Nursing Annual Report 2012 (PDF) - Renown Health

2012Nursing Annual Report

A Legacy of Nursingby Gail Green and Jeff Stout150 years of nurses providing careto families in Northern Nevada!It fills us with pride knowingnursing has been leading the wayin providing healthcare to ourcommunity over centuries.In reviewing individual journalentries by nurses of the late 1800’s,it’s obvious our foundation ofcaring, commitment, and optimizingour patients’ health care experiencewas started when they arrived byhorse or train!In their journals,nurses spoke of manychallenges and fears,and ensuring a safeplace for patients torecover from illness.Keeping patients safefrom hospital acquiredinfections and diseases,whether Typhoid in the1800’s or MRSA today,is a common goal ofnurses then and now.to travel to the wild west to providecare. We hear the same enthusiasmfrom our nurse graduates as theytransition into their new roles.Although ailments have changedslightly, our propensity for beingon the front lines has not changed.We take tremendous pride in ourprofession and are proud to be partof a healthcare system dedicated toserve everyone in the community.It is fair to say our Pathway toExcellence ® journey did not beginover the recent years, but wasstarted by the first nurses whoarrived in Reno in the 1800’s withone mission in mind – optimize ourpatient’s healthcare experience!From left, Gail Green, MSN, RN, ChiefNursing Officer for Renown SouthMeadows and post-acute care facilities; andJeff Stout, MSN, RN, Chief Nursing Officer,Renown Regional.How exhausted and scared we canbe when faced with an unfamiliarsituation or after a challenging12-hrshift! Reading one nurse’s journal,we can hear her excitement as sheleaves the safety of the east coastFrom left, Melodie Osborn RN, MBA, Director of Nursing, Renown South Meadows; and GailGreen, MSN, RN, Chief Nursing Officer for Renown South Meadows and post-acute carefacilities visited local schools with the White Knight, Renown’s restored classic ambulance.2

Future of Nursing Looks BrightWhat will the nursing professionbe like in the future? A recentnational study yielded answers tothat intriguing question, as well asrecommendations that will enhancenursing careers and patient care.Following a two-year study, theRobert Wood Johnson Foundationand the Institute of Medicine issueda report on the Future of Nursing inOctober 2010.Working on the frontlines of patient care,nurses play a vital roleand must be able torespond effectivelyto rapidly changinghealthcare settingsand an evolvinghealthcare system.As a follow-up, RWJF has launchedits Campaign for Action withthe vision for all Americans tohave access to high-quality,patient-centered care in ahealthcare system where nursescontribute as essential partners.Action Coalitions have been formedin most states, including Nevada.The campaign focuses on five areas:• Strengthening nurseeducation and training.• Enabling nurses to practiceto the full level of theireducation and training.• Advancing interprofessionalcollaboration across thehealth spectrum.• Expanding leadership ranksto ensure that nurses have avoice on management teams,in boardrooms and duringpolicy debates.• Improving healthcareworkforce data collection.“If nurses are to be as effectiveas possible in helping to providehigh-quality patient care, they’llneed to be better prepared. Weneed more nurses with advanceddegrees to provide primary careand teach the next generation ofstudents,” said Jeff Stout, MSN, RN,NEA-BC, Chief Nursing Officer atRenown Regional Medical Center.Residencies help prepare newnurses for the workforce, andcontinuing education helps nursesretain clinical skills and developleadership abilities.“Studies support anassociation betweeneducational level andpatient outcomes inacute care settings.”– Jeff Stout, MSN, RN,Chief Nursing Officer,Renown Regional.3

Successful Residency Program Benefits NursesRenown’s Nurse Residency Programgives new graduate nurses anopportunity to gain experience in avariety of specialties.This program is an expansion ofan internship pilot program thatwas funded by a grant from theUS Health Resources and ServicesAdministration. In 2011, 20 internsparticipated in the successfulprogram. This year, 60 nursesare taking part in the NurseResidency Program.in that track. Through the pilotprogram, we found that developingmore opportunities to look atdifferent areas of nursing helpswith flexibility and learning how toutilize resources.”After the first year, the residentscan be interviewed and hired intoone of the units or into the floatpool. Of the first groupof 20 nurse interns, all stayedat Renown.Reaction to the internship programwas uniformly positive, Richardssaid. “The feedback from theinterns was that the program wasa phenomenal learning experienceand that we should do it for everynew nurse. That is why we aretrying it on a larger scale. This year,all new graduates are hiredas residents who report collectivelyto the managers of the units intheir track.”“Rather than being hired intoone specific unit, the residentsare hired into a track: Medical/Surgical, Telemetry or CriticalCare,” explained Jennifer Richards,PhD, RN, CNRN, Director of NursingEducation and Research. “Over ayear, they rotate through all units“I loved being part of the internship program fornew nurses. I attended more training and was ableto meet more people than I would have if I onlyworked on one unit. ”- Mazie Etter, RN4

