Nursing Annual Report

Welcome from the President and Chief Executive Officer The care our patients and families receive at Anne Arundel Medical Center is special. I know this because they tell me via letters, emails, phone calls and some even stop me in the grocery store. They mention the personal connections they made with their nurses and other healthcare providers, how they appreciate the ways they were included in their care, and how somehow, despite the busy unit or office, they felt as if they were the only patient in the world when their nurse was in the room. This type of care, and the nurses who provide it, are a part of why this was such an important year for AAMC. In September 2014, we received the exciting news that AAMC had earned Magnet® designation. We became one of only six percent of healthcare organizations to achieve this status. We were honored for our innovative approach to including patients and their families in healthcare decisions by two national organizations: the Caregiver Action Network and the Institute for Patient-and Family-Centered Care.

We made special preparations to handle a potential Ebola outbreak by reviewing and updating infection control protocols and providing special training to employees. Because of this work, AAMC was selected and is receiving funding to be one of five Ebola assessment hospitals in Maryland. Through it all, AAMC nurses continued to care for their patients, community and each other, just like they do every day, with excellence. I am delighted to present to you AAMC’s FY’15 Nursing Annual Report. Knowledge and caring, the hallmarks of AAMC Nursing, are evident in each story. Please join me in celebrating all we have accomplished and all that is to come. In good health,

Victoria W. Bayless President and CEO Anne Arundel Medical Center

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Welcome from the FY’15 Chief Operating Officer and Chief Nursing Officer Welcome to the first Anne Arundel Medical Center Nursing Annual Report. I am proud to present this overview of FY’15. As you read the report, you’ll appreciate the knowledge and caring that is the essence of AAMC nursing. You’ll read examples that illustrate who we are, what we do, how we do it and why. An important milestone in FY’15 was Magnet® designation. The Magnet® credential recognizes top-tier clinical outcomes, patient satisfaction, and nursing satisfaction and turnover. Consistent with these outcomes, we determined early on that we wouldn’t do our work, our Anne Arundel nursing care, for Magnet®. Rather, our goal has been to do what’s right for patients and the people who take care of patients. As it turned out, this focus led to Magnet® designation and a commitment to steadfast pursuit of excellent outcomes. A continued welcome and thanks to Barbara Jacobs, MSN, RN, who joined AAMC as our Chief Nursing Officer in FY’16, September 2015.

Barbara is a true “nurse’s nurse” and has already distinguished herself as an inspiring leader with commitment to deliver the best care to patients, families, and to care for our teams. Next year, I am certain she will proudly present the FY’16 AAMC Nursing Annual Report. Serving as AAMC’s Chief Nursing Officer and Chief Operating Officer was a major honor of my professional life. My most earnest thanks to you – the always present Anne Arundel nursing staff. Thank you for understanding what it means for humans to be sick, old, weak and vulnerable. Thank you for your care to patients, families, and each other. Thank you for the thousands of connections you make each day that are not captured in a report, but shared only between you and your patients and families. With warmest regards,

Sherry B. Perkins, PhD, RN, NEA-BC FY’15 Chief Operating Officer, Chief Nursing Officer Anne Arundel Medical Center

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Note from the Magnet® Coordinators We are pleased to present AAMC’s Nursing Annual Report for fiscal year 2015. Most of these stories were collected as we compiled AAMC’s successful Magnet® document; others reflect more recent events. Together, they showcase the extraordinary efforts of nurses in every part of our organization and at every level of nursing. You will learn about our biggest accomplishments of FY’15 and the many ways in which the care of our outstanding nursing team improves the practice environment and elevates excellence for our patients, our families, our community and each other. Prepare to be inspired by the knowledge, caring and skill AAMC nurses bring to the job every day! Holly Greever, MSN, RN Magnet Program Coordinator Anne Arundel Medical Center Rita Linnenkamp, MSN, RN Magnet Program Coordinator Anne Arundel Medical Center

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Our Biggest Achievements Transformational Leadership

Excellence in Clinical Outcomes, Patient Satisfaction, and the Work Environment Exemplary Professional Practice After AAMC’s initial Magnet® designation, we held a Nursing Grand Rounds to celebrate the amazing work of AAMC nurses. During this Grand Rounds, entitled “It’s not bragging if it’s true: AAMC Rocks!” FY’15 Chief Operating Officer/Chief Nursing Officer Sherry Perkins, PhD, RN, NEA-BC, and the Magnet® Coordinators Holly Greever, MSN, RN and Rita Linnenkamp, MSN, RN, along with eight nursing teams, presented work that showcased excellence in practice, outcomes and satisfaction.

Thunderous applause for our Magnet® nursing team.

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Labor and Delivery Triage Efficiency Jill Smitley, BSN, RN, Robin Colchagoff, MSN, RN, and Ann Tabor, BSN, RN Problem: > Inefficient triage process led to lengthy times between OB triage and disposition (admission or discharge). Intervention: > Change of physical environment. > Creation of standard work. > Standardization of order sets. > L&D Patient Care Technician role expansion. Outcomes: > Significant reduction in time between patient arrival in OB triage to disposition – from 166. minutes pre-intervention to a low of 80 minutes.

Structural Empowerment

Nurse Residency Program Mary Beth Tubiolo, MSN, RN-BC, and Andrea Williams, MS, RN Problem: > Lack of continuing education and support post-orientation. > Inconsistent program structure and curriculum across organizations. > Increased turnover rates during first year of practice. Intervention: > Created the Maryland Nurse Residency Collaborative through Maryland Organization of Nurse Executives initiative. > AAMC joined with 15 other Maryland hospitals to adopt the University Health System Consortium and American Association of Colleges of Nursing’s Nurse Residency Model.

askAAMC Community Outreach Janet Henery, BSN, RN-BC Problem: > Lack of community health resources in Anne Arundel County. Intervention: > Nurse clinics at Morris Blum apartments. > Education programs for heart health and diabetes. > Walking club. > Nutrition programs for children. > Flu shots for Housing Authority of the City of Annapolis. > Faith-based community health education and screenings. Outcomes: > Improved community access to healthcare. > AAMC awarded the Martha Wood Leadership Award.

Outcomes: > AAMC’s Nurse Residency Program ranked #1 in the nation for two years.

(Left) Sherry Perkins, PhD, RN, NEA-BC, Holly Greever, MSN, RN, Rita Linnenkamp, MSN, RN, and (right) Jazmin Manlapaz, BSN, RN, CMSRN, have some fun with a western-themed selfie contest during Nursing Grand Rounds.

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Exemplary Professional Practice

STEMI – Decreasing door-to-balloon times Toni Schiller, RN Problem: > 67% of STEMI patients with off-hours arrival did not meet the door-to-balloon goal of 60 minutes or less.

Pediatric & Neonatal Surgical Initiative Amy Cratty, BSN, RN, and Lisa Laking, MSN, RNC-NIC Problem: > With the addition of pediatric general surgery, gaps were identified in patient, family and staff preparedness for this special population.

Intervention: > Examined off-hours process for system-related delays. > Identified STEMI patients earlier via pre-hospital activation. > Developed ED bypass protocol.

Intervention: > Created the pediatric surgical quality taskforce. > Utilized concepts of patient and family centered care. > Developed NICU perioperative team. > Completed staff education in surgical services. > Implemented measures to ensure continuity of care.

