Nurses Making a Difference Dana Rogers, RN-SNIII, 2010 Nurse of the Year
Congratulations to Dana Rogers, RN-SNIII, Salinas Valley Memorial's 2010 Nurse of the Year. Dana joined SVMHS as a nursing assistant in 1993 while attending Hartnell's nursing school. She graduated in 1995 and worked as a staff nurse on Level II for five years before moving to ICU/CCU. Dana has a demonstrated passion and enthusiasm for achieving the best possible patient care as well as a professional nursing environment. As a Staff Nurse III since 2008, she is also well regarded and respected as a collaborator, a leader who teaches by example and a person whose ideas help enhance the lives of others at work and in the community.
Over the past two years, Dana has represented the Nursing department on the multidisciplinary teams that developed and implemented two key patient care improvement initiatives—the Pressure Ulcer Initiative and the Bariatric/Safe Patient Handing Initiative. She also helped improve methods of charting that have benefitted patients and nursing staff alike.
"I have always been proud of being a nurse," says Dana, "and to be part of an organization that does so much for our patients and community. SVMHS makes sure we have the most advanced equipment and technologies to serve the needs of our patients. The hospital is so committed to supporting and encouraging staff to further their education, learn more about evidence based practice and hone the skills we need to ensure safety and high-quality patient care."
Hailing from Kansas City, Missouri, Dana moved to California in 1981 and has lived in the Salinas Valley since 1991. In her leisure time she most enjoys relaxing by her pool with family and friends while listening to good music.
Congratulations Dana and to all 2010 nominees!
Deborah Avilez, BSN, RN-SNIII, PACU
Julie Gattis, RN, AHN in Mother/Baby
Cathy Gomez, BSN, RN, AHN in MSCV3
Lety Hernandez, RN-SNII, PCCN, Heart Center
Marie Marbach, RN-SNIII, MSCV3
Diane Martin, RN-SNIII, Mother/Baby
Kathryn McMillan, RN, Case Management
Diane Mesiroff, RN, AHN in CCC
Neena Moriyama, RN, AHN in ONS
Wendy Ogden, MSN, RN, CCRN, PCCN, Education
Sara Silacci, RN, AHN in Heart Center
Suzette Urquides, MPA, RN-SNIII, CCRN, Cath Lab
Two SVMHS staff nurses—Gloria Dela Merced, MN, CCRN, CEN, PCCN, Level II and Joanna Callahan, RN, MA, CCRN, CSC, CMC, PCCN, Level II and ICU/CCU—are spreading the word of the many benefits of nurse specialty certification and belonging to related professional organizations. Both were selected to serve as Ambassadors for the national American Association of Critical-Care Nurses (AACN). They are also very active in the AACN Central Coast of California Chapter—Joanna is president, Gloria is president-elect and will begin her term in July.
The AACN covers nurses in critical care, progressive care, telemetry, ICU/CCU, Level II, Heart Center, interventional radiology, Emergency Department, cath lab and the Towers. "Certification increases nursing knowledge and confidence with the ultimate benefit of improved patient safety and care," says Joanna. Many credentialing organizations, including the AACN, offer 24/7 on-line access to resources such as mentors, evidence based literature and networking opportunities.
In March, Joanna and Gloria were two of 85 ambassadors attending the AACN West Coast summit in Long Beach. "For me, the best part of being involved in my professional organization is learning from others," says Gloria. "You can explore best practices at other hospitals rather than reinventing the wheel."
Joanna developed a PowerPoint presentation that focuses on the value of certification; what it means to a hospital and the individual's nursing practice. Presented at Director Huddles, AHN/Director Huddles and other meetings, it outlines how nurses can expand their knowledge and challenge themselves to improve and demonstrate their professional skills. "Earning certification demonstrates a dedication to the life-long learning process for nurses," says Joanna.
Gloria and Joanna go unit-to-unit and talk with nurses, send MOX and Outlook messages and staff booths at skills days and during National Nurses Week. They offer brochures on all the different types of nursing specialty certifications and professional organizations. Through the Central Coast of California Chapter of AACN, they have offered continuing education at SVMHS, Watsonville Community Hospital, Natividad, Dominican Hospital in Santa Cruz and CHOMP.
"A large body of evidence shows that certification increases patient safety and is a key indicator for Magnet and Beacon (an AACN program) status," says Gloria. "Salinas Valley Memorial recognizes the true value of credentialed nurses and is very supportive of nurses pursuing certification and re-certification."
Born at Salinas Valley Memorial Hospital, Veronica Camacho, RN, Progressive Care, says, "it feels like home here, like I'm part of a family." As a CNA, she started working in our Emergency Department in 2001. "Once I saw the impact nurses have on patient care, I knew that's what I wanted to do," she says. "Being fluent in Spanish and English, I felt I could make a real difference at SVMHS and in the community." Veronica became a LVN in 2006 and graduated from the nursing program at Hartnell in 2008.
