driving change East Jefferson General Hospital

driving change
nurses
2009
Nursing Annual Report
East Jefferson General Hospital
Louisiana’s First Nurse Magnet Hospital
our mission
is to provide compassionate healthcare that is respected by our patients,
colleagues, physicians, and community. Our passion is to make a difference
in the lives we touch, thus gaining self-fulfillment.
our vision
Clinical services, as an integrated team, will partner with our medical staff
and all departments in support of our mission, as we work toward our goal
of becoming the regional leader in healthcare.
our values
quality. We commit to quality in everything that we do, through
achievement and innovation, always contributing to excellent care and
patient satisfaction.
integrity. We uphold the highest of standards of behavior encompassing
fairness, trust, respect, and ethical practices.
compassion. By our thoughts, words, and deeds, we create and maintain
a caring, compassionate environment.
collaboration. Teamwork is the key to our success. Working together, we
ensure everyone benefits from our collective wisdom.
continual improvement. We embrace and encourage creativity and
innovation, as well as ongoing self-evaluation of our processes and
outcomes.
On the Cover:
Donna Carbajal, RN
2009 EJGH Team Member of the Year
East Jefferson General Hospital
www.ejgh.org
Focus on Outcomes
A letter from the Chief Nurse Executive . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Evidence-Based Practice
EBP Showcase participants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
New Knowledge, Innovations and Improvements
Nurses Improve Practice through Technology and Information Systems . . . . . 6
Nurses Driving Change . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Measurable Outcomes
Reduction in Length of Stay: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Process Improvements in Patient Flow and Throughput . . . . . . . . . . . . . . 10
Rapid Response Team . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Prevention of Ventilator Associated Pneumonia . . . . . . . . . . . . . . . . . . . . 12
Insulin Protocols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Reduction in Contaminated Blood Cultures . . . . . . . . . . . . . . . . . . . . . . 14
Reduction in Elective Induction before 39 weeks . . . . . . . . . . . . . . . . . . . 15
RN Satisfaction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Recognition
Certifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Continuing Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Leadership in Professional Organizations . . . . . . . . . . . . . . . . . . . . . . . . 20
Nightingale Awards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
EJGH Foundation and Auxiliary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Great 100 Nurses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
EJGH Awards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Community Recognition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Our passion is to make a
difference in the lives we touch.
American Nurses Association
Code of Ethics and Bill of Rights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Marianne Call, RN
Focus on Outcomes
A letter from our Chief Nursing Officer
Janice Kishner, MSN, RN, FACHE
Chief Nursing Officer
As a maturing
magnet facility,
more emphasis
is now placed on
the components of
new knowledge,
innovations and
improvement,
and empirical
outcomes.
2
Another year has flown by, and we find ourselves, once
again, reflecting back on the challenges and accomplishments of the nursing and clinical staff for 2009. This has been
a stabilizing year for our workforce with the lowest vacancy
rate and turnover rate for all clinical and nursing positions
ever experienced at East Jefferson General Hospital. This
stabilization allows us to concentrate our efforts on the
relentless pursuit of excellence, redirecting our energies from
hiring and orienting new staff to staff development and
practice improvement. Our shared governance structure,
VOICE, continues to strengthen and provide the firm
foundation for frontline staff’s input on key strategies for
patient safety and clinical programs. As staff members grow
in their leadership roles as the chairs of our various VOICE
committees, many have been promoted into supervisor
and director positions. By serving on the various shared
governance committees, individuals have the opportunity to
envision how their daily roles contribute to the betterment
of the entire organization. We have hosted various
healthcare organizations that have requested to spend a day
with our VOICE structure so they too can learn how shared
governance and frontline staff involvement can advance
their agenda for patient safety and clinical excellence.
As we are all well aware, 2010 is our re-designation year for
our magnet status. In some ways, this preparation for our
third re-designation has been made simpler by the fact that
we have incorporated the 14 forces of magnetism into our
daily practice; therefore, providing sources of evidence for
the document submission phase is much easier. However,
as a maturing magnet facility, more emphasis is placed
on the components of new knowledge, innovations and
improvement, and empirical outcomes. In the realm of
innovation, we are very fortunate to have a state-of-theart clinical information system, COMPAS, and a committed
clinical team that uses the technology to embed important
elements of care delivery and exemplary practice. Our
clinical analysts along with the clinical operations committee
are continuously researching opportunities to leverage the
information technology to facilitate our day-to-day practices.
In addition, because all documentation is electronic,
conducting quality monitoring of the documentation
phase of care has been simplified. We are able to provide
immediate feedback to the bedside caregivers, which
impacts care delivery in real time.
The efforts to drive evidence-based practice to the bedside
have been greatly strengthened during the past year.
Numerous clinical areas in both nursing and the ancillary
departments have participated in our research showcase
held every six months. The research questions that have
been surfaced by the frontline clinical team have challenged
our traditional practices and underscored the importance of
evidence-based practice in the management of patient care.
There was a time when the concept of conducting research
was both daunting and elusive for the hospital staff. Over the
last few years, however, research has been demystified, and
we are extremely proud of these types of on-going clinical
investigations.
The role of the advanced practice nurse has also evolved
over the past few years. A recent change in the Medical
Staff Bylaws has strengthened the role of the advance
practice nurse and its partnership with the medical staff
Quality
in terms of the credentialing and privileging processes.
This new committee further highlights the high degree of
collaboration between the medical staff and the clinical staff.
The peer review process has been further developed; being
incorporated at the staff level. Receiving immediate feedback
from one’s peers is probably the most impactful evaluation
one can receive as a professional clinician.
ION
INN
CH
AR
OV
E
S
ASS
RTNERSHIP
A
P
P
OM
MMUNITY
CO
Janice Kishner, MSN, RN, FACHE
AR
AND DS & R
ST
E
ALI
EQU TY
PATIENT
Nursing research, evidenced-based practice,
technology and performance improvement
methodologies support nursing in the
ongoing quest to continually improve
patient care.
EDUCATION
N QUALI
O
I
TY
AT
E
P
C
S
T
RE
RING
CA
C
Finally, in 2009, Dr. Marlene Kramer conducted a third
phase of her studies on her forces of magnetism
focusing, this time, on the socialization of the new
graduate. Once again, East Jefferson General
Hospital’s Nursing Staff scored in the top ten
percentile on the key indicators of autonomy
over practice, decision making, job enjoyment
and RN-to-RN collaboration. This strong
foundation and tradition of clinical excellence
continues to make East Jefferson a great place
for staff to work.
