Molly Toda, BSN, RN
Joyce Uy, BSN, RN
Ashley Webster, BSN, RN
Cynthia Willard, RN
Ronda Wilson, BSN, RN
Denise Wirick, BSN, RN
Traci Kirkner, RN, CPN
Katie Hall Kruppenbach, BSN, RN, CPN
Diane M. Laudy, BSN, RN
Sandi Layell, RN
Rebecca Renee Lewis, RN
Robin A. Lewis, BSN, RN, CBCN
Michele M. Lizano, BSN, RN
Teirraha Lowe, BSN, RN, CPN
Edith Maisano, BSN, RN, MSCRN
Trish Maranville, RN
Maritoni T. Marbella, BSN, RN
Laura Hinshaw Merritt, RN, CNOR
Bernadine Y. Minor, BSN, RN,CHPN
Tracie S. Moore, BSN, RN
Lindsay Morris, BSN, RN, CPN
David O’Brien, BSN, RN, OCN
Moradeke Omolola Ojo, RN
Maggie Nicole Osborne, RN, SANE
Stephanie B. Phelps, RNC
Jennifer L. Richardson BSN, RN
Jessica Ridley, BSN, RN, MS, CMSRN
Kim Stanbery, BSN, RN, OCN
Crystal G. Thompson, RN
Sabrina W. Walter BSN, RN
Sarai Yvonne Wiggins, BSN, RN
Jennifer L. Wilson, RN, BSN
Megan L. Yountz, RN
Certified Nurses 2012
Amanda Adamski • Sharon Adamski • Cynthia Adkins • Tamatha Adkins- Ford • Sharon Alcorn • Faith Allis • Roseanne
Amos • Nicole Annis • Margaret Arp • Tonya Artz • Pamela Ascano • Tammy Ashburn • Cherie Avants • Susan
Bachmeier • Lynn Bailey • Matthew Bailey • Leslie Baity • Stacey Baker • Phyllis Balance • Pamela Baldwin • Crystal
Bandy • Dawn Banks • Vivian Barbee • David Barber • Claire Bauman • Nancy Baxter • Brillante Bayaca • Molly Beal •
Rebecca Beauchamp • Donna Bell • Monica Bell • Jennifer Benifield • Nancy Bennett • Stephanie Bennett • Karen
Benson • Jennifer Bentley • Jean Benton • Amber Berger • Nancy Bivona • Timothy Black • Robin Blackburn • Kevin
Blake • Penny Blake • Penny Blake • Michelle Blakely • David Bodsford • Michelle Bohannon • Marsha Bolen • Amber
Bolin • Allysen Boonbumrung • Teresa Borgending • Connie Bower • Candace Bowman • Leslie Boyd • Lisa Brady •
Beverly Branch • Rachel Brandin • Deborah Brasher • Diane Breeden • Patricia Brenner • Stacey Brickell • Lindsey Brim
• Priscilla Brim • Makia Britt • Cindy Lou Brock • Trena Brooks • Teresa Brotherton • Jennifer Brown • Elizabeth Brown
• Linda Brown • Edward Bryan • Coriena Buckaway • Blossom Bullard • Carol Bullard • Sarah Bullock • Holly Burdette
• Sherry Burleson • Dianah Burnette • Pamela Burris • Rachel Burti • Kathy Bussolati • Wendy Butcher • Amanda Butler
• Marian Byerly • Amy Cage • Nancy Caino • Alycia Caldwell • Jacqueline Camp • Diane Campo • Sherri Capizzani •
Rosalia Caranay • Tammy Cardwell • Suzanne Carroll • Angel Cartagena • Elizabeth Carter • Cathy Carter • Kelli
Carter • Patricia Carter • Tina Casio-Arey • Andrew Cassell • Shirley Cates • Angela Caudle • Kimberly Cavenaugh •
Debbie Cereceres • Mary Chaffin • Sarah Chalk • Jacqueline Chapman • Lauren Chavis • Amanda Cheek • Joni
Chilson • Timothy Chilson • Duffin Clark • Sharon Cline • Lydia Clingerman • Kristi Coe • Nakishia Coleman • Mary
Collins • Michelle Collins • Randy Collins • Crystal Combs • Jennifer Compere • Wanda Conaway • Jay Cook • Sheri
Cook • Kathleen Cooper • Tiffany Cope • Mary Copus • Denise Corey • Karen Cornett • Paula Correa • Arnold Cortez
• Eva Cowan • Kay Cowen • Sally Cowgill • Donna Craven • Kari Crawford • Meji Crawford • Maria Creed • Teresa
Crowe • Janet Crumpler • Jody Cuellar • Indier Culbertson • Angie Cullen • Brandy Culler • Regina Curry • Sarah
Dalrymple • Cynthia Dalton • Amy Dalton • Rebecca Damron • Tracy Daugherty • Brittany Davis • Allison Davis • Paula
Dawson • Elizabeth Deatherage • Melissa Dent • Mary Dixon • Emily Draughn • Patricia Dunlap • Heath Earley •
Ashley Easter • Vera Eckard • Barbara Edwards • Miranda Edwards • Barbara Edwards • Jenny Elliott • Dawn Engles •
Rita Epperson • Linda Esposito • Beverly Essick • Edna Evangelista • Joy Everly • Megan Ezelle • Anna Faust •
Catherine Feaster • Renee Feimster • Li Fenqiun • Emily Fischer • Kristina Foard • Patricia Ford • Chris Foster • Sonja
Foster • Stephanie Fournel • Jill Fowler • Shawn Foy • Cynthia Francisco • Jane Franklin • Heather Freeman • Carolyn
Fulton • Lisa Gaither • Carlotta Gardin • Trina Gatling • Bertrand Gay • Virginia Gerrity • Robin Gibson • Sean Giese •
Julie Gilbert_Kasper • Yasmeen Girardeau • Maria Giron • Lisa Gniewek • Heather Godwyn • Jason Goodin • Elizabeth
Goodman • Terri Gordon • Amy Graham • Connie Greene • Cynthia Greene • Sarah Grenon • JoAnna Gresham •
Angela Griffin • Kent Griffin • Karen Grijalva • Linda Groover • Susan Grubbs • Robin Hack • Ginger Hahn • Marisela
Hairston • Stephanie Haley • Julie Hall • Rose Hall • Sandra Hall • Rebecca Hamby • Scottie Hamby • Lauren Hancock
• Sharon Handy • Sharon Haney • Deb Harding • Anne Harris • Kristen Harrison • Ginger Hart • Jennifer Hartness •
Dustin Harvey • Christine Hastings • Susan Hathcock • Sally Hauser • Heather Hayden • Christy Hayes • Susan Hayes
• Billy Haynes • Maureen Haynes • Leslie Hege • Ann Heilig • Nickolette Heim • Andrea Hendrickson • Wanda Henson
• Vicki Herbst • Anne Hicks • Jaclynn Hicks • Tamara Hicks • Mary Hill • Cathy Hill • Elizabeth Hillebrand • Angela
Hinshaw • Georgianna Hodgin • Wendy Holcomb • Laurie Holland • Monica Hook • Bettina Hoover • Tracy Hoover •
Cheryl Hough • Gail Howard • Michelle Howell • Nichole Howell • Beth Hubbartt • Judy Hubich • Sonia Huff •
Amanda Hughes • Ashley Hussey • Tasha Hutcherson • Kimberly Hutchinson • Wanda Hutchinson • Gina Idol •
Melissa Illig • Michelle Imbium • Jilleon Inman • April Irwin • Nina Ivie • Emily Jaynes • Jennifer Jeffords • Sonya
Jeffries • Wendy Jenkins • Melinda Jenkins • Cynthia Jester • Monica Jester • Judith Jewell • Cynthia Johnakin •
Brenda Johnson • Dawn Johnson • Rayetta Johnson • Alicia Johnson • Whitney Jolly • Jacqueline Jones • Takia Jones
