Nursing Administration

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1 Nominee: Molly Aldrich RN, BSN, Charge Nurse Department: Cancer Center Infusion Area of Recognition: Transformational Leadership, Clinical Practice The Cancer Infusion Center would like to nominate our Charge Nurse Molly Aldrich, as Magnet Nurse of the year. As a group we feel she is an exceptional contribution to UCH and has a strong commitment to enhancing the culture of Magnet. Within the last 6 months, Molly moved into her role as a Charge Nurse from a staff nurse in infusion. During this short amount of time she has made positive changes and supported us as a leader. Within a month of taking on her new role as charge nurse in infusion, Molly evaluated our patient acuities in relation to staff/patient ratios and secured a new Medical Assistant (MA) to help our very busy team. This additional MA has has provided more efficient patient care. Molly also advocated for 2 RN s who wanted to job share. She received approval for the job share of 2 RN s which has benefited those nurses and the unit as well, as they each work a short shift to help cover the unit during the busy hours on our busiest days. Molly was very innovative and started an education campaign promoting what she coined B.Y.E. Best Year Ever. She challenged us to come to work with a positive attitude each day, to work together, to celebrate our successes and learn from the challenges. She asked us each to think when we clock in Why can t this day be the best day ever. That has carried over into our practice, setting a tone and an attitude that is very positive and is noted by our co-workers. Molly has also been instrumental in getting a symbol of patient achievement upon completion of their chemo treatments. She surveyed staff for which inspiring words to engrave on rocks. These rocks are a token of our recognition for patient s hard work and a celebration which is given to patients on their last day of treatment. Molly is integral in spearheading an innovative new interdisciplinary group that meets Thursday afternoons which is aptly named Patient Centered Rounds. The focus of the group is to bring together Dieticians, Social Services, Pharmacy and Nursing to discuss patients that have been identified as having extra challenges. After a patient is identified, a care coordination note is placed in the chart so future providers know of any special situations or concerns that a patient might be dealing with. To improve work flow, which has enhanced our nursing practice Molly has met with IT to review EPIC work flow. Her curious questions and drive to improve work flow resulted in a new design for ordering our home infusion pumps for patients. Prior to this we would print out an order for the chemotherapy and then fax it to the home infusion company. Now we can electronically route this same chemo order which saves paper, resources, and RN time. Molly has made the difference in our everyday. She is a positive, practical, trusted and respected leader. We notice her efforts and appreciate her hard work. As a staff we look forward to the changes that she will bring! Cancer Center Infusion Staff

2 Nominee: Paula Hurlbert RN, BSN, RNC-NIC Department: Neonatal Intensive Care Unit Area of Recognition: Exemplary Professional Practice, Clinical Practice Paula has graced the NICU with her leadership and skills for nearly 2 decades and as a Level III Clinical RN has increasingly ramped up her involvement in hospital and unit activities to improve outcomes for our patients, families and team members. The Neonatal Abstinence Scoring FOCUS-PDCA is an example of a collaborative, interdisciplinary initiative that Paula is leading to improve patient outcomes. This multidisciplinary, evidence based initiative is improving the care of opioid exposed neonates and promoting a more family centered approach to communicating with and educating parents of these infants. Paula has always been a team member interested in improving things for her peers. Over the years she has demonstrated that she is an excellent preceptor and relief charge nurse. Paula decided that she would become part of the ongoing evaluation of the professional practice model and became the NICU representative to the UEXCEL Board in order to help make changes and to entice her nursing peers to credential. Paula has actively promoted the credentialing process in the NICU, taught workshops to credentialing applicants and been an advisor for team members. Paula has also assumed a leadership role in a collaborative interprofessional program to improve the response to infants born in the Emergency Department (ED). Paula s leadership on this effort has spanned 6 years and 2 new ED s, and she persists to this day to identify opportunities for improvement. She has collaborated with others to identify and place appropriate resuscitation equipment, supplies, and medications in the ED. She is an instructor for the Neonatal Resuscitation Program to promote a timely and skilled resuscitation response. Through her work, the ED has identified RN liaisons to work with the NICU team on performing case reviews of ED deliveries. Paula recently participated in a simulation exercise and subsequent debrief, between the OB teams, the ED, and the NICU, involving the delivery of a baby and maternal hemorrhage in the ED. This project has been daunting, but Paula has doggedly continued her efforts to improve neonatal resuscitation in the ED and is making a difference for these small patients and the large teams caring for them. Another example of Paula s exemplary professional practice is the NICU Level III Council. This council was formed to provide a forum for increasing numbers of Level III credentialed NICU RNs, to work together and actively engage in leadership and evidence based practice projects to drive improvements in patient care and outcomes. Paula s leadership ability and interest in promoting and improving the professional practice model made her a clear choice to co-chair this council. The council has become a forum for shared decision making a

