Kenmore Mercy 2017 Nursing Annual Report

2017 Nursing Annual Report

Welcome from the Vice President of Patient Care Services

We Did It! The year 2017 was a stellar one for Kenmore Mercy Hospital nurses.

In April, we were notified by the American Nurses Credentialing Center that Kenmore Mercy Hospital obtained “the highest and most prestigious credential a healthcare organization can achieve for nursing excellence and quality patient care.”

We obtained Magnet® Recognition through the hard work, dedication and commitment to excellence by our nurses and through the collaboration we have with the entire interprofessional team. However, this is not the final destination in our journey, it is just one stop.

As we continue down this road, we will maintain our focus on nursing excellence and enhancing our nursing practice through evidence and innovation. Even though we know every day is different and some days are difficult, we carry on in our journey working to ensure our patients have the best outcomes.

In this 2017 Nursing Annual Report, you will read examples of who we are, what we do, how we do it and why. This includes many of your amazing projects accomplished throughout the year, the work of our outstanding Shared Governance Committee, technological advances, recognitions and awards. This report demonstrates the remarkable work that our nurses have accomplished throughout 2017.

Speaking on behalf our entire leadership team, we are very proud of your commitment to the work you do on a daily basis, overcoming challenges as you continue to provide the best care that you can to all of our patients.

Congratulations Magnet® nurses; you are the best! I am so very proud of all of you!

With sincere gratitude,

Cheryl Hayes, MS, ANP, NEA, BC Vice President, Patient Care Services

Editorial Staff

Dawn M. Cwierley, AS, BS Cheryl W. Hayes, MS, ANP, NEA-BC Amber Mazurek, BSN, RN, ONC

Leadership Messages

Pgs. 2 - 3

2

Transformational Leadership Pgs. 4 - 7

Our Magnet Journey Nursing Professional Practice Model Magnet Conference Nursing By The Numbers Nighttime Shared Governance Masimo Enhancing Patient Safety

Structural Empowerment

Pgs. 8 - 13 Nursing Awardees Certified Nurses’ Day Nursing Degrees Certifications Community Programs LOVE Award Winners MRU Celebrates Special Anniversary Women of Influence Award

Welcome from the President & CEO

Welcome to my first Kenmore Mercy Nursing Annual Report. What an amazing and dedicated group of individuals we have here, leading the way in the future of nursing.

As you read this 2017 report, you’ll appreciate the deep sense of community and caring that makes Kenmore Mercy even more than an excellent place to seek medical care. It is a place that welcomes everyone and delivers on its promise to provide professional, safe, efficient, and compassionate care.

An important milestone in 2017 was Magnet® recognition, which acknowledges our nursing team for its top-tier clinical outcomes, patient satisfaction, and commitment to improving safety. This journey has certainly reinforced the importance of everyone working together towards a common goal, and serves as a reminder of all that can be accomplished when we do so.

Topping off the year, we also achieved our eighth consecutive “A” rating from The Leapfrog Group since 2014 and ranked as a Top Hospital in the General Hospital category for the second year. These achievements demonstrate our commitment to patient safety.

Thank you to all of our nursing team today and throughout our history for the exceptional experiences you have created for our patients.

Sincerely,

Walter Ludwig President & Chief Executive Officer

Exemplary Professional Practice Pgs. 14 - 17 Nurse Sensitive Indicators Great Catches ED Leadership Award

New Knowledge, Innovations, & Improvements Pgs. 18 - 21

Awards & Recognitions Pgs. 22 - 23

Research Conference Poster Presentations Foundation Grants

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Transformational Leadership Our Magnet® Recognition, An Ongoing Journey On April 26, 2017, a conference room filled to standing room only waited anxiously for a phone call from the American Nurses Credentialing Center (ANCC). The phone rang. The room went silent. And then, a great eruption of cheers.

Kenmore Mercy Hospital staff celebrate after receiving a much anticipated call from the American Nurses Credentialing Center’s Magnet Recognition Program.

With that phone call, Kenmore Mercy Hospital was notified that it was a Magnet® recognized facility, an honor held by only 6.7 percent of hospitals nationwide. Receiving Magnet® recognition is the culmination of the hospital’s continued commitment to nursing excellence and reflects the highest standards of nursing professionalism, collaboration and teamwork.

The first application was submitted in July 2015. In April of 2016, Kenmore Mercy Hospital submitted its document to the ANCC Magnet Recognition Program® office, initiating our Journey to Magnet® Excellence. Additional documents were submitted in November 2016, which resulted in the ANCC Magnet® site visit on February 22 – 24, 2017.

“Our document is the story of how you are transforming nursing care, practice, and learnings along the way. We are building on our rich history that traces its roots to early nurse leaders, who were Sisters of Mercy, and eventually the lay leaders who followed in their footsteps,” said Cheryl W. Hayes, MS, ANP, NEA-BC. The Magnet Recognition Program® Model focuses on five components based on outcome measurements and documentation: • Transformational Leadership • Structural Empowerment • Exemplary Professional Practice • New Knowledge, Innovation, and Improvements • Empirical Outcomes Magnet® is a four-year recognition, which means it expires and must be resubmitted for in 2021. In the interim, the hospital must submit specific data to ANCC each year in April, our designation month.

Thank you for your continued work as we grow in nursing excellence and enhance patient outcomes.

