Aultman 2015 Nursing Annual Report

CELEBRATING OUR 3RD MAGNET DESIGNATION

Aultman nurses celebrated achievement of their third Magnet designation in 2015. Being a Magnet organization is a reflection of nursing excellence, and is an honor shared by only seven percent of hospitals in the U.S. On March 9, Aultman Chief Nursing Officer Anne Gunther, DNP, RN, NE-BC accepted a phone call from the Magnet Commission Chair to hear the results of the February site visit to validate and verify Aultman’s document submission. The call, in which the commission chair announced the decision to designate our hospital as a Magnet organization for the third time, was broadcast via speaker and met with cheers and applause from the large group of nurses, executives and allied health personnel who had gathered in Bedford lobby to hear the great news!

LETTER FROM THE CHIEF NURSING OFFICER

Dear Nursing Colleague: The work of nurses is both sacred art and scientific skill, engaging components of compassion, core knowledge, skilled judgment and advocacy. The nurse’s mission to promote health, protect dignity and alleviate suffering marks our profession as one of the highest human callings. Caring behaviors are inherent and visible in nurses’ healing relationships with the patients they serve, and extend to the families and loved ones who surround them. At Aultman Hospital, nurses are held to an elevated level of expectation for quality, reliability and patient satisfaction outcomes. As they engage patients on a personal level, apply principles of safety, practice evidence-based care and demonstrate disease-specific knowledge and skill, Aultman nurses create a protective, individualized and therapeutic environment conducive to optimized health for their patients. In 2015, our deeply rooted culture of caring and reliability led to remarkable achievements for our hospital and our patients. I am honored to present for your review the 2015 Nursing Annual Report, which highlights the passion, commitment and professionalism of our nursing workforce.

Below are a few examples of the incredible work of Aultman nurses: • Successful Site Visit and Redesignation as a Magnet Hospital (third time designee) • Community Heart Attack Education on the City Bus Line • Code Lavender Implementation: Caring for our Own • NICHE Program Development: Specialized Senior Services • Building a Better Unit: 4 South • GTZ Initiatives: Decreased Falls, HAPU and CAUTI • Successful Pharmacology Symposium - Hosted by APRNs • Preceptor Recognition Events It is often said that the difference is in the details. Our nursing vision reflects our understanding that patient outcomes depend on carefully focused attention to superior service, scientific inquiry and prevention of harm. Aultman nurses join forces with allied health professionals to navigate the complexity and nuances that come with individualized, compassionate caregiving. It is only through constant evaluation of ourselves and our practice that nurses can refine and advance nursing science. This continuous concern for bettering the human experience of illness, recovery and health across the lifespan has remained consistent throughout history. Aultman nurses exemplify all of the proud heritage of our caring profession, and carry forward the best aspects of the nurse scholar/ practitioner. The landscape of nursing’s future is taking shape under the watchful eyes and intelligent advocacy of nurses very like our own; I thank them for their stewardship and willingness to learn -and change.

Anne Gunther, DNP, RN, NE-BC Chief Nursing Officer

OUR NURSING VISION Our vision is to Deliver Superior Nursing Service. To accomplish this, we will: • Exceed customer expectations by providing outstanding nursing care. • Prevent harm and achieve best patient outcomes through evidence-based nursing practice. • Manage costs through continuous process improvement. • Engage stakeholders across our health care continuum.

OUR NURSING PHILOSOPHY • We, the nurses of Aultman Hospital, value the exceptional care we provide as we strive for excellence in our nursing practice and reflect the commitment to our core values. • We protect patient rights by respecting privacy, confidentiality and individuality. • We educate patients, families, students and the community - and we recognize and encourage the education and development of our peers. • We are active in maintaining an evidence-based nursing practice through shared decision-making and participation in nursing research. • We accept change as our opportunity to promote safe, quality patient care in a rapidly evolving health care environment. • We value and respect the cultural diversity of our patients and the communities we serve. • We mentor within our profession and are members of a dynamic, interdisciplinary health care team. • We advocate for our patients, their families and our community, in both wellness and illness, from birth to death.

MAGNET CENTER FOR EXCELLENCE TEAM Magnet Program Director Mary Beth O'Connor, MSN, RN, CNORe has the privilege of guiding Aultman’s ongoing Magnet journey. The American Nurses Credentialing Center Magnet Recognition Program® is the highest and most prestigious credential a health care organization can achieve for nursing excellence and high-quality patient care and advocacy. Magnet organizations exhibit five components of “magnetism"all characteristics that attract employees to the hospital - like a magnet! Mary Beth and her team of Katie Emler, MSN, RN-BC and Administrative Assistant Sommer Warwick are already collecting and cataloguing stories and data for our next Magnet document, due in 2019. This evidence validates our level of excellence and reflects the skill, commitment and accomplishments that make us a Magnet organization. Patients can be assured that they will receive exceptional and compassionate care from educated and engaged nurses, applying the latest evidence-based practice recommendations.

2015 NURSING INITIATIVES

1. Strengthen nurse engagement. • Heighten nurse autonomy through workflow redesign. • Evaluate nurse-nurse interaction. • Advance professional development access and opportunities.

2. Achieve top performance with nurse-sensitive indicators. (Patient falls with injury, CAUTI, CLABSI and HAPU stage 2 or greater). • Focus on shared governance (organizational and unit levels) as drivers of EBP changes. • Strengthen clinical nurse awareness. • Focus on staff accountability and the use of HRO tools.

3. Improve patient experience. • Improve clinical nurse awareness. • Reinforce HRO tones. • Expand staff accountability.

4. Build a high-value care team. • Streamline nursing documentation. • Align interprofessional goals and work.

NURSING PROFESSIONAL PRACTICE MODEL A Nursing Professional Practice Model defines the delivery of nursing care within an organization. Three nursing theorists are integrated into Aultman’s model: Watson, Orem and Benner – together, they outline the core essentials of caring, compassion and competency. Our nurses view the patient as the central influence on care, incorporating standards of practice and our mission, vision and values within a culture of shared governance. The model is reviewed annually in the practice council, giving opportunity for evaluation of current nursing practice, theorists and principles supporting the framework.

