Annual Report: Rutland Regional Medical Center Nursing Excellence Department

Nursing Annual Report On the Journey to Excellence

2018

A YEAR IN REVIEW

“Excellence is not a gift, but a skill that takes practice.�

- Plato

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Table of Contents 6

Letter from CNO

19

Leadership

7

Demographics

22

Professional Development

8

Magnet Model

23

Certified Nurses

9

Letter from CEO

30

Collaborative Relationships

11

Professional Practice Model

35

Nurse Celebrities

12

Patient Centered Care

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This report is dedicated in remembrance of

Julie Lawrence, BSN, RN, CEN, CRN On July 20th, RRMC lost one of their esteemed nursing staff, Julie Lawrence, BSN, RN, CEN, CRN to a tragic accident. There are truly no words to illustrate the profound impact Julie has had on those of us who had the good fortune of calling her a friend, colleague, or mentor.

Her dedication to her family and commitment to caring for her patients was only paralleled by the passion she so willingly gave to every cause she believed in.

Julie was an inspiration to all our nurses and was known by so many of us for the way she helped us learn, practice new skills, and develop confidence. She was a fierce advocate for nursing and we will remember feeling that all things were possible with Julie by our side. We will never forget the lessons she taught us, or the witty sense of humor that carried so many of us through our darkest days.

Until we meet again Julie, we will carry you forever in our hearts.

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Letter from the CNO Dear Nursing Colleagues, It is with great pleasure that I share with you the Rutland Regional Medical Center’s 2018 Nursing Annual Report. As another year has passed at Rutland Regional Medical Center, I find myself humbled and grateful to serve among such a tremendous nursing staff and dynamic interprofessional teams.

This publication is intended to recognize and celebrate your achievements during the past year and ensure that our efforts are aligned with our strategic plan and goals. In the past year, our nurses have helped to achieve outstanding patient outcomes, innovated new practices, and continued to advance the professional practice of nursing.

In addition to providing excellent patient care, we have expanded our Shared Governance structure to meet the needs of the changing healthcare environment. We evaluated and revised our professional practice model and participated in many interdisciplinary initiatives. We continue to meet our goals for advancing education and specialty certification. I am extremely proud of all that our nurses have achieved in the past year!

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This is an exciting time to be a nurse at Rutland Regional Medical Center as we prepare for our third Magnet designation in 2019. We look forward to the coming year ahead as we celebrate the achievements of 2018 and continue to advance nursing practice and improve the lives of patients. We recognize the impact that we have on the health and well-being of our community.

I sincerely thank you for the work that you do every day and I am so incredibly proud to be a RRMC nurse!

Carol Egan, MSN, MSA, RN, NE-BC Chief Nursing Officer

Rutland Regional Medical Center

144

88.9

Licensed Beds

97,365

32,629

4,815

341

Outpatient Clinic visits

ED Visits

Surgical Cases

470 36

MSN or highe r8 %

Education Level

BSN 41%

A S N 49 %

Average Daily Census

91% Female 9% Male

11.6 10%

Babies Born

Nurses

Nurse Leaders

Average years of service

Turnover Rate

37%

Specialty Certification Rate

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Magnet Model This was an exciting year as we continued to prepare for our third submission for Magnet designation! In December, we submitted our Intent to Submit Application which included a nursing organizational chart and leader educational table, both important frameworks for meeting Magnet criteria. Our application has been approved and we are on schedule to submit our document in October 2019!

As we look back at 2018, our commitment to Excellence is demonstrated throughout! We continued to foster a culture of

∏ Empirical Outcomes: Nursing makes an essential contribution to patient, organization, and consumer outcomes. The empirical measurement of quality outcomes related to nursing leadership and clinical practice is imperative.

∏ Transformational Leadership: All nurses are transformational leaders. Input from the clinical nurse is essential in the development of structures, processes, and expectations throughout the organization. Nurse leaders partner with clinical nurses to influence change.

∏ Structural Empowerment: Nurses throughout the organization are involved in shared governance decision making structures and processes. Decision making is multidirectional among clinical nurses, leadership, and the CNO.

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shared governance through each of our five nursing councils.

We confirmed our commitment to nursing professional practice when we successfully evaluated our Professional Practice Model and theoretical framework. The nurse residency program was initiated and we welcomed a record number of new graduate nurses to our team. Our BSN and specialty certification goal increases were achieved. We continue to outperform the benchmark in nursing quality indicators, patient satisfaction, and nursing staff engagement.

∏ Exemplary Professional Practice: The Professional Practice Model is developed by clinical nurses to illustrate the alignment and integration of nursing practice with the organization’s mission, vision, values, and philosophy. The Model is supported by leadership with the purpose to promote the professional practice of nurses.

∏ New Knowledge, Innovations, & Improvement: The organization supports the advancement of nursing research. Innovation in nursing is supported and encouraged. Clinical nurses evaluate and use evidence based practice to design and implement improvements that enhance the nursing practice.

Source: ANCC 2019 Magnet Application Manual.

Letter from the CEO Dear Nursing Colleagues, As I approach the completion of my first year as CEO at Rutland Regional Medical Center, I have been impressed with the remarkable caliber and integrity of our nurses.

