New Knowledge, Innovations and Improvements

ChristianaCare nurses act and think locally in their practice areas and globally to influence health care and nursing. They are committed to advancing the science of nursing and developing evidence-based interventions and new models of care.

Challenge accepted: Innovating to prevent CAUTI

The ChristianaCare Innovation Challenge invites caregivers to showcase their ideas for technologies, digital health solutions or inventions that will help us better care for our community. In FY 23, nurses Bridget Remel, MSN, APRN, AGCNS-BC, NPD-BC, CCRN-K, and Gwendolyn Ebbert, MSN, BA, RN, CPHQ, RN-BC, LSSBB, shared their novel approach to reducing catheter-associated urinary tract infection (CAUTI).

CAUTI is dangerous for patients and costly for health systems. It is also highly preventable with the right training, and practice, but not all nurses have the opportunity to practice catheter insertion, especially in units where catheters are infrequently used.

Remel and Ebbert’s innovation is a cost effective, creative approach to training nurses in catheter insertion to help reduce CAUTI. Typical training processes use simulation on expensive, heavy, and cumbersome mannequins. Currently in development, Remel and Ebbert’s idea is a low-cost Urinary Catheterization Training Kit with a complementary virtual training. Available on-site, the kit and training will enable on-the-spot practice and demonstration, increasing caregiver confidence and improving patient satisfaction. The kit and supplemental training will be replicable for settings like skilled nursing facilities.

Getting mORe intelligent

Nurse Manager Heather Pelkey, MSN, MSM, RN, CNOR, took the lead in identifying transformational, cutting-edge software for our Newark Campus operating room (OR).

The augmented reality technology ORtelligence supports surgical teams by providing the right information, equipment and support for surgical cases. It digitizes and optimizes the OR supply chain with software that provides all team members with the right information and support needed for the best possible care for patients. It benefits OR nurses by enabling surgeons to create personalized plans for every patient, laying out for nurses the needs for each procedure. After a successful pilot, the solution will soon expand to our Wilmington campus.

Transforming Cecil County Campus’s EMR Platform as a team

Our caregiver compassion and generosity don’t start and stop with the people we serve, but extend to our colleagues as well. When our Cecil County Campus implemented its new Cerner EMR platform, the team effort crossed state lines as caregivers from across the health system offered guidance and support. The rollout has been overwhelmingly positive among caregivers, who notice a tangible improvement to their workflow.

Creating a culture for pressure injury prevention

An interprofessional group of ChristianaCare caregivers has made tremendous strides in developing and implementing approaches to preventing hospital-acquired pressure injuries (HAPI). Catherine Shull Fernald, DNP, RN, RNC-OB, NEA-BC, FACHE, Susan Mascioli, MS, BSN, RN, NEA-BC, CPHQ, LSSBB, CPPS, and Lindsay McGrath, MSN, RN, CWOCN, along with Daniel M. Grawl, MBA, PA-C, FAAPA, FDAPA, EMT-P, presented their work to the Pressure Injury Safety Collaborative in June. The collaborative was hosted by ECRI, a global, independent authority on health care technology and safety, and the Institute for Safe Medication Practices, a nonprofit devoted entirely to preventing medication errors. The ChristianaCare team shared how it has helped improve HAPI Stage 3+ rates by 88% — from 3.81 to 0.47 — since 2019. In FY 23, their HAPI reduction initiative reduced HAPI incidents by 26% compared to FY 22, in part from:

• Using machine learning to identify patients at highest risk for pressure injuries.

• Creating videos for offloading and positioning education for caregivers.

• Sharing lessons learned monthly.

• Transitioning to a new pressure redistribution mattress and replacing hundreds of mattresses.

• Piloting and transitioning to new moisture management products.

Publications and Presentations

Publications

Melanie Chichester, Lesley Tepner and Denise Cote-Arsenault. (2022, September). “Nursing Care of Childbearing Families after Previous Perinatal Loss.” Nursing for Women’s Health. 26(5):379-388.

Michelle Collins and Maria Brown. (2023, March-May). “Virtual Acute Care Nurses: Implementing Successful Change.” DNA Reporter. 48(2):10.

