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HOUSTON METHODIST NURSE A Magazine for Nurses

SPRING 2015

NURSES GOING THE EXTRA MILE

Patients tell stories of extraordinary care Magnet Assessment at Mexico City Hospital PCA Puts I CARE Values to Work to Save Driver


Liisa Ortegon, senior vice president and chief nursing executive – Houston Methodist Hospital

Becky Chalupa, vice president and chief nursing officer – Houston Methodist San Jacinto Hospital

Janet Leatherwood, vice president and chief nursing officer – Houston Methodist Sugar Land Hospital

Sheila Fata, vice president and chief nursing officer – Houston Methodist Willowbrook Hospital

ALL EYES ON PATIENT SATISFACTION Spring is finally here, and with it comes growth and new opportunities. This issue is the first to be published quarterly and mailed to homes! We hope you are happy with this new distribution, which allows us to reach a broader audience and cover a wider variety of topics. In March we celebrated Certified Nurses Day, thanking all of you for giving every day, and encouraging and aiding those who don’t have certifications to get one. We also had 14 nurses from throughout the system named in the top 150 for the Houston Chronicle’s Salute to Nurses Awards. That speaks volumes about your commitment to excellence. During this quarter, we are recommitting ourselves to patient satisfaction, as the patient is always at the center of everything we do. Our cover story profiles three patients who had exceptional experiences at Houston Methodist and nurses who went above and beyond to ensure they were taken care of. We love to hear these stories, and they should be the rule, not the exception. We have to take special care to make every patient’s experience a good one. As we know, nursing communication indicators are critical to our success: continue to focus on your courtesy

Vicki Brownewell, vice president and chief nursing officer – Houston Methodist West Hospital

Sherri Tumbleson, vice president and chief nursing officer – Houston Methodist St. John Hospital

CONTENTS 9 Magnet Assessment at Mexico City Hospital 10 Cover Story: Nurses Going Above and Beyond 13 MyRounding App Improves Care 14 Career Coach’s Corner/ I CARE at Work 15 Epic Update 16 Magnet Redesignation Journey 17 Evidence-Based Practice: Lateral Turning 18 Wedding at Houston Methodist West 19 Kaleidoscope Conference 2015 20 Evidence-Based Practice: Temperature Study 21 Salute to Nurses Awards 22 Accolades

2015 EDITORIAL BOARD MEMBERS Rosario Alvarado Rebecca Bowman Donna Esposito Sarah Fleming Shuntá Fletcher Elizabeth Gigliotti

Beverly Hughes Beverley LaMoth Carlette Patterson Verna Simmons-Robinson Joy Shiller Robyn Washington

MAGAZINE EDITOR Kelli Gifford

GRAPHIC DESIGNER Phyllis Gillentine

and respect; listen carefully to your patients; and explain things in a way anyone can understand. Take advantage of your hourly rounds to do this, and always keep your I CARE values at the center of what you do. Nurses Week is just around the corner. We have a lot of fun festivities planned at each hospital with the week ending with the annual Nurses Gala. Hope to see you there!

Front Cover: Sarah Woo, RN, pushes patient Julie Wright to Texas Children’s Hospital to visit her newborn baby.


HOUSTON METHODIST HOSPITAL NEWS HMH EARNS GET WITH THE GUIDELINES® – STROKE HONOR ROLL-ELITE AWARD

Houston Methodist Hospital has received the American Heart Association/American Stroke Association’s Get With The Guidelines®–Target: Stroke Honor Roll-Elite Quality Achievement Award. It is one of 559 hospitals to be recognized with the award this year at the International Stroke Conference. To receive this award, hospitals must meet quality measures developed to reduce time between a patient’s arrival at the hospital and treatment with the clot-buster tissue plasminogen activator, or tPA, the only drug approved by the U.S. Food and Drug Administration to treat ischemic stroke.

CELEBRATING CERTIFIED NURSES Certified Nurses Day™ is a special day of recognition to honor the contributions of board certified nurses to the advancement of the nursing profession and to excellence in patient care. A ceremony took place March 19 in Crain Garden, welcoming and congratulating nursing who have earned certifications. The ceremony opened with a prayer from Chaplain Stacy Auld, who also blessed the pins. Brenda Case-Cook gave a presentation on the importance of certifications, and Senior Vice President Michael Garcia and Vice President Kerrie Guerrero and Executive Vice President Roberta Schwartz also said a few words to those in attendance.

UNIT ADMINISTRATIVE ASSISTANTS CELEBRATION National Administrative Professionals Day recognizes the work of secretaries, administrative assistants, receptionists and other administrative support professionals, and on April 21, HMH hosted its first Unit Administrative Assistant recognition event. This included a meet-and-greet, ice cream social and presentation of certificates. Recently, the UAAs have been promoting their professional development through new uniform standards, quarterly education and monthly shared governance council meetings. “We love you, we appreciate you and we celebrate you!” said Aerica Williams, MSN, RN, UAA liaison in the Center for Professional Excellence.

SAVE THE DATES FOR CONTINUING NURSE EDUCATION

In Memoriam

NEUROSCIENCE Nursing Residency Program May 13, 14 and 15, 2015 houstonmethodist.org/neuronursing

Eva and Oscar Ballinas, both Houston

LUNCH ‘N LEARN CLINICAL PEARLS

Oscar, was a housekeeper. Our hearts and

Methodist Hospital employees, tragically lost their lives on April 14. Eva was a patient care assistant in the Fondren CCU, and her husband,

Nurse Practitioner Lecture

prayers go out to the Ballinas family and to all

2nd Tuesday of every month Contact: Meagan Sam at mesam@houstonmethodist.org

their coworkers.

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HOUSTON METHODIST SAN JACINTO NEWS

THE DAISY AWARD Houston Methodist San Jacinto Hospital

THREE SICU NURSES RECEIVE DAISY AWARD Three SICU nurses received the Daisy Award for February: Charles Swallow, Dominique Fontenot and Carla Famjit. Dr. Vijay Nagarajan nominated this group of nurses for their “excellent communication, swift skills and remarkable teamwork.”

SICU employees with Dr. Vijay Nagarajan (left) and DAISY Award winners Charles Swallow, Dominique Fontenot and Carla Famjit.

TEAM WINS AWARD AT PRESSURE ULCER CONFERENCE Congratulations to Cindy Barefield, Vickie Chao and Kathy Arthurs, whose research abstract won first place for new investigator at the National Pressure Ulcer Advisory Panel Biannual conference.

MAGNET MIXER A SUCCESS The Houston Methodist San Jacinto Hospital Magnet Mixer was a huge success. The Magnet Champions at the hospital displayed their hard work at both of the hospital campuses.

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HOUSTON METHODIST SUGAR LAND NEWS MAGNET BOOT CAMP Houston Methodist Sugar Land Hospital kicked off its first ANCC Magnet Boot Camp on March 2 with the theme Get Fit for Magnet! HMSL Magnet Champions planned and coordinated this event that highlighted each unit’s readiness for the anticipated next step in the Magnet Journey — the site visit. Magnet Champions worked with each unit’s staff to create a poster displaying how the unit exemplifies one of the components of the Magnet Model: Transformational Leadership, Exemplary Professional Practice, Structural Empowerment, New Knowledge, Innovations and Improvements and Empirical Outcomes. Everyone attending took part in fun fitness activities including Zumba, Wii fitness games, jump roping, hula-hoops, weightlifting and an obstacle course.

HOUSTON METHODIST SUGAR LAND’S MAGNET JOURNEY UPDATE In February, Houston Methodist Sugar Land submitted its ANCC Magnet document in a Web-based format. The ANCC informed the hospital a month later it met initial qualifications, and its document is currently under review by designated Magnet appraisers. The review is expected to take at least four months. During this time, HMSL’s focus will be on preparing for an anticipated site visit.