Nurses at Rutland Regional Medical Center demonstrate the highest standards of professionalism. Whether it be achieving a professional certification; serving as a preceptor for a new graduate nurse; obtaining an advanced degree; serving on the Shared Governance Councils; or participating in a quality initiative; our nurses consistently demonstrate a strong commitment to advance the professional practice of nursing. This commitment to excellence is the reason that Rutland Regional Medical Center has received the prestigious Magnet Recognition from the American Nurse Credentialing Center, an award achieved by less than 10% of all hospitals in the United States. The 2018 Nursing Annual Report is a tribute to our nurses’ devotion to improve the lives of others. I am very proud of the work that you do and the example that

Claudio D. Fort President & CEO

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Professional Practice Model Development Dear Nursing Colleagues, As President of the Nursing Shared Governance Council, I am delighted to share that we have a new organization-wide Nursing Professional Practice Model (PPM). This new model is exceptionally exciting as it is a direct reflection of the culture and practice of our nursing body.

During 2018, a survey was sent out to all nurses asking two questions “What does it mean to be a RRMC Advanced Practice Nurse, Registered Nurse, Licensed Practical Nurse or Licensed Nursing Assistant?” and “What does professional nursing practice look like at RRMC?” We had an incredible response to the survey and spent several months reviewing the data. I was personally involved in the thematic analysis of the results and learned what it meant to reach a point of data saturation! We identified that Patient Centered Care, Leadership, Professional Development and Collaborative Relationships were the four domains of our nursing practice here at RRMC. The 2018 survey also contained a third question where three statements representing a separate Nursing Theorist were listed. Survey participants were asked to select the statement

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that best reflected their nursing practice the majority of the time. The feedback from that question was overwhelmingly in favor of Joanne Duffy’s Theory of Quality Caring where 74% of participants chose the following statement: “I believe that the nature of nursing’s work is relationship-centered and influences positive health outcomes. The role of nursing is to be the link between the patient, the healthcare team and the unseen possibilities known as outcomes. These are based on mutual respect, faith, hope, trust, and a sensitivity to needs.”

I hope that you are as proud as I am to be a nurse at RRMC where we demonstrate commitment to nursing professional practice every day!

Sincerely,

Alexandra Foley-Bowen BSN, RN, CWON President, Nursing Shared Governance Council

Nursing Professional Practice Model We have adopted the underpinnings of Joanne Duffy’s Quality Care Model that focuses on structure, process, and outcomes in relation to nursing care. We acknowledge and support nursing staff through Pat Benner’s Novice to Expert framework in developing individual nursing practice.

Patient Centered Care: We deliver high quality, compassionate care that is patient centered and evidenced-based to provide best outcomes. We offer love, comfort, and protection to all those around us. We advocate for and promote the health of our community.

Leadership: We believe all nurses are transformational leaders. We educate, mentor, encourage and empower our colleagues. We are committed to the success of our new nurses.

Professional Development:

Collaborative Relationships:

We are educated, skilled, and certified.

We utilize a clinical ladder and celebrate achievements. We work autonomously and at the top of our license.

We are collaborative members of the healthcare team. We respect ourselves, each other, all members of the healthcare team, and most importantly our patients and community.

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Patient Centered Care Medical Oncology Unit Fall TIPS Implementation

Fall TIPS outreach poster

In August 2018, Fred Garrow, MSN, RN, NE-BC, Nursing Director of the Medical Oncology (MOU) and Surgical Care Units and Betsy Hassan, DNP, RN, NEA-BC, CPPS, Senior Director of Nursing, Quality, and Training & Education partnered to develop an action plan to address the patient fall rate on MOU. They established a goal to decrease patient falls per 1,000 patient days from a 6 month average of 7.94 falls per 1,000 patient days by at least 30% within 6 months. The initiative using Fall TIPS (Tailoring Interventions for Patient Safety) Toolkit ™ was implemented with Marvy Mangundayo, BSN, RN and Carrie Lafrancis, RN, both MOU Clinical Nurses as the Unit Champions. Thanks to Marvy, Carrie and all the clinical staff on MOU, the team decreased patients falls per 1,000 patient days to 5.29 ­­­ falls per 1,000 patient days which met their goal.

Endoscopy Unit Teach Back Method Project In February 2018, Nicole Sharrow, BSN, RN, CGRN, Endoscopy Clinical Nurse identified an opportunity to implement training on the Teach Back Method as an effective tool for nurses to assess a patients’ understanding and the adequacy of their teaching in the outpatient Endoscopy setting. By partnering with Colette Myhre, BSN, RN, NEBC, CGRN, Endoscopy Clinical Manager to provide training, nurses were taught that it is the right of every patient to receive information about their care in a way that they can understand and that patients cannot be partners in their health care if they do not have a full understanding of their health information. As part of this project, the nurses revised the current patient education materials reformatted the discharge directions to reflect the appropriate literacy level of the community using the Readability Score feature of Microsoft Word. As a result, the Endoscopy Unit has seen a reflection of this work in their patient satisfaction scores and Nicole has been invited to work with Nursing Councils to implement similar programs throughout the organization.

