Volume 21, Issue No. 26 - June 25, 2012

A Weekly Publication for the People of Queen’s | Volume 21 | Number 26 | June 25, 2012
NSICU Builds Team with Nurse Specialists
Jen Moran, RN, worked the worldwide
web and her connections to find the
staff for a 24/7 Acute Care Nurse Practitioner (ACNP) staffing model for the
Queen’s Neuroscience Intensive Care
Unit (NSICU). There was a need. Although there were neurointensivists
on-call, the eight-bed NSICU at Queen’s
previously did not have 24/7 onsite coverage with specialists trained in neurointensive care.
The Queen’s Neuroscience ICU is not
a place you want to end up, but if you
do, you’ll be glad it’s there. That’s where
traumatic brain injury patients are
rushed, where stroke patients are evaluated and treated, where subarachnoid
hemorrhage cases are managed. Patients
admitted to the NSICU have spinal cord
injuries, are in comas, have epileptic seizures, and many other life-altering or
life-threatening neurological problems.
ACNPs Jen Moran, Sanders Sandoval,
Amy Thatcher, Andy Shirley, and Fay Jung.
Treatment for neurological conditions has come a long way since the
Queen’s Neuroscience Institute was established in 1996. The NSI grew from a
neuro ICU to a center of excellence that
includes neuroscience intermediate
care, a dedicated medical-surgical floor,
a Stroke Center, Epilepsy Center, and a
(Continued on page 2.)
NSICU Nurse Specialists
(Continued from page 1.)
movement disorder telemedicine clinic.
It has a complete laboratory, imaging,
and neurosurgical capabilities. The NSI
has expanded its reach to leading edge
research, education, and outreach to
the community. In 2003, it took a major
step in its growth by expanding to QET
5, with it’s then revolutionary concept
in hospital design.
Jen Moran created the ACNP-based
24/7 staffing model and demonstrated
to Queen’s administration how this coverage would benefit both patients and
the medical center. Jen has experience as
an ACNP in both Neuro and Med/Surge
ICUs. Different from family Nurse Practitioners who focus on outpatients, Acute
Care Nurse Practitioners are trained to
work with inpatients in an acute care setting. They are able to manage patients,
write orders, and have prescriptive authority. They are qualified to perform
invasive procedures and can do neuro
consults, as well as see patients in other
units throughout the medical center.
However, there was a major hurdle:
finding four more ACNPs in addition
to herself and filling the training gap.
Hawai‘i lacks an ACNP training pro-
Service
A W A R D S
In acknowledgment of many years of continued service,
the Queen’s ‘ohana congratulates those who are marking an anniversary. Mahalo to all for your dedicated service. Employees work at QMC unless noted.
June 2012
5 years
Ashley-Jovan Apao
Febe Bautista
Monica Green
Jason Kim
Nicole Lewis
John Naholowa’a
Marichu Talley
Kristin Tome
Michelle Tsutahara
10 years
Janice Asentista
2
Christine Avitia Evans
Jojie Filburn
David Fobel
Gabriel Izumi
Stacie Miyake
Luz Padron
Nieves Pascua
Brent Schultz
Theresa Condit
Evelyn Delgado
Marilyn Ingram
Lona Torcuato
gram, and there is currently no national with adults and children and are new
ACNP organization to help with finding ACNP graduates.
ACNP nurses. Jen scoured the country.
Andy, Amy, and Fay, the three new
She first recruited Sanders Sandoval, ACNPs, went through an intensive, sixwho had experience in the Cardiotho- month orientation and preceptorship,
racic ICU and chest pain as a nurse and where they were taught invasive procein First Assist and Neurosurgery as an dures and were given weekly four-hour
ACNP. Originally from Hawai‘i, Sanders lectures on neuro ICU topics such as inwas working at St. Joseph’s Hospital in terpretation of neuroimaging and elecOrange, California, and was thinking of troencephalography, localization in clinicoming home when Jen contacted him. cal neurology, and management of intraAndy Shirley, who
cranial pressure. At
has Neuro ICU exthe end of the oriperience and is a
entation, the ACrecent ACNP gradNPs were able to inThere was a major
uate, was then redependently evaluhurdle: finding four
cruited. Previousate new admissions
ly a nurse at Johns
and devise treatmore ACNPs…and
Hopkins Hospital
ment plans, perin Baltimore, Jen
form central and
filling the training gap.
worked with Anarterial line placedy there, and alment, and perform
so with neuroinconsultations for
tensivist Matthew
acute neurological
Koenig, MD, who is also now at Queen’s. issues with adequate back-up from an atThen, Amy Thatcher was contacted by tending neurointensivist.