Outcomes: > Increase in pre-hospital activation from 55% to 91%. > Virtual tour won 2013 Aster Gold Award for nation’s best healthcare advertising. > Tour received 2,800 views by the public. > 800 brochures dispersed to surgeons’ offices. > Completed 82 cases on infants under the age of 1. > 19 families participated in Surgical Services Family Day.

One evaluation comment said, “Great work – my husband was one of those patients saved with our door-to-balloon time!”

Lisa Laking, MSN, RNC-INC, and Amy Cratty, BSN, RN, present their collaboration.

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Outpatient Infusion Center Patient Satisfaction Peggy Holston, RN, OCN, and Laura Kucine, RN, OCN Problem: > Overall rating of patient care staff fell to an all-time low of 73%. Intervention: > Created patient satisfaction committee. including patient advocate. > Improved communication between oncology and infusion center. > Implemented follow-up appointment scheduling. > Improved lab run times. > Created guidelines for late appointments. > Established symptom management clinic. Outcome: > Consistent improvement in overall rating of patient care staff to a high of 100%!

Wiihab – Neuro Care Unit Liana Sved, PT, DPT, and Ray Torreon, Patient/Family Advisor Problem: > Patients in acute care spend a majority of the day (53-60%) resting in bed, and only 12.8% of the day engaged in moderate or physical activity. Intervention: > Implemented Wiihab. > Held skills day dedicated to transfers and safe positioning. > Developed mobility tech orders. > Ensured consistent volunteers: Wiihab mentors. Outcomes: > Engaged patients throughout the day. > Improved communication. > Strengthened team unity. > Established first steps to recovery for patient and family. > Created healing and sense of accomplishment for Wiihab mentors.

Ray Torreon and Liana Sved, PT, DPT, share their work on Neuro Care Unit.

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New Knowledge, Innovations and Improvements

Oncology – Hand Hygiene Compliance Anna Hill, BSN, RN, and Jan Clemons, MSN, RN Problem: > Oncology patients are vulnerable to hospital-acquired infections due to disease process, treatment side effects and cancer related co-morbidities. > Hand washing compliance is highly variable among nursing staff, medical staff, ancillary departments and visitors. Intervention: > Implemented a multifaceted hand hygiene education bundle to nursing staff, medical staff and visitors. > “STOP & WASH HANDS” sign affixed to each patient door. > Pre- and post-study comparative data. Outcomes: > Significant improvement in hand hygiene compliance – from low of 50% to high of 84%. > Innovative STOP signs most effective intervention for nurses, medical staff and visitors. > Poster winner for AAMC Evidenced-Based Practice Fair.

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What’s next for AAMC’s Magnet® nurses? We continue to strive for excellence among the big three: nursing quality, patient satisfaction and the practice environment. We’ll perform an annual gap analysis to identify opportunities and make improvements. We’ll build on the knowledge and caring we provide to our patients, families and each other. And we’ll continue to measure outcomes to track our progress. Above all, we’ll keep celebrating! Nursing Grand Rounds will be a yearly event. Round two – “It’s not bragging if it’s true: AAMC rocks!” – is scheduled for September 2016.

Nursing Staff Meets Global Health Challenge Exemplary Professional Practice Among the hallmarks of nursing excellence are the knowledge to quickly and efficiently respond to emergencies on a local, national and international level, and a quick willingness to care for patients affected by diseases that cause fear among the general population. In 2014, our staff was put to the test and passed with flying colors. Around the five components of the Magnet® Model runs a blue ring: “Global Issues in Nursing & Health Care.” While not technically a component, this overarching category acknowledges the various challenges facing nurses today. When Ebola burst onto the world stage in 2014, AAMC Nursing used all the resources that earned us Magnet® designation to meet the challenge. We joined forces with a multidisciplinary group of physicians, Radiology, Lab and Patient Care Technicians to form the AAMC Isolation Care Team. The team included staff from the Critical Care Unit, Emergency Department, Joint/Spine Unit, Edwards Surgical Pavilion, Special Care Unit, General Surgical Unit, Acute Care for the Elderly Unit, Oncology Unit, Interventional Radiology and PACU.

Physicians from epidemiology, critical care, infectious disease, emergency medicine, hospital medicine, and other specialties were prepared to provide care as needed. Patty Sherman, MSN, RN, Emergency Management Coordinator, led the effort. Mary Clance, MD, served as the team’s medical director and Janice Drum, MSN, RN, as the nursing director. Many other clinical and support staff contributed their expertise, including Engineering, Environmental Services, Respiratory, Information Systems, Human Resources, Security, Marketing and Communications, Quality, Infection Control, Finance, Health Care Enterprises and Emergency Preparedness teams. Under Patty Sherman’s leadership, AAMC’s emergency preparedness personnel established a close relationship with the Maryland Department of Health and Mental Hygiene’s Offices of Preparedness and Response and Infectious Disease. We formed collaborative, multi-jurisdictional relationships with other preparedness agencies, including the Maryland Institute of Emergency Medical Systems and Services, the Anne Arundel County Health Department and local EMS. Thanks to this cohesive approach, AAMC nurses are better prepared to respond to newly emerging infectious diseases like Ebola, as well as other global health challenges that may arise in the future. Anne Van Waes, MS, RN, CIC, with Patty Sherman, MSN, RN.

Amanda Wertz, RN, assists Jessica Campbell, BSN, RN, CEN, in donning personal protective equipment.

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Partnering with Families to Create the Ideal Birth Experience New Knowledge Innovations and Improvements AAMC’s commitment to patient-family centered care leads to innovation and a better patient experience. Creation of the family-centered Cesarean demonstrates this commitment in action. In 2014, a woman scheduled for her third Cesarean delivery reached out to Senior Nursing Director Betsey Snow, MPH, BSN, RN, CMNL, with a special request. Immediately after the birth, the woman wished to have her baby placed on her chest during the newborn assessment, rather than have her baby moved to recovery – without her. This would facilitate immediate skin-to-skin contact, which was very important to this mom. The obstetric team responded quickly to honor her request. The delighted mother posted an account of her experience on her blog. Within 24 hours, we’d received numerous requests from other families to replicate this experience, requiring a change in process and culture.

Collaboration was key. With the leadership of Clinical Nursing Director Jill Smitley, BSN, RN, patients, families, nurses and physicians created guidelines for the family-centered Cesarean. Interested candidates submitted an online request to Labor and Delivery charge nurse Lisa Davis, MSN, RN, RNC-OB. Lisa helped set realistic expectations, answered all questions and prepared the delivery team. This process created trust with the family before the birth. Labor and Delivery nurses provided critical knowledge and input. After obtaining input from her fellow nurse colleagues, Allison Piquero, RN, recommended an additional nurse be present in the operating room, assigned solely to the newborn, to provide quick intervention if necessary. Jennifer Lefler, RN, recommended expanding the family-centered Cesarean to include non-scheduled deliveries and off shifts when staffing allowed. We now perform 10 to 12 family-centered Cesareans each week. Families consistently express satisfaction with the experience. Hospitals across the country have reached out for guidance in implementing this innovative process in their facilities. The family-centered Cesarean represents our Professional Practice Model in action. What began as a simple effort to meet the needs of one patient resulted in a fundamental change in care for an entire patient population. Excellent nurses were at the center, every step of the way.

Lauren and Joe Wilusz share a kiss as they bond with their new daughter, Katie in the operating room at AAMC. Kathryn Marie Wilusz was born via a scheduled family-centered Cesarean.

