2018 Nursing Annual Report

Exceptional today, even better tomorrow

NURSING Annual Report 20 1 8

T HE JOY WE C O L L EC TI VELY SH ARE IN OU R PROF E SSION AL PRACT ICE S H I NES BRI GHTLY AS W E AL L SE RVE TOGE T H E R GU ID E D BY OU R VALU E S OF

Excellence and Love.

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VISION STATEMENT

PROFESSIONAL GOVERNANCE

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C A t A N of E

nd Values a o rs i B ehav

To be the transformative and intellectual force improving health through the evolving art and science of nursing.

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We, the nurses of Christiana Care Health System, provide a high-quality, exceptional care experience for every patient, every day, by partnering with our neighbors, colleagues and each other.

A S ta c o nd pe ard s

THE CHRISTIANA CARE WAY

ON THE COVER: Gladys Ndege, BSN, RN, oncology nurse with Christiana Care Oncology Hematology at the Helen F. Graham Cancer Center & Research Institute, guides Sharyn Gambino of Smyrna, Delaware, on a virtual journey to destinations far away from the chemotherapy suite, part of Christiana Care’s Magnet Prize-winning virtual reality program. (See page 3.)

RE F L EC T IO N S ON 2 0 1 8

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hristiana Care nurses have implemented a new Professional Practice Model. This framework creates unprecedented opportunities for collaboration that advance and align nursing practice and create greater value for our patients.

Ric Cuming, Ed.D., RN, NEA-BC, FAAN, chief nurse executive, reflects on how this important work redefines what it means to be a Christiana Care nurse.

Recently, Christiana Care unveiled a new framework to align and advance nursing practice across the health system. How is that transforming nursing practice here?

While it is indeed exciting to help formulate and lead new plans and approaches, the real satisfaction comes when we see evidence of how our direct involvement optimizes care and creates exceptional experiences for those we serve, and for those we serve alongside. These important tools advance our professional practice and create clear channels for every Christiana Care nurse to participate in shared decision-making, deliver relationship-based care and more effectively practice at top of license.

Experienced, professional nurses appreciate working for a health system that values our contributions and recognizes our clinical leadership. Nowhere is this more evident than in our 2018 Nursing Engagement Survey, in which an unprecedented 88% of our nurses elected to participate

(read story, page 21). Christiana Care was honored to outperform the national benchmark in all seven categories of issues important to nurses, and enthused to see score improvements over our own results just two years ago. This success reflects the hard work we’ve done together these last two years to create a supportive, inclusive and missiondriven culture that holds nurses in the highest esteem.

I fervently believe that the “secret sauce” of our professional practice model is that it is so clearly and meaningfully aligned with The Christiana Care Way and our Values and Behaviors, and that it spans our entire health system, from acute inpatient care to ambulatory community and home-based care. We are “all in” when it comes to delivering safe, quality care for our patients.

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RE F LE C T I O N S O N 20 1 8 Nurses do so much for their patients. What is new for nurses these days at Christiana Care?

It is uplifting to read DAISY Award nominations and to hear from patients and their families about how our nurses touch their lives in very meaningful ways. I am honored to work alongside each of these extraordinary caregivers who give so much of themselves to others.

In return, it was important for us as a health system to demonstrate to our nurse colleagues just how valued they are.

Our upgraded Nursing Advancement Scholarship Program more strategically supports nurses’ professional growth and advancement.

Our restructured Nursing Research and Evidence-Based Practice Program drives an even more robust, strategic nursing agenda.

This year we transitioned to the powerful three-step Johns Hopkins Nursing Evidence Based Practice approach to problem-solving and clinical decision-making. This helps nurses quickly and appropriately incorporate the latest research findings and best practices into patient care.

Our expanded professional advancement ladder continues to reward clinical and professional excellence, allowing frontline nurses to continually improve their skills while pursuing their passion for clinical care.

And, because we recognize that our busy nurses are also busy with family, education and community-based commitments, we introduced a full-time flex employment option in 2018 that offers 80-hour benefits for nurses who prefer to work 72 hours.

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There has never been a better time to be a Christiana Care nurse. We have the privilege of practicing at a health system gaining top national honors for excellence in clinical quality and safety. We were thrilled to receive the national Magnet prize for innovative use of virtual reality to transform our patients’ experience during chemotherapy (see story, next page), and we are incredibly proud to have the lion's share of the state's Beacon-honored critical care units, dozens of DAISY-honored nurses, a growing number of Lean Six Sigma Green and Black Belt project leaders and a Fulbright Scholar among us.

How is Christiana Care preparing for the next phase in our Magnet journey to nursing excellence?

Throughout the pages of this report, you will find examples of how our nurses collaborate with interdisciplinary colleagues throughout our health system and share accountability for delivering safe, quality relationship-based care through Exemplary Professional Practice.

You will read how nurses pursue a spirit of inquiry to drive New Knowledge, Innovations and Improvement, and how Transformational Leaders are transforming systems and our environment by modeling strategic planning, advocacy, influence and visibility, accessibility and communication to achieve excellent outcomes. And you will discover how Structural Empowerment through shared decisionmaking and opportunities for continuous learning, career advancement and recognition creates an environment where there is nothing we cannot accomplish together. We do none of this because we want Magnet. We do all of this because we are Magnet.

Christiana Care honored for innovative use of virtual reality during chemotherapy

2018 MAGNET PRIZE On the days when Blonnie Brooks comes to the Infusion Center for chemotherapy, she would rather be almost anyplace else. Now, thanks to an innovative virtual reality (VR) tool introduced at Christiana Care’s Helen F. Graham Cancer Center & Research Institute, Brooks can at least imagine herself elsewhere, walking through a forest, climbing sand dunes at the beach, or perhaps gazing down a cliff into the Irish Sea.

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hristiana Care won the prestigious 2018 Magnet Prize from the American Nurses Credentialing Center (ANCC) for its nurse-led use of virtual technology to improve patients’ experience during chemotherapy and transform the care delivery practice.

The ANCC, which promotes excellence in nursing and health care globally, awards this prize to Magnet-recognized organizations with unique programs where nurse-led innovative action transforms care delivery practices.

Graham Cancer Center nurses partnered with Christiana Care’s Health Technology & Innovation Center and Volunteer Services to bring the healing technology to patients.

“This high-tech, positive distraction improves patients’ experience and gives our exceptional nurses an opportunity to demonstrate our system’s value of serving together with Excellence and Love,” said Chief Nurse Executive Ric Cuming, Ed.D., RN, NEA-BC, FAAN. “It is a perfect example of how Christiana Care nurses live our core value of being curious and looking for innovative ways to create care that goes from good to great.”

Cancer Program Clinical Director Cindy Waddington, MSN, RN, AOCN, NE-BC, said the objective is to offer patients a positive, relaxing distraction, an escape from the confinement of the infusion suite and the boredom, anxiety or discomfort they may associate with chemotherapy.

Beyond the usual amenities offered in any doctor’s office, Waddington found that some chemotherapy patients who visited the Graham Cancer Center Infusion Suite were asking for more creative ways to pass the time — hours for some — while tethered to their IV lines.

This program is a great example of how nurses at Christiana Care are empowered to drive innovation so our patients can achieve optimal health.”

“We see joy come upon patients’ faces when they put the goggles on and find themselves outside in a forest or on a beach,” she said. “They enter a state of calmness they weren’t previously able to find in the infusion suite.”

“

Michelle Collins, DNP, APRN, CNS, ACNS-BC, RN-BC, NEA-BC, LSSBB DIRECTOR OF MAGNET RECOGNITION

Exploring VR through nurse-led evidence-based research Virtual reality positive distraction therapy is proving useful in a variety of settings to instill a sense of wellbeing, reduce anxiety and shift focus from medical treatment or painful procedures. Nurse Scientist Susan Birkhoff, Ph.D., RN, is helping co-investigators Cindy Waddington, MSN, RN, AOCN, NE-BC, Jordan Polironi-Williams, BSN, RN, ONC, Leslie Verucci, MSN, APRN-BC, and Susan Guerino, BSN, RN, launch a research study measuring virtual reality’s effectiveness in lowering anxiety and increasing feelings of self-efficacy for first-time chemotherapy patients. They will share their findings with multidisciplinary professional groups throughout the health system, and nationally through publications and presentations.

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Table 1 98

64

2

36

IN A PILOT STUDY OF 70 PATIENTS, FEEDBACK WAS OVERWHELMINGLY POSITIVE. ALL SAID THEY ENJOYED THE VIRTUAL REALITY EXPERIENCE AND WOULD DO IT AGAIN.

98% 64% 1

SAID VR WAS RELAXING

SAID VR REDUCED ANXIETY AND BOREDOM

We are curious and continuously look for ways to innovate.

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OU R M AGNET JOURNEY CO N TI N U E S Christiana Care holds the distinction as first in Delaware to be twice-designated for Magnet® Excellence by the American Nurses Credentialing Center (ANCC). Our outstanding Magnet Masters, Magnet Ambassadors, nurse leaders and frontline nurses from every practice area within our health system — acute, community and home care — work tirelessly throughout the year to document our nursing excellence. Yet every one of them will tell you that Magnet is far from a document we prepare every four years. Quite fundamentally, Magnet is the authentic culture that every Christiana Care nurse and every one of our extraordinary interdisciplinary caregivers lives and improves upon daily. It is what drives our shared pursuit to be Exceptional Today, and Even Better Tomorrow for those we have the privilege to serve.

Magnet is the authentic culture that every nurse lives daily.

WELL ON THE ROAD TO 2019 MAGNET DOCUMENTATION Christiana Care made tremendous progress throughout 2018 preparing and rigorously reviewing its 2019 Magnet document, due for submission in August 2019 to the ANCC. As of December 31, Magnet Model Components teams collected, analyzed and completed examples of nursing excellence and interprofessional practice for two-thirds of the required standards for our 2019 Magnet submission document. Christiana Care nurses are invited to visit the Magnet page on the Nursing portal to review and celebrate the extraordinary examples of excellence across Christiana Care that will be featured in our 2019 Magnet submission document.

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Two-thirds of Magnet-required standards are completed

100%

Six dedicated Magnet Masters serve as liaisons between Michelle Collins, DNP, APRN, CNS, ACNS-BC, RN-BC, NEA-BC, LSSBB, director of Magnet Recognition for Christiana Care, more than 150 Magnet Ambassadors, and service line colleagues throughout the health system.

They update their colleagues on national Magnet program news, help incorporate our new Professional Practice Model into Magnet education and daily practice and coordinate Magnet Ambassador retreats and the annual Magnet anniversary celebration.

MAGNET MASTERS Maria M. Brown, BSN, RN, PCCN

Andrea N. Locke, BSN, RN-NIC

Stacey E. Strazzella, BSN, RN, CCRN

2B TRANSITIONAL SURGICAL UNIT

NEONATAL INTENSIVE CARE UNIT

2E CARDIOVASCULAR CRITICAL CARE COMPLEX

Surgical Services & Musculoskeletal Service Lines Liaison

Women & Children’s Service Line Liaison

Heart & Vascular and Behavioral Health Service Lines Liaison

Rebekah Crawford, BSN, RN, SCRN

3E MEDICAL INTENSIVE CARE UNIT

Kara Welcher, BSN, RN-BC

Acute Medicine Service Line Liaison

VISITING NURSE ASSOCIATION

NEURO CRITICAL CARE UNIT

Neurosciences & Cancer Service Lines Liaison

Paige Merring, BSN, RN, CCRN

Primary Care & Community Medicine Service Lines Liaison

TRANSLATIONAL TOOL MAKES MAGNET RELEVANT TO EVERYDAY PRACTICE New council-created Professional Practice Model display boards are a translational tool that helps nurses connect how the work they do every day on their unit or in their practice area ties in with the Magnet Model components.

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Lindsey Gaspar, RNII MEDICAL

Exemplary Professional Practice SA F ET Y, PAT IEN T- CE N TE R E D CA R E , IN T ER D ISC IP LIN A RY R E L ATI ON S H I P S AN D P RO F ESSIO N A L AC C O U N TA BI L I TY F O R T H E O U TC O ME S OF CA R E 8

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he essence of a Magnet organization stems from Exemplary Professional Practice within nursing.

This entails a comprehensive understanding of the role of nursing; the application of that role with patients, families, communities and the interdisciplinary team; exchanging peer feedback; fostering a culture of safety; implementing relationship-based care; and advancing our Professional Practice Model.

NURSE-LED QUA LI TY & SA FETY I M P R OVEMEN TS

Nurse-driven pathway improves perioperative glycemic control Using evidence-based practices, a nurse-led interdisciplinary team developed a care pathway for hyperglycemic patients that improved perioperative glycemic control and addressed an increase in surgical site infections.

The project’s nursing leaders worked with colleagues in surgery, anesthesia, pharmacy, endocrinology, performance improvement and data analysis to create a standardized care plan, including evaluating patients for hyperglycemia,

obtaining HgbA1C for known diabetics, monitoring blood glucose on the day of surgery and focusing order sets on treating hyperglycemia. The team engaged perioperative hospitalists to provide glycemic management and discharge planning for patients leaving the Post-Anesthesia Care Unit on insulin drips, and led systemwide education for nurses and providers preceding the launch. An electronic data dashboard supports ongoing monitoring of compliance and outcomes.