Ainy Ali and Susan Shibu share their posters with Magnet Boot Camp attendee, while Ma Cecilia Clarissa “Bing” Advincula reviews a poster.

From left to right, standing: Shamsad Modi, Angela Onyia, Susan Shibu, Ancy John, Bing Advincula, Mercy Samuels, Deion Cross, Philomena Valson, Joy Fey, Rose Gonzales, Tracy Bridges, Sheena Helms, Irene Morrison, Rushi Brahmbhatt. From left to right, kneeling: Karen Cothran, Anifa Andrade, Milli Owusu, Huong Nguyen, Stella Tomy and Ainy Ali.

NATIONAL CERTIFIED NURSES DAY CELEBRATION HMSL celebrated Certified Nurses Day™ on March 19 and recognized 266 certified nurses with cake and punch. These nurses have voluntarily chosen to achieve professional certification, and their efforts, which ultimately contribute to higher standards of patient care and protect the public, are lauded. Front row, left to right: Janet Leatherwood, Susan Shibu, Marykutty Babu, Tricia Lewis, Kumar Yeseudoss, Shawn Winkleman and Carol Thomas. Back row, left to right: Cesar Ramiro, Jessy Raju, Sonam Dhuka, Victoria Jomadaio, Vee Jones, Linda Matlock, Karen Tobin, Liberty Ramas and Karen Fuller.

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HOUSTON METHODIST WILLOWBROOK NEWS

THE DAISY AWARD Houston Methodist Willowbrook Hospital

JOAN BURNHAM RECEIVES DAISY AWARD Joan Burnham, RN-BC, OCN, was awarded the first HMWB DAISY Award of the year. Burnham was nominated by a patient undergoing chemotherapy who was impressed by her expertise and compassionate, personalized care. “Joan is a nurse who consistently goes above and beyond the norm,” the patient wrote. Joan is described as a “source of comfort” both for her drive to make the patient comfortable and through her ability to alleviate fear by helping patients understand their treatment.

TRANSPORTATION DEPARTMENT KICKS OFF The highly anticipated Patient Transportation Department went live in February. Transporters are now available to assist with admissions, discharges, and most interdepartmental transfers. This department was established to fulfill frequent requests from nursing staff for additional ancillary help. The department will play a vital role in our patient progression work and will contribute to patient satisfaction with discharge.

IMPROVING THE NEW PARENT EXPERIENCE Women’s Services recently launched an initiative called bedside transition to improve the new parent experience at HMWB. This initiative allows well mothers and babies to stay together from birth to discharge, a departure from traditional newborn care in which the baby is sent to the nursery for several hours following delivery, allowing families to avoid the disappointment of separation from their new child. In addition to patient experience benefits, bedside transition is helping HMWB families get a happier, healthier start by utilizing rooming-in and skin-to-skin contact, promoting successful exclusive breastfeeding.

ICU RECEIVES SILVER BEACON AWARD

The ICU at HMWB has been awarded a silver-level Beacon Award for Excellence by the American Association of Critical Care Nurses. The Beacon Award for Excellence recognizes ICU caregivers who improve patient outcomes and meet rigorous evidence-based criteria in areas such as leadership structures, staff engagement, learning and development, evidence-based practice and patient outcomes. Hospitals are evaluated based on a written application. In their findings evaluators praised the HMWB team for displaying a “strong focus on acquisition of knowledge and application of research and evidence-based practice.” The unit was also commended for living the I CARE values, stating that the team demonstrated “I CARE…is more than words on paper but an actual guide to achieving excellence in all endeavors.” HMWB is one of only two hospitals outside of the Texas Medical Center and one of six hospitals in the Houston area to earn a Beacon Award for Excellence. 6 HOUSTON METHODIST NURSE


HOUSTON METHODIST WEST NEWS DVT PREVENTION A NEW CORE MEASURE There has been an addition to core measures this year: DVT prevention. As most know, Houston Methodist West Hospital’s goals for 2015 are excellent service and quality, and DVT (deep vein thrombosis) core measure falls right in line with these goals. The primary focus is on prevention. Admitted patients often do not ambulate as frequently as they do at home due to pain and other reasons and are at risk for developing a DVT or PE (pulmonary embolism). It is a nurse’s job to assess for risk, talk with the physician about prophylactic measures and encourage early ambulation. This helps everyone. Patients who develop a DVT or PE require additional treatment and stay longer in the hospital. Early intervention prevents the need for additional treatment and an extended length of stay. Facts about DVT/PE 1. According to the American Heart Association, up to 2 million Americans are affected annually by DVT. Of those who develop pulmonary embolism, up to 300,000 will die each year. – More Americans die annually from DVT/PE than from breast cancer and AIDS combined (which total about 55,000 deaths annually). 2. The risk of DVT/PE in untreated patients after a major surgical procedure is approximately 20 percent. PE may occur in 1 to 2 percent of patients, and fatal PE may occur in 0.1 to 0.4 percent. 3. Nearly half of DVT episodes have minimal, if any, symptoms. Mechanical and Pharmacological Interventions Mechanical intervention examples: SCDs, TEDs, foot pumps Pharmacological intervention examples: apixaban** (Eliquis**) dalteparin (Fragmin) enoxaparin (Lovenox) fondaparinux Na (Atrixtra)

Oral Factor Xa Inhibitor LMWH LMWH Factor Xa Inhibitor

heparin - SQ or gtt only LDUH rivaroxaban *** (Xarelto***) Oral Factor Xa Inhibitor tinzaparin (Innohep) LMWH warfarin/ Coumadin/ Jantoven Coumadin ** Eliquis only OK after hip or knee arthroplasty surgery *** Xarelto only OK if patient has a fib

STILL HAVE QUESTIONS? Meet Kelley Henry, RN, currently working in the quality department as a PI coordinator. One of her major projects this year is to make HMW the best at DVT prevention and DVT core measure. Kelley provides provide resources for preventing DVT and meeting CMS requirements for the core measure. She actively sends educational emails and posts FYI fliers on all units to ensure everyone has the information needed to provide appropriate DVT prevention interventions. Henry meets with charge nurses, managers and staff nurses individually to help answer questions and empower the staff nurses with DVT knowledge.

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HOUSTON METHODIST ST. JOHN NEWS

THE DAISY AWARD Houston Methodist Willowbrook Hospital

3 SURGICAL NURSE NAMED DAISY WINNER Juliet Kahiu from 3 Surgical received multiple nominations from her patients and was recognized as the third-quarter DAISY Award winner. A patient said Juliet “went over and above duty to help me. She is so amazing. I loved her. She is an absolute blessing and an asset to Houston Methodist St. John Hospital.” When accepting her DAISY Award, Juliet gave a lot of the credit to her coworkers. From left: Kathryn Henry, Michelle Vice, Juliet Kahiu, Kathy Johnson-Ridens and William Barros.

FIRST ANCILLARY STAFF AWARD WINNER CHOSEN Chalita Saguiped is the first winner of the new Ancillary Staff Award, created to honor staff who support nurses and patients. Saguiped is a patient care technician on Three Medical and was nominated by multiple peers and patients. Her compassion and smile greatly affects patients and staff in positive ways. The new award will be given quarterly, along with the DAISY Award. A contest underway for St. John employees will determine a name for the new award.

Chalita Saguiped,the first HMSTJ Ancillary Staff Award winner.

PHYSICIAN’S LETTER LEADS TO I CARE AWARD When Amir Soltani’s “warm and welcoming” attitude was noticed by a surgeon at work, he was surprised to learn the doctor had taken the time to send a letter of praise to Soltani’s director. “I have witnessed his enthusiastic engagement in the services he renders and his compassionate initiative in interacting with patients, their family and friends,” the physician wrote. These words reflect the passion that Soltani has for his work every day as an anesthesia tech. His personality and skills have been recognized over the years by many of his customers, leading him to win an I CARE Award.