• Julie Jones • Debra Joyner • Debra Joyner • Leilani Jumawid • Linda Kalafut • Brenda Kelly • Suzanne Kennedy •
Sarah Kerns • Julie Kerth • Amy Kiger • Fran Kiger • Karen Kiger • Juanice Kilgo • Diana King • Donna Kirby • Tracie
Kirkner • Kathy Kiser • Cheryl Klasic • Matthew Klein • Mary Klinepeter • Andrean Knight • Anthony Kofoworola-Kuti •
Charlene Kramer • Alexis Krise • Debbie Krueger • Karen Kruk • Katherine Kruppenbach • Elizabeth LaCount •
Candace Lail • Helen Lampart • Cathy Lane • Vicki Lankford • Deborah Larrimore • Sasha Lawrence • Ashley Leak •
Melissa Legere • Roslynn Lentz • Lauren Leppart • Johnathan Lewis • Robin Lewis • Vickey Lewis • Fenguin Li • Judith
Lindquist • Jennifer Link • Lisa Lippert • Michele Lizano • Wesley Lockman • Nadine Lohr • Kathy Long • Sarah
Losselyong • Angela Lott • Teirraha Lowe • Karen Luper • Anika Lyerly • Marianne Lynch • Dawn Mabe • Rachel Mabe
• Sandra MacDonald • Tawanna MacFarlane • Carolyn Mack • Benjamin Mahaffy • Edith Maisano • Ruby Malit •
Margaret Mangus • Megan Manuel • Tara Marion • Melanie Marsh • Kristy Marvin • Jonna Mason • Holly Mason •
Marwa Massry • Susan Materdo • Melinda Matthew • Sherry Matthews • Tabatha Mauldin • Tabatha Mauldin • Crystal
Maynard • Sara Mayse • Wendy Mccall • Jennifer McClintock • Loren McClintock • Ryanne McDaniel • Johnna
McMillen • Colleen Meehan • Julie Meier • Danica Merriweather • Melanie Meyer • Terrie Michaels • Andrea Mikolaitis
• Charlotte Miller • Elizabeth Mills • Amy Milner • Bernadine Minor • Beverly Minton • Pam Misenheimer • Angel
Mitchell • Lisa Mitchell • Monsurat Mohammed • Laura Moore • Stephanie Morgan • Brad Morgan • Teresa Morgan
• Lindsay Morris • Judy Motsinger • Pam Muetzel • Regina Mulligan • Mechelle Mumford • Valerie Mustamaa • Danna
Myers • Jennifer Myers • Jason Nagle • sandra Nave • Christine Nay • Veronica Naylor • Dewan Neal • Rogena Near
• Joyce Neilson • Barry Nelson • Kathleen Nelson • Brittany Nelson • Kim Nguyen • Chrystal Nichols • Debbie Nifong
• Elif Noell • Kathryn North • Lisa Oakley • David O’Brian • Katherine O’Brien • Erin O’Fallon • Olivia Ogburn • Tonya
Oliver • Annette Oliver • James O’Neal • Angelyn Osborne • Mary Owens • Sherry Owens • Lindsay Pace • Patrick
Parcell • Malinda Parsons • Elizabeth Patton • Tina Pavlacka • Beth Ann Peach • Elizabeth Pearsall • Ellen Pegram •
Sylvia Pegs • Caroline Peifer • Alicia Pender • Christine Peters • Cheryl Peting • Becky Petree • Sharon Pettiford •
Margaret Phelps • Alphea Piper • Janice Pitman • Debbie Pitts • Sarah Plyer • Arthur Powell • Lynn Priddy • Andrea
Pruitt • Kate Przybylowicz • Constance Purkey • Gina Quinn • Ely Ramos • Sue Raring • Wendy Rash • Linda Ravenel
• Mary Ray • Tony Raymond • Elaine Re • Nicole Reavis • Della Reavis • Carmen Redman • Sherry Reece • Lisa Reedy
• Rodney Reedy • Rodney Reedy • Leslie Regan • Michael Register • Shirley Remo • Margaret Rhoney • Andi Rice •
Eileen Rice • Jennie Rice • Terri Richardson • Jessica Ridley • Meghan Rini • Lorie Roark • April Roberson • Penny
Roberts • Carla Roberts • Christi Robinson • Mitzi Robinson • Melanie Rodgers • Kimberly Rogers • Debbie Rogers
• Jennifer Rogers • Karen Rowdy-Lordeman • Deena Rudisill • tamara Rush • Kristin Russell • Erica Russell • Leah Ruth
• Mary Rutledge • Mabe Rutledge • Elaine Ryan • Jimmy Sanders • Morgan Sanders • Pamela Santiago • Elizabeth
Sapp • Birthe Schwartz • Catherine Seagle • Gwen Seawell • Roy Sellars • Anne Shaw • Tracy Shaw • Mary Shearburn
• Kelly Shoaf • Mary Shull • Karen Shumate • Jamie Simmons • Pamatina Simmons • David Simon • Diane Simpson •
Maureen Sintich • Christine Siscoe • Robert Slaughter • Quintina Smallwood • Sheila Smallwood • Amanda Smith •
Daniel Smith • Abigail Smith • Heather Smith • Jill Smith • Kelsey Smith • Lauren Smith • Stacey Snow • Jennifer
Spenar • Betty Spencer • Kristen Stamper • Kim Stanbery • Alisa Starbuck • Takia Starkes • Mary Stauffer • Mary Steele
• Benjamin Steinberg • Lindsey Stephens • Lynnette Stephens • Sarah Stephens • Jennifer Strong • Nancy Sullivan •
Kimberly Surratt • Joann Sutterby • Tammy Sydenstricker • Eileen Tague • Christina Taylor • Jackie Teeter • Carrie
Terwillinger • Andrea Tesh • Paige Tesh • Mihaela Tewinkel • Dianne Thomas • Brenda Thompson • Brenda Thompson
• Brittany Thompson • Crystal Thompson • Jimmy Thompson • Pamela Thompson • Debra Thomson • Debbie
Thomson • Stacy Thomson • Laura Tice • James Tolbert • Heather Triplett • Cawania Tune • Laura Tuttle • Sandy
Tysinger • Andrea Underwood • Joyce Uy • Amanda Valentine • Erin Vandeweerd • Rachel Vasaly • Jessica Vaughn •
Samantha Vaughn • Beverly Vernon • Mariaa Vicario • Kristen Vuxovicin • Jessica Wadie • Leslie Wagner • Kelly
Waisner • Jennie Walker • Brooke Wall • William Wall • Emily Wallace • Monica Ward • Jill Watkins • Elizabeth Watkins
• Gregory Watson • Keith Watson • Carol Watters • Jennifer Waugh • Robin Weiner • Penny Welty • Rolanda Wenger
• Hunter West • Scott West • Charito West • Bryan Whaley • Beverly Whan • Rachel Whipple • Jennifer Whisnant •
Wanda White • Michelle Whittington • Sandra Wiles • Pamela Wilkins • Lisa Wilkins • Jamie Wilkinson • Melanie
Williamson • Karen Williamson • Carrie Wilmoth • Jennifer Wilson • Sandra Wingler • Edith Winters • Jennifer
Woodberry • Jessica Woodie • Suzanne Wright • Carrie Wright • Whitley Wyatts • Martha Wyrick • Kayla Wyrick •
Joreen Yabat • Kelly Yarnell • Teresa Yost • Kelly Younger • Samantha Ziglar
Nurse Participate in the Gift of Life:
Organ Donation
Nurses at Wake Forest Baptist Medical
Center participate in a variety of initiatives
that celebrate and support Organ Donation
in our community. Many of the patients and
families quietly touch our lives.
