Fall 2015

A publication for nurses by nurses

Life-changing education Tackling

the BSN

Many nurses wrestle with the decision to return to school for their BSN. Sharon Iannece was an assistant nurse manager at Virtua Marlton when she decided to pursue her BSN, mostly because she felt it was an expectation.

Surveys also show that nurses who have completed a BSN program earn higher average incomes, and gain access to new and exciting career opportunities.

Now, working as a clinical documentation specialist at Virtua Voorhees, she looks back at her education not as a burden, but a transformational experience. “Once you do it, you will look at everything about being a nurse differently. It will change your practice.”

Returning to school can be costly and timeconsuming. Jillian Whitehurst, a full-time nurse in Marlton’s PCU and mother of two busy schoolaged boys, knows this well. Her advice? “You just keep moving forward, one class at a time.”

Why a BSN?

Virtua is committed to supporting our nurses by offering resources like tuition reimbursement, nursing scholarships and onsite programs. Experts at the Center for Learning can help with program selection and clinical placement.

One of Virtua Nursing's Strategic Goals is that 80% of our nurses will hold a bachelor’s of science degree in nursing (BSN) by the year 2020. Evidence demonstrates the benefits of baccalaureate preparation for both patients and nurses. The BSN degree is linked to improved patient outcomes, such as lower incidence of pressure ulcers, post-operative DVTs, hospital acquired infections, and post-surgical mortality. Left to right: Aisa Reyes, Ariel Parungao, Laurie Crisp-Wyeth

Making it work

Start your journey by calling: Dawn McCall at (856) 761-3816 about undergraduate courses and Amy Glasofer at (856) 761-3806 about graduate courses.

Get-to-know Carly Richman

BSN, RN of Virtua Marlton, 3 North Carly is the safety representative on 3 North at Virtua Marlton. She’s on the S.W.A.T. Team, the Behavioral Health Council, and is co-chair of 3 North’s unit based council. Her shared governance team won a high-performing team Super Star Award in 2015. “Nursing, for me, will never be just a job,” says Carly. “I have a huge passion for it, and each day is a learning experience. I have been incredibly lucky to work with colleagues who help and inspire one another.” Carly is currently enrolled in a dual degree program at Benedictine University, and is a candidate for two masters--one in public health, and another in organizational behavior. “My nursing journey started with Virtua,” she says. “Virtua has helped me grow into both a nurse and a leader.” 2

Q &A How were you first drawn to nursing? I have always been a very nurturing person, and I care a lot about people. Nursing just seemed like a perfect fit for me. What’s the most rewarding part of your job? The trust that patients have in me; it gives me an opportunity to make a real difference in their lives. I love seeing a smile on a patient’s face when I am helping them.

What’s the best piece of advice you ever got? If you feel satisfied at the end of the day, it means you did a good job. What profession might you have pursued, if not nursing? I probably would have become a teacher or educator. What characteristic do you most admire in a co-worker? Honesty and respect. What do you appreciate the most in your friends? Their loyalty. They are always there for me; that means a lot. What natural talent would you most like to be gifted with? I’d love to be able to play an instrument. As a child, I took nine years of piano, but it did not stick.

Who are your heroes in real life? My parents. What is something about you that most people don’t know? I love scuba diving. Just this summer I went on vacation by myself to dive every day in Turks and Caicos. Being underwater is so peaceful. It makes you look at the world differently. What’s your favorite way to relax? Going to the beach, gardening, or reading a book that is not for school. What is your present state of mind? I’m content that I’m healthy, working in a profession that I love, and that I have a great family. What’s your personal motto? Hakuna Matata! (No worries)

Fall 2015

Leveraging Technology Better information means safer, higher quality patient care, better communication and less duplication.

That’s why quality health care is guided by a data-driven “triple aim.” At Virtua, we leverage technology in order to:

> Achieve high quality care > Reduce health care costs > Improve patient outcomes Tools like myVirtua and the health information exchange (HIE), spurred on by Meaningful Use (MU) initiatives, have granted patients and participating care providers access to the portions of each medical record that best promote patient engagement, quality and cost-effective care across the continuum. Improving patient outcomes will take center stage as we move into MU Stage 3.

Already Virtua has developed data analytics tools that evaluate patient outcomes and facilitate quality improvement. For example, the Emergency Department now uses a tool called QlikView, which graphically analyzes throughput, readmission rates, and patient satisfaction. Elsewhere in the Virtua system, a team is developing specifications for a new nursing dashboard that will capture rates for falls, pressure ulcers, and hours per patient day (HPPD), among other quality indicators. Moving forward, technological advances will continue to play an important role in improving clinical practice at Virtua, as new hardware and software allows us to evaluate our interventions and measure positive impacts on our patients in new and exciting ways.