3 and leadership. It has encouraged increased engagement in quality improvement, education and patient safety initiatives and enhances the NICU culture of Magnet! Paula has a vision of what the practice of professional RNs in the NICU can achieve. In her desire to light that fire within the rest of the team, she has taken the NICU team to new levels of practice, engagement and excellence. It is with pride and enthusiasm that I nominate her for the Magnet Nurse of the Year! Christy Math Nominee: Mary Beth Flynn Makic RN, PhD, CNS, CCNS, FAAN Department: Professional Resources Area of Recognition: New Knowledge, Innovations & Improvements, Non-Traditional Practice Dr. Mary Beth Flynn Makic has been employed in the Professional Resources Department since We are honored to work with her. She is caring, compassionate, dedicated to our hospital and our nurses, working tirelessly to mentor others along the way. In addition to her work role at UCH, Mary Beth is an Adjoint Associate Professor at the University of Colorado, College of Nursing, garnering repeated awards for her work. Mary Beth s skill in translating knowledge into practice is extraordinary, touching nurses practicing in all types of settings. Mary Beth s practice expertise focuses on care of trauma and burn-injured patients; acute wound healing; prevention of pressure ulcers and hospital-acquired infections (HAIs); and translation of evidence into practice. In addition, she has worked relentlessly as an integral member of the Research Nurse Scientist team to teach others about research and evidence-based practice (EBP) and to work with them on various research, QI, and EBP projects -- from writing a proposal through data analysis and dissemination. Her work in implementing CHG bathing practices in the ICUs has contributed to significant reductions in HAIs. The ICU educator group, with Mary Beth s guidance, implemented a Preventing CAUTI campaign in October 2013 and the CAUTI rates have been reduced from 3.41 to 1.36 (well below the NDNQI benchmark). She has mentored UCH practicing ICU clinical nurses to undertake EBP studies that have improved patient outcomes such as: accurate weight measurement for stroke patient treatment, visitation practices in the ICU, interventions to reduce HAIs in neonates, nurse-driven burn resuscitation protocol, and bathing practices to reduce HAIs. Improving critically ill skin integrity led to developing an EBP algorithm to reduce pressure ulcers, disseminating this innovation through regional and national presentations. She was awarded the Innovation in Evidence- Based Practice Award from NNSDO for her work engaging nurses to embrace practice based on best evidence. Mary Beth has mentored significant numbers of UCH nurses to present and publish. In 2013, MaryBeth, Mandy Moorer and Alyson Kelleher received the manuscript of the year award by the Journal of Wound, Ostomy and Continence Nursing. Her expertise has resulted in the dissemination of work through more than 60 publications and hundreds of presentations. She has presented at the national Magnet conference each of the last 3 years and has led the series "Evidence-Based (EB) Practice Sacred Cows" at the AACN national conference for 4

