2016 NURSING ANNUAL REPORT
Table of Contents 4 CaroMont Regional Nursing Mission and Vision Mission and Vision CARES Values Principles of Highly Reliable Organizations
8 Transformational Leadership
Nursing Shared Governance Nursing Practice Environmental Improvements in Progressive Coronary Care Unit Patient Placement by Shift Managers/Bed Resource Officers Improving Access to Communication: Implementation of Video Remote Interpreting Succession Planning at CaroMont Regional Medical Center Video Monitoring Improves Patient Safety
16 Structural Empowerment
Coaching Coaches to Improve RN Orientation Community Healthcare Outreach Teaching Nurses How to Teach CaroMont Regional Medical Centerâ€™s High School Shadow Day
21 Exemplary Professional Practice
Nursing Quality Leads to Lower Healthcare Associated Infections Partnering with Patients and Families Patient Experience with Nursing Care Progressive Coronary Care Unit Receives Highest Patient Experience Award 2016 RN Satisfaction Survey
27 New Knowledge, Improvements and Innovations
Research Studies Completed in 2016 Research Presentations in 2016 Advancing Patient Safety through Nursing Research Utilizing Innovation to Increase the Patient Experience Utilizing Evidence-Based Finding to Improve Nursing Practice
33 Professional Development
Commitment to Nursing Professional Development CaroMont Regional Career Ladder
37 Nurse Recognition and Awards
KNOT Award Road to Safety Health Heroes Honored Good Catch Award Celebrating Excellence in Nursing The Great 100 PRN Award Supporting Continued Education for Nurses Impressions from the Caring Science: Framework for Transformation of Self/System
51 CaroMont Regional Board Certified RNs
MISSION & VISION Nursing Mission To provide exceptional nursing care to those we are privileged to serve. Vision We are an extraordinary staff with an unwavering commitment to partner with patients, families, individuals and communities to achieve the highest potential for health and wellness.
The Behaviors and Core Values support the mission, vision and strategic direction of CaroMont Health.
Respect for the Individual. Anticipate and be attentive to the needs of those we serve. Come to work with a positive attitude. Make eye contact, smile and greet everyone in all areas of the organization. Demonstrate empathy and treat others the way they want to be treated.
Integrity; Apologize when appropriate. Find better, faster, less expensive ways to do things while always focusing on patient’s needs. Determine who is going to do what, when and how. Make decisions wisely, consider all ways to handle the issue. Take ownership of actions and decisions; Ask myself how I am contributing to the problem. Follow the CaroMont Health Code of Conduct.
Demand open communication. Teamwork; support smooth interdepartmental and intradepartmental work flow. Identify and push for solutions in which all parties can benefit. Effectively share thoughts and ideas, in both verbal and written ways. Promote and generate cooperation and teamwork. Participate willingly toward accomplishing group goals.
Honor innovation by generating new ideas, processes, methods, systems, products or services. Carefully monitor the details and quality of your work; things are to be done right, thoroughly and precisely. See obstacles as challenges and approach them with a positive ‘can-do’ attitude. Set and meet challenging objectives regularly.
Safety Continuously focus on Quality Patient Care. Commit to creating and maintaining a clean, safe environment for everyone. Honor our Just Culture.
The Five Principles of Highly Reliable Organizations:
Preoccupation with Failure
Reluctance to Simplify
Sensitivity to Operations
Commitment to Resilience
Deference to Experts
HROs are always looking for ways that things could go wrong or processes could fail, and they are never satisfied when things appear to be going right. They are always looking for areas that need further improvement.
HROs refuse to accept a simple answer to a complex problem. They use the tools for Robust Process Improvement to dive deep and identify all possible issues to correct the problem.
HROs understand that the earliest signs of a problem appear as small issues in how the company operates. Involving and empowering those who care for and provide service to our patients is critical to make sure we identify and address issues as soon as possible - before they become more serious.
HROs understand that sometimes, despite their best efforts and past successes, errors will happen. Resilience refers to an organizationâ€™s capability to recognize errors quickly and contain them.
HROs identify those who have the most training, experience or information and allow them to make decisions and guide the performance improvement process.
NURSING 2016: A YEAR IN REFLECTION 7
T Scott Wells, MSN, RN, NEA-BC Vice President Patient Care Services Chief Nursing Officer
Ashley Long, MBA, BSN, RN Senior Director of Patient Care Services
he year 2016 brought nationwide challenges in the wake of healthcare reform. Patient volume and demand for high quality services were at an all time high, while pressures to cut cost and improve efficiencies remained steady. Even with this dynamic healthcare environment, at CaroMont, we have remained focused on honoring our CARES promise: Compassion, Accountability, Respect, Excellence and Safety. This is a commitment to our patients and each other. In addition to CARES, our organization has embarked on a journey to becoming a Highly Reliable Organization. Led by our Chief Medical Officer, Dr. Todd Davis, we commit to making a difference with each and every interaction we have to improve patient and staff safety. In this report, we will reflect upon the successes and accomplishments we have achieved together as a team in 2016. Reflection is the process of exercising a review of your own thoughts and actions with discernment about the decisions that create positive outcomes. Nurses use critical thinking skills every day and reflection of these skills can help identify ways to accomplish new tasks or improve old ones as we learn from our mistakes. A front line nurse’s reflective voice has much power to impact the care of our patients and their families. In the past year, our nurses’ voices achieved outstanding patient outcomes, innovated new practices and continued advancing the professional practice of nursing–all while providing compassionate and Highly Reliable Care to patients and families in our community. Shared Governance and Unit Based Councils have expanded our ability to change our culture by empowering the voice of nurses throughout the building. Whether in one department or in conjunction with several departments, our continued efforts to improve patient care have been evident though the expansion of performance improvement projects and rapid improvement events. Through the use of simple communication tools and initiatives we have improved our patient satisfaction through the best practices of hourly rounding and bedside shift report. Our nurses are also driving our strategic operating plan forward by working together to improve patient outcomes and quality indicators around door-to-needle times, emergency room diversion rates, pressure ulcers, surgical site infections, catheter- associated infections and central line infections.
Our nurses care with their hands and their hearts, and I am proud of all they have achieved. It is because of the daily contributions of our bedside nurses we were able to impact the lives of patients and advance the profession of nursing.
TRANSFORMATIONAL LEADERSHIP Nursing leaders at all levels of CaroMont Health have established high standards for safe and quality nursing care. Chief Nursing Officer, Scott Wells, MSN, RN, NEA-BC, along with nurse leaders, have developed an open and genuine relationship with clinical staff nurses assisting them in a strategic partnership. As a result, CaroMont’s nurses, whose objective is to transform and advance excellence in nursing care, know their voices are heard, their input is valued and their practice is supported. Nursing plays an integral role in improving the organization’s performance, supporting the organization’s goal and influencing the organization’s decision making. The following articles demonstrate transformational leadership within the nursing service at CaroMont Regional Medical Center.
TRANSFORMATIONAL LEADERSHIP 9
Nursing Shared Governance
component of a high functioning nursing service is the level of shared leadership and participative decision making among its nurses. CaroMont Health has a model in place where nurses are formally organized into Shared Governance Councils to make decisions regarding clinical practice standards, quality improvement, staff and professional development, and research. Through hospital-wide councils, CaroMont Nurses have an important role in shaping patient care and the nurse work environment. The Shared Governance Council participation grew significantly in 2016. Many outstanding achievements were the results of diligent work, dedication, and commitment by the leaders and members of these councils. The following are the Shared Governance Councils and Chairperson(s) for 2016.
Council for Nursing Practice
Liaison: Beth Canipe, MSN, RN, NEA-BC
Council for Nursing Research & Evidence Based Practice
Chairperson: Lisa Costner, RN, RNC-OB Liaison: Faye Clements, MSN, RN, RNC-OB
Council for Education & Professional Development
Chairperson(s): Pat Suggs, MSN, RN, PCCN, RN-BC and David Avalos, MSN, RN, OCN Liaison: Char Biamonte-Stockl, MSN, RN, RN-BC, NEA-BC
Council for Performance Improvement & Patient Safety
Chairperson: Joanne Faber, BA, RN, ONC Liaison: Sheila Reagan, MSN, RN, NEA-BC
Council for Nursing Excellence & Recognition
Chairperson: Claire Way, RN, CAPA Liaison: Todd Friday, MSN, RN, OCN, NE-BC
Council for Operations
Scott Wells, MSN, RN, NEA-BC
10 TRANSFORMATIONAL LEADERSHIP
Nursing Shared Governance (cont.) Staff participation in Shared Governance drives the success of CaroMont’s nursing councils. In 2016, each council was able to advance the nursing practice through the following accomplishments: Council for Nursing Practice Developed standard work and education on hourly rounding Created a standard work for hand-off communication Continuously identified patient care issues and forwarded them to the Complex Workflow Committee Utilized evidenced-based practice, reevaluated and implemented new blood transfusion vital sign parameters Developed standard work and education to clinical staff nurses on appropriate use of sequential compression devices (SCDs) Council for Nursing Research and Evidenced Based Practice Facilitated the completion of seven research projects Assisted in publishing two research studies Council for Education and Professional Development Increased the number of Nursing Perspectives with CNE offerings Reinstated monthly unit reports to increase unit based shared governance Hosted an Education Fair to encourage nursing staff to further their professional development Council for Performance Improvement and Patient Safety Created the Patient and Family Experience performance improvement projects for each nursing unit Held Road to Safety competition Council for Nursing Excellence and Recognition Recognized 47 Award for Nursing Excellence recipients and 28 Nursing Team Star recipients at the annual Awards for Nursing Excellence gala Presented three Physician Recognition by Nurses Award Honored eight CaroMont Registered Nurses selected as Great 100 Nurses in North Carolina
TRANSFORMATIONAL LEADERSHIP 11
Nurse Practice Environment Improvements in Progressive Coronary Care Unit
ne of the strategic objectives in CaroMont Regional’s nursing strategic plan for calendar year 2016 was to engage nursing staff to improve their work environment. CaroMont nurses were involved in continuous performance improvement initiatives throughout the organization in the form of Value Stream Analysis (VSA) and Rapid Improvement Events (RIE). Nurse participation in both the VSA and RIE were instrumental in recognizing the issue (VSA) and proposing solutions to the issue (RIE). This provides the nursing staff the opportunity to design their work flow and improve their daily practice. One example of a continuous performance improvement initiative can be seen in the Progressive Coronary Care Unit (PCCU), a very fast paced unit with considerable patient turnover each day. A PCCU-Pharmacy RIE was held the week of February 8 to focus on specific actions to increase PCCU clinical staff nurses’ satisfaction with the medication availability process. To the PCCU nurse, having medications readily available was important in improving the practice environment. The following actions were implemented: The three Pyxis machines on PCCU were optimized in order to add more additional medications. Due to its high usage on PCCU, pre-mixed Heparin bags were added at the request of nursing, decreasing wait times for the nurse to receive this medication. After reviewing Pyxis reports and messages from nurses regarding stock outs (medications out of stock in the Pyxis), the quantity of many medications was increased. In order to have all of the scheduled medications available, the timing of the patient drawer refills was changed to accommodate the needs of the PCCU nurses.