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“Transformational leaders are those who stimulate and inspire followers to both achieve extraordinary outcomes and, in the process, develop their own leadership capacity.” ~ 2014 Magnet® Application Manual

Nurses Attend 2017 Magnet® Conference Twenty nurses represented Kenmore Mercy Hospital on October 11-13, 2017 in Houston at the ANCC National Magnet Conference®, the largest nursing conference in the United States.

With nearly 10,000 nurses from the best hospitals across the world present, the event served as both a celebration of accomplishment for newly designated Magnet® organizations, like Kenmore Mercy, and a showcase of best nursing practices for the Magnet® community.

While in Houston the Kenmore Mercy Hospital nurses learned about innovative and exciting ways to increase both patient and associate engagement, enhance patient satisfaction, and improve associate retention.

“We had lectures from inspirational speakers who have survived horrific tragedies because of the exceptional care and compassion from their nurses,” said Anne Hedges-Creighton, RN, BSN, MS, director of Perioperative Services.

“We met teams from all over the world, all striving to bring the best possible outcomes for their patients,” she added.

The conference raised more than $100,000 for Houston hurricane relief. In addition, Kenmore Mercy’s team brought handmade blankets of comfort for the elderly who have lost so very much during this disaster.

A behind the scenes glimpse of the 2017 Magnet Conference

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Nursing Excellence Professional Practice Model The Kenmore Mercy Hospital Nursing Professional Practice Model (PPM) is a visual representation of our nursing practice and signifies the professional commitment to our patients and their families.

Adapted from nursing theory pioneer Imogene King’s general systems framework and her theory of goal attainment, the model is interwoven with the principles of our faith-based healthcare organization.

The model was created in 2015 by our nurses and embodies what it means to be a nurse at Kenmore Mercy Hospital.

Nursing is represented as the first step, as the foundation of the model. It is the groundwork that supports the structure, followed by the concepts the clinical nurses feel embody their professionalism at the hospital.

The pillars of our nursing practice are labeled with characteristics that the nurses feel are most important as they carry out their professional practice. Each pillar stands for what nurses practice each and every day and in turn act as a support system for building relationships with our patients, families, and interprofessionally.

Nursing utilizes these characteristics to aid in developing mutually established goals with our patients. Improved patient and family outcomes are represented at the top/peak, because the care of patients is our top priority.

Positive outcomes for our patients was identified by our clinical nurses as what we strive for every day.

CNA Awarded Business First Woman of Influence Congratulations to Cheryl W. Hayes, MS, ANP, NEA -BC, vice president of patient care services at Kenmore Mercy Hospital.

She was the winner of Business First’s 2017 Women of Influence Nonprofit Leadership Award.

The award honors women who display high energy and skill in a leadership role at a nonprofit institution or organization.

Cheryl generously donated the $1,000 award presented by Lake Shore Savings Bank to the Kenmore Mercy Foundation.

Cheryl Hayes (r) presents a check to Susan Jandzinski, the foundation’s executive director.

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Shared Governance Addressing Night Staff Needs Meeting the needs of night-shift nurses presents its own unique challenges. To maintain teamwork and morale, much emphasis has been placed on including this group in hospital committees. More recently, nursing extended their efforts with the creation of a night shared governance.

The group only started meeting in late 2017, but are enthusiastic about discussing issues relevant to them.

“This was a way to get the night staff involved in Shared Governance too,” said Carole Woomer, RN, BSN, CMSRN, night supervisor.

“They can share ideas they may have for nursing practice that are unique to the night shift. They are currently contributing to ways we can streamline nurse to nurse report among other topics,” she added.

Hospital Enhances Patient Safety With Masimo With an ongoing commitment to quality care and patient safety, Kenmore Mercy Hospital added the Masimo Patient SafetyNet™ system in 2017, trialing it on the 2 East and 2 South Patient Care Units.

The state-of-the-art system provides continuous remote monitoring using advanced pulse-oximetry technology with direct clinical notification through the patient care units.

“The system displays real-time information from any connected Masimo device at the central station and allows for alarms and alerts from the patient bedside devices to be sent directly to the nurses and central station,” said Deborah Micholas, RN, BSN, ONC, nursing supervisor, who helped roll out the system at Kenmore Mercy.

Registered nurses Natalie Pelton, Julie MacDonald, and nursing supervisor Deborah Micholas check a patient’s vitals using Masimo.

The system’s technology reads through low perfusion and low patient movement, and uses adhesive sensors to the fingertips for pulse rate and oxygen saturation and to the neck for respiratory rate which have proven effective in improving accuracy and reducing false alarms.

This system integration will save many steps for staff that have previously had to manually transcribe values like heart rate, temperature, blood pressure, breathing rate, and oxygen saturation values that can now be wirelessly transmitted directly into the patient electronic record.

“The less time a nurse spends entering data into the system, the more time she can spent at the patient bedside attending to the personal and educational needs of our patients,” added Debbie.

Kenmore Mercy invested $33,000 in bringing the Masimo Patient Safety Net online. This type of technology helps Kenmore Mercy maintain its commitment to improving patient safety.

