Nine outstanding nurses from Saint Joseph Hospital were recently nominated for the prestigious Nightingale award. The nominees were (pictured left to right) Lisa Thompson, Clinical Manager, L&D; Melissa Filter, Director, Nursing Professional Practice and Magnet Program; Susan Zabala, Clinical Educator, Med/Surg; Kristi Legaarden, Interim Clinical Educator, Emergency; Marcy Ackert, RN, OR; Nancy Egener, Clinical Manager, Orthopedic Care; Cori Holloway, Clinical Manager, CV Surgery; Amanda Reff, Clinical Manager, Oncology; Hazel Marez, Clinical Manager, Float Pool (not pictured) along with Mary Shepler, CNO.
In addition to honoring all of these incredible nurses at the regional recognition event held April 1, 2017, Amanda Reff was selected as the 2017 Luminary Award Regional winner making her one of the finalists for the State Nightingale Luminary Award. This honor will be awarded at an upcoming recognition banquet on May 13. Good luck Amanda!
The inspiration for the Nightingale award was the nursing practice of Florence Nightingale. There are two nomination categories for the Nightingale award: Clinical Practice (RNs who practice 50% or more in a clinical role) and Administrative (RNs who spend 50% or more in educator, researcher, and other non-traditional practice roles). In each category, RNs can be nominated in one of three recognition areas: advocacy, innovation, or leadership. Nurses are typically nominated by their peers or organization.
Congratulations to all the nominees for their work in the following areas:
Marcy Ackert was nominated for her work to create policy and coordinate multidisciplinary teams to safely care for patients that have received chemotherapy. She reached out to multiple organizations and researched best practice protocols to put in place.
Nancy Egener led a multidisciplinary team that: 1) Finalized the Self-Medication Administration policy for pancreatic enzyme administration; 2) Changed electronic medical record to reflect the change in practice; and 3) Developed and implemented paper self-medication flow sheet and an education process to ensure proper storage, dispensing, documentation and disposal of the pancreatic enzymes. Additionally, to allow desensitization outside the ICU, Nancy: 1) Worked with the NJH CF nurse coordinators to give Medicine North RNs clinic time to observe 1:1 care for desensitization; 2) Developed an evidence-based nursing guideline for desensitizing CF patients outside the ICU; and 3) Trained Medicine North nurses on desensitization.
Melissa Filter formed grass-roots teams of passionate associates to look at the Magnet standards. Melissa formed relationships with the other Magnet accredited hospitals locally and became part of the Magnet Program Director group to learn and explore options and creative methods to help create pride. Melissa used a variety of methodologies to increase not only nurses perception of what they do but what the entire hospital does to make patient care what it is today. Melissa led or sponsored teams to help lead the charge including a Magnet Steering Committee, Magnet champions team which included EVS to the COO, and created an annual report that showcased how nursing matters!
Cori Holloway’s awareness and advocacy for both nurses and telemetry technician’s allowed her to create a program where the units and the telemetry technicians could work together. Cori worked with the telemetry educator to create a robust program that would allow for successful telemetry monitoring. This education was specifically geared toward proper monitoring, recognition, and resources for non-telemetry units, and was deep rooted with support from the telemetry technicians. Cori also recognized the importance of support and visibility in this initiative, and recruited the CNO, inpatient/ancillary directors, telemetry technicians, shift coordinators, educators, and mangers to run the Tele Trolley.
Kristi Legaarden created the SJH ED Simulation-based learning (Sim) program along with nurse leaders, and physicians. Kristi and the SJH ED physician Sim Team attended a 3-day iSim training. Kristi, working closely with physicians, developed and wrote pertinent scenarios, identified target learners, aligned objectives with SJH’s accreditations / goals, offered staff CEs, and excited / energized staff and providers with her results. Kristi identified multiple latent safety threats (now corrected), improved teamwork among staff members, and helped provide better, safer patient care. Kristi has continued to plan, implement, promote, and steer the Sim program making it one of the most successful programs at SJH.
Under Hazel Marez’s leadership, the ED Flow Team formulated ideal state of patient flow eliminating long wait times with “direct bedding.” Instead of waiting in the waiting room for triage, patients move directly from the waiting room to an available bed with quick triage at bedside by a nurse and immediate physician assessment. Hazel gathered feedback from clinicians during the trial. Nurses liked a nurse consistently in triage as this was a safer practice than leaving triage unattended. Furthermore, nurses suggested Control Techs round in the ED answering call-lights to improve patient experience and PCTs transport patients from triage to the ED room taking vital signs. Hazel incorporated feedback into second trial where process moved smoothly with fewer wait time complaints.
Amanda Reff utilized the Nursing Professional Practice Model (PPM) components of innovation and patient advocacy, to reduce alarm fatigue. By determining the most critical alarms and streamlining processes, the team also met the 2016 National Patient Safety Goal of using alarms safely. After Reff implemented her innovative “Tele Trolley” in February 2016, the alarms per CMR tech in a 12-hour shift decreased from 78.0 in January 23-30, 2016 to 59.3, 61.0, and 41.7 in March 6-12, 2016, March 13-19, 2016, March 20-26, 2016, respectively. Prior to the interventions, the Central Monitoring Care Coordination issues decreased from 0.5 in December for all inpatient units to 0.0, 0.0, and 0.0 in March, April, and May 2016, respectively.
Lisa Thompson’s work resulted in fewer babies having unfortunate outcomes due to her advocacy for the enhancement of nurse knowledge of fetal monitoring, improvement in patient assignment for new nurses on night shift, and support for changes in workflow and unit culture to allow for 10 minute “Strip Rounds” every four hours. From February through December 2016 resuscitation of full-term babies in Labor and Delivery was reduced; down from 3 code blues to 0 and full-term neonates needing brain cooling was reduced from 6 to 1. With Lisa’s support of newer nurses to use the chain of command and incorporation of this into the orientation program she has changed Labor and Delivery unit culture from one of “it wasn’t my patient” to one where all caregivers have a system and safe environment in “Strip Rounds” to voice their concern about any patient showing signs of deterioration.
Susan Zabala played a lead role in a multi-disciplinary team that created the following evidence-based ERAS/ERAB protocol that was incorporated into the electronic medical record (EMR). The ERAS/ERAB protocol now structures pre- and post-operative care with:
• Multimodal Perioperative Care Pathways
• Early recovery after surgical procedures
• Focusing on maintaining pre-operative organ function
• Reducing stress response of surgery
The implementation of ERAS/EARB helped the hospital:
• Re-examine traditional practice and replace with evidence-based practices
• Focus on every aspect of a patient’s surgical journey
• Reduce length of stay
• Decrease complications
• Improve patient satisfaction
• Save $5,000 – $10,000 per patient