12 TRANSFORMATIONAL LEADERSHIP
Patient Placement by Shift Managers/ Bed Resource Officers
aroMont Regional Medical Centerâ€™s patient placement process was not a streamlined process. Patients could be assigned a specific room by various individuals depending on the time of day and level of care the patient required. As a result, clinical staff nurses experienced many instances of newly-admitted patients being transferred to a higher level of care within four hours of admission. With the conversion to EPIC, this was identified as a time to improve the clinical practice of patient placement. Effective with EPIC implementation in August 2015, the bed assignment process would be owned entirely by the Nursing Shift Managers/Bed Resource Officers. Placing the ownership of patient placement with clinical nurses would decrease the number of patients requiring transfers to higher level of care within four hours of admission. Revamping the patient placement process had a significant impact on patient care and was an advancement in clinical nursing practice at CaroMont. By allowing Shift Managers and Bed Resource Offices to utilize their clinical skills and judgment to assign beds, the result has been fewer patient transfers within four hours of admission. This has saved valuable time for the clinical staff nurse who would have previously admitted and then transferred the patient. Over the course of the year, Nursing Shift Managers/Bed Resource Officers have fine-tuned the patient placement process. Prior to assuming the patient placement role, approximately 5% of patients were transferred to a higher level of care within four hours of admission. In January 2016, that rate had decreased to 2.6%. As of December 2016, only 1.98% of all patients required a higher level of care from first bed assigned.
TRANSFORMATIONAL LEADERSHIP 13
Improving Access to Communication: Implementation of Video Remote Interpreting
ommunication is important in all aspects of life; however complete and understandable communication in healthcare is essential. Providing all patients the access to translation services is a patient right. Timely translation services ensure patient safety, patient satisfaction and patient compliance with the plan of care. Although CaroMont Regional Medical Center has interpreting services, there are times when an interpreter may be unavailable. These situations are typically spontaneous and urgent. The 90-minute turnaround time for an outside contracted interpreter to arrive is too long for a patient to wait. Not only is this a patient care issue, but it also creates a stressful practice environment for the nursing staff. Trying to communicate or teach a non-English speaking or hearing impaired patient without an interpreter leads to frustration for the nurses and a feeling of inadequate patient care. Lauren Jordan BSN, RN, on Post Coronary Care Unit (PCCU) experienced a patient care situation where a translator wasn’t available. Lauren was caring for a hearing impaired patient who had been admitted for chest pain and had several questions. Given the patient’s condition and urgency for the stress test results, there was little time to have an American Sign Language interpreter called. This patient’s experience validated the need for immediate interpreting services. In April 2016, 11 Video Remote Interpreting (VRI) tablets were added throughout the CaroMont Health System. Immediate language interpreting is now available at the following locations:
CaroMont Regional Medical Center Birthplace Emergency Department CaroMont Regional Medical Center - Mt. Holly CaroMont Cancer Center Summit Imaging CaroMont Hyperbaric and Wound Center, CaroMont Diabetes Center and CaroMont Rehab & Sports Medicine CaroMont Outpatient Surgery CaroMont Specialty Surgery Coumadin Clinic The nursing team quickly realized the advantages of having interpreting services readily available. The frustration of not being able to communicate with patients has been alleviated.
14 TRANSFORMATIONAL LEADERSHIP
Succession Planning at CaroMont Regional Medical Center
uccession planning is woven throughout the nursing department at CaroMont Regional Medical Center. The Chief Nursing Officer, along with nursing leaders, advocate for continuous professional development and a learning environment that promotes career progression and succession planning. This advocacy supports advancement within the organization and retention of high performers. Patricia “Trish” Goble, DNP, MSN, RN-BC, is an example of succession planning, starting as a bedside nurse. Trish started her career with CaroMont Health in June 2008 with her Associates Degree in Nursing. In 2015, Trish completed her Doctorate in Nursing Practice, and in 2016 was promoted to Director of Medical Services. Trish is an excellent example of succession planning as she followed the same path as her predecessor, Janet Hamrick MSN, RN-BC. Janet mentored Trish during this time to prepare her to be a future leader. Years of professional development through CaroMont’s succession planning program contributed and assisted Trish to achieve the skills as a nursing leader. Trish continues to excel in her role as the Nursing Director of Medical Services.
New Nurse Graduate - ADN
Trish Goble DNP, MSN, RN-BC NURSING DIRECTOR
Clinical Staff Nurse - BSN
Assistant Nurse Manager
Nurse Manager 2011
Clinical Nurse Manager
TRANSFORMATIONAL LEADERSHIP 15
Video Monitoring Improves Patient Safety
n October, CaroMont Regional Medical Center furthered its commitment to providing patients a safe environment by introducing AvaSys Telesitter technology, which monitors patients remotely. The addition of telesitting has increased the number of patients who can be observed while decreasing the number of PCA/ PCTs removed from patient care to observe these patients. CaroMontâ€™s Focused Observers were selected as the staff to spearhead the AvaSys Telesitter and manage the day-to-day operation of the monitoring system. The Telesitter monitoring device is a tool used to ensure patients are kept safe. It is a video camera and two-way audio device, allowing Focused Observers to see and speak to the patients from a central monitor room. The Focused Observers can redirect patients when they notice the patient being unsafe, such as trying to get out of bed or pulling at lines and tubes. If verbal redirection is not successful, the Focused Observers will notify the nursing staff assigned to the patient. This investment in patient safety has yielded great results. Six months after implementation, 36,299 patients have been monitored for a total of 2,300,175 hours. Through monitoring these patients, the Focused Observers have prevented numerous falls, prevented patients from pulling out tubes/lines or self medicating, and other great catches. In addition, the AvaSys Telesitter program has prevented PCA/PCTs from being pulled from direct patient care to fill the Focused Observer role. The top three reasons for monitoring patients via AvaSys at CaroMont Regional Medical Center are for fall prevention, confusion/restlessness, and safety of tubes and lines.
PRIMARY REASONS FOR MONITORING 1%
FALL PREVENTION OTHER
SAFETY OF TUBES/LINES
DELIRIUM/RESTLESSNESS/CONFUSION 59% 10%
STRUCTURAL EMPOWERMENT At all levels, CaroMont Regional Medical Centerâ€™s nursing team is empowered to participate on decision making committees to continually enhance our nursing care. Our commitment to excellence in professional nursing, lifelong learning and professional development, and community involvement are hallmarks valued by the nursing division and supported by CaroMont Health. The strength of CaroMont Regional Medical Centerâ€™s structural empowerment is exemplified in the following articles.
STRUCTURAL EMPOWERMENT 17
Coaching Coaches to Improve RN Orientation
aroMont Regional Medical Center recognizes the importance of facilitating the professional development of newly-hired nurses through a supportive and nurturing environment. The transfer of skills and knowledge from experienced professionals to new nursing staff provides continuity, succession management and continued learning for all involved. CaroMont Regional utilizes “Coaches” to provide a supportive nurturing relationship. The term “coach” was chosen over other terms to encourage the support of a learner in achieving a specific personal or professional goal. The Nurse Manager/Coordinator and CNS/Nurse Educator matches all newly-hired, experienced nurses and new nurse graduates with a Coach. In 2016, the CNS/Nurse Educators revamped the Coach Program. This program was developed from evidencebased practice and is an in-house program provided several times per year. CaroMont Regional provides Coach classes on an ongoing basis and changes are made based on feedback from the Coach and the new hire. The overall purpose of the class is to provide Coaches with tools to promote:
Critical thinking in the new hire Identification of learning styles Successful teaching methods Effective communication
Effective listening Conflict resolution skills Goal setting
The principles of adult learning begin with discovering what the learner already knows (competence) while acknowledging and respecting previous experience. The Coach is provided education on how to bridge the knowledge from previous experiences to new learning opportunities. Each participant in the Coach class completes the VARK (Visual, Auditory, Read/Write, Kinesthetic) learning styles questionnaire. Each learning style is discussed and examples are given on how to successfully use the style, or combination of styles, so the new hire will learn. This also allows the Coach to adjust teaching styles in a way that is conducive to learning. Each coach is also given the Myers-Briggs Type Indicator®. The personality type is discussed and examples are given to successfully incorporate the new hire’s personality with the Coach’s personality for a better learning experience. PIRU (Problem, Intervention, Rationale, and Urgency) is a tool that is used to develop critical thinking skills in the new hire. Four questions provoke the new hire to think through situations and not just focus on tasks. The four questions are: What is the problem? What are you going to do about it?
These questions are asked in the Coach class after reviewing different patient scenarios and then the Coach is encouraged to ask the PIRU questions when they are on the floor with new hire. The plan for orientation is documented on goal forms completed by the new hire, Coach and CNS/Nurse Educator. The CNS/Nurse Educator meets with the new hire and Coach frequently to discuss progress of the orientation and identify how they can help support either the Coach and/or the new hire.
