Regina Grazel, MSN RN BC APN-C Primary Work Function/Position: CNS, NJ Department of Health CCHD Screening Program Education: UNIVERSITY OF PENNSYLVANIA, Philadelphia, Pennsylvania. MSN in Perinatal Nursing. RUTGERS, THE STATE UNIVERSITY, Camden, New Jersey. BSN. Awards/Honors: Alumni Nursing Excellence Award/2013/ Rutgers University School of Nursing- Camden Nursing Excellence Award/2011/Our Lady of Lourdes Medical Center, Camden, NJ REACH Award/ 2008/ National Association of Neonatal Nurses, Delaware Valley Chapter (DVANN) New Jersey Maternal Child Health Nurse Reality Award, Educator category/ 2007/March of Dimes How long have you been a NANN member? 26 years List NANN and/or NANNP Elected Positions and Volunteer Appointments: I served two terms on the NANN Board as Director at Large from 2009-2013. Other elected positions include president-elect of the Delaware Valley Chapter (DVANN) in 2001-2002 and president from
2002-2004. Prior DVANN positions include treasurer, and member of the research and community service committees. As a NANN volunteer, positions include membership on several developmental care related committees and task forces from 2005-2014. I was the Conference Co-Chair for the NANN Leadership Institute and Clinical Practice Institute held in 2000 and for the past three years, I have served as a reviewer for the NANN Faces of Neonatal Nursing photo contest as well as the Brighter Tomorrows Story contest. Elected Positions, Volunteer Appointments, and/or Affiliations with other Organizations: Current volunteer appointments include the New Jersey Hospital Association Baby Friendly Advisory Group since 2014 and the Dean's Advisory Council, Rutgers University School of Nursing, Camden, NJ, from 2012. Previously served on the Southern New Jersey Perinatal Cooperative Board of Directors as a hospital alternate from 2008-2013. Current member of AWHONN and the New Jersey Breastfeeding Coalition. STATEMENTS Describe how you have served as a leader and demonstrated qualities such as vision, strategic thinking, integrity, mentoring, and interpersonal skills: Throughout my neonatal nursing career, I have grown as a leader and have had ample opportunity to demonstrate leadership skills. Leadership was nurtured at the bedside and blossomed to taking on more responsibility on unit based committees and eventually as an advanced practice nurse leading evidence based practice changes and mentoring staff in the process. In partnership with unit and division management, as a CNS, I was a vital member of the Women and Children's leadership team. With vision, integrity, strong communication and relational skills, I was able to lead many unit based and hospital-wide interdisciplinary projects with successful results. I have also enjoyed working with staff one on one in professional development activities to attain advancement on the clinical ladder. In my role as NRP site coordinator and regional trainer, I engaged students in the learning experience while developing new instructors and provided guidance to existing instructors. With proven interpersonal skills in leading teams, and with clear vision and strategic thinking, I organized and led major systems changes to align with implementation of the Ten Steps to Successful Breastfeeding on the Mother-Baby Unit and NICU. This endeavor required substantial planning, multidisciplinary coordination, education, effective communication and strong leadership abilities. In my current position as Project Coordinator at a State Department of Health for a federally funded program, effective governance and leadership are critical to the success of the program. I am responsible to ensure objectives are met and key deliverables are completed on time and within budget while providing support and guidance to the state's birthing hospitals and working collaboratively with core staff at multiple facilities.
