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SENTARA MARTHA JEFFERSON NURSING ANNUAL REPORT

2017

Lindsay Znotens, BSN, RN & Anne Roane, BSN, RN

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Johnsa Greene-Morris, MBA, MHA, BSN and Nancy Maloy, MSN, RN, NE-BC

TRANSFORMATIONAL LEADERSHIP TRANSFORMATIONAL LEADERSHIP

A note from Nancy Maloy on 2017 and her years of service to nursing at Sentara Martha Jefferson Hospital…As I reflect on my 40 years at MJH, I just have to say that this is a very special place to work. We have done some amazing things here in the years that I have been with this organization. I feel very fortunate to work with people in the most trusted of professions – nurses. We care for the sick in their greatest hour of need, when their fears overtake reason, and their families are most troubled and despondent. You do it with patience, grace, and compassion and for most of us it is why we became nurses or went into healthcare in general. Our mission, to improve health every day, is the foundation upon which we deliver care to all our patients. Everyone contributes, everyone has a voice and a purpose, and everyone makes the whole stronger and the organization better.

This year, 2017, has been a tough but rewarding year for me. We’ve experienced another national nursing shortage and therefore severe staffing issues; increased ED boarders/holds; we saw an increase in C. difficile cases

and were unable to meet that goal; and we’ve changed our focus on falls with injury to better align with our safety strategy. However, we’ve also done very good work in meeting our ED treat and admit goal of 240 minutes from door to inpatient bed; we exceeded our patient satisfaction goal with a score of 81.7; exceeded our Readmission and Hospice rates goals; and we achieved the national benchmark of 93% for retention of new graduate RNs.

In November I began preparing to step down from the role as Chief Nursing Executive (CNE) and transitioned my responsibilities to Johnsa Morris, MBA, MHA, BSN. Johnsa has 30 plus years of experience as a nurse and with the Sentara system. I know she will bring much needed change to nursing and to our care processes. Change can be a very powerful force which brings new energy to old work, fresh eyes to familiar problems, new leadership to stale situations, and can cause synergy where least expected.

As I prepare to leave SMJH, I just want to remind everyone of the duty in nursing to teach, guide, and share your knowledge with novices. I believe that nursing has a collective responsibility to “pay it forward”. I encourage each of you to reach out to others to provide whatever mentorship, motivation, inspiration, guidance, and direction it takes to advance your education, skills and nursing careers. Through authentic leadership, skilled communication, true collaboration, effective decision-making, appropriate staffing, and meaningful recognition we can foster an environment where respect for all team members is valued and where excellence in nursing care is the common goal. Leading this nursing organization as the CNO for the past three years has been a privilege and honor. Thank you for keeping the Caring Tradition of Martha Jefferson Hospital alive and well! You make a difference!

Nancy Maloy, MSN, RN, NE-BC

Our 2017 nursing accomplishments at Sentara Martha Jefferson Hospital can be directly linked to the leadership of prior Nurse Executive, Nancy Maloy, MSN, RN, NE-BC. In November of 2017, I transitioned to Sentara Martha Jefferson Hospital as Vice President and Chief Nurse Executive. Although new to Martha Jefferson, I know the ropes of Nursing, of leadership and of Sentara. I started my career with Sentara as a nursing assistant at Sentara Norfolk General Hospital while in pursuit of my RN degree. My 30 year career path has helped me to better understand the role of the nurse and the impact one can make when empowered to reach beyond the status quo.

As I embark on this new and exciting role as your Nurse Executive, I would like to share with you what I envision for nursing and our interdisciplinary collaboration at SMJH. I envision every nurse playing a role in the development and implementation of processes that reflect growth, innovation and autonomy. I believe the innate demeanor of the registered nurse is influential, intuitive and imaginative; all of which makes the career path for the registered nurse a dynamic piece of art that can be molded to serve many roles. I believe that persistence and accountability is driven by our courage to stand up for what is right for our patients, our team and ourselves; that a healthy work environment enhances resiliency and preparation for change to come.

I believe the team at SMJH has impacted and will continue to impact the very foundation upon which we stand to affirm our mission to improve health. Our intrinsic drive to inspire, innovate and influence excellence in nursing practice will enable the engagement and resilience of our teams.

Johnsa Morris, MBA, MHA, BSN

Inspire, Innovate, Influence


Sentara Healthcare’s Philosophy of Nursing outlines the beliefs that help to support the overall mission and vision. We believe:

• The foundation for our work is a culture of safety and accountability;

• Our nursing practice foundations differ between facilities as we respect the culture, history, and diversity of patient populations;

• Our responsibility is to create a caring and compassionate relationship with patient/client/family;

• As nurses, we collaborate with the healthcare team to use evidence-based practice in providing care;

• Nurses assess, manage, coordinate and evaluate the care and education of the patient/family along the continuum of care.

• Our vision is to create an environment of health and healing.

Sentara Martha Jefferson Philosophy of Nursing We believe in the following principles or values that help support the achievement of the broader hospital and discipline mission and philosophy:

• Every nurse is a leader.

• Nurses promote the physical, spiritual, and emotional well-being of our patients and families as embodied in our caring tradition.

• Nurses treat patients and their families with respect, dignity and compassion with our “caring tradition”, sharing the joy of birth, healing the sick, and offering heartfelt care to the dying.”

• Nursing practice is both an art and a science that is based on its own distinct body of knowledge.

• Nursing is a collaborative practice that acknowledges the contribution and value of all professional caregivers, ancillary staff and the patient’s input as the best means of providing excellence in care.

• Nursing involves a lifelong commitment to education, learning, teaching and the willingness and flexibility to manage change.

• Nursing is a partnership with those to whom we provide care and education.

• Nursing offers equality of care to patients, their families and loved ones regardless of cultural, social and economic differences.

• Nurses exhibit accountability for their own clinical practice as well as responsibility for the fiscal implications of their care.

• Nurses continually seek to enhance their competence and skills as new knowledge and technology become available.

TRANSFORMATIONAL LEADERSHIP TRANSFORMATIONAL LEADERSHIP

MissionVisionValues

Sentara Healthcare Sentara Nursing

We improve health every day. We improve health every day through nursing excellence.

To be the healthcare choice of the communities we serve.

To create an environment of health and healing.

People, Quality, Patient Safety, Service & Integrity

• Nurses nurture and mentor each other, embracing both new graduates and nurses returning to the profession.

