Nursing Update 2009 - 2010 - Yale-New Haven Hospital

n u r s i n g u P D A T E
The work of The nurse AT YALe-new hAVen hosPITAL
2009–2010

NuRSINg uPdaTE
2009–2010
1 Letter from Sue Fitzsimons
2 Letter from the Staff Nurse
Council Co-Chairs
3 Transformational Leadership
6 Structural Empowerment
8 Exemplary Professional Practice
12 New Knowledge, Innovations
and Improvements
14 Recognition
20 Publications and Presentations
Ynhh suPPorTs
Marna P. Borgstrom, President and CEO,
Yale-New Haven Hospital:
Yale-New Haven Hospital consistently ranks
among america's finest hospitals, and our
exceptional nurses contribute significantly
to our national reputation for excellence. We
have recently applied to the american Nurses
Credentialing Center (aNCC) for Magnet
certification, a designation only 6 percent of
american hospitals achieve. The hospital's
Board of Trustees, senior leaders and
employees universally applaud and support
the extraordinary work our nurses have
invested in this application, and we eagerly
await the decision of the aNCC.
Richard d’aquila, Executive Vice President
and COO, Yale-New Haven Hospital:
at Yale-New Haven, we pride ourselves
on being a destination hospital – that means
people choose us for themselves and their
loved ones when they are concerned about
getting the best medical care possible. Our
nurses should be extremely proud of the part
they play in making YNHH the special and
sought-after institution that it is.
Peter N. Herbert, Md, Chief of Staff,
Yale-New Haven Hospital:
Our physicians and nurses work extremely
well together to deliver the exceptional care
and positive outcomes that our patients
expect for themselves and their loved ones
when they choose Yale-New Haven. This kind
of collaboration is the hallmark of a great
hospital, and I am delighted that you can read
about some of the fine work that our nurses
are doing to advance patient care.
Joseph R. Crespo, Chair, Yale-New Haven
Hospital Board of Trustees:
The members of the hospital’s Board of
Trustees are extremely proud of the work of our
nurses. Over the past few years, their efforts
to draw on the observations and experience
of the nurses who work at the patient’s
bedside have contributed greatly to advances
in practice throughout the institution. We
wholeheartedly support the hospital’s pursuit
of Magnet designation.

The journeY To mAgneT
Dear Colleagues and Friends of Nurses:
This has been a busy and productive year for Yale-New Haven nurses. Let me tell you
about some of the events and achievements of the past year – some of which are written
about in this issue.
As of June, staff on all inpatient care units now use electronic medical records to
document patient assessments, progress and medications. Adjusting workflow and
learning to use the system efficiently have been significant challenges for everyone, but
timely, accessible and accurate electronic records contribute to patient care and safety.
Another major milestone for our nurses is the transition to uniforms. The Staff Nurse
Council was instrumental in helping nurses achieve consensus on the style and color of
the uniform. Our patients now know with confidence that the woman or man at their
bedside in the blue uniform is their nurse. This change significantly increases patients’
sense of safety and security while we care for them.
In October, we proudly opened Smilow Cancer Hospital at Yale-New Haven with
memorable employee and community celebrations. Smilow consolidates our cancer
services and makes treatment easier and more convenient for patients and families. In
addition to the oncology inpatient medical and surgical units and outpatient services, we
have moved the Medical Intensive Care and Step-Down units to Smilow, where our nurses
are able to provide care in the most thoughtful of settings.
Lastly, Magnet! Magnet absolutely permeates this Nursing Update – a reflection of the
positive impact this rigorous application process has had on our hospital. We grouped
this year’s information under four of the same headings that we are using in our Magnet
application. Much of the work we have done in preparation for Magnet submission
has come to fruition, and it is with delight that I share this with you in Nursing Update
– including stories on bedside reporting, decreasing bloodstream infections, using
therapeutic hypothermia in the ED – and more.
I hope you share my feeling of pride as you read about the incredible work of the nurse at
Yale-New Haven. We have some exciting months ahead of us, and my hope is that next year
when I write, it is to tell you that our hard work, passion for our practice and commitment
to safe patient care have earned us that important nursing designation – Magnet.
Sincerely,
Sue Fitzsimons, RN, PhD, CENP
Chief Nursing Officer
Senior Vice President
Patient Services

Nora O’Keefe, RN
Heather Miska, RN
2 n u r s I n g u P D A T e
Dear Colleagues:
As we write this letter, we are finalizing our application to the American Nurses
Credentialing Center for Magnet status. We are proud that the Staff Nurse Council (SNC)
has played a crucial role in capturing, studying and sharing the best practices that abound
throughout this hospital – a crucial standard for Magnet consideration.
In the past year, the SNC has increased awareness of collaborative governance and
strengthened the process of practice improvements. Our vision of achieving excellence
through continuous improvement and innovation is what drives our practice to provide the
safest quality care to our patients every day.
Another area that is paying dividends for our patients’ safety is the culture of research that
the Staff Nurse Council has nurtured among our nurses through collaborative governance.
Not long ago, few of us were engaged in research, and evidence-based nursing was seen
more frequently in classrooms than in patient care rooms. But we are proud to say: we have
changed all that.
As you read Nursing Update, you will learn about ideas and implementations – driven by
nurses at the bedside and supported by our nurse leaders – that have raised the bar for
patient care in this organization. You will read about vastly reduced bloodstream infections
in the Pediatric Intensive Care Unit, how psychiatric nurses are helping colleagues on
medicine units better identify and care for patients struggling with mental illness, and the
positive impact bedside reporting has on increasing patient safety and satisfaction.
Yale-New Haven Hospital is a complex institution that is frequently near full census. Many of
our patients come to us with illnesses, diseases and injuries that other hospitals are simply
not prepared to treat. Some of our patients undergo groundbreaking surgery, others receive
cutting-edge diagnostic procedures, and others come in, deliver healthy babies and leave
after two days, happily unaware of the medical muscle poised to help mothers or babies if
their condition requires it.
Last year, we helped to treat almost 55,000 inpatients and had almost 611,000 outpatient
visits – a record in both areas. Starting in October, we opened Smilow Cancer Hospital at
Yale-New Haven, and over the course of seven months, we’ve opened new patient care units
or moved existing ones into this impressive new facility.
The journey to Magnet is a rigorous process that reflects extremely well on those hospitals
that achieve it. The Staff Nurse Council is proud of the role we play in harnessing the
energy, talent and passion for excellent practice that marks each and every Yale-New Haven
nurse and in giving those nurses a voice. These voices join collaboratively to improve how
we deliver safe, quality care to our patients, and Staff Nurse Council is extremely proud to
contribute to this important effort.
Sincerely,
Nora O’Keefe, RN Heather Miska, RN
Staff Nurse Council Co-Chair Staff Nurse Council Co-Chair
Heart and Vascular Center Children’s Psychiatric
Nursing Procedures Inpatient Service

TrAnsformATIonAL LeADershIP
success of rounding with
staff nurses
Each week, members of the Nursing Cabinet
– the hospital’s nursing
leadership – receive valuable feedback
from one unit’s entire interdisciplinary
team as they walk the floor and meet with
staff and patients.
During this time, staff nurses tell cabinet
members about topics such as equipment
needed for increased patient safety, how
an additional computer would decrease
the time spent documenting information,
compliance progress or a job well done by
staff or an individual.
Do you have what you need to do your
job? Tell me a little bit about your patient.
Such open-ended questions elicit key
information about what is important so
nurse leaders can address the issues of
the staff nurse. Cluster leaders and Staff
The Nursing Cabinet at YNHH includes (front row, l-r): Patricia Span, RN, director, Center for Professional
Practice Excellence; Leslie O’Connor, APRN, director of nursing, Yale-New Haven Psychiatric Hospital; Carol
Kupec, RN, director of nursing, Emergency Services; Sue Fitzsimons, RN, PhD, senior vice president, Patient
Services; Diane Vorio, RN, vice president, Patient Services; Ena Williams, RN, director of nursing, Perioperative
Services; Francine LoRusso, RN, director of nursing, Heart and Vascular Center; and Cathy Stevens, RN, director
of nursing, Women’s and Infants Services. In the middle row are (l-r): Bertie Chuong, RN, director, Ambulatory
Services Division; Kathy Kenyon, RN, director of nursing, Medicine; Catherine Lyons, RN, clinical program
director, Smilow Cancer Hospital; Nora O’Keefe, Staff Nurse Council co-chair; Heather Miska, RN, Staff Nurse
Council co-chair; and Carol Just, RN, director of nursing, Surgery. In the back row are (l-r): Stephanie Bilskis,
RN, practice administrator, Community Health; Sherri Barnhill, RN, coordinator, Nursing Safety and Quality;
and Cheryl Hoey, RN, director of nursing, Pediatrics. Missing from photo are: Lori Hubbard, RN, Magnet
coordinator; and Janet Parkosewich, RN, DNSc, interim nurse researcher.
Nurse Council members are frequently
part of rounding, which helps to more
widely disseminate awareness of emerging
patient safety and quality issues.
“We want to hear directly from the staff
nurses about their challenges, concerns
and questions and to hear about their
successes improving the quality of care
for our patients,” said Diane Vorio, vice
president, Patient Services. “Rounding
provides us with an excellent opportunity
to facilitate needed changes more quickly
so the nurses can focus on patient safety
and satisfaction.”
nurses strengthen, improve
practice within heart and
Vascular Center
Yale-New Haven Hospital Heart and Vascular
Center is Connecticut’s largest and
most comprehensive provider of heart
and vascular services, including adult and
pediatric cardiac operating rooms, interventional
laboratories, rhythm management
facilities, advanced imaging services
– nuclear, CT and MRI, and a Chest Pain
Center.
Because of its reputation for excellence,
Yale-New Haven attracts some of
Y A L e - n e w h A V e n h o s P I T A L 3