18 STRUCTURAL EMPOWERMENT
Community Healthcare Outreach Substance Treatment and Rehabilitation
aroMont Regional Director of Nursing for Women and Children’s Services, Beth Canipe, RN, MSN, NEA-BC, worked with the Gaston County Health Department to provide education to community providers who care for neonates diagnosed with the widespread diagnosis of Neonatal Abstinence Syndrome (NAS). NAS is a syndrome of drug withdrawal seen in neonates born to mothers who are physically dependent on a substance during pregnancy. According to the National Survey on Drug Use & Health, approximately 160,000 neonates in the US are born to women who use addicting substances during pregnancy. It is estimated that 95% of neonates exposed to opioids in-utero will experience NAS. This condition can be severe and life-threatening if not adequately assessed and treated.
April Hullender BSN, RNC-NIC
April Hullender, BSN, RNC-NIC volunteered to provide a Substance Treatment and Rehabilitation (STAR) program to community providers. The STAR program includes support for the pregnant patient and also to the community healthcare providers in use of the evidence-based Finnegan Scoring Tool for assessment of NAS.
Upon completion of the STAR course, providers were able to accurately assess opioid exposed neonates for the clinical signs and symptoms of withdrawal. Providers were also able to decipher clinical signs and symptoms of withdrawal using the Finnegan Neonatal Abstinence Scoring Tool. Ultimately, the healthcare providers are able to achieve 90% reliability in the use of the Finnegan Neonatal Abstinence Scoring Tool. As of September 2016, April presented eight educational conferences for the STAR program with more classes scheduled to occur monthly over the next two years.
Buttons Take on New Life in Art Piece
collection of buttons submitted by cancer survivors across Gaston County have been used to create a beautiful art piece serving as an inspiration to newly-diagnosed cancer patients. The project, which was a partnership between CaroMont Faith and Health Ministry, CaroMont Cancer Center and Cancer Services of Gaston County, was organized by Parish Nurse Lisa Marisiddaiah, BSN, RN, FCN. The buttons were collected in faith communities, banks, local businesses and agencies, and health facilities. Each button has a story behind it and represents a local cancer survivor’s unique journey. Local artists used the buttons to create “The Tree of Life.”
STRUCTURAL EMPOWERMENT 19
Teaching Nurses How to Teach
urses are teachers and CaroMont Regional Medical Center supports its nursing team in learning the fundamentals of teaching. One example of this can be found in the Birthplace where new clinical staff nurses learned to effectively teach families how to participate in the birth and care of a newborn.
Birth is an experience that affects a woman and her family for a lifetime. A woman’s confidence and perceptions of her experience are influenced positively or negatively by every person involved in her care and the care of her baby. A well meaning family/support person can diminish the new mother’s ability to effectively move through the hard work of birth and caregiving for her newborn. This is a result of the family/support person not knowing how to share and apply purposeful techniques that aid in relaxation, provide pain relief, and promote a calm and safe environment for the childbirth experience. The Birthplace’s family-centered care model allows the nursing team to improve the abilities of the family/support person by teaching them skills that will be helpful during labor and in the days post delivery. Involving the laboring patient’s family/support person in their care during the labor and delivery process impacts the quality of the experience for both the patient and their family/support person. In March 2016, the Perinatal Concept Class Series was developed by the Perinatal Educator, Frieda Norris, BSN, RN, MPH, with the support of the Educational Services Department’s Continuing Nurse Education Specialist, Nancy Baker, BSN, RN. One of the desired outcomes from class participation was to provide Birthplace nurses with the teaching strategies to educate the patient and her family/support person on labor techniques. This will be helpful to the patient during birth as well as in the days afterward. CaroMont’s nurses are supported by classes like these to learn how to teach the patient and their support system so care can be continued once discharged.
20 STRUCTURAL EMPOWERMENT
CaroMont Regional Medical Centerâ€™s High School Shadow Day
ecognizing the need to be creative in how we encourage entry into the nursing profession, CaroMont Regional Medical Center, Human Resources and Nursing Leadership partnered with Gaston County High School students through a Shadow Day. This collaboration created an educational offering to Gaston County high school students interested in the nursing profession. On March 30, 2016 and April 13, 2016, nursing leaders shared educational requirements for entry into professional practice, as well as the role and responsibilities of the professional nurse. The students shadowed nurses for approximately two hours and were able to see many of the attributes and responsibilities involved in the delivery of care. At the end of the session, each nurse was interviewed to ensure their assigned student met the educational requirement. This opportunity was valuable for these students, and the time they spent shadowing these nurses provided them direction for their future.
EXEMPLARY PROFESSIONAL PRACTICE CaroMont Regional Medical Center represents exemplary professional nursing practice in a culture of safety, quality monitoring and quality improvement. CaroMont Regional nurses partner with patients, families, support systems and interprofessional teams to positively impact patient satisfaction, high quality outcomes and provide exemplary professional nursing care. CaroMont nurses ensure care is comprehensive, coordinated and monitored for effectiveness. CaroMont Regional Medical Centerâ€™s nursing division is proud of the outstanding patient care and quality outcomes achieved in 2016. The subsequent examples highlight these achievements.
22 EXEMPLARY PROFESSIONAL PRACTICE
Nursing Quality Leads to Lower Healthcare Associated Infections Nursing plays an integral role in patient outcomes and the prevention of Healthcare Associated Infections. CaroMont Regional Medical Center submits data to benchmark against other same sized hospitals. Comparing CaroMontâ€™s outcomes to other facilities is crucial, as it allows CaroMont to celebrate its successes and focus resources and attention on opportunities. For 2016, CaroMont nurses had outstanding success in preventing Healthcare Associated Infections. The following is how CaroMont Regional Medical Center compared to other North Carolina hospitals with 400 or more beds.
Catheter Associated Urinary Tract Infections (CAUTI)-First in North Carolina
Hospital acquired MRSA First in North Carolina
CRMC Rex Healthcare Carolinas Medical New Hanover Mission Hospital Novant Health Novant Health Cape Fear Valley Moses Cone Wake Med
CRMC Rex Healthcare Carolinas Medical Mission Hospital New Hanover Moses Cone Wake Med Cape Fear Valley Novant Health Novant Health 0
Hospital acquired C Difficile-First in North Carolina CRMC Carolinas Medical Mission Hospital New Hanover Cape Fear Valley Novant Health Moses Cane Rex Healthcare Wake Med Novant Health 0
Standardized Infection Ratio
These results were attributable to the diligent work of CaroMont Regional Medical Centerâ€™s nursing staff. Their attention to detail and desire to provide the best possible care is why CaroMont Regional Medical Center is leading the state of North Carolina in keeping patients free from infections.
EXEMPLARY PROFESSIONAL PRACTICE 23
Partnering with Patients and Families
aroMont Regional Medical Center understands the importance of listening to the voice of the customer because our patients provide the best insight into improving the care we deliver. In January 2016, a patient provided suggestions from his treatment experience to ensure that all patients who required regular infusions (including chemotherapy, blood, IV medications, IV fluids and antibiotics) could be treated in the Infusion Center. When the Infusion Center was over capacity, the majority of the patients were sent to an inpatient unit. The Infusion Center patient noted the amount of time to receive a blood transfusion was much longer on the inpatient units as compared to the Infusion Center. Infusion Center and 5 South nursing staff partnered to identify improvement opportunities. From this collaboration, a Rapid Improvement Event (RIE) was scheduled with an interprofessional team to delve into the outpatient infusion patient experience. The RIE team set a goal for all ambulatory patients requiring outpatient infusion treatments to be treated in the Infusion Center. This would decrease the number of patients being sent to inpatient beds, therefore creating a better patient experience. The RIE team identified that 20% of outpatient infusion patientsâ€“approximately 14 to 19 patients each monthâ€“ receive infusions on an inpatient unit, which results in an increased length of stay and decreased patient and staff satisfaction. The previously mentioned patient was involved throughout the RIE to represent the voice of the customer. The plan was implemented and the results were astonishing. The number of outpatients being assigned inpatient units to receive care, rather than being placed in a chair at the Infusion Center, decreased from a baseline of 14 to zero during the month of June 2016. By listening to patients and addressing their concerns, the Infusion Center continues to accommodate all patients by decreasing the need for inpatient beds for outpatient infusions.
24 EXEMPLARY PROFESSIONAL PRACTICE
Patient Experience with Nursing Care
here were many initiatives focusing on the patient and family experience in 2016. Bridging the gap between providing the safest and highest quality of nursing care and having the patient perceive this care is consistently a challenge.
To ensure each patient understands they are receiving quality care, all inpatient units implemented bedside reporting, which includes the patient and family in the plan of care. Evidence in nursing journals and articles proves holding report at the bedside and including the patient and/or family in the discussion results in improved outcomes and increased patient satisfaction. In addition, all inpatient nursing units standardized hourly rounding. Nursing staff rounding on patients on a consistent hourly schedule has shown patients feel safer, believe their needs are met in a timelier manner and have an overall better patient experience. All of the diligent work with bedside reporting and hourly rounding has improved the patient experience. HealthStream, CaroMont Health’s partner who manages the patient experience survey process, randomly surveys patients to assess their level of satisfaction during their hospitalization. In 2016, CaroMont Regional Medical Center’s scores related to CaroMont’s nursing care exceeded the percent excellence compared to the other hospitals served by HealthStream.
PATIENT EXPERIENCE WITH NURSING CARE
CRMC Percent Excellence
HealthStream Percent Excellence
CLEAR COMMUNITCATION BY NURSES
COURTESY/RESPECT OF NURSES
NURSING LISTENING CAREFULLY TO PATIENTS
Our patients are seeing the great care being provided. Thanks to each person who has made a difference in the care and lives of our patients.