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Top Box Rank for Overall Rating of Endoscopy Unit from Consumer Assessment of Healthcare and Systems Overall Rating 70

63

60 50 50 40 30

26

20 15

10 0 Jan-Mar 2018

Apr-Jun 2018

Jul-Sept 2018

Oct-Dec 2018

Patient Centered Care Impact of a Nurse-led Heart Failure Program on Readmission Rates The Heart Failure Team at the Rutland Heart Center is an interdisciplinary team of health professionals co-led by Cardiologist Adam Coleman, MD and Nurse Supervisor Mary-Beth Martin, MSN, RN that was established in 2017 to reduce the hospital readmission rates of patients diagnosed with congestive heart failure. The team developed and implemented tools such as the Initial Assessment Form, Ongoing Assessment Form and the Heart Failure Journal and created a patient care model that involves a series of nurse visits in the clinic during the first 30 days following hospital discharge. As a result of this work, the Team has continued to reduce the 30-day readmission rate throughout 2018.

CHF Readmission Rate within 30 Days, Age over 64 years Readmission Rate per 3 Month Period 24 22

22.7 21.7

20

18.6

19.4

18 16

18.5 16.6

16.9

14

14.2

12 Jan-Mar 2017

Apr-Jun 2017

Jul-Sept 2017

Oct-Dec 2017

Jan-Mar 2018

Apr-Jun 2018

Jul-Sept 2018

Oct-Dec 2018

Resuscitation Quality Improvement Program In October 2018, Stephanie LaFaso, MSN, RN, Emergency Department Clinical Educator co-led the Training & Education Department with the implementation of a new simulation program called Resuscitation Quality Improvement (RQI). The program was developed by the American Heart Association to improve skills related to resuscitation life saving techniques learned through Basic Life Support (BLS), Advanced Cardiovascular Life Support (ACLS), and Pediatric Advanced Life Support (PALS). Evidence has shown that the traditional two-year retraining

cycles are not optimal for maintaining the skills and knowledge required to effectively perform life saving techniques when encountering a cardiac arrest. RQI is a self-directed resuscitation training program that incorporates cognitive modules, simulated patient cases and psychomotor skills modules. Skill demonstration for each discipline is conducted on an RQI Cart equipped with an adult and infant manikin. To maintain BLS, ACLS, and PALS certifications and validate competent practice, RQI requires the clinician to demonstrate their skills on a quarterly basis. The RQI training platform is interfaced with HealthStream so that the student is recognized and identified via their existing profile.

Successful skills demonstration of the RQI module is automatically recorded and tracked in the student’s HealthStream transcript. Assignments for each quarterly RQI module are created and managed through the HealthStream system. Training & Education has three

RQI carts available 24/7 in the hospital building at designated locations. Every 90 days the carts are rotated to a different area of the hospital to offer convenient access for staff and providers. Feedback thus far has been very positive, and several nursing units have integrated RQI into their skills day agenda as well as other educational opportunities.

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Patient Centered Care Every year the Nursing Department celebrates the dedication and commitment of our clinical nurses in delivering patient centered care with the DAISY Award for Extraordinary Nurses. In March of 2018, the recipients and nominees celebrated with friends, family, and colleagues in the CVPS Leahy Conference Center.

2018 Individual Nominees: Kayla Webster, MSN, RN Mattie Sowards, RN Paige Trigony, RN

2018 Team Nominees: Medical Oncology Unit

DAISY Individuals Award Recipients

Danielle Robillard, BSN, RN Progressive Care Unit Danielle was nominated for being a role model in teamwork and care for all the clinical staff on PCU. Her nomination described Danielle’s response to an emergency situation as “She was quick to keep the patients care in mind at all times even while she was assisting her coworkers.”

Larina Steinke, RN, RN-BC Psychiatric Services Inpatient Unit Larina received ten DAISY nominations where she was recognized for organizing a birthday party for a patient that was depressed and for spending hours assisting a patient with personal hygiene so that the patient would be more comfortable. A coworker wrote “She is always noticing small details that make her patients feel truly cared for.”

Melissa Messier, BSN, RN, RN-BC Medical Oncology Unit Melissa was recognized for her smile and willingness to always help. Her nomination noted that “She is caring and kind to her patients, their families, and coworkers. She stands out as a great nurse.”

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Patient Centered Care DAISY Team Award Pictured: Jessica Jackson, RN, OCN, Lindsey Munger, RN, OCN, & Holly Fox, RN, OCN accept the Award on behalf of the Foley Cancer Center The Foley Cancer Center received the DAISY Team Award for providing compassionate and patient centered care to every patient, every day.

“Watching closely during my infusions I realized that I was not the only one feeling this way.

I could see the reaction from every patient they touched and cared for, knowing they would agree this was a team worthy of this DAISY Award… They are truly a caring and devoted special group of nurses and each of them will always hold a special place in my heart.”

- Foley Cancer Center Patient

To nominate a nurse for the DAISY Award, please go to www.RRMC.org.

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Patient Centered Care National Awards and Recognition U.S. News & World Report has named Rutland Regional Medical Center a “Best Regional Hospital” for 2017-2018. Out of 4500 hospitals evaluated nationwide, only 545 achieved “Best Regional Hospital” status, and Rutland Regional was the only “Best Regional” in the state of Vermont.