Dr. Jill Biden Visit Highlights Nursing EducationDr. Jill Biden’s January 2012 visit toRenown Regional Medical Centerhighlighted the importance ofnursing education. While in Renowith Vice President Joe Biden, shemet with nurses to discuss theireducation and profession.Jill Biden, PhD, is an Englishprofessor at a community college inVirginia. “I think that I have actuallytaught hundreds, maybe thousandsof nursing students,” she said.The visit was the result ofRenown’s collaboration withTruckee Meadows CommunityCollege, thanks to a three-yeargrant TMCC received from the USDepartment of Labor to improvestudent retention in the nursingprogram and through the first yearof employment.Five Renown nurses participated in a roundtable discussion with Jill Biden, fourth from left,and Secretary of Labor Hilda Solis, third from left, on their education and career.Five nurses who used the grantmoney and now work at Renownparticipated in a roundtablediscussion about their education,lives and careers. They thankedBiden and Secretary of Labor HildaSolis, who was also at the Renownevent, for the help they received inachieving their goal of anursing career.Renown hires about 75 percentof all TMCC nursing graduates,according to Jeff Stout, ChiefNursing Officer. “TMCC has anexcellent nursing school, and theyproduce top-notch nurses withexcellent skills.”“The schools do a fantastic jobof educating nurses, and we areproud of Renown’s transitionprogram,” said Jennifer Richards,PhD, RN, CNRN, Director of NursingEducation and Research.Biden credited the nursingeducation program for providingtraining in careers in whichthere are opportunities not justfor employment but for greatsatisfaction.“Student success both within the nursing program and in their employmentshows that these types of programs benefit the college, the employers of thegraduates and the community at large.”– Karen Fontaine, RN, MSN, CNE, TMCC Nurse Instructor5

ANCC Pathway to Excellence ®On Friday, August10th, 2012 RenownRegional MedicalCenter andRenown SouthMeadows MedicalCenter becamethe first Pathway toExcellence ® hospitals in Nevada. ThePathway to Excellence ® designation,granted by the American NursesCredentialing Center (ANCC), isbased on the confirmed presenceof characteristics known as “ThePathway to Excellence ® Criteria.”For an organization to earn thePathway to Excellence ® distinction,it must successfully undergo athorough review process thatdocuments foundational qualityinitiatives in creating a positivework environment, as defined bynurses and supported by research.These initiatives must be present inthe facility’s practices, policies, andculture. Nurses in the organizationverify the presence of the criteriain the organization throughparticipation in a completelyconfidential online survey. Thesurvey requires a minimum of 51%participation and an overall 75%positive response to the questions.Both Renown Regional MedicalCenter and Renown South MeadowsMedical Center met these surveyrequirements and were commendedon having several exemplars inthe written portion of theirrespective applications.Continued on page 7“This has been anexciting journey, andreally encouragingto see our direct carenurses and SharedGovernance teamscome together todefine all of the waysbeing a Renown RNfulfills their careers.”– Gail Green, MSN, RN,Chief Nursing Officerfor Renown SouthMeadows and postacutecare facilities6

Cont. PathwayThe written documentation includedevidence to support how we meetthe 12 Pathway to Excellence ®Practice Standards:• Nurses control the practiceof nursing• The work environment is safeand healthy• Systems are in place to addresspatient care and practice concerns• Orientation prepares new nurses• The Chief Nursing Officer isqualified and participates in allorganizational levels.• Professional development isprovided and utilized• Competitive wages/salaries arein placeJeff Stout, MSN, RN, Chief Nursing Officer, Renown Regional (center) and Pathway toExcellence ® team members made a rap video to encourage nurses to take thePathway to Excellence ® survey.• Nurses are recognized forachievements• A balanced lifestyle is encouraged• Collaborative interdisciplinaryrelationships are valued andsupported• Nurse Managers are competentand accountable• A quality program and evidencedbasedpractices are utilizedThe Pathway to Excellence ®designation identifies the elementsof work environments where nursesflourish and as a result, whereoptimal patient care is deliveredevery day. In the words of LorraineHaines, MSN, RN “receiving thisdesignation is a great recognition ofthe dedication and determination ofour nurses to keep patient care thepriority in this ever challenging andchanging healthcare environment.”“I cannot over-emphasize thesignificance of the Pathway toExcellence ® designation for RenownRegional and Renown SouthMeadows Medical Center nurses, ourpatients, our community, and ourstate, said Jennifer Richards, PhD,RN, “I am honored to be part of thistruly remarkable achievement whichhas put Nevada on the map in a verypositive way.”“We have joined an elite fraternity of chosen hospitals who demonstrate anongoing commitment to going above and beyond and placing our patients andfamilies at the center of all of our decisions. This is evidence of the amazing workyou do every day. I am so proud to be part of Renown.”– Jeff Stout, MSN, RN, Chief Nursing Officer, Renown Regional7