EXEMPLARY PROFESSIONAL PRACTICE 25
Progressive Coronary Care Unit Receives Highest Patient Experience Award
n August 2016, the Progressive Coronary Care Unit (PCCU) was recognized by HealthStream, CaroMont’s patient experience partner, as a recipient of their 2015 Excellence through Insight® Award. This award is given to the nursing unit with the overall highest patient experience scores in each of HealthStream’s categories. PCCU received this award for achieving the highest patient experience score in the step-down category as compared to all other step-down units HealthStream surveys. Dedicated to creating a culture of excellence, the PCCU team has created a culture of collaboration with staff and physicians on the unit. Some of their focus areas included: Regular structured staff meetings to improve communication Increased staff involvement in house-wide Shared Governance Councils Encouraged staff ownership and empowering staff to make patient care improvements through unit based Shared Governance Councils Intensified efforts to provide staff with the equipment needed to provide excellent care Enhanced leadership structure Empowered staff to have a decision on hiring their peers Provided staff and leadership the opportunity to participate in continued professional development Supported continued formal education through schedule flexibility Recognized staff’s achievements in certification and advancing education Implemented safety huddle to improve patient safety Implemented bedside reporting Displayed and discussed patient satisfaction scores and results
26 EXEMPLARY PROFESSIONAL PRACTICE
2016 RN Satisfaction Survey
aroMont Regional Medical Center’s Registered Nurses participated in the 2016 National Database of Nursing Quality Indicators (NDNQI) nursing satisfaction survey. Hospitals participate in the NDNQI nursing satisfaction survey to measure nursing quality, nurse satisfaction, the nursing work environment, and to assess staffing levels. The results help hospitals identify nursing needs, improving the nurses’ work environment, and enhance retention and recruitment. In the 2016 survey, CaroMont Regional Medical Center’s nurses weighed in on several categories including: The level of autonomy which reflects the amount of independence, initiative and freedom the nursing staff has in their daily work activities The fundamentals of quality nursing care incorporating nurses’ competencies, high standards, and a safe environment to practice nursing and provide nursing care The adequacy of staffing to provide quality patient care Nurse-Nurse interactions which entails the amount of teamwork and collaboration among nurses at their facility
CaroMont Regional Medical Center June 2016 RN Survey Goal
CaroMont Regional Medical Center
Nursing Foundations for Quality of Care
Nurse to Nurse Interaction
PERCENT OF UNITS OUTPERFRMING NDNQI MEAN
The survey captured the voices of CaroMont Regional Registered Nurses. In each category, CaroMont exceeded the benchmark of having at least 50% of its nursing units outperform the 2016 NDNQI mean of hospitals of comparative size.
NEW KNOWLEDGE, IMPROVEMENTS AND INNOVATIONS Nursing practice is not static at CaroMont Regional Medical Center. Nursing staff integrates evidence-based practice and research into their professional practice, while seeking the safest and best practices for their patients and practice environment. Innovations in patient care, nursing and the work environment leads to high quality, effective and efficient nursing care. The following pages demonstrate CaroMontâ€™s continual dedication to new knowledge, innovation and improvement in patient outcomes.
28 NEW KNOWLEDGE, IMPROVEMENTS AND INNOVATIONS
Research Studies Completed in 2016 Susan W. Leonhardt, BSN, RN, PCCN and Penny G. Stepp, BSN, RN, CCRN, both from Cardiovascular Short Stay Unit, completed their research study “Pain medication prior to sheath removal: Does it make a difference?” Scottie Q. Graham, RN, CRNI and Heather H. Rodriguez, BSN, RN, CRNI, both from the Vascular Access Team, finalized their “A nurse perception of vein size prior to PICC insertion” research study. Susan C. Philbeck, BSN, RN-BC and Elizabeth G. Porter, RN-BC, BS, both from Cardiovascular Short Stay Unit, completed their research study “Femoral vs. Radial Caths: Patient preference and experience.” Faye K. Clements’, MSN, RN, RNC-OB “The impact of nurse leaders’ influence and professional preparation on patient outcomes” concluded in 2016. Lisa M. Costner, RNC-OB, Birthplace, completed her research study “Evaluating the reliability and validity of the post epidural falls risk assessment score.” Renee H. Lawing MSN, RN, ACM-RN, finished the research project, “Job satisfaction among case management nurses.” Donna Stallings’, MSN, RN, CMSRN, “Making a difference: Lateral violence” concluded in 2016. Omar Alzaghari, PhD, MSN, CNS, RN, completed his project, “Factors influencing 30 day unplanned rehospitalizations in patients with heart failure.” Ashley Issac-Dockery, ANP-BC, Rehab and Pain Center, completed her evidence based practice project “Prevention of shoulder injury during flu vaccine administration.” Priscilla Moyer, MSN, RN, Imaging Nursing Unit, completed her project, “Unique stressors and the influence of these stressors on intention to leave.” Melanie Funderburk, RN, VA-BC completed her participation in the “One million global catheters peripheral IV catheters study” a global prevalence study in which involved 418 hospitals from 51 countries. The study was conducted by the Alliance for Vascular Access Teaching and Research Group from Brisbane, Australia.
Research Studies Published in 2016
at Suggs, MSN, RN, PCCN, RN-BC, Rebecca Lewis, BSN, RN, PCCN, and Ann Hart, MSN, RN, NEA-BC, successfully submitted their research project, “What’s Your Position? Strategies for Safely Reaching Patient Comfort Goals After Cardiac Catheterization via Femoral Approach” in Dimensions of Critical Care Nursing.
NEW KNOWLEDGE, IMPROVEMENTS AND INNOVATIONS 29
Research Presentations in 2016
inda Wollack, RN, CAPA and Kim Aldridge, BSN, CAPA, both from the Day of Surgery Unit, presented their “Working 9 to 5” poster at the National American Society of PeriAnesthesia Nurses conference in Philadelphia.
imberly Barker, RN, CAPA, Rebecca Waters, RN, CAPA, and Teresa Morgan, BSN, CAPA, of the Day of Surgery Unit, presented their “Perceptions of Healthcare Professionals Regarding Optimal Length of Smoking Cessation for Adult Patients Prior to an Elective Surgery” at the National American Society of PeriAnesthesia Nurses conference in Philadelphia.
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Advancing Patient Safety through Nursing Research
isa Costner, RNC-OB was the principal investigator for the nursing research study titled “Post Epidural Fall Risk Assessment Score for the Obstetric Patient.” The study was completed in March 2016.
Her study compared the use of the Morse Scale developed for use in hospitalized adult populations to the Post-Epidural Falls Risk Assessment Score (PEFRAS) developed to assess the readiness to ambulate in the post-epidural maternity patient. Sixty-one (61) subjects were enrolled in the study. One hundred percent of the subjects showed the Morse Scale indicated the patient was not a fall risk while all subjects were identified as falls risk per the PEFRAS. The study supports the use of a fall risk tool developed for the post epidural maternity patient. Because of the importance of Lisa’s findings, she had the opportunity to present to the following groups: The Council for Research and Evidence Based Practice on April 20, 2016. On May 10, 2016, the study was presented to the Women and Children’s Health Services (WCHS) nursing leadership team. In June 2016, the study was included in the CRMC FOCUS: High Reliability Nursing newsletter. Also in June 2016, Lisa disseminated the knowledge gained through the study to the Women’s Quality Council. In September 2016, Lisa was invited to present her poster to the Annual North Carolina/South Carolina Perinatal Partnership Conference. Members of the Women’s Quality Council supported adopting the PEFRAS for obstetrical post epidural, which will change how OB patients are assessed for falls risk. By completing this research project, Lisa has directly impacted patient safety at CaroMont Regional Medical Center.
NEW KNOWLEDGE, IMPROVEMENTS AND INNOVATIONS 31
Utilizing Innovation to Increase the Patient Experience
atient and family engagement are paramount in providing safe, smooth and successful transitions. Providing shift change reports at the patient’s bedside is just one method identified to provide patient and family engagement. With the implementation of EPIC throughout CaroMont Regional Medical Center, it was time to utilize this new technology in assisting patients to become active partners in their health care. Through a collaboration between clinical staff nurses from the Council for Nursing Practice and Informatics nurses, a plan was implemented to design and customize an EPIC-based handoff. This handoff would be used specifically at bedside to report on each patient. Months of designing the EPIC handoff screen, educating staff and testing the design led to the target implementation date of January 2016. The Council for Nursing Practice was charged with implementing bedside reporting. Council for Nursing Practice chair Beth Canipe, MSN, RN, OCN and council members including Airiel Spencer, BSN, RN, CMSRN, Casey Gunnon, BSN, RN; Harlan McGuire, BSN, RN, PCCN; Mary Hillegass, RN, ONC, Heather Matthews, RN, CMSRN, and Shannon Williams, BSN, RN, CMSRN formed a temporary action group (TAG) to discuss the obstacles facing bedside handoffs. From this TAG, issues identified and shared included: Patient privacy and violating their protected health information Disturbing patient’s rest and visitation The time involved
January 2016 INTERVENTION
CaroMont Regional Medical Center June 2016 RN Survey Goal
CaroMont Regional Medical Center March 2016
HEALTHSTREAM TOP BOX PERCENTILE RANK
As a result of the bedside shift to shift handoff utilizing EPIC, the HealthStream question “Nurses Listening Carefully to Patients” increased by 320%. Sharing accurate and useful information between nurses, patients and families through nurse handoff at the patient’s bedside was a monumental step in mitigating risk and increasing the patient experience.
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Utilizing Evidence-Based Findings to Improve Nursing Practice
aroMont Regional Medical Center nurses noted the frequency of vital signs during blood transfusions was confusing and not followed consistently. This was taken to the Nursing Administration Council (NAC) who discussed blood audit results and the current blood administration vital sign policy. The previous policy stated that vital signs should be taken immediately prior to starting the blood, 15 minutes after the start of the blood, hourly until blood is completed and then at the end of the transfusion. The NAC group deferred to the Council for Research and Evidence Based Practice for a literature review of best practices and regulatory guidelines regarding vital signs monitoring with blood transfusions. The Council for Research and Evidence-Based Practice then took the evidence-based findings to the Council for Nursing Practice. The Council for Research and Evidence-Based Practice recommended that the frequency of vital signs for blood transfusions be changed to: 1. Just prior to the start of transfusion 2. 15 minutes after the start of transfusion 3. Within one hour of the transfusion end time These recommendations were taken to the Council for Nursing Practice. The Council for Nursing Practice appointed a subgroup including Cindy Isenhour, BSN, RN, ACM; Airiel Spencer, BSN, RN, CMSRN; Todd Friday, MSN, RN, OCN, NE-BC; Misty Broom, BSN, RN; David Mills, MBA, BA, BMST, ASCP; and Beth Canipe, MSN, RN, NEA-BC to consider this recommendation and the implications to clinical practice related to patient safety. After careful deliberation, the subgroup supported the recommendation provided by the Council for Research and Evidence Based Practice. The Council for Nursing Practice then agreed to move forward with the policy change to reduce the frequency of vital signs as outlined above. In October 2016, the Blood Administration, Whole Blood and Packed Red Blood Cells Policy was revised to incorporate the evidence-based recommendation of vital sign monitoring during blood transfusion from the Council for Nursing Practice. This is a prime example of Shared Governance in action utilizing evidence-based practice to improve nursing practice at CaroMont Regional Medical Center.