4 years. These oral sessions have generated publications in Critical Care Nurse, which is disseminated to all AACN members. In addition, she is a co-editor of the textbook, Trauma Nursing: From Resuscitation through Rehabilitation, the leading reference for trauma nursing practice worldwide, and has received book of the year awards. Mary Beth currently serves as section editor for the AACN Procedure Manual for Critical Care, and has authored chapters in previous editions. This text, used nationally and internationally, is the gold standard for guiding critical care nursing practice to ensure safe, excellent care. Mary Beth has been actively involved in the American Association of Critical-Care Nurses (AACN) for 25 years, Society of Critical Care Medicine for 22 years, and local AACN chapters. Mary Beth has served two terms on the editorial board of AACN Advanced Critical Care, and served as guest editor on a recent issue focusing on complex symptom management. As a recognized critical care expert Mary Beth provides expert consultation to AACN members regionally and nationwide to identify strategies to use best-evidence to improve patient care. We are very pleased to be nominating Mary Beth for the 2014 UCH Magnet Nurse of the Year award. We believe her body of work, contributions and dedication to UCH patient care are most deserving of this prestigious honor. Regina M. Fink, RN, PhD, AOCN, FAAN Research Nurse Scientist Kathy Oman RN, PhD, FAEN, FAAN Research Nurse Scientist Nominee: Amanda Moorer RN, BSN, CCRN, Nurse Residency Program Coordinator Department: Professional Resources Area of Recognition: Structural Empowerment, Non-Traditional Practice It is my pleasure to nominate Amanda (Mandy) Moorer for the Magnet Nurse of the Year award through her exemplary Transformational Leadership. While the Post-Baccalaureate Nurse Residency Program at UCH has always been rooted in excellence, Mandy took on the role during substantial expansion into the new Emergency Department and eventually the creation of AIP2. The typical New-Graduate cohort of nurses has since been dwarfed with classes reaching up to 60+ Nurse Residents. Mandy rose to the challenge, aiming to keep the classes as cohesive as possible, ensuring no Nurse Resident s voice was lost in the mix. She even goes so far as taking individual pictures of each Nurse Resident so she doesn t forget anybody s name while juggling multiple cohorts. Nurse Residents are encouraged to write reflective narratives with each class, and Mandy takes the time to carefully read each one. With Mandy s encouragement and guidance, a recent Nurse Resident s narrative is being featured in an upcoming national Nursing Journal. With each new cohort, Mandy offers guidance and encouragement, helping each Nurse Resident pursue an EBP project that they are passionate about, encouraging them to find improvements in patient care. Mandy has attended the UHC/AACN Nurse Residency Program Annual Meeting with New-Grads to participate in podium, panel, and poster presentations. A recent

5 group also presented their work at the Rocky Mountain Interdisciplinary Research and Evidence-Based Practice symposium, winning second place for the Evidence-Based Practice award. The true display of Mandy s passion can be seen been through the Nurse Resident s 2013 UHC Annual Outcomes Report, which display an overall improvement in Nurse Resident s opinions of the program since she took over as Program Coordinator. For example, Mandy has successfully added relevant content and classes for specialty areas including the Women s Care Center, Neonatal ICU, and OR. Results for the survey item: The Nurse Residency program allowed me to transition from advanced beginner toward competent professional nurse in the clinical environment increased from 51% strongly agree in to 68% strongly agree in Perhaps of greater significance, 100% of Nurse Residents from would recommend the program to others - compared to 94% from Mandy is constantly seeking ways to make the NRP program better, surveying New-Grads after each class to note their proposed improvements and concerns for future cohorts. She makes sure to highlight all the paths past Nurse Residents have expanded to within the hospital, providing inspiration to the ample growth opportunities UCH provides. Through the noticeably growing confidence of Nurse Residents, and the attention to detail the Nurse Residency Program provides, I am confident Mandy is the role model of Transformational Leadership. I look forward to watching the Post-Baccalaureate Nurse Residency Program continue to thrive under Mandy s leadership. Best Regards, Lindsay Knorr RN, BSN, CCRN Cardiothoracic ICU/Surgical ICU Nominee: Amanda Nenaber RN, MS, CCNS, ACNS-BC, Advanced Practice Nurse for Heart Failure Service Department: Heart Failure - Cardiology Area of Recognition: Exemplary Professional Practice, Clinical Practice It is my sincere pleasure to nominate Amanda Nenaber for Magnet Nurse of the Year. Amanda has been at the forefront of establishing the best possible care for the Heart Failure (HF) patient population. Every day she demonstrates an extraordinary contribution to UCH and an undeniably dedicated commitment to enhancing the culture of Magnet. Amanda has expanded the existing Heart Failure program structure to provide significantly increased levels of care continuity. This has led to a decrease in re-hospitalization rates in our patient population from 22% in FY 2011 to 20% in FY 2013, a significant decrease given the complex patient population we care for. She developed hospital-wide education modules for the Nursing, Nutrition, Dietary Services, PT/OT, and Case Management/ Social Work in regards to the management and resources for HF patients. She obtained a 97.9% staff completion rate on these modules.