the sickest patients for care. The doctors
and nurses who work in the Heart and
Vascular Center are highly trained and
experienced in helping patients recover
from heart disease and complex surgery.
Heart and Vascular nurse leaders have
tapped into the expertise and creativity
of their staff nurses to improve patient
benefits and outcomes. On the Cardiac
Intensive Care Unit (CICU), staff nurses
have conducted research on continuous
ischemia monitoring using new software
called the ST-map. The study was
completed in late 2008, and YNHH nurses
presented the results at national nursing
and medical conventions.
“We worked with an outside vendor to
get our bedside monitors upgraded with
the ST-map software. At the same time,
we secured a research mentor to help us
collect and analyze the data,” explains
Prasama Sangkachand, RN, service line
educator, Cardiac Intensive Care Unit.
“Continuous ischemia monitoring
helps us identify patients with acute – but
often silent – myocardial ischemia before
he or she becomes symptomatic – improving
patient care,” says Sangkachand.
“Based on the results of this study,
continuous ischemia monitoring using
the ST-map is now a standard of care in
the CICU.”
Innovative approach helps
staff help psychiatric
patients
In 2007, Yale-New Haven Hospital
estimated that more than 30 percent of
non-psychiatric and non-OB patients had
a secondary diagnosis of mental health
issues. In 2008, that translated into more
than 10,000 cases.
“At first, the numbers surprised us but
they really made sense when we analyzed
them,” said Leslie O’Connor, APRN,
director, Psychiatric Nursing Services,
Yale-New Haven Psychiatric Hospital.
“In the U.S., the psychiatric population is
aging and developing the same pains and
illnesses that the rest of us are developing.
As patients, they have co-occurring
psychiatric disorders that can interfere
4 n u r s I n g u P D A T e
During the Year of the Unit, the Staff Nurse Council was also proud of its year of accomplishments. The members
shown are (front row, l-r): Mary Ann Meehan, RN, General Medicine; Roseann Della Ventura, RN, and Laurie
Jonason, RN, both of the Newborn Special Care Unit; SNC co-chairs Nora O’Keefe, RN, Heart and Vascular
Center (HVC) Nursing Procedures, and Heather Miska, RN, Children’s Psychiatric Inpatient Service; Rhonda
Pattberg, RN, Labor and Birth; Shelley Harrigan, RN, Adult Primary Care Center; and Liliana Lara, RN, Post-
Partum Unit. In the second row are (l-r): Sandy Cayo, RN, Medical Oncology Unit; Laurie Finta, RN, Perioperative
Services, Ambulatory Services; Ebony Wright, RN, Children’s Hospital Operating Rooms; Lisa Waterbury, RN,
HVC Nursing Procedures; Sybil Shapiro, RN, Shoreline Surgery Center: Endoscopy; Kelly Baran, RN, Gyn/
Oncology Unit; Jason Malia, RN, Surgical Intensive Care Unit; and Deborah Gallagher, RN, Pediatric Emergency
Department. Missing from photo is Mary Kelly O’Shea, RN, Pediatric Post-Anesthesia Care Unit.
with their ability to participate in their
own treatment and recovery.”
O’Connor worked with nursing and
medical staff leaders, and William H.
Sledge, MD, medical director, YNHPH, to
develop the Behavioral Intervention Team
(BIT). The interdisciplinary BIT includes a
clinical nurse leader, an advanced practice
registered nurse, a social worker and a
psychiatrist.
BIT members train staff on the medical
and surgical units where these patients
are most frequently admitted. Once patients
are identified, BIT members consult
with clinicians – and with the patients.
“With the BIT, we’re able to address
the special needs of psychiatric patients
on inpatient units,” said Susan King,
RN, clinical nurse leader, YNHPH, and a
founding member of the BIT.
“BIT training is helping our nurses better
care for our patients who have psychiatric
needs,” explains King. “The results
are very positive: patients are better able
to participate in their own care, and we
are providing a safe environment for the
patient and staff.”
nurses play pivotal role
in move to patient- and
family-centered care
YNHH has embarked on a hospital-wide
model of care known as patient- and familycentered
care, and its nurses are considered
the champions and educators of its core
concepts: information sharing, dignity and
respect, collaboration and participation.
“Nurses are helping to lead the charge
on this initiative because they are pivotal
caregivers, present for every decision
from admission to discharge,” explains
Cheryl Hoey, RN, director, Pediatric Nursing.
“Focusing on the patient and his or
her family will change the entire culture of
how we care for our patients.”
Measures such as providing patients
and families with a phone number that
they can call to activate a team if they
feel that the patient needs help urgently,
allowing family members to be present in
Emergency Department trauma rooms,
and referring to family members as
“guests” rather than visitors, all reinforce
the concept that at YNHH, the patient is
truly at the center of his or her care. ■

Connecticut Hospital association’s Nursing Workplace Environment
assessment Survey
Through participation with the Connecticut Hospital association, YNHH nursing provided the leading benchmark
for all other participating Connecticut hospitals on a fall 2008 staff engagement survey. This survey revealed that a
majority of YNHH nurses feel empowered to create a quality and safe environment for all patients and their peers.
%
80
70
60
50
40
30
20
10
0
RNs believe they have
shared decision making at
all levels of the hospital/
organization
■ YNHH (n=608) ■ all CT Hospitals (n=2083)
RNs believe they are
recognized for their
performance
RNs believe they have
opportunities at
work for them to learn
and grow
RNs are proud to work
at YNHH
SNC members Sybil Shapiro (second from left), RN, Shoreline Surgery Center: Endoscopy, and Liliana Lara
(right) RN, Post-Partum Unit, paid a nighttime visit to General Medicine (9-7) on one of their SNC “road
shows” to show staff the kind of information they can now access on the nursing website. Shown (l-r) are:
Chizuru Bosley, RN; Shapiro; Susan Nichols, RN; Jasmin Rosales-Ancheta, RN; and Lara.
Y A L e - n e w h A V e n h o s P I T A L 5

sTruCTurAL emPowermenT
Ynhh submitting
application for magnet
As this year’s Nursing Update goes to press,
Yale-New Haven Hospital is submitting
its application for Magnet status to the
American Nurses Credentialing Center.
In the three years leading up to submission,
YNHH nurses have made enormous
strides in accepting collaborative governance
as the optimum way to ensure communication
between nurses at the bedside
and the highest levels of nursing and
administrative managers in the hospital.
Leading the collaborative governance
charge has been the Staff Nurse Council, a
thriving and vibrant organization embraced
– crucially – by both senior leaders and
nurses. Staff Nurse Council been creative
in developing the nursing website, grand
rounds and the popular 12-hour road shows
to patient care units. Most importantly,
however, this group has spearheaded the
process for introducing evidence-based
practice changes throughout the institution.
With its emphasis on evidence-based
practice, Magnet preparation has revitalized
research efforts among nurses at Yale-
New Haven. Research and evidence-based
practice enjoy a symbiotic relationship.
6 n u r s I n g u P D A T e
Research examines and confirms what
works correctly and is best for the patient
over time, and evidence-based practice
can create ripe opportunities for nurses
to research how a best practice can be improved.
At Yale-New Haven, this constant
testing of known best practices and pushing
to uncover new ones raises the bar for
quality and safe patient care – a hallmark
of a Magnet hospital.
nurses lead moves, transition
to smilow Cancer hospital
As outpatient services and inpatient
units have opened in the state-of-the-art
Smilow Cancer Hospital at Yale-New Haven,
nurses have worked tirelessly, often
after hours and on weekends, to prepare
the rooms, organize and place supplies
and equipment in their proper places,
and anticipate patient flow and needs to
ensure a flawless transition.
Smilow Cancer Hospital opened in
October 2009, with a phased move-in that
was complete in spring 2010. To help all
staff prepare for the phased-in moves,
nurses developed an innovative, multidisciplinary
“day in the life” scenarios for
Smilow Cancer Hospital at Yale-New Haven has established an award it will give each year during National
Oncology Nursing Month. The winner of the first award was Maria Wasko, RN, Multispecialty Treatment
Center. Shown at the breakfast at which she was honored are (l-r): Catherine Lyons, RN, MS, clinical program
director, Smilow; Wasko; and Thomas Lynch, MD, physician-in-chief, Smilow.
each major move-in.
“I couldn’t be more proud of the nursing
staff’s efforts to ensure that we were
completely prepared to move into all areas
of Smilow – we did not experience one
interruption of service to our patients,”
said Catherine Lyons, RN, clinical program
director and director of Oncology Nursing,
who noted that the move-in schedule was
aggressive. “Our nurses are all excited to
be part of the talented team that provides
world-class cancer care to this community.”
To prepare nursing staff for caring for
patients in the state-of-the-art building that
houses the latest technology, all oncology
nurses were required to attend 12 hours of
training and receive an extensive orientation
to learn about the physical layout of the
500,000-square-foot facility and become
acquainted with the 12 disease teams that
will be diagnosing and treating patients.
staff nurse Council impacts
nurse vacancy rate
Since its creation in 2007, Yale-New Haven
Hospital’s Staff Nurse Council (SNC)
has provided nurses with clear communication
channels and the authority to make
the clinical decisions that affect nursing
practice. The SNC and the empowerment
it represents have improved the hospital’s
nurse retention rate and are a valuable
recruitment draw for new applicants.
“Yale-New Haven Hospital is an employer
of choice, and the SNC is an impressive recruiting
tool when candidates want to know
more about us,” explained Nancy Collins,
director, Recruitment and Staffing. “Having
a vital staff nurse council and collaborative
governance structure show how the hospital
values the voice of the nurse and how nurses
can influence decisions.”
At job fairs, members of the SNC
engage applicants and discuss how
participating in the decision-making process
contributes to the positive nursing
environment at YNHH. ■

YNHH RN turnover and vacancy rates Fiscal Year 2009
Within healthcare organizations, the chief nursing officer sets strategic nursing targets based on benchmarks.
destination hospitals like Yale-New Haven regularly exceed those targets. Over the past year, YNHH nursing
has exceeded organizational and national goals by its lowest numbers to date for both vacancy and turnover
rates for nurses.
TurnoVer rATes
national 14.2%
northeast 11%
ynhh target 10.5%
%
14
12
10
8
6
4
2
0
More than 100 YNHH registered nurses, including members of the Staff Nurse Council, joined Human
Resources recruiters at a nursing recruitment fair to support hospital recruiting efforts. The nurses spoke with
prospective employees about nursing practice, the Magnet initiative and work on the various clinical practice
units. Marie Devlin, RN, from the SICU, speaks with two nurses interested in working at YNHH.
■ YNHH RN turnover rate 2009 ■ YNHH RN vacancy rate 2009
11 10.9 10.8 10.5
5.6
3.8
1st quarter 2nd quarter 3rd quarter 4th quarter
5
1.7
VACAnCY rATes
national 6.1 – 23.2%
ynhh target 6%
Y A L e - n e w h A V e n h o s P I T A L 7

8 n u r s I n g u P D A T e
exemPLArY
ProfessIonAL PrACTICe
At change of shift on General Medicine (5-7), Terance Anderson, RN, and Kathleen Millhollan, RN, discuss a
patient at his bedside. Bedside reporting allows the patient to have an increased role in his care and gives staff the
opportunity to ask the patient questions – resulting in better, safer care for the patient.