• Nurses enhance quality care by continually seeking opportunities for process improvement.

• Nurses create a professional practice environment where patient care is evidence-based, and nursing research is both valued and encouraged.

Sentara Martha Jefferson Hospital Professional Nursing Practice Model


STRUCTURAL EMPOWERMENT STRUCTURAL EMPOWERMENT

Shared Governance

Sentara Martha Jefferson Hospital has had an active nursing Shared Governance for over a decade. As part of a healthcare system, the need to align with the system councils and develop strong communication channels was identified. In the summer of 2017, a Shared Governance Steering Committee was formed with representatives from key areas of nursing in the organization: the chief nurse executive, directors, managers, current council chairs and other staff nurses, educators, case management. The Index of Professional Nursing Governance (IPNG) Survey along with questions specifically geared to analyze SMJH’s current processes and structures was administered to all nursing staff. The steering committee reviewed the IPNG survey results, information gathered from focus groups with managers, educators, and staff nurses, information from other hospitals within and outside of the Sentara system, and findings in the literature. The information was analyzed and used to identify both opportunities to strengthen structure and processes as well as recommendations for improvement during weekly meetings of the committee. Modifications to the current structure and process were recommended by the SG Steering Committee. Plans were developed for restructuring and educating to the new structure, process changes, and shared governance in general.

Several nursing staff representatives along with nurse educators met to plan, develop, and carry out a Shared Governance Fair. The fair included a hot cocoa bar, informational posters explaining the new shared governance structure, and prizes for attending. The new structure and processes were discussed in shared governance councils and staff meetings and included in the nursing newsletter over a period of several months. Two offerings of the Shared Governance Academy were planned for January and March of 2018 in order to educate staff about shared governance at SMJH and prepare council members, chairs, and sponsors for the upcoming year.

The full IPNG survey will be repeated in 2019, after the changes have been in place for at least one year. Shared governance will continue to be evaluated, supported, and tweaked as needed via the new Shared Governance Coordinating Council.

Below are some of the highlights of what the central shared governance councils worked on in 2017:Celebrations and recognitions:

• Week of the Nurse

• Certified Nurses Day Celebration

• Graduation Celebration

• Goody bags and notes for nurses in school

Shared Governance Academy

Hospital and unit BSN and Certification rates

Education Fair

Creation of VitalLink nursing newsletter

Evidence-based practice projects:

• Continuous pulse oximetry for post operative patients

• Suggamedex: do the benefits outweigh the cost for a reversal agent for patients receiving general anesthesia

• Walkability in Cancer Survivors

• Use of glucose on neonates’ gums to stimulate bonding and breastfeeding

SMJH Nursing Poster Presentation

SIPC and Obs/PCDU waiting room process

Roll-out of “The Moment” or “The Pause” – a concept developed by Jonathan Bartels that allows for the family and healthcare team to acknowledge the patient and the care team after a patient has passed away


Presidents Awards


This year, two nurses were recognized as President’s Award recipients in recognition of the exceptional care and service they provide to their team, patients, and to Sentara Martha Jefferson Hospital. Below are excerpts from their nominations:

DAISY Awards

In our second year of the DAISY program, twelve more nurses were recognized as honorees for their extraordinary and compassionate care. Each story and celebration was unique and a testament to the fact that the Caring Tradition is alive and well at Sentara Martha Jefferson Hospital. Our Magnet Champions/DAISY Committee selects three honorees from the fifty to sixty nominations submitted each quarter. All nurses that receive a nomination are presented with a letter from our CNE and a DAISY nomination pin.

In 2017, the committee also voted to begin presenting an annual DAISY Team Award and DAISY Nurse Leader Award. These awards will be presented for the first time in 2018.

Debbie Desmond, MBA, SPHR, SHRM-SCP, Jennifer Stancil, RN, Angela Bishop, BSN, RN, Johnsa Greene-Morris, MBA, MHA, BSN, Frank Jargowsky, Nursing Student, Ashley Gentry, Tara Williams, BSN, RN, Joshua Wright, BSN, RN

Patti Dawson, RN Susan Peterson, RN

Leadership Allison Crawford is always engaged and thoughtful in every decision she makes. She is a dedicated leader who, regardless of the situation, remains positive, seeking understanding and solution with complete resolution. Allison is resilient beyond measure and serves as an incomparable role model and leader.

Clinical Heather Noble goes above and beyond to improve patient care across the organization. Her commitment to her team is unwavering; even in times of adversity. Heather remains optimistic and steadfast in her dedication to create a positive environment for her co-workers and patients.

Gabrielle Rittenhouse, BSN, RN

Luis Morales, RN

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DAISY Award Winners

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Sarah Hobbs, RN

Loren Ivey, BSN, RN

DAISY Award Winners


Stacey Johnson, BSN, RN Roger Jackson & Tammy Kincaid, BSN, RN

Maura Rodriguez, BSN, RN Troy White, RN, CCRN

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Nurse AwardsCongratulations to this year’s nursing and nursing support person awards, and thank you for your extraordinary work.

HOLLY METZ AWARD - Maura Rodriguez, BSN, RN RN OF THE YEAR - Sarah Norris, RN

PRECEPTOR OF THE YEAR - Erika Halloran, RN SUPPORT PERSON OF THE YEAR - Raven Curtis, RN



Continuous Professional Development

Furthering Our EducationIn September, we once again recognized those who had become an RN or advanced their formal nursing education over the last year. While making the effort to develop ourselves professionally is incredibly rewarding both personally and professionally, it is no small feat to pursue a degree at any time in your life. It can be especially challenging to do so while working and even managing families. Sentara’s tuition assistance program provides financial support for tuition and books to help ease the financial burden. Based on feedback received from staff regarding the increasing costs of school, the amount of tuition assistance was doubled for the upcoming year. Besides Sentara’s tuition assistance, our local community also provides tremendous financial support for nursing education via the Haden Nursing Institute. Our community believes in supporting and developing a strong nursing presence at SMJH and does so by providing scholarships that pay for up to 90% of tuition costs for our nurses.