Shannon Connolly. (2022, December). “A New Nurse’s Unexpected Discovery.” Nursing for Women’s Health. 26(6):485-486.

Odai Dweekat, Sarah Lam, and Lindsay McGrath. (2022, December). “A Hybrid System of Braden Scale and Machine Learning to Predict Hospital-Acquired Pressure Injuries (Bedsores): A Retrospective Observational Cohort Study.” Diagnostics. 13(1)31.

Odai Dweekat, Sarah Lam, and Lindsay McGrath. (2022, December). “Machine Learning Techniques, Applications, and Potential Future Opportunities in Pressure Injuries (Bedsores) Management: A Systematic Review.” International Journal of Environmental Research and Public Health. 10(1):796.

Catharine Kelly, Amanda Latina, Tara Babe, Paige Fox, Megan Nucifora and Abigail Walker. (2023, April). “An Interdisciplinary Approach to Reduce Hospital-Acquired Pressure Injuries Using a Manual Tilt-in-Space Wheelchair and Seating Protocol.” Nursing 2023 53(4):49-52.

Paula Klemm and Hason Jafrey. (2022, November). “Recruitment of Minorities into Nursing, Best Practices: A Scoping Review.” Open Journal of Nursing 12:683-701

Maureen Seckel and Dannette Mitchell. (2022, October). “What Is the Preferred Method for Endotracheal Tube (ETT) Securement When Prone Positioning to Prevent Pressure Injury.” Critical Care Nurse 42(5):77-79.

Presentations

Susan Birkhoff and Kat Collard. (2023, March). Innovative Robot Collaborates with Nurses to Improve Care Delivery. Podium presentation at ACHE in Chicago, IL.

Susan Birkhoff and Cynthia Waddington. (2022, October). Virtual Reality: Nurses Innovating to Enhance Patients’ Experiences. Podium presentation at Magnet conference in Philadelphia, PA.

Karen Clarke, Brian Matson, Rebecca Brockson, and Hayley Sweetser. (2023, April). Excellence in Practice-John Hopkins Activity & Mobility Promotion (JH-AMP) at ChristianaCare: Sustainable Education, Promotion & Awareness. Podium presentation at Johns Hopkins 6th Annual Activity & Mobility Conference in Baltimore, MD.

Kat Collard, Debbie Howard, and Lindsay McGrath. (2022, October). Pressure Injury Identification Process Utilizing Camera Capture. Podium presentation at Oracle Cerner Health Conference, virtual.

Kat Collard. (2022, October). The Robot Next Door: ChristianaCare’s Experience with Robotic Assistants. Podium presentation at the HealthCare Academy CNIO/CIO Conference in San Francisco, CA.

Kat Collard and Greg Springan. (2023, April). Supporting and Evolving the Delivery of Patient Care: Collaborative Robots and Healthcare. Podium presentation at HIMSS Nursing Informatics Symposium in Chicago, IL.

Kat Collard and James McAdams. (2023, April). ChristianaCare’s Experience Integrating Cobots. Podium presentation at HIMSS Global Conference in Chicago, IL.

Michelle Collins. (2023, March). Elevating the Workforce Collaborative Knowledge Transfer. Virtual webinar with Vizient.

Michelle Collins. (2022, September). Making the Most of the Magnet Conference. Virtual webinar with Tipton Communications.

Michelle Collins and Maria Brown. (2023, June). Speaker for Policy Development Session. Podium presentation at American Nurses Association Membership Assembly in Washington, DC.

Michelle Collins and Maria Brown. (2023, April). Virtual Acute Care Nurses: Implementing Successful Change. Poster presentation at 27th Annual Research Evidence-Based Practice, Performance Improvement Conference, virtual.

Michelle Collins and Ric Cuming. (2023, April). From Pilot to Scale: Making the Business Case for Nursing Technology Adoption. Podium presentation at HMA CNO Academy in Palm Beach, FL.