ELLENCE
C
X
E
RTESY C
OU
Another major initiative in 2009 that has resulted in
house-wide collaboration is improvement in patient
throughput. Admitted patients holding in the Emergency
Department is a patient safety issue as well as a patient
dissatisfier. The entire team has joined forces and worked
exceedingly hard to make best use of our resources by moving
patients through the organization as efficiently and effectively
as possible. This initiative has resulted in a significant decrease
in length of stay and improved patient satisfaction.
The commitment to quality by the East Jefferson General
Hospital leadership resonates throughout the organization.
It begins with the strategic initiatives set by the Governing
Board and permeates throughout every level. Nursing’s vision
for quality aligns with the strategic initiatives and places the
patient in the center of care as depicted by the nursing patient
care model. It is the focus on this model that drives nursing to
transform care at the bedside. At EJGH, nurses are at the heart of
improving care for our patients.
The nursing patient care model depicts
nursing’s vision for quality by placing the
patient in the center of care.
3
Evidence-Based
Practice
In 2009, two evidence-based
practice showcases were hosted
at East Jefferson General Hospital.
These EBP projects were the
result of the direct-care nurses’
clinical inquiries regarding practice
issues. Posters were presented
to disseminate the outcomes of
their research to all nursing staff.
Researching nurses utilized the
Evidence-Based Practice Model and
the Clinical Science Investigates
(CSI) toolkit to guide them, confirm
current practice, make recommendations for practice changes or to
determine if additional evidence
is needed prior to drawing a
conclusion.
4
Teamwork is the key to our success.
Evidence-Based Showcase
Presentations: May 2009
First place winner – Oncology
Is the Palliative Care Team underutilized in the inpatient population?
Second place winner –
Critical Care
Zap Vap: Will a specialized
Endotracheal tube help?
Third place winner –
Skilled Nursing FLoor & Rehab
Joint Project
Will an effective, evidence-based bowel
and bladder program impact falls rate
in the post-acute setting?
5 East: Step-Down telemetry
In a witnessed cardiac arrest, is a
pre-cordial thump more effective than
no pre-cordial thump?
Critical Care
Implementation of an evidence-based
clinical pathway to improve heart
failure
Intensive Care Unit
What is the appropriate solution for
hemodynamic lines?
Wound Center / Wound OStomy
Continence Nurses
Do pressure reduction measures
improve outcomes with patients
scoring 16 or above on the Braden
Scale?
Honorable mention –
7 East: Orthopedics
The effects of focused rounding on
post-op orthopedic patients in the
acute care setting
3 East: Step-Down telemetry
Does the use of a mobility protocol
decrease length of stay?
Critical Care Unit
Implementation of Evidence-based
clinical pathway to improve heart
failure.
Evidence-Based Showcase
Presentations: November 2009
GI / Endospcopy
Is the current standard of practice
of pulse oximetry during endoscopy
procedures with procedural sedation
adequate to safely monitor patients for
cardio respiratory complications?
2 East: Step-Down telemetry
What is the best practice for
ambulation protocols on post-op heart
patients?
Same Day Surgery
In SDS patients, what is the most
effective pre-op anti-emetic to control
post-operative nausea?
Post Anesthesia Care Unit
What is the effect of multigenerational
nursing staff on PACU patients in terms
of PACU length of stay, unanticipated
ICU admits, and job satisfaction?
3 East: Step-Down telemetry;
Wound ostomy continence
nurses; Skilled Nursing Facility
Is no-sting skin prep effective in
preventing skin breakdown in the
incontinent patient?
Peri-operative Services
What are the most effective
mechanisms for decreasing flash
sterilization in the Operating Room?
Pulmonary Rehab and
Respiratory Care
What are evidence-based tobacco
dependence screening and treatment
services?
Emergency Medical Services
Does 12-lead EKG acquisition
and transmission from the field
(pre-hospital) improve overall response
time from STEMI?
Emergency Department
What are the national standard
practices for reducing blood culture
contamination as compared to policies,
procedures, and practices employed at
EJGH?
6 East: Acute Care
Does standardization of handoff
communication impact the quality of
care in medical surgical patients?
Cardiology
What is the safest minimal length of
bed rest required for patients who
have undergone an uncomplicated
diagnostic angiogram followed by
manual removal of the arterial sheath?
Wound ostomy continence
nurses
Compared to national benchmarks, are
EJGH patients with diabetes admitted
to the ICU more at risk of developing a
hospital-acquired pressure ulcer?
Pulmonary
What are the standards for cardiac
monitoring during oxygen desaturation
studies?
Coronary Care Unit
What are the mechanisms for
minimizing interruptions in CPR during
defibrillation?
5 East: Step-Down telemetry
Would oral care protocol decrease
hospital acquired pneumonia among
NPO patients in the acute care setting?
Woman and Child Services
Is the Woman and Child Services
nursing practice consistent with
national guidelines for skin-to-skin and
breastfeeding augmentation?
5
New Knowledge,
Innovations and
Improvements
Nursing practice is advanced by
new knowledge and innovation.
It is clear through examples that
utilization of new knowledge and
innovation drive improvements
in the quality of patient care.
Our shared governance model,
utilization of our Electronic Medical
Record (EMR), e-learning and
human simulation lab are major
components that guide our nurses
to design changes to systems that
make a difference for both nurses
and our patients.
6
Nurses Improve Practice through
Technology and Information Systems
Emergency Department Redesign and
Computerized Physician Order Entry (CPOE)
Implementation
The initiative to implement CPOE was begun to
improve patient safety and throughput in the
Emergency Department. The Clinical Applications
Department Manager and Information
Technology’s COMPAS Program Manager led
the project and were joined by a Nurse Analyst,
who is an experienced Emergency Department
nurse. They were chosen to assist Emergency
Department physicians to design any workflow
changes that would be required of Emergency
Department nursing staff.
INet Implementation
INet is CERNER’s documentation and data retrieval
solution for intensive care patients. INet allows for
more efficient input of nursing assessment results
including interfacing of data from the bedside
monitors directly into the EMR, once accepted by
the nurse. It also facilitates viewing of the results
in a method that is designed for intensive care
patients. The project leader for iNet was a Nurse
Analyst with ICU experience and the co-leader
was a Nurse Analyst with NICU experience.
Ventilator Acquired Pneumonia (VAP)
New computer orders, tasks and powerforms
were created to support practice changes to
drive reduction of VAPs. This initiative was the
result of recommendations from the Clinical
Nurse Specialist in the Critical Care Division.
Electronic Documentation Forms
As a result of feedback from direct care nurses
during Nurse Analyst rounds or via email, multiple
changes were made to electronic documentation
forms.
Improving Care Processes
The Nurse Analysts were able to develop and
make changes to existing reports in an effort
to assist charge nurses and nurse managers in
following up with care processes.
We embrace and encourage creativity and innovation.