PROFESSIONAL DEVELOPMENT Continuing professional development is important because it delivers benefits to the nurse, their patients and our community. Professional development ensures nurses keep pace with the current nursing standards, and maintain and enhance knowledge and skills, allows advancement in the nursing profession, can lead to an increase in the publicâ€™s confidence and contributes to improved nursing outcomes.
In 2016, CaroMont Regional Medical Centerâ€™s nursing staff took strides in advancing their education and nursing certifications.
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Commitment to Nursing Professional Development
urses in the United States choose a specialty area for their practice such as Critical Care, Emergency Department, Medical Surgical, etc. Once the specialty nurse has gained clinical experience in the area, he or she may choose to become certified in that specialty area. Certification recognizes the nurse as having expert knowledge in the specialty. CaroMont Regional Medical Center supports nurse certification through: Celebration and recognition of all certified nurses annually Recognition in the FOCUS: High Reliability Nursing newsletter of those achieving initial certification Personal congratulatory note from the Chair of the Council for Education and Professional Development A CaroMont Regional Certified Nurse pin Recognition of certification in the RN Career Ladder Paid time to take the certification exam A 5% base pay increase for eligible certified nurses Prior to implementing a 5% base pay increase for eligible certified nurses, CaroMont’s nursing service worked to find funding to pay for initial nursing certifications. Spearheaded by Char Biamonte Stockl MSN, RN, RN-BC, NEA-BC, Director of Psychiatric Services, the group received a grant from the CaroMont Health Foundation for $60,000. The grant money was used to pay for the examination cost for those seeking their initial certification. From July 1, 2016 to December 31, 2016, approximately 40 Registered Nurses were able to complete their specialty certification at no cost thanks to the CaroMont Health Foundation grant. In addition, there are 128 Registered Nurses whose certifications have been paid for and will be taking their certification test in 2017. The graph below demonstrates the growth in specialty nursing certifications among CaroMont Regional Medical Center’s direct care nursing staff in 2016.
Professional Nursing Certification Direct Care Nurses - CaroMont Regional CRMC Certified Direct Care Nurses
PERCENT CERTIFIED DIRECT CARE NURSES
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CaroMont Regional Medical Center’s nursing service supports continuing education and lifelong learning. The Institute of Medicine has encouraged health care organizations to promote associate’s and diploma degree nurses to enter baccalaureate nursing programs. To accomplish this, CaroMont Regional Medical Center implemented several initiatives in 2015 which included: Increasing tuition reimbursement from $1,000 to $2,000 for full-time employees and $500 to $1,000 parttime employees Increasing Career Ladder points from 15 to 25 for each credit hour a nurse was enrolled to advance their nursing degree Supporting nurses who are pursuing a higher nursing degree with flexible scheduling Promoting numerous scholarships offered by the CaroMont Health Foundation and the CaroMont Regional Medical Center Auxiliary As a result of these initiatives, 2016 saw an increase in baccalaureate prepared nurses. CaroMont Regional Medical Center nurses embraced these opportunities and furthered their education.
CaroMont Regional BSN or Higher Degree Nurses 2014 - 2016 CRMC Certified Direct Care Nurses
PERCENT DIRECT CARE NURSES WITH BSN OR HIGHER DEGREE
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CaroMont Regional Career Ladder
he CaroMont Regional Medical Center’s Career Ladder Program is designed for RNs seeking to contribute to the hospital’s success, our communities we serve and the body of knowledge we call nursing. The Nursing Career Ladder is a voluntary program that recognizes and rewards nurses who provide patient care for at least 50% of the time. Nurses participating in the Nursing Career Ladder must demonstrate significant contributions to the quality/high reliability of patient care, nursing practice and promote strategic and operational goals of the organization. The goals of the Career Ladder Program are: To promote excellence/high reliability in patient care To advance organizational strategic and operational initiatives To provide professional growth, development opportunities and to retain high performing personnel To recognize informal leaders who promote the mission and vision of CaroMont Health To encourage volunteerism that improves the health status of the community and promotes CaroMont as an essential healthcare provider in the community CaroMont Regional has approved three levels of achievement: Bronze, Silver and Gold. Each level is independent of each other and demonstrates increasing professional growth. Each level has an associated reward/bonus associated with achievement. CaroMont Regional had 63 RNs in the Career Ladder Program in 2016. 2016 Career Ladder Council Members April Jones, BSN, RNC-MNN (COCHAIR) Sheri Ortiz, CNS (CO-FACILITATOR) Beth Porter, ADN, RN, ANCC-BC (CO-CHAIR) Susie Stokes, MSN, RN, ACNS-BC (FACILITATOR)
Breanna Beckwith, ADN, RN-C Amy Cody, RN Holly Eury, ADN, RN, ONC Elizabeth Hinkle, BSN, RN Cindy Isenhour, RN Emily Krech, BSN, RN Elizabeth Marisiddaiah, BSN, RN
Tonya Overman, RN Heather Phillips, RN Hayley Reep, BSN, RN Heather Rodriguez, BSN, RN, CRNI Lane Rowland, RN, CNOR Alvina Scaff, BSN, RN Meredith Shermer, RN
Teresa Stines, ADN, RN, CGRN Kimberly Straughan, RN Cindy Welch, ADN, RN Linda Wollak, ADN, RN, CAPA
Elizabeth Marisiddaiah – Silver Jennifer Mayes – Silver Magan McMillan – Silver Caroline Newton – Silver Tonya Overman – Silver Hayley B. Reep – Silver Kandy Rhew – Silver Tameron Rushing – Silver Onh Saynorath – Silver Meredith Shermer – Silver Ariel Spencer – Silver Carshena Stover – Silver Constance Wilson – Silver Amy Casper – Bronze Rebecca Eaker – Bronze Amy Heavner – Bronze Sharon Herd – Bronze Amy Killian – Bronze
Emily Krech – Bronze Susan Murphy – Bronze Wendy Norwood – Bronze Abigail Peters – Bronze Heather Phillips – Bronze Teresa Saunders – Bronze Anicia C. Stover – Bronze Lauren Strain – Bronze Cynthia W. Welch – Bronze
2016 Career Ladder Program Nurses Kim Barker – Gold Leslie Bolin – Gold Shannon Branch – Gold Sandy Brazzle – Gold Lisa Medlin Costner – Gold Annette Cross – Gold Holly Eury – Gold Melanie Funderburk – Gold Scottie Q. Graham – Gold Judy S. Hartman – Gold Pamela Jackson – Gold Susan Leonhardt – Gold Rebecca L. Lewis – Gold Heather Matthews – Gold Cathy Maynor – Gold Charity Moore – Gold Teresa Morgan – Gold Susan C. Philbeck – Gold
Beth Porter – Gold Heather Rodriquez – Gold Penny Wilson Stepp – Gold Teresa Stines – Gold Kim Straughan – Gold Patricia Suggs – Gold Rebecca L. Waters – Gold Linda Wollak – Gold Kim Aldridge, – Silver Rebecca Bass – Silver Jessica Beavers – Silver Lindsay Bonham – Silver Amy Cody – Silver Maranda Griffin – Silver Diane Howard – Silver Linda Jarrett – Silver April Jones – Silver Katie Leonhardt – Silver
NURSE RECOGNITION AND AWARDS Meaningful recognition can positively impact individuals and the organizational culture. Recognizing our nursesâ€™ contributions in a meaningful manner can lead to increasing their self-awareness of the impact they have made, reconnecting nurses with why they chose nursing as their profession, and building and elevating their sense of pride regarding their work. CaroMont has a robust nursing recognition program. We are proud of the nursing staff who provide excellent care to the community we serve. The following pages highlight the staff recognized in 2016.
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n keeping with the purpose of The Council for Education and Professional Development, the Council sponsors The Knowledgeable Nurses-Outstanding Teachers, or KNOT Award. The KNOT Award, created in 2010 by the Council for Education and Professional Development, is an opportunity for nurses to develop and share educator knowledge, techniques and skills with others. Criteria for the award includes creativity, method/ strategy, objective and overall presentation. Sharing stories of staff driven education recognizes the talent of individuals and groups leading these educational offerings. The Nursing Council for Education and Professional Development presented the 2016 KNOT Award to Hayley Reep, BSN, RN-C and Constance Wilson, RN-C from the Birthplace. Haley and Constance created a new standard work and educated their peers about â€œUmbilical Cord Sampling for Toxicology Screening.â€?
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Road to Safety
he Road to Safety contest, sponsored by the Performance Improvement and Patient Safety Council, was held October 26, 2016 in the CaroMont Regional Auditorium.
Magan McMillan, RN, CMSRN from 5 South, won first place for her performance improvement project entitled “In the Know: Adding Medication Details to Discharge Instructions.” The goal of the project was to enhance patient education, patient safety and patient medication compliance at home. A corresponding goal was to increase 5 South’s documentation of “reasons for use of medications” in discharge instructions. In order to accomplish this, Magan created an “In the Know” tip sheet of commonly prescribed medications, highlighting the reason for use and common side effects. The results demonstrated a 76% improvement in the documentation of discharge medication reasons.