Sanders. Amy had been taking a review
The Queen’s NSICU gets busy, and the
course for her American Nurses Creden- patients come in waves. It’s not uncomtialing Center board exam in California mon for two to three trauma patients
when she met a former instructor of to come in during a shift, along with a
Sanders from Cal State LA, where he few acute stroke admits, and a couple
went to school. Amy happened to men- of subarachnoid hemorrhage patients
tion that she was moving to Hawai‘i be- transferred from other hospitals. The
cause her fiancé (now husband) was sta- day shift starts at 7:30 am. An NSICU
tioned here. The instructor gave Amy’s physician and an ACNP now assess all
email address to Sanders, who told her the patients together, examining films
about the opportunity at Queen’s. After like x-rays and new CT scans, then parbeing hired, Amy told her good friend ticipate in rounds with the staff RNs.
Fay Jung about it and put her in touch During rounds, each patient’s issues
with Jen. Former roommates at UCLA, are reviewed from head to toe, and the
Amy and Fay had earned their master’s ACNP and the physician collaborate
degrees in nursing together. Both nurs- on a care plan for the day. The day’s
es have Cardiothoracic ICU experience routines are constantly interrupted by
head trauma calls from the ER, as well
as acute stroke pages from the Stroke
Patrick Bulac
15 years
Center and transfers from neighbor
Kevin Kwan
Mario Chavez
island hospitals. During the evening
Elisapeta Maiava
Ortencia Dugay
shift, an ACNP assesses patients, takes
Richard Rosehill
Leighton Ho
on new admissions, and does everyLorraine Sakamoto
Heidi Hori
thing on their own except rounding.
Shelley Yokota
Lance Imamura
Neurointensivists are on-call.
Araceli Limos
30 years
The 24/7 staffing in the Queen’s NSIConstancia Menor
Randy Arase
Nadine Pauole, MGH
CU
is provided by a one ACNP during
Leonida Balais
Sandra Rezentes
13-hour
overlapping shifts with all five
Elena Fronda
Roxane Takara
ACNPs
rotating
on a day-night schedJune Nakahara
Stacey Teramae
ule. The NSICU is still not the place you
35 years
25 years
or your loved ones want to be, but now
Fermin Cainglit
Edwina Bishop
more than ever, highly trained staff are
Gail O’Connor
Claudia Boyko
onsite to provide the best care possible.
“
”
Managing Kritical Keiki in Hawai‘i
TBI, or Traumatic Brain Injury. The
dread of emergency and neuroscience
medical professionals. It’s often more
heartrending when it affects children.
An estimated 1.7 million TBIs occur annually in the U.S. Of this total, over
500,000 children 0 to 14 years of age suffer disproportionately from TBIs—more
than any other age group. Taking care of
pediatric neuro patients in the ICU is a
burgeoning new field. Because the field
is new and only just emerging in medical
literature—and because of the need—
The Queen’s Medical Center is hosting a
conference called “Managing the Kritical Keiki” on Friday, August 3, from 7:30
am to 5:00 pm at The Kahala Hotel and
Resort. The conference has been planned
in collaboration with Kapi‘olani Medical
Center for Women and Children.