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Structural Empowerment 2017 Nursing Associate Recognition Awards Nurse of Distinction

Outstanding Staff Nurse

Amber Mazurek

Grace Logie

—

BSN, RN, ONC Project Advisor

—

Operating Room RN

Outstanding Nurse’s Assistant —

Denise Walker 2 West

The nurses from our Care Management team enjoyed our 2017 Oscar’s themed Nurse’s Week Celebration when nursing associate awards were presented.

Medical Staff Associates of the Year 2017 —

Scott Berube

RN, CCRN Post Anesthesia Care Unit 8

Each year, members of Kenmore Mercy’s Medical Staff recognizes outstanding associates for their service to patients and associates at a December presentation. These individuals are well-respected among his/her peers, patients, families and the physicians of Kenmore Mercy Hospital.

“Magnet® structural environments are generally flat, flexible, and decentralized. Nurses throughout the organization are involved in shared governance and decision-making structures and processes that establish standards of practice and address opportunities for improvement.” ~ 2014 Magnet® Application Manual

2017 DAISY Award Winners Summer 2017

Winter 2017

Bridget Walborn

Kayla Limardi

—

RN, CCRN Intensive Care Unit

—

MSN, BSN, RN 2 West

Other nominations this year included: 2 East Staff • Samantha Belter, RN • Rita Colicchia, NP • Andrea Doll, RN Samantha Esnaola, RN • Emily Glasgow, RN • Bobby Gross, RN • Tara Groulx, RN • Michelle Harris, RN • Jenna Holevinski, RN Kourtney Kijanka, RN • Jennifer Lee, RN • Morgan LePage, RN • Kelly Martin, RN • Jennifer Rennells, RN Rachel Santana, RN • Shaina Taylor, RN • Ann Uldrich, RN • Delores Watkins, NA • Candice West, RN

The DAISY Award (Diseases Attacking the Immune SYstem) was established by the DAISY Foundation in memory of J. Patrick Barnes who died at the age of 33 of idiopathic thrombocytopenia, an auto-immune disease. Nurses are nominated by patient families and selected twice a year by the hospital’s Nursing Shared Governance Committee based on their compassionate bedside manner and excellent clinical skills.

Emergency Nurse of Excellence

Outstanding Surgical Technologist

2017

2017

Amanda Kowalski

Desiree Evaldi

—

RN, CEN Emergency Department

—

CST Surgical Services

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Certified Nurses Day Celebration In celebration of Certified Nurses Day, Kenmore Mercy Hospital hosted a breakfast for nurses on March 24, 2017.

Certified Nurses Day is a national day to honor and recognize the important achievement of nursing specialty and subspecialty certifications.

Certification is a mark of excellence that requires continued learning and skill development to maintain. Nurses achieve certification credentials through specialized education, experience in a specialty area, and a qualifyAmong the breakfast attendees were certified nurses ing exam.

Congratulations to all the nurses who have achieved the important career milestone of certification. More than 70 Kenmore Mercy nurses have specialty certifications, in 17 different areas.

Heather Telford, Cheryl Hayes, Kathy Daley, Tina McGee, Sr. Mary Walters, and Mary Applegate, as well as former president & CEO Jim Millard, in the back row.

Continuously Developing and Improving Nurses at Kenmore Mercy Hospital work hard to continuously develop and improve their skills.

Congratulations to the following nurses who completed academic nursing degrees in 2017.

Lauren Ciarpelli, NA D’Youville College - Bachelor of Science in Nursing Nicole Faulkner, BSN, RN 2 East/2 South University of Buffalo - Doctor of Nursing Practice Julia Gajewski, RN Daemen College - Bachelor of Science in Nursing Practice

Sarah Luckett, BSN, RN Intensive Care Unit D’Youville College - Master of Family Nurse Practice Candice West, RN Emergency Department Trocaire College - Bachelor of Science in Nursing Michele Yeates, BSN, RN Nurse Supervisor University of Buffalo - Master of Nursing Leadership Gita Zhulovchinova, BSN, RN 3 East D’Youville College - Master of Family Nurse Practice

Kayla Limardi, BSN, RN 2 West D’Youville - Master of Family Nurse Practice

New Niagara University Cohort Announced After a rigorous application and interview process, the new cohort for the Catholic Health/Niagara University “RN to BSN” program has been decided. Kenmore Mercy has four nurses pursuing their Bachelor of Nursing degree.

Congratulations and good luck to Bobby Gross, RN - 3 East; Amanda Kowalski, RN Emergency Department; Kelly Martin, RN - 3 East; and Jessica Schulte, RN - 2 West/IT who began their program in January 2018.

Bobby

Amanda

Kelly

Jessica

Catholic Health covers the cost of tuition and books, and provides a laptop computer for each nurse enrolled in the program. In exchange, the nurses agree to remain employed within Catholic Health for three years after earning their bachelors’ degrees.

Thank you to all of our nurses who are working to obtain advanced degrees.

Their work demonstrates commitment and advancement in nursing.