By empowering nurses in the perioperative setting to optimize care and reduce harm, the pathway has:

✓ Increased diabetic HgbA1C

✓ Reduced hyperglycemia for

67%

30%

measurement to 67% from 29%.

diabetics by 30%.

✓ Helped reduce the surgical site

infection rate by 0.5% per 100 cases.

0.5%

Streamlined interventions, collaboration reduce variation in fall-prevention approach Integrated, systemwide efforts to standardize fall prevention interventions and care management guidelines helped reduce the overall fall rate at Christiana Care by 16% and falls with major injury by 25% in 2018.

Service lines review falls weekly to identify risk trends and opportunities and to highlight efforts that work well. Every other month the systemwide Fall Prevention & Mobility Team — reformatted in 2018 to include a designated

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Fall Prevention (continued) nursing leader from each of the nine service lines — shares successes and opportunities for improvement and updates care management guidelines based on the latest evidence.

• Non-skid footwear, gait belts and a staff member within arm’s reach of any high-risk patient getting out of bed.

Collaboration reduces variation in our fall-prevention approach and ensures that the same strategies and guidelines are in place in both ambulatory and acute-care practice areas. Patients and their family members are included in care plan meetings and bedside shift reports to make sure they understand fall risks and safety interventions.

• Video surveillance provides a second set of eyes on high-risk patients who may attempt to get out of bed without assistance.

• Bed brakes, chair and exit alarms checked hourly.

• Increased focus on mobility helps patients safely maintain strength and balance.

Exemplary Professional Practice

We listen actively, seek to understand and assume good intentions.

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Our goal in fall prevention, as in every patient encounter, is to be even better tomorrow. By working as a team, we continue to find innovative and more effective ways to keep our patients safe from falls.”

Denise Lyons, DNP, APRN, AGCNS-BC, LSSBG CO-CHAIR, SYSTEMWIDE FALL PREVENTION & MOBILITY TEAM

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Performance improvement bundle leads to TRAPI reduction A nurse-led post-procedure care bundle that drives care standardization and reduces variation in nursing, respiratory and provider practice helped Christiana Care sustain the elimination of tracheostomy-related pressure injuries (TRAPI) through 2018. Lois M. Dixon, MSN, APRN, AGNP-C, RN-BC, CWOCN, Wound Ostomy Continence clinical leader and Susan Mascioli, MS, BSN, RN, NEA-BC, CPHQ, LSSBB,

director, Nursing Quality and Safety, were part of an interprofessional Christiana Care team to author an article published in AACN Advanced Critical Care (Volume 29, Number 4, pp. 426-431). The bundle was also featured in posters at the National Association of Healthcare Quality in Minneapolis and at the American Nurses Association Quality Conference in Orlando.

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One of the most critical components of this successful bundle was the interprofessional approach that helped us work with our colleagues to find a safer way to deliver care.”

Susan Mascioli, MS, BSN, RN, NEA-BC, CPHQ, LSSBB DIRECTOR, NURSING QUALITY AND SAFETY

ICARE advances Nursing Bundle success Christiana Care introduced a Nursing Bundle dashboard in February 2018 to help patient-care teams track compliance with Nursing Bundle data. The Nursing Bundle combines best practices, including hourly rounding, bedside shift report, leadership rounding, teach-back, service recovery and a quiet environment to promote relationship-based care. Direct care nurses were directly involved in formulating and educating colleagues on the bundle, which is driving top box scores in patient experience. Based on the Institute for Healthcare Improvement’s ISHAPED model, Christiana Care bedside nurses and nurse leaders also created ICARE to more consistently engage patients and families in the plan of care during bedside shift report.

BEDSIDE SHIFT REPORT

QUIET ENVIRONMENT

LEADER ROUNDING

RELATIONSHIPBASED CARE

PURPOSEFUL HOURLY ROUNDING

TOUCH-BACK

SERVICE RECOVERY

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EXEMPLARY PROFESSIONAL PRACTICE DRIVES SUCCESS TOWARD ZERO HARM Christiana Care’s Zero Harm program recognizes a unit’s achievement of no preventable patient harm in 12 consecutive months for any single harm measure. Twenty units are now in their fourth year without harm, led by the Center for Advanced Joint Replacement, which has now exceeded four years in the categories of CAUTI, CDIFF, MRSA and UAPU. The following patient care units achieved Zero Harm Awards in 2018: CAT H E T E R -A S S O C I AT E D U R I N A RY T R AC T

M E T H I C I L L I N - R E S I STA N T STA P H Y LO C O C C U S

INFECTION (CAUTI)

AUREUS (MRSA)

12 months: 3 Medical, 5A Medical, 6W Center for Rehabilitation, Wilmington Intensive Care, 8S Acute Care for the Elderly, Transitional Surgical, 5D Medical, 2E/Cardiovascular Critical Care, 6S Stepdown 24 months: 4C Surgery/GYN, 5C Medical, 6C Stroke Treatment and Recovery 36 months: 4N Medical, Bone Marrow Transplant, 3B/3C/4B Maternity/ Well Mom & Baby, Transitional Medical 48 months: 7S Center for Advanced Joint Replacement, 7E Spine/Joint Replacement

12 months: 3M Medical, 6B Medical, 4W Surgical, 5B Medical, 8S Acute Care for the Elderly, Medical Intensive Care, Transitional Surgical 24 months: 4N Medical, Bone Marrow Transplant, 5E Heart Failure, 4D Surgery Stepdown 36 months: 6A Acute Care for the Elderly, 7E Spine/Joint Replacement, 2C Ortho/Neuro/Trauma Surgery, 4C Surgery/GYN 48 months: 7S Center for Advanced Joint Replacement, 6C Stroke Treatment and Recovery, 4W Surgical, 3A Antenatal Stepdown, 3B/3C/4B Maternity/Well Mom & Baby, Neonatal Intensive Care, 6W Center for Rehabilitation

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Our unrelenting focus on reducing preventable harm ensures that the care we give our patients is exceptional today, and even better tomorrow.”

Catherine Shull Fernald, DNP, RN, RNC-OB, NEA-BC CHIEF NURSING OFFICER, ACUTE CARE

C E N T R A L- L I N E -A S S O C I AT E D B LO O D S T R E A M INFECTION (CLABSI)

12 months: Transitional Neuro, 6A Acute Care for the Elderly, 6B Medical, 4E Cardiac Stepdown, 6C Stroke Treatment and Recovery, Neuro Critical Care, Wilmington Intensive Care, 5B Medical, 3 Medical 24 months: 4N Medical, 3A Antenatal Stepdown, 4W Surgical 36 months: 8S Acute Care for the Elderly, 7E Spine/Joint Replacement Surgery, 7S Center for Advanced Joint Replacement, 2C Surgery, 6W Center for Rehabilitation CLOSTRIDIUM DIFFICILE (C. DIFFICILE)

12 months: 6W Center for Rehabilitation, 6C Stroke Treatment & Recovery, 3N Medical, 4N Medical 24 months: 3B/3C/4B Maternity/Well Mom & Baby 48 months: 4A Pediatrics/GYN, 7S Center for Advanced Joint Replacement

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UNIT-ACQUIRED PRESSURE ULCERS (UAPU)

12 months: 6S Stepdown and Intensive Care, 2C Ortho/Neuro/ Trauma Surgery, 4W Surgical, Transitional Surgical, 6W Center for Rehabilitation, 3M Medical, 8S Acute Care for the Eldery, 6A Acute Care for the Elderly, 7E Medical Intensive Care 24 months: 6E Medical Oncology 48 months: 7S Center for Advanced Joint Replacement, 4C Surgery/GYN FALLS WITH MA JOR INJURY

12 months: 4E Medical Observation, 5B Medical, 2E Cardiovascular Critical Care, Wilmington Emergency Department, 6W Center for Rehabilitation, Christiana Medical Observation, 4A Pediatrics/GYN 24 months: 4N Medical, 5A Medical, 6B Oncology, Surgical Critical Care, 6C Stroke Treatment and Recovery, 6A Acute Care for the Elderly, 7N Psychiatry 36 months: 5D Medical 48 months: Middletown Emergency Department, Medical Intensive Care, Transitional Medical, 5E Heart Failure, 7E Spine/Joint Replacement Center, Wilmington Intensive Care, Cardiac Short Stay, 4C Surgery/GYN, 4D Surgery Stepdown, Transitional Surgical, 3A Antenatal Stepdown, 5C Medical, 2C Surgical ALL FALLS

12 months: Bone Marrow Transplant, OB Triage, Transitional Surgical 36 months: Neonatal Intensive Care

#HitMeWithYourFluShot RNs PARTNER TO VACCINATE THOUSANDS OF CAREGIVERS IN SINGLE DAY In 17 hours at more than 71 Christiana Care locations, 7,868 Christiana Care caregivers were vaccinated against the flu as part of a monumental #HitMeWithYourFluShot vaccination campaign.

The success of the event was a resounding affirmation of Christiana Care’s commitment to protecting the health of its patients, caregivers and community.

“

As caregivers, we have the opportunity to lead by example and show our neighbors how much importance we place on getting a flu shot to keep our community healthy.”

The single-day campaign doubled as a drill to determine Christiana Care’s ability to quickly vaccinate all employees in the event of a bioterrorism attack or other emergency. Nearly 300 caregivers, including 152 RNs, volunteered for this important systemwide effort.

Kathy Wroten, MSN, RN, CIC, FAPIC DIRECTOR, INFECTION PREVENTION

On the big day, Chief Nurse Executive Ric Cuming, Ed.D., RN, NEA-BC, FAAN, participated in live radio interviews as caregivers lined up nearby to lead by example.

The success of the #HitMeWithYourFluShot campaign sparked national media coverage including NBC National News, more than a dozen TV stations and front page newspaper coverage reaching a potential audience of nearly 24 million people across the country!

17

HOURS

71

LOCATIONS

152

RN VOLUNTEER VACCINATORS

6,600 7,868 10,000 FACEBOOK LIVE INTERVIEW VIEWS

View the video

CAREGIVERS VACCINATED

93.8%

✓ Leading by example:

In all, 93.8% of Christiana Care’s workforce was vaccinated for the 2018-2019 flu season, exceeding the goal of 92%

NUMBER OF IMPRESSIONS ON FACEBOOK, TWITTER AND INSTAGRAM

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Andrea Locke, BSN, RN, BNC-NIC N E O N ATA L I N T E N S I V E C A R E

Iisha K. Hackett, BSN, BSW, RN B E H AV I O R A L H E A LT H

Transformational Leadership TRA N SF O R M IN G SYSTE MS A N D T HE EN V IR O N M EN T TO ACH I E V E EXC ELLEN T O U TCOME S

Maria Brown, BSN, RN, PCCN TRANSITIONAL SURGICAL 14

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oday’s nurse leaders are integral in transforming their organization’s values, beliefs and behaviors.

This requires vision, influence, clinical knowledge, and a strong expertise relating to professional nursing practice. Our new professional practice model affords clinical nurses unprecedented opportunity to influence organizational change and advocate for resources through strategic planning that aligns with organizational priorities.

N , Innovations & Imp ledge rove now me K Practice Councils nts w e N

Professional Nurse Council

Off Shift Support Council

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Technology & Innovations Council

Advanced Practice Registered Nurses Council

Nursing Value Council

Research and Evidence-Based Practice Council

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Nursing Executive Council

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Quality and Safety Council

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Administrative Council

Workforce Connection Council

Practice Councils

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More than 60 nursing practice councils provide a forum for practice-area staff to improve care delivery and outcomes that support departmental and organizational goals. Eleven system nursing councils are organized around Magnet model components.

They follow contemporary internal and external evidence-based practice, national professional nursing practice standards, and the ANA Code of Ethics and Scope & Standards of Practice to define and promote professional practice.

Education Development & Advancement Council

e

PROFESSI ONA L G OVE R NA NCE STRUCTURE

onal Governanc fessi eS o r l Empowerment Tea P tru ctura g m u r t n ct S i C o u e n c i c t i c l s a s r P ur ur

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We are curious and continuously look for ways to innovate.

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NURSING VALUE COUNCIL CHAIR: JENNIFER L. MARSCHALOK, BSN, RN-BC

• Hosted quarterly Nursing Assembly presentations.

• Streamlined process for System Nursing Council member application process.

• Assessed progress toward Nursing Strategic Plan.

Transformational Leadership Team

WORKFORCE CONNECTION COUNCIL

EXECUTIVE COUNCIL CHAIR: RIC CUMING, ED.D., RN, NEA-BC, FAAN

• Reviewed operational needs that support clinical and professional nursing practice.

• Established standards for nursing practice consistent with state, national and regional regulations.

• Optimized nursing care delivery systems and multidisciplinary collaboration to allow all nurses to work at top of license.

A D M I N I ST R AT I V E C O U N C I L CHAIR: LAURI L. LITTLETON, MSN, RN-BC, NE-BC

• Restructured council as a vehicle to identify, develop and implement initiatives related to health system strategic aims.

Transformational Leadership

• Assisted with systemwide initiatives, including emergency preparedness roll-out across inpatient units, new nurse leader face cards for patients and families and format changes to data dashboards.

• Continued to advance organizational strategic goals, including caregiver collaboration, compliance with the nursing bundle and prevention of back injuries.