Recently, she joined the Magnet Steering Committee. "I need to be part of the process of improving care and safety for our patients. I can't just voice my opinion and then do nothing. If at the end of a shift, I know I've had a part in helping a patient get one step closer to going home, then I can go home happy."
Veronica was raised in Gonzales, where she continues to live with her husband and three children. In her spare time she enjoys playing sports, scrap booking and watching her kids' sporting activities.
SVMHS has been preparing for conversion from our MOX intranet system to Microsoft Outlook Web Access (Outlook) since early 2008. Because the nursing departments have more than 1,000 staff—including RNs, LVNs, CNAs, UAs, CAs, secretaries and technicians—a specialized training program was launched in April 2010.
The MOX to Outlook Committee that includes chair Stephanie Davi, RN-SNII, ONS;
Doreen Faiello-Burnett, RN, MHA, Senior Administrative Director Patient Care Services; Annie Gonzales, IT; Jeremy Hadland, RN, Nursing Supervisor; Alicia Lerma, IT; Gloria Lochridge, MSN, RN, FNP, Education; Jeff Sevey, RN, Education and
Judy Snyder, MS, RN, BC, Director, Education/Patient Care Systems, was formed to coordinate training. Committee members and Patient Care Champions are assisting with training.
Outlook training began at the April 15th Competency Camp and more than one-third of the staff who attended completed their training. Trainers and computers were also set up for training in the cafeteria weekdays from 7:30 a.m. to 4:30 p.m. To date, 86 percent of our staff has been trained. Those who have not yet completed it will be trained on their units.
Some tools that have been created to assist in the conversion from MOX to Outlook include a detailed PowerPoint presentation available on Healthstream, a pocket-size quick-reference guide to emailing and navigating Outlook, and a skills-checklist that is completed during the training process. The committee also created flyers, screen savers, MOX messages and emails to remind nursing staff to complete the training.
This year, we introduced a new house-wide approach to Competency Camp. The first of the quarterly camps—involving one-quarter of each unit's staff—was held April 15 in the Education Building and its Experiential Learning Center. Other sessions are scheduled for June 11, August 17 and October 12. "A number of our Staff Nurse IIIs and nurses on units that most frequently use a specific competency were selected and trained to serve as validators," says Judy Snyder, MS, RN, BC, Director, Education/Patient Care Systems.
This year, two competencies were adapted from the traditional "tell me how" to simulation-based "show me how" format. They were: Complications of Orthopedic Surgery and Defibrillation/Cardioversion. "Introducing simulation-based competencies created the unique opportunity to survey nurses both before and immediately after participating in their first simulation," says Rachel Failano, MSN, RN, Clinical Simulation/Skills Lab Coordinator. "This was done to find out their perceptions, attitudes and feelings related to experiential, simulation-based learning." Three questions were asked both before and after. The results indicate nurses feel that participating in simulation-based learning has a positive effect on their ability to increase patient safety and recognize changes in a patient's condition. The questionnaires will be used at the three remaining competency camps and the data analyzed.
Nurses Week Celebration Speaker
Jane Hirsch, RN, MS, NEA-BC
On May 3, SVMHS nurses attended presentations by guest speaker Jane Hirsch, RN, MS, NEA-BC, University of California, San Francisco School of Nursing
Clinical Professor and Director, Nursing & Health Systems Leadership. In three identical sessions, Jane offered keen insight in her presentation—Nursing Leadership: From the Bedside and Beyond. Her message was one of helping nurses realize they are leaders whatever their position in an organization; reveals ways to discover how the nurse's approach can positively impact others; and gives nurses tools to identify and define their personal leadership skills.
Staff nurses help select patient care supplies
An important part of the process of selecting a new vendor for IV tubing and solutions was gathering input from staff nurses as well as pharmacists and anesthesiologists. At a March 29 product fair, 46 participants—a majority of whom were bedside nurses, representing nearly all nursing units—were invited to review and evaluate each of two vendor's products by responding to eight statements: 1) The IV extension set will meet my needs; 2) The IV bag was easy to use; 3) The IV tubing is acceptable for gravity flow; 4) The flow regulator is easy to regulate; 5) Y-site connections work well; 6) The secondary medication is easy to reconstitute; 7) The secondary tubing connection works well; and 8) I feel this product would meet my patients' needs. "The input of bedside staff is most valuable in influencing our decision," says Wendy Ogden, MSN, RN, CCRN, PCCN, Clinical Nurse Educator. "They bring experience and professional knowledge to the process to ensure we make the best choice for our patients."