Community Partnerships and Activities
Nurses throughout the Medical Center are active in
community projects such as holding food drives and participating in walks that raise awareness and money for stroke,
breast cancer and colorectal cancer. Nurses also participate
in screenings and children’s camps such as Victory Junction
Camp. Other unique activities include:
Donating old scrubs. Jilleon Inman,
BSN, RN, and the Old Salem chapter
of the American Association of
Critical Care Nurses collected old
scrubs for high school CTE programs
in the surrounding area. Some 500
scrub pieces (tops, pants, jackets)
were given to 11 schools in four
counties. Remaining pieces were
given to pastoral
care for use by
patients being
discharged.
“Caring Quilts:
Made for you”
is an ongoing
program started
by Sally H.
Cowgill, RN,
MSN, OCN.
This initiative provides quilts for
oncology patients facing a long
hospitalization, such as those with
acute leukemia. Nearly 300 quilts
have been distributed. Quilts
are donated by nurses and other
health care professionals as well
as members of the community.
People can sponsor a quilt by giving
donations through the Cancer
Patient Support Program. Several
physicians have been supportive
through this means. Receiving these
quilts touches the hearts of patients
and their family members. As one
woman wrote: “I hope you know how
much joy and love you are bringing
to the recipients of your cancer
quilts.” The Donate Transplant Council is a multidisciplinary
council that includes representatives from various
nursing units (4A, 4B, 4C, 4RT, 5A, 5B, 5C, PICU, ED,
CCU, and NICU). Valeria Blue, BSN, RN, CCRN and
Janice Draughn, MSN, RN, co-chair, work with Carolina
Donor Services, transplant and critical care physicians,
palliative care representatives, Clinical Educators, North
Carolina Eye Bank representatives, and staff nurses from
the various units. Formed to increase communication
and improve the donor process, the group discusses
data related to eye bank review, the timely referrals
and retrieved organs per unit. Transplant updates on
organs transplanted are shared by physician group.
WFBMC has received several medals for timely referrals,
eligible donors, and conversion rates from the National
Learning Congress
for the Donation
Organ Donation Statistics 2012
and Transplantation
Organs per donor 3.04
Community of Practice
(a collaborative of
Referral rate 100%
HRSA and Organ
Conversion rate 74%
Donation and TransTimely notification 81%
plantation Alliance)
that is held annually in
Effective requester 90%
Texas. Subcommittees
include initiatives
such as Tree of Life Ceremony, Donate Life Walk, Flag
Raising Ceremony for every donor, and organ donation
education for nurses in a variety of forums including
Divisional Critical Care Shared Governance, Surgical
Services, Trauma Quality Improvement Committee,
Emergency Department Charge
Nurses, and biannual education for
the critical care nurse.
Making an end-of-life decision
isn’t easy. Would you know what
decisions to make for your loved
one? Wake Forest Baptist Medical
Center has created a culture that
helps to support families in those
difficult times. One of the decisions
that may need to be made is
about organ donation. A family
that supports organ donation and
consents for their loved one to
be an organ donor can help up to
eight other people. The Medical
Center has taken steps to honor
the decisions of the donor and their
families. The Tree of Life, created
in 2003 from private donations,
resides in the main lobby of the
hospital. Leaves on the Tree of Life
display the names of donors and
the year of their donation. Every
October, a ceremony is held to bring
the previous year’s donor families
together to see their loved ones’
leaves be placed on the tree. The
team recently began a flag-raising
ceremony, held at the flagpole in
front of the hospital to honor the
organ donor at the time of their
donation. Pastoral care, hospital
staff, Carolina Donor Services and
the family gather at the flag to have
a brief ceremony. An employee
from Engineering or Security raises
the flag, which flies for 24 hours in
honor of the precious gift. Janice
Draughn, MSN, RN, Nurse Manager
share how their loved ones were able
to live on through organ donation.
for 4B and 11Ardmore West, has
attended one of the ceremonies
and says that whether or not you
have been directly involved with the
donor process, it is one of the most
rewarding ceremonies to attend
because of the way it honors death
and life. So whenever you see the
Donate Life flag flying outside, know
that someone has become a hero
and saved other people through
organ donation.
April is Donate Life Month across
the nation. Wake Forest Baptist
Medical Center, Forsyth Medical
Center and Carolina Donor Services
partner to share information about
donation with the community by
walking, or for those who want a
little more challenge, running. This
pet-friendly event is the Donate
Life 3K Walk and 5K Run. It starts at
Forsyth Medical Center and ends at
Wake Forest Baptist Medical Center.
The event brings recipients together
to talk about how an organ transplant saved their life. Donor families
The story of Nina and Kristopher
illustrates the commitment of
our critical care nurses to families
working through the donor
process. Their story is one of great
love and great loss and the support
they received from their nurses. It
was a story that was told twice in
The Charlotte Observer, first because
their long distance courtship was
so special and Kristopher was
a specialist in the Army’s 173rd
Airborne Brigade based in Vicenza,
Italy. The second time when Nina
was an organ donor and nurses in
5C ICU supported Kristopher
through his decision and goodbye.