“I have witnessed his enthusiastic engagement in the services he renders and his compassionate initiative in interacting with patients, their family and friends.”

I CARE Award winner Amir Soltani, anesthesia tech.

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HOUSTON METHODIST ST. CATHERINE NEWS BLESSING “JESUS THE GREAT PHYSICIAN” STATUE A blessing ceremony for the statue “Jesus the Great Physician” at HMSTC attracted distinguished guests including Dr. Marc Boom, president and CEO of Houston Methodist, Wayne Voss, CEO of Houston Methodist West Hospital, Willy Wang, the statue’s sculptor, Mark Klein, donor of the statue, and members of the community. The statue signifies the healing and comfort of patients throughout Houston Methodist, and each hospital has a statue displayed in a prominent area. The statue is one more source of consolation and comfort to patients.

PROVIDING HOLISTIC AND COMPASSIONATE CARE The health care team at HMSTC is constantly looking for ways to provide holistic and compassionate care to patients due to the long course of their stay. In addition to the medical and clinical care, the team focuses on restoring a sense of accomplishment and empowerment to patients. Taking a patient to “see the stars” at night in one of the outdoor healing gardens, facilitating personal pet visits for others, providing haircuts, reading to a patient in front of the fountain, weekly art therapy, trips to the gift shop, singing to patients and decorating their rooms, are some of the “above and beyond” actions generated by the team. Patients have respond positively to these interventions and families have observed outcomes they did not believe could happen, with several families stating “this is a miracle.”

HOUSTON METHODIST GLOBAL HEALTH CARE SERVICES

Magnet assessment performed at ABC Hospital in Mexico City A team of Houston Methodist nurses arrived at ABC Hospital in Mexico City, Mexico, on March 8 to provide a comprehensive Magnet assessment of their nursing organization. A team of Houston Methodist nurses shared their Magnet expertise with ABC Hospital in Mexico City last month, expanding our Leading Medicine promise to patients in another country. The team was led by Alicia Hernandez from Houston Methodist Global Health Care Services, and Dana Scott, Magnet director for Houston Methodist Willowbrook Hospital. Kerrie Guerrero and Susan Puls, who are doing a semester with Houston Methodist Global Health Care Services, were a critical part of the team and the assessment process. Elizabeth Brown, Magnet coordinator from Houston Methodist Sugar Land Hospital, also provided critical support.

The team began the assessment on March 9. Following a morning of meetings with key nursing leadership from both hospital sites, the team explored ABC Hospital’s infrastructure and processes required to prepare for Magnet and Pathway to Excellence eligibility. The team proceeded to visit and talk with nursing staff on each of the units. Global Services Chief Operating Officer Ann Scanlon McGinity met with Alejandro Alfonso, the CEO of ABC Hospital, and a board member who were both eager to support their nursing organization’s Journey to Magnet. The closing conference was attended by all ABC Hospital’s nursing leadership where Scott and Hernandez shared a comprehensive debrief: the team’s recommendations are to apply for Pathway to Excellence in 2017 and Magnet designation in 2020. Following the timeline recommended, it is anticipated that ABC Hospital will be the first in Mexico City to achieve Pathway to Excellence.

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ABOVE

AND

GOING BEYOND

Houston Methodist Hospital nurse Sarah Woo pushes Julie Wright to Texas Children’s Hospital to visit her newborn baby.

Patients receive extraordinary care at Houston Methodist

By Kelli Gifford, Magazine Editor

JULIE WRIGHT, PATIENT AT HOUSTON METHODIST HOSPITAL

very supportive of me going over to see her, making sure I was spending time with her.”

When Julie Wright, 31, was 14 weeks pregnant with her second child, she started suffering headaches and constant nausea. After some testing and an eventual MRI, doctors found a brain tumor.

This is just one story of a patient who received exceptional care at Houston Methodist.

Research shows a clear correlation between patient outcomes and patient satisfaction scores — and that’s why we stress it at Houston Houston Methodist doctors waited as long as they could before Methodist. Julie attests that Houston Methodist nurses go the doing surgery, but when Julie was 31 weeks pregnant, doctors extra mile to put the patient at knew they must remove as much of the center of everything they the tumor as possible and that the “The nurses went above and beyond, taking do, focusing on showing respect baby would have to be delivered. me over to Texas Children’s every day for to patients and their families, Charlotte was born at 3 pounds, – Julie Wright the skin-to-skin contact. ” listening to their concerns and 8 ounces, and was taken to Texas explaining everything thoroughly. Children’s Hospital’s NICU. But the distance wasn’t going to keep mother and baby apart. “The nurses went above and beyond, taking me over to Texas Children’s every day for the skin-to-skin contact,” says Julie. “They set up for me to have everything transported with me and were

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“Any effort it took to have Julie see and hold her newborn baby was worth it,” says Sarah Woo, RN, BSN, one of the nurses who cared for Julie. “I was immediately impressed with Julie and her whole family. They were extremely patient while we got Julie ready to leave the unit and kept a great sense of humor despite all Julie was going through.


“This daily routine of taking Julie over to TCH was essential to her healing process. It illustrates the compassion our doctors have for the patients. It exemplifies how social needs are just as important when making sure our patients have complete care and a successful recovery.”

I was racing from Houston Methodist to Texas Children’s with baby Charlotte. On top of that, the next day she came back to visit Julie to check on her,” says Steve.

For Julie, nurses in the Neuro ICU had to take a lot of precautions in order to wheel her through Houston Methodist Hospital, down through the tunnels and over to the Texas Children’s NICU. In the beginning, Julie had an external brain drip so the monitors and IV had to be wheeled along with her.

“Having the opportunity to provide continuity in care for the couple weeks Julie was there prior to delivery enhanced our relationship. When the decision was made for the date of the C-section, it wasn’t even a question — I was going to be there. The amount of clapping in the operating room after the announcement of ‘It’s a girl!’ had me in tears! It was such a special thing to be a part of and something I will never forget.

“One important thing I need to say is thank you to all the amazing nurses,” says Steve Wright, Julie’s husband. “Julie had a neuro ICU nurse bring in some preemie clothes for us to borrow out of the kindness of her heart. Nobody prepares to have a preemie, but to have friends and nurses say, ‘Here you go,’ is more than amazing. “The reality is all the nurses have been really great, but one really stands out. Michelle (Schoen) volunteered to come in and help with the delivery. Pregnant and the mother of two herself, she came in on her off night to be there for Julie during the delivery. Then she stayed with Julie for a couple hours postdelivery while

Schoen says it was a pleasure caring for Julie and her baby.

“Working for Houston Methodist and using our I CARE values every day has made me a better nurse, and I can only hope as I continue on in my career that I never forget what nursing is all about.” After having a shunt put in and a second brain surgery that removed the all but 10 percent of her tumor, Julie was discharged on March 14, and baby Charlotte joined her at home four days later. Story Continued on Page 12

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story cont’d from page 11

JAMES GIBSON, PATIENT AT HOUSTON METHODIST WEST HOSPITAL James Gibson, 59, was admitted to Houston Methodist West Hospital in early February with shortness of breath related to a history of asthma. His pulmonologist worked at another Houston-area hospital, but Gibson refused to go anywhere else. James’ asthma is so severe that he is in the process of receiving thermoplasty treatments. He is very sensitive to medication and the doctors spent most of Gibson’s time in the hospital trying to find the perfect combination, making sure his pain was controlled in the meantime. Eventually, the regimen began working and he began to feel better and was allowed to go home. “When I rounded on him, he had nothing but amazing things to say about the hospital from housekeeping to food services to nursing,” says Sarah Fleming, MBA, BSN, RN. “He told me that every person he encountered was excellent, friendly and professional.” Fleming said James felt well-respected and well cared for, also mentioning that during previous hospitalizations elsewhere his wife would not leave his side because he needed help and did not always get it, especially during the night. This admission, he told his wife to stay home at night to rest because he felt in such great care.