Process Improvements Enhance Patient CareTransformational Healthcare is acoordinated effort to transformthe methods and practices bywhich patients receive healthcareservices. One of the tools used areweeklong sessions called RapidProcess Improvement Workshops(RPIWs), where teams of employeesexamine ways to do their jobs moreefficiently and effectively alwayswith the patient in mind.Transformational Health CareSpecialist Jessey Bargmann-Losche,MPH, CHES, said, “RPIWs providea standard work-specific path or“We broke downbarriers, so thatthe process runssmoothly andthe patient istransported morequickly.”– Melodie Osborn,RN, MBA, Directorof Nursing, RenownSouth Meadows.procedure. These are documentedstandards that everyone follows.”Post Acute CareOne RPIW looked at carecoordination for patients whoneed post-acute care after beingdischarged from the hospital.Focusing on the Orthopedic unit,the RPIW was designed to identifypost-acute needs early, to help withselecting post-acute services, andto encourage patients to stay in theRenown system for consistent care.Continued on page 98

Nurses partcipating in a mock code drill, a component of annual Professional Development.Valerie Luevano, MSW, LSW,Supervisor of Social Services, saidthe recommendations created“a game plan for patients afterthey leave the hospital. Patientsand families receive informationmore quickly so they can makedecisions.”Emergency Room TransportA February 2012 RPIW focusedon the Emergency Room atRenown South Meadows MedicalCenter. It looked at the lengthof time it takes for a patient tobe transported from the ER to aninpatient bed.Both workshops resulted inimproved communications betweennurses in different departments andother hospital staff. In addition,standard policies for patientinteractions and hand hygienewere developed and implemented.A process flow chart before the RPIW for Early Idenification ofPost Acute Care Services.A process flow chart after the RPIW for Early Idenification of PostAcute Care Services.9

Strategic Plan Drives the FutureRenown Health recently adopted astrategic plan for nursing that providesa roadmap for the future. It is theresult of a collaborative effort designedto take nursing to the next level.Development of the strategicplan began in early 2011, asnursing leadership, divided intoteams, conducted an analysis anddeveloped key initiatives, goalsand strategies for implementationthroughout the healthcare system.Jeff Stout, MSN, RN, NEA-BC, ChiefNursing Officer at Renown Regional,explained, “We need to knowwhere we’re coming from, wherewe are and where we’re going.Laying out a three-to-five-year planfor nursing helps keep us focusedand on track.”Renown has adopted a nursingphilosophy for the entireorganization:We, the nurses at RenownHealth, demonstratecommitment to ourpatients and their families,our colleagues, and ourprofession through theintegration of caring,clinical expertise, education,evidence-based practice andthe pursuit of quality patientoutcomes. We respect,advocate and embrace thediversity of the populationwe serve.Five major initiatives and goals wereidentified in the strategic plan:• Recruitment and Retention88 percent retention rate forRenown Health Nursing.• Professional DevelopmentIncrease educational level andcertification rates for all nursingleaders and, subsequently, directcare nurses.• Clinical ExcellenceTransparency and engagementrelated to quality/patientexperience outcomes throughoutthe nursing division.• DiversityIncreased cultural awareness andsensitivity throughout the nursingdivision.• Leadership Succession PlanningContinuous identification andsupport of potential futurenursing leaders.“The key initiatives were developedthrough consensus of all nursingleadership in the organizationand our Shared Governancecommittees. The initiatives addressthe wide range of care nursesprovide throughout the healthcarecontinuum,” said Gail Green,MSN, RN, Chief Nursing Officer forRenown South Meadows MedicalCenter and Post Acute CareServices. Teams will meet quarterlyto give updates and track progress.“The strategic plangives an overallfocus for where theorganization is going.We are committed toaccomplishing whatwe set out to do.”– Jennifer Richards, PhD,RN, CNRN, Directorof Nursing Educationand Research10