Nina and Kristopher were a young
couple separated by Kristopher’s
military obligations. They met on
eHarmony. They had long romantic
talks on Skype. He proposed on
Facebook. They dated a year but
they have been together face-toface for less than two weeks. They
kept in touch regularly by Skype
after they married, and every
Friday night was “date night.”
While Kristopher was away, Nina
worked out regularly but during
one session she suddenly crumpled
to the floor. She was rushed to the
hospital and diagnosed with an
intracerebral hemorrhage from an
aneurysm. Kristopher was called
home and returned to be with her.
By the time he arrived, Nina was
unresponsive. Over the next few
days it was evident that Nina would
not recover and Kristopher made
the difficult decision about what to
do. Tracy White, RN, and Lori Roark,
BA, BS, RN, CNRN, nurses in the
5C ICU, arranged for Kristopher to
have one last date night with Nina.
They bought a special blanket for
the couple along with sunglasses,
which family members said she loved
to buy, to cover her very edematous
eyes. They styled her hair. Kristopher
brought flowers and a video of their
wedding and he crawled into the
bed with her to hold her and watch
their movie together for the last
time. Tracy and Lori gave Kristopher
the glasses and the blanket to take
with him when he left. Because Nina
was an organ donor, Kristopher
and his family participated in the
flag ceremony outside the hospital.
One flagpole held the US flag and
the other held the North Carolina
flag with the donor flag beneath it.
That night there was no wind. The
flags were limp on the flagpoles.
Kristopher looked up at the stillness
and beyond into the dark and told
his mother that he wished the wind
would blow so he could see it. After
a moment a breeze gently lifted
the flags.
Transformational Leadership
Nursing Strategic Plan Accomplishments
•Clinical Ladder developed by the Nursing Professional
Development Council.
•Increased certified nurses by 10 percent.
•Increased education of BSN and MSN nurses.
•Dedicated charge nurse position — 155 trained in the
first year.
•Expanded RN float pool, developed Ambulatory and
Critical Care float pool.
•Sitter pool transitioned to certified nursing assistants.
•Service lines developed cross-training strategies.
•Organizational Development (OD) provided assessment
of leadership skills of co-management teams and
presented programs in collaboration with executive
nursing leadership.
•Caring Practice Team incorporates Lexington Medical
Center in Caring practice.
•Caring Leadership classes include nurse managers, assistant
nurse managers and charge nurses across the organization.
•I CARE exchange simulations for new hires focused on
bedside report/hourly rounding.
•Care Boards in patient rooms.
Nursing leaders can be found throughout
the organization — they are in all settings
and at all levels. These are people who
demonstrate a clear vision and have a plan
to accomplish the best outcomes.
•Resource Conservation Committee addressed employee
awareness of fiscal responsibility with a collaborative
partnership with Nursing Shared Governance and
addressed IV start kits and increased recycle bins.
Nursing Statistics
RN turnover
10.4%
RN vacancy
4.5%
Direct Care Nurse BSN
51%
Certification31%
Leader BSN and above 82%
Certification72%
Leaders Recognize and Reward Innovation
Nurse leaders throughout the organization routinely recognize the effect the direct
care nurse has on safe, quality, patient-centered care.
Leadership Rounds occur twice monthly, over
different shifts and days of the week. Maureen
Sintich, CNO, in partnership with Tom Sibert, MD,
President and Chief Operating Officer of Wake
Forest Baptist Health (originally in his role as the
CMO), established Leadership Rounds in 2010 to
recognize those who had improvements in patient
satisfaction. The rounds now include celebration and
discussion rounds with staff.
PICU staff was invited to rooftop festivities in
Brenner Children’s Hospital on Aug. 2, 2012 by Alisa
L. Starbuck, MSN, RN, NNP-BC, Director of Nursing
and Heath Earley, BSN, RN, Nurse Manager of the
PICU. The PICU staff celebrated two years without
a ventilator-associated pneumonia. Earley provided
incentive to the staff early in the journey and if
successful, he was willing to shave his head! In the
spirit of success he did just that!
February 2012 Celebration Round
Recognition List
May 2012 Celebration Round
Recognition List
Hand-washing Compliance
Patient Satisfaction Outpatient
•Most Improved (past six months):
4EMU
Most Improved: Pediatric
Hematology/Oncology Clinic
•Trauma Registry Team nominated
by Rebecca Beauchamp, MSN,
RN, CENP
•Most Consistent (six-month
averages): 6IMN and 10NT,
Burn ICU
Most Improved:
Abdominal Transplant Clinic
•7RT nominated by Sandy
Tysinger, MSN, RN, PCCN
Top performers in Priority Areas
of Improvement
•Day Hospitals nominated by
Sandy MacDonald, BSN, RN
• Sensitivity to Patient Needs: UIMA
•Kelly Key nominated by Michelle
Collins, BSN, RN, CEN
Patient Satisfaction Inpatient
Most Improved: 11 North Tower
Most improved: Emergency
Department (Pediatric and Adult)
•Adult ED: 4 percent increase in
top responses
•Peds ED: Nurses 4.4 percent
increase in top responses; doctors
5 percent increase in top responses
•Fast track: 12 percent increase
in top responses for information
relayed to family/friends
Top performers in Priority Areas
of Improvement
•Response to concerns
or complaints: 8NT
| 25
2011 – 2012 |Nursing
2011 – 2012
25 | Nursing
Annual Annual
Report Report
Quality Metrics
•NICU: 197 days (through Dec. 11)
without a ventilator-associated
pneumonia; 297 days (through
Dec. 11) without a catheter-associated blood stream infection.
•Stacey Sloane and Devon
Brennan nominated by Michelle
Collins and Paula Correa
•4B ICU nominated by Janice
Draughn, MSN, RN
• PIMC: 400 days without a catheterassociated bloodstream infection.
•Abdominal Transplant Team
nominated by Janice Draughn
•8 General Pediatrics, 9 Pediatric
Hem/Onc, 9 Adolescent and
Peds Behavioral Health: 442 days
without a Code Blue.
•Cardiothoracic Surgery
Team nominated by Melanie
Williamson, RN, CCRN
•PICU: 532 days (through Dec. 11)
without a ventilator-associated
pneumonia; 506 days (through
Dec. 11) without a catheterassociated bloodstream infection,
February 2012.
