2020 Annual Nursing Report

Honoring Our Heroes Carolinas HealthCare System Blue Ridge 2020 Nursing Annual Report

Content 04 11 19 29 41 47

Nursing at Carolinas HealthCare System Blue Ridge

Nursing Awards & Recognitions

Nursing Response to COVID-19

Nursing Quality Initiatives

Nursing Education

Nursing Community Relationships

Letter

from Vice President, Nursing and Chief Nurse Executive As 2020 was designated as the Year of the Nurse, our team of nurses at CHS Blue Ridge had no idea what this would mean to the nursing profession. The spotlight truly shined on our nursing team as we navigated the uncharted waters of the COVID-19 pandemic.

Our nurses stepped up and took on the challenge that was presented to them. We worked hand in hand with our colleagues within the organization to provide high-quality care to our patients. Nurses in every area of our healthcare system adapted to our new world and took part in developing solutions to meet the needs of our community. The nursing team participated in virtual care solutions, COVID-19 testing, vaccine administration, developing and implementing our surge plan, participating in incident command meetings, and many more tasks that helped drive our organization through a difficult time.

As the Chief Nurse Executive for the system, I am proud to work with a dedicated group of passionate care providers. Our nurses pulled together to make the best out of a truly challenging year. Florence Nightingale would be proud of how our nurses responded to the challenges of the COVID-19 pandemic. The following quote from Ms. Nightingale is very fitting to nursing’s world and their response in 2020 - “I am of certain convinced that the greatest heroes are those who do their duty in the daily grind of domestic affairs whilst the world whirls as a maddening dreidel.”

I am honored to be a part of a team of such dedicated and caring nurses. Thanks to all our nurses at CHS Blue Ridge for the care of our community during an unprecedented time.

Barry C. Nelson MSN, RN, CENP Vice President of Nursing Chief Nurse Executive

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Carolinas HealthCare System Blue Ridge

Mission | Vision Our Mission

Our Vision

To enhance life by excelling in care

To be the best community healthcare system in America

Carolinas HealthCare System Blue Ridge Nursing

Vision | Values

Our Nursing Vision To be the first and best choice for nursing care and practice

Our Nursing Values Caring

We treat you with dignity, respect, courtesy, and gentleness; responding to the needs of patients and each other.

Teamwork

We are professionals working together; recognizing accomplishments of our patients and each other.

Integrity

We are honest and ethical; respecting the rights of patients, families, and each other.

Commitment

We are dedicated to promoting a clean and safe environment; speaking up for the safety of our patients and each other.

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Nurse Leaders Across the Organization

Danielle Baird, MSN, RN Nurse Manager Surgical Services, Post Anesthesia Care

Ashley Carpenter, MSN, RN, CEN Nurse Manager of Critical Care

Haylie Coffey, MSN, RN Patient Safety Officer

Dorothy Cooper, MSN, RN, CNE Manager of Nursing Resources

Carol Ervin, BSN, RN, NE-BC Director of Behavioral Health

David Everhart, MSN, RN, CEN Executive Director of Nursing Operations

Emily Heien, BSN, RN Nurse Director of Clinical Operations

Amanda Krause, BSN, RN, CEN Nurse Manager of Cardiac Care

Jacqueline Lawrence, MSN, RN Director of Nursing Support

Nancy Lovelace, MSSL, BSN, RN, NE-BC, LNHA Administrator of Healthcare Services at Grace Ridge

Jana Messer, BSN, RN Nurse Manager of Medical/Surgical

Terry Moore, MSN, RN Director of Surgical Services

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Leslie Mull, MSN, RN, CEN Director of Emergency Services, Critical Care, and Cardiac Care

Mindy Pearson, MSN, RN Nurse Manager of Surgical Services Operating Room

Regina Rhodes, MSN, RN Director of Quality and Care Management

Leanora Mahoney, RN Nurse Manager of Emergency Services

Joset Taylor, BSN, RN Director of Operations Ambulatory Surgery Centers

Regina Turner, RN Manager of Drexel Medical

Andrea Wagner, MSN, RN-MNN Nurse Manager of Family Center & Special Care Nursery

Kerbey Welch, MSN, RN-BC Director of Medical/ Surgical, Family Center & Special Care Nursery, and Wound Care

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Letter

from President and Chief Executive Officer In the year 2020, I watched as the country and even the world realized that nurses are the lifeblood of any healthcare organization. They are the discipline that is at the bedside 24 hours a day, every day of the year. They are the discipline that epitomizes the title “hero.” These healthcare heroes stepped into the pandemic, often at risk to self, to take care of our patients.