RN:

Megan Crowley, RN (Wendel 3)

Caitlyn Elliott, RN (Cornell 2)

Katelyn Seay, RN (Cornell 2)

Megan Stokes, RN (Cornell 3)

Tiffany Townsend, RN (Physician Practice)

Camry Yates, RN (Cornell 3)

RN to BSN:

Sue Ann Asby, BSN, RN (Admit/Recovery)

Stephanie Dudley, BSN, RN (Nursing Admin)

Drena Faris, BSN, RN (Wendel 3)

Tiffany Fick, BSN, RN (Wendel 1)

Becky Fletcher, BSN, RN (OSC)

John Hammer, BSN, RN, NREMT-P (FSED)

Jenny Hughes, BSN, RN (Admit/Recovery)

Samantha Level, BSN, RN, PCCN (Cornell 1)

Jennifer Lyons, BSN, RN (Obs/Peds/CDU)

Ashley Mawyer, BSN, RN (Cornell 1)

Danielle Merritt, BSN, RN (PACU)

Lyndsey Schaffer, BSN, RN (Cornell 3)

Pamela Schlunz, BSN, RN (Cornell 2)

Molly Schwoebel, BSN, RN (Cornell 1)

Lisa Smith, BSN, RN (Cornell 1)

Tammie Smith, BSN, RN (ED)

Ivy Talley, BSN, RN (Cornell 3)

Amy Undercoffer, BSN, RN (Cath Lab)

Joanne Visnesky, BSN, RN (Cornell 2)

Meredith White, BSN, RN (Cornell 2)

LaDonna Winegar, BSN, RN (Cancer Center)

BSN to MSN:

Kiley Bailey, MSN, RN, RNC-OB (Wendel 3)

Amanda Deinlein, MSN, RN, PCCN (Nursing Education)

Jennifer Gaines, MSN, RN, CHSE (Nursing Education)

Gina Gilmore, MSN, RN, AGACNP, CCRN (Wendel 1)

Melissa Proffitt, MSN, RN, RN-BC (Admit/Recovery)

MSN to DNP:

Judy Kauffman, DNP, RN, CNN (Nursing Admin)

Patra Reed, DNP, RN, CNML , CCCTM (Integrated Care Management)

Congratulations to the following nurses who achieved or advanced their degrees between September, 2016 and September, 2017:

Certifications

Sentara Martha Jefferson Hospital encourages our nurses to enhance their professional practice by becoming certified in their specialty area. Not only does Sentara participate in many programs to help pay up front for certification exam fees, the Haden Nursing Institute continues to provide reimbursement to those nurses who successfully pass their certification exams for recertification or for those nurses whose certifications do not fall under one of these programs.

In 2017, Sentara further expanded its partnerships with certifying organizations to provide even more opportunities for nurses to take their specialty certification exams without incurring any out of pocket expense. Our programs now include:

• American Association of Critical-Care Nurses (AACN) Vouchers

• American Nurses Credentialing Center (ANCC) Success Pays™

• Medical-Surgical Nursing Certification Board (MSNCB) FailSafe

• Orthopaedic Nurses Certification Board (ONCB) Retest for Success

• National Certification Corporation (NCC )

• Certifed Perioperative Nurse CNOR Take 2 Program

• Board of Certification for Emergency Nursing (BCEN) Yes You Can!

• Oncology Nursing Certification Corporation (ONCC) Freetake

In addition to these programs, nurses are also able to participate in certification prep courses through Sentara’s subscription to CE Direct. The Haden Nursing Institute has also enhanced this subscription to provide SMJH nurses with access to Focused CE Direct, providing multiple online certification prep courses and Continuing Education Units (CEUs).

The following nurses are to be commended for their commitment to professional growth and to the safe and effective care of our patients by achieving and maintaining their specialty nursing certifications:

Admit Recovery:Paula Alberts, RN, RN-BCMelissa Proffitt, BSN, RN, RN-BCJoy Rosson, RN, CPNSusan Wheeler, RN, CMSRNLinda White, RN, CMSRNAmy Williams, BSN, RN, CPAN


Regina Perkins, BSN, RN, Mike Bannister, RN, Melissa Proffitt, MSN, RN, RN-BC, Katie Olsen, BSN, RN, Jennifer Frashure, BSN, RN



Radiation Oncology:Marsha Taylor, RN, OCN

Cath Lab:Sara Morris, BSN, RN, CMSRN

Surgical Services:Marcia Arnold, RN, CNORLori Boles, BSN, RN, CNORTee Goyer, BSN, RN, CNOR, RNFAJulianna Hoback, BSN, RN, CNORVictoria Wright, BSN, RN, CNORKaitlin Young, BSN, RN, CNORVascular Interventional Radiology:Andrew Fletcher, BSN, RN, CEN, CFRNMark Mayberry, BSN, RN, RN-BCCarla Morris, BSN, RN, CCRNRoy Tomlin, BSN, RN, CCRN

Infusion Center:Hollis Campbell, BSN, RN, OCNJessica Cooper, BSN, RN, OCNAurora Durkee-Warren, RN, RN-BCPatricia Kearns, RN, OCNMike Nelson, BSN, RN, OCNElizabeth Pruette, MSN, RN, OCNLeanna West, BSN, RN, OCN

Cancer Care Services:Janelle Gorski, MSN, RN, ANP-BC, AOCNPMary Beth Revak, BSN, RN, OCN Valerie Wright, BSN, RN, CGRN

Cornell 1:Dana Graves, BSN, RN, PCCN Barbara Holman, BSN, RN, CCRNSusan Humphrey, MSN, RN, PCCN, SCRNSamantha Level, RN, PCCNSusan Loomis, RN, PCCNGail Parrish, BSN, RN, PCCNTony Sapino, BSN, RN, PCCN

Lyndsey Schaffer, RN, PCCNLisa Smith, BSN, RN, SCRNKathleen Trainor, BSN, RN, RN-BC

Cornell 2:Deborah Brown, BSN, RN, RN-BCAndrea Caldwell, BSN, RN, CHPNJulie Drexler, RN, RN-BCKable Pluger, RN, RN-BCKrystyna Portell, BSN, RN, RN-BC Pam Schlunz, BSN, RN, RN-BCPatricia Scott, BSN, RN, RN-BCLila Smith, BSN, RN, RN-BCDanine Stoner, RN, RN-BCMeredith White, BSN, RN, RN-BC


Certifications

Cornell 3:Vera Gibson, RN, CMSRNEbony Lindsay, BSN, RN, CMSRNMelinda Schmidt, RN, CMSRNShaela Shifflett, RN, CMSRNStacey Williams, BSN, RN-BC