•8 Brenner Pediatrics Discharge
Improvement Team nominated by
Penny Blake, MSN, RN, NEA-BC,
CENP, Director of Nursing
•Sepsis Team nominated by
Maureen Sintich, MSN, MBA,
RN, WHNP-BC, NEA-BC, Vice
President, Operations/Chief
Nursing Officer
•Transitional Care Management
Team nominated by Maureen
Sintich
•CCU nominated by
Sandy Tysinger
•Jilleon Inman nominated by
Carolyn Roberts, RN
•4C and 4RT staff nominated by
Luz Dixon, RN
•Caroline Farmer and Julie
Paradis nominated by Libby
Pearsall, BSN, RN, NE-BC
August 2012 Celebration
Round Recognition List
MICU Respiratory Care and
Nursing and Physician Quality with
corresponding metrics
•CAUTI, 4RT, for 2 Quarters = 0
(down from 1.32)
º 4C, for 4 Quarters = 0
•CLABSI, 4C, for 4 Quarters = 0
º 4RT, for 3 Quarters = 0 (from 2.19)
•VAP, 4C and 4RT, for 4 Quarters = 0
•ALOS, from July 2011 to June 2012
= 2.50 (lowest ever, considering the
range to be 3.65 – 2.50) and benchmark
range (4.10 – 3.90)
•PICU Quality: No ventilator-associated
pneumonia for two years
Patient Satisfaction
Most improved Inpatient unit:
2SA, 4.2 points
New Knowledge
Acquiring knowledge
through research, program
development and acting
on ideas is a key mission for
nurses, and helps create a
powerful environment
for patient care and the
nursing profession.
WakeOne Electronic Health Record
In February 2009, Congress passed the American Recovery
and Reinvestment Act, which established incentives for the
adoption of an electronic health record system by hospitals
and physician offices. This incentive program and our goal to
improve the qualtity of patient care led to our implementation
project — WakeOne. The goal of WakeOne is to improve the
quality, safety, efficiency and effectiveness of the care we provide.
The requirement for meaningful use will influence how we use
the WakeOne system and will help us report our compliance and
utilization to the government.
It is not enough to simply implement a new Electronic Health
Record (EHR). Hospitals and physicians must demonstrate
meaningful use. There are 15 core requirements for a hospital to
achieve that status. Nurses using an EHR can improve the quality
of patient care by promoting care coordination, improving continuity of care, reducing medical errors, improving the population
health, reducing health disparities and reducing chronic diseases.
Nurses can apply meaningful use to their practice by completing full
assessments, including height and weight, BP, BMI and VS, and completing
growth charts, and recording smoking status and advance directives. It is
imperative that we utilize Best Practice Alerts that help us complete requirements for our documentation standards and evidence-based care. It is
vital to develop daily and visit goals with our patients. In addition, there is
emphasis on teaching the patient and their families to care for themselves
so they can prevent readmissions to the hospital.
At Wake Forest Baptist Health, the Nursing Content Review Committee
includes managers, staff development educators, assistant managers,
staff nurses, clinical educators, WakeOne team members, and nursing
infomaticists. The committee’s charge is to communicate the changes
and provide communication and a decision-making process for the new
electronic record, WakeOne. Decisions are often patient-centered, and
include questions such as: “Which patient ID band is best?” “How will Early
Warning Scores be integrated in WakeOne?” and “What form will critical
lab values take?” Patient safety is a central focus.
Research Council/Center for Nursing Research
Nursing research and evidencebased practice continued with
15 current research studies and
seven additional in development.
Eight studies were completed
and closed. A Daisy Research
Grant was awarded to four nurses
to complete a randomized,
controlled study of 300 outpatient
chemotherapy patients. The
study examined the effect of
Healing Touch, Guided Imagery
and standard care on patients
received chemotherapy. The “Pain
Resource Nurse Study” examined
attitudes of nurses completed a
two-day course covering multiple
topics related to pain. Preliminary
results have shown a statistically
significant change in practicebased questions pre- and two
months post-class. Other study
topics included “The Utilization
of the Charge Nurse Role — Job
Description vs. Reality” and
“Nursing Stress in the Pediatric
Intensive Care Unit.”
International Caritas
Patient Assessment Study
The Nursing Research Council began
participation in the International Caritas
Patient Assessment Study, a multisite study
sponsored by the Watson Caring Science
Institute. As an affiliate, council members
collected patient surveys on the adult
medical, surgical and medical/surgical
units asking six questions related to their
perception of a caring environment. The
first two quarters’ results were, on a 7-point
scale, 6.42 and 6.51 in overall scores.
Research Internships
Nursing Research Internships were created to provide experience for
nurses who were interested in the research process. Six participants
were selected by the members of the Nursing Research Council. They
completed the didactic phase and are currently preparing studies.
They are:
Lori Nifong, BSN, RN: “Zinc Sulfate Supplementation in the
Prevention of Radiation-induced Oral Mucositis in Head and Neck
Cancer Patients.” In eIRB; awaiting approval.
Jennifer McClintock, MS, BSN, RN, CNRN: “The Effect of Healing
Touch on Pain and Length of Time in the Post Anesthesia Care Unit.”
Finishing up eIRB submission.
Jessica Ridley, MS, BSN, RN, CMSRN: “Structured Rounding with the
‘Four P’s and its Effect on the Percentage of Patient Falls and Levels of
Patient and Staff Satisfaction.” On hold; teaching WakeOne.
Cathy Lane, MS, BSN, RN, CRRN: “Effect of Aromatherapy on
Violent/Aggressive Behaviors in the Acutely Ill Elderly Patients.’’
Working on proposal.
Joanne Buckner, BS, RN: “The Comparison of Two Types of
Tourniquets: Standard Tourniquet vs BP Cuff to Obtain Blood
Specimens.” On hold; changed jobs but still wants to do study;
protocol done.
Carolyn Haithcock, RN: In development.
New Knowledge
Integrative Therapies
The Center for Nursing
Research has promoted the
development of Integrative
Therapies concentrating on
three modalities for use by
staff and with our patients.
The Healing Touch Consult Program celebrated its first year with over 550 inpatient sessions!
Healing Touch, a gentle, relaxing energy therapy helps to balance the physical, mental, emotional
and spiritual well-being. This inpatient, collaborative, volunteer service combines 37 Healing
Touch students and certified practitioners from the community and staff from the medical center
to provide 20-30 minute sessions at no cost to the patient. A Consult Line is available for patients,
families and staff to make requests. Patients are seen Monday through Saturday with a target of
24 hours from the request. A physician order is not required.
Nurses in the hematology oncology clinic partnered with the Center for Nursing Research to investigate healing touch, guided imagery, or standard care in patients receiving chemotherapy and the
impact on anxiety. Guided Imagery is a gentle, but powerful technique that focuses and directs the
“I was serio
usly injured
in an automo
and have a le
bile accident
ft arm becau
s
e of the skill
surgeons Dr.
of
(Christopher
) Tuohy and
Pestana and
D
r.
their partner
(Ivo)
s and residen
nurses. My ab
t doctors an
ility to handl
d
e 14 surgeries
weeks and al
in eight
l that entailed
with greater
and a good at
comfort
titude I owe
to the love an
I received fr
d energy
om my comm
unity and the
I received fr
therapies
om the nurs
es and comm
volunteers o
unity
f the HT (H
ealing Touch
will be return
) program. I
ing in Novemb
er for more
surgeries and
orthopedic
will be reques
ting more HT
while there.