In Hawai‘i, the children’s hospital is
Kapi‘olani. The trauma center for both
children and adults is Queen’s. According
to Cherylee Chang, MD, Medical Director of the Queen’s Neuroscience Institute,
Neurocritical Care, and the Stroke Center,
the word of the day is collaboration, not
just with Kapi‘olani, but with all Hawai‘i
hospitals. “It’s a great opportunity for hospitals to collaborate on all levels,” she says,
including all health professionals—EMTs,
emergency room staff, ICU staff, doctors,
nurses, social workers, pharmacists, dietitians, and everyone else. “If you take care
of kids at all, from out in the field to the
ICU and everything in between, this conference is relevant for you.”
Queen’s is unique in that most neuro
ICUs don’t manage children. “The field
is new and burgeoning,” said Dr. Chang.
“We’re working collaboratively to create
a niche to provide the best care for children in a specialty that is new.” Unfortunately, once the brain is injured, the cells
do not heal or grow back. The brain can
only “recover” by rerouting its functions.
When children have brain injuries, it impacts their entire future. Brain injuries
can lead to behavioral and sleep disorders, seizures, headaches, learning disabilities, memory problems, and a shortened life span. Disabilities may require
full-time care by parents or other caregivers. Thus, much of Kritical Keiki focuses on preventing additional brain in-
Educational Learning Objectives
• Optimal management of the acutely
brain-injured child
• New guidelines and management of
TBI in children
• Treatment of intracranial hypertension
in children
• Challenges and new opportunities for
rehabilitation of the brain-injured child
• Transfer guidelines and transport of
brain-injured children in Hawai‘i
jury by following current evidence-based
practices and guidelines. It covers care
from in the field to transfer to the ICU.
Some of the sessions include:
• Update on pediatric TBI guidelines
• Airway & ventilation
• Hemodynamic management–hypotension, shock, and fluid management
• Nutrition and glycemic management
• Pain and sedation management
• Recognition & evaluation of child abuse
• Cervical spine clearance in children
•Cool kids–Moderate hypothermia in
children with TBI
• Neurosurgical concerns in the PICU
• Medical & surgical management of increased intracranial pressure
•Transfer of injured children, including from the neighbor islands
Kritcal Keiki features keynote speaker
P. David Adelson, MD, Director of Barrow Neurological Institute at the Phoenix
Children’s Hospital and Chief of Pediatric Neurosurgery and Children’s Neurosciences. Bringing needed expertise to
Hawai‘i, Dr. Adelson helped write the
Registration Fees By July 20 After July 20
MD, QMC
MD, Non-QMC
RN/Other, QMC
EMT, Hawai‘i
$130
$150
$100
$80
$150
$170
$140
$100
guidelines for pediatric traumatic brain
injury care. Wendy Lin, MD, Pediatric
Physiatrist, Rady Children’s Hospital, San
Diego, is the guest faculty. The Hawai‘i
faculty includes a dozen health professionals from Queen’s, Kapi‘olani, the
John A. Burns School of Medicine, and
private practice physicians. Early registration is by July 20, 2012. For more information or to register, contact the Queen’s
Office of Continuing Medical Education
at 691-7009 or email [email protected].
3
A blood drive will be held on Monday,
June 25 from 7:30 am to 3:30 pm at the
old ER turnaround. Make an appointment at 848-4770.
. . . . . . . . . . . . . . . . . . . .
A retirement tea for OR surgical tech
Pete Samiano will be held on Friday, July 6 at 2:00 pm in the Harkness Dining
Room. All are invited to stop by and bid
Pete aloha after 40-plus years at Queen’s.
. . . . . . . . . . . . . . . . . . . .
Melanoma in the New Millennium,
a free Speaking of Health community
lecture, will be held on Wednesday, June
27 from 6:00 to 7:00 pm at the Queen’s
Conference Center. Join surgical oncologist Shane Morita, MD, PhD, as he
explains the work-up of melanoma, discusses treatment regimens, and shares
new information on melanoma in minority groups in Hawai‘i. Call the Referral Line for reservations at 691-7117.
. . . . . . . . . . . . . . . . . . . .
A Primer on Organ Transplant Immunosuppression by Gabriel Danovitch, MD, Professor of Medicine, UCLA
School of Medicine, and Medical Direc-
Sell
Biomodulator Plus: Tennant, new, use
for pain management, accelerate healing,
balance body organs & systems & more.