TRANSLATING THEORY TO PRACTICE Watson’s Theory of Human Caring

Orem’s Self-Care Deficit Theory

Benner’s Novice to Expert Theory

“We demonstrate holistic caring through the use of guided imagery videos, the use of earplugs and a face mask if needed for patients, and open visiting hours.”— 4 South

“We have a mobility protocol to help patients maintain/improve mobility and functional level at the time of discharge.”— 6 North

“Nurses advance from novice to expert on our unit through a planned orientation involving classroom and 1:1 (instruction) with an appropriate level preceptor.”—CCU

“Collaborating with child life specialists to assist with pediatric patients.”— Emergency Department “We developed a grief cart, which includes resources for families including a blanket for their loved one, a brochure of the dying process and a sympathy card that will be mailed to the family.”— MICU “Effective, personalized caring promotes health and individual or family growth.”— Pain Management

“Patients’ needs and desired goals are incorporated into individualized care plans to maintain independence.” — 5 North “We support patients to return to their highest level of self-care via early ambulation, return demonstrations, disease education and home care planning.”— Main 5

“We learn from each other with consideration for the level of (a nurse’s) experience.”—Aultman North “Case managers advance from novice to expert with an ongoing mentoring process that supports development of the nurse.”—Case Management

CELEBRATING OUR 3RD MAGNET DESIGNATION

United Way Day of Caring

Cancer Screening Day

Cancer Screening Day

Making Strides Against Breast Cancer Walk

“Meet the Team with More Heart” Events

“Meet the Team with More Heart” Events

Making Strides Against Breast Cancer Walk

“Meet the Team with More Heart” Events

“Meet the Team with More Heart” Events

United Way Day of Caring

Safety First

Safety First

HOF Senior Day

Cancer Survivors’ Celebration

Safety First

Cancer Survivors’ Celebration

HOF Senior Day

Safety First

American Cancer Society Relay for Life Walk

American Cancer Society Relay for Life Walk

AULTMAN COLLEGE BSN COMPLETION GRADUATES In alignment with the Institute of Medicine (IOM) Future of Nursing report recommendation to achieve an 80 percent BSN workforce by 2020, Aultman nursing leaders collaborated with Human Resources and Aultman College to offer opportunities for nurses to conveniently advance their nursing degree. Initiatives included flexible scheduling for school, tuition reimbursement, a hybrid, onsite BSN completion program, scholarship opportunities and tuition reduction for specified cohorts of nursing students. All of these measures demonstrate the transformational nature of our nursing leadership, and a commitment to building structures and services designed to empower our nurses.

The Aultman College of Nursing and Health Sciences’ inaugural class for the BSN completion program began in fall 2013. The first cohort of 18 students graduated in May of 2015. Kellie Boll, BSN, RN Barbara Brown, BSN, RN Carol Crawford, BSN, RN Rachael Deitrick, BSN, RN Carrie Dimmerling, BSN, RN Deborah Dysle, BSN, RN Amy Erb, BSN, RN James Kelley, BSN, RN Diane Limbach, BSN, RN Penny Mobberley, BSN, RN Michelle Newman, BSN, RN Angela Quinn, BSN, RN Loretta Raff, BSN, RN Robin Rennie, BSN, RN Christy Richards, BSN, RN Debra Stimmel, BSN, RN Ginny Storsin, BSN, RN Kristy Yochum , BSN, RN

GRADUATIONS Consistent with a culture of lifelong learning, a large number of Aultman nurses committed to advancing their education in 2015. Degree completions included the following: Bachelor’s Degrees

Jen Stevens, BSN, RN

Doctoral Degrees

Sabrina Funk, BSN, RN

Kristen Fisher, BSN, RN

Stephanie Boyd, DNP, RN

Chelsea Flight, BSN, RN

Debbie Wise, BSN, RN

Dianne Gibbs, DNP, RN

Ronda Plaskett, BSN, RN

Hannah Bitticker, BSN, RN

Jared Campbell, BSN, RN

Teresa Neff, BSN, RN

Heather Bracken, BSN, RN

Michaella Constanine, BSN, RN

Lindsey Fernandez, BSN, RN

Martha Grage, BSN, RN

Ted Trzaska, BSN, RN

Jamie Kent, BSN, RN

Deb Domer, BSN, RN

Kimberly Chmielewski, BSN, RN

Kayla Ward, BSN, RN

Jessica McAvinew, BSN, RN

Katlyn Dittmar, BSN, RN-BC

Lee Ann Miller, BSN, RN, OCN

Sue Pachuta, BSN, RN, CPAN Kristy Russell, BSN, RN

Master’s Degrees

Suzanne LaBuda, BSN, RN

Beth Doslak, MS, BSN, RN

Cindy Strait, BSN, RN

Laura Bitonte, MAEd, BSN, RN

Shannon Kincaid, BSN, RN

Angela Easterday, MSN, RN

Lori Wyler, BSN, RN

Katie Pfalzgraf, MSN, RN, CNP, AGACNP-BC, CCRN

Kristy Winkhart, BSN, RN

Laura Fenn, MSN, RN, CNP, AGACNP-BC, CCRN

Susan Dinarda, BSN, RN, CRRN

Rochelle Fausneaucht, MSN, RN, AG-ACCNS-BC

Cathleen Leedy, BSN, RN

Jerrod Plotts, MSN, RN, CCRN-CSC

Ginelle Breyer, BSN, RN, CCRN

Alan Merry, MSN, RN

Lisa DeRita, BSN, RN

Patty Russell, MSN, RN

NURSING CERTIFICATIONS Nursing certification represents a strong commitment to elevating professional knowledge within a nursing specialty to a defined level of excellence. Study, mental preparation and testing are components of the process. Aultman supports nursing certification via hosting prep classes on-site, scheduling attendance for approved outside prep classes, and reimbursement for certification testing and recertification. The following Aultman nurses successfully completed the rigorous nursing certification process in 2015: Melissa Brown, BSN, RN, CCRN