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Current Certifications For Nursing By Speciality Adult Nurse Practitioner (ANP) Esther Sprehe, ANP Certified Emergency Nurse (CEN) Amanda Kramer, RN Heather Telford, RN Sue McClure, RN Kelsey Wielgosz, RN Board Certified Nurse Practitioners (CNP) Rita Colicchia, NP Susan DePlate, NP Mary Dowd, NP Patricia Lorusso, NP Andrea Schmitt, NP Esther Sprehe, NP Sister Mary Walter, NP Certification in Cardiac Medicine (CMC) Sandra Conti, RN Certified Gastroenterology Nurse (CGRN) Heidi Frushone, RN Janet Gonzalez, RN Jane Weidner, RN Certification for Nurse Managers and Leaders (CNML) Margy Donofrio, RN Christine Schwinn, RN Ellen Swan, RN Certified Nurse Operating Room (CNOR) Rachel Achtziger, RN Linda Butski, RN Cara Howitt, RN Melissa Kowalski, RN Esther Sprehe, ANP Jacob Walck, RN Certified Post Anesthesia Nurse (CPAN) Scott Berube, RN Margy Donofrio, RN Pam Farrell, RN Sue Hartl, RN Rene Marriott, RN Certification in Wound Ostomy Nursing (CWON) Mary Applegate, RN Certification in Diabetic Education (CDE) Megan Kosmoski, RN Critical Care Registered Nurse (CCRN) Julie Marshall, RN (CCRNK) Sandra Conti, RN Christopher Dowd, RN Rachael Kaplan, RN Brenda Cramer, RN Mary LaMartina, RN Lori Ann Meder, RN Kristen Parisi, RN Maria Richardson, RN Connie Skulski, RN Bridget Walborn, RN Elizabeth Wood, RN

Interventional Radiology Nurse Certification (CRN) Deborah Arnet, RN Kathleen Daley, RN Christine McGee, RN Robert Morello, RN Med-Surg Certification (CMSRN) Johanna Boyd, RN Nancy Chojecki, RN Jessica Cianfrini, RN Brenda Cramer, RN Kelly Ford, RN Annette Gillies, RN Kayla Limardi, RN Brooke Little, RN Chrissy Logan, RN Jessica Schulte, RN Carole Woomer, RN Jessica Yormick, RN Nurse Executive, Advanced-Board Certified (NEA-BC) Cheryl W. Hayes, NP Nurse Executive, Board Certified (NE-BC) Elaine Schrutt, RN Orthopedic Nursing Certification (ONC) Delreta Billips, RN Alan Chittley, RN Christine Clark, RN Nicole Faulkner, RN Briana Geddis, RN Mary Hojnacki, RN Pamela Koetzle, RN Betty LoFaso, RN Amber Mazurek, RN Deborah Micholas, RN Christine Reaser, RN Susan Wasielewski, RN Suzanne Zeisz, RN Certified Ambulatory Nurse (CAPA) Margy Donofrio, RN Certified Case Manager (CCM) Nina DiCarlo, RN Deb Hurd, RN Janet Kay, RN Ella Mendez, RN Chris O’Mara Sandy Olear, RN Certified Registered Nurse First Assistant (CRNFA) Esther Sprehe, ANP Stroke Certified (SCRN) Joy MacNeil-Ennis, RN Sandra Conti, RN Wound Care Certified (WCC) Robert Gross, RN Kristen Nazaruk, RN Mary Jane Lodico, RN Sue Zeisz, RN This list includes certifications completed prior to December 2017.

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Nurses Caring for Our Community Caring for the community is an important component of a Magnet® organization and Kenmore Mercy’s nurses and associates extend their compassionate care beyond the walls of the hospital in a variety of ways.

Every February, nursing associates from 3 East and Cardiology Services team up with a variety of hospital departments to host a Go Red for Women Awareness Day and National Heart Day. As part of Colon Cancer Awareness Month in March, the Gastrointestinal nursing team hosts an education fair and speakers to help individuals gain a better understanding of colorectal cancer and gastrointestinal diseases. This happens during and Gastrointestinal Nurses & Associates Week.

Registered nurses from the GI Unit – Marie Sullivan, Nancy Nikisher, Michelle Harris and Cheryl Lewandowski – are dedicated to helping patients.

Speakers for their 2017 event included gastroenterologist Dr. Maya Srivastava, and colorectal surgeon Dr. Daniel Leberer. They also offered a raffle and raised $165 for the Helping Hands fund.

During Pulmonary Rehabilitation Week in March, nurses hosted an informational table to educate individuals about chronic obstructive pulmonary disease, asthma, chronic bronchitis, and pulmonary fibrosis.

They also provided screenings.

Dave Peters from facilities and engineering got some TLC as pulmonary rehab nurses Ann Carroll and Karen Hamp did his screening.

The interprofessional group that makes up the Palliative Care Committee also hosted advanced directive days in the hospital and in the community to answer questions about Health Care Proxy and/or MOLST forms and advance directive planning.

A number of nursing team members were helpful in planning the inaugural Christmas Shoppe Program in December. It helped bring a little joy to at least 40 families, as well as 103 children this past Christmas.

Associates donated new pajamas, underwear/diapers, socks, and much more.

Thank you to these dedicated nurses for their commitment to improve the health of others with their proactive actions and service.

Thank you to the Christmas Shoppe Committee and volunteers for their dedication to helping those in need.

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LOVE Award Winners Second Quarter 2017

Third Quarter 2017

Jennifer Woods

Teresa Viverette

—

Night Nursing Assistant 2 West

—

Nursing Assistant 2 East/2 South

The LOVE Award recognizes outstanding associates who demonstrate a personal commitment to our core values of Reverence, Compassion, Justice, and Excellence in their daily work.