Obs/Peds/CDU:Whitney Digney, M.Ed, BSN, RN, CMSRNTamara Talley, RN, CPN

Endoscopy:Layne Brophy, BSN, RN, CGRNKarron Good, RN, CGRN

Wendel 1:Kathleen Ellis, RN, CCRNTenaya Thurston, RN, PCCNEmily Peterson, BSN, RN, PCCNVictor Somers, RN, CCRNKristin Walker, MSN, RN, CCRN Carol Wayner, BSN, RN, CCRNJose Sta Ana, BSN, RN, CCRNHillary Bowen, BSN, RN, CEN, NREMT-PEmily Brady, MSN, RN, CNLNina Dennis, BSN, RN, CCRNNicole Kirby, MSN, RN, CCRN

Troy White, RN, CCRNHilda Taylor, DNP, RN, CCRN, PCCN, CNLAshley Nelson, BSN, RN, CCRN

Wendel 2:Teresa Brock, BSN, RN, ONCShannon Welch, BSN, RN, ONCEmergency Department:Gerald Perry, RN, NREMT-PBeth Sousa, BSN, RN, CSRNFree-Standing ED:John Hammer, RN, NREMT-PBrittany Shifflett, RN, NREMT-B

Wendel 3:Crystal Adcock, RN, C-EFMKiley Bailey, MSN, RN, RNC-OBTina Connell, BSN, RN, RNC-OBStephanie Dennis-Bowers, RN, RNC-OBHeidi English, BSN, RN, RNC-NICSharon Fickley, MSN, RN, RNC-OB, C-EFM, CNLAmanda Harrison, BSN, RN, C-EFMChristine Hibbert, RN, RNC-OBLaura Matheny, BSN, RN, C-EFMPenny Merrel, BSN, RN, IBCLCAllyson Michaels, BSN, RN, IBCLC

Erin Muller, BSN, RN, RNC-OB, IBCLCKatherine Rainey, BSN, RN, IBCLCWendy Rutan, RN, RNC-LRNLaura Salvatierra, BSN, RN, CLDElaine Shinsky, BSN, RN, RNC-OB, EFM-CKristin Von Thelen, BSN, RN, RNC-OB

Nursing Education:Amanda Deinlein, BSN, RN, PCCNCarrie Ferrel, BSN, RN, CENDonna Freeman, BSN, RN, CNORAshley Mangum, BSN, RN, CCRNCarolyn Ramwell, MSN, RN, COCN


Certifications

CANCER CENTER GOES PINK: Back Row (L to R): Janelle Gorski, MSN, RN, ANP-BC, AOCNP, Dr. Erika Struble, Jennifer Raymond, MSN, RN, Patti Kearns, RN, Jill Hall, Pam Schlunz, BSN, RN, RN-BC, Josephine Thacker, Hollis Campbell, BSN, RN, OCN, Lori King, Shawna Stokes, RN, Jessica Cooper, BSN, RN, OCN, Erica McLeod, Brandy Maxton, RN, Dr. Andrew Romano Front Row (L to R): Katelyn Blondino, Sarah Hartsock, RN, Lauren Roach, LaDonna Winegar, BSN, RN, Amy Brown, BSN, RN

Mary Beth Revak, BSN, RN, OCN

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Nursing Resource Pool:Norah Anderson, RN, RN-BC

Patient Educator:Bev Castrina, RN, RN-BCAngie Craig, BSN, RN, OCN

Cardiac Rehab (Health & Wellness):Debbie Wilkinson, BSN, RN, RN-BC, CCRP

Integrated Care Management:Jamie Caruccio, BSN, RN, CCMKaren Fassel, BSN, RN, ACMSusan Lebeis, RN, CCMPatra Reed, MSN, RN, CNMLPatient Safety & Quality:Megan Hall, BSN, RN, RN-BCChristi Hankle, MSN, RN, CNRN

Outpatient Surgery Center:Patricia Arcidicono, MSN, RN, CAPA Dawn Haasnoot, BSN, RN, RN-BCJody Reilly, MSN, RN, CAPAPatricia Sawyer, BSN, RN, CNORRobin Workman, BSN, RN, CMSRNSurgical Program Development:Connie Summy, BSN, RN, ONC

STRUCTURAL EMPOWERMENT


Certifications

PASS:Teresa Haynes, BSN, RN, RN-BCMary Huff, BSN, RN, RN-BC

Practices/Hospitalist Group:Peggy Bishop, MSN, RN, AANP, ACHPNBeth Carta, RN, CMSRNBarrie Carveth, MSN, RN, FNP-CJennifer Hall, MSN, RN, CEN, AGACNP-BCAngie Honeycutt, MSN, RN, ONC, FNP-C Jessica Kenty, MSN, RN, NP-CNicole Lepsch, MSN, RN, FNP-CElizabeth Lawwill, BSN, RN, FNP-C, CMSRNBarbara Martin, BSN, RN, CDE, WHCNPCaroline Mateja, MSN, RN, CCRN, AGACNP-BCMatthew Mildonian, MSN, RN, FNP-CCynthia Napier, MSN, RN, FNP-CImelda Solis, RN, RN-BCLaura Trissel, MSN, RN, OCNGenevieve Barron, MSN, RN, AANPCPGina Gilmore, MSN, RN, CCRNChris Hucks, MSN, MBA, RN, NP-C, NRP

Administration/Nursing Administration:Amy Black, DNP, RN, NEA-BCAllison Crawford, BSN, RN, CRNILaura Decker, BSN, MSHA, RN, NEA-BCAbby Denby, MSN, RN, NE-BCMina Ford, MSN, RN, AOCNS-BCJudy Kauffman, DNP (C), MSN, RN, CNNNancy Maloy, MSN, RN, NE-BCKelly Via, BSN, RN, RN-BCBeth Vitolo, BSN, RN, NREMT-B


MAPP

Clinician IIIAllred, KimberlyBannister, Mike W.Dawson, PatriciaDennis, NinaDillenbeck, TamseyDurkee-Warren. AuroraArgon, DeborahBarnard, SusanBoyd, Roben L.Brandt, SusanBrooks, Elizabeth M.Burnett, LoriCaldwell, AndreaConner, JacquelineCramer, VirginiaCritzer, Rebekah SeayCrusse, KendallFrashure, JenniferGarmey, SarahGoettlich, BrianneGoranson, Connie L.Guinn, Ana KarinaHenderson, Gabriel H.