PETER CHAN, PATIENT AT HOUSTON METHODIST SUGAR LAND HOSPITAL On a nice winter

“Peter gave a lot of hope to a morning in January, profession that sometimes doesn’t see Peter Chan went a lot of hope.” – Eleanor Chan for an 11-mile run. An avid athlete, this was common for the 48-year-old. His wife, Eleanor, was on her way to pick up their son from middle school and their 15-year-old daughter was at home. When Peter returned, he talked with some neighbors then went inside to stretch. His daughter soon heard noises from the family’s exercise room and went to investigate. She found her father, who wasn’t breathing. She called 911 and started CPR, and a neighbor who is a fire marshal came over to assist until the ambulance arrived. When the EMTs got there, they couldn’t find a pulse and did total defibrillation of him seven times on their way to Houston Methodist Sugar Land Hospital. “Even in the ER he was trying to fight through it,” said Eleanor. “He was trying to regain consciousness and was fighting anything being done to him, so they had to sedate him. The ER nurses were really patient, explaining what was going on, that they had to sedate him for his own safety.”

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Sarah Fleming on patient rounds.

James reiterated how his time at Houston Methodist West was “a totally different experience” from his time at other hospitals. “I’ve been in hospitals before where they just do their job and go home; they don’t really care. I never had that experience at Houston Methodist West. I’m so glad I was there with that group of people … I got really good care from them all.”

Because of Peter’s condition he doesn’t remember much of his hospital stay, but his wife was there every step of the way. Noli Rivera, RN in the ICU, introduced himself as Peter’s nurse. Eleanor said Rivera took great care of Peter and was very comforting to her. “I kept her informed of what was going on and what to expect. In the ICU, you’re not only taking care of a patient, you also have to take care the family members,” says Rivera. Throughout Peter’s stay, Eleanor said all of the nurses went out of their way to keep her informed. “Every time something was going on I would watch and they would explain every single step to me.” Eleanor says Peter had no health issues before this happened, and all the tests run on him came back normal. “I realized more and more that Peter gave a lot of hope to a profession that sometimes doesn’t see a lot of hope.” Eleanor says it was a “blessing” to be at Houston Methodist Sugar Land and “to be surrounded by such great caring people — especially the nurses — who knew where I stood in my faith and believed in a complete healing for Peter.” Peter was discharged two and a half weeks after his incident and has been doing well.


MY ROUNDING APP ALLOWS NURSES TO IMPROVE PATIENT CARE IN REAL-TIME By Dan Hootman and Kimberly Goode

NURSES HAVE MANY TOOLS AT THEIR FINGERTIPS TO REINFORCE BEST PRACTICES THAT ENHANCE QUALITY AND SERVICE. The MyRounding app for iPad helps in conducting nurse leader rounds (NLR). Each patient on every inpatient unit is visited by a nurse leader, who asks a series of questions to ascertain that care and communication are at their best. Using the app, the nurse leader generates reports that share the number of rounds completed and to report any outstanding issues. These rounds offer nursing leaders a chance to collect real-time feedback from patients as well as “in the moment” opportunities to solve problems and perform service recovery. Hourly rounding also enhances the experience of patients and families. Patients should be seen by staff each hour to address questions and concerns as well as 4 P’s: pain, position, potty needs and possessions. The prescriptive rounding tool is anchored using the communication tool of AIDET (acknowledge, introduce, speak about duration, explanation and thanks). When managing the expectation of hourly rounding to provide unparalleled safety, quality and service, staff build trust and accomplish great things.

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CAREER COACH’S CORNER

PERSEVERANCE PAYS OFF By Shuntá Fletcher, MSN, RN, NE-BC, CVRN-BC

Berhanu “Bebe” Beyene, a PCA I in the Emergency Department at Houston Methodist Hospital, thanks the career coaching he received for helping him get there. In 2010, Beyene came to the United States from Ethiopia with hopes and dreams of working in health care. He was hired as a housekeeper in a hospital but realized he could work closer with patients if he took classes to become a certified nurse assistant. After becoming certified as a CNA, he heard about Houston Methodist and its wonderful reputation with patients and employees. He applied and was hired in 2013 to work in the Food and Nutrition Department. He yearned to use his CNA certification and work in patient care. Someone told him to see the career coach for help.

Berhanu Beyene. PCA

Beyene met with a career coach, listening intently to learn a better path to success. He followed the advice and volunteered in the ED to learn the culture and the people. After seven months of volunteering and improving his English skills, they offered him a job. He has since transferred to ED. “I love it there,” he said. Sharon Tatum, RN IV in ED, said “I believe the patients enjoy seeing his face, because he is smiling all the time.” If you would like greater career success or need help in solidifying your vision for the future coaching appointments are flexible and are conducted by face-to-face interview or telephone. For more information please contact The Center for Professional Excellence at cpecareercoaching@houstonmethodist.org or 713.441.4546.

I CARE AT WORK Tawanna Myers, PCA

THE RIGHT PLACE AT THE RIGHT TIME Tawanna Myers, a PCA on Main 4 Neurosurgery, wasn’t even supposed to be working on a winter Saturday. She was asked to cover a shift and felt compelled to come to work. As Myers and carpooling co-worker Mary Kinchen headed home that night on I-45 north, they spotted a green Ford Explorer swerving near the interchange for I-10. He lurched across traffic and hit the concrete barrier. Myers, who was a few car lengths ahead, saw the incident and pulled over. Tawanna Myers, PCA

“I jumped out of the car and told Miss Mary to dial 911,” Myers said. “The passenger then got out of the car, holding his head and staggering. I told him to get away from the freeway and sit down.”

The passenger kept telling Myers to help his friend, who had suffered a seizure. At this point another driver pulled over to help, and together they got the driver out of the SUV and placed him on a mat that Myers had in her car. She put him on his side to keep him from aspirating, took his pulse and stayed with him until the ambulance got there. Once EMTs arrived, she Myers filled them in. They asked if she was a nurse. “I will be in two months,” she replied. She is graduating from Chamberlain College of Nursing this spring. They saw she was wearing a shirt from Houston Methodist and asked if she worked here. She said yes and the EMTs responded “We can tell,” and commended her for a job well done. “I have always been one to jump into action,” said Myers. “I love nursing, and I’ve had obstacles and setbacks that tried to distract me, and it took me a while to get to this point, but I knew I was never going to give up. I love being at Houston Methodist, I represent for Houston Methodist, and it is by far the No. 1 place to work. I think God had me there for a reason; that I worked that day for a reason.” Kinchen agreed. “I was so proud of Tawanna for doing an outstanding job and showing compassion for another human being.”

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ENGAGEMENT OF NURSE SUPER-USERS INSTRUMENTAL IN EPIC LAUNCH

By Kimberly Nichols

As Houston Methodist continues to work toward the 2016 launch of the Epic system, nurse super users (SMEs) are playing a key role in decisions that will impact the patient experience, safety and quality, efficient operations and research and innovation.

