2010 Nursing ANNUAL v4d - PinnacleHealth

Nursing Annual Report 2010Transformational LeadershipMagnet Champions:Alicia Urich, North 10Altair Dasilva, CTOAmy Topper, HH – EDAshley Krawczyk, Main 5Bethany Bonczek, Main 4Carol Engle, North 9Cathy Kulick, MaternityCathy Zubrickie, MaternityAlexis Aaronson, MSICU/CCUCrystallein Egresits, PediatricsCynthia Spaulding, DialysisDanielle Lambert, Labor and DeliveryElizabeth Moore, HH Endo/GIGina Recce, CG ICUIldko Stegman, Main 6Janet Huston, OSBJennifer Schleig, CTPOJuliet Jenney, ORKaren Fake CG Outcomes ManagementKaren Marencic, CG PerianesthesiaKaren Szukalski, CVORKathy Diltz, CTICUKelli Buzzard, Float PoolKelly George, Main 10Marcia Hair, CG- EDMaria Lukoskie, HH Outcomes ManagementMary Ann Raker, CG ORMelissa Stolley, Enterostomal TherapyMelissa Yiengst, HH-PACUPaulette Smith, Cath LabRebecca Shemas, CTORobin Albert, NICURobin Howard, CTOSantina Sperling, CINTSharon Perrine, IV TeamViktorija Jagodina-Sherron, RehabDeb Schafer, CNS (advisor)Kim Fowler, CNS (advisor)Cheri Bechtel, NM (advisor)Magnet CommunicationWorkgroup Members:Michalena Levenduski, CNSMary Ann Clement, CNSJudy Nipple, CMTiffany Boyd, SDIRobin Albert, NICURobin Howard, CTOKelli Buzzard, Float PoolCheryl Hammonds, PSCUKendra Ferguson, MarketingOur Magnet Re-Designation Journey –Mission Magnet: Get It Again in 2010The past year has been one of excitement, enthusiasm and hard work as we beganour Magnet re-designation journey. Many hours were spent gathering stories anddata to support the required Magnet Sources of Evidence. My dedicated team andI had the privilege of writing and compiling this information into one 2,950 pagedocument. I would like to thank everyone who contributed information and stories.Additionally, I would like to give special recognition to the following people:• Cheryl Key, VP of Nursing Professional Development and Practice— for support and guidance• Kim Fenstermacher, MS, CRNP, PhD(c) — co-writer and editor• Pam Neubaum, Administrative Assistant — document preparation andorganization• Melanie Duffy, CNS; Sally McClellan, Bed Coordinator and Kim Fowler,CNS — proofing and editing• Carol Colussi, DON; Kathy Boyer, PI Specialist; and Stephanie Okum,Director of Customer Relations — preparation of data and graphsThe Magnet Champions developed a re-designation theme: “Mission Magnet: GetIt Again in 2010.” A new Magnet Communication Workgroup was established tolead communication efforts about the re-designation journey. Both groups werebusy with a variety of Magnet events such as displays at summer employeepicnics, Octoberfest events and holidayfairs. A weekly “Magnet Moment” wasstarted to share stories of excellenceacross the system that represent theMagnet Model. Several of these storieswill be showcased throughout this report.PinnacleHealth nurses havehad a phenomenal year andcontinually are raising the barfor nursing excellence.PinnacleHealth nurses have had aphenomenal year and continually areraising the bar for nursing excellence.Within the framework of the MagnetModel, this report highlights many keystories and accomplishments thatrepresent exceptional leadership, superbclinical practice, quality outcomes,community outreach and professionaldevelopment. It is a tribute to our nursesand clearly represents our Mission Magnetslogan – “Get It Again in 2010”!!Sarah Harne-Britner, MSN, RN,CCRN, CNS-BCClinical Nurse Specialist/Magnet Project Coordinator4

Within the Magnet Model, the domain of Transformational Leadership callsfor a CNO who leads nursing services with a strong vision and strategic plansfor quality outcomes. Innovation and clinical excellence are recognized andrewarded. Transformational leaders are strong advocates for staff and patients.They work to keep the nursing organization moving forward with nurses wellpositioned to take a leadership role in the evolution of positive change.

2010-2012 Nursing Strategic PlanStrategy 1:Be the recognized employer of choiceStrategy 2:Have optimized quality and safety of patient careStrategy 3:Develop risk taking behaviors of nursing leadershipStrategy 4:Advance an environmentof professional developmentStrategy 5:Promote an environment of researchand evidence-based practiceNursing Mission, Vision and Guiding PrinciplesMission Statement: To provide quality care focused on the patient experience.Vision Statement: To be the recognized leader of comprehensive nursing care in Pennsylvania.Guiding Principles: Practice, Professionalism and PridePractice Core Values: Patient-centered Care, Sensitivity to Diversity,Evidence-Based, Quality and SafetyProfessionalism Core Values: Open Communication, Career Advancement,Empowerment, Accountability, PinnacleHealth Citizenship, LeadershipPride Core Values: Recognition, Retention

Nursing Annual Report 2010Transformational LeadershipPromoting a Safe Work Environmenton the Respiratory/Toxicology/PCU UnitWorkplace safety is a significant concern to the staff on the Respiratory/Toxicology/PCU Unit, because of the complex physical and mentalhealth needs of the patients and the physical separation of thetoxicology patients from the other areas of the unit. Connie Lauffer,Nurse Manager worked with the Unit Steering Committee to identifyseveral initiatives to address staff concerns and elevate the securityof the nurses. After the implementation of additional safety measures,baseline RN Satisfaction scores for job enjoyment improved from ascore of 36.42 in 2008 to a score of 57.06 in 2010. The followingchanges were made through the collaborative efforts of the staff:• Creation of a full-time Psychiatric Technician to proactivelyintervene to de-escalate potentially violent situations withpatients and to promote positive, therapeutic communicationto decrease patient anxiety.• “Code of 3” system to assure that a minimum of three staffmembers are always on the unit so that one can call for helpand two can stay with the patient should an emergency arise.• Open Door policy on night shift when the risk for patientelopement is low in order to decrease staff isolation from therest of the unit.• Installation of a panic button that activates a strobe light andalarm to call for additional resources.• Development of “Guidelines for Dealing with the ViolentPatient” to provide consistent and prioritized interventions forminimizing patient and staff injury during an episode ofpatient violence.Maternity Throughput Improves with SixSigma ProjectA Six Sigma Maternity team was formed to improve throughput onthe Maternity Unit. Baseline data showed that only 31.5% ofpostpartum patients were leaving the hospital by noon. After settingperformance goals, the team examined the current throughputprocess for postpartum patients by identifying the supplier, inputs,process, outputs and customer. Several initiatives were started as aresult of the team’s analysis. The implementation of the processchanges enabled the Maternity Unit staff to achieve their goal ofhaving 50% of postpartum patients discharged by noon.Process changes include the following:• Development of discharge appointments and patient selfassessments for education• Dedicated Charge nurse positions were created to facilitatethroughput.• Soarian electronic documentation system was developed andimplemented to streamline the communication process.• Bili-blanket equipment required for home treatment of babieswith hyperbilirubinemia is now available on the unit ratherthan waiting for one to be delivered.• Integration of the lactation consults and documentation intothe Soarian clinical information system and nursing care plan.• Transportation attendants now take discharged mothers andbabies to their cars during the peak discharge hours ratherthan maternity staff.The Six Sigma Maternity Unit Team was led by Barb Emberg,Performance Improvement Benchmark Analyst and the followingmaternity nurses: Patti Maurer, Nurse Manager; Megan Strohecker,Clinical Manager; Lois Gaul, Clinical Manager; Stacy Chubb, SDI;Barb Ritter, Lisa Hackenberg and Sue Stempel.The Maternity Unit staff nurses participated in the implementationof the process changes. Jenny Miller-Morris, RN, ClinicalInformatics Specialist, assisted in the development of theMaternity Discharge Workflow.8

Standardization of DialysisUnit Equipment andProcesses Saves $240,000Over the past two years, PennyFrownfelter, Director of Nursing, has ledthe merger of the Dialysis Units at theHarrisburg Campus and CommunityCampus to form one cohesive unit. Inspite of the challenges of two separatelocations and a variety of differencesbetween processes and policies, the finaloutcome of a combined department hasresulted in better care for our patients,increased staff satisfaction, and a costsavings of $240,000. The followingchanges were initiated with great success:• Creation of a nurse manager positionto oversee both Dialysis Units. Thisposition was filled by KathleenGarcia, RN.• Staff worked collaboratively todetermine which supplies andequipment would be stocked in eachunit.• A Pyxis machine and MAK softwarewere installed for more efficient, safemedication administration.• The nursing unit budgets werecombined to one cost center topromote more effective staffingpatterns.• A day shift charge nurse position wascreated to facilitate patientassignments and flow.• One on-call nurse was designated tocover both units to improve responseto fluctuations in work load.• All staff members rotated throughboth units to improve consistency ofpatient care.• A Dialysis nurse represents the uniton the Practice Council. This inputresulted in a pre-printed order set toenhance care processes.• A dedicated Dialysis Intranet siteprovides nurses with easy access toimportant dialysis policies, hours ofoperation, and resources fordialyzable medications.Emergency DepartmentThroughput DramaticallyImprovedSheri Matter, CNO, has beeninstrumental in championing the EDthroughput project to improve patientflow, financial outcomes, patientsatisfaction, and quality outcomes. Sherimet with Emergency Departmentmanagers and staff to identify ways toimprove the throughput process atCommunity General. Six Sigmamethodology was utilized to eliminateerror and reduce variation in processes.In March 2008, an interdisciplinary SixSigma team was formed to examine thisproblem and multiple strategies wereimplemented to address the major issues.With the success of the CGH Throughputinitiative, a Six Sigma project for EDThroughput at Harrisburg Hospital wasinitiated resulting in improvements inED length of stay and patients leavingwithout treatment (LWOT). At bothcampuses the LWOT rate has decreasedby 50%. The creation of the PatientLogistics Center and implementationof the TeleTracking System has also hadsystem-wide impacts. It has centralizedprocesses for patient placement and haseliminated the need for direct admitpatients to be sent to the EmergencyDepartment. The system has also improvedcommunication between multipledepartments such as Housekeeping,Physical Therapy, Speech Therapy,Outcomes Management and Rehab.Emergency DepartmentThroughput ImprovementStrategies1. Increasing bed capacity bymaking the EAU a virtual unit.2. Adjusting staffing patternsto meet patient volume.3. Re-designing the triageprocess.4. Non-urgent patients are placedin a results waiting area in achair in order to wait for finaldisposition orders after theyare triaged.5. The Emergency DepartmentClinical Assistants’ scheduleswere adjusted to better meetthe patient volume demand.6. A core group of designatedCharge Nurses was established.7. Standardized preliminaryadmission orders weredeveloped.8. Telemetry bed capacity wasincreased.9. Additional point-of-care lab testswere made available in the ED.9