Bedside reporting increases
patient safety and
satisfaction
Before bedside reporting began last summer
on General Medicine units 5-7 and 9-7, their
data showed that a significant percentage of
patient falls occurred during shift changes.
“At change of shift, nurses gave report
in a large conference room,” said Kathleen
Kenyon, RN, director of nursing, Medicine.
“Up to 16 staff could be talking about patient
plans of care. It was not an optimal environment
for sharing information or learning.
“On our units, we have moved change
of shift right to the patient’s bedside,”
continues Kenyon. “Staff now roll their
workstation on wheels into the patient’s
room to do the handoff. We used
evidence-based research to introduce a
change that is improving both patient
safety and patient satisfaction.”
Rochelle Mikolinski, RN, patient
service manager, General Medicine Unit
(7-5), points to the additional benefits of
the bedside hand-offs. “We increase our
patients’ involvement in decisions that
affect their care and help novice nurses
develop critical thinking through a goalcentered
report. Bedside reporting is also
very efficient: it takes less time, so it has
allowed us to reduce incidental overtime.”
“By doing bedside reporting at changeof-shift,
we include the patient in the process,
and he or she has an increased sense
of ownership in their own care because
they are involved in information-sharing
and decision-making,” said John Sward,
RN, patient service manager, General
Medicine Unit (9-7). “Nurses now start
their shift with improved understanding
of each patient’s status.”
Yale Pediatric Advanced
Care Team improves quality
of life for patients
Cindy Jayanetti finds that her pediatric
patients most appreciate the smallest gestures
– offering a drink of water or asking
how school is going. Jayanetti, APRN,
coordinates the Yale Pediatric Advanced
Care Team (YPACT), which provides the
extra support measures her chronically ill
patients and their families need. Whether
it’s scheduling a much-in-demand massage,
a Reiki or aromatherapy session, or
providing better communication within
and among the patient’s interdisciplinary
teams, Jayanetti works to improve the
quality of life for her young patients. With
the support she receives from collaborating
nurses and physicians, she’s been
able to increase the number of patients
she cares for over the past year.
“I see how patients improve when they’re
able to relax, whether it’s because of a massage
or having their questions answered,”
she said. “It makes a real difference.”
Palliative care helps
adult patients
Leslie Blatt, APRN, coordinator of palliative
care, recalls a 59-year-old cervical
cancer patient who had had a resection.
For 15 years, she had done well until a
fistula caused increasing pain and then
hospitalization. While the patient was
hospitalized, it became clear that her
cancer had reoccurred and that she was
nearing the end of her life.
“Working with a team of physicians,
nurses, a social worker and chaplain, we
managed her physical and emotional pain
which enabled her to be alert with her
loved ones,” recalls Blatt. “She was able
to say good-bye and also help ease their
burden because she was able to make her
own end-of-life arrangements. What was
most valuable to this patient was having
the ability to tell everyone in her life what
they meant to her.”
nurses lead chest pain
center accreditation
YNHH is the first and only Connecticut
hospital to receive Cycle III accreditation
from the Society of Chest Pain Centers
(SCPC) as a Chest Pain Center with Percutaneous
Coronary Intervention. Cycle III
is the highest level of accreditation that
the society gives.
“Gaining this three-year accreditation
is a major accomplishment that says
volumes about the quality of care patients
receive here at Yale-New Haven,” said
Mariane Carna, RN, MSN, executive
director, Heart and Vascular Services,
who notes that YNHH is the largest
provider of heart and vascular services in
the state.
Charlotte Hickey, RN, the clinical coordinator
of our Women’s Heart Program,
was responsible for organizing staff
and meeting the SCPC’s deadlines. The
rigorous accreditation process examined
the hospital, its policies and processes,
the competencies and training of the
staff who care for cardiac patients, community
education on heart disease, and
performance measures for diagnosing
and treating patients with acute coronary
syndrome.
“We are a designated chest pain center
that provides the best in cardiac care to
our patients,” said Hickey, who also does
community outreach. “But we also work
hard to keep people from developing
cardiac disease in the first place.”
A truly patient-, familycentered
care experience
Kelley Reddington, RNC-OB, admitted a
patient at 34 weeks gestation, whose
baby – with Down syndrome – had died in
utero and was to be induced. The family
also had an 8-year-old son, to whom they
wanted to introduce – however, briefly –
his sister. However, the unit’s visitor policy
excludes children under the age of 12.
“After conferring with the family, I
knew their emotional needs were of the
utmost importance,” explained Reddington.
“By using a team approach, I was
able to create a unique plan of care for this
grieving family that would allow their son
to visit.”
As the mother was about to be discharged,
Reddington visited the patient,
who told her that she had gone “above and
beyond” in her care for the entire family.
“I just treated them the way I would want
to be treated,” Reddington recalls. “They
touched my life and made me realize I love
being a YNHH nurse because I have the
autonomy to change the standard of care
to meet the needs of my patients.”
Y A L e - n e w h A V e n h o s P I T A L 9

This year, YNHH received accreditation from the Society of Chest Pain Centers as a Chest Pain Center with
Percutaneous Coronary Intervention. Charlotte Hickey (left), RN, clinical coordinator of the Women’s Heart
Program, and Twila Balint, RN, Occupational Health, discuss the accreditation process and preparation.
nurse gets vendor to label
breast implant boxes clearly
After an incorrect implant was inserted
into a woman’s breast, Heather Pantalone,
RN, Ambulatory Surgery, was determined
to find a way to differentiate the identicallooking
boxes of breast implants. Although
the patient had suffered no harm
when the incorrect breast was removed,
Pantalone did not want to see this situation
happen again at YNHH. She discussed
the problem with the surgeon and the
hospital’s legal department, and then approached
the distributor.
“I decided to take it to the next level
because our patients’ safety is our priority
and any positive change we can make
benefits them,” explains Pantalone. She
1 0 n u r s I n g u P D A T e
developed a colored sticker system that
clearly distinguishes one box of implants
from another. Pantalone provided an inservice
session on the new sticker system
for the other nurses in the ambulatory
surgery department. In addition, the nurses
now read aloud to the surgeon which
implants is being used to minimize the
chance of choosing an incorrect one.
high patient satisfaction
rate at shoreline medical
Center emergency
Department
“Everyone in Guilford and the surrounding
towns is so happy that the Emergency
Department is there on Goose Lane.”
“I received prompt, courteous, professional
care.” “Great staff and excellent care.”
After a visit to the Emergency Department
(ED) at Yale-New Haven Hospital’s
Shoreline Medical Center, patients
frequently rate their experience highly. As a
result, the ED’s patient satisfaction scores –
as scored by a national company – routinely
rank in the 98th percentile nationally. Now
open 24/7, the full-service, fully staffed ED
is housed in the shoreline area’s largest,
most comprehensive medical center.
“We have a skilled staff of nurses here
who are very sensitive to patients’ needs
– expediting their care and keeping them
informed throughout their treatment,”
said Carol Kupec, RN, director of nursing,
Emergency Services. “Despite the pace,

we work hard to ensure a pleasant work
environment. As a result, we have virtually
no staff turnover and that translates
positively to our patients.”
nurses lead recycling efforts
in Ambulatory services
Division
With virtually no recycling in their building
18 months ago, nurses in YNHH’s
Ambulatory Services Division have since
taken recycling in the one-day surgery
center to heights that could put some
municipalities to shame.
Located in a non-hospital-owned building,
the nurses began recycling plastic
bottles, cans and newspapers. Then they
turned their attention to waste in the
clinical areas to determine what could
be safely reused. They creatively involved
groups as diverse as the Newington (Connecticut)
Humane Society and local art
teachers. Both groups now use the paper
that once wrapped surgical trays.
Darlene Cox, RN, Post-Anesthesia Care
Unit, led the recycling efforts. She also
found a new intravenous solution bag
that didn’t require an outer plastic wrap,
which had created significant amounts of
discarded plastic.
Pediatric Intensive Care unit bloodstream infection rates
Through collaboration with the National association of Children Hospitals and Related Institutions,
the Pediatric Intensive Care unit was able to decrease bloodstream infections by introducing
interventions to improve the quality of care given to patients. The unit went a remarkable 326 days
without an infection.
Infections / 1000 device days
8
8
7
7
6
6
5
5
4
3
2
1
0
Nurse Certification Day is a popular event for YNHH nurses. Hundreds attend the all-day information fair to
meet with the hospital’s certified nurses and learn more about getting certified or recertified themselves.
Here (l-r) are: Rosanna Tangredi, RN, Heart and Vascular Center Cardiac Intensive Care Unit; Mary Davis, RN,
Cardiac Unit; and Belen Hilario, RN, Medical Intensive Care Unit, share information about certification with
Mary Pierson (second from left), RN, assistant patient service manager, Heart and Vascular Center Cardiothoracic
Step-Down Unit.
■ PICu
■ NHSN median
■ NHSN 25th percentile
■ NHSN pooled mean
1/06 2/06 3/07 4/07 1/08 2/08 3/08 4/08 1/09 2/09 3/09 4/09 1/10
quarter / year
“The staff benefits by using this product
because it eliminates a step in our
procedures,” Cox explained. “Everyone
has embraced the recycling efforts, and
some have gotten involved beyond their
eight-hour days.”
PICu goes 326 days without
bloodstream infection
For 326 days last year, the number of patients
with bloodstream infections in Yale-
New Haven Children’s Hospital’s Pediatric
Intensive Care Unit (PICU) was zero.
“This life-saving achievement is a
result of PICU nurses reliably implementing
best practice ‘care bundles’ – a group
of practices that, when applied together,
result in substantially greater improvement
for our patients,” explained Susan
Reynolds, RN, patient service manager,
PICU. Since becoming part of the National
Association of Children’s Hospitals and
Related Institutions collaborative in July
2008, the hospital’s PICU nurses
can compare diagnoses and procedures
used by 50 other children’s hospitals and
institutions to increase their compliance
and improve patient care. The collaborative
is a multi-year initiative focused on
preventing catheter-related bloodstream
infections in the PICU, which will save
lives, prevent infections and conserve
healthcare dollars. ■
Y A L e - n e w h A V e n h o s P I T A L 1 1

new knowLeDge,
InnoVATIons AnD ImProVemenTs
nurses trained in Pedi eD
to use intraosseous tool
to inject into marrow
Nurses in Yale-New Haven Children’s
Hospital’s Pediatric Emergency Department
and Pediatric Intensive Care Unit are
now equipped with a palm-sized tool that
allows them to deliver intraosseous drugs
and fluids quickly and safely to a patient
through the marrow, if vascular access
is not available. Nurses in both departments
have been trained to use the EZ-IO
intraosseous power driver, a drill-like
tool that provides emergent intravenous
access in less than 10 seconds and has
proven to be a safe and effective alternative
to intravenous access for the patient.
“Paramedics and EMTs have used this
tool pre-hospital for several years, but it
is a relatively new practice for nurses,”
comments Denine Baxter, RN, patient
services manager, Pediatric ED. “This
safe and reliable tool provides us with an
alternative method of delivering drugs
and fluid when timing is critical for our
young patients.”
Ynhh nurses conduct
range of vital research
Yale-New Haven Hospital is committed to
supporting nursing research as a means
to generate new knowledge, promote innovations
in nursing practice and improve
the quality of care. The hospital’s Nursing
Research Committee, established in 2007,
provides the ongoing research support
needed by staff. The committee matches
nurses with research mentors who guide
them through every phase of the process.
Nurses of varied backgrounds and
tenure have developed research projects
1 2 n u r s I n g u P D A T e
based on questions arising from clinical
practice, nursing and patient education,
health policy, nursing administration or
informatics.
Currently, 18 teams are in various phases
of conducting studies in several clinical
settings. Some of the studies include: use
of an internet-based medication tool that
reduces medication errors in kidney and
liver transplant patients; accuracy of chemstrips
for screening urine prior to chemotherapy
in children; ambulating patients
with pulmonary artery catheters who are
waiting for heart transplant; and a study of
inadvertent hypothermia in adult patients
undergoing interventional radiologic
procedures.
“YNHH is committed to supporting the
scientific inquiry of its nursing staff and
is always looking for ways to increase the
number of studies conducted here,” said
Janet Parkosewich, RN, DNSc, interim
nurse researcher.
hospital introduces
therapeutic hypothermia
into eD
With research supporting the effectiveness
of slowing down brain metabolism
in patients who remain unconscious
after suffering cardiac arrest, YNHH’s
critical care team began providing
therapeutic hypothermia treatment last
year. Arctic Sun is a non-invasive device
that delivers this therapy using waterfilled
hydrogel pads that are applied
directly to the patient’s back, chest and
thighs to lower the body temperature and
maintain it at 91.4° F. Unit-based nurse
educators led the education efforts for
the Arctic Sun equipment and the
Inadvertent hypothermia in
adults undergoing interventional
radiology procedures with
moderate sedation/analgesia
Twenty-five patients participated in this pilot
study. Results demonstrated a wide variation in
temperatures. Mean temperature was 98.54° F
pre-procedure, immediately post-procedure, it
was 98.43° F, whereas temperature in the recovery
area was 98.26° F. Twenty percent of the patients
reported feeling cold immediately post-procedure,
and 28 percent felt cold in the recovery area. Of
those denying thermal discomfort, 75 percent had a
temperature decrease immediately post-procedure,
whereas 69 percent experienced a temperature
decrease in the recovery area.
Percentage not cold
100
90
80
70
60
50
40
30
20
10
0
75%
Immediately
Post-Procedure
69%
Recovery
area