Health Heroes Honored
he Health Hero program began in 2013 as a way for our patients and their families to recognize the extraordinary care they received at CaroMont Health. Health Heroes are awarded a custom designed pin and recognized at a Health Heroes reception. Since its inception, there have been more than 70 Health Heroes recognized, and in 2016, 15 CaroMont Regional RNs were recognized. The 2016 recipients were: Linda Jarrett
Jennifer Deese Craig
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Good Catch Award
he Good Catch Award recognizes employees for their contributions to patient safety. This award honors those who go the extra mile to provide a safer environment for patients, visitors and workforce members. In our journey to become a Highly Reliable Organization, being focused on zero patient harm, identifying mistakes and correcting them before they happen is critical. Six CaroMont Regional RNs were awarded the Good Catch Award in 2016. Thank you for your commitment to becoming a Highly Reliable Organization. January 2016 Angela Nodine-PCCU February 2016 Melissa Jordan, RN-NICU March 2016 Shelly Dellinger, RN-Shift Managers August 2016 Tracy Burrell, RN-Pediatrics November 2016 Melissa Hartzel, RN-Birthplace December 2016 Jennifer Mayes, RN-EP Lab
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Celebrating Excellence in Nursing
aroMont Healthâ€™s Nightingale Award is based on the ideals set forth by Florence Nightingale, the founder of nursing as a modern profession.
Ronnie Pittman, BSN, RN, CPAN, CAPA, was named the 24th Nightingale Award recipient. The award is presented annually to a recipient who has distinguished themselves through their nursing excellence, professionalism, community service and commitment to continuing education. Sponsored by the Council for Nursing Excellence, Nurses and Nursing Stars (PCAs and UCCs) are chosen by their peers to be honored for Nursing Excellence based on their patient care skills, compassionate behavior, positive relationships, responsiveness to patients, families and others, and their support of the healthcare team.
Ronnie Pittman BSN, RN, CPAN, CAPA IMAGING NURSING UNIT
More than 70 members of our nursing staff were honored during the Nursing Excellence Awards Gala at the Gastonia Conference Center on November 17, 2016. Congratulations to Ronnie and all award winners! Thank you for showing our patients how we care!
2016 Nursing Team Stars Julie A. Bailey PCT/UCC, NICU
Jennifer A. Carpenter Psych Tech/UCC, 7 North
Belle Q. Jackson PCA/UCC, Critical Care
Bessie Lynn Owens UCC, Courtland Terrace
Kelly M. Boyd ECT, Emergency Dept
Sarah E. Casciani PCA/UCC, 6 North
Theresa James PCT/UCC, Infusion Center
Jo A. Palmer PCT/UCC, DOSU
Ashley J. Brooks UCC, Robin Johnson House
Eddie Davis ECT, ED - Mt. Holly
Benita S. Kelbaugh Certified Surgical Tech, COPS
Pamela J. Pfoutz Psych Tech/UCC, 7 South
Amanda L. Broome PCA/UCC, HMI Ortho
Jonathan Deal PCT/UCC, HMI Neuro
Dana L. Lowery PCT/UCC, Occupational Medicine
Christie N. Robertson PCA/UCC 3 South
Kaylyn M. Bryson PCT/UCC, HFTU
Kim M. Hall Surgical Liaison Team Leader, Operating Room
Lisa H. Marlow PCT/UCC, 5 South
Brooke M. Wilson PCA/UCC, PICU
Diane L. Miller PCT, Endoscopy
Greta B. Wright Focused Observer, Focused Observer
Wanda M. Buchanon CNA 1, CHPNA, Gaston Hospice Kimberly A. Camp UCC II, CVSS Ashley T. Campbell PCA, 6 South
Betty B. Hanna Secretary, Integrated Pain Chloe B. Herron PCT/UCC, PCCU
Heather P. Newton PCT/UCC, Birthplace
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2016 Nursing Excellence Winners Cathy M. Abernathy BSN, RN, Medical Rehab
Danyell Dreher RN, HMI Neuro
Dawn P. Hunt RN, Pediatrics
Heather N. Ray RN, 3 South
Sarah E. Ayer BSN, RN, CCRN-CMC, Intensive Care Unit
Elaine M. Dunn MSN, RN, Operating Room
Angie S. James RN, Neonatal Intensive Care Unit
Kandy K. Rhew RN, Post Anesthesia Care Unit
Nancy Baughman RN, Hemodialysis
Brittany L. Eaker BSN, RN, Progressive Coronary Care Unit
Sonda H. Johnson RN, Post Intensive Care Unit
Heather H. Rodriguez BSN, RN, CRNI, Vascular Access Team
Nicole Beason BSN, RN, CNOR, CaroMont Specialty Surgery
Cathy B. Everhart RN, Progressive Coronary Care Unit
Ann M. Bodnar RN, 6 North
Jeannie L. Jones RN, BS, Courtland Terrace Emily M. Kincaid RN, Emergency Department
Amy A. Sarvis BSN, RN, Patient Safety/Risk Management
Amanda P. Felton RN, BSPS, Cath Lab
Bob Knox BSN, RN, 7 North
Amanda G. Self RN, Emergency Department
Lorie A. Bryant BSN, RN, Utilization Review
Barbara L. Foster LPN, Endoscopy
Ashley B. Snyder BSN, RN, Wound Center
Kelly N. Carter RN, Coronary Care Unit
Melissa M. Gunter BSN, RN, Surgical Intensive Care Unit
Meredith Leatherwood BSN, RN, CCM, Post Acute Services
Melanie I. Conger RN, ED Psych Suite Lisa M. Costner RNC-OB, Birthplace Tracy Deitz RN, 6 South
Nancy G. Harless MPH, BSN, RN, CIC, Infection Prevention Diane M. Haught RN, Cancer Center
Shelly E. Dellinger RN, CEN, Nurse Shift Managers
Crystal A. Hoyle BSN, RN, ONC, 5 South
Sandi G. Dobbins RN, Robin Johnson House
Jaime D. Huneycutt RN, CNOR, CaroMont Outpatient Surgery
Nicole G. Lineberger BSN, RN, ACM, Case Management Jacqueline M. McKnight RN, Heart Failure Therapy Unit Caitlin E. Merritt BSN, RN, Birthplace Julienne D. Nortey BSN, RN, Diabetes Center Ronnie Pittman BSN, RN, CPAN, CAPA, Imaging Nursing Unit
Melissa Triplett RN, Emergency DepartmentMt. Holly Claire N. Way RN, CAPA, Pre-Anesthesia Screening Services Katy Wilder RN, Cardiovascular Surgical Unit Tarra D. Wilkinson RN, Gaston Hospice April M. Willis MSN, RN, PCCN, Informatics Mandy Jo Woodward BSN, RN, HMI Ortho
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The Great 100
he Great 100, Inc. is a grassroots peer recognition organization honoring the nursing profession in North Carolina. This organization acknowledges 100 North Carolina nurses annually who demonstrate excellence in practice, commitment to their profession and positively impact nursing as a profession. This year, CaroMont Health received eight of the 100 statewide recipients. Nominations across the state are submitted and reviewed by Great 100 scorers. All identifiable information (the nominees’ names, the organizations in which they practice, the town in which they practice, etc.) are removed so the determination as a Great 100 recipient is solely determined by the nominee’s accomplishments.
CaroMont Health Great 100 Nurses Kathleen W. Champion, BSN, RN, CHFN Kathleen (Katie) Champion, BSN, RN, CHFN has a strong commitment to nursing excellence. With a nursing career that spans more than 44 years, Katie is a respected role model and leader among her peers at CaroMont Regional Medical Center and a deserving recipient as a North Carolina Great 100 nurse. Katie works tirelessly to support the best outcomes for her patients. She provides each patient and their caregivers undivided, individualized attention so they have the best chance for success. Examples of the excellent care Katie provides include going to patients’ homes to deliver scales so they can monitor their weight, calling a patient’s favorite restaurant to determine whether low sodium options were available, locating a specific scale for a heart failure patient who weighed more than 600 pounds, calling and rescheduling conflicting appointments for discharged patients, finding transportation for a patient to keep his follow up appointments, and convincing an oral surgeon to do a total teeth extraction free of charge for one of her heart failure patients. For years, Katie has quietly advocated for CaroMont patients. Her peers state that, “if Katie is working with you as a patient, you will get the things you need because of her caring and commitment.” Katie does not seek recognition. Because of her tremendous commitment, dedication, and advocacy for the care of individuals, the community and her coworkers, Katie is definitely worthy of being selected as a Great 100 North Carolina Nurse!
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Alison Hayes, BSN, RN, CPN For 32 years, Alison Hayes, BNS, RN, CPN, has carried out her passion for helping people in the nursing profession. Specializing in pediatrics, she continues to inspire others and provide patients and their families with excellent nursing care at CaroMont Regional Medical Center. Allison is an advocate for professional development. She became a boardcertified Pediatric Nurse, a personal achievement that has offered her additional training within her specialty. She also encourages learning opportunities among staff. She developed a unit-based Pediatric care training program designed to teach novice nurses strong assessment skills and the culture of excellence at CaroMont. Allison’s contributions to the nursing profession have been recognized by her peers with the Nursing Excellence award three times over the course of her career. Alison’s amazing personality radiates goodness from within and makers her not only an outstanding nurse but an outstanding person.
Jennie G. Hogan, RN A dedicated and valued member of the Critical Care Services department at CaroMont Health, Jennie Hogan, RN has earned a reputation among her peers as one who leads by example, emulates the values of nursing and is a friend to all she encounters. Spanning 23 years, Jennie’s nursing experience has always focused on the patient, their family and in making safety a top priority. Beyond work, Jennie is actively involved in her community through volunteering and supporting benevolent causes. For more than 10 years, Jennie has been volunteering for Meals on Wheels. She also buys food and Christmas gifts for several local under-privileged school children and she regularly donates to the Children’s Home of North Carolina. Additionally, Jennie and her husband fund two college scholarships every year: one that supports an employee who is employed at an assisted living facility in the community and the other goes toward a high school graduate. Jennie also serves on a local community foundation scholarship committee. Accomplished on many fronts, Jennie is a strong team player who enjoys helping others succeed and is the first to admit that she is only as successful as her team.
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CaroMont Health Great 100 Nurses
April Hullender, BSN, RNC-NIC April Hullender, BSN, RNC-NIC provides expert care to each patient and family and was recognized by her peers to receive the Award for Nursing Excellence. This is the highest honor that can be presented to a nurse. As a leader in the NICU, April firmly believes in personal and team professional development. She is passionate about education and believes that to gain and share knowledge is to empower yourself and others around you so they can provide the excellent care every patient and family deserves. April has presented lectures in anatomy and physiology, thermo-regulation, de-escalation, neonatal and pediatric resuscitation, and is a Neonatal Resuscitation Program (NRP) instructor. April was the second Neonatal Intensive Care Certified Nurse in CaroMont Regional’s NICU, and since then, she has encouraged other staff to become certified as well. As a result of her encouragement, one-quarter of the NICU team is now certified as Neonatal Intensive Care Nurses. April has been a member of the Association of Women’s Health, Obstetric and Neonatal Nurses, Academy of Neonatal Nursing and National Association of Neonatal Nurses for the past six years.