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Creating the Country’s #1 Nurse Residency Program Structural Empowerment In 2013, AAMC leaders, Sherry Perkins, PhD, RN, NEA-BC and Irma Holland, MSN, RN-BC in collaboration with the Maryland Organization of Nurse Executives, paved the way for the Maryland Nurse Residency Collaborative. Initiated with 15 Maryland hospitals, it is now the nation’s largest collective of CNOs, educators, legislators and regulators to promote mentorship of new graduate nurse transition from the academic environment to the clinical setting.

The curriculum, developed by University Health System Consortium (UHC) and the American Association of Colleges of Nursing (AACN) focuses on three core concepts: leadership, patient outcomes and the professional role of the nurse. The goal is to ensure that all new graduate nurses across the state receive standardized training and education during their first year of practice.

A special congratulations to this year’s Nurse Residents! From left to right: Karla Thornton, RN (ED), Megan Mascetti, RN (HVU), Kelly Bosworth, RN (SCU), Karen Dove, RN (HVU), Catherine (White) Miller, RN (SCU), Stephanie White, BSN, RN (ONC) Not pictured, Mariel Parrish, RN (HVU).

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AAMC’s Nurse Residency Program is a year-long experience that ensures our new graduate nurses transition smoothly into professional practice. The Nurse Residency Program consists of classroom, clinical and simulation instruction, precepted clinical experience, and mentorship activities. Mary Beth Tubiolo, MSN, RN-BC, and Anne Marie Holland, MSN, RN, CNOR, from the Clinical Education and Professional Development Department, hold monthly education sessions with graduates throughout the year. The curriculum includes time management and setting priorities, delegation, advanced IV therapy, advanced wound care/assessment, code management, documentation standards, pain management, conflict resolution, evidence-based practice, literature searches using online databases, error reporting and root cause analysis processes. Nurses also practice self-care through yoga and journaling. This education gives new graduates the skills they need to make a successful transition to the work environment. Since the inception of the Nurse Residency Program, 43 new graduate nurses have been hired with a retention rate of 95%. The knowledge and care that defines AAMC is evident throughout this program. Based on data collected from Nurse Residency participants nationwide, AAMC’s Nursing Residency Program was ranked #1 in the country in 2013 and 2014 by UHC/AACN.

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Our Nurse Residents agree. They enjoy learning, laughing and growing together – and forming friendships that last: > “I have felt supported and been given plenty of guidance. I am always able to get the support I need.” > “I feel much more confident and comfortable compared to when I started. I still have a lot to learn, and knowing that is a little scary. It is comforting to know that I have a great staff to support me and still have the continued support of my cohort.” > “[The program is] very well organized and thoughtfully planned. I feel there are multiple sources of support and many staff members who are invested in my professional growth.”

Caring for Patients Innovatively Simple Solution Improves Patient Care and Nurse Satisfaction Transformational Leadership Bedside shift report (BSR) helps ensure the safe handoff of care between nurses at the patient’s bedside. At AAMC, it is a core element of our patient- and family-centered care bundle, along with open visiting and bedside rounding. Ongoing efforts to ingrain BSR into our daily practice sparked innovative thinking from clinical director Lil Banchero, MSN, RN, and nurse informaticist Tina Andersen, BSN, RN, ONC. Why not use the same scanning technology already prevalent in so many other patient safety processes to facilitate BSR? To make things even easier for nurses, Lil and Tina recommended wireless scanners that could be removed from a dock and carried to the patient. No more clumsy cords or stretching to reach the patient from across the room. New wireless scanners were purchased and a pilot was conducted on several units to study their ability to facilitate BSR. At shift change, outgoing and oncoming nurses used the wireless devices to scan the patient’s identification band and document BSR in the electronic health record.

Jeanette Walton, RN, ONC, uses new cordless scanner.

The technology improved efficiency, safety and scanning compliance. It not only achieved the goal of bringing nurses to the bedside for BSR, but also generated improved nurse satisfaction and extremely positive feedback:

“It’s like a gift every day when I use the new wireless scanners – these are great! Thank you!” “Wireless scanners are awesome! These scanners have really helped with scanning at the bedside.”

With such an overwhelmingly affirmative response, FY’15 Chief Operating Officer/Chief Nursing Officer Sherry Perkins, PhD, RN, NEA-BC, advocated for and received wireless scanners for all units. AAMC is now the only hospital in the country scanning patient bracelets at the bedside to document BSR. AAMC Nurses commitment to knowledge and care paved the way for this innovation.

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Oncology Nurse Navigators: Supporting Cancer Patients and Their Families Exemplary Professional Practice A diagnosis of cancer is frightening and overwhelming. AAMC oncology nurse navigators help patients and families cope with the logistical and emotional challenges. They are advocates, coordinators, facilitators, educators and counselors. A single call – from patient, family member or physician – begins the process. Navigators schedule tests and appointments, help solve insurance issues, and educate patients about what to expect during treatment. Above all, through this sharing of knowledge and provision of care, they allow the patient to focus solely on healing.

“We have the ability to drop whatever we are working on to solve problems immediately, on the spot, whether it be scheduling the first oncologist appointment or helping a patient through a tough moment,” says Teresa Putscher, BSN, RN, OCN, who notes that she and her fellow nurse navigators work closely together to ensure continuous service whenever a physician, patient or family member reaches out. Putscher recounts a recent call from a primary care physician about a patient with a suspicious MRI result. She and her colleagues – Judeth Davis, BSN, OCN, Jacqueline Shanahan, BSN, OCN, and Deborah Stone, BSN, ANON – immediately contacted specialists and obtained appointments to move the patient to diagnosis and treatment within a week. “Trust and collaboration are key,” says Putscher. “This fast action wasn’t the work of one person, but a seamless system including the primary care physician, orthopedic physician, medical oncologist and four dedicated navigators.”

(From left) Teresa Putscher, BSN, RN, OCN, Deborah Stone, BSN, ANON, Judeth Davis, BSN, OCN, and Jacqueline Shanahan, BSN, OCN.

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Nurses Create Mentorship Programs to Enhance Patient Recovery Exemplary Professional Practice Take the voice of the patient, combine it with aspiring leaders in our organization, and use a methodology to efficiently look at needs and solutions. The result? A higher level of care. Every day, we give patients their lives back, but how do these patients get back into life? From the passion of one patient-family advisor – a stroke survivor – AAMC created the Power of 2, a peer-based mentorship program for stroke patients. It was modeled after Survivors Offering Support (SOS), a mentorship program for breast cancer patients. Eight stroke survivors were matched with supportive, encouraging mentors – people who had been through the same experience and could offer advice and support. Karla Balch-Reno, the first stroke patient who was mentored, summed it up. “This relationship was just as important to my recovery as any medical care that I received,” she says.

AAMC nurses wondered, would other patient populations benefit from mentorship programs? Using Lean methodology, a multidisciplinary team and members of the LEAD Academy conducted an A3. The group included patient-family advisors, social workers, nurses, rehabilitation therapists and program coordinators. It identified strengths and opportunities of the Power of 2 and SOS programs, developed a standardized process to ensure consistency, approved a grant-funded program coordinator position, established metrics for outcome measurement and created an organizational chart. Nurses Jennifer Hoover, BSN, RN, PCCN, Theresa Maloney, MSN, RN, Jeanne Morris, BSN, RN, Katie Music, BSN, RN, and Mary Beth Tubiolo, MSN, RN, RN-BC, were involved in this project. Their work demonstrates how nursing knowledge and care, combined with the collaborative engagement of our patient-family advisors, has further enculturated patient-family centered care into the fabric of our organization.