6 She researched the use of a volunteer Patient Navigator, through a Colorado based program called Boomers Leading Change and has trained this volunteer in the dispersion of patient information and available resources for the HF population. Amanda has also assisted in the design and implementation of a clinical decision support (CDS) system that allows for real-time identification of patients hospitalized with HF and an assessment of their risk stratification for readmission through EPIC. This system has been proven to identify, with 89% accuracy, a patient who will be discharged with a diagnosis of HF. This allows Amanda and her team to start interventions and education for these patients at time of admission. Amanda is currently partnering with home health care, long term care, and skilled nursing facilities to provide seamless transitions for care of our HF patient population. In addition, Amanda worked with the American Heart Association and EPIC to implement Target Heart Failure : a telephone follow-up form for discharged HF patients. Amanda is also co-chair of the Hospital to Home (H2H) HF Task Force. She constantly brings new, creative ideas and energy to her role as leader. It was with Amanda s leadership and direction that UCH received Joint Commission HF Certification in 2012 and most recently Joint Commission Advanced HF Certification in 2013, only the second organizations in the state of Colorado to receive this certification. Not only is Amanda extremely active at UCH, she is also a Taskforce member on the American Association of Heart Failure Nurses (AAHFN) Patient Education Committee. The Executive Director noticed a UCH Insider article and asked Amanda for her involvement in a newly developed national patient education committee. Amanda s involvement on this committee has allowed her the opportunity to improve educational materials we provide at UCH through the work and materials developed at the national level. Amanda has accomplished all of this while taking classes full time and working towards her Doctor of Nursing Practice (DNP) degree from UCDenver, she graduates this spring. Amanda s passion and drive are inspiring and make her a highly deserving and perfect candidate for the Magnet Nurse of the Year Award! Theresa Heyborne, RN, CHFN Nominee: Sylvia Park RN, BS, Medication Safety Nurse Specialist Department: Pharmacy Area of Recognition: Transformational Leadership, Non-Traditional Practice Dear Magnet Steering Committee Members, It is with great pleasure that I write this letter in support of Sylvia Park, RN, BSN, for the 2014 Magnet Nurse of the Year in Non-Traditional Practice Transformational Leadership.