Michelle Collins, Maria Brown, Marybeth McMahon, Melanie Ries, Denise Lottero, Bonnie Osgood, Justin Bartels, and Lauren Klein. (2023, April). Virtual Acute Care Nurses: Implementing Successful Change. Poster presentation at 27th Annual Research EvidenceBased Practice, Performance Improvement Conference, virtual.

Emily Colonna and Leasha Roy. (2022, September). Stay on Target: Optimizing TTM Outcomes. Podium presentation at Diamond State Chapter American Association Critical Care Nurses Conference in Lewes, DE.

Ashley Connell and Lisa Katrowski. (2023, April). Career Day presentation at William Penn High School in New Castle, DE.

Laura Dechant. (2023, May). Game Changers in Structural Heart Care: TAVR and MitraClip. Podium presentation at National Teaching Institute in Philadelphia, PA.

Catherine Shull Fernald. (2023, April). Telehealth, Remote Care and What Clinical Leaders Still Need to Succeed. Panel presentation at Becker’s Hospital Review: 13th Annual Meeting in Chicago, IL.

Catherine Shull Fernald. (2022, September). The Focused Leader: Embracing Vulnerability, Risk Taking, and the Potential to Succeed. Guest lecture presentation at Delaware Organization for Nursing Leadership, Leading Nursing into the Future Annual Summit in Wilmington, DE.

Edna Green. (2023, April). Hypertension Medication Management Protocol for Nurse-Led Visit. Poster presentation at American Academy of Ambulatory Care Nursing Conference in Orlando, FL.

Lija Greesh. (2022, November). Research, EBP and QI: How Does It Help with Innovations in Nursing. Podium presentation at National Indian Nurse Practitioners Association Nursing Conference in New York, NY.

Nancy Homan. (2023, April). Too Sweet for Surgery — Implementing Perioperative Hyperglycemia Pathways to Optimize Outcomes. Poster presentation at ASPAN National Conference in Denver, CO.

Stephanie Kwabi. (2023, March). Promoting Prediabetes Screening Within the Primary Care Setting: An Evidence-Based Approach Utilizing the Diabetes Prevention Toolkit. Podium presentation at the UD School of Nursing DNP Program in Newark, DE.

Denise Lottero and Kelly Moyer. (2023, May). Self-Surf: Increasing Patient Portal Enrollment. Poster presentation at Jefferson’s Health Equity and Quality Improvement Summit in Philadelphia, PA.

Lisa Markiewicz. (2022, October). Innovative Governance Council Improves Nurse Satisfaction. Poster presentation at Magnet Conference in Philadelphia, PA.

Brian Matson, Karen Clarke, Rebecca Brockson and Hayley Sweetser. (2023, April). Excellence in Practice – JH-AMP @ ChristianaCare. Podium presentation at the Johns Hopkins Activity and Mobility Conference in Baltimore, MD.

Julie McCulloh Nair and Alex Waad. (2023, March). Limited English Proficient Patients’ Healthcare Experiences with Interpretive Services. Podium presentation at Eastern Nurses Research Society in Philadelphia, PA.

Steven McPherson. (2023, May). Impact of Integrated, Automated, Traveling Cobot Assistance on Time and Motion of Nursing Care Delivery. Poster presentation at American Nursing Informatics Association in Louisville, KY.

Paige Merring. (2023, April). Who Are You Tapping? Harnessing Nurse Engagement through Development and Mentorship. Podium presentation at Delaware Organization of Nurse Leaders monthly meeting, virtual.

Paige Merring. (2022, September). Who are You Tapping? Harnessing Nurse Engagement through Development and Mentorship. Podium presentation at Diamond State Chapter American Association Critical Care Nurses Conference in Lewes, DE.

Ryan Miller, Sarah Delgado, Andrew Benedict-Nelson, Linda Cassidy, and Cheryl Peterson. (2023, May). Let’s Start Now: Designing Strategies to Promote Appropriate Staffing. Podium presentation at NTI in Philadelphia, PA.

Greg O’Neill. (2022, October). I See You! Equity, Health Literacy, and Empathy. Panel discussion at University of New Mexico Hospitals Webinar Series, virtual.