(From left) Theresa Maloney, MSN, RN, Mary Beth Tubiolo, MSN, RN, RN-BC, Jeanne Morris, BSN, RN. (not pictured) Jennifer Hoover, BSN, RN, PCCN, and Katie Music, BSN, RN.

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Caring for Each Other AAMC Medical Staff Honors “Agent for Change” Jessica Campbell, BSN, RN, CEN Exemplary Professional Practice AAMC nurses often brag that we have the best physician partners around. As we work together to ensure our patients receive the highest quality care, we build professional relationships based on mutual respect and trust. At their 2015 Appreciation Dinner, AAMC’s medical staff recognized Jessica Campbell, BSN, RN, CEN, for her excellent care of patients and her significant contribution to the healthcare team. An excerpt from her nomination reads: Dedicated, hardworking, insightful, and an agent for change: These are just a few of the attributes that Jessica Campbell, RN, incorporates into her daily nursing practice. She has developed from an orthopedic technician in the Emergency Department (ED) to one of our most energetic and proficient bedside nurses and clinical leaders. Jess is the nurse that you would like to have at your bedside to provide care and assist you through your ED experience.

Jessica Campbell, BSN, RN, CEN, receives her award from Dr. Mary Clance, on behalf of the Medical Staff.

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Over the last year, Jess has been integral to the implementation of essential initiatives to improve the model of ED care and has helped prepare staff for emerging infectious disease threats. By combining her observations as the Team Leader Nurse in the Rapid Clinical Examination (RCE) area, as well as her work in her staff nurse role, Jess identified multiple ways to improve patient flow and safety. She has been chairing an interdisciplinary committee to identify and implement a process improvement program in the RCE area. Jess has also been instrumental in assisting and coordinating Ebola training for all of the ICU, ED and medical staff. The final component of Jess’s professional life that should be highlighted is her commitment to continuing her own development. She is currently enrolled in the rigorous Doctor of Nursing Practice program at the University of Maryland with a focus in becoming a Family Nurse Practitioner. Jessica is a role model and mentor to both experienced and novice emergency room nurses. She is a dedicated employee with more than 15 years of commitment to AAMC and an exemplar of superb patient care. She is a change agent with a focus on quality patient care and safety – a true asset to our medical center.

Promoting Growth and Advancement Structural Empowerment Professional certification both validates the knowledge and abilities our nurses possess and reflects their care and dedication to patients, families, AAMC, and the profession of nursing. Each year, more and more AAMC nurses obtain professional certification. Currently, 40% of eligible nurses are certified. AAMC supports nursing professional certification in a myriad of ways. We offer financial assistance, educational resources, promotion opportunities and recognition. Nurses receive free online continuing education credits, tuition reimbursement, and rewards for certification. AAMC also offers nursing staff two innovative programs designed to alleviate test anxiety and promote certification. The American Nurses Credentialing Center’s (ANCC) Success Pays™ program and the Competency and Credentialing Institute’s Take 2 Program give nurses two opportunities to earn specialty certification in a year. As a result of participation in these opportunities, 71 nurses obtained certification in FY’15.

Fifteen-year veteran Carol Chell, BSN, RN-BC, who works for ask AAMC, decided 2015 was the year to pursue her certification. “I began preparing for the Ambulatory Care Nursing Certification Exam in April, but put off sending in my application due to the $390 fee required,” she says. “It wasn’t exactly a financial hardship, but I always had – or found – a more pressing (or pleasing) place to put that money. In June, I learned of the Success Pays Program through the Clinical Education Department. I submitted my application, was deemed eligible by ANCC and took the exam. I passed. Hooray! I am now board certified in Ambulatory Care Nursing, and I’m not sure when I would have achieved this if not for AAMC’s commitment to encouraging, and financially facilitating, the education and advancement of its nurses. This is another reason, among the many, that I am so proud to be a part of this hospital.” Malorie Smith, RN-BC.

Malorie Smith, RN-BC, received her certification this year. “It has been a goal of mine since the beginning of my career as a new graduate on the Medical Surgical floor to grow as much as possible in my profession,” she says. “I told my grandmother when I first started that I wanted to collect as many letters next to my name as possible. A great group of my coworkers all decided to pursue their certifications together and I am glad that we did! I am also in school to obtain my Bachelor’s degree – my next big achievement.”

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AAMC Nurses Receive DAISY Award for Exceptional Care Structural Empowerment The DAISY Award is a beautiful testimony to the life-changing, and often difficult, work bedside nurses perform every day. It was established by the family of J. Patrick Barnes, who died of complications from the auto-immune disease idiopathic thrombocytopenia purpura at 33. DAISY stands for Diseases Attacking the Immune SYstem. During Pat’s eight-week hospitalization, his parents were awestruck by the care and compassion his nurses provided—not only to Pat, but to everyone in the family. One of their goals in creating a foundation in Pat’s memory was to recognize the extraordinary bedside nurses who make an enormous difference in the lives of so many people.

Since our first DAISY Award in 2010, AAMC has celebrated the knowledge and caring of 12 exceptional nurses. Each nurse was nominated for this honor by a patient or colleague, and each is a role model for compassionate, excellent, patient- and family-centered care. Traditionally, DAISY nurses are surprised during their shift by their family, friends and colleagues. Amid tears and laughter, Sherry Perkins, AAMC’s FY’15 Chief Operating Officer/Chief Nursing Officer, extends her congratulations and presents the winner with a DAISY plaque and figurine. Colleagues and nominators also present gifts and share stories about their relationship with the DAISY nurse. This year, two deserving AAMC nurses received the DAISY Award: Lorraine Antel, RN, who works on the Critical Care Unit, and Amy Holston, RN, who works on the Mother-Baby Unit.

Patients Honoring Nurses Lorraine was nominated by her patient Jill. Here’s an excerpt from her letter: During a recent stay at AAMC for bilateral mastectomies and reconstructive surgery, I had the honor/pleasure of being a patient of Lorraine Antel’s. Lorraine’s dedication to providing excellent care made what was probably the most traumatic event of my life a tolerable event.

(Third from the left) Lorraine Antel, RN, holds her DAISY award.

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After 13 hours of surgery I was in pain, scared and confused. Lorraine cared for me in a compassionate and caring way which fostered a sense of trust and a feeling of safety. Her dedication to my medical needs, which were many at the time, allowed me rest more comfortably. She treated me with dignity and respect… and let’s face it – it is hard to feel much dignity when someone else is bathing you and rolling you around to change the sheets. But not once did I feel like it was a chore for her or just a job… she really made me feel cared for and protected. She was respectful and communicative as she built a rapport with my family, which eased their fears as they felt I was receiving the best care possible. Lorraine cared about the little things … the details… that may not matter in the big scheme of things, but that make us feel human – and in that environment it is sometimes impossible to feel human. When I was being moved from the Critical Care Unit to the Oncology Unit, Loraine made sure I was bathed before I went (which is no easy task I’m sure, since I’m no lightweight) and made sure my basic needs were met. She probably could have let them do it when I got there, but she had already built a rapport and trust with me and I am thankful that she took the time and effort to take care of me before my transfer. She also wrote extensive notes and spoke in detail regarding my care with the Oncology Department, where I ended up. I have an extreme fear of needles and Lorraine always was respectful in recognizing my fears and helping me cope with what was a very difficult situation emotionally for me.