Julie Brown, BSN, RN-BC, CEN

Danielle Adams, RN, CCRN

Emily Carr, BSN, RN-BC

Molly Martino, RN, CNOR

Justin Lonca BSN, RN, CCRN

Paula Merten, BSN, RN-BC

Lynette Herrington, BSN, RN, OCN

Jody Hershberger, BSN, RN, CHPN

Sabrina Funk, BSN, RN, CCRN

Laura Vandervaart, BSN, RNC-NI

Cody Litman, BSN, RN, CCRN

Connie Hammen, RN, ONC, BC

Shanna Roberts, RN, C-EFM

Selena Riordan, MSN, RN-BC, CNP

Kelly Carmany, MSN, RN, CNE

Justin Lonca, BSN, RN, CCRN

Ying Liu, BSN, RN-BC

Leya Kelly, BSN, RN-BC Angela Ott, MSN, RN, NE-BC, CGRN

GETTING TO ZERO (GTZ) COMMITTEE ACCOMPLISHMENTS 2015 CAUTI Committee 2015 Quarterly Surveillance Audits

Continued quarterly surveillance audits in conjunction with skin prevalence study. Auditing small orange label on urinary catheter bag below vent.

Bladder Scanner Representative Educated Staff on Bladder Scanner Usage

Provided each unit director with a folder containing educational materials to be used with competency, along with the link to the bladder scanner education.

Quick Reference Cards for Bladder Scanners

Formulated and applied laminated quick reference cards to the BVI 3000 & BVI 9400 bladder scanners.

Foley Catheter Insertion Policy

Revised the policy: Urinary Catheterization of the Adult Male or Female Patient: Insertion, Care and Removal.

Bladder Scanner Charges & Documentation Opportunities

Education with screen shots sent to all unit directors on how to charge and document the bladder scanner.

Elements for Performance for CAUTI from Joint Commission.

Instructions provided on Cerner documentation and where to go to print a copy of the FAQ sheet - to be provided to unit directors.

FAQ Sheet to be Provided to All Patients & Their Families if Foley is Present CAUTI Poster

Presented a poster for Spirit of Inquiry. Poster accepted for 2016 ANA conference.

Managing Urinary Elimination after Urinary Catheter Removal Protocol

Protocol formulation in progress - will address indications for bladder scanners usage.

CAUTI Data

Number of CAUTIs: 2011 = 92 2012 = 24 2013 = 15 2014 = 7 2015 = 6

GETTING TO ZERO (GTZ) COMMITTEE ACCOMPLISHMENTS 2015 CLABSI Committee 2015 Tracking & Trending of CLABSI Data

Cerner Documentation Updated

Infections reviewed monthly to identify trends. Unit directors with a CLABSI on their unit attend the meeting and provide an overview of their follow-up. Action plans requested from units with multiple CLABSIs. Central line maintenance bundle documentation implemented with Cerner iView go-live.

Monthly Unannounced Maintenance Bundle Audits

IV team audits all central lines for maintenance bundle compliance each month. Unit directors and/or assigned nurse are notified immediately for areas out of compliance.

Monthly Curos Cap Audits

IV team audits Curos cap usage on all central lines with a goal of 85% compliance based off the manufacturer’s recommended minimum goal. Compliance with goal has been demonstrated.

Next Generation Curos Jet Caps Implemented

Hospital-wide in-service and implementation of next generation Curos Jet alcohol protector caps were implemented in September.

Monthly Live RN-RN Unit Education

Central line dressing change education with “Chester the Chest” implemented in February. Ongoing “handson”education completed in 11 units.

PICC/CVAD Policy Review

The CLABSI committee reviewed PICC/CVAD policy to ensure best practice and procedures.

IV Tubing Securement Device

Centurion “IV Tubing Securement Device” identified and made available to anchor tubing connected to central lines placed in the jugular vein.

GETTING TO ZERO (GTZ) COMMITTEE ACCOMPLISHMENTS 2015 Falls Committee 2015 Completion of Bed Alarm Cord Distribution

• • • •

Complete bed alarm education for staff. Bed alarms distributed on all floors. Reviewed progress, barriers and issues. Bedford rewiring to enhance bed alarm.

Review Correlation between Polypharmacy and Falls

• Pharmacy reports out to identify trends linked to falls.

Review Correlation between Delirium and Falls

• Dr. Baum joined committee to correlate falls and delirium. • Trialed CAM and mini-cog assessments to assess increase falls risk.

Engage Committee Involvement with the Community

• S. Nuske (Trauma) joined committee to provide community perspective. • Multidisciplinary task force formulated.

Falls Awareness Prevention Day

• Tables in lobby of the main hospital, Aultman West, Aultman North, Aultman Carrollton, Aultman Orrville and Woodlawn providing literature to the community to heighten falls awareness. • Self-assessment tool provided for community to assess their risk of falling.

Community Engagement

• TUG test preformed by volunteers to assess possible fall risk.

Community Outreach

• Interview with WHBC. • Dr. Baum and Andy Beltz participated in radio interview to increase fall awareness in the community.

10 Million Steps to Prevent Falls

• Sept. 23, 2015 - Staff participated in walk sponsored by the Institute on Aging.

Reviewed Falls Policy

• Reviewed falls policy for updates.

Benchmark New Safety Products

• Sara Steady & Sara Steady Plus, Dycem strips, falls risk assessment tool, bathroom alarms and patient transport tarp.

Joint Commission Preparation

• Readiness for Joint Commission recertification by review of Sentinel Event Alert.