As key decision-makers, Nurse SMEs provided input on the integrated workflows, which will debut at the Workflow Walkthrough (WFWT) event June 16-17 at the Houston Marriott Medical Center. What’s unique about the WFWT is attendees will experience Epic the way a single patient experiences it. Organized by the Epic Instructional Design team, WFWT highlights the integration of multiple Epic roles and workflows from ambulatory to inpatient. Executive leadership, committee chairs, physicians, directors, administrators and workgroup SMEs are invited to the event. Nurse SMEs were instrumental in reviewing clinical workflows for Epic applications such as ClinDoc, Orders, OpTime, Stork, Ambulatory and Patient Scheduling as part of the Clinical Content Build-Out (CCBO), which kicked off a few months ago. Their input provided the foundation for what the Houston Methodist Epic build will ultimately look like. “The nurses are very engaged with both WFWT and CCBO,” said Susan Laws, Epic nurse champion for Houston Methodist Sugar Land Hospital. “This level of involvement gives everyone a sense of ownership and empowerment for Epic.” Laws recognized that nurse involvement for design decisions significantly helps with adoption. “I’ve been involved in several Epic implementations. Some went well and others were rough. The hospitals with go-lives that went well empowered the clinical staff and physicians to make decisions about the system they would end up using to care for patients,” Laws said. Cindy Theriot, who doubles as the quality reviewer for performance improvement and the Epic nurse champion for Houston Methodist San Jacinto, is also excited about the Epic GoLives in 2016 and 2017. “Epic won’t be a magic wand or an easy button for some of the more challenging issues we face on a day-to-day basis, but it will be worth the effort we put into it for our patients and clinicians,” Theriot said.

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HOUSTON METHODIST HOSPITAL

Preparing for ANCC Magnet site visit By Mary Shepherd, RN, MS, NEA-BC

This year Houston Methodist Hospital will welcome visitors from the American Nurses Credentialing Center (ANCC) to conduct the Magnet site visit. Every four years Magnet hospitals must recertify to validate that the Forces of the Magnetism, which serve as the foundation for practice and provide a framework to transform the environment, continue to be embedded in the culture. The documentation required is extensive and includes 106 stories and evidence that is submitted in two phases. PHASE I • Chief Nursing Officer’s resume • Hospital’s organization chart • Nationally benchmarked nurse satisfaction tool • Nursing vice president’s and nursing directors’ credentials (must have a degree in nursing, baccalaureate or graduate)

• Demographic nurse credentials (extracted from the nursing census and Human Resources files)

PHASE 2 Narratives, examples and other evidence representing a variety of clinical settings and nursing leadership, must be submitted. This documentation must address processes, programs and outcomes and how each is operationalized in these settings. Houston Methodist offers unlimited opportunities to excel, and this is precisely what the stories convey. In 2014, ANCC raised the bar and Houston Methodist Hospital rose to the challenge as the team responded with stories that capture the essence of the Magnet Program and the benefits to patients, families, staff and community.

MAGNET TEAM FORMULATES DATABASE TO ASSESS SHARED GOVERNANCE By Everett Stafford Magnet-designated organizations such as Houston Methodist Hospital are characterized by nurse autonomy over practice, nurse control over the practice environment, and effective communication between nurses, physicians, other disciplines and administrators.

“They want to see how innovative we are and if we are evaluating ourselves and our outcomes.” – Mary Shepherd, Magnet program director

“Organizations where the ‘Forces of Magnetism’ become the ‘Forces of Stagnate-tism,’ don’t get redesignated,” said Mary Shepherd, RN, MS, NEA-BC, Magnet program director for HMH. “They want to see how innovative we are and if we are evaluating ourselves and our outcomes.” In light of the current redesignation effort, and in the spirit of evaluation and innovation, the Magnet team formulated a plan for assessing the structure and effectiveness of the unit/departmental nursing shared governance at HMH. The team determined that a data collection tool was needed before a valid assessment could take place. As a result, an Excel-based user-form was created to streamline the process of collecting data on all unit-based shared governance council structures and their specific goals as they apply to the Pillars of Excellence. Some of the benefits of having this data: 1. Partnership: A comprehensive list of shared governance chairs facilitates direct communication with nursing. 2. Equity: Confirms that each unit addresses service and quality pillars through their shared governance structure. These pillars are considered the minimum standard for achieving desired outcomes. 3. Accountability: Confirms that council goals are aligned with nursing’s priorities, and with their dashboard/scorecard outcomes. 4. Ownership: Having defined goals allows staff to drive actions and own their outcomes. This data collection tool was introduced at the February 2015 Nursing Leadership Assembly and subsequently emailed out to all directors and managers. HMH envisions the future of this tool as a Web-based form where shared governance chairs can update council membership and goals in real-time. REFERENCES American Nurses Credentialing Center. (2015). Magnet Recognition Program® Overview. Retrieved March 31, 2015, from www.nursecredentialing.org/magnet/programoverview Keeping Patients Safe: Transforming the Work Environment of Nurses. (2004). Washington, DC: The National Academies Press. Retrieved from nap.edu/catalog/10851/keeping-patients-safe-transforming-the-workenvironment-of-nurses Swihart, D. (2011). Shared governance a practical approach to transform professional nursing practice. Danvers, MA: HCPro. Retrieved from http://search.library.wisc.edu/catalog/ocn815396777

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HOUSTON METHODIST HOSPITAL

EFFECTS OF LATERAL TURNING ON MECHANICALLY VENTILATED PATIENTS By Shannan K. Hamlin, PhD, RN, ACNP-BC, AGACNP-BC, CCRN

Mechanically ventilated critically ill patients are at high risk for developing preventable pulmonary complications. A standard of care to reduce complications is lateral turning every two hours. Lateral turning in mechanically ventilated intensive care unit (ICU) patients has been shown to affect adversely hemodynamic status. Although adverse hemodynamic effects are typically transient, clinicians may be reluctant to laterally position mechanically ventilated patients who are critically ill. Positive pressure ventilation can reduce venous return and cardiac output. Lateral turning may augment adverse hemodynamic effects in mechanically ventilated patients. Evidence suggests a decrease in blood pressure in the lateral position, compared with the back position. Gawlinski and Dracup (1998) found blood pressure recovered to baseline values within five minutes of a turn, suggesting that lateral turning has a transient effect. Because factors causing decreased venous return would be maintained throughout time in the lateral position, transient effects on blood pressure suggest either (a) hemodynamic compensation, or (b) the hemodynamic changes are responses to the physical act of turning and not to the lateral position per se. Research on the hemodynamic effects of lateral turning has been limited by the use of discrete measurements (e.g., ≤ 5 time points in each lateral position) and short study duration. The hemodynamic effects of automated turning have not been systematically evaluated. We conducted a randomized clinical trial (RCT) pilot study to compare the efficacy for prevention and treatment of pulmonary complications and safety of two turning interventions (ClinicalTrials.gov: NCT00542321): manual turning every two hours (standard of care and control group) and continuous automated turning with a kinetic therapy bed (experimental group). As a component of the safety assessment, we examined turning-related hemodynamic responses, defined as changes in heart rate (HR), mean arterial pressure (MAP) and pulse pressure (PP). Using a time-series design with automated signal processing and ensemble-averaging, HR, systolic blood pressure (SBP), diastolic blood pressure (DBP) and MAP were captured every

six seconds for > 24 hours, and PP was computed. Thirteen adult, mechanically ventilated medical-surgical ICU patients from two tertiary hospitals were randomly assigned to the manual-turn or the automated-turn protocol for up to seven consecutive days. HR and arterial pressure were sampled every six seconds for > 24 hours, and PP was computed. Thirteen patients completed the study. Seven patients (54 percent) had an indwelling arterial catheter. Statistically significant (p ≤ .05) changes in HR, MAP, and PP were observed with the manual turn. Recovery of the hemodynamic variables to baseline values required up to 45 minutes (p ≤ .05) in the manually turned patients compared with the expected recovery time of ≤ five minutes. However, clinically important changes, defined as ≥ 10 bpm or ≥ 10 mm Hg, dissipated within 15 minutes of the lateral turn. The steady-state HR response on the right was slightly greater (three beats/min) than on the back (p < .01). Automated turning resulted in no clinically important changes in HR, MAP or PP.