Henley (Pluger), KableHoover, RebeccaJohnson, RachelKaraca, AdelleKearns, PatriciaKunk, Heather PLandis, JoshLevel, Samantha G.Maxton, BrandyMcgee, Dannette

Mcgehee, JamieMohr, JoshuaMorris, AlexisMorris, CarlaOrange, KatherineRead, SaraShifflett, ShaelaSilverman, SarahSims, ShaneSmith, Gabrielle

The following nurses achieved a Clin III or higher on the Sentara Martha Jefferson Advancement in Professional Practice (MAPP) clinical ladder program:


Luis Morales, RN



MAPP

Squire, CariSquire, KellenStokes, ShawnaSznajder, SamanthaTalley, RebeccaWalsh, MeghanWest, LeannaWheeler, SusanWhite, LindaWilliams, AmyWoodside, Allison E.

Clinician IVAdams, AmyAnderson, HeidiBegert, Diann B.Bossieux, ConnieBraenovich, MaggieBrown, Amy CBrown, Amy L.Butler, Kathryn H.Campos, AmberCastrina, Beverly S.Clatterbuck, Sheri M.Colley, MichelleDeane, (Ashley)Danielle

Clinician IVDickinson, Nicole M. Drumheller, M. Brittany L.Ellis, KathleenEnglish, Heidi WolfeFick, TiffanyFord, Lietzle A.Gentry, TamaraGlover, ShellyHaynes, Teresa G.Huff, Mary F.Hughes, JenniferJohnson, Stacey

Kimble, CourtneyKrevansky, Kathy L.Matheny, Laura T.Morris, Sara S.Nania, PaulaNoble, HeatherPainter, Maura (Liz)Peterson, EmilyPetrella, Barbara Pippin, Paula M.Proctor, KevinSacre, Michelle


Rachel Ragland, RN and Vanessa “Nicole” Lawson, RN

MAPP


Schaffer, LyndsaySchlunz, PamelaShaffer, BethanyShinsky, Elaine C.Smith, Tammie W.Stancil, JenniferToliver, Etta C.Tomlin, Roy G.Undercoffer, AmyWelch, ShannonWilliams, Stacey L.Wright, VictoriaYoung, KaitlinRowe, Crystal A.

Clinician VArnold, Marcia D.Brown, Deborah A.Cooper, Jessica L.Gilmore, Gina L.Good, KarronMelander, VictoriaMerritt, DanielleMichaels, Allyson M.Parrish, Sharon G.

Rosson, Joy P.Sawyer, PatriciaScott, PattySmith, Lila J.Smith, LisaTaylor, HildaVon Thelen, KristinWayner, Carol A.Wilkinson, Debbie D.

JOINT CENTER DISCHARGE BRUNCH, Abby Denby, MSN, RN, NE-BC



SMJH PUBLICATIONSYear Author/Authors Subject Title Publisher,

Journal or Website

2017 Susan Winslow, DNP, RN, NEA-BC; Joani Brough, MSHA, BSN, RN, NE-BC; Lesley Cook, MSN, RN, NE-BC; Susan Cutrell, MSN, RN, NE-BC; C. J. Robison, BSN, RN, CMRSN; Catherine Smith, MSN, RN, CCNS, CCRN

Transformational Impact on Direct Care Nurses Supporting the Magnet Site Visit

Nursing Administration Quarterly, July/September 2017, Volume 41, Issue 3

2017 Valerie Lacey, RN, BSN, CGRN; Karron Good, RN, ADN, CGRN; Chris Toliver, RN, AND; Shirley Jenkins, MT(ASCP),Pamela B. DeGuzman, PhD, RN, CNL

Evaluation of 12-Week Shelf Life of Patient Ready Endoscopes

In press at Gastroenterology Nursing

SMJH POSTERSYear Author/Authors Subject Title Place of

Presentation National (N), Regional (R), or Local (L)

2017 Heather Noble, Danielle Merrit Sugammadex: Do the benefits outweigh the cost?

ASPAN (N)

2017 Heather Noble Which postoperative patients need continuous pulse oximetry?

Virginia Commonwealth University EBP Symposium (L)

2017 Heather Noble Which postoperative patients need continuous pulse oximetry?

University of Virginia EBP Symposium (L)

Continuous Professional Development Workforce

NRP COHORT 3 WITH VALENTINE’S DAY STRESS RELIEF STRING ART: Susan Bankowski, Shantay Bennett, Emily Brady, Kimberly Chafee, Megan Crowley, Brandi Hicks, Catherine Kipps, Alexandra Kownurko, Ashley Mawyer, Kathryn Murray, Megan Stokes, Ivy Talley, Mary Van Clief, Vickie Walker, Camry Yates, Lindsay Znotens, Ashley Mangum

New grads in NRP 44

Enrolled in a program to further their education

MAPP participants

Currently on scholarship 67

82

123 26%Specialty Certified

62%BSN

or higher degree

Meghan Walsh, BSN, RN, Shane Sims, BSN, RN, Amy Undercoffer, RN (Not Pictured: Amber Campos, BSN, RN)

Danielle Merritt, BSN, RN and Heather Noble, BSN, RN



FoundationThe Haden Nursing Institute is an investment in arguably the single most important aspect of great care and outstanding outcomes—the expertise and compassion of the nurses who serve our patients. Funded by the generosity of our community’s philanthropy, the Haden Nursing Institute will continue to focus on and support those expectations for the future good of our community.

With over $14 million raised in gifts and endowment, this multimillion-dollar initiative fosters nursing excellence through community philanthropic support for formal education and professional

certification, funding for nursing research and evidence-based practice fellowships and practice innovations, support for a clinical simulation learning lab, funding for expansion of advanced practice nursing roles, and capital support for implementation of best practices and innovative care delivery models.

Scholarships, primarily for RN to BSN education, is a core component of the Haden Nursing Institute. In the past several years, 140 scholarships have been awarded with 68 nurses currently on scholarship and in school. Scholarships have also been provided for Masters Degrees and for a few

Nurse Practitioners. We are looking at how we can also support Hospital staff who may want to enter nursing as a career with support at PVCC for their Associates Program.