WINNER 2017

Rutland Regional Medical Center was the only hospital in Vermont to receive an “A” for Patient Safety in Spring 2018. Nationally, Rutland Regional was one of the 832 out of 2600 hospitals in the US to achieve an “A” rating. This award reflects the commitment of our staff in delivering compassionate care to our patients in a safe and secure environment.

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Patient Centered Care 2018 Journey to Excellence Winners in Nursing: Each month staff that have been nominated for excellence are entered into a raffle to win the Journey to Excellence prize.

Lynn Denno, RN Mattie Sowards, RN Victoria Baker, LNA Emily Flanders, LNA Danielle Robillard, BSN, RN Danika Beaulieu, RN Lisa Thompson, BSN, RN Alex Towle, RN, CM Keri Rouse, RN

Barb Ax, RN, CCRN Pam Brooks, RN Margaret Fredette, LNA Amy Clisham, BSN, RN Laura Cohen, DNP, APRN, ACNP-BC, ANP-BC Katy Moore, RN Shirley Moyer, RN Andrea Jones, RN Ariane Dulski, BSN, RN

2018 Clinical Employees of the Quarter: Brittni Racine, BSN, RN, RN-BC, ONC, ACU Clinical Nurse was awarded Employee of the Quarter in March. Brittni’s colleagues described her as kind, caring, and compassionate. In her nomination, one staff member shared a personal story of when Brittni cared for her mother in an exceptional way that made her comfortable and addressed all her concerns before surgery. Nurses like Brittni provide the kind of care that helps reduce patient anxiety before surgery!

Pam Brooks, RN, ICU Clinical Nurse was awarded Employee of the Quarter in December. Pam was praised for her competent and compassionate patient care, great source of knowledge, and willingness to always support her nursing colleagues when needed.

It was shared by colleagues that she has immense integrity and a heart of gold. Pam is known to our nurses as a shining example of perseverance and commitment!

Heather Perkins, RN, Women and Children’s Unit: “She was caring and thorough and would not discharge me until she figured out why my oxygenation was below normal. She caught a lifethreatening diagnosis.”

Shelby Robbins, RN, DI Nursing: “Shelby is extremely personable and always making me feel welcome and at home. She goes above and beyond to make my daily infusions comfortable and as pleasant as possible.”

Samantha Helinski, MSN, RN, CWOCN, Transitional Care Program: “Sam has a special talent in her job, one in a million. Sam is very professional and able to transcend her personality with her patient. I believe truly that she saved my life.”

Jessica Blanchard, RN, Surgical Care Unit: “When I was having one of my sickest moments in my life, she was there to help me and keep me comfortable. Thank you to Jess for the kindness and encouragement.”

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Patient Centered Care PA/NP of the Year Juanita Morris, APRN, ANP-BC, Rutland Digestive Services Nurse Practitioner, was awarded the PA/NP of the Year award! The award was created to honor and recognize the increasingly important role of advanced degree nurses and physician assistants to healthcare. Juanita was honored at the 2018 RRMC Medical Staff Excellence Celebration where she enjoyed a celebration dinner with her family and colleagues. Juanita is a board-certified Adult Nurse Practitioner with 20 years of nursing experience and has provided care to patients at Rutland Digestive Services since 2015. She was recognized for her sense of humor, warm personality, and the way that she treats every patient with respect, care, and compassion.

“Juanita is a highly skilled compassionate Nurse Practitioner who consistently displays and promotes the highest ethical standards. She is a positive role model and a collaborative interdisciplinary team player. She continuously advances her own personal knowledge and exemplifies what it means to be a lifelong learner. Juanita gives of her time selflessly.

She is a volunteer at the Rutland Free Clinic. She does this to improve the mental health of many clients seeking care at the Free Clinic. She remains nonjudgmental and is dedicated to improving the overall health of the clients serves. Juanita is a volunteer coach in the Manchester area school system.�

- Laura Cohen, DNP, APRN, ACNP-BC, ANP-BC, Hospital Medicine

Clinical Employee of the Year Pam Paolino, RN, Emergency Department Clinical Nurse, received the Clinical Employee of the Year Award. Pam was recognized at the 2018 Service Awards Banquet where she was celebrated by her friends and colleagues for being an exemplary role model for nursing by providing patient centered care that is described as compassionate and genuine. Pam was also recognized for her commitment to the nursing profession through her preceptorship of new graduate nurses to the Emergency Department.

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Humanitarian of the Year Bastian Fagginger-Auer, MSN, RN, Operating Room Clinical Nurse, received the Humanitarian of the Year Award.

The award is presented annually to individuals whose work and deeds have served to improve the quality of our lives and inspired us to greater heights. Bastian was recognized to embody the qualities of a true humanitarian such selflessness, dedication, and service above self in the work that he has done with the Long Trail Little League Program.

Leadership: Strategic Planning

QUALIT Y

In April 2018, the Nurse Directors attended a full day retreat to develop the two-year Nursing Strategic Plan for 2019 to 2021. The Nursing Strategic Plan was then reviewed with the Nursing Shared Governance Council and additional input was added based on direct care nurses feedback for a shared vision of the Nursing Department. The Nursing Strategic Plan was created in alignment with the organization strategic plan and enhances Nursing’s unique contribution to Rutland Regional Medical Center. This framework will help to guide the Nursing Department in advancing nursing practice and the goals we have set forth to achieve. To see the full Nursing Strategic Plan visit the Nursing Page on the RRMC Portal.