Every day I watched these nurses go above and beyond for our patients and their families. They were the skilled hands providing care, the loving hearts providing compassion, and the soul providing hope.

As you read this report, please pay attention to how these men and women make a difference in the lives of others. As you interact with our nurses, please take the opportunity to express your gratitude for what they do and the difference they make. This year has made it even more obvious how important they are to all of us.

While healthcare will continue to evolve and change, the hearts and compassion of these caregivers never will – not when it comes to doing what they do best – taking great care of our patients one by one, 365 days a year.

I am proud to be a nurse, and I invite you to join me in celebrating our nurses and the great work they do.

Kathy C. Bailey, FACHE President and CEO Carolinas HealthCare System Blue Ridge

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One Month at Carolinas HealthCare System Blue Ridge

PHYSICIAN VISITS: HOSPITAL INPATIENT & OUTPATIENT ENCOUNTERS:

22,909

10,122 BABIES DELIVERED: SURGERIES:

68

698* *Services closed for 6 weeks due to COVID

EMERGENCY DEPARTMENT VISITS: NEW PRIMARY CARE PATIENTS:

3,307

385

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Nursing By The Numbers

NUMBER OF NURSES:

446

NUMBER OF NURSE ADVANCED PRACTICE PROVIDERS (NP, CNM & CRNA):

NURSE AVERAGE YEARS OF SERVICE:

9.2

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NUMBER OF NURSES EMPLOYED IN CARE SETTINGS:

360 OUTPATIENT: 86

NUMBER OF NURSES RECRUITED IN 2020:

56

INPATIENT:

NUMBER OF NURSES PROMOTED IN 2020: NUMBER OF NURSES HOLDING ADVANCED DEGREES:

273

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Nursing Awards & Recognitions

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North Carolina Great 100 Nurses Carolinas Healthcare System Blue Ridge Nurse Leader Receives Prestigious Award Carol Ervin, BSN, RN, Director of Behavioral Health, was selected as one of 2020’s Great 100 Nurses in North Carolina. This prestigious award is a statewide once-in-a-lifetime recognition.

The Great 100 recognizes and honors Nurses for their commitment to excellence and to advocate for the nursing profession.

Carol has been a teammate at Carolinas HealthCare System Blue Ridge for thirty-five years. During this time, Carol has been an integral part of the Behavioral Health Units transformation. Under her leadership, the Behavioral Health Unit has accomplished high teammate engagement levels and considerable improvement in patients’ perception of their experience.

Carol pioneered the Mental Health First Aid program at Carolinas Healthcare System Blue Ridge. This program has provided training to over 350 teammates, leaders, and community members. Carol has also been instrumental in bringing system-wide and community attention to mental health awareness by organizing and implementing the “Run as One” Annual Behavioral Health 5k.

Carol has dedicated her nursing career and life to caring for others. She exhibits kindness, compassion, empathy, and respect to all she encounters. Carol is a dedicated leader who providers hope, restores dignity, and elevates the human condition.

Every and any act of kindness we can extend, can go a long way.

– Carol Ervin

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Carol Ervin, BSN, RN Director of Behavioral Health Unit

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Pinnacle Award Nominee The Pinnacle Award is a prestigious award within Atrium Health. Teammates have the opportunity to submit nominations of fellow teammates who make a difference by embodying the Atrium Health values of Caring, Commitment, Integrity, and Teamwork.

The Carolinas HealthCare System Blue Ridge Senior Leadership team reviews our Pinnacle nominations and chooses two candidates as nominees for the system.

In 2020, Dara Melker, BSN, RN, a Clinical Supervisor for the Emergency Department was nominated by a fellow Emergency Department teammate for her outstanding compassion for others. Dara has a passion for teaching and seeks out every opportunity to be a preceptor and always finds a moment to teach others.

In addition to Dara’s passion for teaching she is an unwavering advocate for patients and their families. Dara’s passion for her patients and their families led her to develop and lead the “Heartbeat in a Bottle” project where the last heart rhythm strip of a patient before they pass is printed and placed in a small glass bottle then given to the family.

Dara exemplifies our Core Values as she leads by example in her daily practice to enhance life by excelling in care. Dara’s infectious, positive attitude and can-do demeanor make her a role model for the department and reflects the mission of Carolinas HealthCare System Blue Ridge – enhancing life by excelling in care.

What sets Dara apart is her endless compassion for the welfare of others.