In medical-surgical mechanically ventilated ICU patients, manual lateral turning to ≥ 45 degrees was associated with changes in HR, MAP, and PP, with changes persisting for up to 45 minutes. Automated lateral rotation to a mean angle of 32 degrees had negligible hemodynamic effects. Further research with a larger sample size is indicated to validate these findings, and future research should be conducted on patients with hemodynamic compromise and their ability to tolerate manual and automated lateral rotation.

For a complete report on this research study please see: Hamlin, S., et al. (2015). Hemodynamic changes associated with manual and automated Lateral turning in mechanically ventilated intensive care unit patients. AJCC, 24(2), 131-139. LEADERS IN NURSING 17


CENTER FOR PROFESSIONAL EXCELLENCE

ESSENTIAL EDUCATION FOR EXCELLENCE: Groove to Improve

By Meredith J Cowan MS, RN-B, RNC-OB and Roberta (Bobbi) Musgrove, MSN, RN-BC, CIC

In an effort to provide Houston Methodist Hospital nurses with timely, critical information on institutional priorities, the Center for Professional Excellence (CPE) conducted Essential Education for Excellence in January. In eight 15-minute sessions, CPE educators worked with a talented group of content experts who diligently condensed their complex topics into essential “take away” messages. The involvement of these experts, representing departments across the hospital, was critical to the activity’s overall success. Topics included bed alarms, pressure ulcer prevention, catheter associated UTI and BSI, advance directives, restraints, medication safety, patient satisfaction and handoff communication. All presentations were evidence-based and carried the distinction of high priority throughout the organization. Classroom and hallway decorations illustrated the disco theme, and music propelled staff from one education station to the next. The energy and enthusiasm were contagious, sparking spontaneous breakouts of hallway dancing, lip-syncing and singing.

More than 1,800 RNs participated in the Essential Education event. Many department leaders indicated they believe staff benefited from the activity. Results of the post-test included aggregate scores above 80 for patient satisfaction, fall prevention, pressure ulcers, medicine administration safety and handoff communication. CPE is looking at opportunities for further education based on lower scores for questions relating to advance directives, restraints and infection prevention.

HOUSTON METHODIST WEST HOSPITAL

LOVE AND WEDDING BELLS FILL THE HALLS By Sarah Fleming

Nurses and staff at Houston Methodist West Hospital became impromptu wedding planners in January when a patient expressed the desire to be married before he underwent coronary bypass surgery. The patient suffered cardiac arrest at home but received CPR from a friend. He was transported to HMW, where doctors discovered he needed surgery. Perhaps inspired by his close call, he wanted to get married to his longtime love.

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The ICU at West pulled out all the stops to ensure this would be a wedding to remember. Laura Espinosa, ICU director; Nancy Jo Goldie, ICU manager; Rebecca Yarborough, CV coordinator; and Eun Young-Kim, the patient’s nurse, helped decorate. The ICU pharmacist, Jessica George, and dietician Ann Matocha created beautiful bows to create an atmosphere of love. The patient’s room transformed into a wedding chapel within hours. Dietary services delivered a stunning cake to help celebrate after the ceremony. Music was provided by dietary service manager Dennis Ha, a violinist, with vocals by administrative secretary Jaunice Venson. The couple’s children sprinkled rose petals prior to the ceremony, adding a final touch of magic to the event. A wedding, especially one with so much love, is an excellent reminder of the miracles nurses perform and witness every day.


KALEIDOSCOPE 2015 NURSING CONFERENCE Obstetrical, Neonatal and Women’s Health Nursing: A Labor of Love By Rosario Alvarado, MSN, RN, CCRN

NEARLY 600 ATTENDED THE 32ND ANNUAL KALEIDOSCOPE PERINATAL, NEONATAL AND WOMEN’S HEALTH NURSING CONFERENCE

sponsored by Houston Methodist with support from the March of Dimes Feb. 9-10 in Galveston. The conference offered education on current advances in perinatology, women’s health care, and ethical and societal issues impacting women, newborns and childbearing families. The planning committee included members from Houston Methodist, Memorial Hermann Health System, Texas Women’s Health System, and Harris County Health System. Attendees came from throughout Texas, and more than 40 vendors participated and provided support.

supported her efforts to increase women’s awareness about heart disease by wearing red. She talked about coronary artery disease (CAD), the No. 1 killer of American women, emphasizing how nurses can impact the incidence by educating women about modifiable risk factors such as smoking, obesity, diabetes and hypertension. Olinda Johnson, PhD, CNS, RNC, opened the Feb. 10 general session with “Refocus on a Mission: A Rededication to the Profession of Nursing,” reminding attendees why they became nurses, the commitment to the profession of nursing, and ending with a pledge reaffirming their dedication to a lifetime of caring and compassion that began in the era of Florence Nightingale.

“Our dream of a successful conference was accomplished.” –Melissa Dover

Dr. Marc Boom, president and CEO of Houston Methodist, opened the general session Feb. 9. His lecture on “Sustaining and Enhancing a Value-Driven Culture” reminded attendees about the importance of demonstrating the I CARE values, the rapid growth of the organization, and how our work helps Houston Methodist become one of FORTUNE magazine’s “100 Best Companies to Work For.” His lecture also touched on how the quality of care provided by nurses can impact financial reimbursement by Medicare. In the afternoon, cardiologist Dr. Karla Kurrelmeyer, from Houston Methodist DeBakey Heart & Vascular Center, presented a lecture on “Heart Disease in Women — Go Red.” The planning committee members and many participants acknowledged and

The conference ended with a timeappropriate lecture for the week before Valentine’s Day presented by Dr. Danielle D. Antosh and Uchenna Ossai, PT, DPT, WCS, CLT. “Let’s Talk About Sex: Recent Advances in Female Sexual Dysfunction” informed attendees that it is acceptable for women to speak about sexuality and that today’s advances in medicine and technology have cures for just about any physical or psychological problem we may have. “Our dream of a successful conference was accomplished,” said Melissa Dover. “Everyone seemed to really enjoy the conference — the great speakers, the vendors — and they had fun. So many people contributed to the success of this conference, and I thank you!”

LEADERS IN NURSING 19


HOUSTON METHODIST SUGAR LAND HOSPITAL

TEMPERATURE STUDY AS A MAGNET EXEMPLAR FOR NEW KNOWLEDGE By Betty Gonzales DNP, RN, ACNP-BC, CCRN, Director of NP Services

TEMPERATURE IS ONE OF THE MOST COMMONLY MEASURED PARAMETERS IN HEALTH CARE. It is used as a diagnostic tool, often to guide therapy. Nurses at Houston Methodist Sugar Land Hospital recently compared the accuracy of certain thermometers commonly used in the hospital. RESEARCH/PICO QUESTION In a community hospital, in the medical surgical patient population, is a temporal artery (TA) temperature (two different approaches) comparable to oral temperature (OT) measurement? LITERATURE REVIEW A review of literature revealed various opinions regarding TA temperature measurements. Some found statistically significant differences between TA and oral temperatures, but concluded the difference was not clinically significant. This meant that it did not change the patient’s plan of care and that TA readings were suitable for clinical use. Other studies indicated that temporal artery temperatures were not accurate in the critical care population. Still other studies reported that while TA data was accurate in the normothermic patient, the results were variable and unreliable in the hypothermic and/or hyperthermic patient. Inconsistent outcomes in the literature led the nursing staff to conduct a study with their own medical surgical patient population. In the spirit of scientific inquiry, the clinical nurses on 6 West volunteered to participate in a research study to evaluate the accuracy of TA temperatures in the medical-surgical patient.