Strategic Statement

Strategic Elements

Quality: Articulate and practice patient care standards (as published by the Joint Commission, CMS, ANCC, and professional nursing literature) to ensure we maintain a high level of quality of care demonstrated by excellent clinical outcomes and maintain Magnet standards for quality.

Standardized Communication Boards will be placed for staff in all patient care areas.

Quality measures will be displayed and disseminated through all patient care areas.

Any measure at or below benchmark will have an action plan.

The Magnet requirements of the Demographic Data Collection Tool (DDCT), biennial Interim Monitoring Report, and quadrennial re-designation application will be submitted.

2 Year Projection All patient care areas will have NDNQI measures and applicable action plans displayed on the standardized communication board.

Nursing staff will be able to articulate their roles in the nursing quality results.

Nursing will maintain Magnet status by reporting the required evidence to demonstrate high quality of care standards throughout the organization.

ENGAGEMENT

CUSTOMER SERVICE

Utilize a proactive approach in all clinical areas to maintain regulatory readiness.

Customer Service: Provide patient and family centered care by partnering with the patient, family, and support staff to promote collaboration throughout the care process.

Engagement: Engage nursing staff through structural empowerment and shared decision-making.

Encourage a sense of professional collaboration and shared appreciation between nursing, support services, internal and external customers.

Interdisciplinary Rounding will be patient and family centered.

Incorporate the voice of our patients and their families in the decisions we make about our care and services.

Nursing will continue to participate in The Community Collaborative and lead initiatives.

Nursing will continue to participate in the expansion and growth for the role of the Patient and Family Advisory Council (PFAC).

Patients and family members will continue to be involved in appropriate nursing initiatives through the PFAC.

Promote shared decision-making through monthly Nursing Shared Governance Council meetings.

Nursing Shared Governance Council will continue to be an influential body in nursing decision-making.

Facilitate unit-based committees to continue to achieve unit-based goals for engagement and satisfaction.

Each unit-based committee will report quarterly to the Nursing Shared Governance Council.

Nursing will participate in community initiatives and volunteer opportunities.

The image of nursing in RRMC is elevated and evident within its community.

The Transitional Care Program will continue to expand to meet the needs of our community.

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Leadership Mary Beth Martin, MSN, RN was the recipient of the DAISY Leader Award. She was nominated by the entire staff at the Rutland Heart Center!

“Mary Beth exemplifies the true definition of a nurse. She is caring, knowledgeable, understanding, energetic, flexible, a problem solver, and has great interpersonal skills. These qualities have allowed her to develop in to an exceptional nurse leader,” - Karen Fuller, RN, RN-BC “What most impressed me about Mary Beth is her relentless capacity to get the hard work done. She has phenomenal energy and always maintains a happy, cheerful and optimistic demeanor. She clearly ranks among the best nursing clinical leaders that I have worked with.”

- Stanley Shapiro, MD, FACC, FASNC “Mary Beth is an extraordinary person and clinician who epitomizes nursing at its best. She is highly skilled, compassionate, a sound critical thinker, and consistently displays the highest ethical standards. She serves as the ultimate patient advocate.”

- Laura Cohen, DNP, APRN, ACNP-BC, ANP-BC

Board Membership: Jillian Nichols, BSN, RN; Fritz Asunscion, RN and Virginia McQueen, RN served as members of the Student Advisory Council for Castleton University Nursing Department.

Betsy Hassan, DNP, RN, NEA-BC, CPPS served as Vice President of the Vermont ANA and as a member of the North East Multi State Board of Directors, Sigma Theta Tau International Nursing Honors Society Nu Beta Chapter Governance Committee, and the Castleton University, Nursing Department, Advisory Board Amy Martone, RN, MBA, CPHRM, served as President Elect of the Northern New England Society of Healthcare Risk Management 20

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Kathleen Boyd, MSN, RN, NE-BC, RN-BC, CCM; Carol Egan, MSN, MSA, RN, NE-BC; Laura Cohen, DNP, APRN, ACNPBC, ANP-BC; and Jacki Becker, MSN, RN, FNP all served as Board Members of the Rutland County Free Clinic Sheena Daniell, MSN, RN, CEN, served as a member on the Board of Directors of Homeless Prevention in Rutland Jody McIntosh, MSN, RN, served as a member on the Board of Directors for both the Rutland City Parks Foundation and Wonderfeet Children’s Museum.

Tom Neumann, RN, CEN served as a member of the Benson Board of Civil Authority

Leadership Successful Succession Planning: Alyssa Scott, BSN, RN, PCCN, Director of ICU & PCU Alyssa Scott, BSN, RN, PCCN has always demonstrated leadership abilities in her time at RRMC. Carol Egan, MSN, MSA, RN, NE-BC, Chief Nursing Officer knew she had potential to fill the Director of ICU & PCU position upon its vacancy because of how well Alyssa had been prepared for the role in her time as one of the Unit’s Clinical Managers.

As a Clinical Manager, Alyssa was provided opportunities to participate in budget planning and monitoring, staff management, and leadership accountability. Through each experience Alyssa built relationships with staff and organizational leadership to ensure that the patients on ICU & PCU are well cared for and the staff feel appreciated and valued.