Incl electrode pads & book. Pd $2,400,
asking $1,600/obo. www.senergy.us. 3775606, 8am-8pm.
Smart phone: T-Mobile HTC HD7
Windows, fairly new, w/ charger. $175/obo.
478-6909 or [email protected].
Netbook: Toshiba NB 300 Series. $115.
Call 691-5384.
Smart phone: HTC Wildfire, never used,
configured for Mobi or Verizon. $120.
Call 343-0102.
’09 Jeep Patriot: Beige, exclnt cond. 20K
mi. Call June @ 277-1516.
4
tor of the UCLA Kidney Transplant Program, will be held on Thursday, June
29, from 8:00 to 9:00 am at the Queen’s
Conference Center. Email Bucky at [email protected] for more information.
. . . . . . . . . . . . . . . . . . . .
The Hawai‘i Sjogren’s Syndrome
Support Group meets on Thursday, July
19, from 5:30 to 7:30 pm at the Queen’s
Conference Center. The guest speaker is
dermatologist Miki Garcia, MD. RSVP
to [email protected].
. . . . . . . . . . . . . . . . . . . .
The fourth annual Translational Cancer Medicine Symposium, “How Do We
Reduce Cancer Risks? Altering Pathways
to Obesity and Tobacco Use,” will be held
on Friday, July 27 at the Queen’s Conference Center. The symposium provides a
valuable opportunity to share study findings, exchange research ideas, develop collaborations, and ultimately develop new
research programs that minimize the cancer burden on communities and patients.
For registration or more information, contact the Office of Continuing Education at
691-7009 or at [email protected].
. . . . . . . . . . . . . . . . . . . .
Ischemia, Injury, & Infarction—12
Lead EKG Workshop will be held August 18 from 8:00am to 2:30 pm in the
Queen’s Conference Center’s 2nd Floor
Lobby. Learn how to differentiate between an anterior MI and an inferior
MI. Review of coronary anatomy and
making the link between what type
of MI your patient is having and what
some of the potential complications and
treatments might be. Basic EKG is not a
prerequisite for this workshop. Register at eww.queens.org/education/ekg.htm.
. . . . . . . . . . . . . . . . . . . .
The Queen’s Medical Center was voted
Hawai‘i’s Best hospital by readers of the
Honolulu Star Advertiser. Queen’s was featured in the Hawai‘i’s
Best special section
in the Sunday, June
24 issue.
....................
Team Captains from each department
and nursing unit are being sought for this
year’s American Heart Association Heart
Walk, which will be held on Saturday, August 11 at Kapi‘olani Park. Contact John
Scherry at [email protected] or at 6918559 to find out how you can create a new
team. Team captains are eligible for great
prizes from the AHA, including outer-island trips, hotel stays, and great gift cards.
Rent
Nr Academy of Art: 1/1/1 apt, coin w/d.
$925 incl water. NS, no pets. Call 533-4987.
Misc
Wanted, iPhone 4s: Must be factory
unlocked. Call/text 221-2381.
Boat bottom cleaning: Islandwide, fast,
reliable, satisfaction guaranteed. Call
Barnacle Blasters @ 808-450-1861.
Placing an ad: Queen’s employees only. Include
name, phone and Employee ID number. Mail to
Creative Services—Print Connection, fax to
547-4002 or e-mail to [email protected] by
Wednesday. The Print Connection reserves the
right to edit or refuse any ad. The Print Connection
does not make any warranty about the fitness of any
product or service listed in Q-Mart.
Weekly
The Queen’s Print Connection is published
by Creative Services. If you have news or
wish to opine, call us at 691-7532 or e-mail
[email protected]. The news deadline is the Monday prior to publication.
QHS/QMC President. . . . . Art Ushijima
Publisher. . . . . . . . . . . . . . . . Roy Cameron
Editor/Writer. . . . . . . . . . . . Jason Kimura
Assist. Ed./Writer. . . . . . Glee Stormont
www.queens.org
The Queen’s Medical Center is a 501(c)(3) nonprofit corporation.
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