- Teammate

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Dara Melker, RN, (center) is shown here with Leslie Mull, MSN, RN, CEN, Director of Emergency Services, Critical Care, and Cardiac Care; Barry Nelson, MSN, RN, CENP, Vice President of Nursing and Chief Nurse Executive; David Everhart, MSN, RN, Executive Director of Nursing Operations; and Haley Suttles, MSN, RN, CEN, Nurse Manager of Emergency Services.

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Preceptor Recognition Program The Carolinas HealthCare System Blue Ridge Preceptor Recognition program was derived from Atrium Health’s preceptor recognition program. Our Shared Governance Recruitment and Retention Council revised the program to better suit our culture.

The council chose to recognize one RN and one CNA from each nursing department ED, Float Pool, Family Center-Special Care, Behavioral Health, Cardiac Care, CCU, and Med-Surg. The council’s nurse leader advisor presented a nomination with the person being nominated kept anonymous to the voting council. Recipients were chosen based on: • Ability to role model professionalism • Ability to effectively communicate • Being a super educator • Ability to socialize new teammates into the unit culture • Advocating for new teammates • Ability to evaluates and offer meaningful feedback.

During 2020, the Preceptor Recognition Program recognized 12 RNs and CNAs.

This CNA is a positive role model for teammates, especially newly hired teammates. Her positive energy is uplifting, and she demonstrates teamwork in all of her interactions with any unit she is assigned to work. She has helped me with vital signs, turning patients, and taking patients to the bathroom – even though she wasn’t assigned to those patients. She is a great example of what teamwork looks like!

– A nomination for Preceptor Recognition Program

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Amy Powell, RN Family Center & Special Care Nursery

Bee Hemmings, CNA Critical Care

Bethany Smith, RN Cardiac Care

Chandra Nunnery, CNA Emergency Dept.

Chasity Parker, CNA Cardiac Care

Dede Abernathy, CNA Medical/Surgical

Eric Woody, RN Behavioral Health

Kaitlyn Stephens, RN Medical Surgical

Mary Patrick, RN Float Pool

Lisa Harless, CNA Float Pool

Lacey Pope, OB Tech Family Center & Special Care Nursery

Melissa Eaches, RN Emergency Dept.

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2020 Nursing Awards Good Catch Awards Carolinas HealthCare System Blue Ridge encourages and supports non-punitive reporting of “near misses.” 2020 has been an unprecedented year, but through it all our teammates remain committed to our patients and their safety. A Good Catch Award is given when an error is caught before it reaches the patient (“near miss”). It prevents an actual adverse event and/or stimulates efforts to improve a current system or process. To promote a culture of patient safety, we encourage and support non-punitive reporting of “near misses.” A Good Catch nomination should be submitted for those who go above and beyond the duties defined in their normal job descriptions.

Nurses who earned the Good Catch Award in 2020: Emily Lambert – Float Pool Nurse

Donna Abbott – Family Center Nurse

Katie Head – Emergency Dept Nurse

Tyler Huffman – Emergency Dept Nurse

Christy Brown – Float Pool Nurse

Jocelyn Woods – Family Center Nurse

Ariana Dunham – Medical Surgical Nurse

Lori Reed – Cardiac Care Nurse

Caitlin Hughey – Emergency Dept Nurse

Lisbeth Yanez – Medical Surgical Nurse

Brittney Tinsley – Medical Surgical Nurse Daisy Awards Sabrina Patterson, RN - Emergency Department Francia Mendez, RN - Family Center Terry Rhyder, RN - Surgical Services

Patterson

Mendez

Rhyder

Values In Action Excellence Award Amy Powell, RN

Powell

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Nursing Response to COVID-19 19

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Nursing and Virtual Care The Virtual Hospital (VH) is an intensive home monitoring program for proactive management of COVID-19 positive patients who do not require hospitalization.

The VH nurses educate patients on symptoms regarding viral illness course, warning signs for escalation of care, how to prevent further spread, testing guidance, coordination for PCP follow up, resources for food, medication or other essentials and discontinuation from isolation/return to work guidance. They are in regular contact with patients during their recovery and can assist with the coordination of escalation of care.

The team of five nurses - Lisa Landers, BSN, RN; Traci Greenwood, BSN, RN; Otela Flanders, LPN; Kaylan Rogers, BSN, RN; and Donna Cox, BSN, RN - cover patients seven days a week to make sure they are contacted to monitor for symptom management.

Since the implementation of the Virtual Hospital on April 22, 2020 there have been more than 2,500 patients enrolled in 2020. The increased census with a daily peak of 314 lead to the utilization of an electronic patient screening system to assist with symptom monitoring.

The team is proud to provide this service to the community.

I feel like I am doing my part to help out my community during the crisis.