In April of 2018, Alyssa was appointed as the Director of ICU & PCU and she has worked with the staff on many achievements over the past year. Alyssa has supported the staff on ICU and PCU to expand the number of New Graduate nurses they accept each year – which was a true demonstration of the team’s preceptor commitment. Through her leadership, the PCU was able to reduce nurse traveler hours to zero! Alyssa has also championed her nursing staff in professional development opportunities and supported them to start a Unit Based Practice Council.

Through Alyssa’s transformational leadership, the ICU and PCU are excelling, advancing nursing practice, and providing excellent care to our community.

“It has been wonderful to see Alyssa develop into the Director role. She cares greatly for patients, staff, and the community. I know she will continue to support her units in advancing nursing practice and will continue to make RRMC an organization nurses love to work for.”

- Carol Egan MSN, MSA, RN, NE-BC, Chief Nursing Officer “Alyssa brings much positive energy to the ICU, PCU and Centralized Telemetry team. She is approachable, visible, supportive and respected. It is exciting to see Alyssa develop into the Director we knew she would be and to see our teams grow along with her.”

- Karen St. Marie, RN, CCRN, ICU Clinical Nurse Nursing Annual Report 2018 |

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Professional Development Clinical Advancement Program (CAP): The purpose of the RRMC Clinical Advancement Program is to promote ongoing excellence in patient care through the development of increasing clinical expertise and to formally reward and recognize clinical excellence in direct care nursing. These nurses exemplify and model the Nursing Excellence Criteria as outlined in the ANCC Magnet Recognition Program.

Three nurses received approval for CAP:

Ariane Dulski, BSN, RN, RN-BC, MOU Clinical Nurse was approved for CAP Level 2

Danielle Gray, RN, RN-BC, ENTA Clinical Nurse was approved for CAP Level 1

Trang Ho, BSN, RN, RN-BC, ENTA Clinical Nurse was approved for CAP Level 2

Six nurses received renewal for CAP: Crystal Bennick, BSN, RN, RN-BC, CRNI, DI Clinical Nurse renewed CAP Level 2 Bonnie Corsi, RN, RN-BC, MOU Clinical Nurse renewed CAP Level 1 Melissa Messier, BSN, RN, RN-BC, MOU Clinical Nurse renewed CAP Level 2 JoEllen O’Connor, BSN, RN, RNC-MNN, BC Clinical Nurse renewed CAP Level 2 Samantha Roberts, RN, RN-BC, MOU Clinical Nurse renewed CAP Level 1 Larina Steinke, RN, RN-BC, PSIU Clinical Nurse renewed CAP Level 1

All 2018 CAP Nurses: Level 1: Marcia Bergen, RN, CCRN Ashley Bergendahl, RN, RN-BC Bonnie Corsi, RN, RN-BC Sarah Gemmiti, RN, RN-BC Danielle Gray, RN, RN-BC Amanda Keller, RN, CGRN Cindy Mullin, RN, CGRN Mona Rickert, RN, RN-BC Samantha Roberts, RN, RN-BC Karen St. Marie, RN, CCRN Larina Steinke, RN, RN-BC Monica Weber, RN, CPAN 22

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Level 2: Crystal Bennick, BSN, RN, RN-BC, CRNI Danielle Brown, BSN, RN, OCN Ariane Dulski, BSN, RN, RN-BC Rita Hansen, BSN, RN, CPAN Trang Ho, BSN, RN, RN-BC Julie Lawrence, BSN, RN, CEN, CRN Melissa Messier, BSN, RN, RN-BC Jill Noble, BSN, RN, CEN, SANE JoEllen O’Connor, BSN, RN, RNC-MNN Melodie Schaffer, MSN, RN, CPAN, CAPA Lisa Schauwecker, BSN, RN, OCN, CRRN, RN-BC Jolana Washburn, BSN, RN, CCRN

Celebrating Our Certified Nurses

2018

Rutland Regional Medical Center recognizes and honors the unique contributions of our Board-Certified Nurses. In alignment with the American Nurses Credentialing Center (ANCC) Magnet® designation, Rutland Regional nurses continue to demonstrate their professionalism, leadership and commitment to excellent patient care. List is reflective of nurses certified as of 12/31/18.