therapeutic hypothermia protocol.
“This truly was a collaboration among
cardiology, critical care medicine, emergency
and neurology services and allows
us to start treatment without delay,” said
unit-based educator Prasama Sangkachand,
RN, service line educator, Heart
and Vascular Center. “The Arctic Sun is
technologically much farther advanced
and easier to use when compared with
traditional body cooling-methods. Most
important, it allows us to spend more
time on patient care – and less on the
equipment.”
Sarah Gillespie (left), RN, is a nurse in the Cardiac Intensive Care Unit who also volunteers for the hospital’s
Listen and LeaRN program. Here she takes a blood pressure reading of a visitor at the hospital’s annual
Community Health Fair where nurses and other health professionals provide free health screenings and
information to greater New Haven area residents who come to the popular event.
ICu nurses trained for
mArs therapy
In October 2009, YNHH became the
first U.S. hospital to offer Molecular
Adsorbents Recirculating System
(MARS) therapy – a form of artificial liver
support. MARS is FDA-approved for the
treatment of drug overdose and poisonings.
The patient is simultaneously connected
to a continuous renal replacement
therapy machine and the liver dialysis
machine. Often described as bridge
therapy, MARS therapy may lessen the
morbidity and mortality associated with
liver failure because it buys precious time
to locate a donor liver or for the liver to
regenerate.
Specially trained critical care nurses in
the Medical Intensive Care Unit (ICU) and
Surgical ICU initiate the MARS therapy
while working with an interdisciplinary
team consisting of staff from hepatology,
nephrology and pharmacy.
“Our first patient’s positive outcome
provides a glimpse into a new and
exciting future for the treatment of liver
failure,” said Dawn Cooper, RN, service
line educator, MICU. ■
Y A L e - n e w h A V e n h o s P I T A L 1 3

nine nurses honored
for excellence at
nurse week celebration
One of the enduring Nurse Week traditions
at Yale-New Haven Hospital is the
Recognition and Rewards ceremony that
The nine winners of the 2009 Nursing Excellence Awards were (seated, l-r): Mary Ann Meehan, RN, General
Medicine, Outstanding Impact on Patient Safety and Quality; Danielle Huseman, RN, General Medicine, Early
Clinical Practice Excellence; Suzann Blanchard, RN, Labor and Birth, Excellence in the Charge Nurse Role; and
Kristin Valerio, RN, Orthopedics Unit, Graduate Nurse of the Year. Standing (l-r) are: Prasama Sangkachand, RN,
service line educator, Heart and Vascular Center, Nursing Education Excellence; Sue Fitzsimons, RN, PhD, senior
vice president, Patient Services; Patricia Gatcomb, APRN, Hospital Research Unit, Advanced Practice Excellence;
and Shelley Britt, RN, Hospital Research Unit, Nursing Management Excellence. Missing from photo were:
Linda Koch, RN, Radiation Therapy, Preceptor of the Year; and Mary Harris, RN, Cardiac Intensive Care Unit,
Professional Practice Excellence.
1 4 n u r s I n g u P D A T e
reCognITIon
honors its nurses for excellence in nine
areas of practice.
“You bring extraordinary commitment
and caring to the important work you
do,” Marna P. Borgstrom, president and
CEO, told the audience at the awards
ceremony. “We are fortunate you chose
the profession of nursing and even more
fortunate you chose to practice it here at
Yale-New Haven.”

ecognition and Clinical
Advancement Program
In 1991, Yale-New Haven Hospital introduced
an internal clinical ladder called the
Recognition and Clinical Advancement
Program (RCAP), and since then more
than 2,500 nurses have advanced on it.
RCAP has three rungs – Clinical Nurse
II, III and IV – and managers consistently
encourage nurses to climb the ladder
through a rigorous program in which
nurses, working with a preceptor, record
their experiences with patients in a portfolio
of exemplars. Nurses who advance
are recognized in a quarterly ceremony.
The following YNHH nurses advanced
in 2009.
Clinical Nurse IV
Michael Consiglio, RN
Surgical Intensive Care Unit
Karen Esposito, RN
Infant/Toddler Unit
Clinical Nurse III
Mary Ellen Alberino, RN
Maternity
Frank Balisciano, RN
Perioperative Services
Julie Beckham, RN
Heart and Vascular Center Procedures Nursing
Elizabeth Blasiak, RN
Medical Oncology Unit
Bethany Bonazzoli, RN
Surgery Unit (6-7)
Ann Bonviso, RN
Maternity
Christina Capstick, RN
Trauma/General Surgery Unit
Lisa Cioffi, RN
Surgery Unit (6-7)
Melane Cuadra-Ninonuevo, RN
Labor and Birth
Evangeline Curameng, RN
Adult Emergency Department
Kerry A. Daniels, RN
Heart and Vascular Center Cardiothoracic Intensive
Care Unit
Katherine Dempsey, RN
Resource Support Unit
Grace Diresta, RN
Heart and Vascular Center Cardiothoracic Intensive
Care Unit
Guy Dufresne, RN
Heart and Vascular Center Cardiac Step-Down Unit
Maria Eriksson-Patel, RN
Perioperative Services
Helena Erskine, RN
Intensive Care Unit - Resource Support Unit
Margaret Figerle, RN
Psychiatric Dual Diagnosis Unit
Linda Fiorito, RN
South Pavilion Operating Rooms
Emily Flahaven, RN
Surgery Unit (6-7)
Tracey Frith, RN
Maternity
Donna Gabriel, RN
Heart and Vascular Center Cardiothoracic Intensive
Care Unit
Andrea Giordano, RN
Medical Intensive Care Unit
Mary Jane Godfrey, RN
Maternity
Barbara Goffredo, RN
Plastic/ENT Unit
Erwille Gurdek, RN
Labor and Birth
Catherine Hackett, RN
Labor and Birth
Jennifer Haney, RN
Perioperative Services
Deborah Howe, RN
Ambulatory Services Division: Women’s Surgical
Recovery
Susan Howe, RN
Maternity
Danielle Huseman, RN
General Medicine Unit (10-7)
Lisa Jones, RN
General Medicine Unit (10-7)
William Kean, RN
Pediatric Intensive Care Unit
Tracey Kelly, RN
South Pavilion Operating Rooms
Melanie King, RN
School-Age/Adolescent Unit
Joshua Knickerbocker, RN
Pediatric Emergency Department
Rhea Lucas-Loma, RN
Children’s Hospital Operating Rooms
Jamie Malette, RN
Heart and Vascular Center Cardiothoracic Intensive
Care Unit
Alefteria Manchisi, RN
School-Age/Adolescent Unit
Mary McDonald, RN
Shoreline Surgery Center: Surgery
Mary Ann Meehan, RN
General Medicine (10-7)
Rebecca Mennillo, RN
Maternity
Tanaz Mistry, RN
Medical Oncology
Elizabeth Montgomery, RN
Maternity
Tamira Montorsi, RN
Surgical Intensive Care Unit
Diana Moore, RN
Maternity
Martha Moreiras, RN
Surgery Unit (6-7)
Donna Nucci, RN
Ambulatory Services Division: Post-Anesthesia Care
Unit
Pauline Obura-Wilkes, RN
General Medicine Unit (5-5)
Christine Padovani, RN
Children’s Hospital Operating Rooms
Elizabeth Palchick, RN
Acute Care for the Elderly Unit
Roger Panaguiton, RN
Adult Emergency Department
Barbara Pandajis, RN
Maternity
Heather Pantalone, RN
Perioperative Services
Samantha Parillo, RN
General Medicine (9-7)
Erin Patton, RN
Pediatric Intensive Care Unit
Charmaign Pe, RN
Surgery Unit (6-7)
Sharon Peralta, RN
Surgical Intensive Care Unit
Doreen Prentice, RN
South Pavilion Operating Rooms
Juliana Pogroski, RN
South Pavilion Operating Rooms
Crista Prates, RN
Adult Emergency Department
Catherine Rafalowski, RN
Heart and Vascular Center Cardiac Unit
Jeannine Rockefeller, RN
Pediatric Intensive Care Unit
Rita Marie Rossetti, RN
South Pavilion Post-Anesthesia Care Unit
Kathleen Roy, RN
Ambulatory Services Division: Endoscopy
Brenda Sarosario, RN
Heart and Vascular Center Cardiac Intensive Care Unit
Debra Searles, RN
Transplant Unit
Melani Semlow, RN
Heart and Vascular Center Cardiothoracic Intensive
Care Unit
Y A L e - n e w h A V e n h o s P I T A L 1 5