CHAIR: KATHY CRAWFORD, MSN, RN, CCRN

• Implemented a Float Ambassador program to assist/educate staff pulled to other units on unit-specific initiatives for better patient outcomes; created a task force to review weekend rotations to assess the ongoing sufficiency of the nursing staffing plan; and developed strategies to retain nurses eligible for retirement by exploring information gaps relating to the retirement process.

• Assessed and researched techniques for reducing horizontal violence and incivility. collaborated with Human Resources to develop an Incivility/Bullying Policy; established the Blue Bell award to highlight a caregiver who demonstrates civil courage; provided feedback to senior leadership on discriminatory requests, disruptive behavior policies and behavioral contracts.

• Implemented nursing-specific components of the capacity plan and identified barriers to utilizing the discharge lounge; added education to the Charge Nurse Orientation Workshop and new nurse orientation checklist; created detailed response plans to assist managers in supporting staff during changes in capacity surge.

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Exemplary Professional Practice Team

ADVANCED PRACTICE REGISTERED NURSES COUNCIL CHAIR: TINA M. HENDLER, MSN, APRN, NNP-BC, RN

• Increased collaboration with physician assistants through creation of the APC Leadership Council; supported planning of first annual APC recognition dinner with guest speaker.

• Standardized provider orientation and clinician onboarding, including checklist, competencies and EMR training for ambulatory providers.

• Streamlined the APRN student placement process and created mentoring program specific for APCs, and supported education and professional development through APRN grand rounds, annual pharmacology conference and annual town hall meeting with chief nurse executive.

Structural Empowerment Team

E D U CAT I O N D E V E LO P M E N T & ADVANCEMENT COUNCIL CHAIR: CHRISTINA HODDINOTT, MSN, RN IV,

CEN, CPEN

• Led clinical ladder promotion, maintenance and recognition.

• Supported master’s prepared nurses becoming RN IVs as expert clinicians in their practice environment.

• Coordinated Education Development & Advancement clinical ladder retreat, Rising Star and Dot Fowler awards; supported certification awards, Preceptor Excellence Award, certification recognition and BSN recognition.

QUALITY & SAFETY COUNCIL CHAIR: LAUREN J. ROSENTHAL, BSN, RN, CCRN

• Collaborated with key stakeholders and provided feedback and decision-making on numerous quality and safety nursingpractice-related topics.

• Developed a framework and process flow for an Event-Based Nursing Peer Review committee.

• Partnered with the Administrative Council and key stakeholders to promote staff safety by developing and implementing an action plan to reduce nurse lost time related to neck and back injuries and monthly data monitoring on injury rates.

PROFESSIONAL NURSE COUNCIL CHAIR: PAIGE MERRING, BSN, RN, CCRN

• Presented monthly DAISY Awards for Extraordinary Nurses, DAISY Leader Award and DAISY Team Award.

• Coordinated Healer’s Touch ceremonies at Christiana and Wilmington Hospitals.

• Hosted Excellence in Nursing Awards to meaningfully recognize exceptional nursing care.

OFF-SHIFT SUPPORT COUNCIL CHAIR: AMELIA A. TOLSON, MSN, RN, RNC-NIC

• Collaborated with Facilities & Services to open a self-serve food market at the Wilmington Hospital for off-shift employees.

New Knowledge, Innovations & Improvements Team RESEARCH & EVIDENCE-BASED NURSE PRACTICE COUNCIL CHAIR: TARA SALVADORI, MSN, RN-BC

• Championed evidence-based practice and research focus for all Nursing grand rounds; promoted nurse reporting of projects and presentations and assisted with establishment of project repository for RN III and RN IV projects.

• Created pre-education tool for nurses registered for Ask It in a Poster class and worked collaboratively with Nursing Research and Evidence-Based Practice to reorganize the class to include the Johns Hopkins EBP education.

• Piloted virtual journal club for nurses with Surgical Services.

TECHNOLOGY & I N N OVAT I O N S C O U N C I L CHAIR: BRIANNA BUZZARO, MSN, RN, CEN, TCRN

• Launched go-live of immunization history through Cerner.

• Single sign-on capabilities reached 2,000 users.

• Ended the process of printing paper requisitions for discontinued orders.

• Developed resource list of frequently utilized contacts for off-shift staff.

• Coordinated with Virtual Education and Simulation Training Center to offer basic life support and advanced cardiac life support education during off-shifts.

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PARTNER WITH LEADERSHIP ON NEW BEHAVIORAL HEALTH UNIT Christiana Care nurses were integral to the design of an expanded inpatient Behavioral Health Unit that welcomed its first patients in 2018. Nurses’ input from the very beginning and throughout the construction process helped create a state-of-the-art facility that incorporates the latest design, programming and safety advances to improve patient and family experience and provide optimal care.

Nurse Manager Steven Beltran, MSN, RN-BC, said the ability for nurses to put their signature on the unit through open dialogue with the design and construction teams was a highlight for staff. Frontline caregivers find it equally meaningful to see their patients’ reaction to the warm, welcoming environment.

“

Allowing nurses to put our signature on the unit speaks to how Christiana Care trusts, respects and values nurses. We’re not just here to work, we’re here to drive change.”

Steven Beltran, MSN, RN-BC NURSE MANAGER

KATHERINE COLLARD JOINS CHRISTIANA CARE AS FIRST CHIEF NURSING INFORMATICS OFFICER

Transformational Leadership

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Katherine A. Collard, MS, RN-BC, NP, was appointed chief nursing informatics officer, responsible for the strategy and implementation of information technology (IT) systems that directly impact Christiana Care nurses. An experienced IT systems implementer and a strong advocate for her nursing colleagues, she provides insight to various technology strategies to facilitate desired nursing business processes. Before joining Christiana Care, Collard had a substantial tenure at The State University of New York Stony Brook, where she held various roles, including chief nursing information officer and director of clinical transformation.

C H R I S T I A N A C A R E H E A LT H S Y S T E M

VNA PREPARES NEXT GENERATION OF HOME HEALTH NURSING LEADERS A nurse-led team created an innovative plan to identify and prepare highperforming Visiting Nurse Association caregivers destined for the path to promotion as leaders in home health nursing.

Four clinical staff nurses identified by their managers as demonstrating leadership attributes were promoted to leadership positions in 2018. Key to the success of this internal advancement program to create the next generation of transformational leaders is the commitment by VNA nurse leaders to: • Discuss growth opportunities, jointly set development plans and meet regularly with team members to discuss progress on the path to promotion.

• Present leadership experiences, such as team meetings, projects, interim management opportunities and increased committee membership.

• Provide MSN tuition reimbursement to prepare clinical nurses for leadership roles.

Lori Davis-Palmer, MSN, RN, COS-C, who joined VNA nearly 20 years ago as a field nurse, recently advanced through a series of promotions to her current position as administrator and clinical director of operations and clinical services for VNA’s Camden branch.

“VNA’s commitment to supporting the professional development goals of aspiring leaders gives nurses hope to create change and fosters innovation where nurses are able to make a positive impact on the organization,” Davis-Palmer said.

“

• Recommend identified staff for system and industry continuing education.

Guiding our own high-performing nurses on the path to promotion strategically addresses an unprecedented need for innovative, invested leaders versed in the unique regulatory, reimbursement and telehealth challenges of home health nursing.”

Ann Painter, MSN, RN SENIOR VICE PRESIDENT, HOME HEALTH & COMMUNITY SERVICES TEAM LEADER

Systemwide Promotions to Nurse Leadership

FELISHA E. ALDERSON, MSN, RN, CRRN Director of clinical operations, Heart & Vascular Interventional Services and HVIS Prep and Holding MELISSA BOLINGER, MBA, BSN, RN Director of operations, Value Institutte MELISSA CROSSAN, MSN, APRN, FNP-BC, CEN Nurse manager, Emergency Department Observation Unit, Christiana Hospital

CHRISTOPHER OTTO, BSN, RN III, CHFN, PCCN, CCRN Manager, Nursing Professional Excellence LISA HALBERT, BSN, RN, CCRN Nurse manager, Neuro Critical Care Unit and Transitional Neuro Unit, Christiana Hospital

ASHLEE RIDGLEY, MSN, RN-BC Nurse manager, Acute Care for the Elderly Unit, Wilmington Hospital

LYNDA M. HUSELTON, MSN, MSM, RN-BC Nurse manager, Heart Failure Unit, Christiana Hospital

MEGAN SMAKULSKI, MSN, MBA, RN, PCCN Nurse manager, Transitional Medical Unit, WICU and Step-Down, Wilmington Hospital

MICHAEL KNORR, MSN, RN, PCCN Vce president, Patient Care Services, Acute Medicine Service Line

ANDREA SWEENY, MSN, RN-BC Nurse manager, Cardiovascular Stepdown Unit, Christiana Hospital

SHANNON MENEI, MBA, BSN, RN III Director, Case Management

DANIELLE WEBER, MSN, MS, RN-BC, NEA-BC Vice president, Patient Care Services

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Timothy Cannon, MSN, RN II MEDICAL

S H A R E D DE C I S I O N - MA KI NG A N D TH E C O MMI TME NT TO C O N TI N U OU S L E A R NI NG , E DU CATI ON A N D CA R EER A DVA N C E ME N T

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C H R I S T I A N A C A R E H E A LT H S Y S T E M

P

rofessional development, continuing education, community involvement and participation in interprofessional decision-making groups and professional organizations enable nurses to foster strong relationships and interdisciplinary partnerships that truly transform nursing practice.

The Structural Empowerment model component also supports the health system in recognizing our extraordinary nurses for their professional contributions that address strategic priorities within the organization and influence the clinical care of those we serve.

N URSING E XC ELLENCE SURV EY RESULTS AR E. . . EXC EL L EN T !

Christiana Care outperforms national benchmark in all seven Magnet domains on 2018 Nursing Excellence Survey Christiana Care outperformed national benchmarks and improved over its own scores from the 2016 survey in all seven Magnet categories of the most recent Press Ganey Nursing Excellence Survey. The survey looks at nurse satisfaction and engagement in performance areas determined by the American Nurses Credentialing Center.

“

Our engaged, exceptional nurses have spoken. We are ripe for improvement and empowered to drive change to make the environment even better for nurses, our colleagues, our patients and their families.”

Michelle Collins, DNP, APRN, CNS, ACNS-BC, RN-BC, NEA-BC, LSSBB DIRECTOR OF MAGNET RECOGNITION

A N C C C AT E G O R Y P E R F O R M A N C E S C O R E S 5.0

Christiana Care Overall

4.0

3.0

3.55 3.50

3.99 3.91

JAN 2019 National Average

4.29

4.14

3.93 3.82

4.07

3.89

4.26

3.98

4.38 4.27

2.0

1.0

0.0

Adequacy of Resources & Staffing

Autonomy

Fundamentals Interprofessional Leadership of Quality Access & Relationships Nursing Care Responsiveness

Professional Development

RN to RN Teamwork & Collaborations

Moving from good to great Compared to 2016 responses, rated the health S U M M A RChristiana Y B Y C ATCare E G O nurses RY system Category higher in all categories, with the greatest increase in the opportunity Christiana Care Overall JAN 2019 National Average areas ofAdequacy Adequacy of Resources and Staffing Access and of Resources 355.00% and Leadership 350.00% & Staffing Responsiveness.

Christiana Care nurse response most notably elevated 2 Christiana Care above national scores for Professional Development, citing quarterly coaching check-ins by management as valuable. The survey reflects robust advancements in nursing practice at Christiana Care in the last two years under the leadership of Chief Nurse Executive Ric Cuming.

“Christiana Care leadership is listening to nurses and investing in programs to further engage these extraordinary members of our care team,” said Susan Mascioli, MS, BSN, RN, NEA-BC, CPHQ, LSSBB, director, Nursing Quality and Safety. “These impressive results speak to the caliber of our staff and leaders. They are further proof that Christiana Care nurses see this as a great place to work and are committed to being exceptional today, and even better tomorrow.”

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Structural Empowerment

NURSING ADVANCEMENT SCHOLARSHIP PROGRAM SUPPORTS PROFESSIONAL GROWTH AND ADVANCEMENT Christiana Care continues to invest in the ongoing professional development of our nursing staff. Along with 10 academic partners, the health system offers support for an RN-to-BSN Degree Program and expanded the Nursing Advancement Scholarship Program in February 2018.The program aligns with the National Academy of Medicine goal to achieve a predominantly BSN-prepared workforce by 2020.

DNP

77%

NURSES WITH A BSN OR HIGHER

34

DOCTORAL-PREPARED NURSES

50%

OF ELIGIBLE NURSES WITH SPECIALITY CERTIFICATION (REPRESENTING MORE THAN 100 SPECIALTIES)

We are true to our word and follow through on our commitments.

