2015 - Mission Health

Transcription

CARING with a MISSION
2015
NURSING
Annual Report
Caring with a Mission
represents the approach of Mission Health nurses in achieving
Our BIG(GER) Aim
to get each patient to their desired outcome,
first without harm, also without waste and with an
exceptional experience for every patient and family.
ABOUT MISSION HEALTH
Mission Health, based in Asheville, N.C., is the state’s sixth-largest health system and
the region’s only not-for-profit, independent community hospital system governed and
managed exclusively in western North Carolina. Mission Health has been recognized as
one of the nation’s Top 15 Health Systems 2012-2015 by Truven Health Analytics, formerly
Thomson Reuters. Mission Health is the only medium-sized health system to receive this
recognition four years in a row, and the only health system in North Carolina to achieve
that distinction.
Mission Health, which traces its roots in the region back to 1885, operates six hospitals,
numerous outpatient and surgery centers, post-acute care provider CarePartners, and the
region’s only dedicated Level II trauma center. Its medical staff consists of more than 1,000
physicians and is certified in more than 50 medical specialties and sub-specialties.
Mission Health has seven Centers of Excellence: Cancer, Heart, Mission Children’s Hospital,
Neurosciences, Orthopedics, Trauma, and Women’s Health. Mission Hospital, located in
Asheville, is the system’s flagship hospital and is licensed for 795 beds. It is the regional
referral center for tertiary and quaternary care. It also includes Mission Children’s Hospital—
the region’s only children’s hospital. Other Mission Health member hospitals include
Angel Medical Center in Franklin, Blue Ridge Regional Hospital in Spruce Pine, HighlandsCashiers Hospital in Highlands, McDowell Hospital in Marion, and Transylvania Regional
Hospital in Brevard. With approximately 10,600 employees and 2,000 volunteers, Mission
Health is dedicated to improving the health and wellness of the people of western North
Carolina. For more information, please visit mission-health.org or @MissionHealthNC.
Front Cover: Kelley Stewart, RN, Staff nurse, Medical/Surgical Unit and Cardiology Care
Unit/Intensive Care Unit, Blue Ridge Regional Hospital, author of “Caring with a Mission” theme.
Table of Contents
A Message from Kathleen C. Guyette, MSN, RN, NEA-BC
4
A Message from Ronald A. Paulus, MD
5
Mission Health Member Hospitals6
Mission Health Chief Nursing Officer Leaders
7
Accolades
8
Leadership
26
• Lighting The Bridge of Communication, Blue Ridge Regional Hospital 27
• The Remembrance Tree, Blue Ridge Regional Hospital
28
• Emergency Department 2-Way Radio Communication
Regional Member Hospitals
29
Professional Practice
• Coordinating Care for Postpartum Hemorrhage Emergencies
Mission Health
• Journey to Acute Stroke-Ready Hospital, Angel Medical Center
• Cancer Survivorship Program, Transylvania Regional Hospital
• Right Patient, Right Bed, Right Time, McDowell Hospital
• Enhanced Emergency Care, Highlands-Cashiers Hospital
• Crossroads Program for Terminally Ill Patients, CarePartners
• A Board Game Impacts Emergency Care
Transylvania Regional Hospital
• From OB to OR for C-sections, Mission Hospital
• Hospice Wound Care Improvement, CarePartners
Innovations in Care
•
•
•
•
Virtual Sitters on Neurosciences, Mission Hospital
Telehealth Meets Wound Care, Mission Hospital
New Graduate Intensive Program, Highlands-Cashiers Hospital
Renal Medicine Nurses Leading Real Results, Mission Hospital
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
Grateful Patients and Family Members
46
Nurses Week Caps and Quotes
47
A Message from
Kathleen Culhane Guyette, MSN, RN, NEA-BC
Dear Friends and Colleagues,
M I S S I O N H E A LT H N U R S I N G A N N U A L R E P O R T | 2 0 1 5
My heartfelt gratitude goes out to the nursing
teams of Mission Health! Over the past five years,
you made tremendous strides in standardizing
care for our patients and their families in our
facilities across western North Carolina. This year,
we continued the journey through numerous
projects to offer best practice compassionate care
to meet our goals of the BIG(GER) Aim.
4
We focused on improving rural healthcare through
a collaborative project with the University of
North Carolina at Chapel Hill, School of Nursing.
One of our hospitals is among four diverse rural
North Carolina healthcare facilities studying
systems in the emergency department. This
important interprofessional work improves
communication, teamwork and patient outcomes and will inform replication for
other facilities.
Our hospice nurses developed a palliative wound care protocol to increase comfort
for end-of-life patients and decrease time spent in treatment procedures. Through
professional development courses, our home health nursing team enhanced
services to patients who decided to continue curative treatments rather than
choose hospice care.
We implemented an emergency department triage system, which identifies in more
detail the condition of the patient and the resources needed for excellent care. Our
renal medicine nurses used care process model guidelines to significantly decrease
the patient’s length of stay and readmission rates. We extended the new graduate
RN intensive program to regional member hospitals, which augmented resources
to help nurses in the community hospitals transition from the academic world into
nursing practice.
Thank you for your compassionate care, your clinical expertise and your willingness
to consistently improve patient- and family-centered care. You make a difference in
the lives of our visitors, friends and families in western North Carolina!
Kathleen Culhane Guyette, MSN, RN, NEA-BC
Senior Vice President of Patient Care Services and President, Regional Member Hospitals
Mission Health
A Message from
Ronald A. Paulus, MD
Dear Mission Health Caregivers and Community Members,
As you know, Mission Health nurses are at the
very foundation of our BIG(GER) AIM: to get each
patient to the desired outcome, first without
harm, also without waste and with an exceptional
experience for every patient and family. Our
nurses do incredible work!
This year, our nursing teams participated in
projects systemwide that improved the quality or our care and the experiences
for our patients and families. Our nurses met the challenge of caring for our
communities – our many families and friends across western North Carolina. Our
nurses implemented protocols to standardize obstetrical care and developed
innovative, safe and effective ways to use technology to monitor patients at risk for
falls and increase access to wound care.
They also established instant communication models among emergency
department staff members in our regional hospitals and a support program for
cancer survivors. They enhanced care for stroke patients and adopted numerous
care process models to ensure compassionate, consistent and cost-effective care.
WooHoo!
Please join me in congratulating our nursing staff on a job well done. We are
blessed to have such a compassionate, talented and creative group of clinicians!
Ronald A. Paulus, MD
President and Chief Executive Officer
Mission Health
It is my honor and privilege to serve an
organization where nursing plays such a critical
role in the care of our patients and their families
– not only at the bedside, but also in executive
leadership. Over the past two years, the number
of nurses in executive leadership (already
significant) has more than doubled.
5
ACCOLADES
MISSION HEALTH
6
MISSION HOSPITAL
ASHEVILLE, NC
ANGEL MEDICAL CENTER
FRANKLIN, NC
BLUE RIDGE REGIONAL HOSPITAL
SPRUCE PINE, NC
CAREPARTNERS
ASHEVILLE, NC
HIGHLANDS-CASHIERS HOSPITAL
HIGHLANDS, NC
MCDOWELL HOSPITAL
MARION, NC
TRANSYLVANIA REGIONAL HOSPITAL
BREVARD, NC
Mission Health
Chief Nursing Officer Leaders
Kathy S. Hefner, MSN, RN, NE-BC
Chief Nursing Officer
McDowell Hospital
Becky Carter, MSN, RN, FACHE
President and Chief Nursing Officer
Blue Ridge Regional Hospital
Catherine Landis, MN, RN
Transylvania Regional Hospital
Rhonda T. Moore, MSN, MBA, RN,
PCCN, FACHE, CENP
Interim CNO and Director of Patient
Care Services
Angel Medical Center
Cathleen Adams, MBA, BSN, RN, CHPCA
Chief Nursing Officer
CarePartners
Jacqueline Ring, MHA, MBA, RN,
NEA-BC, FACHE
Highlands-Cashiers Hospital
Karen Olsen, MBA, BSN, RN, NE-BC
Vice President and Chief Nursing Officer
Mission Hospital
7
ACCOLADES
Mission Health nurses are committed to their own professional development in their mission
to provide excellent evidence-based care to patients and family members. The following pages
showcase reported professional achievements and recognitions for exceptional work as caregivers.
ADJUNCT FACULTY
Andrea Alvaro, MSN, RN, CCRN, Neurotrauma ICU, Mission Hospital; Nurse Educator MSN Track,
Western Carolina University
Deborah Krueger, MSN, RN, NE-BC, CHTP, Nursing Practice, Education and Research, Mission
Health; Leadership and Management, RN to BSN online, University of Arkansas, Little Rock; Transitions to Professional Nursing, RN to BSN online, Chamberlain College of Nursing
Rosemary Skiner, MSN, RN, CMSRN, Medical Surgical Unit, Angel Medical Center; Nursing 112 and
Nursing 114, Southwestern Community College Pictured above is Ti Austin, MSN, RN, CNML, CNN, Nurse Manager, Medical-Surgical Pulmonary Unit.
Mission Health nurses demonstrate their commitment to high quality patient- and family-centered
care by achieving and maintaining professional certifications. They validate their knowledge and
mastery of skills in their specialty area through testing and ongoing learning. Their dedication to
best practice care improves outcomes for our patients and their families. Here is a list of systemwide
certified nurses who completed a professional RN profile survey.
Andrea Gentry, BSN, RN, CNOR, Surgical Services
Celena Garrett, RN, RN-BC, CGRN, Surgical Services
Debra Robinson, BSN, RN, CNOR, Surgical Services
Donna Hollifield, BSN, RN, CCRN, Surgical Services
Frances A. Giardina, MSN, RN, WHNP-BC, Mission Community Obstetrics and Gynecology
Jamie Wells Pate, RN, CCBE, Labor and Delivery
Pamela Anglin, RN, RNC-OB, Labor and Delivery
Sandra Hamilton, RN, PCCN, Medical Surgical and Coronary Care Units and ICU
Sharon James, BSN, RN, CCRN, Medical Surgical and Coronary Care Units and ICU
Teresa Blanc, DNP, APRN-BC, Hospitalist Group
CAREPARTNERS
Aaron Tyson, RN, CMSRN, Home Health
Ami Bullock, RNS, RN, CRRN, PACE Clinic Manager
Angela B. Stone, RN, RN-BC, WCC, Home Health
April Hays, BSN, RN-BC, Hospice Care
B. Diane Huey, MSN, FNP-BC, Palliative Care
Brian D. Lehr, ND, RN, CWOCN, Home Health
Denise Anthes, ThD, MBA, BSN, RN, CHPN, HNB-BC, HTCP/I, HS, Solace
Donna Sliker, RN, CHPN, Hospice Care
Ellen M. Gordon, RN, CRRN, Rehabilitation Hospital
Fran Kyles, RN, CHPN, Home Health
Georgiana Hill, BSN, RN, CRRN, CWCN, Rehabilitation Hospital
Jeanna G. Barnett, RN, CRRN, Case Management
Karen Reese, MSN, NP-C, Rehabilitation Hospital
Katherine Knihnicki, ThD, BSN, RN, HNB-BC, Hospice Care
Kristi Miller MSN, RN, OCN, Home Health
Magaly Roth, BSN, RN, RNC, Home Health
Marybeth Moscinski, MHEd., RN, CHPN, Home Health
Nore Hunter, BSN, RN-BC, Home Health
Pierre Brazeau, BSN, RN, CPN, Home Health
Rebecca M Gustina, RN, CRRN, Rehabilitation Hospital
Robert G. Credeur II, BSN, RN, CRRN, Nursing Unit Supervisor, Rehabilitation Hospital
Robin W. Borzotta, BSN, RN, CCRN, Rehabilitation Hospital
Sabrina Lacerna, RN, CRRN, Nursing Unit Supervisor, Rehabilitation Hospital
Sharon H. Norton, RN, RNC, Home Health
Sheila J. Pynes, MSN, RN, FNP-BC, AOCNP, Rehabilitation Hospital
Susan M. Bennett, RN, CRRN, Rehabilitation Hospital
Toni Hay, BSN, RN, CCRN, Rehabilitation Hospital
Uta Brandstatter, BSN, RN, CHPN, Solace
Cindy Barloga, BSN, RN, CCM, CIC, ACM, Acute Care
David Alldredge, RN, CEN, Nursing Unit Supervisor, Acute Care
Kathy Hamby, RN, CCRN, Emergency Department
Monica Crook, RN, CEN, Emergency Department
MCDOWELL HOSPITAL
Angela P. Pettus, BSN, RN, CEN, Emergency Department
Brenda F. Davis, BSN, RN, CEN, Emergency Department
Dale J. Buchanan, MSN, FNP-BC, HealthPlus-Surgical Services
Erika Moody, RN, IBCLC, Labor and Delivery
Karen Hicks, MBA, MS, BSN, RN, OCN, Outpatient Infusion