7 Phone: Sylvia has been in Fax: her current position as the Medication Safety Nurse Specialist since December Over this past year, Sylvia has demonstrated exceptional contributions in leading the University of Colorado Hospital (UCH) and UCHealth in achieving significant outcomes related to patient safety. The emphasis of her work has involved various aspects of smart pump technology (SPT), but her strong commitment, clinical expertise and passion for patient safety has had far reaching impact. Sylvia s leadership around SPT has transformed nursing practice at UCH by engaging front line staff in the important role that SPT has in providing safe care. Her vision, influence, clinical knowledge, and strong expertise have been instrumental in leading an active multidisciplinary team at UCH as well as providing support to UCHealth leadership in standardizing SPT across the system. She spent the first two years of her position establishing a strong foundation for the standards of practice related to effective use of SPT, but in 2013, a significant transformation occurred. Staff went from understanding the need to use SPT correctly to truly being invested in the goal of achieving the safest care for patients due in large part to Sylvia s dedication and passion. Staff engagement was demonstrated in 2013 through a 38% increase in the total number of infusions administered via the guardrails technology, the largest increase since Sylvia s position was created. Staff s consistent use of the technology also resulted in a 34% increase in the number of events where severe harm was averted (pump good-catches nurse is prompted to evaluate what they programmed, resulting in the pump being re-programmed to the correct settings), with an associated cost avoidance of more than $4.5 million. Sylvia s visibility across the organization, accessibility throughout nurses day-to-day practice, and encouraging communication style have been key in the transformation of staff s values, beliefs, and behaviors around SPT. Specific examples demonstrating her Transformational Leadership achievement over the past year include work conducted in each of the following 3 Magnet Model Components; Structural Empowerment, New Knowledge, Innovation, & Improvements, and Exemplary Professional Practice: Structural Empowerment: Mentoring more than 200 Graduate Nurse Residents through a newly revised skills training class that provides hands on, case-based training on SPT with 2013 evaluation scores of 3.99/4.00 New Knowledge, Innovation, & Improvements: Creating an innovative Patient Safety Campaign targeting safe IV medication administration practices through the use of one-page flyers (What a DRIP, I Need to VENT) The SPT team has decreased risk for potential or latent errors by making more than 250 changes to the drug library profiles in On the Medication Use Process 2013 Nursing Satisfaction Survey (N=238); for the question: I am satisfied with the service the SPT team provides ; 96% responded favorably Exemplary Professional Practice Sylvia has positioned herself as an expert in SPT. Her expertise has contributed to a publication, speaking engagements and the President s award for Rock Solid Economics.

8 Further support of Sylvia s achievements related to transformational leadership include the application of her strategic vision and dedication as a first time project manager, leading a team to the successful implementation of new Patient Controlled Analgesia (PCA) technology in September This project has resulted in one of the most successful initiatives at improving medication safety UCH has experienced in the last decade. She not only led a large multidisciplinary team in a yearlong project, she helped to reshape pharmacy services related to preparing and delivering high risk medications, optimize EPIC through the revision and creation of new order sets and was key in orchestrating the hospital-wide educational initiative. In the first 4 months of using this new technology, UCH has experienced the following PCA related patient safety outcomes: 30% decrease in Patient Occurrences 52% decrease in Wrong Concentration Occurrences 100% decrease in Wrong Mode Programming Occurrences Finally, Sylvia presented data to hospital leadership related to SPT guardrails usage in the emergency department showing an average compliance of 25%. Barriers to improving this compliance were identified and included lack of pump availability. In April 2013, additional pumps were purchased for the emergency department, who is now averaging 78% compliance (>200% increase) due in part to increased pump availability. Thank you for your consideration of Sylvia Park for the 2014 Magnet Nurse of the Year Award as she truly exhibits the Magnet component of Transformational Leadership in her strong commitment to enhancing the culture of Magnet through her exceptional contributions to patient safety. Sondra May, Pharm.D., Supervisor Medication Safety Team Nominee: Kaycee Shiskowsky RN-BC, BSN, MBA, Nurse Manager Department: Pulmonary Area of Recognition: Transformational Leadership, Non-Traditional Practice Kaycee has been the nurse manager for medicine specialties and pulmonary inpatient units since Kaycee has accomplished many successes and positive outcomes for her units, but it was through her leadership on the UCH Falls Champion Committee that Kaycee has influenced the overall inpatient fall rate. The Fall Champions had historically struggled with increasing fall rates despite a wide variety of interventions. This all changed with Kaycee taking the helm as co-chair of this committee in Kaycee tirelessly reviewed UHC and NDNQI data, evidence and best practices to learn all she could about patient fall prevention strategies. Kaycee effectively engaged our inpatient nurse managers to join the committee, partnering with their unit staff representative. Unit-specific fall rates were reviewed at each meeting with best practices highlighted and take-back tips communicated to the units. Kaycee led an interdisciplinary team in planning the 2012 and 2013 UCH Annual Fall Summits for the Fall Champions. Rapid-improvement initiatives were promoted by Kaycee as well as population-specific, fall-prevention action planning for each inpatient unit.