Ancillary Staff Education on Bed/Chair Alarms

• Education done for porters and transporters.

Cerner Staff Education

• Created education for staff regarding new falls documenting process.

Falls Data

• The fall rate from 2014 to 2015 shows a decrease in inpatient falls.

GETTING TO ZERO (GTZ) COMMITTEE ACCOMPLISHMENTS 2015 Skin Committee 2015 Reference Notebook & Cerner Pressure Ulcer Reference Guides

• Reference notebook distributed to units regarding: o Pressure ulcer prevention protocol. o Pressure ulcer staging. o Sacral ulcer prophylaxis dressing protocol and application guide. o Specialty therapy support surfaces. o Wound VAC reference guides, VAC & VAC Ulta alarm troubleshooting, basic application, VAC Via system, Prevena incision management system. • Wound measuring rulers available on each unit. • Cerner staging guideline reference.

Prevalence Study Action Plan

• E valuation and investigation to decrease device-related pressure ulcers regarding O2 tubing and masks. • Safety task force (new committee) investigating safe patient transfer practices and devices. • Investigating evidence-based practice for decreasing pressure ulcers in critical care areas for the hemodynamically unstable patient. • Noted decreasing trend of HAPU with quarterly studies (3rd and 4th quarters).

Advanced Wound Care Value Analysis Project

• Evaluation of advanced wound care products to improve patient outcomes and budget management.

Specialty Bed Ordering (New Committee)

• Improve process of bed ordering and budget.

Data

• 2014 = 9

2015 = 8

GETTING TO ZERO (GTZ) COMMITTEE ACCOMPLISHMENTS 2015 SSI Prevention Committee Accomplishments 2015 Implementation of OR observations

• Infection Prevention Team performed OR observation of surgical procedures to examine environmental factors and overall technique.

Isolation Education to OR Staff

• Upon request, the Infection Prevention Team provided isolation and infectious disease educational in-service to OR staff. • Infection Prevention Team and OR staff members performed “mock” isolation surgical patient scenarios to examine current practices and areas of opportunity or need for additional education.

Dressing Change Patient Instructions

• Dressing change patient instructions were updated for consistency.

SSI Infection Prevention Strategy Bundle

• • • • •

Patient Communication Avenues

• Review completed to provide alternative means to communicate with patients to increase compliance with prevention measures. Example: texts and/or emails to patients as reminder for CHG shower, etc. • Collaboration with Innovation Team initiated to examine feasible modes of communication. • Patient reminder text/email drafts formulated. • Innovation Team text/email build (electronic pathway) in process to elicit patient reminders. • Innovation Team developing patient education video and text/email scripts.

SSI Physician Champion Reporting Structure

• Members of SEC serve as SSI champions for peer review.

SSI Prevention Bundle-Related Electronic

• EMR pre-procedural checklist updated to include wash and nasal antisepticimperative for o Documentation o Monitoring compliance with product use o Infection follow-up

Documentation Upgrades

Conducted review of best practices and benchmarks. Collaborated with infectious disease physician specialist. Formulation of pre-op evidence-based SSI care bundle proposal. Proposed SSI prevention strategy bundle to surgeon groups. SSI prevention bundle endorsed by hospital administration, SEC, PAC, PEAC and MEC. • Formulation of patient preoperative shower/bathing instructions. • SSI prevention strategy bundle implementation for cardiothoracic and neurospine surgeries.

GETTING TO ZERO (GTZ) COMMITTEE ACCOMPLISHMENTS 2015 VAE/Restraint Committee 2015 NICU VAE Auditing

• NICU leadership added to committee to look at prevalence and prevention of VAE in the NICU. • Revised the audit tool for NICU needs.

VAP Audit Tool Reporting

• Auditing and reporting process has become more standard.

Violent Restraints

• Identified violent restraints as an opportunity for improvement. • Revised education for staff. • Begin 2015 with daily/weekly audit of violent restraints.

VAE dashboards

• 2015 – With changes to classification of VAE’s, no change in incidence.

Oral Care Product Change

• After current vendor discontinued product, A. Hiner, R. Fleischman, R. Fausneaucht and J. Plotts met with vendor representatives from several companies and brought the products to the committee. • Committee voted to move forward with the Sage product. • A. Hiner presented at the PAC meeting and the decision was made to move forward with Sage. • VAE prevalence decreased. • Oral care compliance increased. • A. Hiner & J. Plotts recognized at Spirit of Inquiry for best poster in clinical practice.

GETTING TO ZERO (GTZ) COMMITTEE ACCOMPLISHMENTS 2015

SHARED GOVERNANCE ACCOMPLISHMENTS APRN Council Chair: Crystal Tausch, MSN, APRN Chair-Elect: Stacy Irwin, MSN, APRN Facilitators: Anne Gunther, DNP, RN, NE-BC and Tina Biasella, MSN, RN, NE-BC

Research Council Chair: Susan Gilbert, OTR/L Chair-elect: Brandee Reese, BSN, RN Facilitators: Karen Chirumbolo, MSN, RN, CNS and Anne Paliswat, MSN, RN, NE-BC

• Sponsored two education sessions: • Dr. James Schmotzer presented Anemias • Dr. Margaret Kobe presented Case Studies from Clinical Practice • Hosted a successful Pharmacology Symposium. • Hosted Town Hall Meeting with OAAPN to discuss and educate on HB 216: The Modernization of Practice for Advanced Practice Nurses. • Reviewed bimonthly case presentations.

• Planned Spirit of Inquiry event, which took place Dec. 4, 2015 with 31 practice improvement posters and seven research posters. • Revised Scientific Merit Review Form. • Developed PowerPoint to guide researchers presenting to council for scientific merit. • Validated 30 research project presentations for scientific merit. • Collaborated with librarians to create library website.