Sybil Shaprio, RN
Shoreline Surgery Center: Endoscopy
Janice Smigel, RN
Surgery Unit (6-7)
Cara Smith, RN
Intensive Care Unit - Resource Support Unit
Monica Starr, RN
Psychiatric Adult Unit
Rosanna Tangredi, RN
Heart and Vascular Center Cardiac Intensive Care Unit
Alexandra Tredennick, RN
Psychiatric Adolescent Unit
Colleen Wiedemann, RN
School-Age/Adolescent Unit
Katy Wildes, RN
Surgery Unit (6-7)
Sheila Woodin, RN
Shoreline Surgery Center: Post-Anesthesia Care Unit
Terri Wusterbarth, RN
Surgery Unit (6-7)
Clinical Nurse II
Stephanie Abbati, RN
General Medicine Unit (9-5)
Karen Ahern, RN
Shoreline Surgery Center: Endoscopy
Leslie Alexander, RN
Children’s Hospital Operating Rooms
Marie Altieri, RN
Heart and Vascular Center Cardiac Unit
Liliana Alvarez, RN
Newborn Special Care Unit
Violeta Atienza, RN
Heart and Vascular Center Cardiac Unit
At a recent RCAP celebration, 125 YNHH nurses advanced on their professional ladder, including one nurse who
advanced to Clinical Nurse IV. Shown at the RCAP reception ceremony are (l-r): Guy Dufresne, RN, Cardiac
Step-Down Unit, CN III; Tamira Montorsi, RN, CN III, Surgical Intensive Care Unit (SICU); Tina Capstick, RN,
CN III, Trauma and General Surgery Unit; Michael Consiglio, RN, CN IV, SICU; and Marie Devlin, RN, patient
service manager, SICU.
1 6 n u r s I n g u P D A T e
Victoria Barnes, RN
Acute Care for the Elderly Unit
Betty Barsevich, RN
Heart and Vascular Center Cardiac Unit
Kathleen Benak, RN
Resource Support Unit
Catherine Benni, RN
Temple Surgical Center Post-Anesthesia Care Unit
Jill Berman, RN
General Medicine Unit (10-7)
Amy Berney, RN
Heart and Vascular Center Cardiac Step-Down Unit
Heather Bevilacqua, RN
School-Age/Adolescent Unit
Lauren Bode, RN
General Medicine Unit (9-5)
Keri Bohlen, RN
General Medicine Unit (5-5)
Katie Bouchard, RN
Trauma/General Surgery Unit
Scott Bottomley, RN
Surgery Unit (6-7)
Carolyn Bowen, RN
Intensive Care Unit - Resource Support Unit
Cory Bower, RN
Medical Oncology Unit
Jessica Irizarry Bulat, RN
Children’s Hospital Operating Rooms
Blake Bursey, RN
Medical Intensive Care Unit
Yoo Jung Butler, RN
Medical Oncology Unit
Rowena Calalang, RN
General Medicine Unit (9-5)
Melissa Calvao, RN
Surgery Unit (6-7)
Janette Campos, RN
Heart and Vascular Center Cardiac Step-Down Unit
Michelle Card, RN
Plastic/ENT Unit
Helene Cardenas, RN
Plastic/ENT Unit
Sandy Cayo, RN
Medical Oncology Unit
Courtney Chapman, RN
Neurosurgical Intensive Care Unit
Emily Chodos, RN
Medical Oncology Unit
Monica Cluff, RN
Heart and Vascular Cardiac Intensive Care Unit
Corinne Crane, RN
Shoreline Surgery Center: Surgery
Tina Criscola, RN
Heart and Vascular Center Cardiac Unit
Wendy Cummings, RN
Pediatric Resource Support Unit
Rose D’Angelo, RN
Resource Support Unit
Alicia Decker, RN
General Medicine Unit (9-5)
Maria R. DeLucia, RN
Pediatric Primary Care Center
Stephanie Despres, RN
Shoreline Surgery Center: Endoscopy
Vanessa Dixon, RN
Plastic/ENT Unit
Rhodesia Dizon, RN
Heart and Vascular Cardiothoracic Intensive
Care Unit
Etheline Douglas, RN
General Medicine Unit (9-5)
Elizabeth Drobiarz, RN
Shoreline Surgery Center: Surgery
Judith Duch, RN
Temple Surgical Recovery
Patricia Dummar, RN
Shoreline Surgery Center: Surgery
Reich Duran, RN
Heart and Vascular Center Cardiothoracic Intensive
Care Unit
Zerline Esmer, RN
South Pavilion Operating Rooms
Michele Fabiano, RN
Shoreline Surgery Center: Endoscopy
Lisa Falkenham, RN
Surgery Unit (6-7)
Norma Ferguson, RN
General Medicine Unit (9-5)
Laurie Finta, RN
Perioperative Services
Heather Fisher, RN
Gyn/Oncology Unit
Melissa Gambaccini, RN
Medical Oncology

The 2009 Nightingales were (front row, l-r): Lynn Peckham, APRN, Community Health; Carolyn Bradley, RN,
Resource Support Unit; Lauren Kiernan, RN, Surgical Intensive Care Unit; Rita-Marie Rossetti, RN, Adult Post-
Anesthesia Care Unit (PACU); and Cindy Taylor, RN, Adult PACU. In the second row (l-r) are: Alison Linske, RN,
General Surgery Unit; Claire Krueger, RN, Diagnostic Radiology; Barbara Kavanagh, RN, Hospital Research
Unit; Louise Ward, RN, Labor and Birth; Gina D’Agostino, RN, Hospital Research Unit; and Christopher
DeFrancesco, RN, Adult Emergency Department. Unavailable for the photo was Mary Catherine Gannon, RN,
Transplant Unit.
Cheryl Gans, RN
Medical Oncology Unit
Shelley Geiman, RN
Adult Emergency Department
Mindy Georgi, RN
South Pavilion Operating Rooms
Melanie Glenn, RN
Medical Oncology Unit
Jill Grillo, RN
Heart and Vascular Center Cardiothoracic Intensive
Care Unit
Nancy Guarnieri, RN
Neurosciences Unit
Ping Gui, RN
Heart and Vascular Center Cardiothoracic Step-Down
Unit
Melissa Gutknecht, RN
Medical Oncology Unit
Annie Guy, RN
South Pavilion Operating Rooms
Marsha Habetz, RN
Medical Oncology Unit
Jennifer Haggerty, RN
Medical Intensive Care Unit
Aisling Handley, RN
Heart and Vascular Center Cardiothoracic Intensive
Care Unit
Christine Hanna, RN
Heart and Vascular Center Cardiothoracic Intensive
Care Unit
Allison Harden, RN
Adult Emergency Department
Freda Joy Hatcher, RN
Temple Recovery Care Center
Jessica Hovan, RN
General Medicine Unit (5-5)
Linda Howey, RN
South Pavilion Operating Rooms
Joseph Iacune, RN
Pediatric Intensive Care Unit
Stefanie Johnson, RN
Heart and Vascular Center Cardiothoracic
Step-Down Unit
Rachel Karabeinikoff, RN
Newborn Special Care Unit
Lynn King, RN
Children’s Hospital Operating Rooms
Cally Knight, RN
Heart and Vascular Center Cardiothoracic
Step-Down Unit
Jennifer Kohloff, RN
Shoreline Surgery Center: Surgery
Adam Kosiorek, RN
Heart and Vascular Cardiac Procedures Nursing
Cory Kroon, RN
Surgery Unit (6-4)
Bonnie Landon, RN
Medical Intensive Care Unit
Carine Laverdiere, RN
Surgery Unit (6-7)
hospital named
12 nightingale nurses
In 2009, Yale-New Haven Hospital named
12 nurses as Nightingales. YNHH, the
Visiting Nurse Association of South
Central Connecticut, the Hospital of St.
Raphael and the Community Foundation
of Greater New Haven are sponsors of the
annual award program.
“We work hard to recruit, hire and
retain some of the finest nurses working
in health care,” said Sue Fitzsimons,
RN, PhD, senior vice president, Patient
Services. “It is a pleasure – and difficult at
the same time – to choose the finest candidates
for these awards because we have
so many who exemplify excellence
in nursing.”
Michele Lavoie, RN
Heart and Vascular Center Cardiothoracic Intensive
Care Unit
Lynn Lemoine, RN
Transplant Unit
Kathryn Lovejoy, RN
Maternity
Marjorie Lucas, RN
South Pavilion Operating Rooms
Tara Lynch, RN
Orthopedics Unit
Justyna Machado, RN
Medical Oncology
Patricia Macuch, RN
Ambulatory Services Division: Surgical
Kristin Makhzangi, RN
Orthopedics Unit
Jason Malia, RN
Surgical Intensive Care Unit
Maureen Mandy, RN
South Pavilion Operating Rooms
Carla Mapelli, RN
Heart and Vascular Center Cardiac Intensive Care Unit
Deserene Maribbay, RN
Heart and Vascular Center Cardiothoracic Intensive
Care Unit
Jenny Masbad, RN
Heart and Vascular Center Cardiothoracic Intensive
Care Unit
Y A L e - n e w h A V e n h o s P I T A L 1 7

Patricia Maselli, RN
Neurosurgical Intensive Care Unit
Deborah Mastroianni, RN
General Medicine Unit (9-5)
Jessica McLane, RN
Heart and Vascular Center Cardiothoracic Intensive
Care Unit
Christopher Mead, RN
Adult Emergency Department/Crisis Intervention Unit
Kathleen Millhollan, RN
General Medicine Unit (5-7)
Rebeka Mitchell, RN
Neurosciences Unit
Danielle Morton, RN
Infant/Toddler Unit
Sacha Moss, RN
Children’s Psychiatric Inpatient Service
Marigny Mulock, RN
Resource Support Unit
Amber Natusch, RN
Newborn Special Care Unit
Kathleen Niezelski, RN
Ambulatory Services Division: Surgical
Connie Nunes, RN
Heart and Vascular Cardiac Procedures Nursing
Charina Ofracio, RN
General Medicine Unit (9-5)
Doris Okwu, RN
Medical Intensive Care Unit
Michael O’Leary, RN
Surgical Intensive Care Unit
Mary Outtrim, RN
Ambulatory Services Division: Surgical
Rosemary Ozyck, RN
Plastic/ENT Unit
Muneera Panjwani, RN
Medical Oncology Unit
Carla Maria Par, RN
Children’s Hospital Operating Rooms
Kathy Paznokas, RN
Heart and Vascular Center Cardiac Unit
Cynthia Pick, RN
Adult Emergency Department
Peggy Podoloff, RN
Adult Emergency Department
Michelle Poleszczuk, RN
Heart and Vascular Center Cardiac Step-Down Unit
Dawn Poplizio, RN
Acute Care for the Elderly Unit
Megan Poulsen, RN
Orthopedics Unit
Kelsey Pratt, RN
Heart and Vascular Center Cardiothoracic Intensive
Care Unit
Frances Proto, RN
Medical Oncology Phlebotomy Laboratory
Jeannine Pytlik, RN
Shoreline Surgery Center: Surgery
1 8 n u r s I n g u P D A T e
Laura Radulski, RN
Gyn/Oncology Unit
Theresa Razmakhnina, RN
Heart and Vascular Center Cardiac Step-Down Unit
Andrea Rea, RN
Adult Emergency Department
Maureen Redman, RN
Temple Surgical Recovery
Glennis Rennock-Sullivan, RN
Children’s Hospital Operating Rooms
Margaret Ricciardi, RN
South Pavilion Operating Rooms
Kim Whelan Riccitelli, RN
Psychiatric Adult Unit
Hazel Rivera, RN
Heart and Vascular Center Cardiothoracic
Step-Down Unit
Michelle Robertson, RN
Medical Intensive Care Unit
Johanna Rona, RN
Heart and Vascular Center Cardiac Unit
Emily Roxas, RN
Medical Oncology Unit
Esmeralda Samson, RN
Surgery Unit (6-7)
Keri-Ann Samuels, RN
Heart and Vascular Center Cardiac Unit
Nicole Sanchez, RN
Maternity
Desiree Sanchis, RN
Medical Oncology
Georgina Sannis-Thomas, RN
South Pavilion Operating Rooms
Melissa Santora, RN
Orthopedics Unit
Milton Santos, RN
Plastic/ENT Unit
Meaghen Scalley, RN
Maternity
Anne Scilleri, RN
Pediatric Intensive Care Unit
Nicole Seagriff, RN
Medical Intensive Care Unit
Maria Sebastian, RN
Heart and Vascular Center Cardiothoracic Intensive
Care Unit
Linda Sessa, RN
Shoreline Surgery Center: Surgery
Nancy Sivri, RN
Heart and Vascular Center Cardiac Intensive Care Unit
Sandra Smereczynsky, RN
Maternity
Kaitlyn Snow, RN
Neurosciences Unit
Rebecca Spivack, RN
Gyn/Oncology Unit
Sheila Stepeck, RN
Children’s Psychiatric Inpatient Service
Jennifer Stewart, RN
Maternal Special Care Unit
Shannon Stewart, RN
South Pavilion Operating Rooms
Lynette Strobel, RN
Maternal Special Care Unit
Kathleen Sullivan, RN
Maternity
Michael Sullivan, RN
Adult Emergency Department
Katherine Sutowski, RN
South Pavilion Operating Rooms
Sharon Talbot, RN
Surgery Unit (6-7)
Elizabeth Testani, RN
Heart and Vascular Center Procedures Nursing
Anh Thieu, RN
General Medicine Unit (9-5)
Valerie Thompson, RN
Acute Care for the Elderly Unit
M. Isabel Torres, RN
Infant/Toddler Unit
Jillian Torreso, RN
Pediatric Intensive Care Unit
Valerie Traumuller, RN
Neurosciences Unit
Emily Turner, RN
Maternal Special Care Unit
Michelle Tyler, RN
Resource Support Unit
Ann Vitagliano, RN
Surgery Unit (6-7)
Nicole Wagner, RN
Labor and Birth
Kimberly Walsh, RN
Ambulatory Services Division: Women’s Surgical Center
Britney Watts, RN
Plastic/ENT Unit
Claudette Whitte, RN
Acute Care for the Elderly Unit
Dana Williams, RN
Newborn Special Care Unit
Marie Williams, RN
General Medicine Unit (5-5)
Cynthia Wilson, RN
Acute Care for the Elderly Unit
Sherri Witkins, RN
Perioperative Services
Ebony Wright, RN
Children’s Hospital Operating Rooms
LanLan Zhou, RN
Heart and Vascular Center Cardiothoracic Intensive
Care Unit
Susan Zimmerman, RN
Shoreline Surgery Center: Endoscopy
Iris Zollarcoffer, RN
General Medicine Unit (9-5)