Chief Nursing Officer Carol Egan, MSN, MSA, RN, NE-BC Advanced Practice Nurses Joan Attig, MSN, APRN, ANP-BC, CWON Anne Baylock, MSN, APRN, PMHCNS-BC Gerard Beaudry, MSN, APRN, ACNP Jacki Becker, MSN, APRN, FNP Laura Cohen, DNP, APRN, ACNP-BC, ANP-BC Kathy Felder, WHNP, APRN, CUNP, WHNP-BC Ginger Gillette-Kent, MSN, APRN, ANP-BC, NEA-BC Nicole Hadeka, MSN, APRN, FNP Jodi Hyndman, MSN, APRN, NP-C Meredith Kiesel, MSN, APRN, PMHNP Juanita Morris, MSN, APRN, ANP-BC Ambulatory Care Unit Joan Sienicki, BSN, RN, RN-BC Breast Care Program Melissa McLeod, RN, CLC Case Management Cindy Baumann, BSN, RN, CCM Kathleen Boyd, MSN, RN, NE-BC, RN-BC, CCM Samantha Helinski, MSN, RN, CWOCN Patricia Shaw, MSA, BSN, RN, RN-BC Jill Smith, BSN, RN, CCM Sara Trepanier, RN, CCM Mary Frances Skaza, RN, CCM Jennifer Wasilauskas, MSN, RN, CNOR, ONC Suzanne Woodbury, BSN, RN, ONC, CCM Clinical Informatics Suzanne Sabataso, MSN, RN, RN-BC Coding Susan Haviland, RN, CCDS Community Health Improvement Sharon Decato, BSN, RN, CCM Diagnostic Imaging Crystal Bennick, BSN, RN, CRNI James Callan, BSN, RN, CRN Kelly Carter, RN, VA-BC Brittni Racine, BSN, RN, RN-BC, ONC Emergency Department Robert Bromley, RN, CEN Tamzen Brosnan, RN, CEN Courtney Collins, BSN, RN, CEN, CPEN Sheena Daniell, BSN, RN, CEN Julie Delaney, MSN, RN, CEN Courtney Dumas, RN, RN-BC Alexandra Foley-Bowen, BSN, RN, CWON Sharon Green, BSN, RN, CEN Katie James, RN, RN-BC Ali Kenyon, MSN-FNP, RN, CEN Michael Lawrie, BSN, RN, CEN James Maranville, RN, CEN Shirley Moyer, RN, CEN Thomas Neumann, BSN, RN, CEN Jill Noble, RN, CEN, SANE-A Amy Powers, RN, CEN Jonathan Prendergast, BSN, RN, CEN Thomas Rounds, BSN, RN, CEN Joan Spaulding, MSN, RN, CEN Phillip Sullins, RN, CEN Endoscopy William Bogertman, BSN, RN, RN-BC Danielle Browne, RN, CGRN Amanda Keller, RN, CGRN Cynthia Mullin, RN, CGRN Nicole Sharrow, BSN, RN, CGRN ENT Clinic Cristina Fredette, BSN, RN, RN-BC Trang Ho, BSN, RN, RN-BC Danielle Gray, RN, RN-BC

Foley Cancer Center Danielle Brown, BSN, RN, OCN Holly Fox, RN, OCN Heather Hollister, RN, OCN Kendra Hollister, BSN, RN, OCN Jessica Jackson, RN, OCN Lindsey Munger, RN, ONC Susan Nordmeyer, RN, OCN Pamela Poalino, RN, RN-BC, CEN, SANE-A Melodie Schaffer, MSN, RN, CAPA, CPAN Infectious Disease Clinic Lori Pawlaczyk, BSN, RN, CCM Intensive Care Unit Barbara Ax, RN, CCRN Robert Bassalin, MSA, BSN, RN, CCRN Marcia Bergen, RN, CCRN Antoinette Boltz, BSN, RN, CCRN Margaret Duffy, MSN, RN, CCRN Katherine Gorruso, MA, RN, CCRN Katherine LaMontagne, BSN, RN, CCRN Karen St. Marie, RN, CCRN Jolana Washburn, BSN, RN, CCRN Kidney Center Nancy Grieder, RN, RN-BC Kathlene Pelletier, BSN, RN, RN-BC Labor & Delivery Rebecca Allen, RN, RNC-MNN Sarah Bache, BSN, RN, CLC, RNC-OB Andrea Borchlewicz, BSN, RN, RNC-MNN, CLC Jody Ketchum, RN, RNC-MNN Katy Moore, RN, RNC-MNN JoEllen O’Connor, BSN, RN, RNC-MNN Marble Valley Urology Gina Vitagliano, RN, CURN Medical Oncology Unit Ashley Bergendahl, RN, RN-BC Kristina Criss, BSN, RN, RN-BC Bonnie Corsi, RN, RN-BC Ariane Dulski, MSN, RN, RN-BC Concepcion Flanders, RN, RN-BC Frederick Garrow, MSN, RN, NE-BC RN-BC Tammy Hogenauer, BSN, RN, RN-BC Katherine Lincoln, BSN, RN, RN-BC Kathryn Mason, BSN, RN, RN-BC Melissa Messier, BSN, RN, RN-BC Kelsie O’Keefe, RN, RN-BC Tracee Pockette, RN, RN-BC Korrina Porter, RN, RN-BC Samantha Roberts, RN, RN-BC Carrie Thibault, BSN, RN, RN-BC Nursing Excellence Amy Martone, MBA, RN, CPHRM Betsy Hassan, DNP, RN, NEA-BC, CPPS Operating Room Dayle Burditt, RN, CNOR Deborah Hough, BSN, RN, CNOR Janet Kenyon, MSA, BSN, RN, CNOR Marci Matson, RN, CNOR Kaitlin McCarthy, RN, CNOR Thelecia Molaski, RN, CNOR Palliative Care Mary Conrad, RN, CHPN Rachel Doughty, BSN, RN, CHPN Eva Zivitz, MSN, RN, CHPN Post Anesthesia Care Unit Rita Hansen, BSN, RN, CPAN Monica Weber, RN, CPAN Progressive Care Unit Amy McLaughlin, BSN, RN, PCCN Lauren Miller, BSN, RN, RN-BC Alyssa Scott, BSN, RN, PCCN

Thank you for your commitment to the profession of nursing and the extraordinary care you provide our patients!