Scott Hunter, RN
7
We commit to quality in everything that we do.
Nerissa Wood, RN
8
Nurse advocacy supports unit, division and hospital goals
in the following areas:
Replacement of hospital beds to improve
quality and patient care
Through the analysis of prevelence study data, the
Skin Wound Assessment Team identified a need
for standardization of hospital beds and surfaces.
Reduction in falls and the use of restraints
Members of the Falls Committee of VOICE,
determined that creating an in-house sitter pool
with specific falls prevention training without the
use of restraints would be beneficial to patient
safety and quality of care.
Implementation of an electronic medical
record documentation solution for critical
care areas
The critical care managers and direct care nurses
identified assessment opportunities to improve
quality and consistency of documentation
supporting clinicians in the critical care setting.
Reduction in the average length of stay
Length of stay reduction has been a key focus for
multi-disciplinary teams to ensure patients receive
the appropriate levels of care.
Nurses
Driving Change
Nurses at all levels of the
organization are empowered
and encouraged to identify
resources necessary for safe
and effective patient care.
Nurses serve on almost every
committee or improvement
team that impacts patient care
and team member safety.
Average Length of Stay (February 2008 – December 2009)
7.0
AVERAGE LEGTH OF STAY DAYS
6.5
6.0
Medicare LOS
MLOS GOAL
5.5
All Payer LOS
APLOS GOAL
5.0
4.5
4.0
3.5
2/08
3/08
4/08
5/08
6/08
7/08
8/08
9/08 10/08 11/08 12/08 1/09
2/09
3/09
4/09
5/09
6/09
7/09
8/09
9/09 10/09 11/09 12/09
9
In the beginning of 2009, an action plan was
developed utilizing the evidence-based model
– IHI Real Time Demand Capacity (RTDC) model.
EJGH initiated “Daily Huddles”, a house-wide,
interdisciplinary meeting held each morning
focusing on the demand and capacity of bed
availabilities throughout the hospital.
2500
NUMBER OF BOARDING HOURS
Process Improvements
in patient flow
and throughput
Hours patients were boarded in the Emergency Department 2009
2000
1500
INTERNAL GOAL
1000
500
0
2/09
3/09
4/09
5/09
6/09
7/09
8/09
9/09
10/09 11/09 12/09
Outcome metrics include the following:
• Reduction in Emergency Department wait times
Patients leaving the Emergency Department without being seen 2009
• Improved coordination among Acute and Post Acute
patient flow processes
• Process improvements for bed assignments and moving
of PACU patients to decrease delays
• Enhanced communication regarding discharge planning
and day of discharge
• Identified need for additional Skilled Nursing Beds and
opened SNF 9 in June 2009
10
PERCENT OF PATIENTS LWBS
• Improved communication and collaboration among unit
leaders, care managers and ancillary departments related
to targeted bed needs
4%
NATIONAL AVERAGE
3%
2%
1%
0
2/09
3/09
4/09
5/09
6/09
7/09
8/09
9/09
10/09 11/09 12/09
Rapid Response Team (RRT):
Codes outside Critical Care vs Rapid Response Calls
Codes Outside Critical Care
The Rapid Reponse Team’s purpose is to help reduce the number
of cardiac arrests occurring outside the critical care areas. The goal
for the non-critical care nurses is to adopt the process of activating
the RRT when there has been a change in the patient’s condition.
Recognizing that families are a vital part of the patient’s health
care team, RRT began to explore the concept of allowing persons
(other than healthcare workers), such as guests, to activate a Rapid
Response Call. This concept was approved by administration and
the RRT members began to develop materials for our patients,
guests and staff, keeping the overall goal of saving lives through
the prevention of avoidable deaths as the driving force for the
education. Information regarding Rapid Response is included in
the guest services patient handbook, posters are displayed in the
hospital and the number to initiate a Rapid Response is posted on
the communication boards in each patient room.
25
20
NUMBER OF CODES / RRT
Due to the nurse’s commitment to early intervention when
changes occur in the patient’s status, the number of crisis
interventions resulting in a code outside the critical care areas
has decreased. The nursing staff has embraced this opportunity
to promote positive patient outcomes and decrease mortality.
RRT has been successfully used as a way for our staff to call for
immediate assistance when a patient experiences a change in
their condition, and the outcomes indicate the success of early
detection and its impact on decreasing mortality rates.
Rapid Response Calls
15
10
5
0
11/08 12/08 1/09
2/09
3/09
4/09
5/09
6/09
7/09
8/09
9/09 10/09 11/09 12/09
M
New Knowledge, Innovation, & Improvements
We have an ethical and professional responsibility to
contribute to patient care, the organization, and the
profession in terms of new knowledge, innovations, and
improvements utilizing new models of care, application
of existing evidence, new evidence, and visible
contributions to the science of nursing.
11
Prevention of Ventilator Associated Pneumonia
EJGH Rate
NHSN pooled mean medical surgical all others>15 beds
2.7
3.0
RATE / 1000 VENT DAYS
The interdisciplinary Prevention of Ventilator Associated Pneumonia (VAP)
Team has demonstrated that true collaboration and commitment to translation of research into practice leads to improved patient outcomes. This
team includes critical care nurses, respiratory therapists, a pulmonologist,
Infection Control nurse, Clinical Nurse Specialist and administrators that
monitors emerging research and supports the successful implementation
of strategies to reduce this life-threatening complication. The direct-care
staff, who ensure that evidenced-based care is delivered to patients
receiving mechanical ventilation every day, are the champions of success.
Their commitment to excellence has resulted in a 62% reduction in the
rate of VAP. Building on past success as we work toward eliminating this
healthcare acquired complication, the reduction in VAP since 2007 is 84%.
Ventilator Associated Pneumonia (VAP) Average Annual Rate
2.5
2.3
1.9
2.0
1.5
1.3
1.0
0.5
0.5
0.0
0.0
2008
Celebrating success! “Zapp VAP” potato chips were distributed with labels
2009
2010 YTD Feb
depicting VAP outcomes data.