Structural Empowerment speaks to the structure and processes in placeto promote strong communication and foster the development of collaborativerelationships that support professional nursing practice.

New SharedGovernance ModelEffective shared governance models mustevolve and change to meet the ever-changingneeds of organizations and remain effective.Last year, an updated model was successfullyimplemented. The model reflects sixshared-decision-making councils with thenurse-patient relationship at the core.Practice and Quality Councils are alignedwith the patient while ProfessionalDevelopment and Pride Councils focusprimarily on the nurse. The ResearchCouncil provides support to all councilsand the Leadership Council offers structureto frame the entire model. The newLeadership Council reflects of merger of theprevious Coordinating and LeadershipCouncils. It has increased the membershipof staff nurses in the council and staff nurserepresentation at the leadership level.Practice CouncilChair: Ginger Cassatt, N10Secretary: Denise Schuler, IV TeamAdvisors: Sarah Harne-Britner, CNS; MaryBeth Heller, NM; Deb Schafer, CNS andKaren Zeplin, SDIAccomplishments:• Converted policies and proceduresto Mosby’s online nursing skills• Provided input to revision of Soarianassessment documentation screens• Reviewed nursing care plans and unitstandards of care• Provided input to revisionof pre-operative checklist• Implemented practice “Tip of theMonth” on council intranet siteQuality Council:Chair: Cindy Hallman, Float PoolChair-Elect: Jennifer Eby, PediatricsSecretary: Kristen Crautheim, CG EDAdvisors: Carol Colussi, DONAccomplishments:• Collaborated with CAUTI Initiative topromote and monitor use of cathetersecurement devices on nursing units• Performed quarterly skin prevalencestudies for hospital acquired pressureulcers• Received additional educationon identification, prevention anddocumentation of hospital acquiredpressure ulcers• Collaborated with Practice and ResearchCouncils to develop and pilot the newFalls Prevention program• Led initiative to improve ongoingcleaning and maintenance of computerson wheels (COWS)• Planned and hosted the 2nd AnnualQuality Conference, “The Joy ofQuality.” The conference was attendedby more than 130 nurses across thesystem and featured podium and posterpresentations.• Developed monthly initiative, the“Cooking Up Some Quality” to educatenurses about important terms related toquality11

Nursing Annual Report 2010Structural EmpowermentProfessional Development Council:Chair: Megan Christie, CM, CINTChair-Elect: Mandy Martin, HH EDSecretary: Jaime Steincamp, CTPOAccomplishments:• Promoted CDP and ANA Code ofEthics at Nursing Expo• Developed CBLs for ANA Code ofEthics and Nursing ProfessionalPractice• Collaborated with SoarianDocumentation Committee to hostthe “Mock Trial” presentation• Added peer review and professionalwriting resources to Intranet• Developed an education needsassessment for RN staffPride Council:Chair: Theresa Sellers, NM, CTOChair-Elect: Tiffany Boyd, SDI, CINTSecretary: Tiffany Boyd, SDI, CINTAdvisor: Penny Frownfelter, DONAccomplishments:• Extreme Nurse Experience• Healthcare Career Night• Science and TechnologyHigh School Day• Nursing Excellence Newsletter• Nursing Grand Rounds• Nurses Week FestivitiesLeadership Council:Co-Chair: Cathy Druckenmiller, MSICUCo-Chair: Denise Klahre, NM,PerianesthesiaSecretary: Laurie Radabaugh, NursingAdministrationAccomplishments:• Merged coordinating and leadershipcouncils into new leadership council.Formed new subcommitteesresponsible for various aspects ofcouncil work.• Performed annual review of bylawsand updated nursing charter• Developed updated poster of SharedDecision-Making Model andProfessional Practice Model• Collaborated with Pride Council torevise the Nurse Extern program• Performed quarterly reviewof Nursing Strategic Plan• Developed a proposal to address thepreparation and transition of newcouncil chairsResearch Council:Chair: Mary Lou Mortimer, SDI, NICUChair-Elect: Bonnie Clemence, IV TeamSecretary: Cheryl Capitani, LibrarianAccomplishments:• Approval of three nursing researchstudies• Four Evidence-based PracticeFactsheets approved• Annual Nursing Research Conference• Research Roundtable12

Professional DevelopmentPinnacleHealth provides a healthy workenvironment that supports and encouragesprofessional development for nurses.PinnacleHealth nurses continue to exceedexpectations through their leadership inprofessional organizations, achievement ofcertifications, education advancement andawards.Leadership in ProfessionalNursing OrganizationsThe following nurses held leadershippositions in professional nursingorganizations:• Trish Bennett, CNS, Board memberSVAACN and Challenges in CriticalCare Multidisciplinary ConferencePlanning Committee• Tiffany Boyd, SDI, CINT, Member ofANCC Magnet Continuing EducationTask Force, Magnet ConferenceAbstract Reviewer• Lisa Casey, NM, Main 5, CAAMSNSecretary• Janet Clark, Staff Nurse, MedicalOutpatient Unit, President Elect of thePennsylvania Capital Region Chapter ofthe Oncology Nursing Society• Nina DelGrande, Manager of HomeCare, Recording Secretary, LambdaKappa Chapter, STTI.• Melanie Duffy, CNS, President andImmediate Past President NACNS.Chair of the Practice/RegulationSubcommittee of ANA’s Congress onNursing Practice and Economics.• Cathy Druckenmiller, MSICU,Treasurer Lambda Kappa Chapter STTI• Kim Fowler, CNS, Chair Elect for localNACNS Chapter• Lisa Fox, Staff Educator, LearningInstitute, Leadership Succession Chair,Lamdba Kappa Chapter STTI• Penny Frownfelter, DON, President ofSVAACN• Joye Gingrich, NM, CTU,Corresponding Secretary for LambdaKappa Chapter STTI• Cynthia Howe, CM, Endoscopy, BoardMember SCPAPAN• Jacqueline Hunt, CM, Float Pool,Treasurer of CAMSN• Cheryl Key, VP for Nursing ProfessionalDevelopment and Practice, BoardMember of PONL and Lambda KappaChapter, STTI• Joann Konick-McMahan, SDI, North 10Respiratory/Toxicology/PCU, BoardMember, SVAACN• Connie Lauffer, NM, North 10Respiratory/Toxicology/PCU, BoardMember or SVAACN• Erica Leber-Burnham, CM, CGH ICU,President STTI Lambda Kappa Chapter• Marian LeFevre, Director ofWomanCare Resource Center,Governance Committee, LambdaKappa Chapter STTI• Michalena Levenduski, CNS, SouthCentral PA EBP Consortium Secretary;local CNS Chapter Secretary• Nancy Michaelian, SDI, CGHPerianesthesia, President SCPAPAN• Rita Overcash, RN, BSN, MS, PharmacyImplementation Coordinator, Presidentfor the South Central Organization ofNurse Leaders (SCONL)• Angela Sanders, SDI, Main 5, EducationRepresentative for CAAMSN• Catherine Schneck, Staff Nurse,Perianesthesia, Member of Governmentaffairs committee of PAPAN• Rob Shipp, NM, CINT, EHSF Board ofDirectors• Arlene Smith, Staff Nurse, Dialysis,American Nephrology Nurses AssociationLocal Chapter President• Jessica Stefanic, CM, Main 5, LegislativeRepresentative CAAMSN• Lillian Stiglitz, CM, Main 5, PresidentCAAMSN• Melissa Stolley, WOCN, Legislative Repfor WOC Nurses Society; Board Memberof North East Region WOC NursesSociety; awarded WOCN scholarshipto attend the Nurse in WashingtonInternship, (NIWI) in D.C.• Kim Suda, Stroke Coordinator,SVAANN Board Member, Newslettereditor and member of ConferencePlanning Committee; Capital RegionStroke Symposium ConferencePlanning Committee Member• Tina Wallish, Staff Nurse, OperatingRoom, President-Elect AORN chapter• Cindy Wilson, Benchmark Analyst forPerformance Improvement, VicePresident, Lambda Kappa Chapter,STTI.• Eileen Wydra, Staff Nurse, SurgicalServices, Local AORN Chapter BoardMember• Karen Zimmerman, SDI, Perianesthesia,SCPAPAN Board Member and FinanceCommittee; Member of PlanningCommittee for 2011 State PAPANConference13