Nursing Program Benefits Both Students and Hospital The Dedicated Education Unit Program at Kenmore Mercy has nursing students getting hands-on experience with the help of the hospital’s experienced nurses who act as preceptors.

The program places junior and senior-level students right in the hospital where they experience the full scope of the nurse’s role and patient care.

Currently the hospital has three DEUs, the inpatient care areas 2 West, 2 East/2 South, and 3 East.

“The DEU mentoring approach blends evidence-based teaching approaches with clinical expertise, support, guidance, and role modeling of seasoned nursing staff,” said Cheryl Hayes, MS, ANP, NEA, BC.

Amruddin Kader, a University of Buffalo Kenmore Mercy currently hosts 54 students from University of Buffalo and nursing student worked closely with Niagara University. registered nurse Victoria McDonald while on the 2 South Patient Care Unit.

MRU Rallies to Mark Couple’s Special Anniversary Love was in the air at Kenmore Mercy Valentine’s Day weekend 2017 as patient Jean McNeill and her husband Joe celebrated their 60th wedding anniversary.

After learning that the Tonawanda couple would miss their planned anniversary mass at St. Francis Roman Catholic Church, staff from nursing, food services, facilities, housekeeping, and rehabilitation went out of their way to make it special.

They decorated the Medical Rehabilitation Unit’s dining room and put out a brunch for 25 of the McNeills' closest family and friends.

Joe and Jean McNeill

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Exemplary Professional Practice NURSE SENSITIVE INDICATORS Kenmore Mercy Focuses on Patient Experience In 2017, Kenmore Mercy continued to achieve “top box” ratings in the HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) patient satisfaction survey.

HCAHPS Scores: Treated with Courtesy & Respect by Nurses HCAHPS Scores: Treated with Courtesy & Respect by Nurses

These survey questions allow patients to give a perceptional score to various specific questions related to the care they received while hospitalized.

95 90

Our nursing goal at Kenmore Mercy Hospital is to exceed the benchmarks established by CMS and those indicated by Catholic Health. The graph to the right shows how Kenmore Mercy has surpassed its benchmark goals most of the year.

85 80 75

The hospital’s target was 77 percent for October 2016 through September 2017, which was easily achieved with scores ranging from the high 70s to mid-80s. However a downward trend was noted during the summer months with scores well below target.

70 Jan 2017

Feb 2017

Mar 2017

Apr 2017

May 2017

Jun 2017

KMH Score

July 2017

Aug 2017

Sep 2017

Oct 2017

Nov 2017

Dec 2017

National Average

Patient experience is impacted by every department in the hospital therefore each department has the opportunity to help get our scores back up to where we know we can be.

Reducing Catheter Associated Urinary Tract Infections According to the Center of Disease Control and Prevention, urinary tract infections account for more than 30% of health care-associated infections.

As the most common form of health-care associated infection, UTIs are usually caused by catheters and other instruments in the urinary tract.

Catheter-associated urinary tract infections, or CAUTI, can cause increased morbidity, mortality, hospital costs and length of stay.

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CAUTI Observed/Expected Ratio CAUTI Observed/Expected Ratio 1.2 1 0.8 0.6 0.581

0.4

0.54

0.2 0 2016

2017

CAUTI (obs/exp ratio)

2017 Target = 1.000

CAUTI (obs/exp ratio)

2017 Target = 1.000

“Exemplary professional practice in Magnet-recognized organizations is evidenced by effective and efficient care services, interprofessional collaboration, and high-quality patient outcomes.” ~ 2014 Magnet® Application Manual

Treating Stroke Effectively Increases Chances of Recovery Effective care of patients who experience stroke is of utmost importance for our patient’s recovery.

The quicker clinicians can identify and treat the stroke symptoms, the better the chances are for the patient to recover from the deficits the stroke may cause.

Starting from the arrival of the ambulance, as the patient comes through the Emergency Department doors, the interprofessional team works to achieve the best outcome for the patients.

The quality measures located on this page reflect many of the indicators that are important to the patient’s recovery. These are also reported to New York State and to the Joint Commission at the time of survey.

Get With The Guidelines Stroke Quality Measures KMH GWTG Stroke Quality Measures 100 90 80 70 60 50 40 30 20 10 0 Dysphagia Screen

Stroke Education

Kenmore Mercy’s goal is to be above the target in all of these areas to enhance positive effects on our patients’ outcome.

Rehab.

Considered 2016

Time to IV LDL IV t-PA Arrive by NIHSS Reported Thrombolytic Documented 3.5 Hr, Treat by Therapy-60 min.

4.5 Hr. 2017

Target

Nursing Reducing Hospital-Acquired Pressure Ulcers Each year, more than 2.5 million people in the United States develop pressure ulcers. These skin lesions bring pain, associated risk for serious infection, and increased health care utilization.

Nurses have a role to play in monitoring the success of strategies to reduce avoidable pressure ulcers and to provide accountability and maintain motivation.

Kenmore Mercy continues to educate its nurses in wound care. Four nurses – Kristen Nazaruk, BSN, RN - 2 West; Robert Gross, RN - 3 East; Suzanne Zeisz, RN - 2 East/2 South; and Mary Jane Lodico, BSN, RN - Medical Rehabilitation Unit – completed their certification in wound care.

This certification better prepares them for the treatment and management of pressure ulcers, traumatic and draining wounds, surgical incisions, and tubes and fistulas.