Kathy Hefner, MSN, RN, NE-BC, Chief Nursing Officer
Kimberly Freeman, RN, CDE, CIC, Diabetes Program
Michele Woods, BSN, RN, NE-BC, Manager, Labor and Delivery
Terry Ann Schaefer, RN CWCN, CFNC, Medical Surgical Unit
MISSION HOSPITAL
Adam King, BSN, RN, CCRN, Coli ICU
Adam Sutton, RN, CEN, Cardiovascular ICU
Alesia Carpenter, MSN, RN, ACNS, BC, Simulation Lab
Alesia Whitfield, BSN, RN, RCES, Invasive Cardiology
Anita Renshler, PhD, MSN, RN, FNP-C, Urgent Care Clinic
Ashley Hatch, RN, CLC, Women’s Health Unit
Aubrey A. Balmer, MSN, RN, FNP-C, Urgent Care Clinic
Betty Rogers, RN, CNOR, Surgical Services
Brian D. Bishop, RN, CNOR, RN First Assistant, Surgical Services
Cara Smith, BSN, RN, CEN, Emergency Department
Carol Quairoli, MSN, RN, ARNP-C, Urgent Care Clinic
Deborah Bruner, RNC-OB, CCRN, IBCLC, Women’s Health Unit
Donna C. Campbell, RN, CNOR, Surgical Services
Duane McHan, RN, CEN, Emergency Department
Elizabeth A. Sears, BSN, RN, RNC, Women’s Health Unit
Emily Denise Hoyle, RN, RN-C, Women’s Health Unit
Erma Cooke, MSN, RN, NNP-BC, Women’s Health Unit
Evelyn G. Brow, BSHA, RN, HNB-BC, Same Day Surgery
Holly J. Owen, BSN, RN, CEN, Infection Prevention
Judith Layton, BSN, RN, CNM, Women’s Health Unit
Julie Jenkins, RN, CNOR, Surgical Services
Kecia Hursey, BSN, RN, RNC-OB, Women’s Health Unit
Kimberly Watkins, RN, CDE, Cardiac Rehab
Mary Polanski, MSN, RN, FNP, Urgent Care Clinic
Nancy Holloway, MHSA, BS, RN, OCN, Chemo Infusion Services Endoscopy
Pam Clay, MSN, RN, CEN, Nursing Administration
Patricia D. Foster, BSN, RN, CNOR, Surgical Services
Patricia J. Key, BSN, RN, CEN, CPEN, Emergency Department
Peggy Ramey, RN, CNOR, SANE, Surgical Services
Rita Moss, MSN, RN, FNP-C, CEN, Medical Surgical Unit
Roberta Bowles, BSN, RNC, Women’s Health Unit
Robin A. Villiard, MS, RNC-OB, Women’s Health Unit
Rosemary S. Skiner, MSN, RN, CMSRN, Medical Surgical Unit
Shauna Maxson, BSN, RN, CWOCN, OCN, Nursing Professional Development
Sherril M. Bishop, RN, CNOR, Surgical Services
Sonya Adams, RN, CEN, Emergency Department
Ali Cosgrove, MSN, RN, NP-C, CHFN, Advanced Cardiac Care Clinic
Alicia Reich, RN, RN-BC, Psychiatric Services
Alison Ensley, MSN, RN, FNP-BC, CPEN, Emergency Department
Allison McDaniel, BSN, RN, PCCN, Medical Cardiology Stepdown
Amanda H. Rathbone, BSN, RN, CMSRN, Women’s Surgical Unit
Amanda Hall, BSN, RN, CCRN, CEN, Emergency Department
Amanda Staton, RN, FNE, Sexual Assault Nurse Examiner Program
Amanda Williams, BSN, RN, OCN, Oncology
Amber B. Hull, BSN, RN, CCRC, Asheville Cardiology Associates Research
Amber Hyman, RN, CPN, Mission Children’s Specialists
Amellia J. Gibby, RN, RNC, Mother Baby
Amenia Wiggins, RN, PCCN, Medical Cardiology Stepdown
Amy Brady, MSN, RN, FNP, Diabetes
Amy Coull, BSN, RN, CEN, CPEN, Emergency Department
Amy Hales, BSN, MS, RN, CEN, Emergency Department
Amy Hogue, RN, CNRN, Neurosciences
Amy Riggs, BSN, RN, CCRN, Cardiovascular ICU
Amy Sheets, MSN, RN, CNL, Neurosciences
Amy Williamson, BSN, RN, OCN, Oncology
Andrea Alvaro, MSN, RN, CCRN, Neurotrauma ICU
Andrea Anglin, MSN, RN, FNP, Emergency Department
Andrew Crum, RN, CEN, Emergency Department
Andy Steele, MBA, BSN, RN, NE-BC, Coli ICU
Angela Chandler, BSN, RN, ONC, Orthopedics
Angela D. Wilson, BSN, RN, CWON, Wound Ostomy Continence Nurses
Angela K. Dunham, BSN, RN, C-EFM, Labor and Delivery
Angela Logan, RN, CRNI, VA-BC, Vascular Access Tube Team
Angela Zarrella, BSN, RN, SCRN, Medical Surgical ICU
Ann P. Williams, MBA, BSN, RN, CNOR, CSPDT, Endoscopy
Anna Eller, BSN, RN, OCN, Nursing Professional Development
Anna Gerhardt, BSN, RN-C, Mother Baby
Anne B. Cochrane, MSN, RN, CNOR, Cardiovascular Operating Room
Anne Stuart, RN, CNOR, Asheville Surgery Center
Anthony Guidone, BSN, RN, SCRN, Neurosciences
April C. Briggs, RN, CPN, Pediatric Orthopedics
April W. Messer, MSN, RN, CCRN, Medical Surgical ICU
Aresa Jones, BSN, RN, PCCN, Adult Medical Surgical telemetry unit
Aretha Fannon, RN, CNOR, Asheville Surgery Center
Ashley C. Byrd, MSN, NNP-BC, Neonatal ICU
Ashley Hudson, BSN, RN, CPN, Nursing Professional Development
Ashley Mathus, BSN, RN, CCRN, Coli ICU
Athena A. Carver, BSN, RN, RNC-NIC, Nursing Professional Development
Audrey Forga, MSN, RN-BC, CCM, FAACM, Care Management
B. Gayle Wheeler, BSN, RN, CNOR, Operating Room
Barb McElroy, MBA, BSN, RN, PCCN, RN-C, Staffing Pool
Barbara Bradley, RN, CMSRN, General Surgery
Barbara Bowlin, BS, RN, CCRN, Medical Surgical ICU
Barbara Davison, BSN, RN, CEN, Emergency Department
Barbara R. Sawyer, RN, CCRN, CPEN, Air Medical
Bernadette Bond, RN, CPAN, Asheville Surgery Center
Bernice Wozniak, RN, Emergency Department
Beth MacEachern, RN, PCCN, Cardiovascular Progressive Care
Beth Russell, BSN, RN, RNC-EFM, Labor and Delivery
Beth Trebilcock, RN OCN, Outpatient Infusion
Bethany Dyer, BSN, RN, CMSRN, Pulmonary Medicine
Bill Cote, MSN, RN, Neonatal ICU
Bill Willoughby, RN, CPAN, Surgical Pre-op
Brandee Gil, MSN, RN, CEN, Perianesthesia Care Unit
Brandi Bedrosian, BSN, RN, CCRN, Nursing Administration
Brandi Quinn, RN, RNC-OB, Labor and Delivery
Brandi Tweed, BSN, RN, CPN, Pediatric ICU
Brandy Whitson, RN, PCCN, Adult Medical Surgical telemetry unit
Brenda Fore, MHA, BSN, RN, CLNC, Nurse Practice Education and Research
Brian J. Taylor, RN, CEN, Emergency Department
Brian L. Abbott, RN, CEN, Emergency Department
Brittany Austin, BSN, RN, CPN, Pediatrics
Bryanna Gibbs, BSN, RN, PCCN, Critical Care Service Line
C. Diane Allen, RN, PCCN, Surgical Pre-op
Candace L. Carter, RN, PCCN, Staffing Pool
Carey Estes, MSN, RN, CPPS, Nursing Professional Development
Carlin Smith, MSN, RN, PCCN, Nursing Professional Development
Carol Peracchio, BSN, RN, CPHQ, Performance Improvement
Carole A. Eggleston, BSN, RN, CMSRN, Staffing Pool
Caroline Salinas, RN, CEN, CGRN, Emergency Department
Carolyn C Bryson, RN, CMSRN, 8 North
Carrie Edgison, MSN, RN, NE-BC, Executive Director, Nurse Operations and Critical Care
Carrie K. Underwood, RN, CFRN, Air Medical
Carrie M. Alban, BSN, RN, CMSRN, Staffing Pool
Catherine Lorimier, RN, CNOR, Vascular Operating Room
Cathy Banks, RN, PCCN, HN-BC, Medical Cardiology Stepdown
Cathy Grindstaff, RN, CCRN, Rapid Response Team
Cecil Greck, BSN, RN, CFRN, CCEMT-P, PNCCT, Air Medical
Chandel Dundee, MSN, RN, RN-BC, Surgical Quality
Charles Carter, BSN, RN, CFRN, CPEN, CCEMTP, Air Medical
Charles Phillips, BSN, RN, CEN, Emergency Department
Charlotte Lail, BSN, RN, OCN, Cancer Program
Charlotte Savoy, RN, SANE, Surgical Admission Teaching/Testing Unit
Cherie Palmer, MSN, RN, CMSRN, 8 North
Cherry Odom, BSN, RN-BC, Nursing Practice, Education and Research
Chi Glass, BSN, RN, CMSRN, Wound Healing & Hyperbaric Oxygen Center
Chris Fischer, RN, CEN, Emergency Department
Chris Taylor, BSN, RN, CCRN, ACM, Care Management
Chris West, BSN, RN, CEN, CFRN, Emergency Department
Christi Britt, BSN, RN, CCRN, Cardiovascular Recovery Unit
Christina Riggsbee, RN, CCRC, Clinical Trials-Research Institute
Christine Conrad, BSN, RNC-OB, Labor and Delivery
Christine Loiacono, RN, RNC, Neonatal ICU
Christopher R. Williams, BSN, RN, CCRN, Coli ICU
Chuck Tucker, DNP, RN, CNE, Nursing Administration
Cindy Powers, MSN, RN, CEN, Emergency Department
CJ Merrill, MSN, NEA-BC, CPHQ, Patient Experience and Engagement
CJ Smart, MSN, RNC-MNN, CPN, CPLC, Women’s and Children’s Service Administration
Claire P. Davis, RN, CCRN, CSC, Cardiovascular Recovery Unit
Coates Kennerly, BSN, RN-BC, Emergency Department Psychiatric Evaluation Area
ACCOLADES
CERTIFIED NURSES
9
ACCOLADES
10
Colin Bishop, BSN, RN, PCCN, Medical Cardiology Stepdown
Colleen Rockstroh, BSN, BA, RN, CWON, Wound Ostomy Continence Nurses
Connie Eldreth, RN, CCRN, Coli ICU
Connie L. Cogdill, MSN, RN, PCCN, Care Management
Cora Small, BSN, RN, CCRN, Critical Care Service Line
Corinne Ingle, MSN, RN, ANP-BC, Diabetes
Corrianne M. Billings, BSN, BS, RN, CIC, Infection Prevention
Courtnay Murphy, BSN, RN, CCRN, Medical Surgical ICU
Courtney Haight, BSN, RN, CEN, Emergency Department
Courtney Harris, RN, PCCN, Medical Cardiology Stepdown
Crystal D. Montoya, BSN, RN, CMSRN, General Surgery
Crystal Letterman, MSN, BSN, RN, CMSRN, Spine-Orthopedics Unit
Cynthia Allen, RN, PCCN, Surgical Pre-op
Cynthia Broadhead, BA, RN, ACM, Care Management
Cynthia J. Spaeth, BSN, RN, RNC-NIC, Neonatal ICU
D. Michelle Moerk, RN, CEN, Emergency Department
Dahyeon, BSN, RN, Medical Cardiology Stepdown
Dana Raines, MSN, RN, CAPA, Quality and Safety
Daniel Sutton, BSN, RN, CCRN, Medical Surgical ICU
Daniela Bonea, BSN, RN, VA-BC, Vascular Access Tube Team
Daniella Hatfield, BSN, RN, PCCN, Cardiovascular Progressive Care
Darci K. Hill, BSN, RN, BC-PMHN, Psychiatric Services
Darla R. Walsh, RN, CMSRN, Spine-Orthopedics Unit
Darlene Schleider, MSN, RN, CCRN, Nursing Administration
Darren S. Coleman, MSN, RN, OCN, Oncology
Dawn A. Wascoe, BSN, RN, CWCN, Wound Healing and Hyperbaric Center
Dawn Rollins, BSN, RN, CEN, Emergency Department
Dayton Jacques, MSN, RN, PCCN, Cardiovascular Progressive Care
Deanna McCraw, MSN, RN, Nursing Clinical Informatics
Debbie Lambert, MSN, RN, SCRN, Neurotrauma ICU
Debbie McCoy, BSN, RN, CPN, CDE, Pediatric Endocrinology
Debbie Payne, RN, OCN, Outpatient Infusion
Debbie Tritt, BSN, RN, CNRN, Spine-Orthopedic Unit
Deborah Gerrer, BSN, RNC-OB, Mother Baby
Deborah Gleydura, BSN, RN, NE-BC, CEN, CPEN, Emergency Department
Deborah Gorham, RN, HN-BC, Perianesthesia Unit
Deborah K. Wilson, RN, RNC, Mother Baby
Deborah L. Krueger, MSN, RN, NE-BC, CHTP, Nurse Practice Education and Research
Deborah McDonald, BSN, RN, RNC-NIC, Neonatal ICU
Debra A. Carlson, RN, RNC-NIC, Neonatal ICU
Debra A. Frisbee, RN, CMSRN, General Surgery
Debra C. Ward, RN, CHPN, Psychiatric Services
Debra Caton, BSN, RN, ONC, Orthopedics
Debra Tritt, BSN, RN, CNRN, Spine
DeLena White, BSN, RN, CMSRN, General Surgery
Denise B. Ebert, BSN, RN, CNML, Nursing Administration
Denna S. Reese, BS, RN, CEN, Emergency Department
Desiree Metzger, MSN, RN, ARNP-C, Neurosciences
Destini Z. Wynn, BSN, RN, GRN, CMSRN, Renal Medicine
Diana Ring, RN, CNOR, Operating Room
Diane Dey, BSN, RN, PCCN, Medical Cardiology Stepdown
Diane VanReenen, RN, OCN, Outpatient Infusion
Dianne Lancaster, BSN, RN, CCRC, Pediatric Hematology and Oncology
Diedre B. Bird, BSN, RN, CRNI, Medical Surgical ICU
Dimmerriee W. Brooks, RN, ACM, Care Management
Donna Eaton, RN, PCCN, Adult Medical Surgical Telemetry Unit
Donna J. Smith, MSN, RN, ANP-BC, Psychiatric Service Line
Donna Lingerfelt, BSN, RN, CPN, Nursing Professional Development
Donnie Waid, RN, CNOR, Operating Room
Dorothy J. Allen, RNC-NIC, CNPT, Neonatal ICU
Doy Brown, BSN, RNC, Neonatal ICU
Dru Buesing, MS, RN, NE-BC, Psychiatric Services
Durand Parker, RN, CEN, CPEN, Emergency Department
Edison V. Seel, BSN, RN, PCCN, Care Management
Elena Nolan, RN, CCRP, Heart Path
Elizabeth Allen, RN, CCRN, Advanced Cardiac Care Clinic
Elizabeth Ann Hudson, MSN, RN, CCRN, Cath Lab Recovery
Elizabeth Denning, BSN, RN, CMSRN, General Surgery
Elizabeth Durrett, BS, BSN, RN, CCRN, Coli ICU
Elizabeth Greer, BSN, RN, CCRN, Cardiovascular Progressive Care
Elizabeth Hurlbutt, BSHA, RN, CEN, CPEN, Emergency Department
Elizabeth K. Trexler, RN, CCRN, Coli ICU
Elizabeth Murphy, BSN, RN, CPN, Pediatrics
Elizabeth Owen, BSN, RN, CEN, CPEN, TCRN, Emergency Department
Ellen A. Minier, BSN, RN-BC, General Surgery
Ellen Ferguson, BSN, RN, PCCN, General Surgery
Emily Buchanan, BSN, RN, CPHON, CPN, Pediatric Hematology & Oncology
Emily Hamilton, MSN, BSN, RN, CEN, Emergency Department
Emily Helton, RN, PCCN, Cardiovascular Progressive Care
Erica Dockery, RN, BSN, CPN, Pediatrics
Erika Prezas, RN, CEN, Emergency Department
Ernest Eller Jr, MSN, RN, CNRN, Cardiovascular Progressive Care
Eva K. Crabtree, RN, CMSRN, Adult Medicine
Evelyn M. Davidson, RN, HTCP, HN-BC, Neonatal ICU
Evelyn Wright, RN, CMSRN, Staffing Pool
Fabienne Sterckx, BSN, RN, CCRN, Nursing Professional Development
Felicia F. Cavanaugh, RN, PCCN, Pulmonary Medicine
Frank Alagna, BSN, RN, CCRN, CSC, Nursing Professional Development
Fredia Cooper, BSN, RN, CRNI, VA-BC, Vascular Access Tube Team
Gale Holm, BSN, RN, CEN, Labor and Delivery
Gayle L. Hart, BSN, RN, RNC, Mother Baby
George Alan Sessoms, BSN, RN, PCCN, Medical Cardiology Stepdown