Nursing Annual Report 2010Structural EmpowermentAdvancement of Formal EducationThe Nursing Strategic Plan has set a goal ofincreasing the number of BSN nurses to 43%at the Harrisburg Campus and 37% at theCommunity Campus in 2010. This goal wassuccessfully achieved and is part of anoverall goal to achieve 46% at Harrisburgand 40% at Community by 2013.Bachelors of Science in Nursing Graduates:Chamberlain CollegeJennifer Lenosky, Main 10Angela Mader, PSCUEastern UniversityNjameh Baxley, CINTEmily Anderson, CTUAltair DaSilva, CTOTina Messner, CTOAmy Reisinger, CTUMandie Sampson, CTOElizabeth Welch, CTUChristina Wilson, PSCUMillersville UniversityMaggie Cruse, Rehab UnitHawar Sayed, Main 5Penn State UniversityMarva Richmond, Main 5Esther Smith, Rehab UnitYork College of PennsylvaniaTina Daniels, NICUMasters of Science in Nursing Graduates:Mary Lou Mortimer, MSN, RNC NICU,Mansfield University Nurse EducatorKimberly Martin, Pediatrics MSN inNursing Education, Walden UniversitySpecialty CertificationThe Nursing Strategic Plan has set a goal tocontinually increase the number of nurseswith specialty certification. The goal for2010 was 33% at both campuses. TheProfessional Development Council ledefforts to increase the number of certifiednurses by gaining approval for upfrontpayment of the certification exam. As aresult, the both campuses have met orexceeded the yearly goal.TOTAL PERCENTAGE OFDIRECT CARE CERTIFIED NURSESNurses Achieving Specialty Certification:Oncology Nursing (OCN)Jamie Weeder, OSBGary Anders, OSBCardiac Surgical Certification(CSC - additional certificationfor CCRNs)Barb Hammar, CTICUSandra Myers, CTICUCardiac Vascular Nursing (RN-BC)Shannon Weges, CINTSantina Sperling, CINTJennifer Everhart, CTPONjameh Baxley, CINTKatie Shradley, CTUCritical Care Nursing (CCRN)Gina Recce, CGH ICUKristy Foremny, CGH ICUEmergency Nursing (CEN)Liya Arustamyan, CGH EDAmanda Kauffman, CGH EDJaima Brown, HH EDInpatient Obstetrics NursingCertification (OB-NCC)Candi Le Beau, Labor and DeliveryJolene Skoczynski, Labor and DeliveryDana Dolan, Labor and DeliveryShawnee Jones, Labor and DeliveryCourtney Dyer, Labor and DeliveryInternational Board CertifiedLactation Consultant (IBCLC)Julianne Reiner, RN, Lactation Consultant,IV Therapy (CRNI)Nicole Ascani, IV TeamDianne Enders, IV TeamKelly Wolfkill, IV TeamMaternal Newborn Nursing(RNC-MNN)Sarah Herwig, MaternityAmber LeCadre, MaternityMegan Scott, MaternityJanet Neway, MaternitySherri Phillips, MaternityJulie Reiner, MaternityDeborah Adlon, MaternityMedical Surgical Nursing (CMSRN)Lauren Bowser, Float PoolRebecca Strayer, Float PoolAshley Krawczyk, Main 5Liam Copus, Main 5Jessica Watts, Main 5Sharon Weidler, CGH Nursing SupervisorDiane Morelli, PSCUMichelle Snelbaker, Float PoolSimin Nejabati, CTU14

Neonatal Nursing (RNC-NIC)Brooke Pribilla-Hentz, NICUKelly Weller, NICUNeuroscience Nursing (CNRN)Gabrielle DiMemmo, Main 5Pediatric Nursing (CPN)Jennifer Eby, PediatricsProgressive Care Certified Nursing(PCCN)Carol Jacobs, N10/Toxicology/PCUOrthopedic Nursing (ONC)Tina Keck, Main 10Jennifer Souders, OSBTita Domingos, Main 10Janet Huston, OSBCareer Development Pathway:The Career Development Committee hasimplemented many initiatives to promoteand improve the Career DevelopmentPathway process. A successful CoachesWorkshop was held and attended by 40participants. The committee clarifiedrequirements for research and evidencebasedpractice requirements. Beginningin 2011, the Research Council will provideguidance to potential RN4 candidatesregarding these requirements. These initiativeshave proved successful with approval of 10new nurses at Level 3 and one new nurseat Level 4:New CDP RN3 Nurses:Jennifer Litman, Labor and DeliveryPetra Hammaker, NICUSheena Dellinger, Float PoolSerry Jean Villaraza, Main 10Kimberly Nardis, NICUBrenda Carrasco, MSICUAnne Kurutz, Float PoolBarrie Lynn Painter, Float PoolRoxanne Klinger, HospiceYvonne Hoke, Float PoolCDP RN3 Advanced to RN4:Catherine Schneck, CG PACUNursing Grand RoundsThe Pride Council is responsible for coordinating the monthly Nursing Grand Rounds presentations at each campus. Each montha nursing unit is responsible for providing a presentation that highlights their clinical area. It provides opportunities for nurses to sharetheir knowledge and expertise across the system.2010 Nursing Grand Rounds PresentationsJanuary The Healthy Woman and the WomanCare Advantage: WomanCare Resource CenterTo You, Your Family and Your PatientFebruary A Day in the Life of a Home Care Nurse Home CareMarch Surgical Treatment of Atrial Fibrillation Heart TeamApril Ovarian Hyperstimulation Syndrome: Rare but Serious Disorder North 9May Are Your Patients Cath Lab Ready? Cath LabJune Hypercarbia in the Post Surgical Patient PACU/SPUJuly Acute Coronary Syndrome: Prehospital through CTICU CTICUAugust Pain Management: An Orthopedic Nurse’s Call Main 10September Care of the Knee Surgery Patient OSBOctober Antibiotic Management of the Acute Patient Casey Pinto, CRNPNovember Me oh My, it's an MI Cardiac Interventional UnitDecember EBP Thrives on CTO CTO15

Nursing Annual Report 2010Transformational Structural Empowerment LeadershipPearls to Your Success ProgramThis year’s program was “Building An Effective Team” and provided information on team building techniques, team effectiveness andthe team member role. A total of 169 nurses from both campuses attended the event. Cyndi Wilson, RN, MS, Benchmark Analyst inPerformance Improvement and Kim Etter, Director of Employment and Labor Relations presented “Team Building: Competition vs.Collaboration.” Lynn Wonsick, BS, MEd, Training Specialist in the Learning Institute presented “Team Effectiveness” and “Your Role asan Effective Team Member.” Each year the Professional Development Council plans an educational program to promote the professionaldevelopment of our nurses.Annual Nurses’ Week Celebrations and Nursing Excellence AwardsPride Council planned another outstanding celebration of nursing with a week of special events focused on the theme of “Generations inNursing across the Past, Present and Future.” The luncheon presentation featured a panel of nurses who practiced from the 1940’s to current.Each of the panel members shared stories about how nursing practice has changed across the years. The Annual Nursing Gala concludes theweek of celebration with the presentation of the Nursing Excellence Awards. Congratulations to the 2010 winners and finalists:2010 Nursing Excellence Award Winners and FinalistsClinical Inquiry Winner: Tiffany Boyd, SDI, CINT Finalists: Donna Roller, PediatricsJoyce Hocker, NICULeadership Winner: Lisa Casey, Nurse Manager, Main 5 Finalists: Sue Dwyer, NICUMary Beth Heller, Nurse Manager, PediatricsPatient Advocate Winner: Bridgett Abbott, North 9 Finalists: Ashley Heatley, CTUAutumn Seifert, Main 5Facilitator of Learning Winner: Jeanne Packer-Gotwalt, Learning Institute Finalists: Melinda Paul, NICUSusan Spencer, Float PoolTeamwork Winner: Emily Golden, CTPO Finalists: Jennifer Lenosky, Main 10Elizabeth Welch, Main 4Pride Winner: Michell Leeper, IV Team Finalists: Susan Brackbill, NICUCathy Zubricke, Main 9Novice Nurse Winner: Sarah Weaver, CTPO Finalists: Keatha Gardner, Main 4Alexis Gonder, Main 9Awards and Recognition• Trish Bennett, RN, MSN, CCRN, CNS, was recognized by AACN for 30 years continuous CCRN certification in July 2010.• Altair Dasilva, CTO, displayed an oil painting titled “The Book of James” at the 2010 ANCC Magnet Conference Art Gallery.• Clarissa Leoncio, BSN, RN, 1 Main won the 2010 Best Allied Health presentation award for “Leech Therapy: To Latch or Not ToLatch is the Question” at PHS Medical Education Day.• Tiffany Boyd, SDI, CINT, received the Lifestyle Change Award from the AHA on September 29, 2010.• JoAnne Konick-McMahan, SDI, N10/Toxicology/PCU participated in RN Item Review training by the National Council of StateBoards of Nursing. She is a member of the NCLEX Item Development Panel.16