Overall, I really cannot say enough about the amazing level of care both physically and emotionally that Lorraine provided for me during my stay at AAMC. Her impact on my life during this critical time was immense – her compassion and dedication will never be forgotten by this patient and I am sure many others.

Nurses Honoring Nurses Amy Holston’s nomination letter, written by her colleague Nicole Janes, shows how Amy’s attentive care saved her patient’s life, giving his parents and family precious time with their little boy before he eventually succumbed to complications related to his illness. On March 26, 2009, our very best friends, Daryl and Ashley Knight, welcomed into the world their twins, and our godchildren, Trace and Maddie Knight. It was a beautiful twin delivery with no complications and we were all over-the-moon exited. On their day of birth, hours after leaving labor and delivery, Trace was still not interested in eating. He had an irregular heartbeat, and was just not doing what his nurse Amy Holston was happy with. She contacted the NICU practitioner on call and completed four extremity pulse ox testing on Trace. Amy's attention to the subtle signs Trace was exhibiting and her investigation into what might be causing them is what started the intervention that would save his little life.

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Trace's testing showed significant differences in his pulse oximetry readings. He was brought to the NICU at AAMC where further testing revealed a significant undiagnosed congenital heart defect called Shone's Complex. Trace was transferred to a higher level NICU where they specialized in CHD and CHD treatment.

This year, at our 3rd Annual Heart to Heart dinner, we honored Amy Holston. When I invited her to this year’s dinner as our guest of honor she was shocked. In true humble nurse fashion, she told me she was just doing her job. But, by just doing her job, she saved Trace's life and gave us precious memories and time we may have never had without her assessment and intervention.

Amy's keen sense and high skill level while Trace was just beginning his tiny life at AAMC are what bought us the 3½ years we may have never had with him. On June 18, 2012, our superhero passed away in his mother’s arms after complications from successful mitral valve placement the week before.

(From left) Sherry Perkins, PhD, RN, NEA-BC, and Peggy Holston, RN, help to honor Amy Holston, MSN, RN, CRNP.

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Caring for Our Community Climate Change and Public Health: AAMC Nurse Leads the Way Transformational Leadership As AAMC’s Coordinator of Sustainability, Charlotte Wallace, MS, RN, does not mince words. “Everyone deserves a healthy life,” she says. “All of us – individuals, organizations and businesses – have a responsibility to protect health and prevent disease, not merely treat it.” AAMC nurses commitment to knowledge and caring extends beyond the bedside to our local and global environment. As part of this commitment, Charlotte leads AAMC’s efforts to reduce its energy footprint. In April, she was privileged to represent nursing at a national roundtable with President Obama, U.S. Surgeon General Vivek Murthy, MD, and EPA Administrator Gina McCarthy to discuss the impact of climate change on health. The forum focused on ways to help the public understand the profound effect on our most vulnerable populations, including children, the elderly and people of low income. When one participant suggested that doctors should educate the public because people listen to their doctors, President Obama replied, “I don’t agree. You know who people listen to? Nurses.”

With Charlotte’s help, AAMC was the first hospital in Maryland to earn the U.S. Green Buildings Council Gold Leadership in Energy and Environmental Design (LEED) for our patient tower. In addition, Becker’s Hospital Review named us one of the 50 Greenest Hospitals in America. Here are just some of the ways we make a difference: > Energy. We incorporate environmental sustainability in our daily operations, including high efficiency and lower-wattage lighting, a high efficiency chiller and installation of two green roofs. > Waste. We aim to buy environmentally friendly products that benefit human health. We assess products for their entire life cycle, including their reuse and/or recycle potential. > Local Food. Buying local helps the environment and strengthens our community. We host an on-campus Farmers Market from June through October every year.

Charlotte Wallace, MS, RN represents nursing at a national forum with President Obama and senior administrators.

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Caring for Our Community

Generosity Abounds: Making a House a Home Structural Empowerment For more than five years, AAMC nurses have partnered with the Light House Shelter in Annapolis, generously donating backpacks and clothing, Thanksgiving baskets and much more. It’s part of AAMC’s mission to care for the community beyond the hospital walls. In May, the Community Service Initiative (CSI) team jumped at a new opportunity to care for shelter residents. The team agreed to sponsor a woman and her adult son in their move toward self-sufficiency. AAMC staff donated a wide variety of items for the family’s townhouse, including kitchen, bedroom and living room furniture, and gift cards for groceries and household items. Staff members were so generous, in fact, that there was enough furniture for a second donation to another family. Even the moving company donated its time and talent.

Dawn Knebel, BSN, RN, CWCN, Bekka Ward, OT, Sue Podolin, PT, Mary Perzanowski, RN, work with a team from Two Men and a Truck moving company in Crofton.

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What difference did CSI make for the family? “I can’t believe we have all this for our new house!” the son exclaimed. What difference did the project make for AAMC staff? “The young man was so happy and thankful. What a great feeling it gave me to be a part of this project,” says Mary Perzanowski, RN, charge nurse of JSU and co-lead of CSI. Her fellow CSI leader, Eve Sage, MSN, RN, CMSRN, clinical director GSU and JSU, echoed that sentiment, “We had many donations that were very much appreciated by our clients and the house was looking like a home by the time we left. The clients were very happy!” Dawn Knebel, BSN, RN, CWCN, who led the work with Sue Podolin, PT, says “I am always impressed by the over the top generosity of the AAMC staff. When the word went out, they didn’t hesitate. They made these folks feel well cared for.”

Caring for the International Community

Filmon arrived for his first visit to AAMC in June. Under the care of Dr. James Chappell, and Dr. Sarah Jamieson and nurses in the specialized hyperbaric team, he completed 28 hyperbaric treatments to strengthen his facial tissue for surgery.

Structural Empowerment AAMC nurses care for patients during all phases of their surgical experience, treating more than 1,500 patients each month in our operating rooms. This level of knowledge and care found at AAMC is not found everywhere – sometimes patients must travel long distances to receive the life-changing treatments they cannot obtain or afford in their home country. Such was the case for 19-year-old Filmon Haile of Asmara, Eritrea, in East Africa. Filmon received radiation treatment as a toddler that caused him to have major facial deformities. AAMC oral surgeon Edward Zebovitz, DDS, met Filmon during a mission trip and recognized that our hospital could provide the care he needed for his facial reconstruction. Dr. Zebovitz arranged for Filmon to come to the United States.

Kelly Davis, BSN, RN, Dr Chappell, Filmon Haile, Anita Smith, BSN, RN, and Dawn Knebel, BSN, RN, CWCN.

In July, Filmon underwent a 10-hour procedure, performed by Dr. Zebovitz, to begin the reshaping of his facial bones. A multidisciplinary team of plastic surgeons, anesthesiologists, nurses and others cared for Filmon throughout his treatment. One month later, Filmon returned to the Hyperbaric Center for 11 post-surgical follow-up treatments to continue to strengthen his facial tissue growth. From start to finish, the cost of all of Filmon’s care, treatment and services were either donated or absorbed by the hospital. “Filmon has become near and dear to all of us,” says Anita Smith, BSN, RN, nurse manager of the Wound and Hyperbaric Center. “We are very fortunate to be able to administer this treatment to aid in his healing process. All our prayers are with him and his family.” Filmon’s experience demonstrates how nurses and staff across our organization collaborate with dedicated physicians to truly make a difference in patients’ lives, no matter how far they travel for care.