Pressure PressureUlcers Injuries 0.8 0.7

0.76

0.6 0.5

0.56

0.53

0.4 0.3 0.2 0.1 0 2015

2016

Hospital Acquired Pressure Injuries

2017 2017 Target = 0.53

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Nurses Making Great Catches The Great Catch program is a Quality & Patient Safety initiative designed to help Catholic Health catch and avoid situations that have the potential to cause harm to our patients.

Therese Hanel RN Pre-Admissions

Kathleen LangeStevenson

Leigh Skryznski RN 2 East/2 South

RN 2 East/2 South

Did you know that ...

72 % of our nurses

24%

have Bachelor of Nursing degrees?

of our nurses

have national certifications

Nurses Joy MacNeil-Ennis and Brooke Little on the 2 West Patient Care Unit achieved special certifications in 2017.

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ED Receives Leadership Award

Our Emergency Department team – Dennis Protas, RN; Jean Wood, RN; Marcia Powers, RN; Nora Verity, RN; and Sophia Sok, unit clerk – are helping put our ER on the map in Western New York.

Kenmore Mercy Hospital’s Emergency Department was recognized in May by HEALTHeLINK for being an innovative leader in clinical information exchange in Western New York. It was the first ED in Catholic Health to implement HEALTHeLINK. According to a 2015 study by HEALTHeLINK, the use of health information technology significantly cuts down on unnecessary testing in hospital emergency departments.

Kenmore Mercy Hospital’s Emergency Department was one of 44 practices/organizations HEALTHeLINK recognized for being innovative leaders in clinical information exchange in Western New York.

Charge nurses Amy Shellman, Mary Whelan (front row), Suzanne Harper and Mary Jane Lodico, represent the Medical Rehabilitation Unit.

Associates from the 3 East Patient Care Unit show their Magnet® pride.

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New Knowledge, Innovations & Improvements 2 West Leads Way in Noise Reduction

One of the biggest challenges for hospitals around the country is promoting rest for patients while providing excellent patient care. Kenmore Mercy Hospital nurses face this challenge every day and see what a toll it can take on their patient’s recovery.

In the fall of 2017, the 2 West Patient Care Unit launched their “Reduction of Noise” pilot in an attempt to improve their work environment and the patient experience. An assessment of the nurse call system revealed that the volume for all nurse calls throughout the nursing unit was set at the highest level -“10.”

This meant that at night, all of the patient calls were quite loud, even in the hallway near where patients were trying to sleep. The 2 West nurses shared these patient experiences with their Unit Practice Council and Shared Governance and proposed changes needed. A plan to change the volume, tone, type and location of calls was evaluated and discussed by nursing weighing multiple patient safety factors such as patient fall rates and response times. Ultimately the changes were embraced and implemented by 2 West on September 25, 2017.

The nursing feedback during the pilot period was positive overall. Nurses noticed that they relied on the lights more than the noise, which helped them respond to patient needs faster, which resulted in much quieter hallways. They also realized that working in a quiet environment improved their focus and was calming.

Based on the 2 West initiative and their positive evaluation, the nurse call changes and an updated light patterns to the system were implemented on all nursing units successfully on December 7, 2017.

OR Team Working to Ensure Patient Readiness

Percent

“Ensuring patient safety in the operating room begins before the patient enters the operative suite and includes attention to all applicable types of preventable medical errors,” noted Anne Hedges-Creighton, BSN, MS, RN, director Perioperative Services. “Prevention of surgical errors requires the attention of all personnel involved in the patient’s care.”

The process for improvement started with collecting details about patient readiness from the inpatient units for 60 days.

This data was analyzed and a plan for improvement was developed by an interdisciplinary team, revolving heavily around perioperative/pre-procedure checklist education. complete % incomplete % every shift

Percentage

Percentage of Patient Readiness in 2017 When the results of the 2017 Culture of Safety Survey came Patient Readiness in 2017 in, one big concern was expressed by Kenmore Mercy Hospital’s Perioperative team. They felt that patients coming to the Operating Room from inpatient units were not ready for 61 60 59 surgery upon arrival.

53 46 40

June

38

Oct

incomplete %

38

Nov

Dec

complete %

june

october

november

december

40

53

59

61

60 46 discuss38 September to the

38 elements

Hospital educators went to every patient unit on throughout of the checklist and the significance of each item on the list, along with Kenmore Mercy Hospital‘s policy and procedure.

This education was coupled with the hospital’s Associate Forums in the fall that provided all participants with an overview of the checklist.

When data was collected again in October, there was a significant improvement in patient readiness which continued to increase the rest of the year.

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“Innovations in patient care, nursing and practice environment are the hallmark of organizations receiving Magnet® recognition.” ~ 2014 Magnet® Application Manual

Nurses Present at Research Conference Kenmore Mercy’s nursing team presented five research posters at the 30th Annual Nursing Research & Scholarly Activities Conference in April, held at Classics V. The night long event, sponsored by the Professional Nurses Association of Western New York and the Nursing Honor Society “Sigma Theta Tau International” (Gamma Kappa, Gamma Theta and Zeta Nu chapters), brought together nursing colleagues from across the Buffalo area to share their contributions.