Practice Council Chair: Christina Smith, BSN, RN Chair-Elect: Christine Howell, BSN, RN, CEN Facilitators: Kelly Lilly, MSN, RN, NE-BC and Marie Hooper, MSN, RN, OCN

SURF • Chair: Erika Owens, BSN, RN • Chair-elect: Chris Kestner, BSN, RN • Facilitators: Kathy Zimmer, MBA, BSN, RN • Completed member education for all Cerner system changes. • Accomplished four projects: o Housewide iView- June 2015 o EKG Viewer- July 2015 o Immediate Care Go-live - Fall 2015 o ICD-10 - October 2015

• • • • • • • • •

Implemented “Walk in your Shoes” program. Facilitated “violent patient” education. Completed pain video/education. Completed analysis of SBAR process. Focused efforts on hand hygiene compliance. Assessed blood transfusion documentation. Assisted with CPR policy revision. Contributed to development of Code Lavender. Created Geriatric Resource Nurse Subcommittee.

SHARED GOVERNANCE ACCOMPLISHMENTS

Recognition Council Chair: Phyllis Richards, BSN, RN, CNOR Chair-elect: Michelle Horne Facilitators: Mia Bausell, MSN, RN, CCRN and Anne Paliswat, MSN, RN, NE-BC • Recognized professional disciplines during their national recognition weeks. • Awarded the Recognition Pickle Jar to 45 nominated units throughout the year. • Raised $2,213.55 to benefit the ARNE and TEAM Scholarship Funds. • Planned/hosted Annual Points of Caring Awards dinner. Patient Service Professional Enhancement Council Chair: Nick Webb, BBA Chair-elect: Heidi Seal, RRT Facilitators: Jim Harris, BA, ATC and Jason Shundry • Promoted and hosted Action Academy o 21 participants representing 21 different areas of Aultman Health Foundation.| o Average length of service of participants was ten years, with employees tenured from 33 years to six months. o LMS discussion thread forum was created for 2016 so participants could discuss projects and other topics. • Created an outline/template to track professional development opportunities.

SHARED GOVERNANCE ACCOMPLISHMENTS

Nursing Professional Enhancement Council Chair: Kristy Winkhart, BSN, RN, CCRN Chair-elect: Julie Sisco, MSN, RNC-OB, C-EFM Facilitators: Anne Paliswat, MSN, RN, NE-BC and Mindy Carano, MSN, RN, CPN • Provided materials to honor certified nurses in celebration of Certified Nurses’ Day 2015. • Modified Peer Review Form to address non-clinical nurses. • Developed a recommendation for a nurse mentoring program. Nursing Education Council Chair: Lori Knoch, MSN, RN, CNS Chair-elect: Bianca Doak, BSN, RN Facilitators: Pat Miller, MSN, RN, NE-BC and Tina Biasella, MSN, RN, NE-BC • Conducted 2016 Nursing Needs Assessment; achieved 75 percent response rate. • Developed eight versions of the Annual Nursing Education for Aultman Hospital and other Aultman facilities. • Reviewed and approved 21 mandatory nursing education modules. • Reviewed Nurse, Nurse Aide, Bring Back Day and Critical Care Orientation programs. • Provided classes and contact hours on ten requested topics from 2014 Nursing Needs Assessment. • Developed guidelines for determining appropriateness of LMS-delivered nursing education.

Nurse Manager Council Chair: Nancy Kane, MSN, RN, CNOR Chair-elect: Mia Bausell, MSN, RN, CCRN Facilitator: Anne Gunther, DNP, RN, NE-BC • Participated in multiple community service opportunities. • With CNO, focused on linking Nursing Strategic Plan initiatives with unit bedside practice. • Addressed resolution of issues relative to Monthly Hot Topics (example: scheduling vacations, holidays, 12-hour shifts). Nursing Care Council Chair: Jen Roth, MSN, RN Chair-elect: Kelly Keniray, BSN, RN, PCCN Facilitator: Tina Biasella, MSN, RN, NE-BC • Integrated Aultman Orrville inpatient staff as council members. • Completed Nursing Fatigue Research Study. • Provided education to nursing staff about Staffing Concern Portal. • Completed literature review for RN-RN interaction topic.

NURSES’ WEEK 2015 Aultman nurses celebrated Nurses’ Week 2015 from Monday, May 1 through Friday, May 15. The Nurse Appreciation Committee planned a week of activities to help celebrate, including a traveling photo booth, a display of nursing uniforms from the past, and continuing education opportunities. Aultman nurses joined in the fun, creating some memorable photos to highlight the occasion!

NURSES’ WEEK PROFESSIONAL DEVELOPMENT OPPORTUNITY A special National Nurses’ Week professional development opportunity was offered for clinical staff nurses. A dynamic speaker, Vicki Hess, RN, MS, CSP was engaged by CNO Anne Gunther, DNP, RN, NE-BC to provide a unique and energetic perspective on transforming the nursing workplace. This keynote presentation was based on Vicki’s best-selling book “Shift to Professional Paradise.” The topic was one of three presentations that also included Joseph Feltes, speaking on HIPAA and social media, and Cathy Rainieri with a Category A Nursing Law offering. Nurses from other Independent Hospital Network hospitals attended alongside their Aultman counterparts. Nurses turn POWs into “WOWs” using Vicki Hess’ tools for creating a Professional Paradise.

Nurses from five area hospitals attended the session.

Vicki Hess challenges attendees.

POINTS OF CARING The annual Points of Caring dinner was held Thursday, Oct. 15 at an outside event center. In addition to the presentation of seven Points of Caring awards to Aultman staff members, four scholarship recipients were honored and three guest speakers shared their stories with the 280 attendees. The Points of Caring is Aultman's honors program for outstanding nursing and clinical support staff. The awards spotlight Aultman's best of the best. Each fall, the Points of Caring award is presented to one student from Aultman College, one individual nurse (LPN, RN, APN, etc.), one non-nursing staff member (e.g., lab, respiratory, pharmacy, etc.), one nurse manager, one health professional manager and one group. Each award winner exemplifies the components of the five "points of caring." These outstanding qualities include compassion, customer service, clinical excellence, professional commitment and community involvement.