Edward Zebovitz, DDS.

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Caring for Our Community

AAMC Nurses Receive Martha Wood Leadership Award Structural Empowerment In 2014, the Annapolis City Council presented AAMC nurses with the Martha Wood Leadership Award for their collaboration with the Housing Authority of the City of Annapolis (HACA) on multiple projects. Named for community activist Martha Wood, this award recognizes deserving people or organizations who help make our community a better place. The Council’s official proclamation named several of AAMC nurses’ growing number of outreach activities, highlighting the care and education we provide to our local community, including: > Weekly clinics at Morris Blum Apartments for medication reconciliation and health checks.

> Sponsorship of a walking club. > Advice clinics at Harbour House and Eastport Terrace. > Sponsorship of the Pathways to Opportunities conferences. > Nutrition programs for children attending summer camp. > Flu shots for HACA residents. > Opening of the Morris Blum Clinic (celebrating one year of operation!).

“It was an honor and privilege to accept this award alongside my physician colleagues, Dr. Pat Czapp and Dr. Scott Eden,” says Janet Henery, BSN, RN-BC, askAAMC/Community Health and Wellness. “Kudos to Mary Ellen Turner, Chair of the Award Committee and HACA partner, and Chris Crabb and fellow nurse

> Educational programs for heart health and diabetes, including the Living Well with Chronic Conditions workshops.

Marlou Klamp RN-BC for their leadership in this work.”

Janet Henery, BSN, RN-BC (third from the right) is pictured receiving the award with Chris Crabbs and Marlou Klamp, RN-BC (far right).

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Quality and Evidence-Based Practice AAMC’s Professional Practice Model – Powered by knowledge. Inspired by caring.

Nursing

Trust, Compassion, Quality, Dedication, Innovation, Collaboration, Diversity

Patient and Family Centered Care: Dignity and Respect, Information Sharing, Participation, Collaboration Transformational Leadership: Strategic Plan, Advocacy, Accessibility Structural Empowerment: Clinical Ladder, Continuing Education, Community Involvement, Shared Decision Making, Recognition of Nursing Exemplary Professional Practice: Interdisciplinary Care, Autonomy, Safety, Quality Structure, Staffing, Ethics, Care Delivery Model New Knowledge: Evidence-Based Practice, Nursing Research, Continuous Quality Improvement

Patient and Family Centered Care

Empirical Outcomes: Nurse-Sensitive Outcomes, Patient Satisfaction, Practice Environment

Exemplary Professional Practice The PPM represents all nurses at our hospital, whether they participate in decision-making on a council or work at the bedside caring for patients, families and each other. At the center is a lamp – a historical symbol that represents the town of Annapolis and symbolizes the beacon of light we provide the community as we work to enhance the health of those we serve. The PPM aligns nursing values with those of the organization. Our nursing tenet – “Powered by knowledge. Inspired by caring.” – expresses our professional commitment. Patient and Family Centered Care (PFCC) is AAMC’s care delivery model and the foundation of our PPM. It guides nurses as they partner with patients and families, sharing meaningful and timely information and actively seeking their participation in all aspects of the care process.

Powered by knowledge. Inspired by caring.

Here is how our nurses describe the PPM: “The PPM shows how AAMC provides the environment that allows me to provide a level of care that is excellent and that I can be proud of. This is why I drive to work 50 minutes every day!” “The PPM at AAMC shows that everything we do is for the three outcomes of the lamppost – excellent nursing quality, excellent patient satisfaction and an excellent practice environment.” “The PPM is what our nurses do every day. It’s just what we do.”

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Quality and Evidence-Based Practice

Shared Decision-Making Gives Nurses a Voice Structural Empowerment AAMC Nurses are “Powered by Knowledge. Inspired by Caring.” This knowledge and caring is foundational to the work of our robust nursing shared governance structure, which includes 10 councils. This structure has been in place since 2004, with ongoing modifications to ensure alignment with organizational and nursing goals, as well as changes in healthcare. Every council’s composition varies based on its goals, and may include senior nursing directors, clinical nursing directors, nurse managers, clinical nurse educators, unit charge nurses and bedside nurses. The 10 councils are: > Nursing Directs Council > Nursing Executive Council > Nursing Quality Council > Clinical Education Council > Nursing Operations Leadership Council > Charge Nurse Council > Interdisciplinary Informatics Council > Professional Nurse Council > Nursing Evidence-Based Practice/Research Council > Clinical Practice Council

Nursing Executive Council

Nursing Directs

Nursing EBP/ Research Council

Clinical Education Council Nursing Councils Nursing Operations Leadership

Professional Nurse Council Interdisciplinary Informatics Council

Charge Nurse Council

Our shared governance structure promotes collaborative decision-making by providing a forum for nurses at all levels to participate in decisions that affect their practice and care delivery at a nursing service level – driving nursing practice globally at AAMC. Unit-based quality councils at AAMC allow for nurses to think globally, but act locally. The organizational Nursing Quality Council reviews and evaluates data (e.g. NDNQI, survey data, benchmarks) and develops action plans for overall nursing services. Unit-level nursing quality councils review their own unit performance-trended data to identify specific opportunities for improvement, implement actions for improvement in their work environment and evaluate the outcomes.

The FY’15 Nursing Operations Team works closely to promote and support shared decision-making each day.

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Nursing Quality Council

Clinical Practice Council

Inpatient units evaluate their own trended data for multiple nurse-sensitive indicators including fall reduction. For example, the Acute Care of the Elderly (ACE) implemented evidence-based fall reduction activities specific to its patient population, such as diversion activities with doll therapy, and then evaluated for fall reduction. Think globally = fall reduction; act locally = diversion activities for patients.

As part of their February visit, nurses lobbied for these measures:

The Hospital Pavilion Post-Anesthesia Care Unit (PACU) measured post-operative nausea and vomiting (PONV), implemented evidence-based actions to reduce PONV and evaluated the outcomes. Nursing involvement in shared decision-making at the organization and unit level helps AAMC achieve excellence in the nursing practice environment for our patients, families and each other. Thinking globally, the Professional Nurse Council, which includes staff nurses from each clinical nursing unit at AAMC, advocates for issues affecting nurses and the public.

> Request to restore funding for the Board of Nursing in the 2016 Budget and prevent the transfer of $2.5 million dollars of nursing licensing and certification fees to the general state fund. Despite our best efforts, this funding was not restored.

When Nurses Speak, People Listen In February, AAMC staff nurses traveled to the State House in Annapolis to advocate for issues affecting nurses and the public. The event was part of Maryland Nurses Association (MNA) Nurses’ Night, which provides nurses the opportunity to speak with Maryland lawmakers about current healthcare legislation.To prepare, members of AAMC’s Professional Nurse Council (PNC) educated their colleagues about the legislative and lobbying process.

> Senate Bill 723/House Bill 999: The Nurse Practitioner (NP) Full Practice Act to remove outdated requirements that NPs complete an attestation indicating that they collaborate with physicians. The bill passed and Maryland became the 20th state to change its law.