Once IRB approval was obtained the staff was trained as follows: • To maintain consistency in obtaining informed consent, all members of the research team agreed on verbiage when obtaining consent • All nurses and PCAs obtaining temperatures were required to watch the Exergen online education Since PCAs took the actual temperatures, each was trained and checked off in how each temperature should be assessed (oral temperature, common practice temporal artery temperature, and manufacturer’s recommended temporal artery temperature) • A picture of a thermometer was placed near the room number of each consented patient • A tool was used to record the temperature results • Research team members were present each shift to ensure PCAs were completing temperature assessments as trained • A log maintained temperature results

The study was conducted over a three-week period; all temperatures were compiled in a spreadsheet and the results were sent to a statistician for evaluation.

RESULTS AND DISCUSSION • Pearson’s correlation The Pearson’s correlation factor indicates if the measurements correlate. If both methods (oral and temporal temperatures) would read the temperatures perfectly and equally, the PARTICIPANTS correlation would be 1. If there is absolutely no association The sample population included all consenting patients on 6 West, the correlation would be 0. which treats medical-surgical patients. Each consenting patient would have temperature assessed three different ways every four – Oral temperature and temporal temperature obtained per hours. More than 500 data points were assessed in this study. the manufacturer’s recommendation 0.54 (CI: 0.48, 0.595) METHODS An expedited IRB approval was obtained through the Houston Methodist Research Institute IRB. The study design was quasiexperimental, using a convenience sample.

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– Oral temperature and temporal temperature obtained per common practice 0.57 (CI: 0.513, 0.637) • Bland-Altman plotting The Bland-Altman plots below show the distribution of the data with the red lines indicating the mean and the 95 percent confidence intervals, and the green line representing the regression line. The blue band represents ± 0.5oC,


which is the generally acceptable margin of error for oral temperature readings. According to this sample 25 percent of the data are outside of the generally acceptable error band. This indicates that 75 percent of the time temperatures

SUMMARY AND ANALYSIS OF THE FINDINGS These results indicate there is a weak statistical correlation between oral and either temporal artery temperature method. When a patient’s temperature is <36.5oC or > 37.5oC there is greater variability in temperature results between oral and either temporal artery method. However, approximately 75 percent of the time there is only a ± 0.5oC difference between oral and either temporal temperature method, making it clinically acceptable to use temporal artery temperatures (Bland-Altman plotting). The results of our study suggest that temporal artery temperatures can be trusted when the medical-surgical adult patient’s temperature is between 36.5oC and 37.5oC. Temperature

obtained by either temporal method are within a clinically acceptable range of ± 0.5oC. Additionally, as the temperature gets higher (>37.5oC) or lower (<36.5oC) there is greater variability when compared to oral temperatures.

results outside these limits should be verified by another method such as oral or core temperature assessment. One of the weaknesses of our study is that it was conducted on a limited patient population with only adult medical patients. Furthermore, confounding factors were not addressed such as room temperature or time of day. Specific patient characteristics were also not addressed such as patient weight, patient diagnosis, age, or co-morbidities. IMPLICATIONS Accuracy in temperature results is essential. Further studies should be conducted to assess the best way to assess temperatures in both medical surgical adult patients.

Bellis, M. (2014). The history of the thermometer. Retrieved from http://inventors.about.com/od/tstartinventions/a/History-Of-The-Thermometer_2.htm CAPGO (2014). A brief history of temperature. Retrieved from www.capgo.com/Resources/InterestStories/TempHistory/TempHistory.html Exergen Corporation. (2014). Exergen temporal scanner. Retrieved from www.exergen.com/

HOUSTON CHRONICLE

Salute to Nurses Each May, in celebration of the nursing profession, the Houston Chronicle recognizes outstanding nurses in the Greater Houston area with its annual Salute to Nurses Awards. This year Houston Methodist had had 14 nurses place in the top 150 with Kathy Winburn from Houston Methodist Willowbrook Hospital ranking in the top 10! Other Houston Methodist nurses also recognized were: Myre Omega (HMH) Jennifer Trantham (HMH) LaSandra Brown (HMH) Beverly Hughes (HMH) Silvana Wiebelt (HMH)

Herminia Matthews (HMSJ) Aisha Olaleye (HMW) Maureen Teoh (HMW) Erica Hamilton (HMW) Wendi Froedge (HMWB)

Darla Amundson (HMWB) Therese Bumpus (former employee at HMWB) Chung-win Joy Fey (HMSL)

LEADERS IN NURSING 21


HOUSTON METHODIST SAN JACINTO HOSPITAL

PHYSICIAN-NURSE COLLABORATION SPECIFIES By Rebecca Bowman ROLES IN PATIENT CARE Each month, physicians and nurses at Houston Methodist San Jacinto Hospital come together to synchronize goals and establish each caregiver’s role in the care of every patient. This project makes certain that steps in patient care are not forgotten, and that the physician and nurse both understand what the other’s responsibilities are. It also helps to strengthen the nursing scope of practice through revisiting and sometimes defining policies and procedures. Honey Benitez, RN on 2 West medical-surgical unit, says “the goal of the project is to improve patient care. When physician and nurse understand each other’s responsibilities it makes patient care much smoother and efficient. It also helps define the gray areas in the care of any patient.” Benitez is a charge nurse and represents her unit at the PhysicianNurse Collaboration meetings. Each medical-surgical unit has representation on the team. Nurse representatives and doctors convene once a month and address any unclear policies or procedures on Benitez’s floor. The Physician-Nurse Collaboration

has helped clarify what standing orders need and don’t need to be issued for a nurse to act, transition of care responsibilities, and a multitude of policies that have been revisited and sometimes changed.

NURSING NEWS ACCOLADES Houston Methodist is proud to have nurses who are dedicated to the nursing profession, driven to achieve growth in their professional development, and creative and always compassionate in their care for patients.

HOUSTON METHODIST HOSPITAL Tracy Mouton, nurse manager on Dunn 4 West and Dunn 10 East6, earned her Nursing Executive certification through the ANCC.

AGACNP-BC, CCRN, had a manuscript published in the American Journal of Critical Care January 2015 issue titled “Manual vs Automated Lateral Rotation to Reduce Preventable Pulmonary Complications in Ventilator Patients.”

Girlie Rico, from Fondren CCU, was promoted from RN II to RN III.

Robyn Washington from APEC staff has been promoted to RN III.

Michael Darilek, from Fondren ICU, passed his nursing executive board-cortication exam (NE-BC).

Melissa Crain, RN, at the Pearland Emergency Center, for completed her MSN.

to the quality of physical therapy education. The Commission on Accreditation in Physical Therapy Education (CAPTE) accredits university education programs for physical therapists and physical therapist assistants. Susan is a Level 3 physical therapist in the Acute PT/OT department and has been a site reviewer for CAPTE for many years. Louise Agyemang, BSN, RN, CCRN, CVRN of the flex team department, completed her Master of Science in Nursing (MSN) at the University of Texas Medical Branch to become an adult family nurse practitioner.

Charles Bohanna, perioperative nursing assistant in Dunn OR, graduated with his associate degree in nursing from San Jacinto College.

Shuyan Bi and Jane Ukandu from MOBS earned their FNP degrees, and Jacquelyn Bhones, also from MOBS, earned a master’s degree in Public and Healthcare Administration.

Rebecca Escobedo, RN from Fondren 12, passed her medical surgical certification exam.

Gopika Ganesh, RN, of Dunn SLICU, earned her critical care certification (CCRN).

Case Management and Social Work departments had four promotions: Rosalyn Reed to CM III; Diane Smith to CM III; Margaret Goodrich to SW II; and Linda Pham to SW II.