Left to right: Rosemarie Martin and Angela Bembery of Virtua Marlton 3S share bedside report at shift change, with all patient information at their fingertips. 3

Remembering the Rights of Medication Administration in the Digital Age While computerized physician ordering and bedside barcoding have improved medication administration immeasurably, digital tools can’t replace careful human supervision of these crucial safety measures. Every time a medication is administered, even when using bedside barcoding, the patient's rights must be verified.

it the right patient? Have you it the right time to give the » Isdose? » Isverified the two patient identifiers? Have you checked to see Prepare medication for one individual at a time, and administer as soon as it is prepared.

» Is it the right medication?

Read the medication label carefully. Compare it directly to the ORDER AS WRITTEN. If there is any discrepancy, call the pharmacist before administering the medication. (Even if the discrepancy seems minor, it could have serious implications for the patient.)

it the right dose? If a weight» Isbased dose, have you re-calculated based on the patient's weight?

when it was last administered?

you administering it » Are via the right route? you documented » Have the administration? Double-check your documentation as soon as you have finished giving the medication, and be sure it shows up on the CHARTED LIST. Remember to always carefully inspect the ORDER AS WRITTEN before administering any medication. If there is any question, always ask.

Nursing Education at Your Fingertips The Virtua library makes it easy to access educational resources by offering many of them electronically on the library’s VINE page. Databases available for conducting research or for accessing evidence-based journal articles include CINAHL, Nursing Full Text Plus, ClinicalKey, and Pubmed/Medline. These resources may also be accessed remotely by signing up for a free Athens account. Finally, by clicking ‘Click Here for E Journal Access,’ users may search an A-Z list of journals, databases and textbooks. 4

Please contact David Kruidenier with any questions about Virtua’s resources or to set up a one-on-one tutorial at [email protected].

Fall 2015

Tips for

Balancing

WORK & SCHOOL Thinking about going back to school but worried how to manage it all while you are working? The experts emphasize organization. Here are some of the best tips we’ve found. Establish a timetable and carve it up in small pieces. Divide your semester into weeks, topics covered by week, and all assignments due. Devote one full day a week to studying, plus an hour or two per day. Get ahead of your schedule. Know your assignments and due dates. Live by the calendar. Make separate piles by topic for all assignments, and keep them in a study area where you are least likely to be interrupted. Maintain online versions of your reading so you can catch up when you have a free moment. Use a laptop or iPad to jot notes at any time to help develop your assignment. Maintain a bibliography as you do your reading. Keep exercising. Think you don’t have the time? Just 20 minutes of exercise a day clears the mind for studying and helps manage stress.

Interactive Software Advances Web-Based Training for Nurses The best web-based training programs for nurses include interactive and realistic elements. Recently, Virtua clinical transformation specialists employed Articulate Storyline 2, popular e-learning software used by top companies and universities nationwide, to create custom interactive WBTs for Virtua learners. Each trainee is able to advance through training at his or her own pace, and review the information as many times as needed - two features which accommodate novice to expert competency levels in a manner difficult to match in the traditional classroom setting. For more information on how to access these WBTs, go to the VINE and click on the Virtua Learning System link. Left to right: Alyse Keppen, Christine Gates

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New Support for Nurses Treating Patients with Behavioral Health Issues Have you ever... Felt unsure of what to say to a patient in crisis? Struggled to develop a plan of care for a patient experiencing substance abuse withdrawal? Questioned the best way to deal with a difficult family?

Rick Pessagno, DNP, APN, Program Lead for Behavioral Health, assists nurses with these issues. Rick provides direct consultation, education and support to all Virtua nurses throughout the system in order to better meet patients' and families' mental and behavioral health needs. Whether you have a question, are in the midst of caring for a patient with a challenging diagnosis, or just need to debrief after a tough shift, you can contact Rick at extension 72053 or on his cell phone: (609) 760-5283.

Virtua's First Annual SimWars Medical errors can often be prevented through effective communication and teamwork. A surge of recent research on the prevention of such errors was the inspiration for Virtua’s First Annual SimWars, held this fall. SimWars is a double-elimination competition based on simulated patient scenarios. Interdisciplinary clinical teams will be given a description of an emergency situation, and must care for the fictional patient as they would a real patient in their unit. Winners advance as finalists to compete at the Nursing Congress on October 22, 2015.