Awards, Accreditations and RecognitionsRenown Earns 10th Straight Top 100 HonorRenown Health earned recognition as a Top 100 Integrated Health Network for the tenth year in a row. Renown isthe only Nevada health network to earn a place on this national Top 100 list.ANCC Pathway to Excellence ®Renown Regional Medical Center and Renown South Meadows Medical Center have been designated as the firsttwo Pathway to Excellence ® hospitals in Nevada by the American Nurses Credentialing Center. The Pathway toExcellence ® designation honors a work environment designed to improve overall nursing satisfaction and improveretention of quality nursing staff.Renown South Meadows Medical CenterTopping the list for overall quality in northern Nevada, Renown South Meadows Medical Center was awarded theHealthInsight Quality Award of 2012 ranking in the top 1% for quality of all hospitals nationwide. Renown RegionalMedical Center continues to rank in the top 3 of northern Nevada hospitals.Consumer Choice AwardRenown Health was made the Consumer’s #1 Choice for best overall quality, best nurses, best doctors, and bestimage and reputation since 2007.Renown Regional Medical Center Earns Award for Stroke CareRenown Regional Medical Center received the 2011 America Heart Association/America Stroke Association’s Getwith the Guidelines Stoke Gold plus Quality Achievement Award.Renown Rehabilitation Hospital: the only in Region to Earn AccreditationRenown Rehabilitation earned a three-year accreditation from the Commission on Accreditation of RehabilitationFacilities (CARF) International, an independent, accrediting body of health and human service providers foundedin 1966.Top Performing Hospital, Gold Award, CA Transplant Donor NetworkRenown Regional Medical Center was awarded a Top Performing Hospital Gold Award by the California TransplantDonor Network.Internal Board Certified Lactation Consultants Care AwardRenown Health earned the Internal Board Certified Lactation Consultants Care Award in recognition for staffingIBCLCs and providing a lactation program that is available five days a week for breast feeding families.Leader of the YearAmy McCombs, BSN, RN, Manager of Nursing, Intensive Care Unit, Roseview Tower, Renown Regional11

Awards, Accreditations and RecognitionsNorthern Nevada Nurses ofAchievement 2012Kristen Cleveland-Ceballos, RN,Critical CareBarbara Coruna, BSN, RN,Long Term/RehabilitationElizabeth Krayk, BSN, RN, OCNMedical-SurgicalEmily McClure, MSN, RN, CCRNNursing EducationBecky Haase, MSN, RN,Nursing InnovationRosa Cortez, BS, RN, Office/OutpatientRonnie Varney, RN, CRRNPatient Advocacy (tie)Shannon White, RN,Patient Advocacy (tie)Bethany Wilson, RN,Rookie of the YearFacility WinnersStephanie Shuman, BSN, RN,Renown RegionalAshley McCoy, BSN, RN,Renown South MeadowsEmployee of the Year WinnersOverallKrystal Dorman, RN, RoseviewIntensive Care Unit,Renown RegionalServiceKathleen Rossi, Imaging Line BSN,RN, Special Procedures,Renown Regional2012 Nurses of Achievement award winners from left to right: Rosa Cortez, RN; AshleyMcCoy, BSN, RN; Bethany Wilson, ADN, RN; Shannon White, ADN, RN; Barbara Coruna,BSN, RN; Stephanie Shuman, BSN, RN and Emily McClure, MSN, RN, CCRN.Employee of the Month WinnersFebruary - Kim Boganes, BSN, RNIntensive Care Unit,Renown RegionalApril - Jennifer Langham, RN,Telemetry 8th Floor,Renown RegionalMay - Darlene Roberts, BSN, RN,Emergency Room,Renown RegionalJuly - Chris Hansen, BSN, RN,General Surgical Unit,Renown South MeadowsDanette Gaetke, BSN, RN,Renown Rehabilitation HospitalDAISY Winners – 2012January - Kim Boganes, BSN, RN,Intensive Care Unit, RenownRegionalFebruary - Nina Katovic, RN, Med/Telemetry, Renown RegionalMarch - Marianne Seymour, RN,Cardiac Intensive Care, RenownRegionalApril - Megan Barakat, RN, RenownInstitute for CancerJune - Erika Jolley, BSN, RN,Telemetry, Renown RegionalJuly - Marisa Coffey, BSN, RN, Med/Telemetry, Renown South MeadowsJuly - Jodi Johnson, BSN, RN, CardiacIntensive Care, Renown RegionalAugust - Josh Pierce, RN, CancerNursing Unit, Renown Regional