– Tracie Greenwood, BSN, RN

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Virtual Hospital Discharge Reasons

Virtual Hospital Totals (April 23, 2020 - YTD)

Discharged from VH 3594

Enrolled in VH (+ or -) 3604

Achieved outcomes/max benefit reached Unable to reach Doesn’t not meet enrollment criteria Patient placed in higher level of care

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Nursing Involvement in COVID-19 Response Novel Coronavirus (COVID- 19) brought a unique set of circumstances to Carolinas HealthCare System Blue Ridge. In response to the anticipated impact of COVID-19 on Carolinas HealthCare System Blue Ridge, Incident Command - COVID-19 activated on March 12, 2020.

Nursing was an integral part of our Incident Command COVID-19 team. Taking major roles were: • Barry Nelson, MSN, RN, CENP, Chief Nurse Executive, as Incident Commander • David Everhart, MSN, RN, CEN, Executive Director of Nursing, as Planning Chief.

Nurse leaders holding active roles were: • Leslie Mull, MSN, RN, CEN - Surge Plan Manager, • Jackie Lawrence, MSN, RN - Nursing Operations Manager • Haley Suttles, MSN, RN, CEN - Emergency Department/External Triage Team Manager • Haylie Coffey, MSN, RN - Infection Prevention • Anna Starnes, BSN, RN – Infection Prevention.

COVID-19 Response plan to anticipate a surge in large volumes of patients.

Initial Phase: Emergency Department

Goal: Minimize the impact a surge would have on the efficiency of the Emergency Department.

Interventions: Implementation of a drive-thru queue to facilitate Nurse evaluations to determine the course of action for patient.

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Second Phase: Inpatient Department

Goal: Ensure the management of an increase of patients requiring

admission to the hospital.

Interventions: Development of COVID-19 Cohorts.

• Progressive Care Unit converted to COVID-19 Critical Care Unit – 6 bed cohort.

• Cardiac Care South Unit: Cohort B–3 beds; Cohort C–4 beds; Cohort D–13 beds.

• Critical Care Unit: Cohort E–5 beds (utilized if the COVID-19 Critical Care Unit exceeded capacity).

November and December Surge Interventions: • Cardiac Care North Unit: Cohort F – 15 beds. Inpatient cardiac care services transferred to the 4th floor overflow unit.

By implementing the Emergency Department Surge Plan and the Inpatient Surge plan, we effectively managed the COVID-19 surge during 2020 at Carolinas Healthcare System Blue Ridge.

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Implementation of Surgical Services LPNs During the Novel Coronavirus (COVID-19 ) pandemic, the Carolinas HealthCare System Blue Ridge Surgical Services Department faced various unique challenges.

One such challenge was how to reduce the risk of patient and teammate exposure to COVID-19. Our Surgical Services Department leaders developed a plan to ensure the safety of our patients and teammates.

Leaders identified that the best practice was to test surgical patients before their scheduled surgery. A Surgical Services LPN role was created to guarantee a viable and sustainable testing process. The Surgical Services LPN’s role includes preoperative testing of patients and other pre-anesthesia duties within the LPN scope of practice. In August of 2020, two LPNs entered their full-time position with Surgical Services.

From August 2020 to December 31, 2020, the Surgical Services LPNs have completed approximately 3,200 COVID-19 tests for pre-operative patients. The role of the Surgical Services LPN continues to evolve, and we continue to evaluate their role. We look forward to seeing the continued improvements the Surgical Services LPN brings to Surgical Services.

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Tiffany Gantt, LPN, Surgery Coordinator - Surgical Services

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Connecting Residents During the Pandemic In March of 2020, Carolinas HealthCare System Blue Ridge and Grace Ridge Retirement Community faced COVID-19 and the unique set of challenges it brought to a retirement community. COVID-19 forced Grace Ridge to implement strict visitor restrictions, effectively eliminating families’ ability to visit with their loved ones.

In response, teammates at Grace Ridge had to find new ways to help the residents in connecting with their family and friends. Grace Ridge implemented the use of modern virtual technology, such as FaceTime and Facebook. However, as time progressed, they quickly found that a more user friendly and readily available technology was needed. As a result, the team implemented the use of Zoom, which was well received by patients and their families.

The Grace Ridge Retirement Community team also implemented strategies to allow for in-person visits. To ensure the safety of residents, visits were based on State guidelines and strictly adhered to COVID-19 protocols. The team scheduled window visits, using walkie-talkies to assist with communication. When weather permitted, outdoor visits were scheduled. In unique situations, compassion visits were offered, allowing the family member to come to the resident’s room or designated indoor area.