Two Ynhh nurses named
nurse leader fellows
In 2010, the American Organization of
Nurse Executives (AONE) chose two Yale-
New Haven Hospital nurse leaders to be
fellows.
Sue Fitzsimons, RN, PhD, senior vice
president, Patient Services, announced
that Shelley Britt, RN, MSN, patient service
manager, Hospital Research Unit, and
Sara Newman, RN, MA, patient service
manager, Shoreline Medical Center
Emergency Department, were selected.
“We are proud and happy that two of
our nurse managers have been chosen
for this prestigious fellowship,” said
Fitzsimons. “It is an honor and reflects
the depth of nursing leadership here at
Yale-New Haven.”
Shelley Britt, RN, MSN, began her
career at YNHH 28 years ago on the
former neuropsychiatric evaluation
unit. In 1997, she transferred to clinical
research and in 2006 was promoted to
patient service manager of the Hospital
Research Unit. Originally from San
Francisco, Britt earned her nursing
degree at City College of San Francisco
and her BSN and MSN at Sacred Heart
University.
Sara Newman, RN, MA, began her
career with YNHH in 1999 in the Adult
Emergency Department. She then joined
the Center for Professional Practice
Excellence as a clinical nurse educator
where she coordinated the nurse residency
program and the critical care team. In
2007, she was named patient service
manager for the Shoreline ED, which
routinely scores in the 98th percentile for
patient satisfaction. Newman earned her
nursing degree at Cochran Nursing School
of St. John’s Hospital in Yonkers, NY, and
her master’s in public health education at
Columbia University. ■
Sue Fitzsimons (left) congratulated Sara Newman (center) and Shelley Britt on being named AONE fellows.
Y A L e - n e w h A V e n h o s P I T A L 1 9

2 0 n u r s I n g u P D A T e
PuBLICATIons
AnD PresenTATIons
Yale-New Haven nurses have been very productive over the past year as
they published in journals and made presentations in Connecticut and
beyond. Working collaboratively with staff throughout the organization,
nurses shared valuable information and – by extension – their expertise
in a number of important areas ranging from acute stroke care to reducing
the prevalence of pressure ulcers.
While this is not a comprehensive list, below you will find the names of
many of the YNHH nurses who authored or coauthored articles and the
topics covered. The second list shows where many nurses presented and
the topics they covered.
Winsome Smith, RN, a nurse in the Apheresis/Infusion Unit, discusses treatment with a patient.

Publications
Bush, A., & Banyas, R. (2009). Smoothing the
Transition into Practice: A Survival Guide for New
Oncology Nurses. 2009 Oncology Nursing Society
Conference Abstract, Virginia Henderson
International Nursing Library,
http://www.nursinglibrary.org/Portal/
main.aspx?pageid=4024&pid=21562
Holmes, K., Caprio, S., Cali, A., Allen, K.,
Pierpont, B., Taksali, S., Shaw, M., & Savoye,
M. (2009). Primary defects in beta cell function
further exacerbated by worsening of insulin
resistance mark the development of impaired
glucose tolerance in obese adolescents. Diabetes
Care, 32(3), 456-61. PMID: 19106382
Holmes, K., Caprio, S., Cali, A., Allen, K.,
Pierpont, B., Taksali, S., Shaw, M., & Savoye,
M. (2010). Rosiglitazone improves glucose
metabolism in obese adolescents with impaired
glucose tolerance: A pilot study. Obesity, May 13
[epub ahead of print]. PMID: 20467418
Krom, Z. R., Batten, J., & Bautista, C. (2010).
A unique collaborative nursing evidencebased
practice initiative using the Iowa model:
A clinical nurse specialist, a health science
librarian, and a staff nurse’s success story.
Clinical Nurse Specialist, 24(2), 54-59. PMID:
20168139
O’Connor, R., Krom, Z., & Grossman, S. (2010).
Innovative solutions: Using case studies to
generate increased nurse’s clinical decisionmaking
ability in critical care. Dimensions of
Critical Care Nursing 29(3), 138-142. PMID:
20395734
Parkosewich, J. (2009). Assessment of
cardiovascular function. In S. Smeltzer & B.
Bare (Eds.), Brunner and Suddarth’s Textbook of
Medical-Surgical Nursing, 12th ed. Philadelphia:
Lippincott-Raven
Pennington, C., & DeRienzo, N. R. (2010). An
effective process for making decisions about
major operating room purchases. AORN Journal,
91(3), 341-49. PMID: 20193799
Rao, V. S., Safdar, B., Parkosewich, J.,
Lee, V., D’Onofrio, G., & Foody, J. (2009).
Improvements in time to reperfusion: Do
women have an advantage? Critical Pathways in
Cardiology, 8(1), 38-42. PMID: 19258837
Presentations
Acosta, D., Alcarez, E., Beard, B., Brannin, D.,
Lockwood, C., Colson, E., Dezinno, P., Runai,
E., Godfrey, M., Gosselin, N., Knudson, J.,
O’Keefe, L., Rhee, M., Stevens, C., Suntheimer,
C., & Vorio, D. (2009, May). Improving efficiency
and throughput in postpartum units. Joseph A.
Zaccagnino Patient Safety and Clinical Quality
Conference, New Haven, CT.
Antell, N., Burns, K., Austin, C., Weinstein, R.,
Mulney, C., Spina, K., Downer, P., Halloway, D.,
& Newman, S. (2009, May). Decreasing the time
from patient arrival to initial patient assessment at the
Shoreline Medical Center emergency department (ED).
Joseph A. Zaccagnino Patient Safety and Clinical
Quality Conference, New Haven, CT.
Applewhaite, M., Chiarenzelli, J., Ciaburri, R.,
Ponte, M., & Albert, C. (2010, May). Nurses as
teachers: Engaging the novice to be knowledgeable.
Joseph A. Zaccagnino Patient Safety and Clinical
Quality Conference, Trumbull, CT.
Avella-Villabona, T. (2010, April). Nurse-driven
heparin protocol: Simulation in critical care. Horizons
Critical Care Conference, Burlington, VT.
Avella-Villabona, T. (2010, May). Nurse-driven
heparin protocol: Simulation in critical care. Joseph A.
Zaccagnino Patient Safety and Clinical Quality
Conference, Trumbull, CT.
Bacon, S., Benis, L., Hayes, M., & Dahl Vickers,
V. (2009, May). Creating a safer and cleaner hospital.
Joseph A. Zaccagnino Patient Safety and Clinical
Quality Conference, New Haven, CT.
Bacon, S., Patient Service Managers, Clinical
Managers, MD/LIP Staff, Unit Staff Nurses,
Patient Care Associates (PCA), Business
Associates (BA), & Care Coordinators of Units
4-7, 5-5, 5-7, 6-5, 6-7, 7-5, 7-7, 8-8, 9-5, 9-7,
10-7 in the East Pavilion, of Units 5-2, 5-3, 6-3,
6-4 in the South Pavilion, & WP9 Oncology &
WP8 Gynecology in the West Pavilion. (2009,
May). Safe patient flow: Improving the discharge
process at Yale-New Haven on 17 inpatient units.
Joseph A. Zaccagnino Patient Safety and Clinical
Quality Conference, New Haven, CT.
Bacon, S., Washington, T., Roverts, A., Zergibel,
K., Hayes, M., & Damore, P. (2010, May). Safe
patient flow: Improving productivity of the discharge
team. Joseph A. Zaccagnino Patient Safety and
Clinical Quality Conference, Trumbull, CT.
Baran, K., Della Ventura, R., Harrigan, S.,
Johnson, T., Kelly-O’Shea, M., King, M.,
Lara, L., Meehan, M., Miska, H., O’Keefe, N.,
Radocchia, E., Weir, M. E., & O’Connor, R.
(2009, May). Partners for change: Collaborative
governance. Joseph A. Zaccagnino Patient Safety
and Clinical Quality Conference, New Haven,
CT.
Bates, A., Credé, W., Cunningham, P., &
Tommasini, N. (2009, May). Improving quality of
data on restraint episodes and duration of use. Joseph
A. Zaccagnino Patient Safety and Clinical Quality
Conference, New Haven, CT.
Baxter, D., Santucci, K., Buglione, J., Clark, K.,
Hsiao, A., Nolan, D., & Walker, D. (2009, May).
Healthcare matrix assessment of safety: What’s at the
core? Joseph A. Zaccagnino Patient Safety and
Clinical Quality Conference, New Haven, CT.
Bedard, L., Nystrom, K., Moalli, D., Cusano,
A., Cemeno, M., Baehring, J., Nygard, H.,
Harel, N., Balcezak, T., & Capozzalo, G. (2010,
May). Implementation of a HUB and SPOKE model
for acute stroke care: Part I. Joseph A. Zaccagnino
Patient Safety and Clinical Quality Conference,
Trumbull, CT.
Belton, B., Dembry, L., Giodano, A., Kimmel,
R., & Jurewicz, P. (2009, May). Medical intensive
care unit (MICU) initiatives to reduce catheter-related
bloodstream infections. Joseph A. Zaccagnino
Patient Safety and Clinical Quality Conference,
New Haven, CT.
Benis, L., Jenq, G., Mandel, E., Moin, R., &
Nikiforow, S. (2009, May). Multidisciplinary
morbidity conferences in internal medicine. Joseph A.
Zaccagnino Patient Safety and Clinical Quality
Conference, New Haven, CT.
Billstein, M., Berger, K., Chatillon, H., Katz,
G., Klish, L., Miller, L., Phelan, B., & Poyton,
M. (2010, May). Implementation of a nurse-driven
heparin dose adjustment protocol. Joseph A.
Zaccagnino Patient Safety and Clinical Quality
Conference, Trumbull, CT.
Bilskis, S., Ayala, J., Dermola, L., D’Amato, J.,
Cunningham, L., Diehl, D., Dixon, V., Fenick,
A., Gambardella, J., Gaydos, H., Giles, C.,
Hodge, J., Holmes, J., Nelson, G., Picagli,
D., Rivera, J., Smalls, A., Sart, G., Stewart,
W., & Rivera-Vinas, J. (2009, May). Developing
an alternative method to Press Ganey. Joseph A.
Zaccagnino Patient Safety and Clinical Quality
Conference, New Haven, CT.
Bilskis, S., Fenick, A., Cunningham, L.,
Rodriguez, S., Rivera, J., Jouhsin, L., Liu, C., &
Wheaton, J. (2010, May). Reducing wait times in
a resident continuity clinic. Joseph A. Zaccagnino
Patient Safety and Clinical Quality Conference,
Trumbull, CT.
Bilskis, S., Smart, G., Gross, C., Cain, E., Giles,
C., Fenick, A., Shaw, J., Vaughn, S., Diehl, D.,
Rubeo, D., Stewart, W., Dixon, V., & D’Amato,
J. (2009, May). Collaborating on quality in a diverse
service line. Joseph A. Zaccagnino Patient Safety
and Clinical Quality Conference, New Haven,
CT.
Bodden, D., Burke, J., Coyle, D., Hoffer, L., &
Maccubbin, L. (2009, May). Diagnostic radiology
pre-procedure call sheet. Joseph A. Zaccagnino
Patient Safety and Clinical Quality Conference,
New Haven, CT.
Y A L e - n e w h A V e n h o s P I T A L 2 1