Please describe your 3-5 year vision for neonatal nursing and for NANN: Serving in NANN and DVANN leadership roles over the past 25+ years, including 4 years on the NANN Board of Directors, has prepared me for the challenges and responsibilities of President and are a testament to my commitment to excellence in neonatal care and service to neonatal nurses. My education and experience have provided me with unique perspectives on neonatal care and neonatal nurses from several vantage points including staff nurse, nurse educator, advanced practice nurse, and public health nurse. My vision for NANN is to secure the future of the association through innovation and adaptation to the changing needs of neonatal nurses, and by engaging current and potential members in the mission of NANN by providing quality education and varied opportunities for professional growth. Continued development within the association to meet member needs and recruit new members is essential to sustain the organization and maintain its relevance to neonatal nurses. Through strategic direction and vision that aligns with NANN values and goals, I aim to position NANN as the go-to professional nursing organization for neonatal nurses and the authority on neonatal nursing care. I will continue to represent NANN with other key stakeholders and strengthen NANN's collaborative work with other organizations in efforts to improve care for neonates and families and support neonatal nurses. LEADERSHIP COMPETENCIES Identify your primary and secondary strengths for one or more of the areas below: Administration: Secondary How have your experiences in administration shaped your views on the needs of the neonatal population, the nursing profession, and NANN members? The needs of neonatal nurses change as the nursing profession and the population we care for changes. Patients are more complex; quality initiatives led by nursing teams are at the forefront in many institutions; payment systems, insurance and regulatory bodies drive care practices; patient satisfaction surveys, family centered care models and integration of evidence based practices all influence the modern neonatal nurse and delivery of patient care. Nursing administrators face challenges in balancing institutional priorities and expectations and meeting the needs of their staff. Strong support from managers and other members of the leadership team benefits staff; however, managers need support and mentoring to help lead others. As the division wide CNS, I was able to partner with unit and division management as a vital member of the Women and Children's leadership team. I recognize that teamwork, situational awareness, education and effective governance models are critical to successful management and staff satisfaction. Organizations such as NANN provide important professional support and education for seasoned and fledgling nurse managers.
Advocacy: Primary How have your experiences in advocacy shaped your views on the needs of the neonatal population, the nursing profession, and NANN members? Nurses are positioned especially well to identify and speak up about conditions that may result in adverse events that affect their patients. The American Nurses Association (ANA) includes advocacy in the care of individuals, families, communities and populations as an important component in their definition of nursing. The ANA also addresses the importance of advocacy in its Code of Ethics, in Provision 3: The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient. Advocacy is identified as one of NANN's defined goal areas and advocacy for quality patient and family care is listed as a NANN organizational value. Neonatal nurses, in particular, have an imperative to advocate for their patients who are unable to speak for themselves. Neonatal nurse's role in advocacy may occur at the bedside to improve care quality, prevent unnecessary pain and suffering, and maintain patient dignity. Advocacy may also take the form of public activism for a particular issue, alerting policymakers and officials and collaborating with other stakeholders to influence positive change for patients, families or the nursing profession. NANN's advocacy agenda affords the neonatal nurse greater opportunities to influence decision making on issues that impact neonatal nursing practice and care for patients and families. I have witnessed the power of advocacy by nurses and parents on the local, state and national levels to improve care delivery and access to treatments and other services. In my scope of work, I regularly participate in stakeholder meetings to champion improved care for infants and families. Clinical Care: Secondary How have your experiences in clinical care shaped your views on the needs of the neonatal population, the nursing profession, and NANN members? Provision of age appropriate care using the best available evidence is fundamental to optimal clinical neonatal nursing care. The quality of clinical care can have a profound impact on patient outcomes. As a CNS, I championed evidence based nursing practice by providing staff with the knowledge and tools to apply best practices. I provided consultation and assisted with decision making for complicated clinical cases. I continue to lead education and quality improvement activities to support best practices. Through my volunteer activities with NANN, I have contributed to developmental care and age appropriate care related projects including participation on several committees and task forces, and review of relevant guidelines and position statements. Since 2011, I have maintained the designations of Certified Breastfeeding Counselor and NANN Neonatal Developmental Care