After participating in Nurses’ Lobby Night for several years, Cheryl Briggs, BSN, RNC-LRN, NICU staff nurse, took a lead role in recruiting her colleagues. “Before attending my first Nurses’ Night, I knew nothing about how a bill was passed,” she says. “I came away from the experience very excited about all that I had learned. The delegates were receptive and very interested in what we had to say. Nurses are highly respected for their knowledge and experience and really do make a difference by helping the delegates understand the issues that we face in our daily practice.”

AAMC nurses at Nurse’s Night in Annapolis on Feb. 16, 2015.

Members are role models for the Nursing Code of Ethics Provision 9: to articulate nursing values, maintain the integrity of the profession, and integrate principles of social justice into nursing and health policy.

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Quality and Evidence-Based Practice

Research Drives Quality Projects to Publication New Knowledge, Innovation and Improvement Start with a unit-based quality council, add a clinical question, stir in a literature review, combine it with consistent multidisciplinary work over time, and you have the recipe for an outstanding quality project. If the project yields meaningful results with the potential to impact patient care, you just may have an article in a national nursing journal. A significant opportunity to use nursing knowledge to improve patient care occurred several years ago, when the HP OR Quality Committee observed an increase in surgical site infections (SSI). A literature search pointed to increased foot traffic in the OR as a source. Led by Catherine (CJ) Rovaldi, MS, MBA, BSN, RN, CNOR, the committee implemented a multidisciplinary quality improvement project to measure how fewer OR door openings would impact SSI.

Catherine (CJ) Rovaldi, MS, MBA, BSN, RN, CNOR, is pinned by Jen Smell, MSN, RN, CCRN.

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The committee began by identifying reasons for door openings, evaluating more than 100 joint surgeries. It then analyzed the effectiveness of door-opening deterrents and implemented process changes that resulted in a 50% reduction in door openings compared to baseline. The committee began by identifying reasons for door openings, evaluating more than 100 joint surgeries. It then analyzed the effectiveness of door-opening deterrents and implemented process changes that resulted in a 50% reduction in door openings compared to baseline. CJ and Paul King, MD, knew these results should be shared. They submitted an article about their work to the AORN Journal. “The Effect of an Interdisciplinary QI Project to Reduce OR Foot Traffic” appeared in the June 2015 issue.

Posters and Pins: Evidence-Based Practice Fair New Knowledge Innovations and Improvements Powered by knowledge. Inspired by caring: this is our nursing tenet, adopted in 2008. The 2014 Evidence-Based Practice (EBP) Fair, sponsored by the Nursing Research/EBP Council, showed just how much our practice truly is powered by knowledge. The fourth annual fair offered an opportunity for nurses across AAMC to display their work. The response was tremendous, with more than 40 posters presented! The Quality Improvement winner was the Oncology Unit, for its work displayed on the poster, “Use of Multifaceted Hand Hygiene Education Bundle & the Effect of Hand Hygiene Compliance.” Oncology nurses Jessalyn Barbour, MSN, RN, CON, Jan Clemons, MS, RN, CON, and Anna Hill, BSN, RN, CON, led this improvement effort.

Sherry Perkins, FY’15 COO/CNO, receiving her Magnet pin from Tori Bayless, CEO & President.

Nia Wright, MSN, RN, CNOR, pinning Micheline Holmes, BSN, RN (HP OR).

The Evidence-Based Practice winner was the NICU for its work presented on the poster, “NICU Patient Safety Study to Review Impact of Clinical Alarms.” Cindy Mueller, BSN, RN, led this work with the NICU Quality Council. The Fair featured another special event: nurses received their official Magnet® recognition pins. AAMC’s recent Magnet® designation recognizes nursing excellence and the important role nurses play in the hospital’s commitment to outstanding patient care and outcomes every day. We wear our pins proudly. AAMC nurses rock!

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Patient Stories Grateful Patients Share Their Stories Exemplary Professional Practice At AAMC, nurses connect with patients and families in ways that resonate long after discharge. We’ve compiled a few letters that illustrate this special connection. Our patients’ gratitude is heartwarming — they’ve taken potentially negative circumstances (a coronary artery dissection, cancer, a premature baby in the NICU) and chosen to see the good in it. They are thankful for our nurses’ care, their friendship, their knowledge, their open and easy communication and their compassion.

Cardiac Rehab After a health crisis, cardiac rehab nurses encouraged, coached and cheered for this patient so she could stay healthy and strong for her young children.

Shannon Adkins, BSN, RN with Terri Harding, BSN, CVRN-BC.

It is with a most grateful heart that I send this correspondence. Recently, I experienced a spontaneous dissection of one of my coronary arteries. Following my hospital stay, I was referred to the Cardiac Rehabilitation Program at AAMC. It was the greatest blessing for my family. I was treated with respect, care and sincere concern. I am only 40 years old and have two young children. On more than one occasion, it was necessary for me to bring my children with me. The staff was wonderful. They alleviated all of our fears and always made us feel welcome. The staff was not only nurturing and kind, but extremely knowledgeable. They were truly concerned with my well-being and progress. They were always supportive and displayed genuine concern for my health. I was in good hands and surrounded by positivity and encouragement. I cannot express how truly indebted I am to the entire Rehab staff. I know that their attitudes and expertise were crucial to my rehabilitation. This department is a tremendous asset to AAMC and this community. I am especially grateful to the following staff members: Terri Harding, RN, BSN, CVRN-BC, STAR, Supervisor Shannon Adkins, RN, BSN, Rehab nurse Carol Frazer, BS, MA, CES, STAR, Exercise Physiologist Elyse Seckens, MS, HFS, MS, Exercise Physiologist Kirsten Zoller, BS, Exercise Physiologist Jimmy Harbaugh, BS, Exercise Physiologist Megan Beylo, BS, Exercise Physiologist Dianne Walters, RN, CVRN-BC, STAR, Rehab Nurse

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Outpatient Infusion A patient’s daughter says it all when she writes, “You have made a difference.” My father has been going through chemotherapy treatment for the past two years at AAMC. During this time I have wanted to pass along my praise and appreciation for the care he has received. The professionalism, kindness and compassion I have experienced will never be forgotten. There is no higher compliment to be made other than to say that I trust you with my father’s life. Before saying that we have an exceptional doctor and nurses, I want to tell you that they are extraordinary human beings. I don’t think any words could possibly be adequate to express my feelings of gratitude for the outstanding care my father has received. From the moment I met Dr. Jason Taksey, I knew my father’s care was in good hands. He is professional, extremely knowledgeable, kind, compassionate and above all so genuine in his approach. Dr. Taksey always has time to listen and answer any questions. His responsiveness to concerns is exceptional. This journey has been difficult for my family, but having an oncologist like Dr. Taksey makes this illness a little less rough.

The staff at the Infusion Center is also beyond compare. Three nurses in particular continue to care for my father and they treat my father as if he were their own. Thelma Andres, RN, Julie Buckel, RN, and Mary Shirley, RN, are “angels on earth.” My father is always greeted with a smile. These ladies are so kind to him and cater to his every need. I have never seen such kindness and compassion for others and I appreciate what they do far more than words can express. These individuals are an asset to AAMC. I want them to know that they have made a difference. Thank you.

Outpatient Infusion staff.

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Patient Stories

Critical Care Unit

Labor & Delivery and NICU

This letter of thanks comes from one of our own CCU nurses, Ruth Burall, BSN, RN.