Below is a summary of the many nursing initiatives that are generously supported through financial contributions from the Haden Nursing Institute:

• Magnet® designation

• DAISY nurse recognition program

• Nurse Residency Program

• Professional conference attendance

• Research and Evidence Based Practice Fellowships

• CE Focus certification preparation courses

• Nursing Scholarship Program, especially RN to BSN

• Certification reimbursement

• Our Clinical Skills Laboratory

• Expansive roles in Nursing, such as NP’s in Palliative Care, High-Risk Breast Cancer and Cancer Survivorship Programs and our new Senior Services Nurse Navigator.

Workforce

Anita Carver, BSN, RN

Dannette McGee, RN

EXEMPLARY PROFESSIONAL PRACTICE

Nurses: Inspire, Innovate, InfluenceJim McCoy, Jennifer Kilel, BSN, RN, Sengbu Myitung, BSN, RN, Rebecca Critzer, RN, Karen Kossin, Shawna Dacus, Michael Miller, Carolyn Ramwell, MSN, RN, COCN, Beth Giles, BSN, RN, Genevieve Barron, MSN, RN, AANPCP

Inspirational Leadership and Innovative Care are Influencing Outcomes

At Sentara Martha Jefferson, our nurses embody the ANA’s 2018 Week of the Nurse theme of “Nurses: Inspire, Innovate, Influence”. Cornell 3 is one example of where inspirational leadership and innovative care has come together to positively influence patient outcomes.

Cornell 3 outperformed the national benchmark for all seven Magnet RN categories included in the 2017 Member of the Team Survey: autonomy, professional development, leadership access and responsiveness, interprofessional relationships, fundamentals of quality nursing care, adequacy of resources and staffing, and RN-to-RN teamwork and collaboration. Their patient satisfaction score for 2017 was 83.4%, surpassing their goal of 81%.

Cornell 3 had a remarkable year in regard to other nurse-sensitive indicators with zero Catheter Associated Urinary Tract Infections (CAUTIs), zero Central Line Associated Blood Infections (CLABSIs), and zero Hospital Acquired Pressure Injuries (HAPIs).

Anita Carver is the nurse manager of Cornell 3 and attributes the unit’s success in these areas to great teamwork and low staff turnover. One might dig further to uncover that perhaps the dedicated team on Cornell 3 is a result of Anita’s inspirational leadership. She consistently sets high expectations for her team, inspects what she expects, and is willing to roll up her sleeves to provide patient care when needed. Her positive attitude and dedication are evident and contagious. She believes in developing leaders and has done so with her unit coordinators as well as our new managers recently hired in the hospital. To help onboard these newer leaders, she has developed a manager’s book that starts with “characteristics of a good manager”. Anita strives to get to the heart of her patients and staff in order to provide for their needs and wants. And, in return, the staff of Cornell 3 have come together as an outstanding example of teamwork; consistently rising to challenges, and providing excellent care resulting in positive outcomes for their patients.


EXEMPLARY PROFESSIONAL PRACTICE EXEMPLARY PROFESSIONAL PRACTICE

Empirical OutcomesInspirational Leadership and Innovative Care are Influencing Outcomes

Nurses: Inspire, Innovate, Influence

While Sentara Martha Jefferson Hospital continues to outperform the national benchmark mean for these nurse sensitive indicators, our nurses are consistently working to further improve these outcomes.

Falls with Injury

Catheter Associated Urinary Tract Infections (CAUTIs)

Hospital Acquired Pressure Ulcers Stage 2 & Above

Ventilator Associated Events (VAEs)

Central Line Associated Blood Stream Infections (CLABSIs)

Anita Carver, BSN, RN, Meghan Rowland, BSN, RN, Nicki Eheart, Chris Smith, Liz Painter, BSN, RN,

Dannette McGee, RN

INTERDISCIPLINARY ROUNDS ON CORNELL 3: Anita Carver, BSN, RN, Liz Painter, BSN, RN, Ed Lewis, Sandra Sheppard, Claire Hampton,

Crystal McNabb, Maryanne Higgins, Tammy James, Ahmed Murtuz

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EXEMPLARY PROFESSIONAL PRACTICE

Hospital Acquired Pressure Injuries (HAPI)As our Wound, Ostomy Continence Clinical Nurse Specialist, Carolyn Ramwell describes the interdisciplinary teamwork in place at SMJH that results in consistently stellar results for our patients in regard to skin care and the prevention of pressure injuries. Along with the teams and their efforts she highlights below, Carolyn should also be recognized for her passion and tireless efforts to educate, engage, and empower our staff and patients so that they are able to recognize those patients at high risk and provide the care needed to not only prevent pressure injuries but, in many cases, even improve the condition of their skin both while in the hospital and after they return home.

Hospital Acquired Pressure Injuries (HAPI) is the term used to describe bed sores or other pressure injuries that patients develop while in our care. It still remains one of the most common and significant challenges in health care today for decreasing harm. HAPI is a nurse-sensitive indicator, meaning that our nurses, nursing care partners, and techs can greatly impact this indicator by following best practice and providing early intervention for our most at-risk patients. At SMJH, our nurses, nursing care

Jennifer Kilel, BSN, RN and Carolyn Ramwell, MSN, RN, COCN

partners, emergency department staff, nutritionists, physical and occupational therapy staff either review the patients at high risk for developing PIs and provide early intervention for skin safety.

How do we work together to prevent HAPIs in our patients?

The operating room staff is diligent with positioning for their specific surgical procedures. Our emergency department has become a solid partner in providing frontline interventions. The ICU identified key risk factors and started talking to patients, their families and the team on the importance of turning and pressure injury prevention. They

also purchased state of the art low air loss beds to place are most vulnerable patients in a healing environment. The inpatient unit staff all own the title “Skin Champion”. The nursing care partners are empowered to leverage commodity use and interventions. Our patient transporters use slide boards and take extra care with moving our at risk patients. This multidisciplinary approach works collaboratively to ensure best practice and injury prevention.

The power of WE is what prevents pressure injuries. Our team work is all part of the caring tradition at SMJH.

NEW KNOWLEDGE, INNOVATIONS & IMPROVEMENTS

As the Orthopedic Navigator, Connie Summy has a vast scope of responsibility to ensure quality care and education for our orthopedic patients. In 2017, her role was expanded to include care of the patient outside the hospital’s walls. Connie is now able to follow patients throughout their entire joint replacement experience, from pre-op to months post-surgery.