. .This therap
therapy
y makes a grea
with the trad
t partner
itional medic
ine at the ho
the integratio
spital and
n of this pro
gram at Bapti
progressive an
st is very
d smart, as w
e learn more
much the pat
about how
ient’s own na
tural ability
comes into p
to heal
lay.’’
Mary Ann Mai
er
imagination. The practice of “mental
imagery” or “visualization” through
the use of CDs or a script, is used to
promote relaxation and rest, reduce
anxiety or depression, manage pain and
promote healing.
The Center for Nursing Research
also initiated a program in Clinical
Aromatherapy. Clinical Aromatherapy
is the use of essential oils to effect a
change on the brain and it’s perception
of stimuli and is one of the most
researched integrative therapies. A
policy for Clinical Aromatherapy and
created and competency classes for
nurses who wish to use this modality
in their practice provided to 52 nurses.
Future classes are planned. Nurses
who complete the classes may provide
clinical aromatherapy in their practice
using oils provided by the Center
including rosemary, orange, peppermint
and lavender. Oils are used in the
clinical setting to impact pain, anxiety,
nausea, promote sleep, and impact
memory decline. Requests for essential
oils for clinical use may also be made
by staff for inpatient use. The Center
is also sponsoring a research study
using essential oils and the impact on
dysmenorrhea in the Registered Nurse.
Training
Besides hospital-wide and research-oriented programs, many
departments participated in training and projects that improved
staff knowledge.
Radiology Nursing
Nurses in Radiology underwent various training
and development through the year, in addition to
participating in new projects and education efforts.
• Cross-trained all radiology nurses to at least
one other area within radiology and some to all
four areas.
• Kaizen event to develop radiology nursing
productivity tool with staff nurse input.
• Shared Governance developed PTO guidelines,
team leader roles and responsibilities, and an
orientation pathway for new employees and for
cross-training employees.
• Ongoing Monthly Teamwork Winners, along with
Beads for Deeds Recognition program.
• Participated in several pilot projects to improve
efficiency and patient safety, including US,
MRIand IR/ICU through Departmental Assessment
recommendations.
• Hosted the 2012 Spring Conference for the
Association for Radiologic and Imaging Nurses,
which was coordinated by staff nurses.
• Staff nurse completion of FNP degree/certification.
• Welcomed 14 new radiology nurses since July 2011.
New Knowledge
Ambulatory Nursing
Surgical Services
Ambulatory Nursing continues to evolve, with new clinics opening
on Country Club Road, in Hickory, in Clemmons and on Brookstown Avenue. Other clinics have moved off campus to provide
better accessibility for patients. With a wider span of responsibility,
ambulatory nursing administration added Sendee Casstevens as
Associate Director. With Joanne Gresham, MSN, MHA, CMSRN,
Nursing Director, administration has begun to expand Shared
Governance, with 15 clinics participating in an Ambulatory
Leadership Council and plans under way to merge this into a multidisciplinary meeting to serve the educational needs of the clinics
and share information related to practice. Ambulatory Nursing was
pleased to have two Nurse Excellence Award winners and Great
100 recipient this year.
LifeWings (internally
rebranded as “WakeWings”),
is a patient safety and
Instrument Proces
sing Checklist
teamwork program designed
Does your pan hav
around checklists and
e…
All instruments?
standardized commuCount Sheet (if app
nication. Working with
licable)?
Scrub Handoff Co
an outside consultant,
mmunication She
et?
Repair Tag?
LifeWings Partners, LLC,
Internal indicator
the program was adopted
on every level?
Filters?
by the Divisions of Surgical
Locks?
Services and Surgery, and
Load Card?
the Department of AnestheMissing item lab
siology, and went “live”
el (if applicable)?
Do NOT forget
on July 5, 2011. Through
the load sticker!!!
collaboration with physicians, nurses, astronauts,
pilots and risk managers
helping to teach strategies
that permanently implement the same teamwork behaviors
used by high-reliability organizations found in commercial
aviation (and NASA), this safety program redefined the
operating room culture.
c
c
c
c
c
c
c
c
c
Safety in Hematology/Oncology Clinics
Protecting the workplace is crucial to the nurse who handles
chemotherapy. Typically only personal protective equipment is worn
during direct drug activities. Staff in the Hematology/Oncology
Clinic (Outpatient Cancer Center) collected wipe samples revealing
surface contamination of chemotherapy agents at the chairside.
After implementation of a closed system transfer device (CSTD), no
detection of contamination was found, making this a valuable safety
component of practice, protecting nurse and patient.
Instrument Proces
12-00962
sing Checklist
Version 1
Bowen / Owens
More than 20 customized Patient Safety Tools (e.g., checklists, handoffs, report-outs, etc.) were developed and are used
daily throughout a patient’s continuum of care in the OR and
Endoscopy. The surgery clinics are also adopting WakeWings
principles, and other groups throughout the Medical Center
have started inquiring how to become involved. These Patient
Safety Tools are constantly reviewed and optimized on a regular
as personnel become more familiar with terminology or as new
regulations require additional oversight.
More than 1,500 employees have attended a four-hour Team
Skills Workshop training session, and it is expected that anyone
working in ORs/PACUs/Holding Rooms/etc., or in Endoscopy,
will be “WakeWings-certified.”
Highlights
Brenner Children’s Hospital Highlights
• Achieved two years in the PICU without
a CRBSI or VAP.
• Achieved one year in the NICU without
a CRBSI or VAP.
• Implemented a Pediatric Early Warning Score
to identify changes in condition.
• Achieved overall handwashing compliance
for BCH at 95 percent for the 2012 fiscal year.
• Brenner Children’s Hospital Critical Care
Transport expanded to provide services
for children younger than 18.
• Instituted a Donor Breast Milk Program in
the NICU.
• Pediatric Safety Fair held at BB&T Ballpark
on May 6, 2012.
• Implemented philanthropy-funded Pediatric
Hematology Oncology Navigator position to
improve communication and coordination with
patients and families.
• Opened Joslin Pediatric Diabetes Clinic
in April 2012 as part of the Joslin Diabetes
Center Affiliate at Wake Forest Baptist Health’s
Medical Plaza – Country Club location. The care
team works with patients and their families
to map a customized approach to the care,
education and support they need to stay on a
lifelong pathway to health.
• Implemented Joslin diabetic pediatric acute
care on 9 Brenner Pediatric Adolescent. Staff
completed training and competencies related
to the care of infants and toddlers as well as
educational sessions on diabetes. A diabetes
educator provides ongoing staff, patient and
family education.