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11 NURSES ACHIEVE DOCTORAL DEGREES IN 2018 Congratulations to our nurse colleagues who demonstrated their commitment to be exceptional today, and even better tomorrow by achieving the highest academic accomplishment: MICHELLE COLLINS, DNP, APRN, CNS, ACNS-BC, RN-BC, NEA-BC, LSSBB Wilmington University Nursing Professional Practice Models: Impact on Medical Nurse Empowerment and Job Satisfaction LINDSAY DOUGHERTY, DNP, AGNP-BC Temple University Increasing Advance Directive Completion Rates: An Education Practice Change in Homebound Geriatric Patients

LIJA GIREESH, DNP, APRN, FNP-BC, COHN-S Drexel University Feasibility of an Evidence-Based Stretching Program on Healthcare Worker Pain Scores and Professional Quality of Life NICOLE M. HEAP, DNP, APRN, FNP-C Wilmington University Improving Nursing Documentation of Target Temperature Management to Monitor Adherence to Current Guidelines and Recommendations PAMELA JIMENEZ, DNP, APRN, FNP-BC/PNP-BC Wilmington University Treatment Impact and Neurobehavioral Effects of Neonates with Intrauterine Exposure to Buprenorphine versus Methadone LATONYA E. MANN, DNP, FNP-BC, OCN Wilmington University Evaluation of Symptom Management in Patients with Advanced Stage Non-Small Cell Lung Cancer Referred to Supportive and Palliative Care

2018 NURSE RESIDENCIES

DONNA MOWER-WADE, DNP, APRN, ACNS-BC, CNRN Wilmington University Implementation of a Standardized Approach to the Management of Headache PostSubarachnoid Hemorrhage LORRAINE A. NOWAKOWSKI-GRIER, DNP, MSN, APRN, BC, CDE Wilmington University The Impact of Implementing an Inpatient Diabetes Nurse Mentor Program on the 30-Day Readmission Rate among Diabetic Patients JENNIFER PAINTER, DNP, APRN, CNS, NEA-BC, RN-BC, OCN, AOCNS, LSSBB Wilmington University Development & Evaluation of a Primary Care Nurse Practitioner Residency Program in Delaware

BRITTANY RHOADS, DNP, APRN, NP-C Wilmington University Implementation of a Standardized Pain Quality Assessment Tool

BARBARA V. WILSON, DNP, CNS, APRN-BC, RNC Wilmington University Implementation of an Interventional Radiology Patient Tracking Registry Post Chemoembolization and Radioembolization

Christiana Care’s paid nurse residency programs support newly graduated RNs in their transition to practice.

RESIDENCY FACTS

✓ Transitional, float and

critical care nurse residencies increased to three cohorts per year.

✓ Entry-level associate

degree nurses became eligible for nurse residencies.

• Critical Care Nurse Residency • Emergency Department Nurse Residency • Labor and Delivery Nurse Residency • Neonatal Nurse Residency • Perioperative Nurse Residency • Float Pool Nurse Residency • Medical and Surgical Nurse Residency • Transitional Care Nurse Residency

2018 NURSE FELLOWSHIPS Fellowship programs prepare nurses as leaders and clinical experts in their specific area of practice.

• Advanced Practice Clinician Fellowship • Emergency Department Fellowship • Post-Anesthesia Care Unit Fellowship • Operating Room Fellowship

Advanced Practice Clinician Fellowship broadens membership, adds second cohort The newly renamed Advanced Practice Clinician Fellowship was expanded in 2018 to help nurse practitioners and now physician assistants bridge the gap between education and practice. The fellowship also expanded to two six-member cohorts each year.

Nurses flourish in PACU Fellowship With the 2018 completion of the third cohort of PostAnesthesia Care Unit (PACU) Fellows, nine motivated and experienced medical/surgical RNs have now successfully transitioned to independent practice in the highly specialized fast-paced critical-care environment.

The fellowship strengthens astute critical thinking and time management skills essential for critical care nursing success. PACU Fellows are supported by a mentor and, in turn, will mentor RN colleagues in future cohorts.

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AWARDS AND RECOGNITION Christiana Care nurses are consistently honored for their exceptional clinical skills, compassion, respect and partnership.

THE 2018 DAISY AWARDS FOR EXTRAORDINARY NURSES Presented by the Professional Nurse Council, DAISY Awards for Extraordinary Nurses recognize colleagues who meet and exceed the needs and expectations of patients and their families by demonstrating exceptional clinical skills, compassion, respect and partnership. Christiana Care joins more than 3,400 health care facilities and schools of nursing in all 50 states and 20 other countries to honor nurses with this tribute.

DAISY Honorees JOY ALLEN-COLEMAN, BSN, RN, CAPA Roxana Cannon Arsht Surgicenter, Wilmington Hospital

ASHLEY JACKSON, RSN, RN, CLC Postpartum, Christiana Hospital

KIM BALOGUN, M.ED, BSN, RN Emergency Department, Wilmington Hospital

GRACE NGAMAU, MSN, MSM/HCA, RN Maternity, Christiana Hospital

NICOLE BELL, BSN, RN, CCRN Neuro Critical Care Unit, Christiana Hospital

STEPHANIE NEIFERT, RN Emergency Department, Wilmington Hospital

PAMELA BOYD, MSN, RN, CNOR Medical, Christiana Hospital

NIKKI MARIE RECCHIONI, BSN, RN, CEN, CPEN, TCRN Emergency Department, Christiana Hospital

BARBARA DEAN, BSN, RNC-NIC, CPLC Neonatal Intensive Care Unit, Christiana Hospital

STEPHANIE TROYAN, BSN, RN, VA-BC Medical Intensive Care Unit, Christiana Hospital

JEAN LARSON, RN Radiology Nursing, Christiana Hospital

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JENNIFER VANSANT, BSN, RN Visiting Nurse Association

“

The DAISY Award celebrates the positive impact our nurses have on the lives of others. It allows our community to honor and say thank you to outstanding nurses throughout the year.”

Tammy Layer, MSN, RN, OCN CHAIR, PROFESSIONAL NURSE COUNCIL

DAISY Team Award CARDIOVASCULAR CRITICAL CARE COMPLEX

“ Beyond their obvious skill and knowledge, it was the compassion of these nurses that impressed us most.

Our family is eternally grateful to all of the nurses in the CVICU for their extraordinary care of our brother.”

Excerpt from the DAISY nomination of the Cardiovascular Critical Care Complex

DAISY Leader Award DEBORAH AYRES-HARDING, MSN, RN-BC Assistant nurse manager, Inpatient Psychiatry, Christiana and Wilmington hospitals

“ Nothing is beneath a nurse leader. I am their backup, not their charge nurse. That gives them an opportunity to lead.”

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CHRISTIANA CARE EARNS FOUR MORE BEACON AWARDS FOR CRITICAL CARE NURSING EXCELLENCE Four patient care units at Christiana Care earned Beacon Awards for nursing excellence in critical care from the American Association of Critical Care Nurses in 2018. The Transitional Surgical Unit, Medical Intensive Care Unit and The Lanny Edelsohn, M.D., Neuro Critical Care Unit each earned silver Beacons and the Cardiology Short Stay Unit earned bronze. The Medical Intensive Care Unit has consistently held Beacon designation since 2009.

Awards and Recognition

“

The Beacon stamp of nursing excellence is a humbling honor and one that reminds us of how we can inspire each other to continually strive for being great today and even better tomorrow.”

Kristen C. Foulk, MSN, MS, RN, PCCN, NE-BC NURSE MANAGER, TRANSITIONAL SURGICAL UNIT

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CHRISTIANA CARE’S CRITICAL CARE UNITS AWARDED 8 OF THE 9 BEACONS IN DELAWARE

JUNIOR BOARD GIFTS SYMBOLIZE EXCELLENCE AND LOVE IN NURSING A pair of three-foot African sculptures that represent a patient and caregiver holding one another now have places of honor in the lobbies of Christiana and Wilmington hospitals as a symbol of excellence and love in nursing thanks to a generous gift by The Junior Board of Christiana Care. Carved from serpentine by artists of the Shona tribe of Zimbabwe for the international DAISY Foundation, the sculptures recognize nurses around the world for their extraordinary care. A smaller, personal version of the Healer’s Touch sculpture is presented to every nurse honored worldwide with a DAISY Award for Extraordinary Nurses. The Junior Board also generously gifted $36,051 from The Ruth Shaw Fund to support the Endowed Emergency Fund for Nurses.

“

I look forward to passing The Healer’s Touch every day and pointing it out to colleagues and guests as a beautiful reminder of our nurses’ leadership in our commitment to serve together.”

Janice E. Nevin, M.D., MPH PRESIDENT AND CEO

We anticipate the needs of others and help with compassion and generosity.

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SURGEON’S GIFT HONORS NURSES’ CARE, COMPASSION AND PROFESSIONAL SKILL A generous gift to Christiana Care from Mohammed Chaudry, M.D., expressed the vascular surgeon’s gratitude to his extraordinary nursing colleagues on the health system’s Transitional Surgical Unit for the exceptional care they gave his father following surgery for metastatic prostate cancer.

Night and day for nearly two weeks, the surgeon witnessed firsthand the remarkable way the nurses worked with his father. With their help, the elder Chaudry recovered well enough to return to his home in Baltimore, where he maintained a fighting spirit to the very end.

“

These extraordinary nurses helped my father heal and gave him the most meaningful couple of months of his life.”

Mohammed Chaudry, M.D.

Awards and Recognition

VASCULAR SURGEON, CHRISTIANA CARE CENTER FOR HEART & VASCULAR HEALTH AND GRATEFUL SON

LOESSNER FUND UNDERWRITES RELATIONSHIP-BASED CARE TRAINING The Loessner Fund for Professional Practice Education for Nurses — generously established by long-time Christiana Care Trustee Arno “Skip” Loessner and his wife, Mary, in appreciation for care shown to their family by Christiana Care’s extraordinary nurses — helped to underwrite two days of high-level practice education in September 2018. Interdisciplinary caregivers from the Wilmington Hospital Emergency Department, Intensive Care, Stepdown and Medical units, as well as from Environmental Services and Pharmacy, participated in See Me As a Person: Therapeutic

Practices Clinician Core Competencies. The training promotes relationship-based care techniques to strengthen outcomes in safety, patient care and readmission rates.

“

See Me As a Person has changed the culture on our unit. The feedback from patients and staff is absolutely amazing!”

Jane James, MSN, RN-BC NURSE MANAGER, MEDICAL, WILMINGTON

Your support can help As a not-for-profit health system, Christiana Care relies in part on the generosity of individuals and organizations to support its mission of service to the community. Learn about ways to recognize nursing excellence at christianacare.org/donors.

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MORE THAN 50 NURSES ADVANCE ON HIGHEST RUNGS OF CLINICAL LADDER The Nursing Professional Advancement Program’s clinical ladder recognizes and rewards experience, knowledge and clinical expertise, allowing frontline nurses to continually improve their skill set and practice at the top of their license. Congratulations to the following colleagues who achieved RN III and RN IV status in 2018, including our first ambulatory RN III from the Community Care team.

RN III — Proficient These nurses hold a BSN or MSN and three years of acute or subacute nursing experience; have advanced knowledge and skills and are viewed as mentors, resources and leaders: KIMBERLY BRINTON, BSN, RN III, CCRN Medical Intensive Care Unit

GRACE LINDSEY JORDAN, BSN, RN III, RN-BC, PCCN Cardiovascular Critical Care Complex

NIKKI RECCHIONI, BSN, RN III, CEN, CPEN, TCRN Christiana Emergency Department

REBECCA BROWN, BSN, RN III, CCRN Neuro Critical Care Complex

AMARJIT KUMARI, BSN, RN III, RN-BC Acute Care for the Elderly

LISA CAMPBELL, BSN, RN III, RN-BC Medical Stepdown

SAWDIA LETNIANCZYN, BSN, RN III, CHFN Heart Failure

CHRISTINE RENZULLI, BSN, RN III, CCRN Float Pool

GIRLENE CARINO, MSN, RN III, CNOR Christiana Operating Room

GRACE LINDSEY-JORDAN, BSN, RN III, RN-BC, PCCN Cardiovascular Critical Care Complex

MARYBETH CHAMBERS, BSN, RN III, CCRN Intensive Care Unit

ANDREA LOCKE, BSN, RN III, RNC Neonatal Intensive Care Unit

JACQUELINE CHASE, BSN, RN III, CCRN Transitional Surgical Unit

KRISTIN MACEY, BSN, RN III, RN-BC Acute Care for the Elderly

KIERSTAN CIACH, BSN, RN III, PCCN Stepdown

ALEXA MALONEY, BSN, RN III, RN-BC, OCN Radiation Oncology — 1st RN III from the Community Care team!