Greg O’Neill. (2022, October). Make Your Research Count: Learning from Health Systems What Is Useful and What They Need. Panel discussion at 2022 Health Literacy Annual Research Conference, virtual.

Greg O’Neill. (2023, April). Patient Experience Forum: The Quest for Patient Transparency & Trust. Panel discussion at HIMSS23 in Chicago, IL.

Greg O’Neill. (2023, April). Patient Education Partnerships with IT Are Crucial for Success. Podium presentation at HIMSS23 in Chicago, IL.

Greg O’Neill. (2023, May). Patient Education Partnerships with IT Are Crucial for Success. Podium presentation at Delaware Valley HIMSS in Philadelphia, PA.

Greg O’Neill. (2023, May). Building a Health Literacy Statewide Coalition: Lessons Learned from 5 States. Panel discussion at IHA Health Literacy Conference, virtual.

Teresa Panchisin. (2023, March). The Peer Review Process Can Be More Effective: Optimizing the RL6 Peer Review Module. Podium presentation at RL Palooza in Orlando, FL.

Kristin Papiro and Vince Burch. (2023, March). Let the Data Do the Talking: Preventing Workplace Violence through Data Transparency. Podium presentation at RL Palooza in Orlando, FL.

Joan Pirrung and Joan Realdine. (2023, March). Interactive Discussion on Leadership Journeys. Lecture at Cecil College Leadership Institute in Elkton, MD.

Jessie Powell. (2022, October). A Case Study: Successful Early Autologous Skin Grafting After Significant Debridement of Skin Necrosis from IV Xylazine and Fentanyl Abuse. Poster presentation at the Symposium on Advanced Wound Care in Las Vegas, NV.

Jessie Powell and Kathy Gallagher. (2022, October). Expediting Acute Wound Healing by Integrating Multiple Therapeutic Strategies. Poster presentation at The Symposium on Advanced Wound Care in Las Vegas, NV.

Juliana Rahmer. (2023, March). Use of Virtual Attendings to Support APCs to Increase Patient Coverage and Manage Provider Shortages During COVID-19 Pandemic in a Hospitalist Group. Panel discussion at Vizient Clinical Workforce Conference in New Orleans, LA.

Danielle Sarik and Patricia Pawlow. (2022, October). A Sum Greater Than the Parts: An Innovative Nurse Scientist Model. Podium presentation at ANCC Research Symposium in Philadelphia, PA.

Christine Schrei and Deborah Wambold. (2022, October). Escape the Room — Escaping Traditional Education in Nursing. Podium presentation at the Emergency Nurses Association Conference in Denver, CO.

Christine Schrei and Deborah Wambold. (2022, October). Escape the Room — Escaping Traditional Education in Nursing. Poster presentation at the Magnet Conference in Philadelphia, PA.

Maureen Seckel. (2022, November). All About Sepsis for APRNs. Podium presentation at NCNP 2002 Fall Virtual National Conference for Nurse Practitioners, virtual.

Leslie Verucci. (2023, March). Providing Care to Prevent ED/Hospital Admissions and Delay in Treatment: Care Model Redesign Oncology Express Unit. Podium presentation at Vizient Strategies for the Advanced Practice Provider Workforce Conference in New Orleans, LA.

Colleen White and Mary Stanfill. (2022, October). Accurate Population Health Data: A Success Story. Podium presentation at AHIMA22 Global Conference in Columbus, OH.

Bolded names are ChristianaCare nurses.

ChristianaCare nurse-led conferences

17th Annual Nursing Research Conference

In partnership with other Delaware health systems and universities, ChristianaCare held its 17th Annual Nursing Research Conference, Moving Forward: Sustaining a Spirit of Inquiry. The convening brought together professional nurses and students seeking to use research and evidence-based practices to improve patient outcomes.

10th Annual Pharmacology & Evidence-Based Review Conference

ChristianaCare’s APRN Council hosted the Annual Pharmacology & Evidence-Based Review Conference designed for specialty physicians, pharmacists, psychologists, physician assistants, nurses and nurse practitioners. The event looked at current and new pharmacological and clinical approaches with the goal of achieving safe prescribing practices and optimal clinical outcomes.