• Instituted grant-funded Beads of Courage
Sibling Program that acknowledges the
challenges siblings face when having a brother
or sister who has cancer. Siblings receive their
own collection of beads as symbols of support
and encouragement.
Lexington Medical
Center Highlights
In August 2011, the Emergency Department and
Inpatient areas collaborated on improving patient
throughput to decrease the number of Left Without
Being Treated and increased ED hold times. A multidisciplinary team consisting of staff from Critical Care,
Medical Surgical, Emergency Department, Finance,
House Supervision and Case Management worked
through a Six Sigma-style analysis of ED throughput
times and issues.
The top three areas were:
• ED and inpatient emergencies/crisis
• Patient turnover
• Physician communication
These three areas are unique to Lexington because
many staff are in multiple roles. For example,
Emergency Department physicians cover inpatient
codes, so a code in each area could be paralyzing
for the hospital. From this list, steps were taken to
resolve throughput issues. The multidisciplinary team
made suggestions and leadership acted. Continued
improvements at Lexington — a housewide telemetry
project, a new staffing model, unit consolidation —
continue to affect ED throughput in a positive way. As
Lexington continues to integrate services, including
WakeOne in spring 2013, patients will see a much
cleaner throughput process.
CT Surgery and Pressure Ulcer Prevention
A consistently high occurrence of pressure ulcers, peaking at a rate
of 12 percent, among the CT surgery patient population provided
the motivation for a task force to implement evidence-based
prevention strategies. The task force, composed of nurses from the
CT Operating Room, 5A ICU, 5 RT, Wound Ostomy Nurses and a
nurse educator, implemented care across the continuum including:
•Operating room staff conduct a thorough skin assessment before
applying sacral mepilex
•Replacement of OR stretcher pads
•Soft nasal cannula
•OR patients identified as high risk are placed on an air bed
•Designated unit skin champion conducts weekly surveillance,
educates staff, monitors patient care
Sacral mepilex has demonstrated a decrease in deep tissue injury
and soft nasal cannulas decrease stage I and II pressure ulcers
at the ears. Three months after implementation, unit acquired
pressure ulcers were 0 and deep tissue injury occurring as post
op Day 1 through Day 4 are now an infrequent occurrence.
Unit Aquired Pressure Ulcers 621 5RT
14.0
Pressure ulcer prevalence rate
Empirical Outcomes
Follow-up studies demonstrate that quality nursing
programs — those that respond quickly and adapt
to patient needs in an ever-changing environment —
have a strong record of success.
12.0
10.0
8.0
6.0
4.0
2.0
0.0
3Q11
4Q11
1Q12
2Q12
(Melanie Williamson, RN, CCRN)
Unit Aquired Pressure Ulcers 646 IMC
20.0
Intermediate Care Unit and
Pressure Ulcer Reduction
The Intermediate Care Unit saw improvement in Unit Acquired Pressure
Ulcers as the result of a new process. When a new patient arrives to the
unit, two nurses complete the initial skin assessment as a team to avoid
missing skin integrity issues. This has decreased the number of pressure
ulcers that were being missed on admission. The accepting nurse
documents in their accept note who the RN was that performed the skin
assessment with them. (Carolyn Roberts, RN)
Pressure ulcer prevalence rate
18.0
16.0
14.0
12.0
10.0
8.0
6.0
4.0
2.0
0.0
2Q11
3Q11
4Q11
1Q12
2Q12
11 RT Foley Care
According to the Centers for Disease Control and Prevention (CDC), there
are an estimated 13,000 deaths attributed annually to Catheter Associated
Urinary Tract Infection (CAUTI). Prolonged catheterization is one of the main
modifiable risk factors for the development of CAUTI. The CDC CAUTI
toolkit provides “examples of quality improvement programs that may
ensure appropriate urinary catheter utilization.” One of the examples is the
development of nurse-driven urinary catheter removal protocols. Currently,
Wake Forest Baptist Health has put into motion several initiatives to help
prevent the occurrence of CAUTI. These initiatives include the development
of the insertion bundle, the maintenance bundle and the bladder protocol
for monitoring urinary retention after a urinary catheter is removed.
In order to comply with these initiatives and ensure the best patient
outcomes, the staff of 11 Reynolds uses the morning safety huddle to discuss
those patients on the unit who have in-dwelling urinary catheters. The
designated charge and the primary RN determine whether each catheter
meets the recommendations/criteria set forth by the Institute for Healthcare
Improvement (IHI), Evidence Based Practice (EBP) and the CDC. If the
criteria are not met, the designated charge nurse discusses with the trauma
Nurse Practitioners (NP) the need to discontinue the catheter. One issue
identified in the work flow is the length of time between when the nursing
staff identifies that a catheter needs to be removed and when the order
for discontinuation is placed in the computer. This led several of the staff
members (Amy Townsend, MSN, ANP-BC, NP; Nicole Osborne RN, SANE
and Kristina Foard, RN, MSNEd, CRNA) to develop a nurse-driven urinary
catheter removal protocol. This protocol was developed based on the
previously mentioned recommendations in an attempt to fill the gap in the
organization’s CAUTI prevention program.
VAP Huddles
Nurses in 4A ICU, 4B ICU, 5B ICU and 4 RT ICU implemented VAP huddles
to review the cases of VAP if identified in a particular unit. Nurses who have
taken care of the patient are sent surveys to review any specific events
during their care. A huddle occurs with the Nurse Manager, Medical Director,
Clinical educator, Respiratory Therapist, Quality Resource staff and other
nursing staff. The case is discussed and opportunities for performance
improvement are discussed. New transport guidelines were implemented in
the surgical population with VAP bundles while transporting patients.
Empirical Outcomes
646 IMC
2.5
VAP rate
2.0
VAP in the MICU
1.0
NDNQI Stepdown
benchmark
0.5
The staff of Medicine ICU (4C and 4 RT) improved quality in the areas of ventilatorassociated pneumonia (VAP) and central line-associated blood stream infection (CLABSI).
The MICU team has reached the goal of greater than 95 percent compliance with its
VAP bundle and went 111 days without a CLABSI.
0.0
1Q11
2Q11
1Q12
2Q12
1Q12
631 PICU
3.0
2Q12
655 NICU
3.0
2.5
5.0
2.0
4.0
VAP rate
VAP rate
1.5
1.5
1.0
3.0
2.0
NDNQI PICU benchmark
0.5
1.0
0.0
0.0
3Q10
4Q10
1Q11
2Q11
1Q12
2Q12
1Q12
2Q12
3Q10
NDNQI Level III
NICU benchmark
4Q10
1Q11
2Q11
1Q12
2Q12
1Q12
2Q12
Blood Administration and
Documentation Improvements
Restraints
Nursing has worked hard to improve patient rights and safety with
restraint use. Documentation changes, updates to the policy to include
both required and best practice changes, and an intense audit of use
and documentation have provided improvements in safe application and
monitoring of restraints, effective documentation and in a decrease in the
number of restraint episodes.