“The Book of James” by Altair Dasilva, RNCommitmentto the CommunityPinnacleHealth nurses are committedto serve the community by buildingrelationships that promote nursingprofessional development and improvepatient outcomes.Hospital to Home ProgramA collaborative effort between CTU and theHeart Failure Center is reducing readmissionrates for heart failure patients through theHospital to Home program. The programis a national quality initiative led by theAmerican College of Cardiology to improvethe transition from inpatient to outpatientstatus for individuals hospitalized withcardiovascular disease. CTU developeda unit-based Heart Failure Committee withthe following members: Elizabeth Welch,Keatha Gardner, Tina Dietman, KatieScofield, Patty Novak and Trish Bennett.The group has implemented several processchanges to provide a seamless transitionfor patients to home. Discharge medicationprescriptions are faxed to the patient’spharmacy and follow-up appointments arescheduled prior to discharge. An OutcomesManager is also making follow-up phonecalls within seven days after discharge. Asa result of this collaboration, there has beenan increase in referrals to the PinnacleHealthHeart Failure Clinic.Congregational Health NetworkPinnacleHealth has always had a strongcommitment to parish nursing. Aninterdisciplinary committee was formedled by Barbara Terry, RN, VP for MissionEffectiveness, to develop a CongregationalHealth Network. The network would linkexisting hospital and congregationalresources to assist patients in navigating thehealth system and accessing care. This typeof network could decrease inappropriateutilization of services such as unnecessaryED visits and potentially decrease healthcare costs. It could also strengthencommunication between the broadercommunity and the healthcare system.The Congregational Health Network modelincludes the role of a navigator that isassigned to work with a congregation.The navigator is a member of the PHShealth care team who is responsible fordeveloping a working relationship with anassigned congregation. The navigator willassist the congregation with utilizingresources, problem solving health careissues, and navigating the healthcaresystem. Kelly Lesh, RN, WomanCareNurse Educator, and Theresa Sellers, NM,CTO, are navigators for the Wesley UnionAME Zion Church and hosted a health fairto promote heart healthy behaviors.The congregation has many Puerto Ricanparishioners. Elisabeth Perez, PatientRepresentative, and Hilda Rivera, RN,CDE, Diabetic Educator, have assistedKelly and Theresa with this congregationbecause of their fluency in Spanish. SharonKelly, LI, and Maria Chianos, OutcomesManagement, are navigators forPresbyterian Homes.17

Exemplary Professional Practice represents how PinnacleHealth nursespractice, communicate, collaborate and develop professionally.The Nursing Professional Practice Model represents how nurses achieveprofessional practice at PinnacleHealth.

Nurse SatisfactionThe Quality Council led a successful NDNQI NurseSatisfaction Survey using the theme “World of Nursing.”More than 90% of eligible nurses completed the surveywhich exceeded the PinnacleHealth goal of 85% andthe average of 76% nationally. The survey results werepositive and exceeded the national benchmarks.The survey provides valuable data to validate ahealthy work environment or identify areas forimprovement. Several units used the data toimplement improvements on their units:• Main 5 improved their scheduling processes usingKRONOS and patterned schedules.• OSB (formerly 2 North/South) improvedteambuilding by educating staff on generationaldifferences and conflict management and changingthe shift report process.• Labor and Delivery established a Staff Satisfactionand Retention Committee to increase staff moraleand satisfaction.ConsultantsPinnacleHealth nurses have access to a richenvironment of internal experts and externalconsultants to assist them in providing patient care.This work has made a difference not only to nurses atthe bedside but also patient outcomes.Rapid Response TeamThe Rapid Response Team is a valuable resource oftennoted by staff nurses as “the single most effectiveprogram we have implemented for patient care.” Lastyear, the program was revised to allow family andvisitors to call the team. Liz Burdick, NM for ICU atCommunity General Hospital, led efforts to increasethe use of the team at that campus. The results ofthese efforts resulted in impressive patient outcomes.NURSE SATISFACTIONPRACTICE ENVIRONMENT SCALE MEAN SCORESCODE BLUE AND RAPID RESPONSE TEAMHARRISBURG HOSPITALCODE BLUE AND RAPID RESPONSE TEAMCOMMUNITY GENERAL HOSPITALCNS Leading Efforts to DecreaseHyperbilirubinemia in NewbornsMarianne Allen, MN, RNC, CNS, has led aninterdisciplinary task force to implement evidencebasedpractice changes to decrease the readmission19

Nursing Annual Report 2010Exemplary Professional Practicerates for newborns with hyperbilirubinemia. Nurses who haveparticipated on the task force include Patti Maurer, NurseManager, Maternity Center; Megan Strohecker, Clinical ManagerMaternity Center; Tina Willer, Nurse Manager NICU; Mary BethHeller, Nurse Manager, Pediatrics; Kathryn Scofield, OutcomesManagement; and Jean McDonald, Outcomes Management. Thegroup has implemented the following process changes:• Intensive breastfeeding support and assessment for high riskinfants during hospitalization and after discharge. Electronicreferrals for Lactation Consultants are initiated within 24 hoursof birth and follow-up provided after discharge.• Onsite consignment home phototherapy biliblanket equipmentis available to improve continuity of hyperbilirubinemiamanagement after discharge• Hyperbilirubinemia risk assessment screening tool wasimplemented for use by physicians and nurses• Collaboration with local home health agency to developcontinuity of services for the newborns at risk forhyperbilirubinemia.This work has resulted in a 70 percent reduction in newbornreadmissions for hyperbilirubinemia.Interdisciplinary CareCollegial relationships between nurses and the other healthcaredisciplines promote a healthy work environment that supportsoptimal quality outcomes. PinnacleHealth nurses are leading theway to promote interdisciplinary collaboration and ensure acontinuum of care.Chest Pain Center AccreditationRob Shipp, CINT Nurse Manager, led the efforts forPinnacleHealth to receive Chest Pain Center Accreditation inMarch 2010 by the Society of Chest Pain Centers. Thisaccreditation was the result of interdisciplinary efforts to improvecare for acute coronary syndrome patients in the pre-hospital,Emergency Department, inpatient and the community. Thefollowing nurses played an integral role in this accomplishment:Eugene O'Donnell, Throughput Manager of ED; Cathy Timothy,Cardiac Surgery Practice Manager; Eric Toth, NM, CTICU; LyleSarver, Nurse Manager, ED; and Jean Wiest, Vice President,Cardiovascular and Pulmonary Services.Post-Partum Depression ScreeningAn interdisciplinary team comprised of nurses from WomanCareResource Center and the Maternity, Labor and Delivery, and NICUunits have done phenomenal work during the past year toincrease screening and detection of postpartum depression (PPD)in women that deliver their infants at PinnacleHealth. Nursingrepresentatives on the team include: Kelly Lesh, WomanCareResource Center Nurse Educator; Gina Pupo, Nurse ManagerPhysician Practice Manager; Deb Schafer, Perinatal CNS; TinaWillier, NICU Nurse Manager; Marian Lefevre, Corporate andCommunity Marketing Manager; Vicky Shorts, Labor and DeliveryNurse Manager(retired); Patti Maurer, Maternity Center NurseManager; Cheryl Key, VP for Nursing Professional Developmentand Practice; Sharon Kelly, Learning Institute Manager of Patientand Community Education; Michalena Levenduski, NICU CNS;Judy Bostdorf, Nurse Family Partnership Site Coordinator; LauraReynolds, Women’s Outpatient Health Center-Clinic Supervisor;and Carole Brtalik, Perinatal Educator, Learning Institute. SinceJuly, all post-partum mothers on the Maternity Unit are screenedfor PPD before discharge and receive a follow-up phone call byWomanCare Resource Nurse Educators. This process is providingearlier identification of mothers at risk for PPD.Diabetes Clinical Initiative – Achievement of JointCommission AccreditationPinnacleHealth became the first hospital in Pennsylvania to receiveJoint Commission's Certificate of Distinction for InpatientDiabetes Care in 2010. This achievement was the result of manyinpatient initiatives to improve staff and patient education ondiabetes management. The following nurses across the systemprovide leadership in this interdisciplinary committee: AmyHelmuth, Director of Quality; Barb Hammar, SDI; CathyDruckenmiller; Cecily Lamb; Connie Lauffer, Nurse Manager;Erica Leber-Burnham, SDI/CM; Gina Pupo, Nurse ManagerPhysician Practice Management; Kim Fowler, CNS; KimberlyThompson; Lauren Bowser; Liam Copus; Lillian Stiglitz, CM; LisaCasey, NM; Lynne Derr, Diabetic Educator; Marianne Allen, CNS;Mary Ann Drenning, Clinic Supervisor; Mary Beth Heller, NM;Mary Knackstedt; Nancy Snyder, Supervisor; Susan Butch;Tammy Snyder; Tiffany Boyd, SDI; Trish Bennett, CNS; VanessaSnell, Diabetic Educator; and Vicki McBride, SPPU. Average bloodglucose levels for inpatients have decreased to 110 for critical carepatients and 150 for general inpatients.20