Keys to this success include:
Ventilator Associated Pneumonia (VAP) 2009 Rate
•Endotracheal tubes with continuous aspiration of subglottic secretions
EJGH Rate
•Change from naso-gastric to oro-gastric tube placement
•Oral care every four hours including plaque removal
•Daily assessment of readiness to extubate with a “sedation vacation”
•Protocols that empower clinicians to make decisions based on research
supported approaches to weaning
•“Tightening the Ventilator Bundle” with electronic strategies to improve
consistency of protocol implementation and communication of the
patient response
•Peer review for quality by nursing staff and respiratory care with
real-time feedback
12
4
VAP RATE PER 1000 VENTILATOR DAYS
•Head of bed elevated 30-45 degrees
NHSN mean (med-surg ICU)
Represents 1 Infection
3
NHSN MEAN
2
1
0
1/09
2/09
3/09
4/09
5/09
6/09
7/09
8/09
9/09 10/09 11/09 12/09
M
Insulin Protocols
The team utilized relevant clinical guidelines from the American College of
Cardiology, American Heart Association, and Society of Thoracic Surgeons
to develop solutions for most of the issues raised, yet the need to build
consensus around the IV Insulin Protocol used to achieve the cardiac
surgery glucose management quality measure goal was still present. At the
request of the interdisciplinary team, a subgroup was developed for the
purpose of reviewing the protocol to include the Certified Nurse Specialist,
ICU Nurse Supervisor, Clinical Excellence nurses, Certified Diabetes
Educators, Clinical Pharmacists, and Endocrinology physicians.
The Columnar Insulin Dosing Protocol© was implemented in our cardiac
surgery patient population with a target blood glucose of 140-180 mg/
dL in the fourth quarter of 2009. The improvement in the practice setting
was the result of intense commitment by the entire care team. The graph
illustrates the measure of patient outcomes as a result of the improvement
in the practice setting.
National Quality Measure: Cardiac Surgery Patients with Controlled Glucose (BG<200mg/dL for glucose readings
closest to 6am on post-op days 1 and 2) Before Practice Change Baseline Data: Q1-Q4 2008; After Practice Change
Data:Q4 No hypoglycemia (BG<70mg/dL ) confirmed since practice change.
Solid structures and processes provide an
innovative environment where strong professional
practice flourishes. Staff are developed, directed,
and empowered to find the best way
to accomplish the organizational goals
and achieve desired outcomes.
Cardiac Surgery Patients with
Controlled Post-Op Glucose
97%
100%
CARDIAC SURGERY PATIENTS
At the heart of our cardiovascular patient care team is the goal of evidencebased, high-quality, interdisciplinary patient care that leads to optimal
patient outcomes. The CABG Team formed in 2008 with the goals of
updating order sets and clinical pathways with the latest research evidence
and clinical guidelines, improving our CABG quality indicators, decreasing
our CABG patients’ length of stay, and continuing to promote an interdisciplinary team approach to care. The team included nurses and leaders from
the Intensive Care Unit, Cardiac Rehab, and the telemetry step-down units
as well as physicians from various specialties. We also utilized the expertise
of our care managers, health information management, clinical dietician,
respiratory therapy, coding, laboratory, and surgery staff on the team to
formulate goals and develop plans to achieve them.
Structural Empowerment
90%
80%
71%
70%
60%
50%
1% Hypoglycemia
No hypoglycemic
events with protocol
Before Practice Change
After Practice Change
40%
30%
20%
10%
0
13
Reduction in Contaminated Blood Cultures
East Jefferson identified an increase in blood culture contamination rates in
2008. A team was assembled and a charter written to outline the purpose
of decreasing blood culture contamination rates.
Blood Culture Contamination Rates: Housewide
PERCENT OF NURSE DRAWS
14%
hospital Rate:
12%
2008. . . . 3.6%
2009. . . . 3.3%
10%
8%
6%
4%
3% THRESHHOLD
2%
0
1/09
2/09
3/09
4/09
5/09
6/09
7/09
8/09
9/09 10/09 11/09 12/09
The goals were to:
•Decrease blood culture contamination
•Reduce the associated inappropriate use of antibiotics, costs and
length of stay
•Increase patient satisfaction
•Successfully decrease blood contamination rate to 3% by 3 months
and maintain this level for 3 months prior to reevaluating threshold
The outcome was to include Blood Culture Collection into the annual
mandatory Nursing Updates as continuing education. The Education
Advisory Board deemed the following education necessary:
•Proper supplies for venipunctures
•Preparation of the blood culture bottle preparation
•Preparation of the skin preparation
•Collection process
•Labeling of specimens
•Use of transfer devices
• Order of draw
• Tips for collection
Blood Culture Contamination Rates: CCU – Nurse Draws
Blood Culture Contamination Rates: ICU – Nurse Draws
14%
12%
ICU Rates:
10%
2008. . . . 4.2%
2009. . . . 2.8%
8%
Charge nurses begin draw
6%
3% THRESHHOLD
4%
12%
CCU Rates:
10%
2008. . . . 6.3%
2009. . . . 2.7%
8%
6%
2%
0
0
2/09
3/09
4/09
5/09
6/09
7/09
8/09
9/09 10/09 11/09 12/09
3% THRESHHOLD
4%
2%
1/09
14
PERCENT OF NURSE DRAWS
PERCENT OF NURSE DRAWS
14%
1/09
2/09
3/09
4/09
5/09
6/09
7/09
8/09
9/09 10/09 11/09 12/09
Reduction in Elective Inductions
The EJGH Woman and Child Services nurse educator attended
the AWHONN Fall conference that year. As a result of the
information shared at this conference, information gleaned
through AWHONN’s JOGNN, and the results of the professional
networking with Dr. Simpson, Woman and Child Services staff
designed a plan to begin the process of changing current
practices surrounding elective inductions. Data collection began
in January 2007, and was presented to the Perinatal Work Team
in August 2007. Recommendations to require an “Induction
Indication” at the time of scheduling and the indication was
presented to EJGH Obstetrics Section meeting in December,
2007. A motion was passed to adopt the new standard “Elective
inductions cannot be started before 38 weeks 6 days. Elective
inductions must be scheduled no sooner than 14 days before the
due date.” Education regarding the new standard was conducted
and the new guidelines were implemented in January 2008.
The reduction in the number of elective inductions being
performed less than 39 weeks gestation has meant a decrease in
the number of “near term” infants delivered, with their respective
complications: feeding problems, respiratory immaturity issues,
and thermoregulation issues.
Elective Inductions < 39 weeks
600
NUMBER OF INDUCTIONS
In the May/June 2006 issue of the Journal of Obstetric,
Gynecologic, & Neonatal Nursing (JOGNN), published by the
Association of Women’s Health, Obstetric, and Neonatal Nurses
(AWHONN), a series of articles on “Strategies for Promoting
Perinatal Patient Safety” were published. One of the specific
topics closely followed in the literature and presented at
professional meetings centered on not performing elective
inductions of labor or elective repeat cesarean sections before 39
weeks gestation.
503
400
Practice change implemented
200
111
18
0
2007
2008
2009
15
We create and maintain a caring, compassionate environment.