Congratulations to the 2015 recipients! • Group award: SANE Nurses, Emergency Department • Individual nurse award: Nona Harbert, RN, Hospice and Palliative Care • Individual award: Jeff Oaks, RT(R)(CT) (CV), Imaging Services • Nursing manager award: Jennie Bollinger, BSN, RN-BC, CRRN, Director of Transitional Care • Manager award: Patrick J. Snyder, MPT, Carrollton Fitness and Therapy • Preceptor award: Teri Moore, RN, Memorial 6 South • Student award: Christine Gardner, Aultman College Congratulations also to the four scholarship winners: • Patricia Bowman, RN, Heart Lab • Cara Rich, BSN, RN, CNOR, Critical Care Instructor, Education and Development • Sheila Fye RT(R), Unit Director, Imaging Services • Shelby Phillips, Patient Transport

CODE LAVENDER: CARING FOR OUR OWN When an Aultman unit or department experiences a particularly stressful event – such as the unexpected death of a co-worker, multiple patient deaths or a series of difficult situations – the Code Lavender team is initiated to help the staff cope. The team utilizes a mobile cart to “set up” a room near the unit/department. The room offers a calm, supportive environment in which to relax. “We provide beverages and healthy snacks, soft music, lavender aromatherapy, a healing basket with small giveaways for staff members and Code Lavender team members to provide emotional support,” says Critical Care Liaison Sally Paumier, RN, MA, LPC. “Other options range from a visit from a

Happy Tails dog team to neck massages. We can set up for a time frame ranging from one shift to 48 hours, customizing the elements of the Code Lavender based on a unit’s needs.” The Code Lavender concept originated at the North Hawaii Community Hospital in Waimea, Hawaii in the 1990s. “The Cleveland Clinic has had a Code Lavender program in place since 2009, and we benchmarked that program before crafting ours,” noted Barbara Fordyce, Ph.D., a member of the Aultman Code Lavender team. “It’s been wonderful to work on this project because everyone on the committee is so passionate about helping employees in need.”

BUILDING A BETTER UNIT: MEMORIAL 4 SOUTH One of the highlights of 2015 was the completion of a newly renovated unit and the relocation of Memorial 4 East to Memorial 4 South. Suggestions from patients, visitors and nurses were taken into consideration to create an efficient and comfortable healing Patient Satisfaction  environment. Some of the changes include:  

• Addition of medication CAHPS Dimension  cabinets • outside each patient room. • • New furniture in patientDischarge Information  rooms: • patient friendly Nala chair, easy-to• move overbed table. Communication with Nurses  • Softer décor and colorsCommunication about  in room. •

• Addition of Patient Care Techs. • Addition of nutrition center for families. • Addition of consult rooms. • Natural art. • Addition of music in hallways.

Medications  Overall Rating of Hospital 

Percentile 

 

Softer bedside lighting. 2013  2014  2015  Goal  Design of new nurses’ station. Met  Whiteboards. 38  29  72    New assignment board with staff 14  15  36    pictures. More seating 9  14  for visitors. 25    40 

37 

  42 

The fresh environment positively influenced patient outcomes, specifically quality and patient satisfaction. The graphs below represent the improved scores from Memorial 4 South.   Patient Satisfaction 

Source: Midas Internal Report

 

Percentile 

4 South Patient Falls

 

CAHPS Dimension 

2013 

2014 

2015 

Discharge Information 

38 

29 

72 

Goal  Met   

Communication with Nurses 

14 

15 

36 

 

Communication about  Medications  Overall Rating of Hospital 

9 

14 

 

40 

37 

25    42 

 

  Source: Midas Internal Report

 

4 South Patient Falls Intervention

Intervention

23

22 12

2013

2014

2015

 

COMMUNITY HEART ATTACK EDUCATION ON THE CITY BUS LINE

Ron Manes, BSN, CCRN and Eric Paliswat, RN, BSN took a ride with SARTA on Feb. 24, 2015, representing the Aultman Heart Center. From approximately 9 a.m. to 5 p.m. that day, they joined passengers on various SARTA lines in North Canton, Canton and Massillon, educating riders about heart attack awareness. Ron and Eric were able to review heart attack signs and symptoms, hands-only CPR and risk profiles with members of the community. They also provided brochures with additional information. Almost all of the passengers they talked to had been affected by a heart attack in some way, so the groups were very appreciative of the outreach and receptive to hearing the information. These dedicated nurses exemplify the commitment and dedication of Aultman nurses to community involvement and health promotion.

AULTMAN SPECIALIZED SENIOR SERVICES Aultman nurses continue to focus on patient-centered care for older adult patients. Through participation in the Nurses Improving Care for Healthsystem Elders (NICHE) program — a leading elder care nursing program — Aultman is able to offer evidence-based, interdisciplinary approaches that promote better outcomes, positive experiences and improved care for older adults. This leads to greater satisfaction rates for patients, their families and staff. Several senior-focused initiatives occurred in 2015, including geriatricspecific education programs, delirium prevention strategies, mobility initiatives, geriatric-specific research studies, committee development and support for geriatric certification. Successes have been shared at varying levels including local and national conferences.

The graph below depicts the steady increase in geriatric certified nurses    (GRNs) at Aultman.  