Bogue, C., Baltimore, R., Dickenson, C., Li, S.,
Loth, A., Macolino, J., & Trotta, K. (2009, May).
Eliminating catheter associated bloodstream infections
in the pediatric intensive care unit (PICU). Joseph A.
Zaccagnino Patient Safety and Clinical Quality
Conference, New Haven, CT.
Bolind, C., Adib, R., Devlin, M., Farrington, J.,
Luczycki, S., Maerz, L., McSherry, G., Moss,
L., M’Sadoques, P., Pasquini, D., Pauli, M.,
Psarakis, H., Roumanis, S., Serra, J., Sather, J.,
Schlessel, R., Scorel, K., Siegel, M., Silverman,
D., Vaughn, D., Ulisse, G., & Zimkus, J. (2009,
May). Improving glucose management in surgical
diabetic patients. Joseph A. Zaccagnino Patient
Safety and Clinical Quality Conference, New
Haven, CT.
Bonfiglio, M., Enright, J., Falcone, C., King, J.,
Knoche, E., Koval, N., Lapham, C., Noonan,
M., Paci, G., Petrone, M., Pia, M., Sabo, B.,
Sellers, L., Streimish, I., Uhlan, S., Bizzarro,
M., Chapman, R., Ehrenkranz, R., Gozzo, Y.,
& Khariwala, S. (2009, May). Reducing catheter
associated bloodstream infections in the newborn special
care unit (NBSCU). Joseph A. Zaccagnino Patient
Safety and Clinical Quality Conference, New
Haven, CT.
Bush, A., & Banyas, R. (2009, May). Smoothing
the transition into practice: A survival guide for new
oncology nurses. Joseph A. Zaccagnino Patient
Safety and Clinical Quality Conference, New
Haven, CT.
Casey, B., Chuong, B., Cohen, M., Stahl, R.,
Ellison, D., DeRosa-Linsley, B., & Nucci,
D. (2010, May). Improving hand hygiene in the
ambulatory services division. Joseph A. Zaccagnino
Patient Safety and Clinical Quality Conference,
Trumbull, CT.
Chatillion, H., Phelan, B., Zigmont, J., Bautista,
C., Cooper, D., Devin, L., Hewitt, R., Hinic, K.,
Maccubbin, L., McSherry, G., & Sagkachand,
P. (2010, May). High-fidelity simulation: Its use for
competency evaluation in the critical care environment.
Joseph A. Zaccagnino Patient Safety and Clinical
Quality Conference, Trumbull, CT.
Creatore, T., Fletcher, L., Hall, R., Hoey, C.,
Jenq, G., Kaechele, D., Laird, K., Winter-Lai,
A., Maddern, M., Palumbo, S., Roumanis,
S., Ryzewski, J., Slowikowski, G., Sousa, S.,
Thompson, G., & Vorio, D. (2009, May). YNHH
Healthy Skin Program: A change in attitude and
culture: Reducing pressure ulcer prevalence. Joseph A.
Zaccagnino Patient Safety and Clinical Quality
Conference, New Haven, CT.
Dixon, V., Rodriguez, S., Bilskis, S., Genao, I., &
Gross, C. (2009, May). Reducing the no-show rate
for appointments in the ambulatory setting. Joseph A.
Zaccagnino Patient Safety and Clinical Quality
Conference, New Haven, CT.
2 2 n u r s I n g u P D A T e
Finta, L., O’Keefe, N., Baran, K., Cayo, S.,
Della Ventura, R., Gallagher, D., Harrigan, S.,
Jonason, L., Kelly-O’Shea, M., Lara, L., Malia, J.,
Meehan, M., Miska, H., Pattberg, R., Shapiro,
S., Waterbury, L., & Wright, E. (2010, May).
Collaborative governance: Nurses improving quality
of care. Joseph A. Zaccagnino Patient Safety and
Clinical Quality Conference, Trumbull, CT.
Fountain, S., Bautista, C., Bonito, K., Cashman,
L., Galanter, C., Korn, M., Laurans, M., Lavelle,
E., Schlegel, E., Tong, D., Twohill, G.,& Wallack,
K. (2010, May). Improving patient safety through
hand hygiene. Joseph A. Zaccagnino Patient Safety
and Clinical Quality Conference, Trumbull, CT.
Grimshaw, K. (2009, February). Increasing organ
donation at YNHH. Yale-New Haven Hospital
Nursing Grand Rounds, New Haven, CT.
Grimshaw, K. (2009, February). Nursing and work
with MSF. Yale-New Haven Hospital Nursing
Grand Rounds, New Haven, CT.
Guttman, C., Benis, L., Jenq, G., Hoey, C.,
Hutchins, L., Konet, L., Ryzewski, J., Shah, N.,
Stump, L., & Sousa, S. (2010, May). Healthy skin
24/7: Wound consults on the off-shift, weekends, and
holidays. Joseph A. Zaccagnino Patient Safety and
Clinical Quality Conference, Trumbull, CT.
Guttman, C., Ghidini, J., Kenyon, K., Kurtz,
J., Jones, L., McCollough, K., DeMarco, M.,
Crockette, J, Brantley, K., Zollarcoffer, I., Thieu,
A., Mastoianni, D., Laird, K., Ricker, K., Ruffin,
C., Zweeres, D., Raymond, V., Obura-Wilkes,
P., Carafeno, T., Fradkin, M., Williams, J.,
Barbarotta, L., Ganz, D., Peterson, K., Colon,
M., Robles, M., Rule, P., Anderson, Y., Corso,
C., Sward, J., Mikolinski, R., Doolittle, S., Rock,
C., Spray, J., Pabon, W., Lindewall-Matto, D.,
Parillo, S., Wright, C., Bursey, C., Acker, K.,
Wilson, C., Bownes, T., Burke, S., Marchini,
S., OseiTutu, K., Santiago, A., Hudgens, S.,
Huseman, D., Lawrence, A., & entire staff on
Units 10-7 EP 5-5 EP, 9-7 EP, 5-7 EP, 8-8 EP,
& 9WP. (2010, May). Reducing fall rates through
rapid cycle tests of change: Year two update. Joseph A.
Zaccagnino Patient Safety and Clinical Quality
Conference, Trumbull, CT.
Hajdasz, D., Schwartz, I., & Cohen T. (2010,
May). Improving urgent care safe patient flow. Joseph
A. Zaccagnino Patient Safety and Clinical Quality
Conference, Trumbull, CT.
Harris, M., Siegel, M., Lewis, M., Scanlon, I.,
Billstein, M., Mattioli, E., Page, L., McSherry,
G., Beckham, J., Petrucci, D., Ryder, D., Ryder,
A., Nargi, A., & Blatt, L. (2009, May). Withdrawal
of ventilator support in the adult ICU. Joseph A.
Zaccagnino Patient Safety and Clinical Quality
Conference, New Haven, CT.
Hendrickson, K., Bozzo, J., Zimkus, J., Scorel,
K., Psarakis, H., Maerz, L., Balcezak, T., &
Inzucchi, S. (2010, May). Evaluating inpatient
glycemic management: The QHS. Joseph A.
Zaccagnino Patient Safety and Clinical Quality
Conference, Trumbull, CT.
Hickey, C., Cabin, H., Safdar, B., Bruni, W.,
Carna, M., Capone, D., Collins, D., Fletcher, E.,
Gerber, J., Hajdasz, D., Hewitt, R., Jean-Mary,
R., Kupec, C., LoRusso, F., Morris, V., Reig, B.,
Burns, K., Cone, D., D’Onofrio, G., Moscovitz,
H., Schwartz, I., VanGelder, C., Cleman, M.,
Curtis, J., Giordano, G., Russell III, R., Sinusas,
A., & Thompson, C. (2010, May). YNHH accredited
as a “chest pain center with PCI” (percutaneous coronary
intervention). Joseph A. Zaccagnino Patient Safety
and Clinical Quality Conference, Trumbull, CT.
Hoffer, L., Maccubbin, L., Benish, M., &
Fletcher, E. (2010, May). Improving thermal
comfort and temperature measurement. Joseph A.
Zaccagnino Patient Safety and Clinical Quality
Conference, Trumbull, CT.
Horwitz, L., Borgstrom, C., Roumanis, S.,
Jenq, G., & Benin, A. (2009, May). Effect of rapid
response team activity on front-line staff. Joseph A.
Zaccagnino Patient Safety and Clinical Quality
Conference, New Haven, CT.
Horwitz, L., Dombroski, J., Kaisen, A., Pierson,
M., & Tucker, K. (2010, May). Summary of
development and validation of a sign-out tool study.
Joseph A. Zaccagnino Patient Safety and Clinical
Quality Conference, Trumbull, CT.
Johnson, A., Maccubbin, L., Chandler, R., &
Ferraro, T. (2009, May). Radiation safety in the
Heart and Vascular Center. Joseph A. Zaccagnino
Patient Safety and Clinical Quality Conference,
New Haven, CT.
Just, C., Petersen, J., Washington, T., Roberts,
A., Brophy, C., Malcolm, H., Goetz, G.,
Vasipiano, C., Damore, P., & Hayes, M. (2010,
May). Safe patient flow: Elimination of “purple beds.”
Joseph A. Zaccagnino Patient Safety and Clinical
Quality Conference, Trumbull, CT.
Kenyon, K., Ghidini, J., Kurtz, J., Guttman, C.,
Marchini, S., Tutu, K., Santiago, A., Hudgens,
S., Huseman, D., Lawrence, A., & Unit 10-7
staff. (2009, May). Reducing fall rates through rapid
cycle tests of change. Joseph A. Zaccagnino Patient
Safety and Clinical Quality Conference, New
Haven, CT.
Klein, S. (2009, September). Increasing organ
donation [poster presentation]. International
Nurses Transplant Society Conference,
Montreal, Canada.
Klein, S., Grimshaw, H., Emre, S., Parades,
C., & Jakab, S. (2010, May). Safe discharge from
the integrated solid organ transplant unit. Joseph A.
Zaccagnino Patient Safety and Clinical Quality
Conference, Trumbull, CT.
Klein, S., Grimshaw, H., Emre, S., Parades,
C., & Smith, A. (2009, May). Hand hygiene on
the integrated solid organ transplant unit. Joseph A.
Zaccagnino Patient Safety and Clinical Quality
Conference, New Haven, CT.