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A panel of judges will evaluate each team based on the TeamSTEPPS framework and competencies: leadership, situation monitoring, mutual support, and communication. The winners will have bragging rights for a year and a trophy to display on their unit. Captain Danielle Glogovsky, Virtua Voorhees, was responsible for organizing the team and competition logistics. This is a great opportunity for healthy competition, as well an educational experience for all involved.

Fall 2015

CPR Challenges at Virtua High-quality cardiopulmonary resuscitation can significantly improve outcomes for cardiac arrest patients. To refine our skills, Virtua recently asked ZOLL Medical Corporation to help conduct a “CPR Challenge” at all three Virtua hospitals. They brought special equipment to gauge CPR quality measures: compression rate, depth and chest recoil. Virtua nurses, doctors, respiratory therapists, patient care technicians, and security officers turned out in record numbers.

Each staff person first performed two minutes of CPR as he or she normally would, and the equipment displayed the percentage of clinically effective chest compressions. He or she was then given critical feedback aligned with best practices in CPR technique. The second try was another two minutes on the dummy. The results were remarkable, with many staff reaching 100%. ZOLL will provide our Critical Care Practice Council, Code Blue Committee and Quality Teams with the data compiled from these challenges.

Teresa Price, RN, performs CPR at a Challenge event.

WINNERS Memorial Most Participants 1st ICU 2nd Mother Baby Unit 3rd Respiratory Department Individual Winners 1st Tom Maxwell, ANM, 4NE Pre-test score: 93.1% 2nd April Hook, RN, L&D Most im proved score 3rd Fran Heimgartner, RN, L&D Pre-test score: 84.4%

Marlton

Voorhees

Most Participants ICU

Best Team CU

Most improved CPR skills during the challenge 4 South

Best Individual Jennifer McGill, ICU

Top three CPR Compression Champions 1st Lauren Burk,bRN, ICU 2nd Angela Bembury, PCT, 3 South 3rd Jen Lenzi, RN, ICU

Most Improved Dr. A. Enriquez & Dr. S. Kalihil

4th James Boyd, Security Pre-test score: 79% 5th Marichu Palas, RN, ICU Pre-test score: 79% 6th Regina Gallager, PCT, 4NW/3NW Pre-test score: 69.4% Braveheart Award Rosalind Highsmith, 5 Stokes

Rosalind Highsmith, of 5 Stokes/ Virtua Memorial, earned the Brave Heart award for her perseverance and pursuit of CPR perfection. 7

Funding Your Education Inve$tment

Inspiring Nurses:

Stephanie Hummel, RN As a new nursing school graduate in 2007, Stephanie Hummel had two dreams: to become an ICU nurse, and to travel. After achieving those dreams, Stephanie took on another significant challenge when she enrolled in a BSN program at Rowan University. Prioritizing a healthy work/ life balance, Stephanie earned her BSN over five years. “I plugged away, one class at a time. I was able to continue traveling and working full time. I bought a new home during that time.”

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Stephanie, a 2014 DAISY Award winner who maintained a 4.0 GPA, explains, “I enjoyed most of my classes, but the most exciting opportunity arose from a “general education” requirement.” “Geology of the National Parks,” landed Stephanie in nine states and 14 national parks over an unforgettable month of travel. Stephanie completed her BSN journey this past summer, capped with the Rowan University Award for Nursing Excellence. “I can’t thank Virtua enough for encouraging and supporting me,” she says.

Virtua’s generous tuition assistance program for benefit-eligible employees makes it easier to offset your expenses. Benefiteligible employees can request tuition assistance through an improved online process in PeopleSoft. For your convenience, the selfservice online process will: » Confirm tuition benefit eligibility before making the request » Provide tuition assistance history for all electronic submissions and annual balance » Reduce amount of time required to prepare a request » Display request status such as approved, denied and reason why, and payment information Other scholarship support may be available to nurses interested in pursuing additional education. Go to: collegescholarships. org/loans/nursingstudent-loans.htm for helpful information on scholarships and loans.

Fall 2015

Education Calendar Center for Learning FALL 2015 The Center for Learning is committed to provide ongoing education for our staff. Several new courses have been developed as a result of listening to our customers. Tubes and Drain Skills day, at the Learning Lab at Voorhees, monthly on Mondays for four hours. Wound and Ostomy Skills day, monthly for four hours on Wednesdays at the Learning Lab at Voorhees. Come join us to see the latest in this specialty area. Virtua and the Association for Nursing Professional Development will be jointly providing Nursing Professional Development Certification Preparation. Seating is limited. New to Transition Program is a comprehensive experience for new nurses who have less than one year of experience, or any nurse who is new to the acute care setting or new to the motherbaby units. This program runs for 11-days. Nurse Directors interested in sending their staff should email [email protected] to register. There are also separate monthly, half-day offerings intended to “supplement” and support our new nurses. A variety of topics are discussed. PACU Workshop is a five-day course designed specifically to better meet the needs of our PACU nurses. This course is four-day classroom and one day of simulation with written exam.