Gina Hallstrom, BSN, RN, CMSRN, Spine-Orthopedics Unit
Gina Moore, BSN, RN, CCRN, RN-C, Critical Care Service Line
Ginny Raviotta, MN, RN, NE-BC, Executive Director, Women’s and Children’s Services
Glenda McCall, MSN, RN, CNML, Manager, Medical Surgical Progressive Care
Haley Johnson, BSN, RN, PCCN, Pulmonary Medicine
Haley Ramsey, RN, RNC, Mother Baby
Hannalie Lindsey, RN, PCCN, Cardiovascular Progressive Care
Harriet McGinnis, BSN, RN, CCRN, CSC, CMC, CPAN, Cardiovascular Recovery Unit
Heather Griffin, BSN, RN, CCRN, Staffing Pool
Heather M. Hansen, BSN, RN, CCRN, Neurotrauma ICU
Heidi Nothdurft, BSN, RN, EMT-I, CEN, CPEN, Emergency Department
Heidi Sherman, MSN, RN-BC, Nursing Practice, Education and Research
Helene D. Groarke, MSN, RN, CCRN-K, SANE-A, Sexual Assault Nurse Examiner Program
Holly J. McCormack, BSN, RN, RNC-OB, RNC-EFM, Labor and Delivery
Howard W. Roberts, BSN, RN, CCRN, NR-EMT, Cardiovascular ICU
J. Danielle Martin, MSN, RN, SCRN, Nursing Practice, Education and Research
Jackie Ruscoe, BSN, RN, ACM, Care Management
Jaclyn Gosnell, MSN, RN, CEN, Emergency Department
James DeGrave, RN, CWON, Wound Ostomy Continence Nurses
James Hudson, RN, CCRN, Neurotrauma ICU
James M. Holbrook, BSN, RN, CPEN, Emergency Department
James R. Gibbs, BSN, RN, CEN, Emergency Department
James Wody, BSN. RN. PCCN, Staffing Pool
Jamie Nguyen, BSN, RN, PCCN, Spine-Orthopedics Unit
Jamie Staton, BSN, RN, CIC, Infection Prevention
Jan Adams, RN, VA-BC, Vascular Access Tube Team
Jan Blakely, BSN, RN, CCRC, Research Institute Administration
Jan M. Bailey, MSN, RN, OCNS-C, Nursing Professional Development
Jan Rayfield, RN, CNOR, Operating Room
Jana Mittelmeier, MSN, RN, CNL, Trauma Care Unit
Jane Windle, RN, RNC, HN-BC, C-FM, Labor and Delivery
Janet Magruder, BSN, RN, OCN, CBCN, Breast Program of Mission Cancer Services
Janet Ray, RN, RN-BC, Adult Medicine
Janice Burgess, BSN, RN, CCRN, Rapid Response Team
Janice L. Hovey, BS, RN, CDE, Diabetes Program
Jared Gouge, BSN, RN, CEN, Cardiovascular Recovery Unit
Jean Faulkner, RN, RNC-OB, Maternal Fetal Medicine Unit
Jean M. Saden, RN, CFRN, Emergency Department
Jeanne Anderson, RN, CEN, Emergency Department
Jeanie Bollinger, MSN, RN, ACCNS-AG, CCRN, Nursing Administration
Jeff Bollinger, BSN, RN, CNOR, Asheville Surgery Center
Jennifer Brock, RN, CMSRN, General Surgery
Jennifer Burts, BSN RNC-NIC, Neonatal ICU
Jennifer Kaylor, BSN, RN, CWON, Wound Ostomy Continence Nurses
Jennifer Metzger, RN, RN-BC, Psychiatric Services
Jennifer Robinson, RN, RNC-OB, Maternal Fetal Medicine Unit
Jennifer Swanson, BSN, RN-BC, Trauma Care Unit
Jennifer Wilkinson, BSN, RNC-NIC, Neonatal ICU
Jenny Keener, BSN, RN, Adult Medical Surgical telemetry unit
Jerri Phillips, BS, BSN, RN, PCCN, CHFN, Medical Cardiology Stepdown
Jerry D. Wilson, BSN, RN, PCCN, Medical Cardiology Stepdown
Jessi Ping, BSN, RN, OCN, Oncology
Jessica Black, RN, CEN, CPEN, Emergency Department
Jessica Smith, BSN, RN, PCCN, Coli ICU
Jill Howell, MSN, RN, CNOR, CNE, Nursing Professional Development
JoAnne B. Huff, BSN, RN, CMSRN, Adult Medicine
Jocelyn R. Abuy, BSN, RN, CCRN, Coli ICU
Jody Curry, RN, CNOR, Operating Room
John G. Grindstaff Jr., BSN, RN, AAS-EMS, CMTE, CFRN, CPEN, CCEMTP, PNCCT, Air Medical
John H. Baylor, BSN, RN, CCRN, Medical Surgical ICU
Jonathan D. Argento, BSN, RN, RN-BC, Coli ICU
Joni H. Lisenbee, BSN, RN, IBCLC, Manager, Mother Baby
Josh Lewis, BSN, RN, CNRN, Neurosciences
Joyce S. Case BSN, RN, OCN, Outpatient Infusion
Judith J. Sykes, RN, OCN, Outpatient Infusion
Judy Luff, BSN, RNC-OB, C-EFM, IBCLC, Labor and Delivery
Julia Killen, MSN, RN, CPNP, Pediatric Hematology and Oncology
Julie Holcomb, MSN, RN, IBCLC, Inpatient Lactation
Julie Owings, BSN, RN PCCN, Cardiovascular Progressive Care
June P. Case, BSN, RN, CWON, Wound Ostomy Continence Nurses
Justin Pannell, BSN, RN, CEN, CPEN, EMT, Emergency Department
Justin R. West, BSN, RN, PCCN, Cardiovascular Progressive Care
Karen B. Parsons, BSN, RN, CCRN, Adult Medicine
Karen Bailey, BSN, RN, CNOR, Operating Room
Karen Cassidy Diez, BS, BSN, RN, PCCN, Medical Cardiology Stepdown
Karen Coates, RN, CCRN, Care Management
Karen Cox, RN, CPN, CAPA, Asheville Surgery Center
Karen Grogan, MHA, MSOM, RN, CENP, Nursing Administration
Karen Joyce, BSN, RN, CPN, Pediatric Sedation Support
Karen Nicolai, BSN, RN, PCCN, Medical Cardiology Stepdown
Karen Olsen, MBA, BSN, RN, NE-BC, Vice President & Chief Nursing Officer
Karen Potthoff, RN, OCN, Outpatient Infusion
Karen Rice, RN, CNOR, Operating Room
Karen Sinclair, MSN, RN, PCCN, Medical Surgical Progressive Care
Karen Smith, RN, OCN, Cancer Research
KaSheena Green, BSN, RN, ONC, Orthopedics
Kate McPolin, BSN, RN, OCN, CCRP, Cancer Research
Katharine Day, MSM, RN, CPAN, Surgical Services Administration
Katherine McElreath, BSN, RNC-OB, Labor and Delivery
Kathleen A. McGowan, RN, CNRN, HN-BC, Neurotrauma ICU
Kathleen Genito-Tamaray, MSN, RN, CCRN, CSC, Cardiovascular Recovery Unit
Kathleen Kellogg, RN, PCCN, Medical Surgical Progressive Care
Kathleen S. Leake, BSN, RN-BC, CEN, Emergency Department
Kathryn E Moorhead, BA, RN, CNOR, Asheville Surgery Center
Kathy Alley, BSN, RN, CHFN, Medical Cardiology Stepdown
Kathy Gier, MSN, RN, CNML, Trauma Care Unit
Kathy Inukai, BSN, RN, PCCN, Staffing Pool
Kathy Smith, MSN, RN, ONC, Nursing Professional Development
Kathy Koye, BSN, RN, PCCN, Adult Medical Surgical Telemetry Unit
Katie Cheatham, BSN, RN, PCCN, Adult Medical Surgical Telemetry Unit
Katrina Buckner, BSN, RN, CPN, Mission Children’s Specialists
Katrina Cody, BSN, RN, ONC, Trauma Care Unit
Katrina Pepper, BSN, RN, CCRN, Perianesthesia Care Unit
Katrina Tobin, BSN, RN, Adult Medical Surgical Telemetry Unit
Katy Brooks, BSN, RN, CWON, Wound Healing and Hyperbaric Center
Kaye E. Rollin, MA, BSN, RN, CHFN, Medical Cardiology Stepdown
Kelley Bryson, RN, Vascular Operating Room
Kelly Marsh, RN, Cardiovascular ICU
Kelly Pace, RN, CEN, CPEN, Emergency Department
Kelly S. Harvey, BSN, RN, ACM, Care Management
Kelly Walker, BSN, RN, PCCN, Medical Cardiology Stepdown
Kim Brittingham, BSN, RN, OCN, Oncology
Kim Delk, BSN, RN, CPN, Pediatrics
Kim Wuertz, BSN, RN, ACM, Care Management
Kimberly A. Hendl, RN, Operating Room
Kimberly Ann Helm, BSN, RN, Cardiovascular Operating Room
Kimberly Crosley, BSN, RN, CNOR, Vascular Operating Room
Kimberly Davis, BSN, RN, ONC, Trauma Care Unit
Kimberly Mallory, BSN, RN, CCRN-CSC, Electrophysiology Lab
Kimberly Miller, MSN, RN, CDE, Diabetes Program
Kitty Ratzlaff, MA, BSN, RN, CGRN, Endoscopy
Korah Schwab, BSN, RN, RNC-MNN, Mother Baby
Kristen Seelig, BSN, RNC, NUS, Mother Baby
Kristi Hensley, RN, CNOR, Asheville Surgery Center
Kristy Stewart, MS, RN, ONC, Orthopedics Service Line
Larry Borrelli, MS, RN-BC, Nursing Professional Development
Laura C. Kirkpatrick, BSN, RN, NCSN, Pediatric ICU
Laura Faircloth, BSN, RN, PCCN, Medical Cardiology Stepdown
Laura Long, BSN, RN, CCM, Care Management
Laura S. Isidor, BSN, RN, CCRN, Neurotrauma ICU
Laurel Barbour, RN, RNC-NIC, Neonatal ICU
Laurel S. Roberts, RN, VA-BC, Vascular Access Tube Team
Laurie B. Buckner, RN, CMSRN, Staffing Pool
Laurie Shirey, RN, ONC, Orthopedics
Laurie Zone-Smith, PhD, RN, NE-BC, Executive Director, Nursing Practice, Education & Research
Leah Silver, BSN, RN, PCCN, Adult Medical Surgical Telemetry Unit
Leonard A. Dinardo, BSN, RN, PCCN, Staffing Pool
Leslee Sprague, BSN, RN, C-EFM, Labor and Delivery
Leslie McPeters, BSN, RN, CCRC, CCRP, Clinical Trials-Research Institute
Leslie Verner, BSN, RN, OCN, CCRP, CBCN, Cancer Research
Lina Lam, RN, RNC, Neonatal ICU
Linda Anderson, MSN, RN, BC-NE, Adult Medicine Service Line
Linda O’Neil, BSN, RN, CCRN, CPAN, Asheville Surgery Center
Linda Palmer, RN, CPAN, Perianesthesia Care Unit
Linda R. Nall, BSN, RN, HNB-BC, HTCP, Cancer Program
Linda T. Englert, BSN, RN, RNC-NIC, Neonatal ICU
Linda Y. Smith, MSN, RNC-NIC, IBCLC, Neonatal ICU
Lindsay Livengood, MSN, RN, PNP, Pediatrics
Lisa A. Clark, MSN, RN, PCCN, Asheville Surgery Center
Lisa A. Kirk, RN, CHPN, Palliative Care
MISSION MEDICAL ASSOCIATES
Aubrianne D. Lasuzzo, MSN, RN, FNP-C, Neurology
Barbara S Massey, BSN, RN, CBN, Weight Management Center
Bridget P. Hansel, MSN, RN, CPNP-AC, Asheville Cardiology Associates Pediatrics
Bridget Schmidt, RN, CCM, Asheville Family Medicine
Deanna MacLaren, MSN, RN, FNP-C, McDowell Internal Medicine
Jacqueline Dromm, RN, CHN, Angel Urgent Care
Jessica Lovely, MSN, RN, NP, Neurology
Joanne Latta, MSN, RN, FNP, Psychiatric Practice
Kathryn Higdon, BSN, RN, RD, CBN, Weight Management Center
Morgan Barrett, MSN, RN, CHFN,CNML, PCCN, Vista Family Health
Patricia H. Gambrell, MSN, RN, NP-C, Hospitalists
Rebecca L. Baker, MSN, RN, NP-C, Cashiers Medical Center
Sarah Mohammed, MSN, RN, FNP-BC, Mission My Care Plus-Candler
Scott W. Governo, DNP, NP, FNP-BC, PPCNP-BC, PMHNP-BC, Olson Huff Center Practice
Alison Jill Fore, RN, CEN, Emergency Department
Audrey Rieger, RN, CEN, Emergency Department
Ameran Tooley, BSN, RN-C, CCM, Manager, Medical Surgical Unit
Ann Kleintop, BSN, RN, OCN, Intensive Care Unit (ICU)
Bryan K. Devinney, MSN, RN, CEN, CHEP, NRP, Administrative Supervisor
Cathy Lasater, RN, RAC-CT, Transitional Care Unit
Christie M. Merrill, BSN, RN, CCRN, ICU
Colette M. Badger, BSN, RN, CCRP, Cardiac Rehab
Diane Amiot Davis, MHS, RN, CDE, Diabetes
Erica Dodd, BSN, RN, OCN, Brevard Cancer and Infusion Center
Herme R. McCall, BS, RN, CMSRN, ICU
Jadon Morgan, BSN, RN, CCRN, ICU
Jennifer McDevitt, RN, CMSRN, Medical Surgical Unit
Joy Brooks, MSN, RN, CEN, CPEN, Staff Education
Joy Holz, RN, CNOR, Surgical Services
Joelle Cleveland, RN, OCN, Education and Triage nurse, Brevard Cancer & Infusion Center
Kim Telles, BSN, RN, RN-BC, Transitional Care Unit
Leigh E. Lipsi, RN, CDE, Diabetes
Mary Carson, RN, OCN, Manager, Brevard Cancer and Infusion Center
Mary Lynn Tyler, RN, CEN, Emergency Department
Moyra Evans, BSN, RN, PCCN, ICU
Suzanne Farrell, BSN, RN, RAC-CT, Transitional Care Unit
Theresa Redmond, MSN, MS, APN, ANP-C, CCEP, FAACVPR, Cardiac Rehab
Zachary M. Kuss, BSN, RN, CEN, Emergency Department
Sandra Brewer, RN, C-EFM, Surgical Pre-op
Sandra K. Buckley, BSN, RN, OCN, Oncology
Sandy Beavers, BSN, RN, CCNP, ACM, CHFN, Care Management
Sarah A. Duval, RN, RNC-NIC, Neonatal ICU
Sarah H. Campbell, BSN, RN, PCCN, Medical Surgical ICU
Sarah M. Greene, RN, CPN, Pediatric ICU
Sarah Proctor, BSN, RN, CCRN, Cardiovascular Recovery Unit
Sasha E. Bourne, BA, BSN, RN-BC, Psychiatric Services
Savannah Williams, BSN, RN, PCCN, Adult Medical Surgical Telemetry Unit
Sharon G. Edwards, BSN, RN, CNOR, Cardiovascular Operating Room
Sheila Plemmons, RN, CNOR, Operating Room
Shelia McCall, RN, CNOR, Operating Room
Shelley R. Green, RN, OCN, Care Management
Sherry King, MSN, RN, CCRN, Cardiology ICU
Sheryl G. Adkisson, BSN, RNC-OB, Labor and Delivery
Simona Mortensen, MSN, RN, PCCN, HN-BC, Heart Path
Sonja F. Mann, BSN, RN, CCRN, Perianesthesia Care Unit
Sonya F. Huntley, RN, RNC, Labor and Delivery
Spring R. Moore, BSN, RN, CCRN, Neurotrauma ICU
Stacey Zabel, BSN, RN, CNOR, Nursing Professional Development
Stacy Inman, BSN, RN-BC, CPN, Pediatrics
Stefanie L. McIntosh, BSN, RN, PCCN, RN-BC, Heart Path
Stephanie Arrington, BSN, RN, PCCN, Adult Medical Surgical Telemetry Unit
Stephanie Burnette, MSN, RN, CNML, Manager, Staffing Pool
Stephanie Long, BSN, RN, CPN, Pediatrics
Stephen Weir, RN, CCRN, Critical Care Service Line
Stuart Scott, RN, CCRN, Heart Regional Services
Sue Cox, RN, RNC-OB, Labor and Delivery
Summer Hettinger, BSN, RN, CCRN, Coli ICU
Susan Hester, BSN, RN, CCM, Care Management
Susan Lundblad, RN, CNOR, Cardiovascular Operating Room
Susan McGill, RN, CCRN, Cardiology ICU
Susan Millonas, MSN, FNP-C, APRN, Surgical Admission Teaching/Testing Unit
Susan R. Jones, BSN, RN, CCRN, Coli ICU
Susan Short, RN, CCRN, Cardiovascular ICU
Susan Whitt, BSN, RN-BC, Surgical Admission Teaching/Testing Unit
Suzanne Prinz, RN, CNOR, CRNFA, Operating Room
Suzanne Stepanek, BSN, RN, PCCN, Medical Cardiology Stepdown
Tacey Mack, RN, RNC-NIC, Neonatal ICU
Tamara Mashewske, BSN, RN, CEN, Emergency Department
Tara Knight, RN, PCCN, Medical Cardiology Stepdown
Tara W. Lyda, RN, PCCN, Medical Cardiology Stepdown
Terri LaFevers, BSN, RN, CPAN, Perianesthesia Care Unit