Kimberly Jackson, RN, CCRN As a valued team member of the Cardiovascular Short Stay Unit, Kimberly Jackson, RN, CCRN, brings 31 years of experience to CaroMont Regional Medical Center. She promotes and advances the profession of nursing at both the unit and organizational levels, as well as in the community. It is with great honor that we recognize Kim as a Great 100 North Carolina Nurse. Kim’s compassion for serving is visible in her work outside CaroMont’s walls, as she serves as a First Aid Nurse at World Changers. World Changers is an organization which provides mission experiences to serve others and share the Gospel and help change the world. As part of construction missions, Kim assisted in building a camp for children in Alaska and aiding flood victims after hurricanes. Kim’s drive for professional development and exceeding standards in delivering competent and compassionate care for her patients and their families, as well as her beautiful attitude towards others have earned her the prestigious honor as a Great 100 North Carolina Nurse.
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Lisa Marisiddaiah, BSN, RN, FCN Dedicated to nurturing the human spirit, Lisa Marisiddaiah, BSN, RN, FCN integrates healing, education and spiritual through her role as the FaithHealth Ministry Manager at CaroMont Health. Combining her nursing background and certification as a Faith Community Nurse, Lisa has been able to forge relationships with faith communities, healthcare providers and community organizations to create a “movement” of compassionate care in order to improve the health of the Gaston County community. By connecting church congregations with clinical expertise and community resources, Lisa is able to work closely with individuals within congregations to help them navigate the complex healthcare system, connect them to health resources and encourage them to take an active role in their health in a trusting and caring environment. These are just a few of the reasons Lisa was instrumental in establishing the local Faith Community Nurse Commission. Through her role at CaroMont, Lisa interacts with parish nurses and community lay persons in Gaston County and surrounding counties. Early on, Lisa identified a need to recruit more parish nurses and community lay persons. Currently, there are 36 participating churches, more than 20 nurses, five lay persons and 80 volunteers directly involved in the Faith Health Ministry.
Carole Anne Robinson, BSN, RNC Described by her patients and peers as joyful, patient, kind and compassionate, it is no surprise that Carole Anne Robinson, BSN, RNC has been selected as one of North Carolina’s 2016 Great 100 Nurses. Carole Ann is a patient favorite and it is obvious to her coworkers that she enjoys taking care of her patients as much as the patients enjoy being around her. Carole Anne has invested 30 years into her nursing career. She invests in helping others today just as much as she did as a new nurse graduate. Carole Anne speaks of the privilege of being a nurse when she mentors new nurses and thanks patients and family members for allowing her the honor of caring for them. Carole Anne is an energetic, people person and has received her unit’s peer chosen Award for Nursing Excellence. Based on her professionalism at the bedside and her commitment to go the extra mile as a team member, her peers give her the highest marks on communication and caring.
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CaroMont Health Great 100 Nurses
Ann Marie Stuck, BSN, RN, BC Enthusiastic and highly devoted are only a few of the words colleagues use to describe Ann Marie Stuck, BSN, RN, BC. Through 31 years of nursing, Ann has continued to reinvent and grow with the nursing profession. Ann works diligently to support and help patients and their families navigate of an often arduous healthcare situation. Her tenacity helps to ensure a positive patient experience. Ann values excellence and for the past 13 years, she has maintained her Medical-Surgical nursing certification through the American Nurses Credentialing Center. Moreover, she has completed numerous performance improvement projects that align with her professional ideals. Ann is also an EPIC credentialed trainer and was able to help colleagues during the corporate transition to a new electronic medical record system. CaroMont Health is fortunate to have Ann Marie Stuck as a nurse and ambassador to the community we serve.
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he Physician Recognition by Nursing (PRN) Award is sponsored by the Council for Nursing Excellence. Any CaroMont Regional Medical Center Registered Nurse may submit a physician’s name for consideration. This recognition of physicians by nursing staff is considered valuable and prestigious by our physicians and other health care team members. The physician must consistently excel in all five criteria: Practices high standards of care Exhibits caring and informative communications with patients and families Promotes positive nurse-physician relations Shows respect and values efforts of other health care team members Supports mission and values of CaroMont Health
2016 PRN Award Recipients:
Micheal Case MD, FAAFP, HMDC
John Carson II, DO
Ronald W. Digby, MD
NURSE RECOGNITION AND AWARDS 49
Supporting Continued Education for Nurses
he CaroMont Health Foundation and the CaroMont Regional Medical Center Auxiliary honored 54 recipients with scholarships from six scholarship funds. The scholarships, which totaled more than $191,100, will provide tuition support for students and professionals who pursue a career in healthcare.
Lee Bucci Professional Nursing Scholarship The Bucci Scholarship Fund was established in 2012 in honor of Lee Bucci, retiring Director of Gaston Hospice. This scholarship is awarded to a student seeking an accredited degree in the field of nursing (LPN, RN, or BSN), with special consideration given to the field of palliative care. Charlene Guffey is this year’s recipient of the Lee Bucci Professional Nursing Scholarship.
CaroMont Health Foundation Scholarship Each year, The CaroMont Health Foundation provides a competitive scholarship application process for students interested in pursuing or advancing their careers in healthcare. A scholarship committee carefully reviews each application and interviews applicants. Recipients of the CaroMont Health Foundation Scholarship are: Stephanie Barker, Lee Beard, Christy Beaver, Donna Bolin, Amanda Broome, Kelly Carter, Haley Cline, Carmen Cloninger, Marzette Colon, Tammy Cozad, Buffy Dover, Charlene Guffey, Cristyn Harrison, Hannah Merritt, Charity Moore, Pam Moss, Misty Partin, Sara Peeler, Amanda Pritchett, Ashley Rhyne, Char Biamonte Stockl and Jessica Weathers.
The H. Spurgeon Mackie, Jr. Scholarship The Mackie Scholarship was established in 2006 in honor of H. Spurgeon Mackie, Jr., a long-standing Board Member and friend of CaroMont Health, upon his retirement from Wachovia Bank. Awards from this scholarship program are given to students majoring or continuing their education in nursing and/or allied health professions. Recipients of the H. Spurgeon Mackie, Jr. Scholarship are: Olivia Anderson, Marlena Heracklis and Victoria Price.
The Lonnie and Rachel Waggoner Nursing Education Scholarship The Lonnie and Rachel Waggoner Nursing Education Scholarship is a permanent endowment established in 2005. Awards from this scholarship are given to students seeking an accredited degree in the field of nursing (LPN, RN or BSN). Recipients of the Lonnie and Rachel Waggoner Nursing Education Scholarship are: Lauren Biggers, Catherine Bynum and Haley O’Brien.
Team CaroMont Scholarship The Team CaroMont Scholarship was established in 2015 and funded by employee contributions to the Team CaroMont campaign. All applicants must be employees of CaroMont Health or one of its subsidiaries, and scholarship funds may be used for degree and select non-degree programs. Recipients of the Team CaroMont Scholarship are: Tammy Cozad, Christine Fogarty, Kim Gullstrand, Rebecca Jordan, Jay Nutter, Sonni Sly and Jamie Wozniak.
The Gertrude Clinton Health Career Scholarship Fund The scholarship was established by the Gaston Memorial Hospital Auxiliary in 1971. Following Mrs. Gertrude Clinton’s death, the fund was changed to a scholarship in her memory. Mrs. Clinton served as Gaston County Social Services Director, Personnel Director for CaroMont Health, and was a founding member and President of the Gaston Memorial Hospital Auxiliary. Recipients of the Gertrude Clinton Health Career Scholarship Fund are: Olivia Anderson, Taylor Bailey, Stephanie Barker, Savannah Bartlett, McKenzie Bess, Lauren Biggers, Amanda Broome, Hannah Broome, Tania Brown, Catherine Bynum, Kelly Carter, Tammy Cozad, Buffy Dover, Christine Fogarty, Kim Gullstrand, Cristyn Harrison, Marlena Heracklis, Shelby Hooper, Payton Humphrey, Lindsay Lee, Kristin Lewis, Josie Lucas, James McConnell, Addison McElveen, Macey McSwain, Hannah Merritt, Charity Moore, Pam Moss, Haley O’Brien, Sara Peeler, Amanda Pritchett, Dillon Rhew, Logan Runyon, Elizabeth Scronce, Sonni Sly, Austin Toney, Andrew Walker, Jessica Weathers, Jamie Wozniak and Makayla Wykle.
50 NURSE RECOGNITION AND AWARDS
Impressions from the Caring Science: Framework for Transformation of Self/System
en CaroMont Regional Nurses attended the Gardner-Webb University Hunt School of Nursing 50th Anniversary. To celebrate its 50th anniversary, Gardner-Webb University hosted a symposium by nursing theorist Jean Watson whose theory “Nursing: Human Science and Human Care” is the foundation of CaroMont Regional’s Nursing Professional Practice. Here are impressions from some of our nurses who attended: Pat Suggs, MSN, RN, PCCN, RN-BC– “This was a wonderful experience. The big take away for me was the reminder of how important it is to be ‘seen’ and ‘heard’ especially in this electronic age. Our interactions need to have intentional time for face to face contact with silence of the care giver built in to leave space for the patient to ‘show or tell’ us what their needs are.” Nell Boone, RN, CPN– “When caring for our patients we are touching mind, heart, and soul. Florence Nightingale’s Lamp is a symbol of nursing for we are the light. A quote from Ms. Watson that stood out to me was that, ‘when a nurse enters a room a magnetic field is set up between the nurse and patient. The patient is saying: see me.’ Nursing can lead to burn out when we close ourselves off to our feelings and build walls. Life can bring on emotions that if not dealt with can lead to anger and unforgiveness and we are unable to give healing then.” April Hullender, BSN, RNC-NIC– “The ‘essence of nursing is caring’ is truly displayed at CaroMont Regional Medical Center. At CaroMont it is our goal to always work towards advancing the role of the nurse in everyday practice. It was a privilege for me that my organization supported my attendance to the nursing conference at Gardner Webb University so that I could listen to one of my nursing heroes. CaroMont stops at nothing to ensure our nursing staff have every educational opportunity available to them at all times and I am blessed to be the recipient of this great organization’s incentives.”