Pre-operatively, Connie teaches our Joint Camp; a class for all patients scheduled for their joint replacement and their Care Partners. Connie reviews how they can prepare for surgery as well as what to expect the day of surgery, during their hospitalization and after surgery. During this class she gets to know each patient’s goals and plans for after surgery.

Following their surgery, Connie visits the patients while they are here and holds a “Happy Hour” every afternoon following the group Physical Therapy session. During this time, she provides light refreshments and reviews discharge instructions, tips, and information about the patients next site of care.

Once a patient is discharged, Connie continues to be a resource for patients.

Each week, Connie visits those patients who are discharged to local skilled nursing facilities (SNF). She takes this opportunity to work with the SNF staff; answering questions and clarifying orders within her scope. She ensures there is a clear plan in place for the patients to transition home as soon as safely possible. She visits the patients to ensure they are getting what they need, and she looks at their incision to ensure there are no concerns. Connie is an exceptional liaison between the SNF, patients, and surgeons’ offices.

Connie also visits patients a few months after their surgery when they

attend the Reunion Brunch. The brunch is held quarterly, and patients can come and witness everyone’s progress after their joint replacement, and show off their own progress! During this time, Connie rounds with all of them to discuss their experience and see how they are doing.

Connie’s broadened role with our orthopedic patients to include follow-up throughout their entire experience blends is a true testimony to her commitment to quality outcomes for our joint replacement patients.

Connie Summy, BSN, RN, ONC

Continuity of Care


NEW KNOWLEDGE, INNOVATIONS & IMPROVEMENTS NEW KNOWLEDGE, INNOVATIONS & IMPROVEMENTS

Neuro-Intervention Team

Sentara Martha Jefferson Hospital’s Door-to-TPA administration times for 2017 were impressive! Below is an example that Christi Hankle, MSN, RN-BC, CNRN, SMJH Stroke Program Coordinator provided to illustrate the top-notch stroke care provided through collaboration of the Sentara Blue Ridge hospitals.

Early in the morning on December 18, 2017 a 28 year-old male was taken to SRMH with the inability to use the entire left side of his body, including a left facial droop, as well as neglect of the left side of his body. His NIHSS was 12. Thank goodness his co-workers recognized the symptoms of stroke and called 911. That acting fact action allowed the patient to get to SRMH via ambulance quickly, and also allowed a stroke alert to be called prior to the patient’s arrival to their ED, so the SMJH stroke team was ready to act fast.

Upon arrival to SRMH’s ED, the patient was taken immediately to radiology for a STAT head CT and CTA. Fortunate for this young man, there was not any bleeding in his brain on the CT scan. Due to the devastating nature of stroke symptoms this young male displayed, he was deemed an alteplase candidate, and the medication was delivered at SRMH’s

ED. The CTA, on the other hand, showed finding consistent with a right middle cerebral artery thromboembolic event. In other words, there was a clot blocking blood flow through a main artery that feeds blood to the brain. That is where SMJH’s neuro-interventional radiology team comes in.

The neuro-radiologist at SMJH deemed this young man to be a neuro interventional candidate, so helicopter

Sarah Cousineau, BSN, RN, Ernie Vitolo, Dr Michael Baylor, Josh Wright, BSN, RN

Neuro-Intervention Team

transfer was arranged immediately to bring the patient to SMJH for intervention. The patient spent 1 hour and 14 minutes at SRMH’s ED, and arrived on SMJH’s helicopter pad 13 minutes later. Within 7 minutes the patient was in the neuro-interventional radiology suite being prepped by the Interventional Radiology nursing staff. The groin was punctured

9 minutes later, and the clot was successfully extracted with blood supply reestablished 13 minutes later. The time from arrival at SRMH to revascularization at SMJH was 2 hours and 22 minutes!!!

Post neuro-intervention, the patient was transferred to the ICU for ongoing care, management of both the

alteplase he received at SRMH, and the thrombectomy he received at SMJH. On arrival to the ICU, the NIHSS was down to 3! When he was discharged from the hospital, his NIHSS was 0. This chilling story goes to show that acting fast in the setting of stroke, and working collaboratively with our sister Blue Ridge hospital can truly make a significantly positive outcome from what could have been a devastating, life-long debilitating stroke.

Courtney Lambert, BSN, RN, ED Nurse Manager relayed this message to her staff: “Each TPA administration means a life that is significantly impacted by the precise, prompt and professional care that you demonstrate. These are mothers, fathers, husbands, wives, children, siblings…these are people that have received state-of-the-art care through your care.”

Terry Hunt, Carla Morris, BSN, RN, CCRN Genevieve Barron, MSN, RN, AANPCP, Michelle Spaid, RN



PracticesSentara Martha Jefferson Medical Group’s primary care practices received national recognition for their continued efforts in maintaining Patient Centered Medical Homes (PCMH).This program uses evidence-based, patient-centered processes that focus on coordinated care and building long term relationships with patients. The PCMH model combines teamwork and information technology to improve care, improve the patients’ experience while reducing costs. The team coordination is also built to maximize staff ’s ability to function at the highest level of licensure. Before the patient is seen for their appointment, pre-visit planning allows the staff to ensure all patient information is complete, all labs tests and specialty visit reports are received. This process ensures that the visit is focused and meaningful for the patient and the care team. When patients are discharged from the hospital, a clinical team member will call the patient to conduct medication review, discuss discharge instructions to validate the patient’s understanding of their treatment plan and ensure there is a hospital follow up appointment scheduled. This transition of care process is designed to eliminate gaps in care and provide

Susan Durovy, RN, Camilla Washington, BSN, RN, Carol Fife, LPN, Angelica Chambers, LPN

Natalie Chambers, RN

patients with a seamless transition back into their home. These patients are closely monitored by the care team for 30 days post-discharge to ensure all needs are met and reduce potential readmissions.

We want this achievement to be evident in the care we provide our patients. It is important that we recognize the patient as the center of the healthcare team. We are committed to provide an exceptional patient experience while delivering high quality care and promote the best possible health outcomes.

OR SafetySafety in the Operating Room setting can be challenging due to production pressures, case intensity and power gradients. The Operating Room Leadership team at Sentara Martha Jefferson Hospital faced the challenge of having team members who were uncomfortable speaking up for safety, as well as providers who felt that their concerns were not being heard. Leadership, taking these risks and concerns seriously, developed an action plan to transform the OR culture into one of high reliability.