Terri Y. Queen, BSN, RN, CNOR, Asheville Surgery Center
Terrie M. Smith, BSN, RN, CCRN, Trauma Service Line
Tessa Massey, BSN, RN, RNC-NIC, Care Management
Theresa D. Koenig, BS, RNC, Pulmonary Medicine
Thomas J. Robinson, MSN, RN, CEN, EMT-P, Nursing Professional Development
Tia Cauthren, BSN, RN, CCRC, Asheville Cardiology Associates Research
TiAngela B. Austin, MSN, RN, CNML, CNN, Pulmonary Medicine
Tiffanie Fuller, RN, RNC-NIC, Neonatal ICU
Tiffany T. Roberts, BSN, RN, CCRN, Cardiology Echo
Todd Michaelsen, BSN, RN-BC, Psychiatric Services
Tonja Schroder, MSN, RN, CPN, Simulation Lab
Tracey Gates, RN, CEN, CPEN, Emergency Department
Tracey Parker, RN, CPN, Pediatrics
Traci Zema, RN, SANE-A, SANE-P, Sexual Assault Nurse Examiner program
Tracy Hannah, BSN, RN, CMSRN, Women’s Surgical Unit
Trey Barrett, RN, CCRN, Cardiovascular ICU
Vallire D. Hooper, PhD, RN, CPAN, FAAN, Nursing Practice, Education and Research
Vanessa Mugica, BSN, RN, CNOR, Nursing Professional Development
Velda Biddix, MSN, RN, CRNI, VA-BC, Vascular Access Tube Team
Vicki Bridger, BSN, RNC, Psychiatric Service Line
Vickie B. Moore, MSN, RN, FNP-BC, Emergency Department
Virginia L. Bradley, BSN, RN, ONC, Nursing Professional Development
Virginia S. Tyree, BSN, RN, CPN, Pediatrics
Virginie Pomeroy, BSN, RN, CPN, Pediatric ICU
Wency Richey, BSN, RN, VA-BC, Vascular Access Tube Team
William Flynn, MA, RN, CDE, Diabetes Program
William Green, BSN, RN, CCRN, Invasive Cardiology
William L. Wong, BSN, RN, PCCN, Adult Medical Surgical Telemetry Unit
William P. Owens, BSN, RN, CCRN, Critical Care Service Line
William R. Pope III, BSN, RN, CCRN, Staffing Pool
Zach Clement, MSN, RN, NE-BC, Adult Medicine Service Line
ACCOLADES
Lisa C. Swaim, RN, CCM, Care Manager
Lisa D. Copper, BSN, RN, ONC, Interventional Spine
Lisa H. Guyton, MSN, RN, OCN, Cancer Program
Lisa Marshall, BSN, BA, RNC-MNN, Mother Baby Unit
Lisa Mumpower, RN, CMSRN, Adult Medicine
Lisa W. Williams, RN, ACM, Care Management
Lois Nichols, RN, RNC, Neonatal ICU
Lori Hedrick, BSN, RN, CWOCN, Wound Ostomy Continence Nurses
Lori Lathrop, BSN, RN, CNRN, Neurotrauma ICU
Lori Murrey, MAOM, BSN, RN, CCM, Quality and Safety
Lucille Beard, BSN, RN, CMSRN, General Surgery
Lynn Maloy, MAHS, BSN, RN, CCRN, RN-BC, Surgical Admission Teaching/Testing Unit
Lynne C. Hampton, MBA, MHA, RN, CCRC, CCRP, Research Institute Administration
Lynne M. Smith, BSN, RNC, IBCLC, Mother Baby
Maggie Holmes, MPH, BSN, RNC-NIC, Neonatal ICU
Marc Eden, RN, PCCN, Cardiovascular Progressive Care
Marcy Kirtack, BSN, RN-BC, Psychiatric Services
Margaret Bollo, RN, CNOR, Operating Room
Margaret Lynes, RNC-NIC, Neonatal ICU
Maria Cristina Zambrano, BSN, RN, CMSRN, Adult Medicine
Marianne V. Soderman, MSN, RN, CPAN, Nursing Professional Development
Marie L. Thibeaux, RN, RNC, Neonatal ICU
Marie Makela, RN, CNRN, Neurotrauma ICU
Marilyn Morris, RN, CCRN, PCCN, Staffing Pool
Mark Tripp, BSN, RN, CCRN, Radiology Nursing
Martha Depaola, BSN, RN, CMSRN, Renal Medicine
Martha Hill, RN, RNC-OB, Maternal Fetal Medicine Unit
Martha Shetley, BSN, RN, CCRN, Medical Surgical ICU
Martha Smith, RN, RN-BC, Renal Medicine
Mary C. Robinson, RN, CMSRN, Adult Medicine
Mary Catherine Keith, BSN, RN, CPMHN, Emergency Department Psychiatric Evaluation Area
Mary E. Downes, BSN, RN, CPN, Pediatric ICU
Mary Ellen Wright, PhD, APRN, CPNP, Nurse Researcher, Women’s and Children’s Services
Mary J. Hotko, MSN, RN, CNOR, Nursing Professional Development
Mary Jane Yacopino, RN, CFCN, Wound Healing and Hyperbaric Center
Mary Lindholm, RN, CCRN, Critical Care Service Line
Mary Mills, RN, PCCN, NUS, Adult Medical Surgical Telemetry Unit
Mary P. Richard, BSN, RN-BC, Central Business Office
Mary Teague, MSN, RN, PCCN, Adult Medicine
Maryann Landmark, BSN, RN, ACM, Care Management
MaryJo Smith, BSN, RN, CCRN, Cath Lab Recovery
Marylou Adams, MSN, RN, CCRN-K, CSC, Nursing Professional Development
Matthew R. Daniel, MA, BSN, PCCN, L.Ac., Medical Cardiology Stepdown
Meagan McFarland, BSN, RN, SCRN, Neurosciences
Meg Barks, RN, CEN, Emergency Department
Megan Spicer, BSN, RN, CMSRN, Renal Medicine
Megan Woody, RN, PCCN, Adult Medical Surgical Telemetry Unit
Melanie C. Ballesteros, RN, ONC, Orthopedics
Melanie Clark, BSN, RN, CPON, Pediatric Hematology and Oncology
Melanie Goodwin, RN, CCRN, Coli ICU
Melanie Pugh, BSN, RN, CRNI, Vascular Access Tube Team
Melina Arrowood, RN, CEN, Emergency Department
Melisa Porché, RN, PCCN, Adult Medical Surgical Telemetry Unit
Melissa A. Gapen, BSN, RN, PCCN-CMC, Cardiovascular Progressive Care
Melissa Arnold, RN, RNC-NIC, Neonatal ICU
Melissa G. Bartlett, RN, CCRN, Asheville Surgery Center
Melissa Hanrahan, BSN, BS, RN, CNRN, ACM, Stroke Program
Melissa Mason, RN, CPN, Pediatric Hematology and Oncology
Melissa R. Woodbury, MSN, RN, CMSRN, Nursing Professional Development
Meredith Lee, BSN, RN, RN-BC, Staffing Pool
Michael Craig, BSN, RN, CNOR, Operating Room
Michael F. Sipes, RN, CCRN, RCES, Electrophysiology Lab
Michael Gleydura, RN, CEN, CPEN, Emergency Service Line
Michael Hector, BSN, RN, CCRN, Cardiovascular ICU
Michaellyn M. Pasztor, BSN, RN, ONC, Orthopedics
Michele Rowland, BSN, RN-BC, Informatics
Michelle Chromey, BSN, RN, CNRN, Neurosciences
Michelle DeBiase, RN, PCCN, CHFN, Medical Cardiology Stepdown
Mike Walters, RN,ONC, Orthopedics
Minhwa Kim, BSN, RN, CCRN, Coli ICU
Molly McDonough-Leota, BSN, BA, BM, RN, IBCLC, Mother Baby
Molly McGlamery-Pickens, MSN, FNP-BC, Diabetes Program
Monica Walls, BSN, RNC-MNN, C-EFM, Maternal Fetal Medicine Unit
Nancy McCall, RN, CPN, Pediatrics
Nancy Patton, RN, CAPA, Asheville Surgery Center
Natasha Putnam, RN, CCRC, Research Institute Administration
Nils Erik P. Ingvarson, M.Ed, RN, RN-BC, Pediatric Psychiatric Services
Nina Ponder, BSN, RN, CCRN, Cardiology ICU
Olaf Snyder, RN, BSN, CMSN, Staffing Pool
Olivia Lim, BSN, RN, CCRC, Asheville Cardiology Associates Research
Pam Ertzberger, RNC-NIC, Neonatal ICU
Pamela Wilken, BSN, RN, CPN, Mission Children’s Specialists
Pat Wallenborn, BSN, RN, CNOR, Asheville Surgery Center
Patricia A. Kelly, RN, CCRN, Cardiovascular Recovery Unit
Patricia Ann Ramsey, BSN, RN, OCN, Radiation Therapy
Patricia M. Adamson, BSN, RN, CNOR, Asheville Surgery Center
Patrick Kayes, BSN, RN, OCN, Oncology
Paula Adams, RN, CCRN, Medical Surgical ICU
Pearl Abernathy, RN, OCN, Cancer Research
Peggy Carlson, RN, CNOR, Cardiovascular Operating Room
Philip Price, BSN, RN, CCRN, Emergency Department
Rachel Moynihan, BSN, RN, PCCN, Cardiovascular Progressive Care
Rachelle Rigos, BS, RN, PCCN, Cardiovascular Progressive Care
Ralph Mangusan, MSN, RN, RN-BC, APRN, AGNP-C, AGPCNP-BC, PCCN, CWCN-AP,
Research Institute
Randi Groh, BSN, RN, RN-BC, Pulmonary Medicine
Regina Hawkins, BSN, RN, CCRN, Medical Cardiology Stepdown
Reid Rhodes, BSN, RN, PCCN, Staffing Pool
Renee A. Cauthen, RN, VA-BC, Vascular Access Tube Team
Renee Collette, BSN, BA, RN, SANE-A, SANE-P, Office of Decedent Affairs
Rhonda Lovingood, RN, RN-BC, Vascular Access Tube Team
Rhonda Robinson, MSN, RN, BC, ONC, CNML, Director, Medical-Surgical Units and
Interventional Spine
Rhonda S. Shields, BSN, RN, CNOR, Operating Room
Richard Lee, MSN, RN, CEN, NE-BC, Emergency Service Line
Rita Corcoran, RN, CNOR, Asheville Surgery Center
Robert C. Eggleston, BSN, RN, CCRN, Nursing Administration
Robert Luka, RN, CDE, Diabetes Program
Robin A. Hunnicutt, RN, CNOR, Operating Room
Robin E. Bennett, RN, RNC-OB, C-EFM, Labor and Delivery
Robin Jones, MSN, RN, CNRN, SCRN, Manager, Stroke Program
Robin R. Clendenin, BSN, RN, CAPA, Asheville Surgery Center
Robyn Banta, BSN, RN, CNOR, Surgical Quality
Ronald Eckert, RN, PCCN, Medical Surgical ICU
Rosemary D. Rice, BSN, RN, CAPA, Asheville Surgery Center
Ruth Kirse, BSN, RN, CNRN, Neurosciences
S. Kate Harriman, BSN, RN, CCRN, Cardiovascular ICU
S. V. Stevens, RN, PCCN, Women’s Surgical Unit
Sallie C. McCall, BSN, RN, CPN, Performance Improvement
Samantha Sellars, RN, CNOR, Operating Room
Samuel Mashni, RN, CEN, CPEN, Emergency Department
11
ACCOLADES
12
CLINICAL LADDER, MISSION HOSPITAL
The Clinical Ladder Program recognizes highly experienced, nonsupervisory, direct-care
registered nurses (RN) who promote excellence in clinical nursing practice. The program is
intended to facilitate career and professional development. Advancement in the program
levels requires meeting certain criteria related to clinical practice impact, leadership and
professionalism. Following are all the Mission Hospital nurses who participated in the Clinical
Ladder in 2015 with their achieved levels.
NURSE CLINICAL
AND UNIT
LADDER LEVEL
Alex Lyapin, BSN, RN, CCRN, Cardiology ICU
3
Amanda Williams, BSN, RN, OCN, Oncology
4
Amy Moore, MSN, RN, IBCLC, Mother Baby Unit
4
Amy Riggs, BSN, RN, CCRN, Cardiovascular ICU and Recovery Unit
4
Angela DaltonWilson, BSN, RN, CWON, Wound Ostomy Continence Nurses 4
Anthony Guidone, BSN, RN, SCRN, Neuroscience
3
Ashley Mathus, BSN, RN, CCRN, Coli ICU
4
Barbara Sawyer, RN, CCRN, Mountain Area Medical Airlift
3
Beth Durrett, BSN, RN, CCRN, Coli ICU
3
Caroline Salinas, RN, CEN, RN-BC, Emergency Department
3
CherylBishop, MSN, RN, WHNP, Labor and Delivery
4
Colleen Rockstroh, BA, RN, CWON, CFCN, Wound Ostomy Continence Nurses
4
Crystal Redmon, RN, RNC-OB, Labor and Delivery
3
Debra Caton, BSN, RN, ONC, Orthopedics4
Elena Nolan, RN, CCRP, Heart Path3
Ellen Minier, BSN, RN-BC, Psychiatric Services 3
Gina Hallstrom, BSN, RN, CMSRN, Patient Education
4
Gretchen Howard, BSN, RN, CCRN, Staffing Pool
4
James R. DeGrave, RN, CWON, Wound Ostomy Continence Nurses
3
James Woody, BSN, RN, PCCN, Medical Cardiology Stepdown
4
Janet Reed, BSN, RN, CCRN, Rapid Response Team
3
Jennifer Kaylor, BSN, RN, CWON, Wound Ostomy Continence Nurses
4
Jennifer L. Wilkinson, BSN, RNC-NIC, Neonatal ICU
4
June Case, BSN, RN, CWON, Wound Ostomy Continence Nurses
4
Kari Mauck, BSN, RN, Coli ICU3
Katrina Buckner, BSN, RN, CPN, Olsen Huff Development Center 4
Kim Delk, BSN, RN, CPN, Pediatrics3
Kim Pinkerton, MSN, RN, RNC-NIC, IBCLC, Neonatal ICU
5
Kimberly Pressley, BSN, RN, PCCN, Medical Cardiology Stepdown
3
Laura Faircloth, BSN, RN PCCN, Medical Surgical Progressive Care
4
Laura Kirkpatrick, BSN, RN, NCSN, Pediatric ICU
3
Leah Silver, RN, PCCN, Adult Medical-Surgical telemetry unit
4
Linda O’Neil, BSN, RN, CCRN, CPAN, Asheville Surgery Center
3
Lisa Richmond, BSN, RN, PCCN, Cardiovascular Progressive Care
4
Lou Hipps, RN, HWNC-BC, HTCP, Heart Path
3
MaryJo Smith, BSN, RN, CCRN, Cath Lab Recovery
4
Maureen Winkenwerder, BSN, RN-BC, Women’s Surgical Unit
4
Michaellyn Pasztor, BSN, RN ONC, Orthopedics
4
Michele Lee Sales, RN, MNN, Mother Baby Unit
3
Molly McDonough-Leota, BSN, RN, IBCLS, Mother Baby Unit
3
Penny Morton, BSN, RN, CMSRN, General Surgery
3
Rachel Moynihan, RN, PCCN, Emergency Department
3
Rachelle Rigos, RN, PCCN, Cardiovascular Progressive Care
3
Robin Clendenin, BSN, RN, CAPA, Asheville Surgery Center
4
Roxanne Gosnell, BSN, RN, CCRN, Coli ICU
4
Ruth Kirse, BSN, RN, CNRN, Neurosciences
4
Shanti Volpe, BSN, RN, IBCLC, Lactation4
Suzanne Stepanek, BSN, RN, PCCN, Medical Cardiology Stepdown
3
Virginia Tyree, BSN, RN, CPN, Pediatrics3
Winnie Zieglar, MSN, RN, CCRC, Heart Path
4
The Compassion iN Action Awards recognize certified nursing assistants (CNAs) who model
the Mission Hospital Core Values of MERIT – Mercy, Excellence, Respect, Integrity, and Trust/
Teamwork – and who seek to meet the BIG(GER) Aim.
Emily Birchfield, CNA I,
Spine-Orthopedics
Hannah Layosa, CNA I,
dual skilled, Renal Medicine
Kala Williams, CNA II,
dual skilled, Neonatal ICU
Martha Novoa, CNA I,
Oncology
Nils Bundy, CNA I,
Staffing Pool
Terrance “Brian” Blanton,
Behavioral Health Technician II,
Emergency Department Psychiatric
Evaluation Area
Thelma Jackson, CNA I,
dual skilled, Pulmonary Medicine
ADDITIONAL AWARD HONOREE:
Will Hurley, Behavioral Health Technician I, Psychiatric Services
Cheryl Swann, CNA II,
dual skilled, Orthopedics
ACCOLADES
COMPASSION IN ACTION AWARDS
13
DAISY AWARDS
DAISY Award honorees are selected for their nursing excellence from among nominations by
patients, family members, co-workers or physicians. This internationally recognized award praises
the clinical skills, caring and compassion of nurses in the United States and 14 foreign countries.