 

Nurses Certified in Gerontological Nursing

Nurses Certified in Gerontological Nursing

39 30

39

30

22

22

11 11

Initial Initial

2014 2014

20152015

Jan‐March  2016 Jan‐March  2016  

 

SPECIALIZED SENIOR SERVICES  

 

SPIRIT OF INQUIRY 2015 2015 SPIRIT OF INQUIRY WINNERS INCLUDED: Best in Research Award: Know FIM, No Fall - Maria Page, BSN, RN-BC, CRRN and Pamela Wilson, BSN, RN, CRRN Best in Clinical Practice Award: Oral Care Everywhere Amy Hiner, MSN, RN, ACNS-BC and Jerrod Plotts, MSN, RN, CCRN-CSC Global Impact Award: An Educational Strategy to Increase Nurse Competency - Beth Chenevey, BSN, RN, CCRN Committee’s Choice Award: The Role of a Clinical Pharmacist as Part of an Interdisciplinary Hospice Team - Lacey Davis, PharmD, BCPS, Angela Williams, MBA, BSN, RN, Steve Grossman, M.D., Laurie Hanne, D.O. and Jeffrey Marsh, M.D.

At Aultman, research and continued practice improvement are significant to the development of our caregivers and to our care coordination efforts. The Spirit of Inquiry provides a single platform for sharing research and evidence-based practice occurring within specialties throughout our organization. 2015 marked the twelfth year for this important event, which was created to encourage professional development by promoting and highlighting practice improvement and research projects. The 2015 event was planned by a committee from the Research Council, which reviewed and accepted 31 research and practice improvement projects. Posters were displayed in the Bedford lobby. A lunch and speaker session, followed by an awards presentation, concluded the celebration on Dec. 4.

RESEARCH PROJECTS 2015 Study Title

Principal Investigator Name(s)

Principal Investigator Credentials

Study Location

Will Continuing Education on Rapid Responses and Code Blues Improve Self-Confidence and Competence in a Med/ Surg Unit in a Rural Hospital?*

Beth Chenevey

BSN, RN, CCRN

Orrville

Mentoring-Changing the Culture of Nursing*

Emily Byers

BSN, RN, CCRN

SICU

The Effects of Early Progressive Mobility on Delirium in Intensive Care

Amy Hiner

MSN, RN, ACNS-BC

MICU & SICU

The Effects of Compassion Fatigue in the Emergency Department*

Jennifer Oliver

RN

ED

How Do Hospitalized Patients in Isolation Perceive Their Experience?

Angela Hissner

BSN, RN

CVSICU

Undergraduate Nursing Students’ Learning Experiences of Anatomy and Physiology

Jennifer Hillyer

MSN, RN

Aultman College

Stand up for the Patient! Nurses’ Perceptions of Nurse to Nurse Bedside Report and its Impact on Patient Safety

Cara Rich

BSN, RN, CNOR

E&D/ 5 South

Incidence of Undiagnosed Obstructive Lung Disease in Older Adults from a Northeast Ohio Region*

Linda Griggs (RN) & Tim Larson (RRT)

MSN, RN, ACNS-BC

Community

Weight-based Vancomycin Dosing in the Emergency Department

Brittany Petrosky

Pharm D.; Pharmacy Resident

ED

Exploring Medication Therapy Management (MTM) in an Inpatient Setting

Katie Chizmadia

Pharm D.; Pharmacy Resident

Inpatient Units

RESEARCH PROJECTS 2015 Study Title

Principal Investigator Name(s)

Principal Investigator Credentials

Study Location

Impacting the Nurse's Knowledge Base of Alarm Fatigue on Post-Anesthesia Patients

Tia Judd

BSN, RN, NE-BC, CPAN

PACU

Preoperative Nursing Knowledge of Delirium and Its Risk Factors

Casey Allison

BSN, RN, NE-BC

Same-day Surgery

Diagnositc Accuracy of the Skull Vibration-Induced Nystagmus Test (SVINT) Performed in Room Light (With Fixation)*

Andy Beltz

PT

Tusc. Therapy

Knowledge Retention: Audience Response Technology in Nursing Education

Jo Ann Donnenwirth

MSN, RN, ACNS-BC, EdD©

Aultman College

Participation in a Work-based Journal Club to Improve Evidence-based Practice Self-efficacy: A Quality Improvement Project*

Amber Gotschall

MA, OTR/L

Carrollton

Have our Mock Code Blue Practice Sessions Improved our Pulseless Cardiac Event Survival Rates?*

Debbie Shaffer

MSN, RN

Inpatient Units

Patient Knowledge of Prescribed Medication as an Indicator for Health Literacy*

Stephanie Ascani

LSW

Aultman Physician Center

Identifying Military Service in the Civilian Care Setting*

Bianca Doak

BSN, RN

CCU

Decreasing Pathogen Transmission in the Neonatal Intensive Care Unit: A Study on Infection Risk and Mobile Phones*

Erin Bradley

BSN, RN

NICU

ABCDEF Bundle Improvement Collaborative

Amy Hiner

MSN, RN, ACNS-BC

MICU & SICU

RESEARCH PROJECTS 2015 Study Title

Principal Investigator Name(s)

Principal Investigator Credentials

Study Location

The Post Anesthesia Care Unit Will Breathe Easier: Decreasing SpO2 Alarms in the PACU”

Joyce Hein

BSN, RN, CPAN

PACU

Current Practices in Management of End of Life Secretions

Tammie Thompson

RN

Hospice

Impact of Service Learning Versus Vicarious Learning Experiences in Critical Analysis, Argumentation & Research

Jeffrey Pellegrino

PhD

Aultman College

Caregiver Preceived Barriers to Family Centered Care*

Briana Reardon

BSN, RN

NICU

Do New Graduate Nurses Perceive More Incivilitiy than Experienced Nurses?*

Beth Hendricks

BSN, RN

CCU

The Impact of Restraining Patients on Mechanical Ventilation

Kim Dougan

MSN, RN, CCRN

MICU

*Research Academy Project

PRECEPTORS: IMPARTING A NURSING LEGACY The role of clinical preceptors in nursing education is an extremely significant one because they provide an opportunity for students to combine classroom knowledge with the development of hands-on skills. Many research studies have demonstrated that experienced staff nurses are key to optimal learning outcomes for students within the clinical environment. These expert clinicians (preceptors) lead the students through complex clinical situations which help to advance their assessment and critical thinking skills. The preceptors provide guidance as role models; assist with the development of professional socialization; facilitate students’ utilization of the skills required for prioritization, organization and delegation; and demonstrate the implementation and importance of self-reflection. The following expert registered nurse clinicians and unit directors contributed to the advancement and legacy of the nursing profession by their willingness to precept nursing students or to arrange preceptorship experiences: Preceptor