As an additional initiative to ensure residents and families felt connected, Grace Ridge teammates have taken an active role in snapping pictures of residents to share with family. The feedback from the families is a simple demonstration of the power of a picture.

As Grace Ridge Retirement Community continues to navigate the challenges of COVID-19, the team is continually seeking ways to connect residents with their family and friends.

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COVID-19 Testing Sites In March of 2020, Carolinas Healthcare System Blue Ridge faced the challenge of providing our community with access to COVID-19 testing. Our Incident Command appointed a task force to develop a COVID-19 testing site plan to answer the need.

Individuals from the Blue Ridge Medical Group led the task force - Emily Heien, RN Director of Clinical Operations; Josh Lail, Quality and Safety Outcome Specialist; and Brittany Dobbins, Executive Director of Operations.

The COVID-19 Testing Task Force established testing centers at our four express cares and one urgent care. Teammates throughout Carolinas Healthcare System Blue Ridge staffed the COVID-19 testing site and provided COVID-19 testing for our community members, primary care patients, surgical services patients, and qualifying emergency department patients.

Through the hard work and dedication of the COVID-19 Testing Task Force, Carolinas HealthCare System Blue Ridge provided COVID-19 testing for 34,620 individuals between March 29, 2020 to December 31, 2020.

Rapid antigen testing education created for teammates and patients

Began testing teammates with Rapid Antigen

June 2020 May 2020

Completed 15,901 antigen tests for patients

November

June 2020

June–December

March Antigen testing May

November

Diatherix Lab

November Diatherix available in all PCP offices Diatherix

Antigen test available in Urgent available in all PCP March Care/ May offices Partnered withExpress Care ASC/OR

Partnered with

patients tested ASC/OR

Diatherix Lab March

patients tested May

available in all November

Partnered with Diatherix Lab

ASC/OR patients tested

Diatherix available in all PCP offices

Training created for Urgent Care/ Express Training Care created Sent first PCR for Urgent Care/ test to Diatherix Express Care Sent firstcreated PCR Training test to Diatherix for Urgent Care/ April Express Care

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Sent first PCR April test to Diatherix

PCP offices

Completed 18,719 PCR Swabs Completed 18,719 PCR AprilSwabs

December

Completed April18,719 PCR December Swabs

April-

Nursing Quality Initiatives

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Transitional Nursing Team Earns Award of Excellence

In 2020, Carolinas HealthCare System Blue Ridge established the Virtual Hospital in response to the pandemic. The Blue Ridge Medical Group and Transitional Care Team collaborated regarding the care of COVID-19 positive patients. These patients were contacted by phone to monitor symptoms and intervene as necessary by obtaining the appropriate resources including provider virtual visits, durable medical equipment, or other needs for social determinates of health. The Transitional Care Nursing Team received an Award of Excellence for their commitment to this initiative. The team voiced their passion for making a difference in our community.

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The Transitional Nursing Team, from left, are Lisa Landers, BSN, RN, Traci Greenwood, BSN, RN, Otela Flanders, LPN, and Kaylan Rogers, BSN, RN.

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Stroke Care Coordinator Added to Quality Staff

Sarah VanHorn, MSN, RN Care Coordinator/ Navigator In 2020, the Quality Department added Sarah Van Horn, MSN, RN, an RN Care Coordinator/Navigator, to help manage and grow the stroke program at Carolinas HealthCare System Blue Ridge.

Sarah obtained an MSN in Nursing Administration from UNC-Greensboro. She comes to us with five years of nursing experience and a background in stroke and cardiac care.

As the coordinator for the Stroke Certification program Sarah assists with: • collecting and analyzing stroke data • coordinating communication between interprofessional disciplines • reviewing/updating stroke related policies and procedures.

Sarah also helps facilitate our Stroke Survivor Support Group. Her focus for 2020 was helping to get our organization prepared to be certified by The Joint Commission (TJC) as an Acute Stroke Ready Hospital. We are currently awaiting certification by TJC and hoping to complete this in 2021.

Her role will include future involvement in other disease specific certifications. She is currently assisting the organization to achieve a Spine Center of Excellence certification.

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Gold Plus Stroke Award

In 2020, Carolinas Healthcare System Blue Ridge won the Gold Plus Stroke Award which shows commitment to our patients by providing essential services needed by the community. The award is based on achievement of performance measures at 85% compliance in evidenced-based care.

The criteria included timely administration of: tPA, antithrombotics, VTE prophylaxis, and other recognized measures in the treatment of stroke. Additional quality measures which met 75% compliance included: dysphagia screening, rehab consults, stroke education, LDL documentation, and NIHSS reporting.