There is something very special about recognition from a fellow nurse. This family member, who works at another organization, writes that she was “inspired…to be a better nurse” after observing the care her family received.

It’s been one year. One year since the fever that wouldn’t go away. One year since I almost lost it all. I begged for my life. I prayed. I placed ALL of my trust in my medical team. I learned what it is like to be a patient. I learned what it is like to have no control over anything. I learned how to re-learn. What I never did say was thank you. The healing and recovering from meningitis left me so busy, so forgetful, I never was able to take the time to say thank you to the people who saved my life. The ED, neuro care nurses, Dr. Yang – who did save my life – Dr. Degani, who came to me at my worst when I called. The other CCU docs and nurses who all watched me recover, helped me recover. To all of you from the bottom of my heart, thank you.

Ruth Burall, BSN, RN, is pictured with her CCU colleagues.

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I am taking the time to write you today about the exceptional experience that my family and I had at AAMC. My sister recently delivered her first child at your facility. She and her husband had planned to deliver at an affiliated birthing center, but she went into labor at 36 weeks gestation and was admitted to your hospital. To complicate things further, she had just left her husband at the airport to leave on a business trip. With all of her family hundreds of miles away, she bravely became a mother – not alone as it might seem, but with the amazing support and guidance of the nursing and medical staff in the L&D unit. Once she was able to reach her husband, the nursing staff even arranged for her to video chat with him during his flight so he could see both her and his new son.

Once I arrived to the hospital on Tuesday, I was admittedly anxious and worried for my family. The staff immediately put me at ease. From the volunteers in the gift shop, to the lactation consultants and nursing staff; everyone we encountered was kind, articulate, caring, and provided amazing care. To complicate things even further, on Wednesday evening, it became necessary for the newest member of our family to be transferred to the NICU – another unexpected turn in an already stressful week. Once again, I was amazed at the staff we encountered. The nursing and support staff in the NICU exemplify exactly what care should be: compassionate, collaborative and of the highest quality.

Lori went out of her way throughout our time in the NICU to listen, as well as teach. She provided comfort to my sister and ensured that we were all taken care of – physically and emotionally. Lori is an amazing asset to your institution and inspired me to be a better nurse. I have never written a letter of commendation – to any organization – but I was truly blown away by every aspect of AAMC. As a nurse and a visitor, I can truly say that I knew my family was getting the highest quality of care, by people who truly care about their patients.

Labor and Delivery team.

I would specifically like to mention two of the nurses in the NICU — Michelle Ritter, RN, and Polly White, RN. Both Michelle and Polly helped guide my family through a challenging time and did so with grace and poise. They instilled confidence in my sister during a time when she felt totally out of her element and out of control. I would also like to specifically mention Lori Wagner, CRNP, RN, and Yann-Yann Lin, MD. The daily rounds led by Lori and Dr. Lin could be a model for other centers across the country. Rounds were truly collaborative, including not only other disciplines, but most importantly our family. They answered every question we had and made us all, most importantly my sister and her husband, feel at ease leaving their new child in the care of strangers.

NICU team.

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Patient Stories

General Surgical Unit This handwritten letter of thanks from an appreciative patient praises the GSU team. I was recently a patient on GSU after I had surgery to remove a tumor from my colon. I planned on a short 3-5 day stay at your amazing hospital. However, my body decided not to cooperate and I was there for much longer. Any attempt I make to put into words how fortunate I am to have had the privilege of being cared for at AAMC will fall far short of my true feelings. So just let me say that your entire staff is made up of the greatest people ever assembled. Every minute of every day, I felt as if I was the only patient being cared for. I had no idea such an experience was possible. I didn’t get a chance to say thank you to everyone who got me though my recovery but please know that I thank them every day in prayer. Thank you and everyone at AAMC for your dedication and service. General Surgical Unit team.

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Celebrating Our Designation AAMC Achieves Magnet® Recognition In July of 2014, AAMC welcomed three very experienced and accomplished Magnet® appraisers to our campus for a site visit, eager to show them the high quality of care we provide to our patients and families, each other, and our community. The appraisers spent three days, July 21, 22 and 23, discovering the knowledge and caring that defines AAMC nursing. During their time at AAMC, they: > held 22 interview sessions > toured 30 units > reviewed 8 medical records > met with 120 nurses, 25 physicians, 12 patients, 138 community members, and many of our partners in healthcare (Medical, Ancillary, Pharmacy, Respiratory, Rehab, Social Work, Care Management and Dietary staff) On September 15, 2014 after receiving a call from the AANC, Sherry made this overhead announcement: “I am thrilled to share that today, Anne Arundel has been recognized as a Magnet hospital. Thank you nurses and the whole Anne Arundel team for your care.”

An ecstatic Emergency Department staff after the appraisers toured their unit.

AAMC is Magnet designated! Tori Bayless, CEO/President, Sherry Perkins, PhD, RN, NEA-BC, FY 2015 COO/CNO, Rita Linnenkamp, MSN, RN, and Holly Greever, MSN, RN, Magnet Program Coordinators, receive the exciting call from ANCC.

Sherry Perkins, PhD, RN, NEA-BC, FY’15 COO/CNO, was proud to attend the luncheon for Magnet CNOs.

This designation recognizes our consistent commitment to excellence in quality, patient satisfaction and the work environment. The celebration that began on this day continued to a grand announcement in October at the ANCC Magnet® Conference in Dallas, Texas.

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Thank You you from the Chief Nursing Officer Thank you all for the warm welcome I received as I joined the AAMC Nursing team as your Chief Nursing Officer in September 2016. ItIthas hasbeen beenaa true honor to embrace the inspiring lead of past CNO, Sherry Perkins, and carry on the legacy of nursing excellence for which AAMC is known. In my time here, I’ve learned a lot as I talk with you and other healthcare providers, as well as patients and their families. I’ve seen firsthand your knowledge, your caring, and your commitment to maintaining the highest professional nursing standards. After reading the nursing accomplishments featured in this report, I’m sure you’ll agree – the story of AAMC Nursing is one of compassionate, skillful care, innovative practice, collaborative teamwork and commitment to patient- and family-centered care. We will continue to build on current performance and work together with our multidisciplinary partners to advance improvements in: Excellent Nursing Quality > Meet organizational and unit-based quality targets, outperform benchmark for nurse-sensitive indicators and core measures, including CAUTI, CLABSI, falls, HAPU, specialty nurse-sensitive indicators and clinical variation. > Improve care coordination, continuity of care and attention to health equity.

Excellent Patient Satisfaction > Meet organizational and unit-based targets to outperform benchmarks for nurse-sensitive patient satisfaction. > Implement handover reports with improved compliance and quality through bedside shift report. > Develop initiatives to support community-wide patient education. Excellent Practice Environment > Implement Implementand andbuild buildon onRN RNwell-being well-beingactions. actions. > Assess the RN work environment through the NDNQI RN Satisfaction Survey. > Include Advanced Practice Nurses in decision-making structures. > Meet goals for supporting nurses’ professional development for advancing formal nursing education (BSN, MSN) and professional nursing certification goals. These areas support AAMC’s Vision 2020 to provide the highest level of care to our patients and families, and build a healthier community. With such a strong foundation already laid, I look forward to what’s ahead. With gratitude,

Barbara Jacobs, MSN, RN Chief Nursing Officer Anne Arundel Medical Center

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