Unit

Unit Director/ Assistant Nurse Manager

Preceptor

Unit

Unit Director/ Assistant Nurse Manager

Alisha Abramson

4 North

Tieryn Trissel

Molly Haymaker

6 East

Sara Reich

Kala Triner

4 North

Tieryn Trissel

Nancy Williams

6 East

Sara Reich

Megan Laubacher

4 North

Tieryn Trissel

Brie Riemenschneider 6 North

Amy Colvin

Megan Xiong

4 North

Tieryn Trissel

Deb Blile

6 North

Amy Colvin

Jennifer Ricksecker

4 South

Kristi Cain

Julia Hout

6 North

Amy Colvin

Stacy Eicher

4 South

Kristi Cain

Denise Holben

6 South

Marie Hooper

Rhonda Weikart

4 South

Kristi Cain

Heather Davis

6 South

Marie Hooper

Abby Travis

5 North

Sonja Anderson

Kelsey Streb

6 South

Marie Hooper

Jill Biedenbach

5 North

Sonja Anderson

Matt Hizer

Aultman Specialty Hospital

Terry Regula

Renee Schaffert

5 North

Sonja Anderson

Charlotte Froelich

Birth Center

Nancy Kane

Tammy Dennis

5 North

Sonja Anderson

Jenny Misch

Birth Center

Nancy Kane

Don Hunt

5 South

Tyler Reichman

Jodi Johnson

Birth Center

Nancy Kane

Jillian Dittmer

5 South

Tyler Reichman

Joni Dingey

Birth Center

Nancy Kane

Natalie Ligas

5 South

Tyler Reichman

Mary Snively

Birth Center

Nancy Kane

Emily Carr

6 East

Sara Reich

Megan Gilroy

Birth Center

Nancy Kane

Jaclyn Abrecht

6 East

Sara Reich

Theresa Engle

Birth Center

Nancy Kane

Julie Miller

6 East

Sara Reich

Allen Ayers

CCU

Sandy Bogner

Leya Kelly

6 East

Sara Reich

Brandee Reese

CCU

Sandy Bogner

PRECEPTORS: IMPARTING A NURSING LEGACY Preceptor

Unit

Unit Director/ Assistant Nurse Manager

Preceptor

Unit

Unit Director/ Assistant Nurse Manager

Fran Dean

CCU

Sandy Bogner

Amanda Maurer

NICU

Mindy Carano

Jonathan King

CCU

Sandy Bogner

Amy Jamison

NICU

Mindy Carano

Lisa DeRita

CCU

Sandy Bogner

Gregory Ray

PACU

Casey Allison

Rachel Courtney

CCU

Sandy Bogner

Keri Boswell

Psych

Mick DeWitt

Rose May

CCU

Sandy Bogner

Natasha Ashcraft

Psych

Mick DeWitt

Laura Yoder

Critical Care Resource Team

Jennifer Roth

Anne DeVaul

SICU

Cheryl Wallace

Mandi Testa

Critical Care Resource Team

Jennifer Roth

Emily Byers

SICU

Cheryl Wallace

Amy Hohenberger

Emergency Department

Stacie Howard

Jamie Whitacre

SICU

Cheryl Wallace

Lynn Martin

Emergency Department

Stacie Howard

Cathleen Leedy

Step-Down Resource Team

Jennifer Roth

Ashley Basso

Main OR

Arlene Wingerter

Chris Pfouts

Step-Down Resource Team

Jennifer Roth

Michelle Lane

Main OR

Arlene Wingerter

Judi Abrecht

Step-Down Resource Team

Jennifer Roth

Shirley Tucker

Med/Surg Resource Team

Amy Colvin

Laura Baxter

Step-Down Resource Team

Jennifer Roth

Chelsea Flight

MICU

Kim Dougan

Laura McMorrow

Step-Down Resource Team

Jennifer Roth

Danielle Adams

MICU

Kim Dougan

Tracie Fitch

Step-Down Resource Team

Jennifer Roth

Dawn Barnhart

MICU

Kim Dougan

Sandy Kohler

TCC Hawthorn

Jennifer Bollinger

Deanna Tuggle

MICU

Kim Dougan

Wanda Bagueros

TCC Hawthorn

Jennifer Bollinger

Denise Haidet

MICU

Kim Dougan

Ashley Wallick

TCC Willow

Jennifer Bollinger

Jen Bajornas

MICU

Kim Dougan

Krista Martini

TCC Willow

Jennifer Bollinger

Jim Kelley

MICU

Kim Dougan

Krista Martini

TCC Willow

Jennifer Bollinger

Joanne Foith

MICU

Kim Dougan

Hollie Stefaniak

Woodlawn Rehab

Maria Page

John Glass

MICU

Kim Dougan

Justin Hamilton

MICU

Kim Dougan

Kristen Fano

MICU

Kim Dougan

Lani Lowery

MICU

Kim Dougan

Michelle Allehouse MICU

Kim Dougan

Penny Wise

MICU

Kim Dougan

Sabrina Funk

MICU

Kim Dougan

Tammy Price

MICU

Kim Dougan

PRECEPTOR RECOGNITION EVENTS

Aultman College Featured Preceptor Jonathan King, BSN, RN Spring 2015

Aultman College Featured Preceptor Laura Baxter, BSN, RN (right) Fall 2015 Pictured with her sister, Mia Bausell, MSN, RN, CCRN

Kent State University Barbara Donaho Award Nelda Andrews, RN, RNC