Laurie Norman, RN
16
RN Satisfaction
As a Magnet Hospital, EJGH staff nurses participate yearly in the National Database of Nursing Quality
Indicators (NDNQI) RN Satisfaction Survey. The survey is a vehicle to allow nurses to communicate
their satisfaction with different aspects of their work environment, job satisfaction and relationships
with fellow nurses and physicians. EJGH participated in the 2009 September cycle of the RN
Satisfaction Survey achieving a 72% response rate with 516 total respondents. Areas of highest
satisfaction are RN-to-RN relationships, autonomy and professional status.
• A score below 40 indicates low satisfaction
• A score between 40-60 indicates moderate satisfaction
• A score above 60 indicates high satisfaction
EJGH 2009
70%
EJGH 2008
EJGH 2007
60%
EJGH 2006
ALL
50%
40%
30%
20%
10%
0%
Task
RN-RN
RN-MD
Decision Making
Autonomy
Prof Status
17
Certifications
Since 1991, the East Jefferson General
Hospital clinical ladder has provided
nurses with a framework to grow
professionally. The ladder’s pathway
for growth is based on Patricia
Benner’s “From Novice to Expert:
Excellence and Power in Clinical
Nursing Practice”(1984), and is an
incentive for nurses to realize their
professional potential. The focus of
participation in the ladder program is
based on personal growth and peer
recognition.
Earning one’s certification
demonstrates an advanced level
of knowledge, experience and
expertise. The nurses listed on these
pages have earned certification
demonstrating a commitment
to their area of specialty nursing
practice.
* Indicates a nurse that is participating in
the clinical ladder.
18
BCEN Board Certified
Emergency Nurse
Ann Meyer
Michelle Hoskins
Layne Mistretta*
Karen Silady
Todd Matherne
Terry Slieff
Monique St Romain
Pam Mattio*
Shawn Neely
OCN Oncology Certified Nurse
Sherry Allen
Robin Pumila Atkins *
Elizabeth Dannewald
Nannette Davis
Rebecca Endres*
Kathy Higginbottom
Heather Monteleone
Linda Powers
Barbara Servat
Sherry Sherwood*
Nerissa Wood
Amie Brady
Mary Finney -Bergeron
BHN Breast Health Navigation
Certification
Debbie Schmitz
Anna Heim
Margaret Pennick
CHPN Certified Hospice and
Palliative Care Nurse
April Minnich-Haydel
CNOR Certified Nurse
Operating Room
Mary Morvant
Michelle Blanke
Michelle Benoit*
Patsy Whitehorn*
Pamela Zimmerman*
Susie Hammant
Kay Bourg
Darlene Russo
Jennifer Sanders
Nathalie Walker*
Cindy Fitzsimmons*
Pat McGuinness
Mary Laforge
Mary Jo D’Amico
Ann Seal
Robotics
Pat McGuinness
RN-BC Medical Surgical Nurse
Karen Vix*
Mike Sells
Evelyn Schiro
Beth Hathaway
Janet Seuzeneau
Chris Wedig
Terrie Boutte
Patricia O’Leary *
Christine Voiselle *
Lori Morris*
Trish Tillman*
Carol Wedig*
Anne Ureta*
Jody Torres*
Paula Alford-Estrade*
Cheryl Sanders*
Wanda Cieslinski*
Beth Norris*
Margret Longstreet
Fran Pittman
Sandra Stevens*
Mary Parent*
Cheryl Cottier*
Paula Adamcewicz*
Richard Adamcewicz
Tiffany Holdsworth*
Tia Vilardo*
CMSRN Certified Medical
Surgical Registered Nurse
Debbie Olavarrietta
Royceann Fugler*
Lindy Sells
Amy Denton
Casey Volion *
Anthony Dearman *
Monica Johnson *
Kristie McConnell*
Sandy Schlaudecker
Heather Gilberti*
Michelle Meilleur
Gwen Theard
Stephanie Williamson*
Leslie LeBlanc
Andre Guette
Tanis Quillens
Tanya Solly
RN-BC General Nursing
Christine Rovira*
Ambulatory Care Nursing
Jacqueline Terrebonne *
CCRN Critical Care
Registered Nurse
Mary Lipani *
Carol Muller*
Kelly Meyn *
Irene Schwartz*
Donna Apperson *
Michelle Kingston*
Sandy Lavigne*
Ben Marziale*
Leslie Ricalde*
Becky Zollinger
Lynn Strain*
Mary Rowe*
Ashleigh Amick
Bonnie McCarty*
Patty Parnell*
Karen Schembre*
Patti Ginnard
Jan Glaudi*
Dee Ann Datri*
Lisa Kennedy
Beth Lacoste*
Nicole Jones*
Mary Genovese*
Gerry Schneider
Erika Webb*
Paul Blomakains
Danielle Pepper
Brittany Johnson
Jennifer Lamonte*
Joseph Aclina
Britney Kiger
Bonnie McCarty
Karen Schembre*
RN-BC Pain Management
Marti Highstreet *
CIC Certified Infection Control
Carol Scioneaux
CWON Certified Wound
and Ostomy Nurse
Bernie Cullen
WOCN Wound Ostomy
Continence Nurse
Meliss Carlson*
Susan Scotton *
CON Continence Ostomy Nurse
Linda Davis*
CDE Certified Diabetes Educator
Cindy Freudenthal
Rose Wade*
CRRN Certified Rehabilitation
Registered Nurse
Melissa Constance
Regan Poplin
Joe Eppling*
Janine Fontenot
Bridget Boogaerts*
RN-BC Psychiatric and Mental
Health Nurse
Janet Wusthoff
Stephen Menendez
Tammy Melito
Evelyn Grijak
RN-BC Gerontological Nurse
Marianne Call*
Denise Henry
CPHQ Certified Professional in
Healthcare Quality
Denise Henry
Pam Mattio*
Pam Turner
Aubrie Augustus
CPUR Certified Professional
Utilization Review
Kay Pastor
Pam Turner
Jeanne Downs
Patsy Deluca
Suzanne Snider
Margaret Longstreet
Tara Strickland
Scott Hunter *
Lauren Marx*
Rebecca Olavarietta*
Courtney Guidroz*
Cheryl Sanders *
Melissa Crovetto*