The outcome measures reflect a 12-month period and the target for the Stroke award is based solely on time to IV thrombolytic therapy (within 60 min in >50% of patients). The delivery of rapid appropriate treatment to stroke patients can significantly impact and reduce adverse outcomes such as disabilities or mortality.

The 2020 Gold Plus Stroke Award Team, from left, are Ashley Carpenter, MSN, RN, Debbie Barlowe, BSN, RN, Amanda Krause, BSN, RN, Leslie Mull, MSN, RN, CEN, Hannah Barrier, BSN, RN, David Everhart, MSN, RN, CEN, Sarah VanHorn, MSN, RN, Haley Suttles, MSN, RN, CEN, and Regina Rhodes, MSN, RN.

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Critical Care Unit Named Most Improved The ICU Liberation Bundle aims to free patients from the harmful effects of pain, agitation/sedation, delirium, and immobility in the intensive care setting as well as engage the family in the patient’s plan of care. The intentions are to improve patient outcomes and reduce the risk of long-term consequences from an ICU stay.

In 2020, the Critical Care Unit at Carolinas HealthCare System Blue Ridge was recognized by Atrium Health as a “Most Improved Site” for the ICU Liberation Bundle. The score was improved by 13.1%. This improvement is attributed to focused education on the science behind the ICU Liberation Bundle as well as required charting.

As of November 2020, our score was 77.8% and continues to trend upward. We are looking forward to further improvement in 2021.

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Carolinas HealthCare System Blue Ridge Named Most Improved Facility for IV Pump Guardrail Compliance In early 2020, Carolinas HealthCare System Blue Ridge was completing training to prepare for the implementation of Interoperability software system that seamlessly integrates the Alaris IV pump with the electronic medical record (EMR). Integrating a computerized provider order with an IV pump significantly decreases the risk of IV medication errors by eliminating manual programming of the IV pumps. Unfortunately, COVID-19 halted training and the implementation of Interoperability.

In preparation for the implementation of Interoperability, the use of IV pump Guardrail compliance is necessary. IV pump Guardrail is a medication safety software utilized by the Alaris IV pump system to reduce the risk of harmful IV medication errors and improve the overall quality of patient care. For hospitals with Interoperability implemented, IV pump Guardrail compliance is mandatory; however, for hospitals who have not implemented Interoperability, IV pump Guardrail compliance is expected but not required. However, nurse leaders at Carolinas HealthCare System Blue Ridge chose to move forward with the IV pump Guardrail compliance goal of 90% use to ensure the safety of our patients.

Within the Atrium Health system of hospitals that have not implemented Interoperability, Carolinas HealthCare System Blue Ridge is the only hospital to meet the IV pump Guardrail goal. Throughout 2020, Carolinas HealthCare System Blue Ridge has consistently met the 90% goal for IV pump Guardrail compliance. Carolinas HealthCare System Blue Ridge was recognized within Atrium Health for the proactive and robust work completed to ensure the safety of our patients.

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Nursing Quality Metrics At Carolinas HealthCare System Blue Ridge, the nursing division strives to provide excellent care by providing safe, and quality patient care. We monitor several nursing quality metrics. The metrics that are continually evaluated are:

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Patient Experience Hospital Consumer Assessment of Healthcare Providers and Systems - HCAHPS

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Nursing Education

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Nursing Service Line Educators

2020 Education Offerings Summary

Service Line Educator

Number of Participants

Total Hours of Education Delivered

492

296

Behavioral Health

Laura McAllister

Cardiac Care

Holly Johnson

1,019

662

Critical Care

Mindy Duncan

503

386

Emergency Department

Adrian Krause

1,504

2,407

Family Center

Jennifer Banner

1,012

1,409

Nursing Support: Clinical Education

Linda Smith

1,675

8,035

Medical Surgical

Allison Annas

436

290

Surgical Services

Megan Price

876

290

7,517

14,102

Totals:

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8

Allison Annas, BSN, RN Service Line Educator Medical/Surgical

Jennifer Banner, BSN, RN Service Line Educator Family Center & Special Care Nursery

Adrian Krause, BSN, RN Service Line Educator Emergency Services

Holly Carswell, BSN, RN Service Line Educator Cardiac Care

Laura McCallister, MSN, RN Service Line Educator Behavioral Health

Mindy Duncan, BSN, RN Service Line Educator Critical Care

Megan Price, BSN, RN Service Line Educator Surgical Services

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Implementation of “Escape Room” The Carolinas HealthCare System Blue Ridge Escape Room was created by the Nursing Service Line Educators as part of the NCLEX review course for 2020 new graduate nurses. The purpose of this exercise was to help new graduates with assessment skills and critically think by finding clues through their assessment and solving problems by answering NCLEX questions correctly.