Diversity CertificationThe PHS Diversity Certification Program was developed by theClinical Practice and Education Sub-Committee of the DiversitySteering Committee and was implemented in January 2010.Cheryl Key, Vice President of Professional Development, andMarianne Allen, Maternity Center Clinical Nurse Specialist, wereinstrumental in the development of this program. It provides aninnovative approach to offer all PinnacleHealth employees theopportunity to pursue the journey towards competence indiversity as Diversity Champions and Diversity Leaders.Congratulations to the following nurses who have completed therequirements for Diversity Champions:• Hilda Rivera, CDE, Diabetes Educator, Learning Institute• Donna Roller, Pediatric Unit• Debbie Rowe-Black, Nursing Supervisor, HH• Theresa Sellers, Nurse Manager, CTO• Joan Silver, VP Organizational Quality• Lisa Ulsh, Site Coordinator for Childhood LeadPoisoning Prevention Program• Sharon Weidler, Nursing Supervisor, CGH• Cathy Zubrickie, Maternity Unit• Tiffany Boyd, SDI, CINT• Lori Harkaway, Nursing Supervisor, CGH and HH• Cathy Kulick, Maternity Unit• Gayle Marchi, SPPU• Sandra Phillip, Maternity Unit• Sheree Weaver, Pediatricspresented “The Growing Impact of Patient Satisfaction onHealthcare Organizations.” Carol Colussi, DON and Director ofNursing Quality, shared “Cooking Up Quality” recipes featuring avariety of quality terms. Four quality projects were shared byChristen Lukens, M10; Connie Lauffer, N10; Ashley Krawczyk,M5; and Joye Gingrich, CTU. Seventeen poster presentations fromacross the system were also on display. The following awards werepresented for excellence in quality:• Quality Icon Award: Tina Lau, CTPO• Quality Initiative Award: Amanda Creswell,Toxicology Clinical Coordinator• Quality Unit Award: CTO• Best Quality Poster: Erika Yagel, CTICUFallsThe Quality, Practice and Research Councils partnered to form aFalls Prevention Task Force to develop a new Falls Preventionprogram. The program’s theme, “All Hands on Deck” symbolizesthe concept that falls prevention is everyone’s responsibility. Thenew program was piloted on Main 5, Rehab and Oncology Unitswith positive results. The program is scheduled to be implementedhouse wide in early 2011.FALLS PER 1,000 PATIENT DAYSQuality InitiativesQuality of care encompasses many facets of nursing atPinnacleHealth. Under the leadership of Cindy Hallman, RN (FloatPool), Chair and Carol Colussi, DON, advisor, the Quality Councilhas promoted safe passage for patients and improved outcomes.Quality ConferenceThe Quality Council hosted its 2nd Annual Quality Conference inOctober that was attended by more than 130 nurses. The conference’stheme, “The Joy of Quality” featured a keynote presentation on“The Quest for Healthcare Quality” by Mary K. Blank, MPH, CIC,CPHQ, Manager of Hospital Performance Management atHighmark. Stephanie Okum, Director of Customer Relations21

Nursing Annual Report 2010Exemplary Professional Practice% OF SURVEYED PATIENTS WITH HOSPITALACQUIRED ULCERSPressure UlcersThe Quality Council has spearheaded several initiativesto decrease hospital-acquired pressure ulcers. Councilmembers received additional education on the NDNQIPressure Ulcer tutorial to increase consistency in thequarterly prevalence study. New pressure relievingmattresses were purchased for clinical areas. TheWound, Ostomy, Continence nurses implemented anintranet site and transitioned to online documentationin Soarian. A Six-Sigma team has been formed to identifyadditional pressure ulcer reduction strategies. Theseefforts have resulted in a reduced number of totalpressure ulcers during the past year.CATHETER ASSOCIATED URINARY TRACT INFECTIONSCatheter-Associated Urinary Tract Infections(CAUTI)PinnacleHealth has rates of CAUTI that are well-belowthe CDC benchmarks. This is due to the collaborativework of the UTI Clinical Initiative Committee inconjunction with the Quality Council. Last year, a newnursing plan of care for CAUTI was implemented inSoarian. Infection Control nurses work with nursemanagers and staff to perform root cause analyseson any identified infections.Blood Stream Infections (BSI)Many successful initiatives this year have contributedto the low blood stream infection (BSI) rates atPinnacleHealth. The IV Team nurses now observe allcentral line insertions to monitor the insertion process.Staff education and a new workflow in Soarian haveimproved compliance with discontinuing central lineswithin twelve hours if possible. As a result,PinnacleHealth has BSI rates are below CDC benchmarks.Dysphagia Screening and Aspiration PneumoniaThere has been a direct correlation between dysphagiascreening and aspiration pneumonia rates for strokepatients. As dysphagia screening compliance for strokepatients has increased to 85% during the past year,aspiration pneumonia rates have dropped to less than1%. As a result of this success, all patients are screenedfor dysphagia on the nursing admission assessment. KimSuda, RN, BSN, Stroke Coordinator, has led the efforts toimprove compliance with the dysphagia screening.22

Nursing has played an integral rolein new and ongoing strategies toimprove patient satisfaction.Sepsis Alert ProcessMelanie Duffy, CNS, and Rethea Deveney, PI Specialist, led aninterdisciplinary effort to develop and implement a Sepsis AlertProcess to facilitate early identification and treatment of patientswith sepsis. Goals of the program are 1) rapid identification of theseptic patient, 2) provide aggressive volume resuscitation and 3)antibiotics within 1 hour. The process begins when nurses in theemergency department identify a patient with sepsis and initiate asepsis protocol. Next, the physician is notified, treatment isinitiated and a Sepsis Alert is called. The Rapid Response Nurseresponds to the alert to facilitate transfer to Critical Care. The newprocess has shown improved patient outcomes: door to antibiotictime has decreased from an average of 5 hours to 1 hour and thetime for transfer from the ED to Critical Care has decreased from5.6 hours to 70 minutes.Patient SatisfactionNursing has played an integral role in new and ongoing strategiesto improve patient satisfaction. PinnacleHealth contracted withThe Studer Group ® , a national consulting group specializing inassisting hospitals to succeed in the journey to service excellence.System Strategic Goals have been identified for each of Studer’s sixpillars: People, Service, Quality, Growth, Finance and Community.Several unit-based initiatives that have been implemented toimprove patient satisfaction will be highlighted.Improving the Patient Experience on Main 10Kathleen Kerstetter, RN, MSN, Nurse Manager, Main 10, created aunit-based Patient Experience Committee that has improved patient,family and staff satisfaction. Samantha Kline, RN; Tiffany PolandRN; and Robyn Gleissner, BSN, RN, are members of the committee.Physical therapy sessions and nursing care is scheduled aroundthe patient and family preferences. Registered Nurses and PatientCare Assistants are paired in teams on day shift to improve teamworkand communication. White boards in each patient room are usedto communicate the patient’s pain medication schedule.Improving the Use of Pathfinder in the PACUNurses in the Harrisburg Perianesthesia Unit identified thatPathfinder, an electronic message board, was not being utilizedeffectively resulting in an increase in family complaints. Staff werere-educated on how to properly utilize the Pathfinder. Staffmembers began to make family notification part of their routine inpatient care, they became more aware of length of stay, and theybegan to hear positive feedback from families. Compliance withuse of Pathfinder increased from 33 to 81%.23

An environment that supports evidence-based practice and researchis essential to enable nurses to provide safe, quality care. At PinnacleHealth,the Research Council, Nursing Research Consultant and the Clinical NurseSpecialists provide the infrastructure to promote the development of nurses’clinical inquiry skills and innovation. The IOWA Model of Evidence-BasedPractice provides a framework to explore answers to clinical questions.

Research StudiesThis has been an exciting year for nursing research at PinnacleHealth. Three original nursing research studies were completed and threenew studies were approved.Study Name Investigators Status Study TypeThermoregulation: The Effect of Servo-Control vs. Air-Control on Weight Gain ofPremature Infants in incubatorsTina Daniels, BSN, RNC; Michalena Levenduski, MSN, RNC-NIC;Mary Lou Mortimer, MSN, RNC-NICOngoingQuantitativeExploration of the Postpartum Experienceof Women on Long Term Bed Rest forComplications of PregnancyDeborah Schafer, MSN RNC; Marianne Allen, MN, RNC Completed QualitativeComparison of External BP Measurements inthe Upper Arm and Ankle in Adult PatientsUndergoing Cardiac CatheterizationLisa Fox, BSN, RN; Kimberly Fowler, MSN, RN;Cyndy Wilson, MS, BSN, RN; and Laura Sheads, BSN, RNCompletedQuantitativeThe Effect of Clinical Simulation on CriticalThinking and Clinical Decision Making inGraduate NursesPrimary Investigator: Rhonda Maneval, DEd, RN, TempleUniveristy; Kimberly Fowler, MSN, RN, CNS-BC; John Kays,MSN, RN; Tiffany Boyd, BSN, RN, PCCN; Jennifer Shuey, BSN,RN, CMSRN; Sarah Harne-Britner, MSN, RN, CNS-BC; CynthiaMastrine, BSN, RNCompletedQuantitativeProspective Observational Cohort PilotStudy on the Risk Factors Associated withUpper Extremity Deep Vein Thrombosis inPatients with Peripherally Inserted CentralCatheters. (PICC)Bonnie Clemence, MSN, RN, Principle Investigator; RhondaManeval, DEd, RN Temple Univeristy; Co- Priniciple InvestigatorResearch Assistants Sue Ann Bruce, BSN RN; Sarah Bensinger,RN; Ruth Flynn, RN; Denise Shuler, RN, CRNI; Norine Bilharz,RN, CRNI; Della Houser, RN, CRNI; and Sharon Perrine, RN, CRNIData CollectioncompletedQuantitativeNew Graduate Nurses Retention and RoleTransition: Identification of Best UnitSocialization Practices Research StudySarah Harne-Britner, MSN, RN (Study site coordinator) andMarianne Kramer, PhD, RN, Primary InvestigatorCompletedPhase I QuantitativePhase II QualitativeComparison of the Effects SamplingMethod has on the Amount of Hemolysisin Laboratory Specimens Drawn in theEmergency DepartmentTricia Falgoust, MSN, RN, CEN, Principle InvestigatorData Collectors; Shelley Heinbaugh, RN; Glenn Laverty, RN;Greg Dahlstrand, RN; Jacque Matter, RN; and Jaima Brown, RNOngoingQuantitativeThe Effects of an In-Home Heart AttackRecovery Video on the Recovery of PostAcute Myocardial Infarction (AMI) PatientsSarah Harne-Britner, MSN, RN, Principle Investigator; Co-Investigators: Rob Shipp, MS, RN; Tiffany Boyd, BS, RN; andMegan Christie, BSN, RNOngoingQuantitativePerinatal Loss and Bereavement in Non-Hispanic Black AdolescentsKim Fenstemacher, MS, CRNP, PhD (c) Ongoing QualitativeThe Experience of Parenting for Single,Unpartnered Mothers of Infants in theNeonatal Intensive Care Unit (NICU)Janet Fogg, RNC-NIC, MSN Ongoing Qualitative25