• Creation of an education plan.

• Delivery of training on high reliability organizations

• Delivery of escalation training, focused specifically on OR scenarios

• Revision of daily OR huddle

• Focus on Safety and Great Catches/Near Misses at each OR huddle

• Installation of a Safety Button that stops production in a room when a safety concern is present

• Effort to recognize and hardwire proactive risk identification

To date, the OR team has activated the Safety Button 12 times (9 by MD

and 3 by team members). In addition, the team has identified 150 Great Catches/Near Misses. Great catch/near miss data is tracked for trends and resolution. This information is reported out to leadership and the team.

Implications for practice include Increased safety due to:

• Ability to escalate concerns

• Empowerment of team to stop production when a safety concern is present

Laverne Rush, Jennifer Garfield, Lloyd Richards

Donna Freeman, BSN, RN, CNOR; Marge Shifflett, LPN; Brandy Jasper



The Outpatient Surgery Center

Dawn Haasnoot has been with Sentara Martha Jefferson since August of 2016 when she started as an Admit/Recovery nurse. When we opened the OSC in April of 2014, she chose to transition to the OSC in the PACU area. When we reorganized the leadership structure for the center in the latter part of 2015, she applied for and was chosen to be the Team Coordinator for the Pre/Post section of the OSC, formally filling that role in January 2016. In addition to taking on that role, she continued her education, earning her Master’s degree in Nursing Leadership and Management in December of 2017. One of the OSC nurses shared the following about Dawn “Dawn is an incredible coordinator. Dawn is highly visible to staff on a daily basis and steps in on a regular basis to assist staff manage patient flow in addition to her many other

responsibilities. She is the definition of a working manager. Her easy going nature and pleasant personality are a wonderful example of the Caring Tradition at Martha Jefferson at work. I have no doubt that a large part of our consistently high patient satisfaction scores can be attributed to her contribution and dedication to the OSC. She is a pleasure to work with and work for.” 2017 was a very successful year at the Martha Jefferson Outpatient Surgery Center (OSC).Since the center re-opened in 2014, we have had year over year growth in volume. Our nursing team has been instrumental in all of the case growth, patient satisfaction, and physician satisfaction. In 2017, the OSC surpassed their budgeted OR case numbers and minutes completing 2,670 cases compared to their budgeted 2,400; 270 more than budget. They were budgeted for 161,000 minutes and achieved 187,244 minutes; 26,244 more than budget. The OSC increased their case numbers by 354 over 2017 by opening up a third OR room on Fridays and adding new surgeons to the block schedule. A new medical director, Dr. Matt Panzarella, was onboarded. The center achieved AAAHC-deemed Medicare status for another 3 years and State Health Department license for 2 more years. Operationally, the Pre-Anesthesia Surgical Screening (PASS) program and a recycling program for OR items were established.In June of 2017, the OSC team experienced a fire in the OR and together were able to overcome the event. The patient involved was cared for safely, and everyone’s heroic efforts during and in the weeks after the event are to be commended. Dawn and the entire OSC team were instrumental in working to re-open the center and prevent any patient delays by moving the scheduled patients to the main OR for two weeks.

Carrie Ann Brunet, RN; Teresa Haynes, BSN, RN, RN-BC; Andy Brown, RN; Dawn Haasnoot, BSN, RN, RN-BC; Lucy Moneymaker, BSN, RN; Kim Staudinger, BSN, RN; Robin Workman, BSN, RN, CMSRN

Dawn Haasnoot, BSN, RN, RN-BC

August 12th Protests

August 12, 2017 was a difficult day for our country, our community, and our hospital. Departments across Sentara Martha Jefferson Hospital worked together diligently and thoroughly in order to prepare for any potential scenarios that might occur during the protests held in Charlottesville on that date. Our staff rose to the challenge and provided care for many of those injured that day, but the emotional toil was great as we were affected not only as a healthcare team, but as members of the Charlottesville community. There are many stories and reflections that can be told about the experiences shared on August 12th. Below is a DAISY nomination that was submitted by one of our nurses for one of our nurses due to the care her husband received related to injuries sustained during those August 12th protests. And the caring tradition continues through it all.

Back Row (L to R): Dr Jeff Alberts, Lindsay Znotens, BSN, RN, Joshua Wright, BSN, RN, Cari Squire, BSN, RN, Damian Scott, Courtney Lambert, BSN, RN, Tara Williams, BSN, RN Front Row (L to R): Anne Roane, BSN, RN, Sarah Cousineau, BSN, RN, Mindy Roberts, Kathy Krevansky, MSN, RN, Deronda Eubanks


NEW KNOWLEDGE, INNOVATIONS & IMPROVEMENTS

Brandon Moore, BSN, RN, Abby Denby, MSN, RN, NE-BC, Carolyn Ramwell, MSN, RN, COCN, Stephen Fitzgerald, BSN, RN, Stacey Johnson, BSN, RN, Angela Comisford, RN, Dr Dan Ricciardi, Frank Jargowsky, Johnsa Greene-Morris, MBA, MHA, BSN, Dr Michael Baylor.

My husband was hit by the car during the attack in

Charlottesville. He refused to go to the emergency room, he insisted his injury was minor compared to the young woman that he witnessed die that day on the street. He reported as a witness to the police but did not want to take a place from those in need. Several days later in a lot of pain, he finally went to the ER and was diagnosed with a bone bruise and a broken toe. I

August 12th Protests

am appreciative to the doctor for that diagnosis, but the true magic happened when Stacey Johnson, RN spent 45 minutes talking to my husband and listening to him express his grief and share his story. It’s a rare moment any day when an ER nurse has that time to give to a patient, but Stacey had the time and instead of going back to her desk and sitting there, she spent that time sitting with my husband and just therapeutically interacting with him.

We have a long journey from here. He is going to have to reconcile and get counseling for being unable to close his eyes and not hear the thuds of the bodies bouncing off the car or seeing a young woman die in front of him. Stacey Johnson was the caring tradition that day. She provided more healing than she will ever know. He felt validated and heard by a professional realizing he was not along and can start to heal.

SMJH SHARED GOVERNANCE STRUCTURE

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Sentara Martha Jefferson Hospital | 500 Martha Jefferson Dr, Charlottesville, VA 22911 434.654.7000 | www.sentara.com

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