ASHLEY CONNELL, BSN, RN III, RN-BC Acute Care for the Elderly REBEKAH CRAWFORD, BSN, RN III, SCRN Neuro Critical Care Complex COURTNEY CRUZ-CASTENEDA, MSN, RN III, RN-BC Acute Care for the Elderly LYNN CZECH, BSN, RN III Wilmington Dental Office ROBYN M. DOUGHERTY, BSN, RN III, CCRN Transitional Surgical Unit LAUREN DUFFIELD, BSN, RN III, RN-BC Heart Failure CHARLES EVANS JR., BSN, RN III, PCCN Stepdown ELAINE FARR, BSN, RN III, RN-BC Transitional Neuro Unit TRACY FLITCRAFT, BSN, RN III, CRN Heart & Vascular Interventional Services NICOLE GLENN, BSN, RN III, RN-BC Center for Advanced Joint Replacement EMILY GORRIN, BSN, RN III, RN-BC Medical KATELYN HAYES, BSN, RN III, RN-BC Surgical Stepdown MATTHEW HERTZ, MSN, MSM, RN III, CEN Critical Care Transport VALERIE JENNINGS, BSN, RN III, RN-BC Medical Stepdown

KRISTIN MARTIN, BSN, RN III, OCN Oncology MARLENE MCCORMAC, BSN, RN III, VA-BC Vascular Access Nursing MAHOGANEY MCCRAE, BSN, RN III, RNC-NIC, CPN Neonatal Intensive Care Unit REBECCA MCINTIRE, ASN, BA, RN III, CCRN Cardiovascular Critical Care Complex PAIGE MERRING, BSN, RN III, CCRN Medical Intensive Care Unit KAREN MILILLO, BSN, RN III, CCRN Center for Rehabilitation

EMILY RIDDICK, BSN, RN III, RN-BC Transitional Medical Unit LEE SCHIAVONI, BSN, RN III, CEN Middletown Emergency Department SUSAN SINIGAGLIO, MSN, RN III, CCRN Cardiac Rehabilitation STACIE SMITH, BSN, RN III, CEN Wilmington Emergency Department RENEE STERANKO, BSN, RN III, CEN, CPEN Christiana Emergency Department CHANEL THOMAS, BSN, MA, RN III, RN-BC Medical Stepdown AMANDA VICKERS, BSN, RN III, CCRN Neuro Critical Care Complex BRIAN WHARTON, MSN, RN III, CPEN Christiana Emergency Department BRITTANY WHITE, BSN, RN III, CCRN Surgical Critical Care Complex DANIEL ZIROLLI, BSN, RN III, CCRNE Hemodialysis SAMANTHA ZIZZA, BSN, RN III, OCN Oncology

KAREN MURPHY, BSN, RN III, PCCN Emergency Department Observation SARA O’BRIEN, MSN, RN III, TCRN Christiana Emergency Department HELLEN A. OKOTH, BSN, RN III, RN-BC Transitional Surgical Unit JASMIN ORANGE, BSN, RN III, CCRN Medical Intensive Care Unit CHRISTOPHER E. OTTO, BSN, RN III, CHFN, PCCN, CCRN Cardiovascular Critical Care Complex JUSTINE PAINTER, BSN, RN III, CEN Christiana Emergency Department JESSICA PETERS, MSN, RN III, CEN Christiana Emergency Department SHERRIE POWELL, BSN, RN III, RN-BC Transitional Medical Unit NURSING ANNUAL REPORT 2018

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RN IV — Expert Clinician These nurses served as an RN III for at least two years, have five years of acute or subacute nursing experience and at least three years in a specialty; hold a master’s degree; have chaired or served as project leader of a council or task force; are acknowledged as role models to peers; are active in a relevant professional organization and volunteer in community activities; are recognized for clinical expertise and leadership at the bedside; and demonstrate community involvement and the ability to direct, support and influence nursing practice: KATHERINE CRAWFORD, MSN, RN IV, CCRN Medical Intensive Care Unit

CHRISTINA HODDINOTT, MSN, RN IV Wilmington Emergency Department

NATIONAL AND REGIONAL RECOGNITION NURSE NAMED FULBRIGHT SCHOLAR

Rachel Joseph, DNP, RN, CCRN, of the Neonatal Intensive Care Unit and a Value Institute Scholar, is the first Christiana Care nurse to win a prestigious Fulbright Scholarship. Dr. Joseph used the grant through the Core Fulbright U.S. Scholar Program to advance her project, Empowering Nurses to Enhance Children’s Health, at the Jordan University of Science and Technology between January and May 2019.

Awards and Recognition

“

We are exceptionally proud for one of our own to represent Christiana Care internationally as an esteemed Fulbright Scholar.

This distinct honor elevates Christiana Care to the world stage in demonstrating the direct and meaningful impact nurses have in addressing health disparities.”

Ric Cuming, Ed.D., RN, NE-BC, FAAN CHIEF NURSE EXECUTIVE

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CAROL ABDILL, MSN, RN, CRNI Was appointed to the Delaware Board of Nursing as a member at large.

CYNTHIA GRIFFIN, MS, BSN, RN, CPHQ, CCM Is one of 23 senior level nurse executives throughout the nation selected for an inaugural AONE Nursing Executive Fellowship cohort by the AONE.

KANDIE DEMPSEY, DBA, MS, RN, OCN Received a 2018 Outstanding Administrator Award from the National Cancer Institute Community Oncology Research Program.

DENISE L. LYONS, DNP, APRN, AGCNS-BC Was appointed affiliated assistant professor in the School of Nursing in the College of Health Sciences at the University of Delaware.

COLEEN DEVER, APRN Received a Journal of Trauma Nursing writing excellence award for her manuscript, “Treating Acute Pain in the Opiate-Dependent Patient,” at the Society of Trauma Nurses TraumaCon conference.

NICOLE MCCARRY, BSN, RN Won a 2018 Champions of Service award as part of the prestigious Jefferson Awards program, which honors individuals for excellence in community and public service to our nation. McCarry was Christiana Care’s delegate to the national Jefferson Awards celebration.

SARAH FLANDERS, MSN, RN-BC, CEN Was selected for the American Organization of Nurse Executives (AONE) Nurse Manager Fellowship.

CHRISTIANA CARE’S WOUND, CONTINENCE & OSTOMY NURSE TEAM, LED BY LOIS M. DIXON, MSN, APRN, AGNP-C, RN-BC, CWOCN Achieved 100 percent certification in 2018 in all three specialties.

C H R I S T I A N A C A R E H E A LT H S Y S T E M

The Christiana Care Way We serve our neighbors as respectful, expert, caring partners in their health. We do this by creating innovative, effective, affordable systems of care that our neighbors value.

T H E 2018 C HRISTIA NA CA RE WAY AWA RD S The Christiana Care Way Awards reflect the innovative work and partnership of Christiana Care’s extraordinary caregivers to achieve optimal health and exceptional experiences for the people we serve and for each other, as well as organizational vitality for the system. These awards exemplify the love and respect our caregivers show to each other, by committing to be Exceptional Today, and Even Better Tomorrow. Congratulations to the 2018 nurse-led winning performance improvement teams.

“

It is a pleasure to watch how teams come together to drive improvements that benefit our patients and the community we serve.”

Sharon Anderson, MS, BSN, RN, FACHE CHIEF POPULATION HEALTH OFFICER AND SENIOR VICE PRESIDENT, QUALITY AND PATIENT SAFETY

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T HE 2 01 8 C H RI STI ANA CARE WAY AWARD S Magnet Transformational Leadership Gold Award ED to Stepdown: Optimizing Patient Flow & Boarding Times NURSE LEADERS: KRISTEN C. FOULK, MSN, MS, RN, PCCN, NE-BC; LYNDA M. HUSELTON, MSN, MSM, RN-BC; LINDA LASKOWSKI JONES, MS, APRN, ACNS-BC, CEN, FAWM, FAAN, CLINICAL CHAMPION; SONYA M. STOVER, MSN, RN, CCRN, NE-BC, ANDREA SWEENEY, MSN, RN-BC; KAREN TOULSON, MSN, MBA, RN, CEN, NEA-BC; AND MICHELLE WHEELER, BSN, MS, RN, CNML Magnet Transformational Leadership Silver Award Improving Access to Trauma Care — Building a Level 3 Trauma Program NURSE LEADERS: LINDA LASKOWSKI JONES, MS, RN, ACNS-BC, CEN, FAWM; JOAN PIRRUNG, MSN, APRN, ACNS-BC; MARY LAMBORN, MSN, MBA, FNP, CEN; PAMELA WOODS, RN, ACNS-BC, CEN AND MARILYNN BARTLEY, DNP, APRN, FNP-BC Magnet Exemplary Professional Practice Gold Award If UAPI and You Know It: Reducing Unit-Acquired Pressure Injuries by 50% NURSE LEADERS: KIMBERLY TALLEY, MSN, RN, CRNP, CNML-BC, FAWN; KAREN MCCLOUD, MS, BSN, RN-BC, NE-BC; LINDSAY SANDERSON, MSN, BS, RN-BC; MARLOW BOWSER, BSN, RN-BC; HEATHER BRACKEN, MSN, RN-BC; AND MEGAN SUNGAIL, MSN, RN III Magnet Exemplary Professional Practice Silver Award and Peoples Choice Award Reducing Unit-Acquired Pressure Injuries on 4E NURSE LEADERS: JANET MACHULSKI, BSN, RN, PCCN, RN III; COLLEEN MCGHIE, BSN, RN-BC, RN III; EVALYNE MWANGI, BSN, RN, PCCN, RN III AND BARBARA VOGEL, BSN, RN, PCCN, RN III Magnet New Knowledge, Innovations & Improvement Award VR — Chemotherapy Suite Positive Distraction See story, page 3 NURSE LEADERS: JORDAN POLIFRONI-WILLIAMS, BSN, RN, OCN AND CYNTHIA WADDINGTON, MSN, RN, AOCN, NE-C

Magnet Structural Empowerment Gold Award Delirium Scoring on ICU Patients NURSE LEADERS: BETHANY HIRIAK, MSN, CCRN, RN III AND KARI MIMNAUGH, BSN, RN, CCRN Magnet Structural Empowerment Silver Award Improving Stroke Measures in the NCCU NURSE LEADERS: JACQUELIN SUNKLER, MSN, RN IV, CCRN, SCRN AND LAUREN SMOCZYNSKI, BSN, RN III, CCRN Good Catch Award Christiana Gastrointestinal Lab Nursing Staff NURSE LEADER: JACQUELINE GRAU, RN Operational Improvement Gold Award Signing is Vital: Multidisciplianry Collaboration to Reduce Unsigned Orders NURSE TEAM LEADERS: MARY STIRPARO, MSN, RN, NE-BC AND CHRISTOPHER OTTO, BSN, RN, CHFN, PCCN, CCRN Operational Improvement Bronze Award Chest Pain Pathway Reduces Length of Stay in Cardiology Observation Patients NURSE LEADERS: CHRISTINA DIMARCO, MSN, FNP-BC; ADRIENNE THORNE, MSN, AGACNP-BC; ADEYOYIN ESAKA, MSN, FNP-BC AND ELISABETH BRADLEY, MS, AGPCNP-BC, ACNS-BC Exceptional Experience Gold Award Nursing Bundle for Patient Experience NURSE LEADERS: PAMELA S. BOYD, MSN, RN, CNOR; MICHELLE COLLINS, DNP, RN-BC, APRN, CNS, ACNS-BC, LSSBB; RIC CUMING, ED.D., RN, NEA-BC, FAAN, CLINICAL CHAMPION; BARBARA L. FEENY, MSN, RN-BC, HN-BC; MIKE KNORR, MSN, RN, PCCN; MELVA A. LANE, BSN, MBA, RN-BC; LINDA LASKOWSKI JONES, MS, APRN, ANCS-BC, CEN, FAWM, FAAN; GREG O'NEILL, MSN, APRN, AGCNS-BC, RN-BC, LSSGB; CHRISTOPHER E. OTTO, MSN, RN, CHFN, PCCN, CCRN; JENNIFER PAINTER, DNP, APRN, AOCNS, OCN, RN-BC, LSSBB; KIMBERLY TALLEY, MSN, RN, APRN, CNML-BC, LSSGB, FABC; JUDY TOWNSLEY, MSN, RN, CPAN, NEA-BC, FACHE AND SANDY WAKAI, MSN, RN, CCRN-K Exceptional Experience Silver Award Staying in Line Decreases Time NURSE LEADERS: LORI MECK, MSN, RN-BC, TNCC, RN III AND COURTNEY SLAWSON, BSN, RN-BC, RN II, TNCC

Awards and Recognition

Optimal Health Quality Gold Award Value-Based Care for Substance Dependent Newborns NURSE LEADER: PAMELA JIMENEZ, DNP, FNP/PNP-BC Optimal Health Quality Silver Award Reducing the Rate of Abdominal Hysterectomies Performed at Christiana Care Health System NURSE LEADER: JENNIFER BENSON, RN Value Award Get the SCOOP (Supportive Care of Oncology Patients) Clinical Pathway NURSE LEADERS: KAREN SITES, BSN, RN, OCN AND TAMMY BROWN, MSN, RN, OCN, NEA-BC

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We commit to being exceptional today, and even better tommorrow.

CARECHEX 2018 HOSPITAL QUALITY RANKING U.S. NEWS & WORLD REPORT BEST HOSPITALS

Top 1% in the nation again!

HEALTHGRADES 2018 DISTINGUISHED HOSPITAL OF CLINICAL EXCELLENCE AWARD

One of America’s Best 100 Hospitals

National Recognition

No. 1 in nation for medical excellence in neurological and stroke care No. 1 in nation in patient safety for pneumonia and trauma care

BECKER’S HOSPITAL REVIEW 100 GREAT HOSPITALS IN AMERICA AMERICAN NURSES CREDENTIALING CENTER MAGNET AWARD FOR NURSING EXCELLENCE

Twice designated!