CAROMONT REGIONAL BOARD CERTIFIED RNS
52 CAROMONT REGIONAL BOARD CERTIFIED RNS
Advanced Certified Hospice & Palliative Nurse (ACHPN) Kaye Grubaugh
Accredited Case Manager Jacqueline Bevill Dana Croston Kim Frazier Miriam Holcomb Christina Huitt Libby Huskins Cindy Isenhour Renee Lawing Nicole Lineberger Darlene Oldenburg Courtney Psomadakis
Adult CNS Board Certified (ACNS - BC) Sheri Ortiz Susie Stokes
Advanced Oncology Certified Clinical Nurse Specialist (AOCNS®) David Avalos
Certification in Healthcare Research Compliance (CHRC) Monica Wright
Certified Ambulatory Perianesthesia Nurse (CAPA) Kimberly Aldridge Kimberly Barker Joanne Gittens Judy Hartman Pam Jackson Angela Jones Kathleen Kern-Wells Wanda McCurry Teresa Morgan Susan Padgett Ronnie Pittman Sheila Pope Becky Waters Claire Way Linda Wollack
Certified Breast Patient Navigator-Cancer (CBPN-CANCER) Ashley Cloninger Donna Neil
Certified Clinical Documentation Specialist (CCDS) Carol Canipe Glenda Crowell Wayne Morris Harminder Singh
Certified Case Manager (CCM®)
Certified Diabetes Educator (CDE)
Gayle Burleson Angela Featherston Ashley Fretz Virginia Hartley Meredith Leatherwood Lawrence Mui Teresa Renner Delores Wong
Lisa Clement-Bryant Elizabeth Nicholson Carla Williams
Certified Clinical Research Associate (CCRA®) Monica Wright
Certified Clinical Research Coordinator (CCRC®) Jamie Christopher Melody Lineberger-Moore
Critical Care Registered Nurse (CCRN) Joel Arriaga Amanda Atkinson Sarah Ayer Marty Ballard Marilyn Bartell Diana Brewer Desiree Brown Samuel Chapman Dennis Denton Yvonne Finger Mark Frazier Katherine Humphries Kimberly Jackson Sabrina Messer Sheri Ortiz Tonya Overman Kim Parker Cathy Payne Kelly Rice Sharon Segee Elaine Sommer Penny Stepp Alfred Wiggins
Certified-Electronic Fetal Monitoring (C-EFM) Shannon Alexander Rebecca Bass Lisa Carter Janelle Godfrey Katie Leonhardt Terra Mobley Lauren Mull Leigh Anne Newton Julie Rabb Hayley Reep Carole Ann Robinson Lori Spears Adrienne Waugh Constance Wilson Jamie Wozniak
Certified Emergency Nurse (CEN) Shelley Dellinger Sharry Duncan Melissa Dyer Melondie Edwards William Goforth Robert Kinder Chelsey Martin Lynn McMillan Michelle Remillard Kelly Robinson Ashley Rowe Amanda Self Angela Swift Shannon Wagner Kesia West Tonya Whitaker
Certified in Executive Nursing Practice (CENP) Sheila Reagan
Critical Care Registered Nurse – With Cardiac Medicine Subspecialty (CCRN-CMC) Sarah Ayer Leslie Bolin Meredith Shermer
Critical Care Registered Nurse – With Cardiac Surgery Subspecialty (CCRN-CSC) Marilyn Bartell Meredith Shermer
Certified Gastroenterology Registered Nurse (CGRN) Johnanna Francis Maranda Griffin Mark Rose Teresa Stines
Certified Heart Failure Nurse (CHFN) Kathleen Champion Recinda Green Suzanne Howell
CAROMONT REGIONAL BOARD CERTIFIED RNS 53
Certified Hospice and Palliative Care Administrator (CHPCA)
Clinical Nurse Leader (CNL)
Certified Radiology Nurse (CRN)
Kristine DeJong Lyne Martin Kimberly Williams
Certified Hospice and Palliative Care Nurse (CHPN) Christy Beaver Johna Griesman Susan Haney Donna Matherly Traci McCosh Laura McCraw Paula Robb Kris Rose Julie Scott
Certified in Healthcare Research Compliance (CHRC) Monica Wright
Certified in Infection Control (CIC) Vicki Allen Nancy Harless Eric Lee
Certified Infant Massage Instructor (CIMI) Freida Norris
Certified Medical-Surgical Registered Nurse (CMSRN) Brenna Beckwith Melesa Bohanan Lindsay Bonham Sonja Buckner Amy Cody Angela Costner Elizabeth Evans Lauren Gillespie Allyson Guffey Janet Hamrick Dawn Hawkins Betty Howell Kimberly Jennings Cristeta Jones Amy Killian Heather Matthews Carshena McBeth Kimberly McMillan Magan McMillan Caroline Newton Jill Nixon Tameron Rushing Onh Saynorath Jennifer Smith Airiel Spencer Donna Stallings Kim Straughn Shannon Williams Maria Young
Certified Nurse Operating Room (CNOR) Elizabeth Bankston Nicole Beason Shannon Branch Kay Cornwell Annette Cross Thola Farmer Jaime Huneycutt Dacia Kendrick Angela Lee Lisa Lineberger Susan Osmar Lane Rowland Michael Smith Natalie Sneed Teresa Starr
Certified Neuroscience Registered Nurse (CNRN) Amelia Ervay
Certified Registered Nurse Infusion (CRNI) Ginger Basham Vickey Garrett Scottie Graham Linda Jarrett Heather Rodriguez
Certified Rehabilitation Registered Nurse (CRRN) Stephanie Lowrance
Certified Wound Specialist (CWS) Dawn Graham Teresa Pruett
Faith Community Nurse (FCN) Lisa Marisiddaiah
Certified Occupational Health Nurse Specialist (COHN-S) Nancy Essary
Certified Occupational Health Nurse Specialist (COHN-S/CM) Rachel Clanton
Certified Pediatric Nurse (CPN) Nell Boone Chasiti Brewer Rhonda Harris Alison Hayes
Certified Post Anesthesia Nurse (CPAN) Jenny Barber Mary Beth Halstead Ronnie Pittman Toy Stone Jessica Underwood Barbara Williams
Certified Professional in Healthcare Management (CPHM) Amy Sarvis
Certified Professional in Healthcare Quality (CPHQ) Cathy Murdock
Certified Professional in Patient Safety (CPPS) Anna Lattimore
International Board Certified Lactation Consultation (IBCLC) Lynda Desmariais Karen Ingle Danelle Kinzenbaw Judy Klem
Lamaze Certified Childbirth Education (LCCE) Freida Norris
Nurse Executive, Advanced-Board Certified (NEA-BC) Kathleen Besson Peggy Blackburn Beth Canipe Trish Goble Ann Hart Sheila Reagan Scott Wells
Nurse Executive-Board Certified (NE-BC) Char Biamonte-Stockl Beate Graeter Janice Hill Todd Friday
54 CAROMONT REGIONAL BOARD CERTIFIED RNS
Oncology Certified Nurse (OCN) Pam Barnette Rhonda Bolin Julie Cloninger Todd Friday Crystal Hoyle Lesley Sellers Wendy Smart Kathy Spencer
Orthopedic Nurse Certified (ONC) Sallie Chapman Bethany Dunn Holly Eury Joanne Faber Suzanne Gardner Mary Hillegass Brooke Thomas Kayla Witthoeft
Progressive Care Certified Nurse (PCCN) Jessica Beavers Matt Burchfield Amber Drum Sheila Flowers Adella Habel Brandon Kinders Susan Leonhardt Rebecca Lewis Cathy Maynor Harlen McGuire Joan Merrill Robert Privett Patricia Suggs
Registered Cardiac Electrophysiology Specialist (RCES) Beate Graeter
Registered Cardiovascular Invasive Specialist (RCIS) Beate Graeter Richard Waits Belinda Ward
RN-Board Certified (RN-BC) Nancy Baker Char Biamonte-Stockl Sonja Buckner Elizabeth Burrell Chris Carswell Glenda Crowell Sandy Dellinger Marge Dodgin Elizabeth Evans Emily Gibson Elizabeth Hinkle Robin Lang Marisa Marder
Jenny Mayes Jennifer McHan Valerie Moore Karrie Moraitis Susan Philbeck Elizabeth Porter Ann Stuck Patricia Suggs Deb Turak Mary Warren Shannon Williams April Willis Delores Wong Karen Young
Certified Registered Nurse First Assistant (CRNFA)
Low-Risk Neonatal Nursing (RNC-LRN)
Vascular Access Board Certified (VA-BC)
Maternal Neonatal Nursing (RNC-MNN) Megan England Darlene Forsythe Melissa Hartzell Amanda Heberer April Jones Judy Klem Kara McLeod Alissa Murphy Wendy Norwood Christine Philbeck Angela Phillips Jeanmarie Redder Karen Thompson Tracy Weaver
Neonatal Intensive Care Nursing (RNC-NIC) April Hullender Lauren Hutto Sarah Bolynn Danielle Kahn Holly Roberts Andrea Turner
Inpatient Obstetric Nursing (RNC-OB) Michelle Bain Rachel Bean Wendy Burbage Lisa Costner Ashley Ellis Donna Gunter Marisa Marder Michelle Marquand Ginger McElveen Carole Ann Robinson Jennifer Sciba Leigh Ann Shrewsbury Jamie Wozniak
Sexual Assault Nurse Examinerâ€“ Adult (SANE-A) Lisa Jones
Sexual Assault Nurse Examinerâ€“ Pediatric (SANE-P) Lisa Jones
Sandi Eckert Melanie Funderburk Tammy Glasgow Sharon Herd Jessica Hubers Charity Moore Caroline Poteat
Certified Rehabilitation Registered Nurse Stephanie Lowrance
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