The five Kenmore Mercy research projects included: Samantha Belter and Victoria McDonald, RN for Sydney Dirk, RN 2 East and 2 South The Impact of Gum Chewing on Ileus Rates in Postoperative Hip & Knee Replacements.

Linda Butski, MSN, RN Nurse Manager of Surgical Services/Endoscopy Closing Protocol for Colon Surgery.

Anne Hedges-Creighton, BSN, MS, RN Director of Perioperative Services Kenmore Mercy Hospital Surgical Tray Weight/Associate Injury Reduction Initiative. *Received the Professional Nurses Association of WNY Research Day Award Amanda Kramer, BSN, RN, CEN Nurse Manager of Emergency Department Reduction of turnaround time for Emergency Department patients requiring CT abdomen/pelvis with oral contrast.

Linda Butski, MSN, RN, nurse manger of Surgical Services/Endoscopy presented about colon surgery.

Deborah Micholas, BSN, RN, ONC Patient Care Services Supervisor Sue Wasielewski, RN 2 East and 2 South A Systematic Approach To Reducing Automated Dispensing Cabinet Outdates.

National Poster Presentations Mary Applegate, BSN, RN, CWOCN Wound/Ostomy Educator/Advisor Deep Tissue Injury vs. All Things Purple. SER of the WOCN Society 2017 Annual Conference in Knoxville, Tenn.

Ellen Swan, BSN, RN, CNML Nurse Manager 2 West Safe Patient Handling With “A Move With Care” Program.

2017 Nurse Management Congress in Las Vegas, Nev. Ellen was winner of the Certificate of Excellence Poster Award - runner up.

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Foundation Funding Gives Nursing Staff Step Up The Kenmore Mercy Foundation sets aside funds annually to assist associates with the funding to learn up-to-date techniques. This also helps to provide resources to treat patients with the high quality care for which Kenmore Mercy Hospital was recognized in 2017.

As a result, it was able to distribute $45,000 in Staff Education Grants to Nursing/Patient Care Services associates.

A significant portion of those grants were made possible by the medical staff which donated $100,000 in 2016 and $20,000 in 2017 to assist the Foundation in supporting associate educational opportunities.

In 2017, the Foundation assisted more than 75 nursing associates with educational opportunities they either personally requested to attend or were asked to attend by a manager. Educational opportunities include, but are not limited to, national conferences, certifications, and classes.

The Foundation was also integral in making it possible for twenty nurses to travel to Houston, Texas, to represent Kenmore Mercy at the American Nurses Credentialing Center National Magnet ConferenceÂŽ, the largest nursing conference in the United States.

Thank you to the Kenmore Mercy Foundation for their ongoing support of nursing.

2017 Staff Education Grants 2 South - National Association of Orthopaedic Nurses Conference (2 associates)

Patient Care Services - Healthcare Innovations Conference

3 East - Skin/Wound Care Certification (2 associates)

Patient Care Services - Fall Prevention Challenges Conference

3 East - Managing Emotions Under Pressure (2 associates) 3 East - Incorporating Principles of Palliative Care across the Care Continuum (2 associates) Emergency Department - Stroke Management Symposium (5 associates) Endoscopy - Society of Gastroenterology Nurses and Associates, Inc. (2 associates) Intensive Care Unit - Critical Care Education Intensive Care Unit - UPMC Cardiovascular Update Conference Patient Care Services - Nursing Research and Scholarly Activities Conference (9 associates) Patient Care Services - Managing and Supervising People Patient Care Services - Nursing Management Congress 2017

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Patient Care Services - 2nd Annual Nursing Symposium (3 associates) Patient Care Services - 2017 ANCC National Magnet Conference (20 associates) Patient Care Services - Principles of Palliative Care - Train the Trainer Conference PACU - Post Anesthesia Care Unit Manager Summit Perioperative - Emergencies in the Surgical Department (12 associates) Perioperative Making the Transition from Staff to Supervisor Seminar Pre-Testing - Stress, Resilience & Happiness Conference

Call Bell/Pillow Speakers Made Possible by Foundation The Kenmore Mercy Foundation raised $20,000 at its annual Tribute To Angels event specifically to purchase 140 new nurse call bell/pillow speakers, which adds to its patient experience efforts.

Call bells help ensure clear communication between patients and the nurse’s station and also aid in creating a quiet environment for patients during their stay. Both of these stand out as areas in need of improvement in post discharge surveys through which patients rate their hospital stay.

“Patients expect more than high quality of care, they expect many of the comforts of home,” said Laura Verbanic, PT, BB, CPHQ, director of Quality and Patient Safety at Kenmore Mercy Hospital. “Providing that positive patient experience aids in the recovery process.”

The donations for the nurse call bell/pillow speakers were part of the Tribute to Angel’s “Fund an Item,” during which attendees participate in a live auction to raise funds for a specific item or piece of equipment for the hospital.

A Tribute to Angels raised $128,000 for Kenmore Mercy Hospital to purchase new equipment, support associate training, and help patients in need. Major sponsors of the event included the Penfold Family, Southtowns Radiology Associates, Mr. and Mrs. Thomas Vogt and Vogt Sprinkler Service.

Therapy Dogs Helping Patients and Associates Intensive Care Unit registered nurse Rachael Kaplan and her certified therapy dog Bella have been visiting patients at Kenmore Mercy since the inception of the hospital’s Pet Therapy Program.