AMERICAN ASSOCIATION OF CRITICAL-CARE NURSES BEACON AWARDS FOR CRITICAL CARE NURSING EXCELLENCE AMERICAN COLLEGE OF SURGEONS CLINICAL CONGRESS NATIONAL SURGICAL QUALITY IMPROVEMENT PROGRAM

COLLEGE OF HEALTH INFORMATION MANAGEMENT EXECUTIVES MOST WIRED HOSPITAL 2018 JOINT COMMISSION

Certifications for Hip and Knee Replacement, Advanced Primary Stroke, Advanced Comprehensive Stroke Center, Advanced Heart Failure and Advanced Ventricular Assist Device

AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION GET WITH THE GUIDELINES GOLD PLUS ACHIEVEMENT FOR HEART FAILURE AND STROKE MISSION LIFELINE GOLD STEMI AWARD TARGET: STROKE HONOR ROLL ELITE PLUS HUMAN RIGHTS CAMPAIGN FOUNDATION HEALTHCARE EQUALITY INDEX LEADER IN LGBTQ HEALTHCARE EQUALITY

Meritorious Outcomes in Surgical Patient Care

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Cara Spiess, BSN, RN II EMERGENCY MEDICINE

New Knowledge, Innovations and Improvements A DVA N C IN G N U R S I N G K N OW L E DG E T H R O U G H RE S E A R CH A N D TH E R ED ESIG N O F SYSTE MS A N D P RAC T IC ES TO E N S U R E SA F E , EF F EC T IV E A ND E F F I CI E N T CA R E

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M

agnet organizations have an ethical and professional responsibility to contribute to patient care, the organization and the profession in terms of new knowledge, innovations and improvements. Our current systems and practices may need to be redesigned and redefined if we are to be successful. This component includes nursing research, application of existing evidence, innovations to enhance patient experience and nurse experience and visible contributions to the science of nursing.

RNs help Medicare beneficiaries create personalized prevention plans through Annual Wellness Visits Six Medicare Wellness Program registered nurses are now helping to increase the number of eligible Medicare beneficiaries who benefit from Annual Wellness Visits at Christiana Care primary care medical office practices.

The Center for Medicare and Medicaid Services offers all beneficiaries aged 65 and older with Medicare Part B a no-cost yearly visit — different from a routine physical checkup — to create, with their provider, a personalized prevention plan to improve health and prevent disease.

planning and associated standing orders. The training included discussions regarding end-of-life decisions as well as scheduling and billing/coding processes and electronic health record documentation.

Gloria McGilberry, MSN, RN, manager of Nursing Services for Primary Care, developed Annual Wellness Visit standing orders and workflows to provide guidelines for practicing evidence-based care under the physician’s supervision.

She also led the training session, which included components of the annual wellness visit, advanced care

• Documentation of current providers.

The components of an Annual Wellness Visit are within the full scope of practice of an RN: • Physical and health risk assessments.

• Medication review.

• Medical and family history.

• Screening for risk factors related to cognitive impairment, falls and depression.

• Review of functional ability and safety level.

“

Annual Wellness Visits are an important opportunity for our valued RNs to independently provide evidence-based nursing care using their knowledge, skills and experience to support patients in health promotion, disease prevention and health maintenance.”

Cynthia Griffin, MS, BSN, RN, CPHQ, CCM CHIEF NURSING OFFICER, COMMUNITY CARE

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APRNs instrumental in helping teens stay healthy and focus on education About half of all eligible northern Delaware high school students — some 10,000 adolescents — are registered in their school’s health center for greater access to comprehensive medical and mental-health care, treatment and health education. Teamed with dieticians, licensed clinical mental health providers — and partnering with school nurses — Christiana Care’s school-based health team handled more than 24,000 student visits in the 2017-2018 academic year, which included 12,647 advance practice nursing visits. In the first few months of the 2018-2019 school year, the team had already handled more than 6,000 visits to provide

“

screenings, physicals, treatment of minor injuries and illness, immunizations, reproductive health counseling and services (with parent permission) and referrals to on-site mental health providers or dieticians.

Two key nurse practitioner-led initiatives in 2018 included: • Promotion of well-child checks for students who had not seen their primary care provider in at least two years, and a National School-Based Health Center Asthma Demonstration Project Collaborative with Red Clay Consolidated School District to reduce the number of 911 calls from schools, the majority of which are asthma-related.

Senior Nurse Practitioner Coordinator Kay McLean-Grant, RN, CPNP, leads this project.

Adolescents probably access primary care the least of any population across the lifespan.

In school-based health centers, we are able to address their health care needs.”

Martha Coppage-Lawrence, MSN, RN, CPNP LEAD NURSE PRACTITIONER

New Knowledge, Innovations and Improvements

24,000

VISITS BY CHRISTIANA CARE’S SCHOOL-BASED HEALTH TEAM (2017-2018 ACADEMIC YEAR)

In 2018, nurse champions were instrumental in advancing the multipronged OASIS wellbeing intervention, including serving on multidisciplinary teams to design new OASIS rooms on four units. OASIS, which stands for Opportunity to Achieve Staff Inspiration and Strength, extends beyond massage chairs, Zen gardens and relaxing music and into the culture of the unit. Through staff recognition, team-building activities and education sessions, caregivers learn to better manage the cumulative load of stressors that comes with caring for patients in traumatic situations.

Center for Provider Wellbeing Nurses advance initiatives that care for the caregiver Christiana Care’s Center for Provider Wellbeing partners with health care professionals to foster joy and meaning in their work by building personal resilience and a culture of well-being. Nurses are involved in the Center’s array of pioneering programs.

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Fifteen Christiana Care nurses are on the 24/7 peer support team in the Center’s innovative Care for the Caregiver program. These specially trained volunteers, from a variety of disciplines, provide one-to-one support to Christiana Care health professionals experiencing stress following an adverse patient event. Since its inception in 2015, Care for the Caregiver has supported hundreds of health professionals.

NURSING RESEARCH AND EVIDENCE-BASED PRACTICE

ACCOMPLISHMENTS:

✓ Adopted the Johns Hopkins Nursing Evidence-Based Practice Model.

✓ Merged Evidence-Based Practice and Nursing Research councils to reflect best practice.

✓ Built website and provided resources and tools for all Christiana Care nurses interested in evidence-based practice. ✓ Implemented monthly Journal Club for each service line to enhance critical appraisal skills within the Nursing Research and Evidence-Based Practice Council.

✓ Integrated clinical nurses into the Resident Research Training Program.

Restructured Nursing Research and Evidence-Based Practice Program drives robust, strategic agenda Ignites spirit of inquiry and curiosity among clinical nurses Christiana Care continues to strengthen its Nursing Research and Evidence-Based Practice Program to help practicing nurses identify and address knowledge gaps in patient care, and to drive innovation that not only improves outcomes but creates a more engaged nursing workforce.

To meet the Institute of Medicine goal that 90% of all clinical practice be evidencebased by 2020, Christiana Care has adopted the Johns Hopkins Nursing Evidence-Based Practice Model to help practicing nurses quickly and appropriately incorporate the latest research findings and best practices into patient care. This powerful three-step problemsolving approach to clinical decision-making includes: • Practice questions / information seeking.

• Evidence / synthesis of logical reasoning.

• Translation / transforming knowledge.

Ask It in a Poster: EBP for Beginners course introduces the Johns Hopkins Model, prepares nurses to thrive in a culture of inquiry.

The Nursing Research and Evidence-Based Practice Program introduces practicing nurses to the Johns Hopkins model through a two-day “Ask it in a Poster” course launched in 2018. The course instructs nurses to differentiate among evidence-based practice, research and performance improvement. The course further helps nurses clearly define a clinical problem, develop and define answerable and researchable clinical questions, develop literature search strategies, appraise and synthesize evidence to drive clinical practice changes that measurably improve outcomes. The course is a collaborative effort between the Department of Nursing Research and Evidence-Based Practice and the Nursing Research Evidence-Based Practice Council.

Christiana Care’s first evidence-based project using the Johns Hopkins model was Metronome Implementation in Emergency Department Cardiac Arrest Patients: An Evidence-Based Practice Initiative, led by Kaci Rainey, MSN, RN, CEN, TCRN.

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Research training program introduces nurses to structured research methodology Research-motivated nurses are gaining structured education in research methodology among a cohort of residents and fellows in Christiana Care’s new, nine-month Resident Research Training Program that instructs participants to: • Develop feasible, well-designed projects that result in high-quality national presentations or publications.

• Ask focused questions, employ rigorous methods and choose measurable outcomes.

Curriculum includes research questions and specific aims, literature review, study design and conceptual framework, data collection and management, power and sample size, basic statistics, abstract writing and posters and presentations.

Monica Rochman, Ph.D., RN, program director of Nursing Research and Evidence-Based Practice, is one of three course co-directors.

2018 nurse principal investigators: KATHRYN SHADY, BSN, RN, BA, CCLS Retrospective study to determine the influence of caregiver presence and verbal ability on chemical restraint use for adults with autism spectrum disorder in an Emergency Department setting.

SOPHIA COLLINS, MSN, RN Quasi-experimental study to determine the appropriateness of a visual analog scale to measure post-operative nausea and vomiting and determine participant satisfaction when using peppermint oil as a complementary aromatherapy intervention in the bariatric population.

New Knowledge, Innovations and Improvements

NURSES DRIVE QUALITY IMPROVEMENT THROUGH LEAN SIX SIGMA PROJECTS Christiana Care’s rigorous Lean Six Sigma program offers nurses the opportunity to advance their leadership skills using process-improvement methodology to improve patient experience, clinical effectiveness and organizational vitality. Through well-designed Lean workflow, nurse project leaders help elevate care from good to great.

N U R S E - L E D B L A C K B E LT P R O J E C T S

N U R S E - L E D G R E E N B E LT P R O J E C T S

CARMEN PAL, MSN, MBA, RN GWEN EBBERT, MSN, BA, RN, CPHQ, RN-BC, LSSGB Decrease Cycle Time from Discharge Order to Room Ready

TAMMY BROWN, MSN, TN, OCN, NEA-BC Reduce 4C Medical Unit to Imaging Transport Time

LINDA DANIEL, MSN, RN, CPHQ, LSSGB Improve OR On-Time Starts for Scheduled Cesarean Deliveries DENISE LYONS, DNP, APRN, AGCNS-BC Reduction in Length of Stay for Hip and Femur Fracture Patients

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EILEEN EVANGELISTA, MSN, FNP, RN, CCRN Evaluate and Decrease Readmissions Within 7 Days of Discharge from 6C LESLIE KACZMARCZYK, BS, RN, COS-C Improve Timeliness of Initiation of Home Care Services KRISTIN PAPIRO, MSN, RN, CAPA ANGELA WRIGHT-GLOVER, MSN, RN-BC Reduce Fall Rate on 3N Inpatient Psych Unit at Wilmington

Publishing and Presenting Christiana Care nurses are earning an increasing reputation for their research efforts through invitations to publish in respected nursing, medical and quality journals, as well as speaking engagements and poster presentations at regional, national and international conferences.

Journal Articles

Bayne, Lynn. (1 December 2018). Big Data in Neonatal Care: Big Risk? Big Reward? Critical Care Nursing Clinics of North America. 30(4), p. 481-497.

Benninghoff, Michael, Gajera, Mithil & Seckel, Maureen (2018, January). Use of a Daily Huddle as an Added Layer for Patient Safety. Critical Care Medicine. 46(1), p. 595.

Birkhoff, Susan, Cantrell, M. A., Moriarty, H., & Lustig, R. (2018, July). Examining the Usability and Acceptability of a Patient-Centered Mobile Health Tracking App for Oncology Patients Receiving Radiation Therapy. Advances in Nursing Science. 41(3), p. 243-259.

Dixon, Lois, Mascioli, Susan, Mixell, Jefferson, Gillin, Tom, Upchurch, Camille, & Bradley, Kevin. (1 December 2018).

Reducing Tracheostomy-Related Pressure Injuries. AACN Advanced Critical Care. 29(4), 426-431.

Glasofer, A. & Laskowski-Jones, L. (2018). Mass shootings: A Call for Nursing Awareness and Action. Nursing2018 Critical Care, 13(5), 14-20.

Koprowski, Christopher, Sites, Karen, Petrelli, Nicholas., & Johnson, Edith. (16 November 2018). The SCOOP Program.

Oncology Issues. 33(6), p. 18-27.

Laskowski Jones, Linda, & Jones, L. J. (2018). Frostbite: Don’t be Left Out in the Cold. Nursing2018. 48(2), 26-34.

Laskowski Jones, Linda. (2018, December). Striving for Peace and Goodwill … Year Round [Editorial]. Nursing: The Journal of Clinical Excellence. 48(12).

Laskowski Jones, Linda. (2018, November). Making a Case for Volunteerism [Editorial]. Nursing: The Journal of Clinical Excellence. 48(11).

Laskowski Jones, Linda. (2018, October). A Case for Civility in Publishing [Editorial]. Nursing: The Journal of Clinical Excellence. 48(10).

Laskowski Jones, Linda. (2018, September). Patients as Partners in Publishing [Editorial]. Nursing: The Journal of Clinical Excellence. 48(9).

Laskowski Jones, Linda. (2018, August). The Legacy of Cherry Ames [Editorial]. Nursing: The Journal of Clinical Excellence. 48(8).

Laskowski Jones, Linda. (2018, July). Receiving Constructive Feedback Constructively [Editorial]. Nursing: The Journal of Clinical Excellence. 48(7).

Laskowski Jones, Linda. (2018, June). Giving Constructive Feedback -- Constructively [Editorial]. Nursing: The Journal of Clinical Excellence. 48(6).

Laskowski Jones, Linda. (2018, May). Tribute to the Unknown Nurse [Editorial]. Nursing: The Journal of Clinical Excellence. 48(5).