Preceptor Update is a half-day course highlighting current events, practice skills, and regulatory compliance aspects. In addition, the update enhances nurses’ knowledge for understanding the values that lay the foundation for precepting. Behavioral Health Symposium (12/14/15) is a fullday program created to meet the needs of our staff who work with individuals who have behavioral health issues. This multidisciplinary approach will help to address needs of our patients as well as our staff. 2015 Shared Governance and RelationshipBased Care is offered monthly to all staff (managers and the knowledge workers). This half-day course includes newer concepts such as incorporating the Speak-Up Campaign. Valuable for prior as well as new participants. Basic Dysrhythmia Course, offered every other month for nurses. This two-day course provides the basics of rhythm interpretation. Current version of book is encouraged: Aehlert (2013). ECGs Made Easy. (5th edition). St. Lois, MO: Elsevier. ISBN: 978-0-323-17057-4, as well as a pair of calipers. Critical Care Course is a week-long program intended for nurses working in areas such as ICU’s and PCU’s. This course is designed as a four-day classroom with the fifth day spent in the Voorhees Learning Lab completing simulation and post-test. Physical Assessment: Enhancing Your Skills as a Clinician is a full-day program at the Voorhees Learning Lab. Additional classes have been added due to demand. The day starts out with a review of some basic anatomy and physiology followed by assessment techniques in the systems of respiratory, cardiovascular, gastrointestinal, and neurological. Participants will have the ability to complete physical assessments on each other and use the simulator to produce sounds that are normal and abnormal to help to differentiate between assessments.

All of the courses above are available now on VLS. If you are unable to attend after registering, unregister for the course on the VLS or contact the point person noted for the course on VLS. No-calls and/or noshows prohibit others from participating. Thank you for your cooperation. 9

NURSING ACCOMPLISHMENTS

NURSING EXCELLENCE Sharon Andress

BACHELOR IN SCIENCE DEGREES AWARDED Patricis Cocuzzi

ASSOCIATE'S DEGREE IN NURSING Brandy Kean

Carmen Eberly Natalie Fleagle

MSN DEGREES AWARDED

Kerin Griffis Stephanie Hummel

Kim Bell

Jennifer Hyland

Ann Denton

Annie Itty

Joann Easterday

Maryanne Kuchler

Jill Glass

Barbara McHugh

Jessica Jackson

Jennifer Palma

LaToya E. Myers

Christine Pawliczek

Roslyn Scriber

Mary Williams

Lynn Shinn Kim Stults

OUTSTANDING PATIENT EXPERIENCE

Janet Branco

Lori Andrews

Linda Butler

Tracy Blakey

Barbara Curley

Elizabeth Blandy

Maryanne Gallagher

Patricia Cocuzzi

Lois Hawley

Jaclyn Cook

Rebecca Kelly

Patricia DeHart

Donna Silverman

Angela Hoffman

Lisa Welsh

Ragdee Saberon

NURSING SCHOLAR

NURSING LEADER

Maria Allan

Barbara Fernando

Susan Burt

Jackelynn Fish

Dawn Jones

Kathleen Lado

Kristin Pancoast

Tanya Lewis

Susan Politsky

Christine Ligon

Diane Schiller

LaToya Myers

Jennifer Sherlock

Lisa Tedesco

Amanda Wheeler

Susan Burt Donna Berry Patricia Quackenbush

Diane Costanzo Stephanie Hummel

PUBLICATIONS “Implementation of Transition in Care and RelationshipBased Care to Improve Rehospitalization” Home Healthcare Nurse Journal, July 2015

Dorothy Iannaco Karen Mansfield Meryl Penalver Jennifer Vecere

AWARDS 2015 Rowan University “Wall of Fame” Award for Teaching Excellence 2015 Rowan University "Excellence in Nursing"

David Dacanay Wins GEM Award

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EXCELLENCE IN ADVANCED PRACTICE NURSING

The Giving Excellence Meaning (GEM) Award is presented by Nursing. com. According to Nursing.com, David Dacanay’s nomination indicates his exceptional love of nursing, his compassion for patients, and his commitment to achieving the best possible patient outcomes.

In receiving the award, David recognized the entire staff and leadership of Virtua Voorhees 4A: “We are constantly collaborating on initiatives throughout the year. This yields positive outcomes that transcend any one individual's vision.” Congratulations to David and the 4A team.