Knickerbocker, J. (2010, March). Pain
documentation and barriers in the pediatric
emergency department. University HealthSystem
Consortium/American Association of Critical-
Care Nurses National Nurse Residency
Program, Dallas, TX.
Laframboise, L., Kaplan, L., & Joseph, B. (2010,
May). Improving the care of mechanically ventilated
patients. Joseph A. Zaccagnino Patient Safety and
Clinical Quality Conference, Trumbull, CT.
Maccubbin, L., Chandler, R., Ferraro, T., &
Johnson, A. (2009, May). Radiation safety in the
Heart and Vascular Center. Joseph A. Zaccagnino
Patient Safety and Clinical Quality Conference,
New Haven, CT.
Meady, T., & Gilhuly, T. (2009, March). Family
presence in resuscitation. University HealthSystem
Consortium Conference, Orlando, FL.
Moore, J., Barbarotta, L., Grasso, J., Fischer, D.,
& Nelson, W. (2009, May). When prevention fails,
policy for accidental chemotherapy overdose. Joseph A.
Zaccagnino Patient Safety and Clinical Quality
Conference, New Haven, CT.
Newman, S., Hajdasz, D., Antell, N., Burns,
K., Austin, C., Weinstein, R., Mulvey, C., Spina,
K., Downer, D., & Holloway, D. (2009, May).
Decreasing the time from patient arrival to initial
assessment at the Shoreline Medical Center ED. Joseph
A. Zaccagnino Patient Safety and Clinical Quality
Conference, New Haven, CT.
O’Connor, R., Tichy, E., Mathews, K., Luczycki,
S., & Edwards, C. (2010, May). Quality of care
for the brain dead donor. Joseph A. Zaccagnino
Patient Safety and Clinical Quality Conference,
Trumbull, CT.
O’Keefe, N. (2009, September). A communicationrich
culture panel presentation. Connecticut Hospital
Association Day of Sharing, Wallingford, CT.
O’Mara, E., Agis, K., Buxton, N., Thompson,
A., & Anderson, T. (2010, May). Improving the
well newborn emergency response system. Joseph A.
Zaccagnino Patient Safety and Clinical Quality
Conference, Trumbull, CT.
Parker, M. (2010, March). Nurse residency
bereavement program. University HealthSystem
Consortium/American Association of Critical-
Care Nurses National Nurse Residency Program
National Conference, Dallas, TX.
Parkosewich, J. (2009, January). Decreasing delays
in the real world from symptom onset to open artery
for women with STEMI. American College of
Cardiology Conference, Atlanta, GA.
Parkosewich, J. (2009, February). Why women
delay seeking care for heart attack symptoms: What
you can do. Third Modern Tea, sponsored by the
Connecticut Health Consortium, New Haven,
CT.
Parkosewich, J. (2009, April). Listen and LeaRN
training program: A YNHH women and heart disease
community outreach program. Yale-New Haven
Hospital, New Haven, CT.
Parkosewich, J. (2009, August). Nursing research
methods: Quantitative research designs. Evidencebased
Practice Nursing Workshops, Yale-New
Haven Hospital. New Haven, CT.
Parkosewich, J. (2009, November). Symptom
recognition and reducing time to treatment for
symptoms of acute coronary syndrome: State of the
science. Yale University School of Nursing, New
Haven, CT.
Parkosewich, J. (2009, December). How clinical
nurse specialists use statistics to inform nursing practice:
From performance improvement to patient outcomes.
Yale University School of Nursing, New Haven,
CT.
Parkosewich, J. (2010, January). How staff
nurses generate nursing research questions. Temple
Ambulatory Services Division retreat, Yale-New
Haven Hospital, New Haven, CT.
Parkosewich, J. (2010, February). Fundamentals
of cardiac nursing: Nursing management of patients
recovering from percutaneous coronary interventions.
Heart and Vascular Center Nursing Orientation,
Yale-New Haven Hospital, New Haven, CT.
Parkosewich, J. (2010, February). Fundamentals
of cardiac nursing: Principles of cardiac function and
nursing management of patients with acute coronary
syndrome. Heart and Vascular Center Nursing
Orientation, Yale-New Haven Hospital, New
Haven, CT.
Parkosewich, J. (2010, February). Role of the
advanced practice nurse in promoting a Magnet
environment of nursing excellence. Yale University
School of Nursing, New Haven, CT.
Parkosewich, J., Chyun, D., Bradley, E. H., &
Funk, M. (2009, March). Women’s perception of
lifetime risk for acute myocardial infarction. Eastern
Nursing Research Society, Boston, MA.
Patel, S., Walker, D., Baxter, D., Buglione, J.,
Clark, K., Lazarre, M., Lee, L., McGeary, C.,
& Arnold, S. (2010, May). Failure mode and effect
analysis on medication use in the pediatric emergency
department. Joseph A. Zaccagnino Patient Safety
and Clinical Quality Conference, Trumbull, CT.
Proto, F. (2009, May). Multipurpose, short visit
area increases patient satisfaction, efficiency, and
productivity in outpatient medical oncology. Oncology
Nursing Society Conference, San Antonio, TX.
Proto, F., & Watcke, S. (2009, May). Multipurpose,
short visit area increases patient satisfaction, efficiency,
and productivity in outpatient medical oncology.
Joseph A. Zaccagnino Patient Safety and Clinical
Quality Conference, New Haven, CT.
Raab, C. (2009, May). Evaluating an obstetrical
patient safety strategy. Institute for Healthcare
Improvement National Forum, Orlando, FL.
Raab, C., Pettker, C., Funai, E., Stevens, C.,
Vorio, D., & Lockwood, C. (2009, May). Impact
of a comprehensive patient safety strategy on obstetric
adverse events. Joseph A. Zaccagnino Patient Safety
and Clinical Quality Conference, New Haven,
CT.
Raab, C., Pettker, C., Funai, E., Stevens, C.,
Vorio, D., & Lockwood, C. (2010, May). Impact
of a comprehensive patient safety strategy on safety
climate. Joseph A. Zaccagnino Patient Safety and
Clinical Quality Conference, Trumbull, CT.
Rawlings, J., Genao, I., Hendrickson, K., Diers,
D., & Browne, R. (2010, May). Creating a medical
home through the 340B drug pricing program. Joseph
A. Zaccagnino Patient Safety and Clinical Quality
Conference, Trumbull, CT.
Reddington, K. (2009, September). Increasing
organ donation [poster presentation].
International Nurses Transplant Society
Conference, Montreal, Canada.
Roumanis, S., Devlin, M., DeFlippo, G., Jenq,
G., Bennick, M, Morris, V., Fletcher, L., Benis,
L., Jurewicz, P., & Credé, W. (2009, May). Impact
of rapid response team implementation. Joseph A.
Zaccagnino Patient Safety and Clinical Quality
Conference, New Haven, CT.
Roumanis, S., Devlin, M., Morris, V., Fletcher,
L., Benis, L., Jurewicz, P., Williams, C., & Credé,
W. (2009, May). Improving detection of rapid response
team impact. Joseph A. Zaccagnino Patient Safety
and Clinical Quality Conference, New Haven,
CT.
Ryziewski, J. (2009, May). Healthy skin: 24/7
wound consults on the off-shift, weekends, and
holidays. Joseph A. Zaccagnino Patient Safety and
Clinical Quality Conference, Trumbull, CT.
Ryziewski, J. (2010, January). Healthy skin:
24/7 wound consults on the off-shift, weekends, and
holidays. National Database of Nursing Quality
Indicators Conference, New Orleans, LA.
Sanders-Newton, B. (2009, August).
HealthStream AHA HeartCode BLS cardiopulmonary
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Conference, Mashantucket, CT.
Sangkachand, P. (2009, May). Improving cardiac
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Association of Critical-Care Nurses/National
Teaching Institute conference, New Orleans, LA.
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Joseph A. Zaccagnino Patient Safety and Clinical
Quality Conference, Trumbull, CT.
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D., Gorero, N., LoRusso, F., Marshall, P.,
Maccubbin, L., Devin, L., Fletcher, E., Hewitt,
R., Wira III, C., Curtis, J., Roumanis, S.,
Nyustrom, K., Bautista, C., Schindler, J., Yazdi,
S., DeFlippo, G., Ehrenkranz, R., Mercurio,
M., Swan, A., Perrker, C., & Balcezak, T.
(2010, May). Therapeutic hypothermia. Joseph A.
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Joseph A. Zaccagnino Patient Safety and Clinical
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Rose Mixon (left), RN, prepares bone marrow transplant patient Maura Marden for her outpatient chemotherapy.
2 4 n u r s I n g u P D A T e
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CT.

EdITORIaL BOaRd
YNHH NuRSES’ VISION
Achieving excellence through continuous improvement and innovation.
eDITors
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Chief Nursing Officer
Senior Vice President
Patient Services
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Women’s and Infants Services
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Sue Reynolds, RN
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COVER Mimi Weir, RN, Perioperative
Services, prepares a patient for surgery in
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BaCK COVER Labor and Birth nurses Rhonda
Pattberg, RN, and Melane Ninonuevo, RN,
meet with a patient as she prepares to give
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