Laskowski Jones, Linda. (2018, April). Reconnecting with the why [Editorial]. Nursing: The Journal of Clinical Excellence. 48(4).

Laskowski Jones, Linda. (2018, March). Interprofessional Competence: Teamwork’s Secret Sauce [Editorial]. Nursing: The Journal of Clinical Excellence. 48(3).

Laskowski Jones, Linda. (2018, February). Picture those you love [Editorial]. Nursing: The Journal of Clinical Excellence. 48(2).

Laskowski Jones, Linda. (2018, January). Own your Nursing Career [Editorial]. Nursing: The Journal of Clinical Excellence.

48(1).

Long, Devita, Capan, Muge, Mascioli, Susan, Mosby, D., Arnold, R., & Miller, K. (1 August 2018). Evaluation of User Interface Alert Displays for Sepsis Clinical Decision Support.

Critical Care Nurse. 38(4), p. 46-52.

MacIntyre, Rebecca & Ciechanowski, Mary. (2018, May).

Hyperglycemia Management in Patients with Acute Ischemic Stroke. Nursing 2018 Critical Care. 13(3), p. 14-19.

McCulloh Nair, Julie. (2018, April). Measures of Wellness in Young Adult College Students: An Integrative Review. Journal of Nursing Measurement. 26(1), p. 28-52.

Mitchell, Danette, Panchisin, Theresa, & Seckel, Maureen (2018, August). Reducing Restraint Use in the Intensive Care Unit. Critical Care Nurse. 38(4), e8-e16.

Mitchell, Danette, Seckel, Maureen, Dixon, Lois, & Mascioli, Susan. (8 December 2017). Acute Respiratory Distress Syndrome and Prone Positioning. ACCN Advanced Critical Care. 29(4), p. 415-425.

Novello, Stacey, Bowen, Mary, & Griffioen, Mari. (25 November 2018). A Stroke Reduction Health Plan for Older Adults in Rural Sussex County, Delaware. Delaware Journal of Public Health. 4(5), p. 62-67.

Pearson, Thomas, Frizzola, Meg & Rochman, Monica.

(2018, January). Pediatric Extracorporeal Cardiopulmonary Resuscitation Patient with Traumatic Subarachnoid Hemorrhage and Takotsubo Syndrome. Air Medical Journal.

37(1), p. 64-66.

Price, Michael, Bates, Anne, & Clagett, Michael. (27 November 2018). Improving Efficiency and Standardization in a Robotics Program: A Quality Improvement Project.

Association of Operating Room Nurses Journal. 108(6), p.

652-660.

Robinson, Josie, Panichelli, Heather, Zern, Sue, Qaisim, Zaffer, & Bradley, Kevin. (2018, April). Successful Interprofessional Approach to Development of a Resuscitative Endovascular Balloon Occlusion of the Aorta Program at a Community Trauma Center. The Journal of Emergency Medicine. 54(4), p.419-426.

Seckel, Maureen. (8 December 2018). Advanced in EvidenceBased Pulmonary Care. AACN Advanced Critical Care. 29(4), p. 394-395.

Thress, Shelly. (1 October 2018). Caleb’s Story. Nursing 2018.

48(1), p. 56.

We seek new knowledge, ask for feedback and are open to change.

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PU BLI S H I NG A ND PRESEN TIN G Book Chapters

Cuming, Richard. (2018, February). Concepts Basic to Perioperative Nursing. Alexander’s Care of the Patient in Surgery (16th ed.) by Jane C. Rothrock. St. Louis, Missouri: Elsevier.

Dechant, Laura. (2018). Assessment of the Cardiovascular System.

In D.D. Ignatavicius, M.L. Workman & C.R. Rebar (Eds.), MedicalSurgical Nursing: Concepts for Interprofessional Collaborative Care (9th ed.). St. Louis: Elsevier.

Dechant, Laura. (2018). Care of Patients with Acute Coronary Syndromes. In D.D. Ignatavicius, M.L. Workman & C.R. Rebar (Eds.), Medical-Surgical Nursing: Concepts for Interprofessional Collaborative Care (9th ed.). St. Louis: Elsevier.

Dechant, Laura. (2018). Care of Patients with Cardiac Problems. In D.D. Ignatavicius, M.L. Workman & C.R. Rebar (Eds.), MedicalSurgical Nursing: Concepts for Interprofessional Collaborative Care (9th ed.) St. Louis: Elsevier.

Dechant, Laura & Heimgartner, N. (2018). Care of Patients with Dysrhythmias. In D.D. Ignatavicius, M.L. Workman & C.R. Rebar (Eds.), Medical-Surgical Nursing: Concepts for Interprofessional Collaborative Care. St. Louis: Elsevier.

Emerson, Aliesha. (2018). Behavioral Health and the Medical-Surgical Patient. In D. Martin & P. Braida (Eds.), Medical-Surgical Nursing Certification (pp. 544-563). New York, NY: McGraw Hill Education.

Fitzgerald, Beth. (2018, January). Interventional and Image-Guided Procedures. In Alexanders, R (Ed), Care of the patient in surgery (16th ed.). St. Louis, Missouri: Elsevier.

Laskowski Jones, Linda & Jones, L.J. (2018). Cold Injuries. In S. C. Hawkins (Ed.), Wilderness EMS (pp. 241-254). Philadelphia: Wolters Kluwer.

Laskowski Jones, Linda, Caudell, M.J., Bounds, R.B., Dymond, C.A., Hawkins, S.C., Jones, L.J., Starling, J.M., & Young D.S. (2018).

Wilderness event medicine. In S. C. Hawkins (Ed.), Wilderness EMS (pp. 179-188). Philadelphia: Wolters Kluwer.

Laskowski Jones, Linda & Toulson, Karen. (2018). Principles of Emergency and Trauma Nursing. In D.D. Ignatavicius, M.L. Workman & C.R. Rebar (Eds.), Medical-Surgical Nursing: Concepts for Interprofessional Collaborative Care (9th ed., pp. 117-132). St. Louis: Elsevier.

Laskowski Jones, Linda. (2018). Care of Patients with Common Environmental Emergencies. In D.D. Ignatavicius, M.L. Workman & C.R. Rebar (Eds.), Medical-Surgical Nursing: Concepts for Interprofessional Collaborative Care (9th ed., pp. 133-148). St. Louis: Elsevier.

Laskowski Jones, Linda. (2018). Principles of Emergency and Disaster Preparedness. In D.D. Ignatavicius, M.L. Workman & C.R. Rebar (Eds.), Medical-Surgical Nursing: Concepts for Interprofessional Collaborative Care (9th ed., pp. 149-159). St. Louis: Elsevier.

Pirrung, Joan. (2018, June). Thoracic Injuries. In the Electronic Library of Trauma Lectures (4th ed.).

Seckel, Maureen. (2018). Respiratory System. In Burns & Delgado (Eds.), AACN Essentials of Critical Care Nursing (4th ed.).

St. John, Robert, & Seckel, Maureen (2018). Airway and Ventilatory Management. In McGraw Hill (Eds.), ACCN Essentials of Critical Care Nursing (4th ed.).

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External Presentations

Bartels, Justin. (2018, September). Nurse Engagement through Shared Governance: The New Key to Improving Nursing Outcomes.

Poster presentation at Academy of Medical Surgical Nurses Annual Convention, Lake Buena Vista, FL. Birkhoff, Susan. (2018, April). The Usability and Acceptability of a Patient-Centered Mobile Health Tracking App among a Sample of Adult Oncology Patients Receiving Radiation Therapy. Podium presentation at Eastern Nursing Research Society, Newark, NJ. Bergamo, Molly. (2018, October). Neurobiology and Psychiatric Comorbidities across the Lifespan in the Trauma Population. Podium presentation at International Conference on Forensic Nursing Science and Practice, Reno, NV. Burbage, Darcy. (2018, May). Cancer Survivorship: It’s Everybody’s Business. Podium presentation at 43rd annual Oncology Nursing Society Congress, Washington, DC. Burbage, Darcy. (2018, May). Oncology Nurse Navigation: Innovative Programs that Improve Patient Outcomes. Presentation at 43rd Annual Oncology Nursing Society Congress, Washington, DC. Burbage, Darcy. (2018, June). The Role of the Nurse Navigator in Developing and Implementing a Sustainable Survivorship Program.

Podium presentation at Oncology Nursing Society Nurse Navigation Summit, Chicago, IL. Burbage, Darcy. (2018, June). What Oncology Nurses Hear from Patients about Affordability, Cost of Cancer Drugs & Treatments, and How Nurses & Nurse Navigators Assist Patients Experiencing Financial Challenges. Presentation at Oncology Nursing Society Health Policy Summit, Washington, DC. Bynam, Stacey. (2018, April). LGBTQ Healthcare Equality Resource Team. ANA Quality and Innovation Conference, Orlando, FL. Carrier, Susan. (2018, November). Ambulatory CDI. Podium and poster presentation at ACDIS National Conference, Las Vegas, NV. Carrier, Susan & Campbell, Amy. (2018, May). Clinical Documentation. Poster presentation at ACDIS Outpatient Symposium, Orlando, FL. Collins, Michelle. (2018, September). Nursing Professional Practice Models: Impact on Medical Nurse Empowerment and Job Satisfaction. Podium presentation at Doctors of Nursing Practice 11th National Conference, Palm Springs, CA. Collins, Michelle. (2018, November). Nursing Professional Practice Models: Impact on Medical Nurse Empowerment and Job Satisfaction. Podium presentation at 13th Annual Nursing Research Conference, Newark, DE. Cook, Kay. (2018, November). The Highway of Change Education.

Podium presentation at the South Eastern Nurse Educator Symposium, Wrightsville Beach, NC. Cox, Jacqueline & Williams, Lelia. (2018, May). HAPI Prevention in the Hematology/Oncology Unit. Poster presentation at Oncology Nursing Society Annual Congress, Washington, DC. Crawford, Jacquelin. (2018, May). Improving Patient Experience in an Intensive Care Unit. Poster presentation at American Association of Neuroscience Nurses, San Francisco, CA. D’Amore, Amie. (2018, June). Supporting the Cardiac Vascular Certification. Podium presentation at the Society for Vascular Nursing, Boston, MA. Daniel, Linda. (2018, September). Giving TIME (Triple I to Manage Early onset-sepsis) Back to Moms and babies. Podium presentation at 11th Annual Regional DE/NJ Chapters HIMSS Conference, Atlantic City, NJ. Davis, Samantha Ann. (2018, October). Refraining from Restraining.

Poster presentation at ANCC National Magnet Conference, Denver, CO.

Dauphin, Elizabeth. (2018, May). Checking in After Checking out: The Impact of Discharge Phone Calls. Poster presentation at Oncology Nursing Society Annual Congress, Washington, DC. DeCaire, Anne & Brown, Janet. (2018, October). Enhancing Support for Maternal Mental Health and Substance Use Disorders: What Providers Need to Know. Lecture at Rockford Center Lecture Series 2018, Delaware Medical Society, Newark, DE. Dechant, Laura. (2018, January). CCRN/PCCN Review: Cardiovascular Module. Podium presentation at CCRN/PCCN Review Course at Atlantic Healthcare, Atlantic City, NJ. Dechant, Laura. (2018, January). CCRN/PCCN Review: Respiratory Module. Podium presentation at CCRN/PCCN Review Course at Atlantic Healthcare, Atlantic City, NJ. Dechant, Laura. (2018, January). CCRN/PCCN Review: Respiratory Module. Podium presentation at CCRN/PCCN Review Course at Temple University, Philadelphia, PA. Dempsey, Kandie. (2018, September). Accrual: Obstacles and Opportunities – Patient Barriers/Strategies. Podium presentation at National Cancer Institute Community of Oncology Research Program, Bethesda, MD. Dempsey, Kandie. (2018, September). Research Quality and Effectiveness - Practical Strategies Evidence Based Practice.

Podium presentation at the American Society of Oncology Research Community Forum Annual Meeting, Alexandria, VA. DeParre, Samantha. (2018, September). Vascular Access Nursing and the Behavioral Health Patient, How to Stay Safe from More than Needlesticks. Podium presentation at Association for Vascular Access, Columbus, OH. Dixon, Lois & Mascioli, Susan. (2018, November). Interdisciplinary Collaboration to Reducing Tracheostomy Related Pressure Injuries.