Christine Rome*
Bevin Gautreaux
Julie Marchese
Thuy Duong Nguyen*
Amber Plymale*
Joe Sims*
Chrissy Moore*
Natalie Ripp*
Monica Schinetsky
Nicole Estes
CCNS Adult Acute and Critical
Care Clinical Nurse Specialist
Nicole Jones*
ACNS-BC Adult Health Clinical
Nurse Specialist
Nicole Jones*
Laurie Norman*
IBCLC International Board
Certified Lactation Consultant
Janet King*
Maryleen Lillis
Stephanie Mercola
Barbara Carson*
Mary Downman*
Michelle Garsaud*
Jan Gourgues
Susie Amick*
Heather Frught*
LCCE Lamaze Certified
Childbirth Educator
April Nielsen
Barbara Carson*
Rebecca Chameco*
RN-BC Inpatient Obstetrics
Barbara Carson*
Monique Cerise
Cammy Goldberg*
Lisa Hickey*
Lauren Keim*
Marnie Landry
NCC NICU Nurse
Jenny Laviolette
RN-BC Pediatrics
Cheryl Hollier*
Maternal Newborn Nurse
Rebecca Chameco*
Stacey Duggan *
RN-C Maternal Child Nurse
Linda April
APN-BC Acute Care Nurse
Practitioner
Brenda Salmeron
FNP-BC Family Nurse
Practitioner
Vicki Thiel*
NCC Gynecologic Reproductive
Healthcare For Primary Care
Vicki Thiel*
NCC Low Risk Neonatal Nursery
RN-BC Cardiac Rehabilitation
Janel Lemaitre*
ONC Orthopedic Nurse Certified
Elliot LeNormand
Lauire Norman*
Bridget Boogaerts*
Monica Johnson*
Tammy Dwelle
Evelyn Bijou
Heidi Barth
Diane Hughes
Suzanne Sicotte
RAC-CT Resident Assessment
Coordinator-Certified
Connie Gros
CCM Certified Case Manager
Stephanie Palmisano
CHES Certified Health Education
Specialist
NEA-BC Nurse Executive
Advanced Board Certified
Janice Kishner*
Joe Eppling *
Bernie Cullen
Amy Boimare
CPAN Certified Peri Anesthesia
Nurse
Barbara Glover
RN-BC Board Certified Cardiac
Vascular Nurse
Denise Williams
Jennifer Babin
Robbie Roussel*
Bridget Boogaerts *
Judy Scanlon*
Nicole Jones*
NE-BC Nurse Executive
Basic Board Certified
Paula Alford-Estrade*
Ann Seal
CGRN Certified Gastrointestinal
Registered Nurse
Linda Gelpi
Anne Nash
Mary Downman*
Judy Vollenweider *
NCC High Risk Neonatal Nursery
Gina Bourgeois *
RNC-NIC Neonatal Intensive
Care Nursing
Helen Petrie*
NCC Neonatal Nurse Practitioner
Earl Bollinger
Cindy Danner
Oliver DeGravelle
Shane Landreaux *
Melissa Leonard
Cathy Marcus
Pam Yeager
19
Nurses Currently Enrolled in
Nursing Programs:
Beth Norris MSN Healthcare Systems Mgt.
Christine Rovira MSN Healthcare Systems Mgt.
Marianne Call Nurse Practitioner–Mental
Health
Jennifer Manning Doctoral Program
Leigha Niemann Nurse Practitioner–
Acute Care
Rossy Balmaceda Nurse Practitioner–
Acute Care
Serneka Stevenson Nurse Practitioner
Kawander Parquet Nurse Practitioner
Chloe Villavaso Clinical Nurse Specialist–
Adult Health
Scott St Amant Nurse Practitioner–
Mental Health
Jeannie Delaune RN to MSN
Renee Alexius RN to MSN
Carrie Vargas RN to MSN
Britney Kiger RN to MSN
Erin Young RN to MSN
Kristin Contreras RN to MSN
Kristi Alcina RN to MSN
Thuy Nguyen RN to MSN
Katherine Walker RN to MSN
Scott Hunter RN to BSN
Jennifer Sterling RN to BSN
Dawn Comardelle RN to BSN
Dee Ann Datri RN to BSN
Michelle Atzenhoffer RN to BSN
Bessie Grady RN to BSN
Jason Kiger RN to BSN
Charlotte Prudhomme RN to BSN
Danielle Pepper RN to BSN
Lisa Hoffman RN to BSN
Edward Graebert RN to BSN
Nicole Fox LPN to RN
Deborah Puglis LPN to RN
Nina Joseph LPN to RN
Sandra McCoy LPN to RN
Stephanie East LPN to RN
Geneva Carter LPN to RN
Linda Garic LPN to RN
Tracey Linson LPN to RN
Jacquia Miller LPN to RN
20
Congratulations to our 2009 Nurse
Graduates:
Laurie Norman APRN, CNS Masters of Science
in Nursing–Adult Health Clinical Nurse Specialist
Cynthia Freudenthal Masters in Health Care Administration
Jennifer Manning RN to CNS Masters
Lynn Strain RN to BSN
Vicki Strecker LPN to RN
Dawn Seghers LPN to RN
Theresa Hammrick LPN to RN
Ramsey Schmitz LPN to RN
Tinga Kenner LPN to RN
Alesha Bates LPN to RN
Denise Delange LPN to RN
Cassandra Downing LPN to RN
Leadership in Professional
Organizations:
Janice Kishner
• ACHE Regent for the State of Louisiana
• ACHE Personal Services Committee
• Officer of the Louisiana Chapter of the
American College of Healthcare Executives
• Governing Board: Louisiana Organ
Procurement Agency
• Board of Directors: East Jefferson General
Hospital Foundation Board
• Foundation Board: Delgado Community
College
• Women’s Healthcare Executive Network
Joe Eppling
• Treasurer NOAONE (New Orleans Area
Organization of Nurse Executives)
Bernie Cullen
• Journal reviewer for the Journal of Wound,
Ostomy, Continence Nursing
Victoria Johnson
• President of LA Assoc. of Student Nurses
Lori Morgan Morris
• Board Member of The American Lung
Assoc. (maintained)
• Founder and Facilitator of The Sarcoidosis
Support Group of Louisiana
M
Transformational Leadership
Senior leadership creates the vision for the
future, and the systems and environment
necessary to achieve that vision. We listen,
challenge, influence and affirm as we
make our way into the future.