Throughout her years of service, Rachael noted that the presence of Bella not only had a positive effect on the patients but many of the nurses as well.

The research shows that dog and cat owners make fewer overall visits to their primary care physician; dog owners exercise more, sleep better, and take fewer days of from work; and one year survival after Myocardial Infarction was higher amongst patients who owned a dog.

These are all thought to be mediated by the release of oxytocin that occurs when most humans interact with animals.

Based on the hospital’s Voice of the Associate survey results, the nurses wanted to take new approaches to reducing stress in the ICU. There was anecdotal evidence that therapy dogs were reducing stress and anxiety amongst staff members at Kenmore Mercy Hospital, therefore Rachael decided to test her hypothesis that animal-assisted therapy will reduce stress and anxiety among healthcare workers.

A blood pressure, heart rate, and emotion questionnaire were completed prior to Bella entering the ICU. Participants spent five minutes with her and then blood pressure, heart rate, and questionnaire were again assessed. Rachel’s results found that animal-assisted therapy significantly reduces blood pressure and heart rate in ICU nurses. It also decreases self- reported stress and anxiety levels while increasing feelings of happiness, peace, and relaxation amongst this population.

Registered nurse Mary LaMartina, CCRN, and Bella dressed up for Halloween.

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Awards and Recognitions Advanced Primary Stroke Center Certification Kenmore Mercy Hospital earned the Gold Seal of Approval from the Joint Commission for Primary Stroke Centers (2011, 2013, 2015, and 2017). This means Kenmore Mercy Hospital is now a certified stroke center, a rare distinction for hospitals providing neuroscience care.

American Heart Association Get with the Guidelines – Stroke

Beacon Award Kenmore Mercy was recognized as having one of the nation’s top Intensive Care Units with receipt of the Beacon Award for Excellence (2012 and 2016).

The Beacon Award is given by the American Association of Critical-Care Nurses. This national recognition highlights Kenmore Mercy’s accomplishments in fostering the highest standards of quality patient care as well as healthy work environments.

Kenmore Mercy Hospital received the American Heart Association/American Stroke Association’s Get With The Guidelines® – Stroke Gold Plus Quality Achievement Award in May of 2017. The award recognizes the hospital’s commitment and success in ensuring stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines based on the latest scientific evidence.

Our ICU Team was the first in the area to achieve the Beacon Award.

Disease-Specific Care Certification for Total Knee and Total Hip Replacement Kenmore Mercy earned Western New York’s only Disease-Specific Care Certification for both total knee and total hip replacement from The Joint Commission (2011, 2013, 2015, and 2017).

The 2 West care team was integral in our achieving this stroke award.

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Joint Commission Accreditation The purpose of The Joint Commission survey and accreditation process is to evaluate facilities’ compliance with nationally established Joint Commission standards that relate to quality and safety of care.

The Joint Commission is one of the nation’s most respected accrediting agencies. Achieving The Joint Commission’s demanding standards ensures that our performance and improvement is held to the highest standards nationwide.

Magnet® Recognition Brooke Little, RN; Brenda Queeno, Pharm.; Erika Witt, RT; and

On April 26, 2017, the Commission on Bridget Walborn, RN, are just a few members of our team that Magnet® voted unanimously to desighelp make Kenmore Mercy one of the safest hospitals in the nate Kenmore Mercy as a Magnet® country. hospital. It is currently the only such hospital in Western New York. Magnet® applicants undergo a rigorous evaluation process, including written documentaTop Hospital Award tion, extensive interviews, and an on-site Kenmore Mercy Hospital was the review of nursing services. only hospital in New York State to be named a Top Hospital by The LeapMagnet® designation lasts four years, during which 2017 frog Group in 2016 and 2017. time the American Nurses Credentialing Center (ANCC) monitors the hospital closely to ensure it maintains high standards of care. ANCC is the world’s largest and most Hospital Safety Grade prestigious nurse credentialing organization, and a subIn the Fall 2017 score update, sidiary of the American Nurses Association.

Kenmore Mercy Hospital was honored with an “A” Hospital Safety Grade. Scores range from A, B, C, D, and F, and are released every six months. The hospital has accomplished the difficult task of being awarded Straight “A’s” since 2014.

The Leapfrog Group

US News & World Report Our Magnet® planning team consisted of nurses Amanda Kramer, Amber Mazurek, Heather Telford, Cheryl Hayes and Anne Hedges-Creighton.

The 2017 US News & World Report hospital rankings listed Kenmore Mercy Hospital as “High Performing” for knee and hip replacement.

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OUR MISSION

We are called to reveal the healing love of Jesus to those in need.

OUR VISION

Inspired by faith and committed to excellence, we will lead the transformation of health care in our communities.

OUR VALUES

Reverence: Nursing reflects our values and mission by the acknowledgement of the sacredness of human life and the individuality of their needs and goals.

Compassion: Nursing provides compassionate care by identifying the connectiveness of each person through the relationship with each other and their environment.

Justice: Nursing advocates for our patients to achieve their personal goals, respecting and recognizing the differences in each individual.

Excellence: Nursing continually strives for quality and excellence through the care we deliver through communication to our patients, families and the interdisciplinary team.

Nursing strives to interact with our patients to achieve their goals, promote, maintain and sustain health and to ensure satisfaction of the care the patient receives.

2017