NAHQ Next 2018, Minneapolis, MN. Donahue, Catherine. (2018, March). Calling the Shots: Case Studies in Adding Insulin and Non-Insulin Injectables. Lecture at APRN pharmacology conference, Newark, DE. Donahue, Catherine. (2018, January). Care of the Patient with DM. Lecture at Wilmington University, Wilmington, DE. Emerson, Aliesha. (2018, July). Critical Skills Remixed: Nurses Utilizing Real-Time Response Technology. Poster presentation at Association for Nursing Professional Development Convention, Lake Buena Vista, FL. Emerson, Aliesha. (2018, September). The Elephant in the Room: Opioid Withdrawal. Podium presentation at Academy of Medical Surgical Nursing Conference, Lake Buena Vista, FL. Emerson, Aliesha. (2018, January). Two Sides to the Story: Utilizing Simulation to Improve Communication. Poster presentation at Elsevier Nursing Education Conference, Las Vegas, NV. Gallagher, Kathy. (2018, April). A Case Review Series Of Negative Pressure Wound Therapy with Instillation and Dwell Time (NPWTI-d) Using Hypochlorous Acid (Vashe®, HOCL) vs Sodium Hypochlorite 0.125% (Dakin’s, NaOCL) or 0.9% Normal Saline in Complex Infected Wounds. Poster presentation at Diabetic Limb Salvage, Washington, DC. Gallagher, Kathy. (2018, November). Women: Professionalism and Leadership. Women of Integra Network, Plainsboro, NJ. Gireesh, Lija. (2018, September). Feasibility of an Evidence-Based Stretching Program on Healthcare Worker Pain Scores and Professional Quality of Life. Poster presentation at AOHP National Conference, Phoenix, AZ. Gireesh, Lija. (2018, November). Stretching Program at Work to Evaluate Generalized Pain Scores and Professional Quality of Life. Podium presentation at the 13th Annual Nursing Research Conference, Newark, DE.

Guzman, Shannon. (2018, March). Every Patient, Every Time: Reducing Preventable Falls on an Acute Stroke Treatment and Recovery Unit. Poster presentation at AANN Annual Education Meeting, San Diego, CA. Guzman, Shannon. (2018, August). Every Patient, Every Time: Reducing Preventable Falls on an Acute Stroke Treatment and Recovery Unit. Poster presentation at AANN Stroke Conference, Louisville, KY. Hare, Erin. (2018, November). Use of a Validated Tool to Improve Compassionate Extubation. Podium presentation at 13th Annual Nursing Research Conference, Newark, DE. Hare, Erin. (2018, May). Use of a Validated Tool to Improve Compassionate Extubation. Podium presentation at National Teaching Institute and Critical Care Exposition, Orlando, FL. Holleran, Dianne, Swift, Cheryl, & Daniel, Linda. (2018, June). L&D Nurse Residency Program – the Time to Implement is Now! Poster presentation at the Association of Women’s Health, Obstetric and Neonatal Nurses, Tampa, FL. Kane, Jill. (2018, May). A Comparative Pilot Study of Supply Tray Management in the Medical Intensive Care Unit: Repeated-Use versus Exchanged Supply Tray and Tray Contents. Poster presentation at National Teaching Institute and Critical Care Exposition, Boston, MA. Kohl, Amy. (2018, February). Perioperative Hyperglycemia Pathway.

Podium presentation at Perioperative Perspectives Conference, Newark, DE. Kohl, Amy. (2018, October). Perioperative Hyperglycemia Pathway.

Podium presentation at CBSPAN Eastern Shore District Fall Conference, Newark, DE. Laskowski Jones, Linda. (2018, November). The Dark Side of Publishing: Recognizing The Risks of Predatory Publishers. Nursing Service Organization Advisory Board Annual Meeting, Park City, UT. Laskowski Jones, Linda. (2018, September). Leadership Lessons Learned from Wolves. Nursing Management Congress 2018.

Orlando, FL. Laskowski Jones, Linda. (2018, May). Acute/Emergent Care: Caring for Patients with Wounds in the Wilderness. National Conference for Nurse Practitioners, Orlando, FL. Laskowski Jones, Linda. (2018, June). Summer Emergencies.

Delaware Chapter of the Emergency Nurses Association spring educational meeting, Nemours/ Alfred I. duPont Hospital for Children, Wilmington, DE. Lee, Tiffani. (2018, August). Every Patient, Every Time: Reducing Preventable Falls on the Acute Stroke Treatment and Recovery Unit. Poster presentation at AANN 2018 Advanced in Stroke Care Conference, Louisville, KY. Lind-Maloney, Judith. (2018, October). Mission Trip to Vietnam.

Podium presentation at CBSPAN Fall Conference, Newark, DE. Mankus, Doreen. (2018, May). A.T. L. A. S. Advancing Trauma Learning and Skills. Poster presentation at Delaware Trauma Symposium, Wilmington, DE. Mascioli, Susan. (2018, November). Reducing Tracheostomy Related Pressure Injuries. Poster presentation at National Association for Healthcare Quality’s Annual Conference, Minneapolis, MN. Mattison, Kimberly. (2019, May). There’s No “I” in Team: Value Improvement Teams Improve Outcomes. Poster presentation at ANCC Pathway to Excellence Conference, West Palm Beach, FL. McCulloh Nair, Julie. (2018, April). Undergraduate Student Nurse Peer Mentorship Program. Poster presentation at Eastern Nursing Research Society, Newark, NJ. McGhie, Colleen. (2018, November). Clostridium difficile (C. diff).

Lecture at We Improve Senior Health, Wilmington, DE. Muffley, Cheryl & Heath, Suzanne. (2018, October). Reducing Cost of Care and Improving Outcomes Using Cerner Patient Observer. Podium presentation at Cerner Health Conference 2018, Kansas City, MO.

Otto, Christopher & Collins, Michelle. (2018, March). Using Technology to Increase Staff Engagement in Professional Practice.

Podium presentation at American Nurses Association Quality and Innovation Conference, Orlando, FL. Otto, Christopher & Dennis, Heather. (2018, June). Transitioning from Acute to Community Care: The Value of a Heart Failure Support & Education Group Meeting. Poster presentation at American Association of Heart Failure Nurses Annual Conference, Chicago, IL. Otto, Christopher. (2018, May). Using Technology to Increase Staff Engagement in Professional Practice. Podium presentation at American Nurses Association Quality and Innovation Conference, Orlando, FL. Pal, Carmen. (2018, June). Addressing the Opioid Epidemic in the Acute Care Setting. Podium presentation at the North Atlantic Regional User Group, Hershey, PA. Pal, Carmen. (2018, June). The Use of Care Pathways to Standardize Care. Podium presentation at the North Atlantic Regional User Group, Hershey, PA. Pirrung, Joan. (2018, April). Managing Daily Crisis and Resilience: STN Leadership Preconference Workshop. Lecture at STN Annual Trauma Conference, Portland, OR. Rainey, Kaci. (2018, November). Acute Pelvic Trauma: Myths, Management and Current Treatment Guidelines. Podium presentation at Delaware Emergency Nurses Association, Dover, DE. Rainey, Kaci. (2018, September). Re-Thinking Rib Fractures in the Blunt Trauma Patient. Podium presentation at Emergency Nurses Association National Conference, Pittsburgh, PA. Rebmann, Valerie. (2018, October). Obesity: Healthy or Unhealthy?.

Lecture at Delaware Nurses’ Association, Dover, DE. Remel, Bridget, Painter, Jennifer, O’Neill, Gregory, & Berl, Kimberly.

(2018, May). A Transformational Journey in Nursing Professional Development. Poster presentation at AACN Pathways to Excellence, West Palm Beach, FL. Rodriguez, Rogelio. (2019, April). My Journey with PTSD. Lecture presented at University of Delaware, Newark, DE. Schulak, Jennifer. (2018, April). Care for the Caregiver: The Impact of Creating a Successful Peer Support System at Christiana Care Health System. Lecture at Academy of Professionalism in Health Care, Baltimore, MD. Schulak, Jennifer & Herbein, Alexis. (2018, March). Getting a Handle on Holds. Podium presentation at Chesapeake Bay Society of Peri-anesthesia Nurses, Middletown, DE. Schulak, Jennifer & Speakman, Lauren. (2018, April). The Impact of Creating a Successful Peer Support System at Christiana Care Health System. Presentation at the 6th Annual Academy of Professionalism in Health Care Meeting, Baltimore, MD. Schwartz, Jessica. (2018, May). Preventing Probable Ventilator Associated Pneumonia (pVaps). Poster presented at National Teaching Institution and Critical Care Exposition, Boston, MA. Seckel, Maureen. (2018, September). ARDS Management: Now and Future. Podium presentation at the 3rd Annual Critical Care Symposium, Berlin, NJ. Seckel, Maureen. (2018, September). Breaking Down the Sepsis Guidelines: Impact on the Cardiovascular System. Podium presentation at the 33rd Annual Townsend Cardiovascular Nursing Symposium, Wichita, KS. Seckel, Maureen & Mitchell, Dannette. (2018, March). Driving Practice Changes in Restraint Use in ICU: Project Inception to Publication. Podium presentation at the National Association of Clinical Nurse Specialists Annual Conference, Austin, TX. Seckel, Maureen. (2018, February). Improved Structured Family Meeting Compliance and Quality with Pay for Performance. Podium presentation at the Society of Critical Care Medicine Annual Congress, San Antonio, TX.

Seckel, Maureen. (2018, May). Measure of Fluid Responsiveness in Sepsis. Podium presentation at the National Teaching Institute American Association of Critical Care Nurses, Boston, MA. Seckel, Maureen. (2018, May). Pharmacology Update for Pulmonary Arterial Hypertension. Podium presentation at the National Teaching Institute American Association of Critical Care Nurses, Boston, MA. Seckel, Maureen. (2018, May). Pulmonary Arterial Hypertension and Pulmonary Embolism: A Quick Evidence-Based Review. Podium presentation at the National Teaching Institute American Association of Critical Care Nurses, Boston, MA. Seckel, Maureen. (2018 September). The Right Side of the Heart: Pulmonary Arterial Hypertension & Pulmonary Embolus Review.

Podium presentation at the 33rd Annual Townsend Cardiovascular Nursing Symposium, Wichita, KS. Seckel, Maureen. (2018, May). Top Sepsis Studies 2017-2018.

Podium presentation at the National Teaching Institute American Association of Critical Care Nurses, Boston, MA. Skinner, Evelyn. (2018, May). Difficult Conversations with Patients and Families: Learning to Say ‘’I’m Sorry”. Lecture at ASPAN 37th National Conference, Anaheim, CA. Skinner, Evelyn. (2018, May). Patient and Family Centered Care: How Can I Improve Their Experience with Staff Perception?. Lecture at ASPAN 37th National Conference, Anaheim, CA. Smakulski, Megan. (2018, May). Beacon Bound. Poster presentation at AACN’s National Teaching Institute, Boston, MA. Smakulski, Megan & Heckman, Timothy. (2018, April). Value Improvement Teams Improve Outcomes. Poster presentation at ANCC Pathway to Excellence, West Palm Beach, FL. Smakulski, Megan & Heckman, Timothy. (2018, February). Value Improvement Teams Make a Difference on a Stepdown Unit. Podium presentation at Diamond State Chapter of AACN Spring Symposium, Dover, DE. Swift, Cheryl. (2018, June). Time (Triple I to Manage Early onset-sepsis) Keeps Moms and Babies Together. Poster presentation at the Association of Women’s Health, Obstetric and Neonatal Nurses, Tampa, FL. Swift, Cheryl & Daniels, Linda. (2018, October). Time (Triple I to Manage Early onset-sepsis) Keeps Moms and Babies Together.

Podium presentation at ANCC National Magnet Conference, Denver, CO. Verucci, Leslie. (2018, June). The Great Safety Debate -2018 ASHP Summer Meeting Description. Podium presentation at American Society of Health-System Pharmacists’ Summer Meeting, Denver, CO. Vogel, Barbara. (2018, June). Supporting the Cardiac-Vascular Certification: Standards of Care for Acute Coronary Syndrome and Heart Failure. Podium presentation at the Society for Vascular Nursing, Boston, MA. Volk, Susan & Lind-Maloney, Judy. (2018, October). Medical Mission Trips. Podium presentation at the Chesapeake Bay Society of Peri-anesthesia Nurses Fall Conference, Newark, DE. Ward, Cherie & Lukk, Heather. (2018, November). Identification of Comprehensive Trauma Alert Criteria for Elderly Trauma Patients on Thinners. Podium presentation at 13th Annual Research Conference, Newark, DE. Ward, Cherie, Lukk, Heather, & Pantalone, Abigail. (2018, May) The Importance of Cohesive Trauma Alert Criteria Between Prehospital and Hospital Interdisciplinary Teams; Comprehensive Identification, Activation, and Protocol Adherence to Provide the Best Possible Outcomes for Trauma Patients. Poster presentation at Delaware Trauma Symposium, Dover, DE. Wilson, Barbara. (2018, September). Implementation of an Interventional Radiology Patient Tracking Registry Post Chemoembolization and Radio embolization. Poster presentation at the Doctor of Nursing Practice National Conference, Palm Springs, CA.

NURSING ANNUAL REPORT 2018

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With Excellence We commit

TO BEING EXCEPTIONAL TODAY, AND EVEN BETTER TOMORROW.

We seek new knowledge,

ASK FOR FEEDBACK AND ARE OPEN TO CHANGE.

We use resources wisely AND EFFECTIVELY.

We are curious

AND CONTINUOUSLY LOOK FOR WAYS TO INNOVATE.

We are true to our word

AND FOLLOW THROUGH ON OUR COMMITMENTS.

And Love

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OF OTHERS AND HELP WITH COMPASSION AND GENEROSITY.

We embrace diversity AND SHOW RESPECT TO EVERYONE.

We listen actively, SEEK TO UNDERSTAND

AND ASSUME GOOD INTENTIONS. P.O. Box 1668 Wilmington, Delaware 19899-1668 800-693-CARE (2273)

www.christianacare.org

We tell the truth WITH COURAGE AND EMPATHY.

We accept responsibility FOR OUR ATTITUDES AND ACTIONS.

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