Specialist. I also maintain long-standing certification through ANCC as a High Risk Perinatal Nurse. NANN helps me keep abreast of current trends and best practices in clinical care through the Advances in Neonatal Care journal, local and national conferences and various electronic communications. Education: Primary How have your experiences in education shaped your views on the needs of the neonatal population, the nursing profession, and NANN members? Ongoing education is necessary for all nurses and indeed NANN has listed lifelong learning as one of its organizational values. NANN provides quality educational offerings in many formats to reach neonatal nurses. Whether bedside nurse or university professor, sometimes we are the provider; other times the recipient of education. During my perinatal nursing career, I have gained significant experience as a nurse educator in various capacities from small and informal teaching to formal presentations to professional groups. I have created or presented education in many different formats to meet the needs of the learners or target population including nurses, parents and interdisciplinary team members. My portfolio of education related activities includes conference planner; author of patient education materials including brochures, pamphlets and a comprehensive mother-baby handbook and peer reviewed publications; clinical instructor for undergraduate nursing students; preceptor for graduate nursing students; bedside teacher; classroom instructor; workgroup facilitator; conference presenter; curriculum developer; and organizer of skills sessions. I am a seasoned presenter including poster and podium presentations at local, regional and national professional conferences and recently functioned as lead content expert and reviewer in the development of a nursing distance learning course. Neonatal nurses teach each other, learn from each other, teach parents, listen and learn from parents. Continuing nursing education (CNE), as is offered by NANN, is important to support professional neonatal nursing practice and the delivery of safe, evidence-based, high-quality care for patients and families. Ongoing education is necessary to meet changing needs including application and integration of evidence, new or improved therapies or modalities, improved communication and interaction with fellow nurses and members of the interdisciplinary team including parents. Quality Improvement: Primary How have your experiences with quality improvement shaped your views on the needs of the neonatal population, the nursing profession, and NANN members?
Nurses are an integral part of the healthcare team and are positioned to positively influence patients' experience and outcomes. Neonatal nurses can be actively involved in improving the quality of care. I have contributed to or participated in several quality improvement initiatives to realize systematic changes to improve care or outcomes. As the principal investigator on a MOD grant to improve breastfeeding and human milk usage in the NICU, I led efforts that resulted in significant increases in breastfeeding initiation for all weights and administration of exclusive human milk to infants weighing 1500 grams or less. As the lead hospital representative to the NJ NICU Collaborative, I served as the unit point person for the collaborative's quality and safety projects regarding infection prevention and human milk administration. I directed PDSA cycle implementation at the unit level to improve exclusive human milk rates and was the hospital site coordinator for the NCLABSI patient safety program to reduce central line infections. I was the unit champion for the Agency for Healthcare Research and Quality's Comprehensive Unit-based Safety Program (CUSP) to improve patient safety by reducing line infections and other hospital acquired infections. In working with an interdisciplinary care team, I introduced components of TEAM STEPPS to improve teamwork and response to emergencies. I utilized PDSA cycles to effect systems change in implementing the Ten Steps to Successful breastfeeding in preparation for the goal of Baby Friendly designation. In addition to unit based quality efforts, I am accountable for activities to improve implementation of CCHD screening in birthing facilities statewide. Research: Secondary How have your experiences in research shaped your views on the needs of the neonatal population, the nursing profession, and NANN members? Nurses have the opportunity to be involved in the discovery of new knowledge and the dissemination of research findings. Given the need for research to identify best practices, neonatal nurses require the ability to understand research findings and their application to practice. NANN recognizes the need to drive and support nursing research for its members and has several initiatives to engage members to advance nursing research and evidence-based neonatal care. Nurses lead and participate in research to contribute new knowledge to the profession and translate research to practice. Advanced practice nurses, among others, are charged with dissemination of nursing and neonatal care related research. The ability to contribute, effectively use, and communicate research findings and evidence to nurses, interdisciplinary colleagues, policy makers and the public is vital for the neonatal nurses and the nursing profession.
In addition to champion and director of several evidence based projects in the NICU and Mother-Baby Units, I was the principal investigator of a collaborative project with the NANN Delaware Valley Chapter (DVANN) that evaluated nursing knowledge and practice regarding implementation of the AAP recommendations to reduce SIDS risk in NICUs. The findings of this study were published in Advances in Neonatal Care in 2010. I am currently co-investigator, with a CDC collaborator and in partnership with the NJ NICU Collaborative, of an evaluation of CCHD screening in the NICU; an evaluation with 21 participating sites in 5 states.