Nursing Annual Report 2010New Knowledge, Innovations and ImprovementsNursing ResearchConferenceThe Nursing Research Council hosted the19th Annual Nursing Research Conferencethat was attended by more than 260nurses and students. Rhonda Maneval,DEd, RN, Associate Chair for UndergraduateNursing Education at Temple Universityand Nursing Consultant for PinnacleHealthpresented, “The Iowa Model: PromotingQuality Care through Evidence-BasedPractice.” Bonnie Clemence, MSN, RN,from the IV Team at PinnacleHealth,presented her research fellowship project,“Risk Factors Associated with Catheter-Related Upper Extremity Deep VeinThrombosis with Patients with PeripherallyInserted Central Catheters.” The day alsofeatured podium presentations from theResearch Roundtable groups and posters.Research RoundtableResearch Roundtable is a collaborativeprogram with Messiah College to promotethe development of evidence-based practiceskills in senior nursing students, practicingnurses and advanced practice nurses.Nurses and students form work groupsto address practice questions using theIowa Model. In 2010, the following nursesparticipated in this innovative program.Women’s and Children’s Group:Depression Screening in HospitalizedAntepartum WomenMichalena Levenduski, CNS, NICU(Facilitator)Yovanka Hoover, Labor and Delivery(Facilitator)Laura Martin, SDI, Maternity Center(Facilitator)Nancy Frank, Main 11/North 8Chris Egresits, PediatricsRebecca Weese, Labor and DeliveryMichalena Levenduski, CNSSpiritual Care Group: Prayer as anAdjunct Therapy for Pain Control andWell BeingMary Lou Mortimer, SDI, NICU(Facilitator)Tiffany Boyd, SDI, CINT (Facilitator)Sheena Dellinger, Float PoolTheresa Sellers, NM, CTOAvis Pulaski, North 10Respiratory/Toxicology/PCUMedical Surgical Group: Readiness forHospital DischargeKim Fowler, CNS, CTO (Facilitator)Joann Konick-McMahan, SDI, North 10Respiratory/Toxicology/PCU (Facilitator)Naisha Stoney, Main 5Dawn Schlegel, Float PoolLeighann Oldham, CTUKarissa Harbold, CTOL to R: Research Conference presenters Amy Christeleit, RN,Betsy Caprio, SN, Erin Rhodes, SNCritical Care Group: Narcotic Analgesia:Too Much of a Good ThingBonnie Clemence, CGH IV Team(Facilitator)Amy Lesher, CM, MSICU (Facilitator)Gina Recce, CGH ICUSharon Harig, CGH ICULydia Johnson, PerianesthesiaSandy Rybecki, Float PoolCardiac Education Group: The Effect ofSocial Support on Readmission within12 months with Subsequent CardiacEventsMarianne Allen, CNS, Maternity Center(Facilitator)Cathy Druckenmiller, MSICU (Facilitator)Melanie Sherman, CINTRhonda Maneval, DEd, RNPinnacleHealth Nursing Research ConsultantCardiac Treatment/Post-Op Group:Amiodarone: Worth the RiskTrish Falgoust, Clinical Coordinator, ED(Facilitator)Tina Daniels, NICU (Facilitator)Brittany Baker, CTPOSarah Weaver, CTPOSue Silberman, CTPOShelli Heim, CTPO26

Factsheets on the Research Council intranetto ensure that nursing practice is basedon evidence.L to R: Research Conference presenters Jessica Stefanic, RN,Hannah Serafini, RN, Hannah Nelson, SNInfection Control Group: Implications ofIsolation Precautions on PatientsDeb Schafer, CNS, Perinatal (Facilitator)Donna Roller, Pediatrics (Facilitator)Haley Hardenstine, Infection ControlCindy Hallman, Float PoolNursing ResearchFellowshipThe Nursing Research Fellowship programprovides nurses the opportunity to developand carry out research or implementevidence-based practice changes. There arecurrently three nursing fellows who areprimary or co-investigators of nursingresearch studies:• Tina Daniels, BSN, RNC, NICU• Lisa Fox, BSN, RN, Learning Institute• Bonnie Clemence, MSN, RN, IV TeamEvidence-Based PracticeProjectsThe Research Council and Clinical NurseSpecialists were charged with providingeducation to all nurses on the Iowa Modelof Evidence-Based Practice. In addition,nurses have resources such as “Ask theExpert” and Evidence-Based PracticeMedication Schedule Card EBP ProjectJaime Steincamp, Kelli Buzzard, Mary LouMortimer and Sarah Harne-Britner, CNSimplemented a revised Medication ScheduleCard to improve medication adherence inelderly patients. The revisions were based onevidence found during Research Roundtable.The card is available on the Pinnacle intranetand is accessible to all inpatient andoutpatient areas. Jaime delivered a podiumpresentation on this project at the Universityof Arizona EBP Conference in June.South Central PennsylvaniaEBP ConsortiumPinnacleHealth nurses continue to play anactive role in the growth and development ofthe South Central PA EBP Consortium.Nursing Research Council members, RhondaManeval, DEd, PinnacleHealh NursingResearch Consultant and Carolyn Kreamer,PhD from Messiah College spearheaded thedevelopment of the group in 2009. The goalof the consortium is to promote evidencebasedpractice and research across the region.Approximately 15 academic and healthcareorganizations are represented. Deb Schafer,CNS, and Cheryl Key, VP for NursingProfessional Development and Practice aremembers of the EBP Toolkit Committee.Mary Lou Mortimer, SDI and MichalenaLevenduski, CNS are members of theProgram Committee and secretary for theconsortium. Rhonda Maneval, DEd,PinnacleHealth Nursing Research Consultantis on the Executive Board. Deb Schafer MSN,RN, shared findings from her qualitativeresearch study, “Exploration of thePostpartum Experience of Women on LongTerm Bed Rest for Complications ofPregnancy” at a quarterly meeting.27

Nursing Annual Report 2010Nursing Professional Practice ModelA major focus for 2010 was the implementation of the NursingProfessional Practice Model. The model is a schematicrepresenting how Pinnacle nurses practice, communicate,collaborate and develop professionally. The key componentsinclude: Nursing Mission, Vision and Guiding Principles as theframework; Healthy Work Environment Attributes, SharedDecision-Making Structure, Magnet Culture, Synergy Model ofCare, Professional Development, EBP, Research, Innovation,Reward and Recognition and Quality Outcomes. Each componentprovides support for the next layer, similar to Maslow’s hierarchyof needs with the ultimate goal of quality outcomes.The Magnet Champions have led efforts to develop displays andbulletin boards showcasing how the model is implemented on theunit level. Several examples of how the model has beenimplemented are:28

Pain Rounds on PSCUThe PSCU has always been proud of their exemplary painmanagement for surgical patients. When PinnacleHealthtransitioned to the HCAPHS survey for patient satisfaction, theunit received a limited amount of unit-based data and patientsatisfaction with pain scores varied across each quarter. It wasdifficult for the unit management team and staff to fully assesspatient satisfaction with pain management due to the lownumbers of surveys. In order to provide a more accurate andtimely assessment of patient satisfaction with pain management,the Nurse Manager, Vicki Duffin, RN, and Clinical NurseSpecialist, Mary Ann Clement, CRNP, developed andimplemented unit-based “Pain Rounds.” The goals were to 1)assess patient satisfaction with pain management; 2) assess staffnurse interventions for pain management and 3) mentor staff inappropriate pain management. A rounding questionnaire wasdeveloped by the committee. Mary Ann and Vicki established aschedule to do the rounds on a weekly basis on all surgicalpatients. In addition, the patient’s current pain regime and lengthof stay is reviewed. If the patient is still experiencing pain, the NMand CNS will consult with the patient’s primary nurse. They willreview what interventions have been done to address the pain andprovide suggestions for pain relief strategies. The conversationwith the primary nurse provides an opportunity for educationregarding appropriate pain management. This process has beendiscussed at the interdisciplinary pain committee meeting and hasbeen shared as a best practice.Since October 2009, 320 patients have been surveyed during PainRounds. Results show that 97% of patients are satisfied with theirpain management. In addition, 96% of patients feel thateverything possible has been done to control their pain. Seventyfivepercent of patients report no or mild pain (0-3 score on the0-10 pain scale). Also, 100% of patients report that they are askedto rate their pain on a scale of 0-10. The pain scale is the standardfor assessing pain at PinnacleHealth.Unit Consolidation at Community CampusOn August 30, 2010, two units at the Community GeneralCampus re-located to improve efficiency and enhance the safety ofpatient care. A new 50-bed Cardiac Telemetry Oncology (CTO)Unit was formed by merging the previous 34-bed MedicalTelemetry, 14-bed Oncology and 24-bed 1 Main Units. Themanagement team for the unit includes Theresa Sellers, NM; JudyNipple, CM; Kathi Lenig, CM; Ann Anthony, SDI; and KimFowler, CNS. To provide a smooth transition, staff played anactive role in determining thelocation of supplies and set upof the unit. Social gatheringswere planned to provideopportunities for staff membersto interact and get to knoweach other. The managementteam and staff worked with thephysician groups to promotecollegial relationships.A new Orthopedic, Spine andBariatric (OSB) Unit wasformed from the 2 North/SouthUnit. This new unit did not consolidate staff but did relocate to anew unit on the first floor of the Community Campus. Staffmembers were excited to move to the new unit and were veryinvolved in decisions regarding unit set-up and the storage ofequipment. The unit practice committee assisted in organizing theunit and recreated bulletin boards from the old unit so that it feltlike home.Healthy Work Environment StudyIn 2009, PinnacleHealth was invited to participate in a researchstudy being conducted by Marlene Kramer, PhD, RN, VicePresident of Health Sciences Research Associates. Twenty Magnethospitals were selected across the country to participate. Thepurpose of the study is to examine the impact of the workenvironment on the transition of newly licensed registered nursesduring the first year of practice. Experienced RNs completed theEssentials of Magnetism (EOM) II survey in May 2009. The EOMII measures several work processes or relationships that contributeto a healthy work environment. A total of 657 experiencedPinnacleHealth registered nurses from 34 clinical units completedthe EOM II (43.8% response rate). Dr. Marlene Kramer presentedthe aggregate results of the EOM II survey at the 2010 PHSNursing Research Conference. The results supported the followingconclusions:• Harrisburg Hospital nurses equaled or exceeded the NationalMagnet Hospital Profile on six of the eight EOM II scales. Thisrepresents the 99th percentile of achievement among 205Magnet Hospitals surveyed with the EOM or EOM II.• Community General Hospital nurses equaled or exceeded theNational Magnet Hospital Profile on five of the eight EOMIIscales.29