Ashley Pennington-Tripp, RN
Women’s and Children’s Unit
Holly Owen, BSN, RN
Emergency Department
BLUE RIDGE
REGIONAL HOSPITAL
MCDOWELL HOSPITAL
Ashley Gouge, RN
Labor and Delivery
Teresa Abernathy, RN
Medical Surgical unit
CAREPARTNERS
Joanna Christoph, BSN, RN
Home Health
Susan Malter, MSN, RN
Hospice
ACCOLADES
14
Regina “Gina” Weaver, BSN, RN
Cardiac Rehabilitation
Kansas Jones, RN
Medical Surgical Unit
ACCOLADES
MISSION HOSPITAL
April McCurry, BSN, RN,
Nursing Unit Supervisor,
Medical-Surgical
Progressive Care
Brian Abbott, RN, CEN,
Emergency Department
Catherine “Goldie”
Bates, MSN, RN,
CMSRN, Renal Medicine
Emily Hamilton,
BSN, RN, Emergency
Department
Eva Crabtree, RN,
CMSRN, Adult Medicine
Gilbert Mata, RN,
Neuroscience
James Woody, BSN,
RN, Medical Cardiology
Step-down
Justin Pannell, BSN, RN,
CEN, EMT, Emergency
Department
Kathleen McGowan, RN,
HN-BC, CNRN, NeuroTrauma ICU
Kathleen Rowles, RN,
Oncology
Kathy Taylor, RN,
General Surgery
Kristin Pegg, RN,
Adult Medicine
Margaret “Maggie”
Holmes, MPH, BSN,
RNC-NIC, Neonatal ICU
Mary “Ethel” Robinson,
RN, CMSRN, Adult
Medicine
Mickee Messino, BSN,
RN, CPN, Pediatrics
Natalie Lawter, RN,
General Surgery
Paula Case, RN, FNE,
Sexual Assault Nurse
Examiner program
Ronda McKinney, BSN,
RN, Medical Cardiology
Step-down
Theresa Grable, RN,
Orthopedics
Tiffany Swygert, RN,
Medical Surgical ICU
ADDITIONAL AWARD HONOREES:
Scarlett McKnight, RN, Coli ICU
Vickie Spencer, RN, Neonatal ICU
Alison Ensley, MSN,
RN, CPEN, Emergency
Department
15
DEGREES EARNED
ASSOCIATE DEGREE IN NURSING (RN)
Nateara Hensley, RN, PMCU/PMSD, Mission Hospital
Shannon Williams, RN, Emergency Department, Mission Hospital
BACHELOR OF SCIENCE IN NURSING (BSN)
CAREPARTNERS
Robert Credeur, BSN, RN, CRRN, Rehabilitation Hospital
Georgann Mathis, BSN, RN, Medical Surgical and Coronary Care Units and ICU
Janet Street, BSN, RN, Outpatient Infusion
Reneé Robinson, BSN, RN, Mission Community Primary Care, Grassy Creek
MCDOWELL HOSPITAL
Susan Ogle, BSN, RN, Labor and Delivery
MISSION HOSPITAL
Krys Earles, BSN, RN, Staffing Pool
Lori Lathrop, BSN, RN, CNRN, Neurotrauma ICU
Sara Watson, BSN, RN, Emergency Department
RN TO BSN
Katelyn Grindstaff, BSN, RN, Obstetrics and Observation
MCDOWELL HOSPITAL
April Dobson, BSN, RN, Operating Room
Ashley Shepherd, BSN, BSN, RN, Charge Nurse, Medical Surgical Unit and ICU
Patrick Finn, BSN, RN Operating Room
MISSION HOSPITAL
Elizabeth Killman, BSN, RN, Adult Medical-Surgical Telemetry Unit
Jerry Wilson, BSN, RN, PCCN, Medical Cardiology Stepdown
KaSheena Green, BSN, RN, ONC, Orthopedics
Katherine Jones, BSN, RN, Risk Management Lisa Marshall, BSN, BA, RN, RNC-MNN, Mother Baby Unit Michael Hartman, BSN, RN, Care Management
Stacy Inman, BSN, RN, CPN, RN-BC, Pediatrics
MISSION MEDICAL ASSOCIATES
Nachole Hartman, BSN, RN, Infectious Disease
MASTER OF SCIENCE IN NURSING (MSN)
ACCOLADES
MISSION HOSPITAL
16
Andrea Anglin, MSN, RN, FNP, Emergency Department Emily Hamilton, MSN, RN, CEN, Emergency Department
Jaclyn Gosnell, MSN, RN, CEN, Emergency Department
Karen Sinclair, MSN, RN, PCCN, Pulmonary Medicine Care Unit and Stepdown Mary Cascio, MSN, RNC-OB, C-EFM, Manager, Labor and Delivery and Maternal Fetal Medicine
Marylou Adams, MSN, RN, CCRN-K, CSC, Nursing Professional Development
Wendy Duncan, MSN, RN, Infection Prevention
Theresa Redmond, MSN, RN, NP-C, Manager, Cardiopulmonary Rehab, Clinical Cardiology
PROJECT
PROJECT LEADER
HOSPITAL
Teressa Neill, RN; team members: Michelle
Branch, Scheduling; Nancy Brown, Patient
Access; Becky Carter, MSN, RN, President and
Chief Nursing Officer; Marla Robinson, CHAA,
Patient Access; Denise Self, RN, Obstetrics,
Outpatient and Observation; and Kim Smith,
BSMT, Laboratory
Blue Ridge
Regional Hospital
Momma Hotline
Michele Woods, BSN, RN, NE-BC; Mary Ellen
Wright, PhD, APRN, CPNP
McDowell Hospital
Early Team Evaluation
Jaclyn Gosnell, MSN, RN, CEN
team members: Emergency Department staff
RNs, CNAs and Performance Improvement staff
Mission Hospital
Consistency across
the Continuum: Using
Care Process Models to
Standardize Care
Mary Cascio, MSN, RNC-OB, C-EFM
Joni Lisenbee, BSN, RN, IBCLC
Mission Hospital
Improving Patient
Safety through Daily
Multidisciplinary Rounds
Lianne Fagnant, MSN, RN, C-NPT
Multidisciplinary Team of the Mission Neonantal
ICU
Mission Hospital
Engaging Nurses in Creative
Education in Clinical Areas
Not Typical for a Women’s
Surgical Unit
Melissa Woodbury, MSN, RN, CMSRN
Mission Hospital
Development and Pilot of
NICU Summary Page for
Data Collection
Nikki Barrett, MSN, RN, NNP-BC
Mission Hospital
Development and Pilot of
NICU Quick Orders Summary
Page for Safe Order Entry
Nikki Barrett, MSN, RN, NNP-BC
Mission Hospital
Prevention of Transmitted
Infections in a Pet Therapy
Program: An Exemplar
Pam Hardin, BS, RPP
Janice Brown, MA, CIC
Mary Ellen Wright, PhD, APRN, CPNP
Mission Hospital
Resource Nurse Renewal: An
Investigation in Continued
Competence
Cathy Hebert, MSN, RN, GCNS-BC
Mary Ellen Wright, PhD, RN, APRN, CPNP
CJ Smart, MSN, RN
Denise Anthes, ThD, MBA, BSN, RN, HNB-BC
Julie Bell, DNP, RN-BC
Mission Hospital
Culture and Child Neglect
Mary Ellen Wright, PhD, RN, APRN, CPNP
John Wright, MD, FAAP
Mission Hospital
Infant Screening for Neonatal
Abstinence Syndrome
Mary Ellen Wright, PhD, RN, APRN
Mission Hospital
Child Life and Perinatal Loss
Laura Johnson, CCLS
CJ Smart , MSN, RN
Mission Hospital
The Bridge Team
ACCOLADES
EVIDENCE-BASED PRACTICE PROJECTS
17
EXCELLENCE IN PATIENT EXPERIENCE AND QUALITY OF CARE AWARDS
Annually, Professional Research Consultants (PRC), a national healthcare marketing firm
recognizes hospitals, health systems, units and individual providers that rank in the top
percentiles nationally for patient experience and Overall Quality of Care. Mission Health was
recognized in three categories—4-Star, 5-Star and Overall Top Performer—for excellence in patient
experience and quality of care.
4-STAR
Recognizes facility units (inpatient, outpatient and emergency department levels) that score in
the 75th-89th percentiles of the top 25 percent
• Angel Medical Center – Inpatient Services
• Mission Hospital – Inpatient Services
5-STAR
Recognizes healthcare facilities, providers, outpatient service lines and inpatient units that score
in the top 10 percent (at or above the 90th percentile)
FACILITIES/UNITS
•
•
•
•
•
•
Angel Medical Center – Medical/Surgical
Cancer Care of Western North Carolina, Brevard
Highlands-Cashiers Hospital
Pediatric Hematology/Oncology, Mission Health Cancer Center
Mission Hospital:
o Progressive Care
o Medical Cardiology Step Down A
o Medical Cardiology Step Down B
o Oncology
o Pulmonary Medicine Care
o Renal Medicine
o Maternal Fetal Medicine
o Adult Medical Surgical telemetry unit
o Orthopedics
o Neurosciences
o Spine
o General Surgery
Mission Medical Associates (MMA)
o Asheville Family Medicine
o Mission Children’s Dental
o Mission Family Practice
o Weight Management Center
o Mission Children’s Neonatal Developmental Follow-up Program
o Mission Wound
ACCOLADES
Mission Hospital was also recognized for 5-star awards in three distinctive Hospital Consumer
Assessment of Healthcare Providers and Systems (HCAHPS) categories for inpatient services:
18
1) Communication about Medications
2) Overall Rating
3) Pain Management
OVERALL TOP PERFORMER
PRC’s highest honor recognizes healthcare facilities, providers, outpatient service lines and
inpatient units that score at or above the 100th percentile
• Inpatient Neuroscience Services – Spine, Mission Hospital
• Inpatient Step Down Services – Adult Medical Surgical telemetry unit Step Down, Mission Hospital
June Case, BSN
RN, CWON
Wound Ostomy Nurses,
Mission Hospital
Kathy Smith
MSN, RN, ONC
Nurse Educator, Nursing
Professional Development,
Mission Hospital
Mary Ellen Wright, PhD,
APRN, CPNP
Nurse Researcher, Women’s
and Children’s Services,
Mission Hospital
ACCOLADES
GREAT 100 AWARDS – NORTH CAROLINA NURSING EXCELLENCE AWARDS
Wilma Keller
BSN, RN, MCSM
Clinical Quality Data
Specialist, Performance
Improvement, Mission Health
NURSING ASSOCIATION LEADERSHIP
Jodi Balderrama, RN, Angel Primary Care, member, Mission Health Government Relations,
Nursing Advocacy Council
MCDOWELL HOSPITAL
Michele Woods, BSN, NE-BC, McDowell Birthing Center, Co-Chair, Western NC Section,
Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN); and member,
AWHONN, national nominating/interview committee
MISSION HOSPITAL
CJ Smart, MSN, RNC-MNN, CPN, CPLC, Women’s and Children’s Administration Services,
State Conference Coordinator, NC AWHONN
Diedre Bird, BSN, RN, CRNI, Medical Surgical ICU, Director at Large, National Infusion Nurse
Society
Margaret Bollo, RN, CNOR, Inpatient Surgery, Vice-President/President Elect, Local Chapter
#3406, Association of periOperative Registered Nurses (AORN)
Robin Jones, MSN, RN, CNRN, SCRN, Stroke Program, Board of Directors member, North Carolina
Stroke Association; and Tele-Stroke co-chair, North Carolina Stroke Advisory Council
Tracey Gates, RN, CEN, CPEN, Emergency Department, State Chair, Emergency Nursing Pediatric
Course, North Carolina Emergency Nurses Association; and President Elect, Blue Ridge Chapter,
Emergency Nurses Association
MISSION HEALTH
Deborah Krueger, MSN, RN, NE-BC, CHTP, Nursing Practice, Education and Research, Member,
Ethics Committee, Healing Touch International, Inc.
CJ Merrill, MSN, RN, NEA-BC, CPHQ, Patient Experience and Engagement, Patient Advisory Board
member, Beryl Institute National
Corrianne Billings, BSN, BS, RN, CIC, Infection Prevention, Vice Chair, Professional Development
Committee, Association for Professionals in Infection Control
Mary Carson, RN, OCN, Manager, Brevard Cancer and Infusion Center, Treasurer, Carolina Blue
Ridge Chapter, Oncology Nursing Society
19
ACCOLADES
20
NURSING RESEARCH STUDIES
MISSION HOSPITAL
Blair Simmons, MS, CCLS, Analyst
Stories by Siblings of Children with Cancer: Qualitative Study
Cora Small, BSN, RN, Quality Manager
ABCDEF Bundle Improvement Collaborative
Deborah Glendora, BSN, RN, Emergency Department
An Early Team Evaluation Trial in an Urban Emergency Department Focused on the Reduction of
Length of Stay and Door to Provider Times
Heather Wallen, BSN, RN, Nursing Professional Development
Central Line Associated Blood Stream Infections: Does Patient Education Make a Difference?
Jackie Gosnell, BSN, RN, CEN, Emergency Department
Early Intervention of Non-Invasive Positive Pressure Ventilation in Elderly Patients with Rib Fractures
Jonathan Brandon, BSN, RN, Nursing Unit Supervisor, Pulmonary Medicine
Pre-employment Testing to Improve Nurse Retention
Julian Cate, CCLS, Child Life Specialist, Mission Children’s Hospital
An Autoethnography by a Child Life Specialist of Children Visiting the Adult ICU When the Primary
Caregiver Has a Life Limiting Condition
Kathy Anders, BSN, RN, Manager, Perianesthesia Care Unit
Pre-procedure Warming to Prevent Intraoperative Hypothermia
Mary Ellen Wright, PhD, APRN, CPNP, Nurse Researcher
A Retrospective Longitudinal Study of Infants Pharmacologically Treated for Prenatal Opioid Exposure
Using an Outpatient Model of Care
Pamela Dillingham, BSN, RN, Inpatient Diabetes
Savvy Caregiver Program: Promoting Self-Efficacy and Reducing Contributing Factors in the
Development of Behavioral and Psychological Symptoms of Dementia
PODIUM PRESENTATIONS
Cascio, M., and Lisenbee, J. (November 2015) Consistency across the Continuum: Using Care Process
Models to Standardize Care Completion. Perinatal Leadership Conference, Dallas, Texas
Fragnant, L. (October 2015) Improving Patient Safety through Daily Multidisciplinary Rounds. Vermont
Oxford Network International Conference, Chicago, Illinois
Freeman, K., Hanlon, M. (November 2015) A Collaborative Community Health Initiative. Moses Cone
Nursing Research Symposium, Greensboro, North Carolina
Hooper, V.D. (2015. An Exploration of the Incidence of and Risk Factors for Unplanned Perioperative
Hypothermia (UPH) in the Ambulatory Surgical Patient. STTI 43rd Biennial Convention, Las Vegas,
Nevada
Hooper, V.D., Neubrander, J., Cochran, K. (2015) Building a Baccalaureate Workforce Using an
Academic/Rural Health System Partnership. STTI 43rd Biennial Convention, Las Vegas, Nevada
Hooper, V.D., O’Brien, D, Odom-Forren, J. (2015) Bringing Research to the Bedside: Are You Ready for
the Challenge? ASPAN, 2015 National Conference, San Antonio, Texas
Johnson, L., and Smart, C.J. (May 2015) Child Life and Perinatal Loss. Child Life Counsel National
Meeting Cincinnati, Ohio
Mims, S., Furigay, P., Cody, T., and Wright, M.E., (Fall 2015) Transdisciplinary Team Approach to
Neonatal Abstinence Syndrome. North Carolina Pediatric Society Meeting, Asheville, North Carolina
Mims, S., Furigay, P., Cody, T., and Wright, M.E., (Fall 2015) Transdisciplinary Team Approach to
Neonatal Abstinence Syndrome. Community Care of Western North Carolina (CWNC) regional
meeting, Asheville, North Carolina
Odom-Forren, J., Hooper, V.D., Ead, H. (2015) Writing for Publication. American Society of
PeriAnesthesia Nurses (ASPAN), 2015 National Conference, San Antonio, Texas
Ratzlaff, K. (2015) Electromagnetic Navigational Bronchoscopy: The Who, What, Where, Whoa, and
WOW of a Team Approach. Society of Gastroenterology Nurses National Conference, Baltimore,
Maryland
Woodbury, M. (2015) Engaging Nurses in Creative Education in Clinical Areas Not Typical for a Women’s
Surgical Unit. Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) Conference,
Asheville, North Carolina
Wright, M.E. and Wright, J. (May 2015) Culture and Child Neglect. National Guardian Ad Litem
Conference, Orlando, Florida
Barrett, N. (2015) Development and Pilot of NICU Summary Page for Data Collection. National Neonatal
Advanced Practice Nursing Forum, Washington, DC
Barrett, N. (November 2015) Development and Pilot of Neonatal ICU Summary Page for Data
Collection. Cone Health Research Symposium, Greensboro, North Carolina
Barrett, N. (2015) Development and Pilot of Neonatal ICU Summary Page for Data Collection.
Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) Conference, Asheville,
North Carolina
ACCOLADES
POSTER PRESENTATIONS
Cascio, M., and Lisenbee, J. (2015) Consistency across the Continuum: Using Care Process Models to
Standardize Care Completion. Mission Quality Day, Mission Hospital, Asheville, North Carolina
Cascio, M., and Lisenbee, J. (November 2015) Consistency across the Continuum: Using Care Process
Models to Standardize Care Completion. Perinatal Leadership Conference, Dallas, Texas
Fragnant, L. (2015) Improving Patient Safety through Daily Multidisciplinary Rounds. Mission Quality
Day, Mission Hospital, Asheville, North Carolina
Freeman, K., Hanlon, M. (2015) Taking Control of Type 2 Diabetes: A Collaborative Community Health
Initiative. North Carolina Society of Public Health Educators, Statesville, North Carolina
Freeman, K., Hanlon, M., Blenco, T., Hooper, V.D. (2015). Taking Control of Type 2 Diabetes: A
Collaborative Community Health Initiative. American Academy of Nursing: 2015 Transforming Health,
Driving Policy Conference, Washington, DC
Livsey, K.R., Hooper, V.D. (2015). Developing University and Hospital System Partnerships to
Promote Use of Evidence-based Practice among Baccalaureate Nursing Students. Sigma Theta Tau
International’s 43rd Biennial Convention, Las Vegas, Nevada
Woodbury, M. (November 2015) Engaging Nurses in Creative Education in Clinical Areas Not Typical for
a Women’s Surgical Unit. Cone Health Research Symposium, Greensboro, North Carolina
Woods, M. and Wright, M.E. (2015) Momma Hotline. Mission Quality Day, Mission Hospital, Asheville,
North Carolina
Wright, M.E., and Henderson, S. (2015) Redesign of Childbirth Education. Mission Quality Day, Mission
Hospital, Asheville, North Carolina
PUBLICATIONS
Bourgault, A. M., Heath, J., Hooper, V., Sole, ML, NeSmith, E. (2015) Methods Used by Critical Care
Nurses to Verify Feeding Tube Placement in Clinical Practice. Critical Care Nurse, 35(1), e1-7. doi:
10.4037/ccn2015984
Hardin, P., Brown, J., and Wright, M. E. (2015) Prevention of Transmitted Infections in a Pet Therapy
Program: An Exemplar. American Journal of Infection Control
Hooper, V.D., Ball, K., Drain, C., O’Brien, D., Odom-Forren, J. for the American Academy of Nursing
(2015) Reconsideration of Do Not Resuscitate Orders in the Surgical/Procedural Setting. Nursing
Outlook, 63, 370-373. Doi:10.1016/j.outlook.2015.04.004
Hooper, V. D. (2015) SAMBA Consensus Guidelines for the Management of Postoperative Nausea and
Vomiting: An Executive Summary for Perianesthesia Nurses. Journal of PeriAnesthesia Nursing, 30(5),
377-382. doi:10.1016/j.jopan.2015.08.009
Hooper, V. D. (2015) 2015: The Year of the Nurse Continues. Journal of PeriAnesthesia Nursing,30(1), 1-2.
doi:10.1016/j.jopan.2015.01.004
Hooper, V. D. (2015) PONV/PDNV: Why Is It Still the “Big Little Problem?” Journal of PeriAnesthesia
Nursing, 30(5), 375-376. doi:10.1016/j.jopan.2015.09.001
Hooper, V. D. (2015). Why Is Pain... Still a Pain? Journal of PeriAnesthesia Nursing, 30(3), 260-261.
doi:10.1016/j.jopan.2015.04.001
Mangusan, R. F., Hooper, V., Denslow, S. A., and Travis, L. (2015). Outcomes Associated with
Postoperative Delirium after Cardiac Surgery. Am J Crit Care, 24(2), 156-163. doi:10.4037/ajcc2015137
Wright, M. E. (2015) Caring among a Nurse Practitioner and a Parenting Teen and Child. In Nursing Case
Studies in Caring: Across the Practice Spectrum. (163-171) New York, New York: Springer Publishing
Company
Hebert, C., Wright, M.E., Smart, C.J., Anthes, D., and Bell, J. (April 2015) Resource Nurse Renewal:
An Investigation in Continued Competence. Nurses Improving Care for Healthsystem Elders (NICHE)
National Conference, Orlando, Florida
21
ACCOLADES
22
QUALITY SYMPOSIUM POSTERS AND AWARDS 2015
In November and December, a Quality Symposium was celebrated on all Mission Health campuses.
Posters outlining interprofessional projects and teamwork that made significant improvements in
outcomes for our patients and their families were displayed on each campus. Following is a list of
the many projects implemented at the designated hospital location. Included are the names of staff
members and their collaborating Performance Improvement team member.
POSTERS
PROJECT
LOCATION
STAFF NAME
PERFORMANCE
IMPROVEMENT
COLLABORATOR
PROJECT NAME
Debra Campbell
Improvement in Dyspnea
Sam Sadri
Sam Sadri
Blue Ridge Regional
Hospital
Connie Harrison
John Wood
"Restructuring the Stress Lab
to provide better service to our
Patients, Staff and Community"
Blue Ridge Regional
Hospital
Donald Charlson
John Wood
Blue Ridge Hospital Front End Flow
Blue Ridge Regional
Hospital
Jennifer Kerley
John Wood
Lighting the Bridge of
Communication
CarePartners
Cheryl LeCrann
Sam Sadri
Nurse/Medical Staff
Communication
CarePartners
Sam Sadri
Sam Sadri
Care Partners PACE & Retail
Pharmacy Process Improvement
CarePartners
Sharon Bigger
Glen Seils
Hospice Wound Care Process
Improvement
Highlands-Cashiers
Hospital
Sam Sadri
Sam Sadri
Highlands-Cashiers Eckerd
Living Center Medical Process
Improvement
McDowell Hospital
Rachel Meadows
Glen Seils/John
Wood
Mission Health
Cindy Brasher
Sam Sadri
Standardization of Medications in
Adult Code Carts at Mission Health
System
Mission Health
Idallas Brown
Sallie McCall
Mission Health System: Outpatient
Mission Neurology
Mission Health
Melissa Mason
AMC Pharmacy Workflow
Improvement
Taking Control of Type 2: A
Collaborative Community Health
Initiative
Use of Calendars to Improve
Documentation of Adherence to
Oral Chemotherapy
STAFF NAME
PERFORMANCE
IMPROVEMENT
COLLABORATOR
PROJECT NAME
Diane Kilbourn
Hold Hours
Transylvania Regional
Hospital
Joelle Cleveland
Bringing Out The Brave
Mission Hospital
Carey Estes
Sallie McCall
Mindful Medication Administration
Mission Hospital
Cathy Retskin
Dawn Burgard
Resource Coordination Center –
Documentation Streamlining
Mission Hospital
Chandel Dundee
American College of Surgeons
National Surgical Quality
Improvement Program® (ACS
NSQIP®) Identifies Improvement
Opportunities and Creates a
Collaborative Culture
Mission Hospital
Dana Raines
Early Oral Pain Medications and the
Effects on Length of Stay
Mission Hospital
Dawn Bugard
Dawn Burgard
Choice as Related to Certificate
of Public Advantage (COPA) – The
Rest of the Story
Mission Hospital
Derek Hudson
Derek Hudson
Early Team Evaluation (ETE)
Mission Hospital
Ellen Crouch
Mission Hospital
Jaclyn Gosnell
Derek Hudson
Early Intervention of Non-Invasive
Positive Pressure Ventilation in
Elderly Patients with Rib Fractures
Mission Hospital
Janice Hovey
Sallie McCall
Insulin Safety in the Hospitalized
Patient: Hypoglycemia and
Medication Error Prevention
Mission Hospital
Jennifer Kaylor
Randy Burkert
TeleWound Coming to a Galaxy
Near You
Mission Hospital
John Wood
John Wood
Behavioral Emergency Response
Team (BERT)
Mission Hospital
Larry Buckner
Wade Astin
Product Recall Process
Improvement
Mission Hospital
Linda Smith
Shannon Jacquess
Improving Patient Safety Through
Daily Multidisciplinary Rounds
Mission Hospital
Liz Lafitte
Liz Lafitte
Renal Care Process Model (CPM)
Mission Hospital
Martha Hoskyns
Fit Testing
Spinal Fusion Surgical Site
Infections
Transylvania Regional
Hospital
ACCOLADES
PROJECT
LOCATION
23
ACCOLADES
24
PROJECT
LOCATION
STAFF NAME
PERFORMANCE
IMPROVEMENT
COLLABORATOR
PROJECT NAME
Mission Hospital
Mary Ellen Wright
Tom Knoebber
Redesigning Women's Health
Education
Mission Hospital
Mary Ellen Wright
Tom Knoebber
Consistency across the Continuum:
Using Care Process Models to
Standardize Care
Mission Hospital
Melissa
Woodbury
Tom Knoebber/
Shannon Jacquess
Engaging Nurses in Creative
Education in Clinical Areas Not
Typical for a Women's Surgical Unit
Mission Hospital
Nikki Barrett
Tom Knoebber/
Shannon Jacquess
Development and Pilot of NICU
Summary Page for Data Collection
Mission Hospital
Sam Sadri
Sam Sadri
The Evolution of Pharmacy
Transitions of Care at Mission
Hospital
Mission Hospital
Sam Sadri
Sam Sadri
Improvements in Medication
History Outcomes with Student
Pharmacists on an Innovatively
Designed Longitudinal Clerkship
Mission Hospital
Sandra Turbyfill
Mission Hospital
Scotta Orr
Scotta Orr
Bowel Care Process Model (CPM)
Mission Hospital
Shannon
Jacquess
Shannon Jacquess
Severe Sepsis
Mission Hospital
Wilma Keller
Wilma Keller
Mission Health Performance
Improvement Clinical Analysts:
Drivers of Change
Surgical Admissions Teaching and
Testing Unit: Preparing Patients for
an Excellent Surgical Experience
Following are the winners of the Quality Symposium Awards based on the components of the
BIG(GER) Aim: to get each patient to their desired outcome, first without harm, also without
waste and with an exceptional experience for every patient and family.
BIG(GER) Aim Without Harm Winner
Renal Care Process Model (CPM)
Liz Lafitte
ACCOLADES
QUALITY SYMPOSIUM AWARDS
BIG(GER) Aim Without Waste Winner
Behavioral Emergency Response Team (BERT)
John Wood
BIG(GER) Aim With Excellent Service Winner
Improving Patient Safety through Daily Multidisciplinary Rounds
Linda Smith and Shannon Jacquess
PEOPLE’S CHOICE AWARDS (voted by attendees at each hospital’s Quality Symposium)
AMC Pharmacy Workflow Improvement – Sam Sadri
No Fall Season – Glenn Seils
CAREPARTNERS
Nurse/Medical Staff Communication – Cheryl LeCrann and Sam Sadri
Highlands-Cashiers Eckerd Living Center Medical Process Improvement – Sam Sadri
MCDOWELL HOSPITAL
Taking Control of Type 2: A Collaborative Community Health Initiative
– Rachel Meadows and Glenn Seils
MISSION HOSPITAL—MEMORIAL CAMPUS
ACS NSQIP® Identifies Improvement Opportunities and Creates a Collaborative Culture
– Chandel Dundee and Tom Knoebber
MISSION HOSPITAL—ST. JOSEPH CAMPUS
Tele Wound Coming to a Galaxy Near You
Jennifer Kaylor and Randy Burkert
Bringing Out the Brave – Joelle Cleveland and Glenn Seils
WEBINARS
Wright, M. E. (Summer 2015) Infant Screening for Neonatal Abstinence Syndrome. Webinar.
Perinatal Quality Collaborative of North Carolina (PQCNC)
25
LEADERSHIP
Every nurse is a leader. Mission Health nursing leadership is visible in the everyday
care of patients and their families by our bedside nurses. Our nursing leaders,
who manage and direct the care provided on nursing units and in ancillary
departments, serve in key positions to ensure advocacy and support for our
direct care nurses. Nurses collaborate among our own colleagues and other
interprofessional teams, as we take the lead in streamlining processes and
improving communications to provide optimal quality care across the western
North Carolina region.
Pictured above is Adam King, BSN, RN, CCRN, Nursing Unit Supervisor, Coli Critical Care.
– BLUE RIDGE REGIONAL HOSPITAL
In an ongoing effort to provide excellent
service in scheduling outpatient
procedures, Blue Ridge Regional Hospital
(BRRH) staff members reached out to
community healthcare providers and
facilities. The group formed The Bridge
Team to increase focus on patient- and
family-centered care via streamlined
processes.
Several members of The Bridge Team work with their group to
provide excellent service in scheduling outpatient procedures. (L to
R) Nancy Brown, Patient Access Supervisor; Denise Self, BSN, RN,
Manager, OB/Outpatient/Observation/Chemotherapy; Teressa Neill,
RN, Manager Clinical Operations; Kim Smith, BSMT (ASCP), Manager
Laboratory; and Michelle Clark, Surgical Services & Scheduling
COMMUNITY AFFILIATES
•
•
•
•
Brian Center Health & Rehabilitation
Brookside Rehabilitation & Care
Bakersville Community Medical Clinic
Blue Ridge Medical Clinics
PATIENTS & FAMILY MEMBERS
•
•
•
•
Celo Health Center
Yancey House
Mitchel House
Cranberry House
COLLABORATIONS RESULTED IN
- Development of a hospital directory for
community affiliates with specific BRRH
department contacts
- Creation of a scheduling process algorithm to
improve workflow
- Facilitation of long-term care physicians obtaining
hospital privileges for timely continuity of care
& COMMUNITY AFFILIATES
- Significant improvements of The Bridge Team
members in their performance, communication
and teamwork
33 POINTS
The interdisciplinary effort included
monthly face-to-face meetings with
representatives from BRRH and eight
community affiliates, including health and
rehabilitation care, senior living facilities
and medical practice clinics. BRRH staff,
such as nurses and staff from patient
access, radiology, lab and scheduling met
with the nursing leaders of skilled nursing
facilities and physician practice office
managers.
LEADERSHIP
LIGHTING THE BRIDGE OF COMMUNICATION
Patient satisfaction increase
27
LEADERSHIP
28
THE REMEMBRANCE TREE
– BLUE RIDGE REGIONAL HOSPITAL
The nurses of the Obstetrics, Outpatient and Observation department rallied to respond to a
patient’s request to honor lost loved ones. The patient had seen the Memory Butterfly tree in
the hospital lobby, placed there in March 2015 by the Mitchell-Yancey Pregnancy and Infant Loss
(PAIL) committee. The group, comprised of staff from various community agencies, installed the
table-top tree to acknowledge that even the tiniest and shortest lives deserve to be remembered.
Inspired by the overwhelming response of the community to the Memory Butterfly tree and the
specific request of one of their outpatients, the nurses brought the idea of a permanent wall
mural honoring the memory of loved ones to a staff meeting. After discussions with Manager
Denise Self, BSN, RN, and Teressa Neill, RN, Manager, Clinical Operations, staff nurse Ashley
Gouge, RN, presented a sketch of the planned Remembrance Tree to President and Chief Nursing
Officer Becky Carter, MSN, RN, FACHE.
Carter immediately granted approval and full support for the project. Gouge, who is a
photographer and a mother personally affected by loss, painted the Remembrance Tree and
prepared a flyer that tells patients and family members how to add their loved one’s name to
the tree. The nurses view the tree as a way to show care and concern not only for their patients
who passed away but also for the family left to cherish their memories. This project initiated by
nurses exemplifies the patient- and family-centered care concepts championed by Mission Health
nurses.
“Happiness pokes through in a time of grieving when you are granted the opportunity to
recognize and honor your child. The beautiful Remembrance Tree allows my Little Bit’s
name to be acknowledged.”
Katelyn Grindstaff, RN, Women’s Services, mother and patient
“This memory tree was created as a way
for us to honor those people that are no
longer with us. This includes even the
smallest of babies. It is important to us
and the family that everyone recognizes
that no matter how big or small a person
is, they leave a lasting impression on our
life and we will always remember them.”
Ashley Gouge,
RN, Women’s Services, mother and patient
– REGIONAL MEMBER HOSPITALS
When the nurses in the Angel Medical Center emergency department (ED) decided to move
their triage nurse closer to patients in the waiting room, they focused on implementing a
communication method to allow staff easy access to each other without walking to the nearest
phone. Interim Manager Diane Kilbourn, MBA, BSN, RN, CEN, CPEN, led discussions in multiple
staff meetings to determine the best plan. A communication system using two-way radios
evolved and was implemented in three other member hospitals in the system – Blue Ridge
Regional Hospital, McDowell Hospital and Transylvania Regional Hospital.
“The radios gave us a better method of communication; we went from good to great! It
gives us added peace of mind, and our workflow is better. Our patients have accepted
the radios well; we greet them, introduce ourselves and tell them that we are in frequent
contact with our team. We can turn down the volume, while we talk with patients and
family members. The ear piece and microphone are discreet and attach easily to our
scrubs.”
Jennifer Barrington, RN, ED staff nurse, Angel Medical Center
“We love them! The radios are a great way to communicate. We stay in touch on a secure
channel that protects patient privacy.”
Susan All, RN, Manager, ED, Transylvania Regional Hospital
Jennifer Barrington, RN, ED staff nurse, Angel Medical Center, demonstrates the use of
the hand control switch on the two-way radio.
The interprofessional team in each ED discovered benefits in coordinating patient care for
improved quality, safety and time efficiency. Team members, including nurses, ED techs,
behavioral health sitters, health unit coordinators and registration staff, have instant and continual
contact with each other. All staff can be quickly notified when a patient with a life-threatening
emergency is arriving. Questions can be swiftly answered to facilitate completion of patient tests
or procedures. Lifting help can be summoned. The prompt connection with colleagues fosters
teamwork and reduces footsteps around the department to allow greater timeliness in patient
care.
LEADERSHIP
EMERGENCY DEPARTMENT
2-WAY RADIO COMMUNICATION
29
PROFESSIONAL PRACTICE
Standardizing nursing practice across Mission Health is a high priority in the
delivery of safe excellent care for the communities we serve. Attention to the
specific needs of different patient populations with varying health conditions
elevates the level of care and improves outcomes for our patients and their
families. One of the benefits of a hospital system is the timely sharing and
implementation of best practices within Mission Health.
Pictured above is Sheila Prynkiewicz, BSN, RN, CPN, Nursing Unit Supervisor, Mission Children’s Hospital.
– MISSION HEALTH
The joyous occasion of giving birth can quickly become an emergency if excessive bleeding
occurs. The perinatal team at Mission Hospital recognized the need to standardize the approach
to these situations across Mission Health facilities offering obstetric care. Nurses from Angel
Medical Center, Blue Ridge Regional Hospital and McDowell Hospital joined the Mission Hospital
team to formulate a plan.