Roberto Francisco and Doris Hunter both have advanced to RN III on Dunn 9 CVIMU.

Connie Hilder and Trina Rutledge from MICU achieved their RN III promotions!

Susan Crabtree, PT, who was chosen to receive the CAPTE Distinguished Service Award in recognition of her contributions to the quality of the accreditation process and

Rebecca Escobedo, RN on Fondren 12, passed her Med/Surg certification exam.

Carol Laurents, former charge nurse for Dunn 6 OR, has accepted a manager position with combined responsibility for both Dunn 6 and Main 3 ORs. Shannan Hamlin, PhD, RN, ACNP-BC,

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Sharon Sullivan, director of the Michael E.


DeBakey Heart and Vascular Catheterization Lab, passed the Nurse Executive Certification Exam. Jasmine George, RN on Main 4 Northwest, passed her Meg-Surg Certification. Jasmine George, RN-BC, from Main 4 obtained her Med-Surg Certification! Ponz Villarena, RN, (nights) and Christy Justice, RN, (days) were promoted to managers for Jones 10. T Flex nurse Jasmin Jacob, RN, BSN, completed her Master of Science in Nursing (MSN) at the University of Texas - Houston to become a family nurse practitioner (FNP)! Tayray Jasmine, director on Dunn 9, passed her NEA-BC. The February 2015 edition of the AORN Journal Frontline Innovations accepted and published an article titled “Standardizing the OR to PACU Patient Handover” by NaKeisha Washington, BSN, MBA-HCM, RN, CNOR; LaSandra Brown, BSN, MBA, RN, CNOR; and Janet C. Gilmore, MSN, RN, CMSRN, NE-BC. Susan Heines, from PICC team, passed her certification in vascular access (VAT-BC); Raina Minaschek, endovascular manager, passed her CRN certification exam; and Rebekah Le passed her stroke certification exam. Rhonda Young, manager in Dunn 3 OR, earned her master’s in Business Administration with specialization in Healthcare Management. Susan Mithun passed her CCRN, and Evelyn Al-Dubais, obtained her NIH certification. Both nurses are Medical ICU nurses. HMH was represented by the following poster at the American Physical Therapy Association Combined Section Meeting in Indianapolis on Feb. 5. “The assessment of mobility status of patients after lung transplant in intensive care unit: a comparison to predicted risk of mortality.” Authors were: Ricardo Nawa(1); Colleen Lettvin(2); Christiane Perme(2). Colleen Lettvin, PT, CCS, and Chris Perme, PT, CCS, are physical therapists, Level 4, in the Acute Physical Therapy department. Chris Perme, PT, CCS, presented the Annual Acute Care Section Lecture at the APTA CSM meeting in Indianapolis on Feb. 5. This lecture is presented by the outstanding clinical physical therapist from Acute Care Section for the previous year. Lecture topic was “Solidifying the Future of the PT Profession in the ICU: The Time is Now.” Chris Perme, PT, CCS, received the “Outstanding Mentor” Award from the Cardiovascular Pulmonary Section of American Physical Therapy Association at

their membership meeting in Indianapolis on February 5, 2015. Saadia Ali, PharmD, BCPP, Marshall J. Getz, PhD, and Heather Chung, RN, MSN, PhD, NE-BC, were published in the Mental Health Clinician journal with their article “Bridging the Gap for Patients with Mental Illness.” Tracy Mouton, nurse manager for Dunn 4 West and Dunn 10 East, accepted an award for contributions to the success of the heart transplant program at FIRST Heart Transplant Celebration on behalf of her units. Nneka Chidolue from the MOBS team won first place last quarter for her Magnet on Your Mind essay. Angelica Corpuz, BSN, RN-BC, on Main 4, passed her Pain Certification. The following Main 4 nurses achieved their RN certifications: Angelica Corpuz: Pain Certification; Nkem Ezezue: MedSurg Certification; Joy Iwundu: Med-Surg Certification; and Edwin Ndungu: Med-Surg Certification. Terry Clark, BSN, CCRN, successfully completed her Nursing Executive Board Certification Exam (NE-BC). Kendall Linz, Janet Nguyen, Jessica Renaudo and Sara Wade from Jones 9 were promoted to RN II. Cindy Hildebrand from Jones 9 was promoted to PCA II. Rebecca Greenberg and Amanda Whaley recently passed the Certification in Emergency Nursing (CEN). Verna Simmons Robinson, a utilization specialist in the Case Management and Social Work department, finished her requirements for RN licensure and passed the NCLEX. Transplant Center nurses Lorri Wolff, RN, CCTC, and Allison Skelton, RN, CCTC, recently became certified clinical transplant coordinators. Kathleen Guziak, social worker, was named Outstanding Field Instructor of the Year from the Graduate College of Social Work from the University of Houston. Social worker Tessy Jerome passed her LCSW exam. Holly Shui, from MOBS unit, passed the Certified Nephrology nurse exam, and Lynnette Winters, from MOBS unit, passed the Gerontological Nursing Certification Exam. JoAnne Gaudet, MSN, RN, CCRN, Jared Pittsenbargar, BA, RT(R), and Gwendolyn Amos, BA, RT(R)(CT), published an article titled “Commit to Sit in Radiology” in Radiology Management this month.

Cecilia Alalay, RN, MS, CVRN, CNML, director of Dunn 10 West, passed her CNML (Certification for Nurse Manager and Leader) from the American Organization of Nurse Executives. Joanna Hoopingarner, RN, CWOCN, successfully completed testing to achieve certification in Wound, Ostomy and Continence (CWOCN). Joanna also became credentialed via testing as a Certified Foot Care Nurse (CFCN). Inpatient Physical Therapy received notification that their application to establish a residency in Acute Care Physical Therapy has been granted recognition status and will be listed on the American Board of Physical Therapy Residency and Fellowship directory of Developing Programs. Houston Methodist is the second organization in the nation to apply for residency development in the newly recognized advanced practice area of Acute Physical Therapy. HMH will have two years to develop and implement the residency curriculum. The Cancer Center-Infusion Services (OPC-21) team has created the Above and Beyond Award, recognizing a team member that demonstrates an attitude of excellence, teamwork, and goes above and beyond the expectations of their job duties. The OPC-21 team is proud to present the first award to Jessica Klein, RN. Melissa Crain, RN, MSN, NP, from Pearland Emergency Care Center, passed her nurse practitioner boards.

HOUSTON METHODIST WILLOWBROOK HOSPITAL Tecklar Machaya, RN, from endoscopy, received her CGRN certification.

HOUSTON METHODIST WEST HOSPITAL Sandra Turner obtained her RN III. Rosalie Ramirez obtained her CM III (Case Manager III). Ana Hermosillo was the Daisy Award winner from the Birthing Center. Gabriela Lonzo was the Daisy Award Winner from Med/Surg. Amy Goggans obtained her CCRN certification.

HOUSTON METHODIST ST. JOHN HOSPITAL Lisa Chotas advanced her career from critical care tech to LVN in 2011 and then to RN this year. Lisa Frankart, charge nurse on 3 Surgical, received her Med/Surg Certification.

LEADERS IN NURSING 23


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T H A N K YO U, N U R S E S !

At Houston Methodist, the care, compassion and clinical expertise that our nurses exhibit each and every day provides a true reflection of our organization’s commitment to Leading Medicine. This Nurses Week, we are proud to recognize our nursing professionals for their significant achievements and countless contributions to our health care team. Through the exceptional care they deliver to patients and their families, Houston Methodist nurses greatly impact thousand of lives — and in the process, they continue to leave an indelible mark on our hospital’s longstanding history of nursing excellence. For this, and so much more, we say thank you!

BE SURE TO ATTEND YOUR NURSES WEEK ACTIVITIES • MAY 4-8, 2015

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