Like nursing, SVMHS Respiratory Care Services provides around-the-clock care for patients in all hospital units—both inpatient and outpatient. At SVMHS, it's not unusual for a RCP to care for patients in the Emergency Department, PACU, ICU/CCU, patient rooms and the Sleep Medicine Center, all in one day's work. The 45-person department includes licensed respiratory care practitioners (RCP) who work collaboratively with nurses and physicians.
RCPs focus on the lungs and airways and have expertise in pulmonary testing, procedures and treatments. They play an important role as members of Rapid Response Teams, high-risk deliveries and in multidisciplinary rounds in the NICU and ICU/CCU. "We partner with physicians and nurses to provide the safest and most effective care for our patients," says Kathy Barry, RRT, RCP, Assistant Director of Respiratory Care/Neurodiagnostics.
"Respiratory Care Practitioners are specialists in the airways and lungs and care for patients of all ages, including newborns in the NICU," says Elvie Hall, RRT, RCP. "We work hand-in-hand with nurses and physicians to make sure every patient gets the most effective care."
"We have a symbiotic relationship with nursing," says Chris Anastacio, RRT, RCP, Educator/Supervisor for adult respiratory care. "Nursing and Respiratory Care work collaboratively at the patient's bedside, with the RCPs focused on delivering vital pulmonary care. We learn a lot from one another."
"Nurses know they can count on us to be there anytime night or day when they have a patient with respiratory issues," says Emily Brandt, RRT, RCP, NPS (neonatal-pediatric specialist). "Once we've addressed those issues, we collaborate with nurses on what's best to do next."
"We are like firefighters," says Celia Quadracci, RRT, RCP. "When there's a patient with a respiratory emergency or one who needs specialized care, we're there to put the fire out. Many of our patients are having some sort of respiratory emergency and we literally help save lives."
This year marks the 25th anniversary for the Mark Velcoff, MD Asthma Day Camp created and organized by Respiratory Care Services. The camp provides children ages 6 to 12 with opportunities to learn to manage their asthma while enjoying a fun and active summer camp experience.
"Since I was a little girl, I've wanted to be a nurse," says Patti Garcia, RN, ICU/CCU. "It's a calling." She graduated from nursing school at Thornton Community College, South Holland, Illinois in 1978 and moved to Monterey in 1980. She joined SVMHS two years later and has worked in the ICU/CCU for all but four years when she was a nurse in the Emergency Department.
Learning that the Magnet Steering Committee (MSC) was looking for new members, she volunteered, and following the interview process, joined the MSC in April. "I want to be part of the hospital achieving Magnet status, making it an even better place for our patients, staff and the community."
Patti also serves on her Unit Practice Council and is working with Dana Rogers on the Safe Patient Handling Project—highlighted in one of the posters selected for the 2010 Evidence Based Poster Expo. "I've worked at several hospitals and none have been as supportive of nursing as SVMHS," Patti says. "It's like being part of a family."
She and her husband live in Prunedale and enjoy horseback riding and packing in to campsites on their horses.
Monterey County Emergency Medical Services (MCEMS) has approved Salinas Valley Memorial as a Designated Code STEMI Receiving Center. "This designation confirms that we have all the experience, processes, systems and protocols in place to provide the best care for people who are having a heart attack," says Anne Robinson, BSN, RN, CPHQ, Director, SVMHS Quality Management Services (QMS). "That means re-establishing blood flow to the damaged portion of the heart within 90 minutes or less of hospital arrival."
"Studies have confirmed that the sooner a person can be treated in a Cath Lab when they're experiencing a heart attack, the better the outcomes are likely to be," says Richard Gerber, MD, Chief of Cardiology at SVMHS and physician champion for the STEMI initiative.
"The Cath Lab has been operating for 23 years and is prepared around-the-clock to care for patients," says Debra Short, MSN, RN, Clinical Director, Cath Lab. "Using advanced imaging and current interventional technology, our highly-experienced staff works closely with physicians to locate and rapidly treat the area of the heart that is causing the myocardial infarction."
The designation is the result of a unique collaboration between MCEMS, the SVMHS ED, QMS and the Cath Lab. SVMHS ED physician Rakesh Singh, MD and Kim Brown, RN provided training for EMTs in the use of a 12-lead EKG. "If a person has symptoms of a heart attack, the EMT performs an EKG in the field to know for sure," says Renee Comee, MSN, RN, Assistant Director of Emergency Services at SVMHS. "The information is relayed to us and a team is assembled in the ED so that life-saving care can begin as soon as the patient arrives."
"While SVMHS has long been an option for EMTs, we're now officially recognized as a STEMI Receiving Center," says Athar Syed, MSHS, MBBS, Clinical Performance Improvement Specialist for QMS. "We continuously collect data on the STEMI program and share it with MCEMS and our staff, enabling us to maintain and improve our excellent quality care."