The result was the August implementation of standardized components to improve care for newly
delivered mothers affected by obstetric hemorrhage (OBH):
• OBH code carts in the four hospitals providing obstetric care
COORDINATING CARE FOR
POSTPARTUM HEMORRHAGE EMERGENCIES
• Medical Alert: OBH notifications via overhead paging to summon the care team
• OBH learning module for nurses
• Order set to provide emergent care
To promote better understanding and translate education of the processes into practice,
simulation exercises were held in the four hospitals. The interprofessional team of nurses,
physicians, residents, midwives, Rapid Response team members and nurse practitioners used
real life scenarios and simulation mannequins to walk through OBH mock codes and hardwire
responses for more effective communication and better patient outcomes in emergencies.
“Establishing protocol for early recognition of risk factors in Labor and Delivery has
decreased the number of postpartum hemorrhages on the Mother-Baby unit. Safer care
for our new mothers with better outcomes was our goal, and we are achieving that.”
– CJ Smart, MSN, RNC-MNN, CPN, CPLC,
Outreach Coordinator, Women’s & Children’s Services
Jennifer Hogan, BSN, RN, Labor
and Delivery (left) checking the OB
hemorrhage code cart and discussing
emergency medication protocols with
Mary Cascio, MSN, RNC-OB, C-EFM,
Nurse Manager, Labor and Delivery/
Maternal Fetal Medicine Unit.
• Policy of guidelines to recognize risk for hemorrhage and identify stages of hemorrhage
and primary treatment goals
31
JOURNEY TO
ACUTE STROKE-READY HOSPITAL
– ANGEL MEDICAL CENTER
A new Disease Specific Advanced Certification Program for Acute Stroke-Ready hospitals (ASRH)
has been developed by The Joint Commission that recognizes hospitals that meet standards
to support better outcomes for stroke care. This is an important focus since at least 50 percent
of the U.S. population lives in areas that are more than 60 minutes away from a primary stroke
center. Acute Stroke-Ready Hospitals help meet the needs of patients and families that have
experienced a stroke in these rural settings. Hospitals that achieve this certification provide
evidence of the following:
•
•
•
•
•
A relationship with local EMS that encourages communication with the hospital prior to
bringing a patient with a stroke to the emergency department
Stroke protocols along with an acute stroke team to help expedite the assessment and
treatment of a patient presenting with acute stroke symptoms
The ability to perform diagnostic imaging and laboratory tests 24/7 – with results within
45 minutes of testing
Access to stroke expertise 24/7 (in person or via telemedicine)
The ability to administer intravenous thrombolytics if needed
In September 2015, a core stroke leadership team was formed to assist Angel Medical Center
(AMC) in applying for The Joint Commission’s newly formed Acute Stroke-Ready Hospital
Certification. Nurses Hollis Whitehead, RN, Shauna Maxson, RN, BSN, Kayla Brooks, RN, and
Grace Kim, RN, participated in the interdisciplinary teams that included Emergency Medical
Services, Angel Medical Center and Mission Stroke. The project leadership team met bimonthly
to address each Joint Commission criteria. Using evidence-based guidelines and the Mission
ischemic stroke care process model, the team addressed algorithms, protocols, policies and
procedures related to stroke care. Nurses working at AMC completed stroke education and
became certified to perform the NIH Stroke Scale.
To increase awareness of the warning signs of stroke in the community, AMC staff provided
stroke education at the Macon County Fair. On World Stroke Day, Hollis Whitehead, RN, presented
information about stroke warning signs and the importance of calling 911 on the local Franklin
radio station.
These efforts have enhanced the
care of patients with strokes in rural
communities and have allowed
AMC to prove that exceptional
stroke care doesn’t mean having to
travel to the nearest Primary Stroke
Center. In third quarter of 2015,
AMC demonstrated improvement
in response times, code stroke
activation times, CT interpretation
and lab times. The journey to
become an ASRH has improved
communication among care
providers and improved transitions
of care for those transferred to
Mission Hospital.
Hollis Whitehead, RN, (left) presenting stroke warning signs on a
local radio station.
“Wow, this is real. That’s our hospital on the Joint Commission website…I believe this
team is a perfect example of what systemization is really about, working collaboratively to
improve the stroke care in western North Carolina.”
– Hollis
32
Whitehead, RN, ED Manager AMC
– TRANSYLVANIA REGIONAL HOSPITAL
In the fourth quarter of 2015, Brevard
Cancer & Infusion Center (BCIC)
initiated a post-treatment education
and survivorship program, helping to
bring a BCIC long-term goal to fruition.
Joelle Cleveland, RN, OCN, led nurses
in a qualityimprovement project that
included gathering information from
patients, partnering with providers
and staff, and researching other
survivorship programs. This work
helped make the case for survivorship
become part of the services offered at
BCIC.
Through the survivorship program, Cleveland meets with patients for one-on-one treatment
education sessions, completes the National Comprehensive Cancer Network (NCCN) distress
screening tool and follows the patient throughout the course of treatment. Even after treatment
completion, Cleveland reviews the available resources based on individual treatment needs and
the distress screening. In a few short months, patients have reported feeling more supported
with this guidance.
“It amazed me how incredibly friendly everyone was and that they were able to take time
to hear me. It did not matter what question I asked, they would give me a thoughtful
and supportive answer. I miss them when I am not there; they encourage me and feel
like family. When I get stronger and feel up to it, my goal is to be able to give back to my
community and help with survivorship.”
–
Barbara Womack, a grateful patient
“By listening to the voice of our patients one-on-one and by survey, it became clear that
we needed a formal survivorship program to meet their needs. Many patients expressed
concerns of fear, stress or ‘What do I do now?’ Since cancer survivorship is becoming a
standard of care, I wanted to make sure the patients at Brevard Cancer & Infusion Center
continued to receive the high quality cancer services they deserve. TRH leadership
supported this goal. When Joelle, who has a heart for survivorship, came on board as our
Education/Triage RN, we were able to make it a reality. Within a short timeframe our
patients are stating they feel more supported. The entire BCIC team is committed to the
success of our patients, the survivorship program and the BIG(GER) Aim.”
– Mary
Carson, RN, OCN, Manager, Brevard Cancer and Infusion Center
The quality improvement project
titled “Bringing Out the Brave” was
shared at the Fall Quality Symposium
Mary Carson, RN, OCN, Manager, BCIC (left), and Joelle Cleveland,
Poster Contest, winning the “People’s
RN, OCN, Patient Education/Survivorship/Triage Nurse, with
Choice” award at TRH. Through a grant
grateful patient Barbara Womack (seated).
from the ONS Clinical Projects Grant
Fund, the team was able to create
patient education packets and implement the program. Survivorship starts with the initial cancer
diagnosis and continues throughout the entire experience.
CANCER SURVIVORSHIP PROGRAM
33
34
RIGHT PATIENT, RIGHT BED, RIGHT TIME
– MCDOWELL HOSPITAL
Being admitted to the hospital can be a frightening experience. Facing the unknown with
potentially long wait times can increase anxiety. To enhance the patient experience, nurses at
McDowell Hospital formulated a philosophy and plan to get the right patient to the right bed at
the right time. They developed methods to allow consistent and efficient focus on the elements
of patient flow: admission, transfers, plan of care, staffing and discharge. Expediting these patient
flow processes promotes timely best-practice care and fosters healing.
Their philosophy for patient flow is based on the 3 Rs: Right Patient, Right Bed, Right Time. These
fundamentals support delivery of quality cost-effective care with increased patient satisfaction.
Wait times are decreased and treatment is implemented faster.
Patients can be admitted or transferred to an acute care unit from a variety of settings, such as
the emergency department, another hospital, directly from home or the physician’s office, the
surgical recovery area, the outpatient infusion center and a rapid response urgent patient event.
To facilitate this patient movement, nurses adopted the mindset of “pulling” the patients to the
receiving units instead of waiting for them to be “pushed.”
The nurses’ plan that enables “pulling” the patient to the receiving unit requires:
•
•
•
All admissions to be done within 20 minutes of the physician order
All discharges to be done within 60 minutes once discharge criteria are met
All nurse reports to the receiving unit to be done with one call – if the assigned RN is not
available, any RN will take report
“By decreasing the amount of time between admission and transport to floor, outcomes
have been improved thru implementing physicians’ orders sooner and decreasing patient/
family anxieties of the unknown and unexpected.”
–
Preston McHone, RN, Medical-Surgical Unit
Dillon Salladin BSN, RN, (on stretcher) and Brenda Davis BSN, RN CEN, Nursing Unit Supervisor, both of the Emergency
Department, demonstrate the timely transfer of a patient to promote best practice care and improved outcomes.
– HIGHLANDS-CASHIERS HOSPITAL
The first step in providing care to a patient in the emergency room is triage or prioritizing the
severity of the patient’s condition or injury. Early in 2015, the majority of RNs from the emergency
department (ED) at the Highlands-Cashiers Hospital (HCH) attended a two-day triage education
course at Mission Hospital in Asheville to enhance their triage skills.
To further improve patient care in their ED, HCH nursing leaders adopted the five-level Emergency
Severity Index (ESI) triage system. This method not only identifies the acuity level of the patient,
it also incorporates assessment of the resources, such as lab tests, X-rays and intravenous fluids,
needed to treat the patient. The five-level ESI promotes more well-defined communication of
patient needs through common language and helps with patient flow by quickly identifying
patients who need immediate care and those who do not have life-threatening conditions.
Changing from a three-level triage system to the five-level ESI achieved one of HCH’s goals
identified through a value stream mapping quality improvement project through joint
participation with Mission Hospital. Adoption of the five-level ESI, which is supported by the
American College of Emergency Physicians (ACEP) and Emergency Nurses Association (ENA),
shows HCH’s dedication to providing exemplary service.
Tim Gill, RN, documenting patient information in the electronic
medical record.
On December 1, 2015, the ED joined the entire facility in converting to electronic patient
documentation. Patient safety and staff accountability was elevated to a higher standard with
barcode scanning, electronic medical record (EMR) and computerized provider order entry
(CPOE).
ENHANCED EMERGENCY CARE
35
36
CROSSROADS PROGRAM
FOR TERMINALLY ILL PATIENTS
– CAREPARTNERS
The Crossroads program at Care Partners is made up of a specialized home health team that
performs home visits to patients with end-of-life issues who may not qualify for, or desire,
hospice care. Patients seeking curative treatment, such as radiation or chemotherapy for their
condition, can receive education on the effects of chemotherapy or radiation and be offered the
opportunity to discuss goals of care. The Crossroads program provides for the acute care needs of
patients with all the resources of a Medicare-certified home health agency while the patient is in
an acute care delivery model. Crossroads can assist in the transition to other care areas including
hospice, as the patient or family decides what best meets their needs. In 2015, the Crossroads
team cared for 202 patients and family members allowing each patient time to determine goals of
care.
This past year, the dedicated
nurses that help make up the
Crossroads program attended
the “End of Life Nursing
Education” course at Mission,
part of a new curriculum
designed to enhance the
knowledge base and skills
needed to care holistically for
Crossroad’s patient population.
The curriculum also includes
a two-day hospice orientation
and enrollment in the fellowship
conferences through the
Mountain Area Health Education
Center (MAHEC). The Crossroads
program is just one way that
CarePartners provides unique
and specialized services through
their highly trained staff to meet
the needs of the residents of
western North Carolina.
(L to R) Marybeth Moscinski, RN, CHPN,
Home Health, talks with Crossroads patient
Betty Destino and her loving daughter-in-law,
Charlotte Destino.
202
PATIENTS received services in 2015
through CarePartner’s Crossroads program
– TRANSYLVANIA REGIONAL HOSPITAL
SHAPING SYSTEMS
TRH TEAM MEMBERS
Allison Tinsley, RN, ICU
Ameran Tooley, BSN, RN-C, CCM, Manager,
Acute Care Services
Christie Merrill, RN, NUS,
Intensive Care Unit
Erin Abernethy, PA, ED
A board game called “Friday Night in the
Emergency Department” promotes teamwork
and critical thinking in a quarterly conference of
four rural North Carolina hospitals. Transylvania
Regional Hospital (TRH) is one of those hospitals
participating in a Health Resources and Services
Administration (HRSA) grant-funded project led
by the University of North Carolina at Chapel Hill
School of Nursing.
Glenn Seils,
Quality Improvement Advisor
Since the ED is a microcosm of the hospital, the “Shaping Systems” project focuses on care and
processes in the four EDs. The mission is to design processes that could be replicated in other
rural hospitals across interprofessional teams via the following elements:
• Improved communication and shared decision making
• Relationships characterized by mutual respect, shared goals and shared knowledge
• Coordination that leads to improved ED patient experience, population health
management, decreased costs and outcomes
“We are very excited to be part of this collaborative. It’s a great learning experience, and
we’ve already noticed an improvement in teamwork among our departments.”
– Val
Smith, MHS, RN, Manager, Clinical Operations
Members of the TRH Shaping Systems team
review and celebrate their success in reducing
hold hours and moving patients to acute care
in less than 60 minutes. Lynn Tyler, RN, CEN,
Nursing Unit Supervisor (NUS), Emergency
Department (ED); Tracey Carrol, RN, Charge
Nurse, ED; Zach Kuss, BSN, CEN, RN, ED; Ameran
Tooley, BSN, RN, CCM, Manager, Acute Care;
Christie Merrill, BSN, RN, CCRN, NUS, ICU; Susan
All, RN, CEN, Manager, ED; and Jennifer McDevitt,
RN, CMSRN, NUS, Medical Surgical Unit.”
Nurses and interprofessional staff from TRH’s
emergency department (ED), Medical-Surgical Unit
and Intensive Care Unit collaborate to promote
Joseph Cohen, MD, ED
timely and appropriate care of patients who are
Lynn Tyler, RN, ED,
admitted to those areas. They learn strategies and
Nursing Unit Supervisor (NUS)
skills to enhance effective use of resources, while
Nikki Combs, RN, Medical-Surgical Unit
maintaining safe high quality care for patients and
Scott Johnson, RN, ED
Susan All, RN, Manager, ED
their families. The board game is just one aspect of
Tracey Carroll, RN, ED
the learning experiences in this plan to strengthen
Val Smith, MHS, RN,
teamwork and move patients more efficiently
Manager, Clinical Operations
through their evaluation and treatment phase to
Van Helms, MD, ED
admission or discharge. In monthly conference
calls, team members from the four hospitals discuss
best practices and collaborate with the UNC team, including the dean of the School of Nursing.
Jennifer McDevitt, RN, NUS,
Medical-Surgical Unit
A BOARD GAME IMPACTS EMERGENCY CARE
37
38
FROM OB TO OR FOR C-SECTIONS
CARE EVERY STEP OF THE WAY
– MISSION HOSPITAL
The birth of a new baby is one of the most celebrated days in an individual’s life. No caregiver
understands this better than the nurses working on Mission Hospital’s labor and delivery unit.
Labor and delivery nurses are strong advocates for women and their families, and the philosophy
of family-centered care. These nurses go above and beyond providing high quality care for
patients; they assist those patients, and their families, in achieving exceptional experiences.
To further strengthen the model of care in labor and delivery, a new training program was
developed in the spring of 2015 to enhance the skills of labor and delivery nurses, preparing them
to play a larger role in the OR and PACU in the event of a C-section. This also allowed nurses to be
there for their patients throughout the entire birth experience, without having to handoff to OR
staff. The training program was developed in collaboration with leaders and educators from the
women and children’s service line, OR and PACU.
Nurses take online modules and complete education from Association of PeriOperative
Registered Nurses (AORN) and American Society of PeriAnesthesia Nurses (ASPAN), review
OR and PACU policies, demonstrate circulatory, scrubbing and recovering competencies, and
complete 8-36 clinical hours in PACU with an additional 100-plus clinical hours in the main
OR. Follow-up involves trained staff rotating through the OR for scheduled C-sections. The
transition to labor and delivery nurses expanding their role in the OR and PACU has improved
the effectiveness, efficiency and the patient experience for women having a C-section. Ongoing
clinical and didactic training will continue to prepare nurses for their role in the OR and PACU,
allowing for these special nurses to be there every step of the way.
Shanna Gardin, RN, (left), and Gale Holm, BSN, RN, CEN, both of Labor and Delivery, review patient
information as they prepare to transfer a mother from the OB operating room to the OB Peri-Anesthesia
Care Unit after a family centered C-section.
– CAREPARTNERS
In the beginning of 2015, CarePartners’ Hospice began a new program aimed to advance the skills
of nurses who provide wound care for patients in hospice. These skills emphasized the important
differences between both palliative and traditional home health treatment approaches since
the goals and treatment options are sometimes different for hospice patients. Curative wound
treatment can sometimes worsen pain and require an increased focus on managing the wound
when the patient would prefer to focus on other goals of care. Palliative wound care treatment
allows patients to focus on what matters most to them, enjoying family at home, addressing
spiritual needs and self-determined life closure.