Brenda Lege
• Program Director for Magnolia Chapter
of Hospice and Palliative Care Nurse
Association
Bonnie McCarty
• President-elect of Greater New Orleans
Chapter American Association of Critical
Care Nurses
Cheryl Carter
• Chair of Southeast Region Emergency
Nurse Special Interest Group
Beth Lacoste
• Ambassador American Association of
Critical Care Nurses
Andre Guette
• Secretary Academy of Medical Surgical
Nurses Deep South Chapter
Denise Henry
• Ex-Officio CCA Representative for the
Louisiana Chapter of American College of
Cardiology
Monica Johnson
• Historian Academy of Medical Surgical
Nurses Deep South Chapter
Marianne Call
• Board Member New Orleans Continuity
of Care
Donna Block
• Member at Large Southeast Louisiana
Infusion Nurse Society (SLINS)
Rose Wade
• President-elect South East Louisiana
Association of Diabetes Educators (SeLade)
Karen Silady
• Treasurer Louisiana Emergency Nurses
Association
Leslie Batson
• Secretary Louisiana Emergency Nurses
Association
Layne Mistretta
• Louisiana Emergency Nurses Association
Board of Directors
Paula Adamcewicz
• Board Member Greater New Orleans
Immunization Network
Natalie Walker
• Louisiana Nursing Supply and Demand
Commission member
• Association of periOperative Registered
Nurses National Treasurer
• Association of periOperative Registered
Nurses of New Orleans Chapter member of
nominating committee
• Association of periOperative Registered
Nurses of New Orleans Chapter Vice
President-elect
• Association of periOperative Registered
Nurses National periOperative Nursing
Data Set Task Force (PNDS) member
• Association of periOperative Registered
Nurses National Award Committee
Barbara Roth
• Board Member Louisiana Society of
American Pain Nurses
East Jefferson General Hospital Foundation
The EJGH Foundation is the philanthropic arm for East Jefferson
General Hospital and is governed by a community Board of Trustees.
Their generous support of the community provides the resources
necessary for EJGH to maintain its excellence in technology, facilities
and programs. Their mission is to generate philanthropic support
for East Jefferson General Hospital through advocacy, education,
communication and active ambassadorship to the community.
In 2009, The Foundation provided over $256,000 for patient care,
community outreach, nursing and clinical training, and humanitarian
efforts. Services and organizations that directly benefited from the
support included:
East Jefferson General Hospital
Janice Kishner, MSN, RN, FACHE
Bonnie McCarty, RN
2009 Nightingale Awards
The Louisiana State Nurses Association hosts the Nightingale Awards each
year to honor nominees from across the state recognized by their peers
and organizations. This prestigious award highlights nurse accomplishments in quality services, community work, education, leadership and
mentorship. On February 20, 2010, the Louisiana Nurses Foundation hosted
its ninth Annual Nightingale Awards Program. EJGH proudly recognizes the
following exceptional nurses for 2009:
Nurse Administrator of the Year Nominee
and Award Recipient
Janice Kishner, Administration
Clinical Practice Nurse of the Year Nominee
and Award Recipient
Bonnie McCarty, Intensive Care Unit
Advanced Practice Nurse of the Year
Nominee
Beth LaCoste, 2 East Step Down Telemetry
Nurse of the Year Nominee
Barbara Carson, Woman & Child Services
Mentor of the Year Nominees
Tanis Quillens, Center for Nursing
Knowledge and Research
Monique St. Romain, Emergency
Department
Rookie of the Year Nominee
Ramsey Schmitz, Skilled Nursing Facility
Nurse Educator of the Year Nominee
Monica Johnson, 7 East Orthopedics
Cancer Survivor’s Brunch
Clinical Leadership Program
EJGH Ladies Auxiliary
Humanitarian Fund
Nursing Educational Material
Pastoral Care Department
Volunteer Services Department
Wellness Center
Women and Child Department – Clinical
Nursing Education Program
Community
American Heart Association
American Cancer Association
Delgado Community College
Allied Health Program
Five Wishes Advanced Directive
Program
New Orleans Medical Mission
Our Lady of the Lake
Accelerated Nursing Program
Senior Expo
Ladies Auxiliary
Founded in 1971 to support the aims and objectives of the hospital, the
Auxiliary has supported East Jefferson through volunteer service and
fundraising efforts ever since. At its inception, this non-profit group
was comprised of community volunteers dedicated to brightening the
stays of EJGH patients by delivering books and magazines throughout
the hospital. Eventually, the Auxiliary expanded to include a myriad of
philanthropic programs and events, including the hospital gift shop,
The Sunshine Boutique.
Nursing certification and education is at the heart of the Auxiliary’s
mission by offering financial support to those in need. In 2009, through
a generous contribution of $29,295, 107 individuals were awarded
financial assistance.
21
Great 100 Nurses
The idea for an event to recognize
outstanding nurses and nursing’s many
successes was conceived in 1986. This event
formally honors 100 great nurses and their
contribution to our state and profession.
Every year, statewide community, civic,
health care and government leaders,
family, friends and peers join together at
a fall celebration to honor these great 100
nurses. Their patients, families, colleagues,
friends and community leaders nominate
these nurses for this prestigious award.
The Louisiana Great 100 Nurses celebrated
its 23rd year as it again recognized nurses
throughout the state for their exemplary
contribution to the profession of nursing.
EJGH is proud of the individuals recognized
as leaders in nursing. The Great 100
Foundation honored the following EJGH
nurses as Great 100 Nurses for 2009:
Amie Brady
Melissa Crovetto
Anthony Dearman
Lori Gagliano
Heather Gilberti
Cammy Goldberg
Cheryl Hollier
Jennifer LaMonte
Jennifer Manning
Rebecca Olavarrieta
Judy Scanlon
Karen Schembre
Janet Seuzeneau
Sherry Sherwood
Sandra Stevens-Schlaudecker
Linda Silversten
Nerissa Wood
22
EJGH Great 38
In honor of its 38th anniversary, EJGH
recognized 38 extraordinary team
members for their dedicated service to
the hospital. Team members throughout
the hospital submitted nominations, and
those recognized were selected by a
panel and awarded for their contribution
to the hospital and the community we
serve. The following nurses were honored
as part of East Jefferson General Hospital’s
Great 38:
Merv Wheat, 5 East Step Down Telemetry
Rachel de Mahy, Endoscopy
Bonnie Hensley, Geriatric Behavioral
Health Unit
Angel Houle, Oncology
Lori Morris , Respiratory Care
Kim Licali, Labor & Delivery
Rose Martin, 4 East Woman & Child Services
Jennifer Martinsen, NICU
Stephanie McDermott, NICU
Maureen Nelson, NICU
Jeanne Tillery, 3 East Step Down Telemetry
Fran Pittman, 3 East Step Down Telemetry
Ann Meyer, Emergency Department
EJGH Team Member Recognition
Program
East Jefferson is proud of a hospital-wide
recognition program that names a Team
Member of the Month and Leader of
the Quarter. Each is nominated, selected
and highlighted for their outstanding
contributions. The following nurses were
recognized in 2009:
January Team Member of the Month
and 2009 Team Member of the Year
Donna Carbajal, RN, Organizational
Effectiveness
February Team Member of the Month Renee Coleman, RN, Care Management
The following nurses were recognized as
Leaders of the Quarter in 2009:
2nd Quarter 2009
Jody Torres, RN, Information Technology Nurse Analyst
3rd Quarter 2009
Jenna Wilson, RN, Staffing Office
EJGH Focus on Excellence Award
Recognition Program
The EJGH Focus on Service Excellence
Award recognizes and rewards projects,
teams and departments that demonstrate a significant organizational impact
resulting in service excellence and
improved outcomes.