By successfully putting together the clues and solving problems, the nurses would Escape. The goal was to complete the “Escape” in under 60 minutes.

After many hours of research on how to implement this modality in the hospital setting, the Educators started developing the Escape Room in May 2020. The Escape Room was set up on the 4th floor of the Valdese Campus in an old ICU room and utilized a mannikin that talked, coughed, groaned, and yelled.

Novice Nurses (RN 1 year or less) and Nursing Preceptors were invited to participate in trial sessions in July 2020, prior to hosting New Grad Nurses. The first New Grad Nursing session was held on July 22, 2020 and Educators hosted five New Grad sessions.

The Escape Room went on to host Nurse Managers and Nurse Directors. It was decided that the Escape Room would be used as a team building exercise. Teammate Escape Room sessions were held between June 2020 and October 2020. Educators have hosted 12 Teammate sessions and 60 teammates have participated in the Escape Room.

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Advanced Degrees Earned by Nurses in 2020

At Carolinas HealthCare System Blue Ridge, we embrace lifelong learning and have put programs in place to offer incentives for RNs seeking to advance their education to the BSN and higher degree level. These incentives include streamlining and simplifying the system’s tuition reimbursement program; making tuition assistance easier to access; creating minimum education requirements for leaders; and implementing a requirement that Associate Degree RNs hired to work in the hospital agree to complete a BSN. Nursing teammates earning a higher degree in 2020 are: • Ashley Perkins, Grace Ridge Director of Nursing: Master of Science NursingLeadership and Management

• Bradley Scott Hughes, ED RN: BSN

• Melissa Rawlins, ED RN: BSN

• Tiffany Gentry, Cardiac Care RN:,BSN

• Melissa Kanupp, Radiation Therapy RN: BSN

• Meghan Crater, OR Valdese RN: BSN

• Jessica Ray, ED RN: BSN

• Kaylee Huffman, Family Center: BSN

• Christine Silver, ICU RN: BSN

• Megan Huskins, BH RN: BSN

• Adela Gurley, ICU RN: BSN

• Alicia See Tele, RN: BSN

• Zaranie Althea Collado, Cardiac Care RN: BSN

• Joshua Yount, ED RN: BSN

• Kaylin Eastwood, ICU RN: BSN

• Angela Rowe, Cardiac Care RN: BSN

• Megan Hentschel, ED RN: BSN

• Sarah Gordon, Neo Nate RN: BSN

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Nursing Recruiter Jordan Sherrill, BSN, RN, joined the Human Resources Department as the Nurse Recruiter in January 2021. Jordan joined Carolinas HealthCare System Blue Ridge as a Cardiac Care nurse in November 2017. She completed her Bachelor of Science degree in Communication with a concentration in Public Relations and a Bachelor of Science in Business with concentration in Marketing in 2011, both from Western Carolina University. In 2017, she completed a Bachelor of Science in Nursing from the University of North Carolina at Wilmington.

2020 Nurse Recruitment Events

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Burke Public Schools and WPCC Cohort

1/3/2020

Revised Nursing Recruitment Book

1/7/2020

Revised High School Healthcare Opportunities

1/8/2020

ICC Practical Nursing program Advisory Committee

1/24/2020

Open House

2/6/2020

Gardner-Webb University’s 2020 Healthcare Career Fair

2/12/2020

Revised NC Hospital Recruitment Site

2/12/2020

Social Media for OB RN and PT

2/12/2020

Western Piedmont Community College RN Luncheon

2/13/2020

App State

2/25/2020

Foothills and Mayland Senior RN Luncheon

2/26/2020

New Grad Virtual Tour

4/14/2020

App State Virtual Career Fair

6/16/2020

Developed Power Point for Surgical Techs

7/17/2020

UNCC On line recruiting

7/31/2020

Burke County Job Fair Virtual

9/22/2020

App State Internship and Job Fair Virtual

9/23/2020

Burke Country Job Fair Virtual

9/24/2020

New Nurse Experience at Carolinas HealthCare System Blue Ridge Video developed

October

CCC Fall Health Careers Virtual

10/5/2020

Virtual Open House for Exp Nurses

10/23/2020

LR Nursing Virtual Event Handshake

11/5/2020

Caldwell Community College Health Sciences Career Fair Virtual

10/5/2020 - 10/08/2020

New Grad Virtual Open House Presentation

4/13/2020; 4/14/2020; 4/15/2020; 4/16/2020; 4/17/2020

Skype and Face Time Mock Interviews for WPCC

4/14/2020; 4/15/2020; 4/21/2020

Virtual Presentation for Senior Nursing Students

9/21/2020; 9/25/2020; 9/30/2020; 10/1/2020

Nursing Community Relationships

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2020 Nurse Leader Community Board Memberships Carol Ervin