Over the past year, Nursing has concentrated efforts to improve the safety
of blood administration and documentation. Documentation changes,
policy updates to include best practices and routine audits of the blood
administration process were implemented. As improvements were made
in the administration process, audits were changed to concentrate on
compliance with the vital signs associated with safe blood administration.
Blood administration documentation maintained at or above 95 percent
with no deviations over the four quarters. Just Culture was utilized by
management to address specific documentation issues with staff and to
provide education and remediation opportunities. The overall compliance
with administration and documentation for the final quarter of FY 2012 was
98 percent with no reported safety issues. Results indicated that the process
was stable and that the changes to care were successful.
Blood Administration Vital Sign Documentation
99
98
97
Policy
changes, staff
re-education
completed
96
Goal rate of 95%
95
Began monitoring
5 VS components
of blood admin.
documentation
93
92
8-29
11
9-6
11
9-12 9-19 9-26 10-3 10-10 10-17 10-24 10-31 11-7 11-14 11-21 11-28 12-5 12-12 12-19 12-26 1-9
11
11
11
11
11
11
11
11
11
11
11
11
11
11
11
11
12
2-15 3-15 6-15
12
12
12
Restraints Documentation
100
Percent VS documented per polic
Percent VS documented per polic
100
94
Restraint documentation maintained at or above 95 percent with no deviations over the four quarters. Just Culture was utilized by management to
address specific documentation issues with staff and to provide education
and remediation opportunities. Overall compliance documentation for the
final quarter of FY 2012 was 99.6 percent with no reported safety issues. The
rate of restraint use was at 3.7 percent for the house, which is one of the
lowest rates recorded in over five years. Results indicated that the process
was stable and that the changes to care were successful.
99
Changes implemented
after staff re-education
98
97
96
Goal rate of 95% and above
95
94
93
Identified area of
documentation where
changes were required
92
10-17
11
10-24
11
10-31
11
11-7
11
11-14
11
11-21
11
11-28
11
12-5
11
12-12
11
12-19
11
12-26
11
1-9
12
2-15
12
3-15
12
6-15
12
Empirical Outcomes
5B Guide: Feeding Protocol:
Catch-Up (24-hour Feeding Protocol)
This protocol has recently been trialed in our Level One Trauma Unit
because feedings are interrupted frequently for procedures and/
or surgeries. The interdisciplinary team consisted of a nutritionist,
surgeons and nurses. Nutrition is important to assist in and promote
healing, and the team members believed they might decrease the
length of stay and prevent pressure ulcers by maintaining feedings
on trauma patients. The 24-hour, volume-based feeds are intended to
allow the patient to “catch-up” on tube feeds missed while in surgery
or held for procedures. The 24-hour volume feeds are delivered from
7 am to 7 am. The 24-hour volume is determined by multiplying the
hourly rate by 24 hours. Outcomes demonstrate improvement in
pressure ulcer incidence, length of stay and VAP rate.
5B Fed within 48 hours
Catch Up
Pilot 4-23
Cor Trak
100%
100
93
93
86
94
FEB
MAR
95
100
93
90%
80%
70%
60%
50%
Outcomes: 24-hour Feeding Protocol
Pre-Pilot Post-Pilot Unit Acquired Pressure Ulcers Incidence 4th Quarter 2011 Ulcer 1st and 2nd Quarter
2012 0 pressure ulcers
Benchmark
30%
20%
Length of Stay 12/11: 4.32 (days) 1/12: 4.26 4/12: 3.12 (days) 5/12: 3.18
6/12: 2.63
7/12: 3.05
4.30 (days)
Ventilator Associated Pneumonia Rate 2nd Quarter 2012 0%
2.11
2nd Quarter 2011 15.11 40%
10%
0
2009
2010
2011
JAN
APR
MAY
Patient Satisfaction with Nursing Attitude All Units
Patient Satisfaction Metrics
Statistics consistently show patient
experiences outforming benchmarks
in different categories.
Attitude toward requests
100
96
92
88
600+ bed hospitals mean benchmark
84
80
76
72
Jul 11
Aug 11 Sept 11 Oct 11
Nov 11 Dec 11
Jan 12
Feb 12
Mar 12 Apr 12 May 12 June 12
Nurses’ attitude toward requests
Top Performers
•Epilepsy Monitoring Unit: 11 out of 12 months above the benchmark
•Day Hospital, 9 PA, 7 AT, 9 NT, 9 AE: 10 out of 12 months above the benchmark
Promptness response to call
Friendliness/courtesy of the nurses
• DHAT, DHSP, EMU, 9PA: 12 out of 12 months above the benchmark
•8 NT, 7 AT: 11 to 12 months above the benchmark
• 7 RT: 11 out of 12 months above the benchmark
Patient Satisfaction with Nursing Courtesy and Respect All Units
96
92
600+ bed hospitals
mean benchmark
88
84
Jul 11
100
Nursing Response TIme
Attitude toward requests
100
Patient Satisfaction with Nursing Response Time All Units
96
92
88
84
600+ bed hospitals
mean benchmark
80
Nov 11 Dec 11
Jan 12
Feb 12
Jul 11
Nov 11 Dec 11
Jan 12
Feb 12
Empirical Outcomes
Patient Satisfaction Metrics
All units
Patient Satisfaction with Education All Units
Satisfaction with education
100
96
92
88
84
80
Jul 11
100
How well pain controlled
600+ bed hospitals
mean benchmark
Nov 11 Dec 11
Jan 12
Feb 12
Patient Satisfaction with Pain Management All Units
96
92
88
600+ bed hospitals
mean benchmark
84
80
Jul 11
Nov 11 Dec 11
Jan 12
Feb 12
High performers — Acute Brain Injury Unit and Rehabilitation Unit
Patient Satisfaction with Education 174 ABI/Rehab
96
92
88
84
600+ bed hospitals
mean benchmark
Nov 11 Dec 11
Jan 12
Feb 12
Patient Satisfaction with Pain Management 174 ABI/REHAB
96
92
88
600+ bed hospitals
mean benchmark
84
80
80
Jul 11
100
How well pain controlled
Satisfaction with education
100
Jul 11
Nov 11 Dec 11
Jan 12
Feb 12
Department of Nursing
Medical Center Boulevard
Winston-Salem, North Carolina 27157

Nursing Annual Report - Wake Forest Baptist Health

Transcription

Similar documents

Nursing Pharmacology

When Colette Foisy-Doll arrived in Qatar last year

Travel Nursing 101: Get the Facts

Nursing Education Initiative Application Checklist PLEASE

Private Nursing

Gamma Alpha Chapter News

Mary Ellen Smith Glasgow, PhD, RN, ACNS-BC

Who are we?

vital signs - College of San Mateo

You Bet - SAFE Planning