Mary Kaye Frankey, RN, CWCN, (left) Case Manager, Hospice, and Francine Weinhagen, RN, Wound
Resource Nurse and Weekday Clinical Manager, Solace
The program included a series of classes through the Hospice Education Network. At the end
of these classes, a post-education survey showed significant improvement in nurses’ general
wound care knowledge, hospice specific protocols and comfort in choosing appropriate wound
care dressings. In addition to the classes, hospice wound resource nurses were trained to offer
guidance and consults to other nurses, eliminating the need to contact the Home Health WOCN
for all needs. The team, with help from the resource nurses, developed a palliative wound care
protocol with a dressing selection guide. Hospice staff nurses now use the protocol and consult
the resource nurses if they need additional assistance. A wound resource nurse for both Hospice
Homecare and Solace (inpatient) is available by phone or in person when needed. A palliative
approach to wound care allows nurses and patients to tailor the plan of care to meet the patients’
priorities and goals of care.
HOSPICE WOUND CARE IMPROVEMENT:
TAILORING CARE
39
INNOVATIONS IN CARE
Mission Health nurses continually look for new and innovative ways to improve
care, eliminate harm and offer quality services across our region. We strive
to design new models that develop newly graduated professional nurses and
strengthen the workforce for generations to come.
Pictured above is Melina Arrowood, RN, CEN, Nurse Manager, Emergency Department, Mission Hospital.
To help address fall prevention, Mission Hospital has explored new and innovative ways to reduce
inpatient falls. In collaboration with the Center for Innovation, Cerner and Mission Neurosciences,
a virtual sitter pilot began in July 2015 on the neurosciences floor at Mission Hospital. This pilot
trialed a new solution to address fall prevention using specialized room monitors and designated
monitoring stations.
The pilot spanned three months
and resulted in 1,169 re-directs, or
times when a monitor tech could
prevent the patient from getting up
unassisted. In this same time period
Noelle West, CNA, Staffing Pool, monitors patients on camera and
there were also zero unassisted
verbally intervenes when they attempt to get out of bed or perform
falls reported. Additionally, many
an unsafe behavior.
families have commented that they
feel more comfortable when their family member is being monitored 24/7 in their absence. The
virtual sitter pilot is a result of interdisciplinary teamwork and application of new technologies to
improve patient care.
1,169
0
UNASSISTED FALLS
reported during
three-month pilot
RE-DIRECTS (times when a monitor
tech could prevent the patient from
getting up unassisted)
To begin this pilot, Randy Burkert, Manager, Center for Innovation, Josh Lewis, BSN, RN, CNRN,
Anthony Guidone, BSN, RN, and Ellen Blackmon, BSN, RN, met to review historical fall trends to
develop an algorithm to help staff identify candidates who would benefit from the technology.
Identified patients were offered a special camera system in their rooms. The camera system
allowed for depth sensing and had the ability to set up virtual zones that notified a monitor tech
when crossed by the patient. The virtual sitter monitor tech was stationed in another location
and was able to observe patients on
camera and verbally intervene when
they attempted to get out of bed
or perform an unsafe behavior. The
pilot demonstrated that one central
monitor tech could monitor up to six
patients at once. Using a centralized
monitor tech also limited the number
of times nurses and CNAs were called
away from caring for other patients or
performing other tasks.
I N N O VA T I O N S I N C A R E
VIRTUAL SITTERS ON NEUROSCIENCES
DECREASE FALLS IN HIGH-RISK PATIENTS
41
42
TELEHEALTH MEETS WOUND CARE
Lack of resources for expert wound care can lead to less than desirable patient outcomes. In
a pilot program started at Mission Hospital, wound care ostomy continence nurses (WOCN), in
collaboration with the Center for Innovation, tested the use of telehealth technology to evaluate
and treat patients’ wounds, with an ultimate goal of being able to provide comprehensive wound
care services to underserved areas in western North Carolina.
The pilot used seven inpatient units at Mission
Hospital to assess the validity and feasibility of
telehealth technology in performing remote
wound assessments. Remote bedside
assessment was conducted using an iPad with
HIPAA compliant software and interactive
videoconferencing. To compare the treatment
plan developed through the telehealth visit to
the traditional bedside treatment plan, WOCNs
conducted in-person consultations on the same
patients after the telehealth evaluation.
In all 28 cases performed with telehealth
technology, no alterations were made to
treatment plans, indicating that telehealth
consults can be used effectively to evaluate
and treat wounds by remote presence. This
technology has the potential to facilitate
the delivery of high quality, low-cost wound
assessment and management across
underserved areas. The telewound program is
slated to begin at Blue Ridge Regional Hospital
in 2016. Through expansion in rural parts of the
region, Mission hopes to enhance the wound
care resources available, enabling all patients
throughout the system to have access to the
care they deserve.
Beth Durr, RN, (above) transmits
images of a patient’s skin to a wound
care nurse like Jennifer Kaylor,
BSN, RN, CWON, Wound Ostomy
Continence Nurses (right), who can
visualize the area and offer expert
care consultation in real-time.
– HIGHLANDS-CASHIERS HOSPITAL
Anthony Heltsely, RN, joined the Highlands-Cashiers Hospital (HCH) nursing team in July 2015
shortly after graduating from Southwestern Community College. He is the first new graduate
at HCH to participate in Mission Health’s New Graduate Cohort. The cohort entailed weekly
commutes to Mission Hospital in Asheville for classes and clinical hours as well as one-on-one
experiences with a preceptor on the Acute Care and Swing-bed units at HCH. The nine-month
cohort period was an outstanding opportunity to learn, practice and experience situations that he
may not have had as a student or in the small hospital setting.
“Being part of the cohort reinforces all of the evidenced-based practices we learned in
nursing school, as well as teaches us new and current techniques that are implemented
for patient safety. It has helped me be more confident in interactions with my patients
and my colleagues.”
– Tony
Heltsely, RN
• Prepares new nurses to make a smooth
transition from the academic world into
nursing practice
• Engages the new nurse in both clinical
and cultural aspects nursing
Provides support tailored to the nurses’
unique learning needs in preparation for
providing safe, effective quality care in
the acute care hospital
Karen Hendricks, BSN, RN, Quality Safety
Manager (left) discussing patient care supplies
with Anthony “Tony” Heltsely, RN.
215
ATTENDEES IN
MISSION HEALTH’S
Registered Nurse Intensive
Program the past 3 years
2013
2014
2015
MISSION HEALTH’S REGISTERED
NURSE INTENSIVE PROGRAM
•
NEW GRADUATE INTENSIVE PROGRAM
43
44
NURSES LEADING REAL RESULTS
WITH ACUTE KIDNEY INJURY CPM
Acute kidney injury (AKI) may result in potentially life-threatening complications, including
volume overload, hyperkalemia, acidosis and uremia. Therefore, management of various issues
in the patient with AKI should begin early in the course of the disease process. Management of
the acute kidney injury patient often continues after hospital discharge and the care processes
set in place during hospitalization must incorporate a smooth transition to the outpatient setting.
Through care process model (CPM) work completed by a multidisciplinary team, several new
processes were implemented to enhance care for this patient population.
Care process models strive to ensure that all care delivered by the health system, regardless of a
patient’s location in the continuum, is medically necessary, the leading edge in medical science
and the appropriate treatment intensity. Put into effect, these models help to systematize
treatment processes across all hospitals and practices, improving consistency as well as
effectiveness.
CPM work for renal medicine began in 2014 and became fully implemented in 2015. The CPM on
R-Med started with reviewing current processes related to acute kidney injury and comparing
these to evidence-based recommendations. Throughout the process, the team developed
protocols, recommendations for transitions of care, three power plans and new patient education
materials.
Education materials were part of a new education pathway that included three tiers of education,
with each progressive tier focusing on a different phase of acute kidney injury. Handouts were
also developed, free of medical jargon to help create clear concepts that patients and families
could understand. The tiered approach guides the nurse to adapt the education to the specific
needs of the patient. A patient newly admitted with AKI or new onset renal failure would have
information that focuses on steps to correct AKI, modifiable and nonmodifiable risk factors and
signs and symptoms of worsening renal failure while another patient whose goal of care is to
preserve residual renal function would be offered by the nurse, tier 3 education that offers more
specific information on renal diets, dialysis access care, weight measurement and mediations.
By developing learning material with clearer concepts and written on a level that facilitates
understanding, the education pathway hopes to improve the processes of comprehension and
retention of information.
CARE PROCESS MODELS (CPM) IMPLEMENTED ACROSS MISSION
HEALTH IN 2015
Care
Process M
ACU TE KID
NEY INJU
RY
Acute Kidney Injury
Atrial Fibrillation
Bowel Surgery
Coronary Artery Bypass Graft Surgery
Cardiac Valve Surgery
Cesarean Section
Heart Failure
Normal Newborn
Pneumonia
Sepsis
Stroke
odel
© 20 14
ACUTE KID
NEY INJU
TRANSITIO
RY
NS ALGORI
THM
PAT IENT
REA DY FOR
DISC HAR
GE WIT H
AKI
Sched ule
Appo intme
nts:
PCP (if establ
ished) within
14 days
Verify Seat
Time
for Hemo
dialysis
Care Proce
ss Model
Ac ute Kid ne
y Inj ury
Comp lete
SPA
Proce ss (if
indica ted)
yes
If not establ
ished,
find accep
ting
provid ers
& sched ule
ON DIAL
YSIS?
no
Provid e Dialys
is
Educa tion
Sched ule
Transp ortati
on
to Dialys is
Follow-up
with
MKHA and
PCP
MKHA
Appo intme
nts
Occur at Dialys
is
Clinics
RENA L FUNC
TION
RECO VERE
D?
no
yes
Follow-up
with
PCP Only
Sched ule Kidne
y
Smart Class
Send Prescr
iption
Patien t's Pharm s to
acy
(sched ule
pick-u p
as neede d)
Provid e Educa
tion
Mater ial and
Teaching
yes
HIGH RISK
FOR
FUTU RE
DIALYSIS?
no
Sched ule
Appo intme
nt:
MKHA within
7 days
17
| 24
IMPROVEMENT in
re-admittance rate
Renal Medicine also restructured how nurses and providers round on the Renal Medicine unit to
include a multidisciplinary, nurse-led approach. MDR-empowered nurses to be proactive and
allowed them address needs in a timelier manner. Providers incorporated geographical rounding
and one provider was assigned to cover both the renal unit and hemodialysis for seven days in
a row to ensure continuity of care. The access to providers demonstrated positive outcomes.
There was improved coordination of care, reduced order time to implementations, reduction in
duplicated services, a heightened focus on quality initiatives and improved discharge planning.
The length of stay on the Renal Medicine unit dropped 8 percent and the readmittance rate
improved by 18 percent. Renal Medicine staff is proud of knowing that nurses are leading real
results for patients, families and Mission Health.
Lindsay Sugg, RN, staff nurse, Renal Medicine, and patient Charles Wilson review a
patient education brochure together that is free of medical jargon.
Another function of the CPM was to identify best practices for treatment options and publish
these as guidelines for caregivers. Treatment plans were developed for hepatorenal syndrome,
rhabdomyolysis and hyperkalemia as well as referral guidelines for nephrology consults. These
models were developed with the goal to increase patient satisfaction through a multidisciplinary
approach to care and to provide more efficient and effective AKI patient care.
8%
18%
DROP in length of stay
45
GRATEFUL PATIENTS AND FAMILY MEMBERS
e way
much for th
y
er
v
so
ou
nk y
when we
To:
s, care
loved one],
We both tha
es
y
ln
[m
u
tf
er
h
ft
g
a
ed
d gaining
r thou
lized]
everyone look is doing very well an
uch for you
ta
m
pi
os
so
h
s
ou
a
y
w
ful there
one
. He
Thank
e are thank
ho was
needed you
W
e [my loved
w
.
il
e
y
h
a
w
on
d
y
y
y
g
n
er
a
er
your
th ev
find
and en
ich is due to
more streng
ould be
. We didn’t
h
y
sh
w
er
s,
ou
rg
ct
Y
.
su
fe
d
ef
is
s.
side
after h
ut also kin
ou showed u
aren’t any
ofessional b
d love that y
n
a
re
ca
not only pr
t
.
excellen
ber
of your team
Family Mem
very proud
d
er
n
b
a
t
em
en
M
ti
a
y
P
Famil
A Grateful
Patient and
A Grateful
n
Mega
en &
r
u
a
Art, L
hris,
, the
e
ett
Br
C
y
all
eci
–
esp
,
me
for
d to m shift
ing
o
s
o
r
To: Everyone who cared
g
u
y
ry
or n
ris
as ve
he da
th flo
nurse
aff w anks to t hough Ch
t
To: 9
s
g
t
h
n
t
i
d
n
s
l
e
n
pecia
e nur
ryone at the hospital
rt. Ev
ent a
I would like to thank eve
l of th y stay! S ris and A ind, pati y needs,
l
th
six
A
the
to
up
y
the wa
Ch
gm
ry k
th m
starting from the ER all
durin rticularly he was ve point wi a good
k really good
too
d
an
ce
ni
so
,
n
s
a
wa
o
e
g
de
floor. Everyon
and p st startin
right They ma
s
a
w
.
u
t
care of me.
was j ional. Ar otionally
m
ss
l
cia
spe
y
profe lly and e
nt
s goes to a ver
a
Patie
c
l
i
But very special thank
d
u
e
He
f
.
ett
e
Br
t
-m
a
ed my heart
A Gr
!
person who really touch
or. He put my
team
flo
th
six
–
ift
sh
d
3r
was the nurse on
da
ays had a kind word an
nerves at ease and alw
ain
ag
u
yo
k
so much. Than
ingle
smile. That meant so,
To: Kim Sw
e end of
rses from on
to everyone.
u
n
y
b
r
fo
are the
red
nvinced you
After been ca
co
m
I’
,
A Grateful Patient
er
h
the ot
e should be.
the state to
what a nurs
of
e
pl
m
a
k you so
g ex
better! Than
most shinin
d
te
ea
tr
n
ee
ave b
I couldn’t h
much.
laughing.
keeping us
d
n
a
g
n
ri
for ca
Thank you
jokes!
r
Loved you
Patient
A Grateful
ssisted us
Those who a
46
els in ICU
To: The ang
MISSION HEALTH NURSING ANNUAL REPORT EDITORIAL BOARD
EDITOR – CHERRY ODOM, BSN, RN-BC, Nursing Communication Specialist
Nursing Practice, Education and Research, Mission Health
ASSISTANT EDITOR – J. DANIELLE MARTIN, MSN, RN, SCRN, Manager, Evidence Based Practice
Nursing Practice, Education and Research, Mission Health
BARBARA THORNHILL, RN, Staffing Pool, Mission Hospital
CINDY BENTON, MSN, RN, FNP-BC, Manager, Clinical Operations, Highlands-Cashiers Hospital
HOLLY OWEN, BSN, RN, CEN, Infection Prevention, Angel Medical Center
LAURIE ZONE-SMITH, PhD, RN, NE-BC, Executive Director Nursing Practice, Education and Research, Mission Health
LEAH FRADY, BSN, RN, Emergency Department, McDowell Hospital
RANDI GROH, BSN, RN-BC, Nursing Unit Supervisor, Pulmonary Medicine, Mission Hospital
ROSS GRAHAM, RN, Inpatient Rehabilitation, CarePartners
TERESSA NEILL, RN, Manager, Clinical Operations, Blue Ridge Regional Hospital
VAL SMITH, MHS, RN, Manager, Clinical Operations, Transylvania Regional Hospital
MISSION MARKETING AND COMMUNICATIONS
FERRISS ROBERTS, Communications Consultant
BYRON HUDSON, Creative Director
ANDY GUZY, Creative Consultant
ROBERT A. POARCH, Copy Editor
Photography: RYAN CHAMBERS, JOSEPH DIX, JENNIFER HOLLIFIELD, RODNEY FOUSHEE, DONALD ZAWELA
NURSES WEEK CAPS AND QUOTES
During Nurses Week 2015, Mission Hospital nurses were invited to write their thoughts and
feelings about nurses and nursing on notepaper shaped like the nurse’s cap of yesteryear. Here
are a select few of the many meaningful messages that indicate the caring, commitment and
dedication of our nurses.
47
FRIENDS OF NURSING
EDUCATION FUND
The nurse is the one you turn to when you need clinical care,
compassion and healing hands. Now our nurses are turning
to you to help provide opportunities that will advance their
knowledge and expertise. Additional training to work
in specialty areas, pursue higher level education, board
certifications and attend national educational conferences
help nurses grow and implement the newest best practices
at the bedside where our patients benefit the most.
Your support of nursing education will make a difference!
The Mission Health Department of Philanthropy aims to
raise money for the Mission Health Friends of Nursing
Education Fund, a special fund set up just to benefit the
needs of Mission Health nurses.
Your gift today will:
• Fund innovative quality and research
initiative presentations
• Further professional development
• Equip nurses with the knowledge to bring a
higher level of knowledge to the bedside of
patients through certifications
For the nurses who care for you, let’s show them how
much you care about them.
For more information and ways to give to Nursing Education,
visit www.missionphilanthropy.org.
Pictured above is Fern Pittman, BSN, RN, CEN, Nursing Unit Supervisor, McDowell Hospital.
MC-MH-1538-040516

2015 - Mission Health

Transcription

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