2009 Focus on Service Excellence
Award Recipients
• 7 East Ortho/Neuro Charge Nurse
and Receptionist
Implementation of the Ortho/Neuro
Charge Nurse and role of receptionist
resulted in enhanced patient care
and timely information sharing. Also,
a marked improvement in the 7 East
PRC patient satisfaction scores were
noted as well as positive feedback
from physicians and staff.
American Heart Association Gold
Performance Achievement Award
for Heart Failure
East Jefferson General Hospital was
awarded the Gold Performance
Achievement Award, the highest
possible honor, from the American Heart
Association’s “Get With The Guidelines”
program for improving the care of heart
failure patients in our community. This
award signifies that the American Heart
Association recognizes EJGH for practicing evidence-based, quality care of our
heart failure population.
American Cancer Society
Spirit Award
Bernie Cullen, RN, and Heather
Montoleone, RN, were named recipients
of the American Cancer Society’s Spirit
Award for their contributions to the field
of cancer and for their work with cancer
patients in the Greater New Orleans area.
The Spirit Award was established to honor
and celebrate those in the community
who have made significant contributions
in the fight against cancer. The distinction
is presented to medical professionals, as
well as to those who do not work directly
in the medical field.
New Orleans CityBusiness
• 2009 Best Places to Work
• 2009 Women of the Year
Mary Genovese, RN
Mary was recognized for her life-long
dedication to the nursing profession,
the patients entrusted to her care, and
for being a mentor to the generation
of nurses who have followed her path.
• 2009 Innovator of the Year
Computerized Physician Order Entry
Innovator of the Year recognizes individuals, companies and organizations
that succeed by operating in new
and exciting ways or creating unique
products. Honorees are selected
based on key innovation, years on
the and success in the marketplace.
Computerized Physician Order Entry
is the latest technology added to the
Emergency Department. It represents
a multi-disciplinary approach to
advancing electronic health records
and allows physicians to directly assess
a patient and order tests in real-time
with hand-held computer scanners.
• 2009 Health Care Hero
Cheryl Carter, RN
Cheryl was recognized as a 2009
Health Care Hero for leadership,
compassion and dedication to the
community she serves. Health Care
Heroes Awards are given to healthcare
professionals throughout the metropolitan area and highlight clinical
excellence. Categories include physician, nurse, first responder, professional, volunteer and animal care.
Working together, we ensure everyone benefits from our collective wisdom.
Nicole Jones, RN
23
The American Nurses Association’s Bill of Rights for Registered Nurses
Registered nurses promote and restore health,
prevent illness, and protect the people entrusted
to their care. They work to alleviate the suffering
experienced by individuals, families, groups, and
communities. In so doing, nurses provide services
that maintain respect for human dignity and
embrace the uniqueness of each patient and
the nature of his or her health problems, without
restriction in regard to social or economic status.
To maximize the contributions nurses make to
society, it is necessary to protect the dignity and
autonomy of nurses in the workplace. To that end,
the following rights must be afforded:
professional standards and legally authorized
scopes of practice.
3. Nurses have the right to a work environment
that supports and facilitates ethical practice, in
accordance with the Code of Ethics for Nurses and
its interpretive statements.
4. Nurses have the right to freely and openly
advocate for themselves and their patients,
without fear of retribution.
5. Nurses have the right to fair compensation for
their work, consistent with their knowledge,
experience, and professional responsibilities.
1. Nurses have the right to practice in a manner that
fulfills their obligations to society and to those
who receive nursing care.
6. Nurses have the right to a work environment that
is safe for themselves and their patients.
2. Nurses have the right to practice in environments
that allow them to act in accordance with
7. Nurses have the right to negotiate the conditions
of their employment, either as individuals or
Code of Ethics for Nurses – Provisions
1. The nurse, in all professional relationships,
practices with compassion and respect for the
inherent dignity, worth, and uniqueness of every
individual, unrestricted by considerations of social
or economic status, personal attributes, or the
nature of health problems.
2. The nurse’s primary commitment is to the
patient, whether an individual, family, group, or
community.
3. The nurse promotes, advocates for, and strives
to protect the health, safety, and rights of the
patient.
4. The nurse is responsible and accountable for
individual nursing practice and determines the
24
collectively, in all practice settings.
The American Nurses Association (ANA) is a national
professional association. ANA policies reflect the thinking
of the nursing profession on various issues and should be
reviewed in conjunction with state association policies
and state board of nursing policies and practices. State
law, rules, and regulations govern the practice of nursing.
The ANA’s “Bill of Rights for Registered Nurses” contains
policy statements and does not necessarily reflect rights
embodied in state and federal law. ANA policies may be
used by the state to interpret or provide guidance on the
profession’s position on nursing. Adopted by the ANA
Board of Directors: June 26, 2001.
The Nursing Services of East Jefferson General Hospital
embraces and endorses the Code of Ethics for Nurses, voted
and accepted by the American Nurses Association House
of Delegates, June 30, 2001. Every aspect of the practice of
nursing and professional development will embody these
ethical guidelines herein.
Voted and accepted by the ANA House of Delegates on June 30, 2001.
appropriate delegation of tasks consistent with
the nurse’s obligation to provide optimum patient
care.
5. The nurse owes the same duties to self as to
others including the responsibility to preserve
integrity and safety, to maintain competence, and
to continue personal and professional growth.
6. The nurse participates in establishing, maintaining,
and improving health care environments and
conditions of employment conducive to the
provision of quality health care and consistent
with the values of the profession through
individual and collective action.
7. The nurse participates in the advancement of
the profession through contributions to practice,
education, administration, and knowledge
development.
8. The nurse collaborates with other health
professionals and the public in promoting
community, national and international efforts to
meet health needs.
9. The profession of nursing, as represented by
associations and their members, is responsible for
articulating nursing values, for maintaining the
integrity of the profession and its practice, and for
shaping social policy.
Exemplary Professional Practice
The true essence of a Magnet organization stems from exemplary
professional practice within nursing. This entails a comprehensive
understanding of the role of nursing; the application of that role
with patients, families, communities, and the interdisciplinary
team; and the application of new knowledge and evidence.
Beth Ramsey-LaCoste, RN
M
Empirical Quality Results
As pioneers of the future, we demonstrate inventive
solutions to numerous problems inherent in our healthcare
systems today through innovative structure and various
processes. We remain focused on achieving the best
possible outcomes for the patients we serve.
East Jefferson General Hospital
Louisiana’s First Nurse Magnet Hospital
4200 Houma Blvd • Metairie, Louisiana 70006 • 504-456-4000 • www.ejgh.org