Nursing Annual Report 20102010 Presentations and PublicationsMedical Education Day PodiumPresentations“An Enterocutaneous Fistula: The Financialand Emotional Ramifications” by LynnDeMartyn, BSN, RN“Leech Therapy: To Latch or Not ToLatch is the Question” by ClarissaLeoncio, BSN, RN“Let’s Practice Safe Sedation” by SharonTruitt, RN, CCRN“Quality of Care in Hospice: The Patient’sPerspective” by Nina DelGrande, BSN,MHA, NE-BCMedical Education DayPoster Presentations“Code STEMI Proven Results” by RobertShipp MS NEA-BC RN; CathleenTimothy, BSN RN; Eugene J. O’Donnell,MS RN; Shelly Lauer, BS, HCA, RMA;Donald Durbeck, MD FACC; Dana Kellis,MD, MBA, FACHE, FACPE; Lewis Shaw,MD, FACEP; Jean Wiest, MSN, RN; ErikToth, BSN, RN; and Lyle Sarver, BSN,RN, CEN“Interventions that Improve a.m. InsulinAdministration in the Adult CardiacSurgery Patient” by Laura Sheads, BS,BSN, RN-BC; Cheri Bechtel, BSN, RN-BC“Optimizing Patient Flow in theHarrisburg Hospital PerianesthesiaDepartment” by Cyndy Wilson, RN,BSN, MS“Reduction in Central Line-RelatedBloodstream Infection (CLBSI) as a Resultof Multiple Process ImprovementChanges” by Renee Smith, MT (ASCP);Kimberly Rivera, MT (ASCP); LisaSnedeker, MT (ASCP); Jana Wolfgang, RN,BS; Lisa Rose, MT (ASCP); and HaleyHardenstine, RN, BS“Reduction of Indwelling UrinaryCatheter-Associated Urinary Tract InfectionThrough System-wide Interventions” byHaley H. Hardenstine, RN, BS; KimberlyRivera, M.T; Kimberly A. Fowler, MSN,RN, CNS-BC; and Jana Wolfgang, RN, BS“Screening for Depression in OutpatientPulmonary Rehabilitation” by JoyReardon, RNBC, BSN“The Obese Patient: Delivering QualityCare to a Challenging Population” byCindy Hallman, RN“Transitional Care: Improving PatientCare in Acute and Home Care Settings”by JoAnne Konick-McMahan, RN, MSN,PCCNNursing Research Conference –Podium Presentations“Delirium in the ICU” by Amy Lesher,BSN, RN; and Hilary Smith, SN“Effect of IV Solution on Duration ofLabor” by Becca Weese, RN; Becky Kirby,SN; and Diane Gentner, SN“Effect of Nerve Blocks in Total KneeArthroplasty and the Incidence of SkinBreakdown” by MaryAlyce McCormick,BSN, RN; and Laura Harris, SN“ER Readmission and the Elderly Patient”by Amy Christeleit, BSN, RN; RachelHendrie, SN; and Erin Rhodes, SN“Experiences of Primary CaregiversPresent During Resuscitation of TheirChildren” by Susan Brackbill, RN; SarahGarraty, SN; and Leah Easterbrooks, SN“Healthy Mouth, Healthy Heart; PreoperativeOral Care to PreventPost-operative Infections” by KarenSzukalsi, RN, BS, CNOR; and AmandaMontenegro, SN30

“Nurse Satisfaction and Burnout” by JessicaStefanic, BSN, CMSRN; Hannah Serafini,BSN, RN; and Hannah Nelson, SN (Podium)“Palliative Care and Chronic Illness” byCarrie Ent, BSN, RN; and Janine Wallis, SN“Risk Factors Associated with Catheter-Related Upper Extremity Deep VeinThrombosis with Patients with PeripherallyInserted Central Catheters” by BonnieClemence, MSN, RN“Temperature Accuracy: Tympanic Comparedto Oral” by Cindy Zimmerman, RN;Njameh Baxley, RN; and TheodoreSimmons, SNNursing Research Conference –Poster Presentations“Accurate Dysphagia Screening DecreasesAspiration Pneumonia Rates” by KimMichelle Suda RN, CNRN, BS, EMT;Patricia Casciano-Light MACCC-SLP/ESL;Ann Anthony RN-BC; and GabrielleDiMemmo, RN“Accurate Assessment of Stroke Patients,the Pinnacle in Pressure Ulcer Prevention”by Kim Michelle Suda RN, CNRN, BS,EMT; Karissa Harbold RN; Wesley FryeRN, BS; and Melissa Stolley BSN, RN,CWOCN“Addressing Weight Bias ThroughSensitivity Training in the Acute CareSetting” by Margaret Brady, BSN,RN; HollyFrey, RN; and Babette Rudick, BSN, RN“Does Early Oral Intake of Crackers andToast Prevent or Relieve Post-Op Nausea?”by Mary Ann Clement, MSN, CRNP; andValerie Stokes, BSN, CMSRN“Effect of Body Positioning onGastroesophageal Reflux in PrematureInfants” by Michalena Levenduski, MSN,RNC; and Mary Lou Mortimer, MSN, RNC“Exploration of the Postpartum Experienceof Women on Long Term Bed Rest forComplications of Pregnancy” by MarianneAllen, MN, RNC-OB; and Deb Schafer, MS,RNC“I'm Hungry Mom: Evidence-Based Initiativesto Improve Breastfeeding Outcomes ofNewborns” by Marianne Allen, MN, RNC-OB; Stacy Chubb, BSN, RNC-MNN; PatriciaMaurer, MSN, MBA, RNC-MNN; and NancyMcDaniel, RN, IBCLC“Innovative Interdisciplinary Approach toReduce Catheter Associated Urinary TractInfections” by Kimberly A. Fowler, MSN,RN, CNS-BC; Haley Hardenstine, BS, RN;Jana Wolfgang, BS, RN; and KimberlyRivera, MT, (ASCP)“Lemierre's Syndrome: All But Forgotten,But Not Gone!” by Karen Zeplin, BSN, RN,CCRN“Maintaining Peripheral IV CatheterPatency in the Pediatric Population: AnEvidence Based Practice Change” by MaryBohenick, RN; Jennifer Eby, BS, RN, CPN;Crystallein Egresits, RN, CPN; Mary BethHeller, MSN, RN-BC; Kimberly Martin,BSN, RN; and Donna Roller, RN, CPN“Multifaceted Rounding: Ensuring OptimalPatient Care” by Lisa Casey BSN, RN,CMSRN; and MaryAnn Clement, MSN,CRNP“My Neuro Patient is a FALLS RISK …Now What?” by Kim Michelle Suda RN,CNRN, BS, EMT; Autumn Seifert, RN;Jessica Stefanic BS, RN, CMSRN; andMegan Baker, RN“Power of Prayer to Decrease Pain andIncrease Well-being” by Sheena Dellinger,BSN, RN, CMSRN“Reduction in Central Line-RelatedBloodstream Infection (CLBSI) as a Result ofMultiple Process Improvement Changes” byRenee Smith, MT (ASCP); Kimberly Rivera,MT (ASCP); Lisa Snedeker, MT (ASCP);Jana Wolfgang, RN, BS; Lisa Rose, MT(ASCP); and Haley Hardenstine, RN, BSQuality Conference –Poster Presentations“30 Day Readmissions - Cause, Care,Containment” by Jean McDonald, BSN,RN, CCM; and Kathryn M. Scofield, BSN,MPA, RN, CCM“Addressing Weight Bias throughSensitivity Training in the Acute CareSetting” by Margaret Brady, RN, BSN; HollyFrey, RN, BSN; Judith Orndorff, RN; andBabette Rudick, BSN, RN, CCM“Beta Blockers and The Post OperativeCardiothoracic Surgery Patient” by ErikaYagel, BSN, RN, CCRN; Cindy Melnick,BSN, RN; and Dan Rohrer, BSN, RN“Expediting the Journey from Gurney toBed” by Jessica Stefanic, BS, RN, CMSRN;Lillian Stiglitz, BSN, RN, CMSRN; AngelaSanders, BSN, RN, CMSRN; Jeannie Fellin,RN“Getting a Grip on Pain: Utilizing PainRounds on the Post Surgical Care Unit(PSCU)” by Mary Ann Clement, MSN,CRNP; and Vicki Duffin, BS, CMSRN“Hearing the Voice of the Primary Nurse: AQualitative Evaluation of Synergy Rounds”by Lisa Casey, BSN, CMSRN; and MaryAnn Clement, MSN, CRNP“Improving Perioperative GlycemicControl” by Nancy Michaelian, BSN, RN,CPAN; Karen Zimmerman, BS (major innursing), RN, CAPA; Denise Klahre, BSN,RN; Sandy Warner, MSN, RN; VickieMcBride, RN; Linda Houseal, CRNA, MS;Amy Helmuth, MS, RN; Renu Joshi, MD;and Ronald Kratz, MD31