Fall 2015 PRESENTER(S)

PRESENTATION TITLE

ORGANIZATION / EVENT

Donna Barto

ECG interpretation

Lippincott Clinical Nursing Conference

Donna Berry Mary Alice Lynch

Empowering Staff Nurses to Lead in an Evidence Based Culture: A 3-Prong Approach to Reducing Hospitalizations

Home Care Annual Conference

Nicole Carroll Dr Nicole Lamborne

Keeping Normal Normal : Virtua's best practice efforts resulting in reduction in overal c/s rate, as well as primary c/s rate.   

NJ Perinatal Collaborative Webinar

Dolores Buonacuore Marianne Crane Karen Mansfield

“Perianesthesia / Perioperative Handoff

American Society of PeriAnestheisa Nurses National Conference

Christine Catts Andrea Mottershead

Reduction in NICU CLABSI through shared governance

ANA Quality Conference

Marianne Crane   Karen Mansfield David Meyer

Perioperative Handoff

Association of PeriOperative Registered Nurses National Conference

Nate Collins

Quality Reporting in AMKAI Charts - Webinar Panelist

AMKAI Webinar

Rhonda Coyle Jaclyn Cook

Promoting a safe pain management regimen

The implementation of pressure ulcer prevention Debora Horn bundle on an orthopedic unit in hip fracture patient Janet Medley-Gbassa population

Meridian Health’s Evidence-Based Care Conference

Jessica Plum Amanda Mazaleski Anthony Papeika

Using a post-fall debriefing process to structure education needs to decrease adult inpatient fall rates

Tammy Huster Kate Gillespie

Joint Replacement Institute: Strategies for Sustaining Excellent Patient Satisfaction and Quality Outcomes

National Association of Orthopaedice Nurses Conference

Karen Mansfield Donna Fahey

Integrative Nursing in the Virtua Health System

1st Integrative Nursing Symposium, Reykjavik Iceland

Jackie Miller

Camp Oasis: Implementing a day of support for children National Oncology Nursing Society who have a parent diagnosed with cancer Conference

Christine Moraca Wendy Rosen Lauren Hodges Shirley Donato

Virtua's Nursing Education to promote exclusive breastfeeding to over 500 RNs across the systen

California Breastfeeding Collaborative

Susan Politsky

Relationships Among Self-Care Behaviors and Professional Quality of Life in Oncology Nurses

International Conference of Cancer Nursing

Toni Schmidt

Meeting the needs of AMKAI Customers

AMKAI conference

Lisa Smith Dr. Susanne Adamson Barbara Hansen

Virtua system wide effort to comply with Baby Friendly Steps 3 and 10, in effort to support exclusive Breastfeeding

June NJ Mother Baby Summit

Christina Stone EriKa Stahl Victoria McClain

Skin to Skin: Making an Evidence-Based Practice Routine Through Six Sigma

UCLA Evidence Based Care Conference Awarded 3rd Place

Patricia Quackenbush

Medication Management in Home Care – Practical Solutions to Drive Better Results

Home Care Annual Conference in Florida

Sharice Thayer

Adjuvant Endocrine Therapy in the Hormone Receptor Positive Breast Cancer Patient

Best of ONS Congress 2015

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C on tr ib ut or s Amy Glasofer Carly Richman Leslie Foran-Lee Karen Ruffin Maryanne Kuchler Maria Benemerito

Sharon Camperchioli David Kruidenier Stephanie Hummel Susan Politsky Richard Pessagno Jeannette Conrad Dorothy Boresky

401 Route 73 North Lake Center Bldg. 50, Suite 404 Marlton, NJ 08053

Nonprofit US Postage PAID Permit No. 1775 Bellmawr, NJ 08031

E di to ri a l B oa rd Dorothy Boresky Cheryl Carr

Karen Kemmerer Mary McCormick

VirtuaNurse welcomes contributors and editorial review board members. Contact Dorothy Boresky at [email protected].

You’re a VirtuaNurse – share it with pride. Write to NursingNews@ virtua.org if you need a magnet to display.

All things Nursing are now in one place for easy access on the VINE. SharePoint? Check. Policies? Check. And much more. Just go to the VINE and click on Virtua Nurse.

Presenters from Virtua Marlton at Meridian Health Conference, left to right: Rhonda Coyle, Jaclyn Cook, Debora Horn, Janet Medley-Gbassa, Jessica Plum, Amanda Mazaleski, Anthony Papeika View All Nursing Accomplisments on pages 10 - 11.