Nurse-led project posters shown at second annual Evidence Based Poster Expo
The second annual Evidence Based Poster Expo, held May 3, 2010, was a resounding success. Eleven posters displayed the evidence based work of nurses at SVMHS. New this year was an external blind peer review of all poster abstracts. The reviewers—all PhD nurses with no affiliation to SVMHS—used scoring criteria developed by the American Nurses Credentialing Center for Magnet Research Conference abstract reviews. Collaborative Rounding: Enhancing the Patient's Experience by Proactively Meeting Needs received the highest score. Authors were Ortho/Neuro/Spine (ONS) Unit Practice Council (SONIC) members Neena Moriyama, RN, AHN; Rebecca Pullen, RN, CMSRN, ONC, AHN; Amelia Martinez, RN; and Joyce Tuazon, CNA.
2010 Evidence Based Posters and Participants
Evaluation of Staff Nurse Experiences with Language Standardization in the Community Hospital Setting: The CIDR Project (Clinical Interdisciplinary Documentation Redesign)
Jeffrey M. Adams, PhD, RN
Debra Denham, PhD, RN
Irene Neumeister, MSN, RN, Senior Vice President, Patient Care Services
Ginny Williams, MSN, RN, Director, Nancy Ausonio Mammography Center
Passing the Torch: Partnering for Self-Care, Meeting Heart Failure Core Measures Through Patient Preference
Megan L. Lopez, MSN, RN, CNL, Heart Center
Suzette M. Urquides, MPA, RN-SNIII, CCRN, Cath Lab
Collaborative Rounding: Enhancing the Patient's Experience by Proactively Meeting Needs
Neena Moriyama, RN, AHN ONS
Rebecca Pullen, RN, CMSRN, ONC, AHN ONS
Amelia Martinez, RN, ONS
Joyce Tuazon, CNA, ONS
The Baby Friendly Journey: Adopting the Ten Steps to Successful Breastfeeding
Shawna Helmuth, RN-SNIII, BS, IBCLC, Lactation Services
Safe Patient Handling: An Evidence & Role Based Approach to Protect Staff From Injury While Providing for the Safe Handling of Patients, to Include the Special Needs of the Bariatric Population. Project Management Methodology
Patti Garcia, RN, ICU
Dana Rogers, RN-SNIII, ICU/CCU
Linguistic Compatibility: Primary Language and Rapid Response Team (RRT) Outcomes
Rachel M. Failano, MSN, RN, Clinical Simulation/Skills Lab Coordinator, Education
Infant Driven Feeding: A Cue-Based Approach to Feeding in the NICU
Julie Akin, RN, NICU
Addressing an Opportunity for Continued Performance Improvement: The Broselow Crash Cart Project
Lisa Garcia, MSN, RN, CNS, Pediatrics
Teresa Woodrow, RN, AHN Pediatrics
Diana Lemke, RN, Emergency Department
Post Operative Normothermia Study Enhancing Surgical Patient Outcomes through Multidisciplinary Interventions
Laura Welch, RN,
Operating Room Information Specialist, Chair, Peri-operative Clinical Practice Council
Decreasing the Potential for Medication Errors: Adoption of Online Orders
Marie Marbach, RN-SNIII, MSCV3
Cathy Gomez, BSN, RN, CMSRN, MSCV3
Agnes Lalata Nieto, MSN, RN, CMSRN, MSCV3
David Kasting, MD
Doreen Faiello-Burnett, MHA, RN, Senior Administrative Director, Patient Care Services, Support
Laura Mittendorf-Zerbe, BSE, Organizational PI Specialist
Migration to Meditech 6.0—the e-Care Initiative—underway
Staff nurses are leading and participating in the migration to Meditech 6.0—the e-Care Initiative. The new and improved Meditech documentation system is slated for implementation by February 2011 and is an important step toward developing an electronic health record (EHR) at SVMHS. "The new windows-based Meditech platform enables us to completely revamp our clinical documentation to make it more user-friendly," says Lilia Meraz-Gottfried, MSN, RN, Director of Clinical Informatics. "It streamlines the workflow, makes it much easier for clinicians to access the information they need and enables better communications among disciplines."
The core e-Care team includes Kathryn Maurer, RN-SNIII, Kim Stewart, RN, Mary Ann Artuz, RN-SNIII, Emmy Ferber, RN-SNIII and Sabrina Bohbot, BSN, RN. They will receive extensive training both at SVMHS and at Meditech. "These staff nurses have been involved in Clinical Informatics projects in the past," says Lilia. "The majority work in the Float Pool, giving them a broad perspective and a wide base of experience and knowledge. Staff nurses play a key role in this multidisciplinary collaboration to enhance patient care and efficiency, drive quality of care and improve patient outcomes. Additional nurses will be added to the team as the project unfolds."
The Clinical Leadership Informatics Committee (CLIC) and the Multidisciplinary Informatics Committee (MIC) provide direction for the e-Care initiative.