9 It was due to Kaycee s transformational leadership, patient advocacy, commitment and persistence that resulted in significant decreases in UCH fall rates from 3.19 falls/1,000 patient days in 2012 to 2.68 falls/1,000 patient days in 2013! Kaycee presented this work at the 2014 ANA conference in Phoenix. Kaycee is dedicated to pulmonary nursing and is viewed by her staff and colleagues as a clinical expert and advocate for pulmonary hypertension (PH) and cystic fibrosis (CF) populations. Kaycee recently attended a PH conference in Washington, DC, where she visited with our Colorado, Wyoming and Nebraska legislators to lobby for Senate Bill The proposed bill supports a research focus on accurate PH diagnosis because PH signs and symptoms are frequently confused with other common diseases such as COPD and asthma. With increasing managerial span of control and retention issues within her nurse manager peer group, Kaycee promoted and participated in a nurse manager satisfaction research study. The research findings resulted in senior nursing leadership strategy development in removing barriers to effective day-to-day management and promoting work-life balance for the nurse managers. This research study was published in JONA May Thank you for your consideration of Kaycee Shiskowsky for the 2014 Magnet Nurse of the Year Award as she truly exhibits the human caring, professional nursing and transformational leadership characteristics inherent to this award. Respectfully submitted, Deb De Vine, RN, MS, Director, Patient Services Nominee: Karen Wheeler RN, BSN, VA-BC Department: Interventional Radiology Area of Recognition: New Knowledge, Innovations & Improvements, Clinical Practice I would like to nominate Karen Wheeler for Magnet nurse of the year in the category of Innovation. Karen is a charge nurse in Interventional Radiology and lead PICC nurse. As part of her role she partners with all the ICUs to ensure that our patients receive safe patient care. There are 2.5 million deep vein thrombosis (DVTs) and 60,000 pulmonary embolus (PEs) diagnosed every year in the United States. PE is the most common preventable cause of death among hospitalized patients. Neuro patients are at a higher risk of DVT and PE due to immobility and hypercoagulable states. In 2012, the Neuro ICU had 141 PICCS placed. Our DVT rate at the time was 17%. The national average is 4%. Karen started researching to see what products would be available that could assist in decreasing our DVT rates. She found a newly FDA approved PICC that was made from new polymer that resists platelet adhesions. She formed a team a began a four month trial in Dec After trialing the BioFlo product, our DVT rate drastically decreased from 17% to 7%.

10 However we were not able to continue with the new product as the catheters were not compatible with our equipment. Currently we do 50% of our PICC placements at the bedside and 50% under fluoro. Thus, Karen found the Vaso Nova System and trialed that with her team. The Vaso Nova system allowed for a tip positioning system to be used in conjunction with BioFlo. In addition, since CXR confirmation for PICC placement is no longer the gold standard, the goal of the team was to eliminate CXR in as many instances as possible. Karen felt with the adoption of Vaso Nova, her team would be able to achieve the goal of going CXR free. Based on a 55% decrease in our current DVT Rate, UCH will save $594,000 in treatment costs by using the new Vaso Nova product, In addition, we will eliminate CXR for a savings of $6,000 per line, for an annual cost savings benefit of $419,000. We really appreciate her taking the time and effort that she has put into this project. It was lengthy and time consuming, but she persevered as it was what we needed to improve our DVT prevalence. Now all the patients who need PICC lines for care will be treated with the highest quality of care. Mary Holden

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