Leslie Mull

David Everhart

Dottie Cooper

Kerbey Welch

Danielle Baird

• • • •

Advisory Board Big Brothers/Big Sisters Burke County Board of Health Burke County Board of Directors Burke Substance Abuse Network Leadership

• Foothills Nursing Consortium – School of Nursing Advisory Board • Options of Burke County • Western Piedmont – School of Nursing Advisory Board

• Caldwell Community College & Technical Institute • Lenoir Rhyne University – School of Nursing – School of Nursing Advisory Board Advisory Board

• Lenoir Rhyne University – School of Nursing Advisory Board

Mindy Pearson

• Catawba Valley Community College – Surgical Technology Advisory Committee

Burke Women’s Fund – Steering Committee Member

Regina Rhodes

• New Dimensions Charter School – Board of Directors Chair

Jackie Lawrence • • • • • • •

Appalachian State University– School of Nursing Advisory Board Compassionate Hearts Clinic Gardner Webb University – School of Nursing Advisory Board Isothermal Community College– School of Nursing Advisory Board Lenoir Rhyne University – School of Nursing Advisory Board McDowell Tech Community College – School of Nursing Advisory Board Western Piedmont Community College – School of Nursing Advisory Board

2020 Nursing Community Involvement Cardiac Care

Emergency Department

Recruitment & Retention Council – Shared Governance • Sponsored 40 children for Children’s Christmas Project – 25 teammates children and 15 school children.

Critical Care • Donated 80 pounds of hygiene supplies to South Mountain Children’s Home.

• Donated $400 of food and school supplies to Burke County Schools.

• Teammates joined Compassionate Hearts Clinic for volunteer services.

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• Donated 264 pounds of hygiene supplies to Burke United Christian Ministries.

• Provided Meals to 60 EMS during EMS Week.

Retention and Recruitment Council Children’s Christmas Drive The Nursing Retention and Recruitment Council chose to sponsor children for Christmas in 2019 in lieu of hosting a Christmas party, as it was decided that giving back to children in our community during Christmas would be more meaningful and rewarding. In 2020, the council elected to sponsor children again, and also extended the invitation to leaders outside of nursing.

The response was heartwarming, as the council received a total of 21 responses across the organization expressing a wish to participate in this event. With the help of Cindy Cross and the rest of our Human Resources team, we were able to sponsor 25 of our teammate’s children and 15 children from the Burke County School System.

The council scheduled a time frame for department representatives to drop off their gifts on Thursday, December 10, and were touched by the amount of caring and kindness that was demonstrated by teammates throughout the organization. Once all gifts were received, council members filled up three large cars and delivered teammate gifts to the Human Resources Department and two large cars were packed with gifts and delivered to the Burke County School System Central Office.

Each child that was sponsored meant so much to the members of the council, and were treated as they were their own. Being able to sponsor children in the community and children of teammates within the organization was incredibly meaningful and uplifting, especially during this time of the current pandemic. The council was honored to be able to sponsor children at Christmas this year, and hopes for the opportunity to sponsor a greater number of children in 2021.

On behalf of the Nursing Retention and Recruitment Council, we would like to thank the Human Resources Department for their partnership and each teammate who donated gifts, wrapping paper, time and efforts, etc., to assist in sponsoring children at Christmas this year.

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Nursing Partners in Education Schools of Nursing and 2020 Partnerships

Nursing Students Completion of Clinical Rotation at Carolinas HealthCare System Blue Ridge School of Nursing

Clinical Group

Total *Preceptorship Preceptorships Preceptorships Research Covid 19 Leadership Clinical Students Students

Appalachian State University

6

Caldwell Community College & Technical Institute

34

5

Foothills Nursing Consortium

48

12

Gardner Webb University

3

9

3

42

4

20

84

2

2

4

Isothermal Community College

14

14

Lees McRae

12*

0

Lenoir Rhyne University

48

Mayland Community College McDowell Technical Community College

14

1

1

63 1

40

40

UNC - Greensboro

1

1

Walden University

1

1

Western Carolina University

20*

Western Piedmont Community College

96

Total Number of Schools: 13

286

1

1

4

6 96

19

9

46

1

361

*Displaced from other facilities when preceptorships were canceled due to COVID-19

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