Nursing Annual Report 2010“Maintaining Peripheral IV CatheterPatency In The Pediatric Population: AnEvidence Based Practice Change” by MaryBohenick, RN; Jennifer Eby, BS, RN;Crystallein Egresits, RN, CPN; Mary BethHeller, MSN, RN-BC; Kimberly Martin,BSN, RN; and Donna Roller, RN, CPN“Multifaceted Rounding: Ensuring OptimalPatient Care” by Lisa Casey, BSN, CMSRN;and Mary Ann Clement, MSN, CRNP“No Interruption Zones: DecreasingDistractions During MedicationAdministration” by Joanne Konick-McMahan, MSN, RN, PCCN; and ConnieLauffer, MSN, RN, CCRN“Nurse Coaching Using MotivationalInterviewing in Diabetes Self Management”by Teresa Fesen, MS, RN CDE“Optimizing Patient Flow in the HarrisburgHospital Perianesthesia Department” byCyndy Wilson, MS, BSN, RN; JoyceMcKelvey, RN, CAPA; and Sandra Boswell,BSN, RN, CAPA“Reduction Of Indwelling Urinary CatheterAssociated Urinary Tract Infections(CAUTI) Through System WideInterventions” by Haley H. Hardenstine,BS, RN; Kimberly Rivera M.T. ASCP;Kimberly A. Fowler, MSN, RN; and JanaWolfgang, BS, RNSafely Sustaining a Low Median Time toPCI (Percutaneous Coronary Intervention)”by Rob Shipp, MS, NEA, BC, RN; andCathleen M. Timothy, BSN, RN“The Double Banding Process: My Promiseto a Young Mother in Surgical PatientProcessing” by Sandra Boswell, BSN, RN,CAPA“Time Out: A Bridge to Patient Safety” byNancy Michaelian, BSN, RN, CPAN; andTammy Springman, BSN, RN“Treat and Street: An ED Process Changewith Proven Results” by Jennifer Gutshall,RN; Mandy Martin, RN; Christie Muza,BSN, RN, CEN; and Elizabeth Owen, RNPinnacleHealth System 1st AnnualNeuroscience RehabilitationConference – Podium Presentations“MY NEURO PATIENT IS A FALLS RISK,NOW WHAT?” by Kim Suda BS, RN,CNRN, EMT; Jessica Stephanic, BS, RN;and Autumn Seifert RN“Accurate Dysphagia Screening DecreasesAspiration Pneumonia Rates” by Kim Suda,BS, RN, CNRN, EMT; Ann Anthony RN;Gabby DiMemmo, RN; Patty Light, SLPLocal, Regional and NationalConferences – Podium Presentations“A Contemporary Framework for ClinicalNurse Specialist Practice” by Melanie Duffy,MSN, RN, CCRN, CCNS. 6th InternationalNurse Practitioner/Advanced PracticeNursing Network Conference in Brisbane,Australia and ANCC Magnet Conference,Phoenix, AZ.“APN Role in Health Care Reform” byMelanie Duffy, MSN, RN, CCRN, CCNS.Bloomsburg University Department ofNursing, Bloomsburg, PA.“Caring for the Patient with Special NeedsDuring the Mass Evacuation of a HealthcareFacility” by Kim Michelle Suda, BS, RN,CNRN, EMT. Homeland SecurityConference, Harrisburg, PA.“Driven By Data” by Sheri Matter, CNO,MBA, MS, NEA-BC. 20th Annual SummerInstitute in Nursing Informatics,Baltimore, MD.“From Toxic to Top Notch: How toTransform a Unit” by Penny Frownfelter,MSN, RN, NEA; Kathleen Garcia, BSN, RN,CNN; and Connie Lauffer, MS, CCRN. 2010ANCC Magnet Conference, Phoenix, AZ.“Interventions to Improve Timely a.m.Insulin Administration in the AdultCardiac Surgery Population” by CheriBechtel, RN, BSN-BC; and Laura Sheads,BS, BSN, RN-BC. 11th AnnualNational/International Evidence-BasedPractice Conference, Phoenix, AZ.“Late Preterm Infant: Who Am I? Using anEvidence-Based Practice Model to ExpediteImprovements in Care to VulnerableInfants” by Marianne Allen, MN, RNC-OB;and Stacy Chubb, BSN, RNC-MNN.NACNS Conference, Portland, OR.“Meaningful Recognition: Supporting theHealthy Work Environment” by SheriMatter, CNO, MBA, MS, NEA-BC. NationalHealthcare CNO Summit, Las Vegas, NV.“Medication Compliance Elderly” by JamieSteinkamp, AD RN-BC. 11th AnnualNational/International Evidence-BasedPractice Conference, Phoenix, AZ“Perinatal Bereavement: Tools to HelpGrieving Families” by Marianne Allen, MN,RNC-OB. NYU Medical Center, New Yorkand the Nurse-Family PartnershipConference, Gettysburg, PA.“We All Make Mistakes” by Sheri Matter,CNO, MBA, MS, NEA-BC. 2010 NationalMagnet Conference, Phoenix, AZ.“What's New in Neuro?” by Kim Suda, BS,RN, CNRN, EMT; Martha Faison BS, RN,CNRN, CNOR, CRNFA. HACC AnnualEducation Conference, Gettysburg, PA.32

Local, Regional and NationalConferences – Poster Presentations“Accurate Assessment of Stroke Patients,the Pinnacle in Pressure Ulcer Prevention”by Kim Michelle Suda, RN, CNRN, BS,EMT; Karissa Harbold RN; Wesley Frye,RN, BS; and Melissa Stolley, BSN, RN,CWOCN. NorthEast Region WOCNConference, Atlantic City, NJ, and theNeuroscience Nursing Conference,Hershey, PA. Awarded 3rd place prize forbest poster presentation at theNeuroscience Nursing Conference.“Accurate Dysphagia Screening DecreasesAspiration Pneumonia Rates” by KimMichelle Suda, RN, CNRN, BS, EMT;Patricia Casciano-Light, MACCC-SLP/ESL;Ann Anthony, RN-BC; and GabrielleDiMemmo, RN. Neuroscience NursingConference, Hershey, PA.“Boning Up on Team Building” by JamieShirey, BSN, RN, CMSRN; Theda Shaw,BSN, RNC; Kim Curtis, RN, CMSRN; andTeresa Biagio, BSN, MBA, RN, ONC.National Association of OrthopaedicNurses Congress, Seattle, WA. Received2nd place award for best poster.“Do No Harm, Prevention of Extravasationand Infiltrates” by Norine Bilharz, RN,CRNI; Catherine Raybould, RN, CRNI;Theresa Stapleton, RN, CRNI; BonnieClemence, RN, MSN; and Sharon Perrine,RN, BSN, CRNI. League of IntravenousTherapy Educators (LITE) Conference,Baltimore, MD. Awarded 2nd prize forbest poster presentation.“Effective Staff Stroke Education Can BeFun” by Kim Michelle Suda, RN, CNRN,BS, EMT. Neuroscience NursingConference, Hershey, PA.“Expediting the Journey from Gurney toBed” by Jessica Stefanic, BS, RN, CMSRN,Lillian Stiglitz, BSN, RN, CMSRN; AngelaSanders, BSN, RN, CMSRN; JeannieFellin, RN. Academy of Medical SurgicalNurses Annual Convention, Las Vegas, NV.“Exploration of the Postpartum Experienceof Women on Long Term Bed Rest forComplications of Pregnancy” by MarianneAllen, MN, RNC-OB; and Deb Schafer, MS,RNC. AWHONN Conference, Las Vegas, NV.“Getting a Grip on Pain: Utilizing PainRounds on the Post Surgical Care Unit(PSCU)” by Mary Ann Clement, MSN,CRNP; and Vicki Duffin, BS, CMSRN.Academy of Medical Surgical NursesAnnual Convention, Las Vegas, NV.“Graduate Nurses and the Effect ofSimulation on Critical Thinking” byTiffany Boyd, BS, (Major in Nursing), RN,PCCN; Cynthia Mastrine, BSN, RN-BC;and Jennifer Shuey, BSN, RN, CMSRN.National Nursing Staff DevelopmentOrganization, San Diego, CA.“Improving the Patient Experience on theOrthopaedic Unit at Pinnacle HealthSystem” by Kathleen Kerstetter, MSN, RN;Maryalyce McCormick, BA, BSN, RN;Kimberly Hohenshelt, BSN, RN, CMSRN,ONC; and Teresa Biagio, BSN, MBA, RN,ONC. National Association ofOrthopaedic Nurses Congress Seattle, WA.“Improving Perioperative GlycemicControl” by Nancy Michaelian, BSN, RN,CPAN. 28th Annual National ASPANConference, New Orleans, LA.“Late Preterm Infant: Who Am I? Using anEvidence-Based Practice Model toExpedite Improvements in Care forVulnerable Infants” by Marianne Allen,MN, RNC-OB; Stacy Chubb, BSN, RNC-MNN; Deborah Hamor, RNC; and CathyZubrickie, RNC. AWHONN Conference,Las Vegas, NV.33