Psychiatric Services Katelynn Brown, BSN, RN, RN-BC Lesa Cathcart, MSA, BSN, RN, RN-BC Tara Cornell, BSN, RN, RN-BC Bonnie Hanley, MSN, RN, RN-BC Maria Houston, BSN, RN, RN-BC Lindsey Lyle, RN, RN-BC Mary Kate Marcellus, BSN, RN, RN-BC Cynthia Papineau, BSN, RN, RN-BC Larina Steinke, RN, RN-BC Quality & Safety Ann Irons, BSN, RN, RN-BC Nancy Meszaros, BSN, RN, CIC Susan Shayne, BSN, RN, RN-BC Resource Staff Pool Jessica Ponto, RN, PCCN Sally Rogers, BSN, RN, RN-BC Rutland Diabetes & Endocrinology Center Elizabeth Kowalczyk, BSN, RN, RNC-MNN Lauren Oberg, BSN, RN, CDE Rutland General Surgery Joan Attig, MSN, RN, CFCN, CWCN Lisa Leedom, RN, CWOCN Rutland Heart Center Karen Fuller, RN, RN-BC Rutland Women’s Healthcare Megan Hasbrouk, RN, IBCLC Lisa Underhill, RN, CLC Surgical Care Unit Anne Day, BSN, RN, RN-BC Karen Ferreira, BSN, RN, RN-BC Colette Myhre, BSN, RN, NE-BC, CGRN Nupur Naik, BSN, RN, RN-BC Katie Ruby, BSN, RN, RN-BC Lisa Schauwecker, BSN, RN, CRRN, ONC, RN-BC Karen Waterworth, RN, RN-BC Training & Education Judith Long, MSN, RN, CHSE, RN-BC Carole Mayes, MSN, RN, RN-BC, CNOR Heather McRae, MSN-Ed, BSN, RN, PCCN, RN-BC Rhonda Roberts, MSA, BSN, RN, RN-BC, RN-BCP Utilization Management Karen Edgerton, BSN, RN, RN-BC Jenna Hayward, BSN, RN, RN-BC Elaine Imhof, RN, RN-BC Abigayle Polhemus, BSN, RN, RN-BC West Ridge Center Julia Fonte, RN, RN-BC Kerri Joslin, RN, RN-BC Women’s and Children’s Unit Suzan Brower, RN, RNC-MNN Kayla Cawvey, RN, CLC Jill McCullough, BSN, RN, RNC-MNN Mona Rickert, RN, RN-BC Catherine Toda, MSN, RN, RNC-OB Amy Walter, RN, RNC-MNN Wound, Ostomy & Continence Nursing Amanda Bogertman, BSN, RN, CWON

Congratulations to Katherine Gorruso, MA, RN, CCRN for achieving 40 consecutive years of certification!

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Professional Development BSN Program Nurses at RRMC continue to demonstrate their commitment to professional development and continuing education. One of the ways our nursing staff has demonstrated their commitment is by an increasing number of nurses achieving their BSN. In 2010, the Institute of Medicine put forth a recommendation that the nursing profession should strive for 80% of nurses to be BSN prepared by 2020 as it correlates with improved patient outcomes.

Nurses will a BSN or Higher BNS or higher 60 55 50

Congratulations to all our registered nurses that earned a BSN this year!

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Melissa Angelo-Coloutti Kimberly Balch Kaitlin Bissette Claire Brosnan Mary Brothers Katelynn Brown Joshua Correia Lacey Dahlin Andrea Doran Andrea Doran Shelby Fillmore Megan Fox Lauren Griffin Ryan Handfield Johnna Helinski-Stach Debbie Hough Maria Houston Nicole Hunt Julianna Kimball Karina Knapp

Kristina Lafond Stacy Lee Morgan Little Amber Mann Mary Marro Chanda McCarthy Morgan Medeiros Thomas Neuman Jillian Nichols Dana Piontek Heather Rogers Katie Ruby Eliza Russ Kelsey Scarborough Nicole Sharrow Yulia Smith Rex Stimmel Lisa Thompson Ashlie Whittemore John Wood

49.1

45 42.5

42.8

43.4

2015

2016

2017

35 30 25 20 10 5 0 2018

In 2015, the RRMC BSN rate was 42.5% and as of December 2018 we have increased this percentage to 49.1%! We have achieved our goal to demonstrate an annual increase of 1.5%.

Congratulations to Julie Delaney, Phillip Sullins, Kayla Webster & Eva Zivitz for earning their master’s degree!

A Special Thank You! “In 2018 RRMC onboarded more than 70 nurses into our organization. This task would not have been possible without the dedication and devotion of our Clinical Educators and Nurse Preceptors. Their commitment to the organization, ensuring excellence in nursing care, and providing a welcoming and engaging environment for our new staff is so appreciated! Thank you to all the Educators and Preceptors for all you have done to make RRMC a wonderful place to be a nurse!”

- Betsy Hassan, DNP, RN, NEA-BC, CPPS, Senior Director of Nursing, Quality and Training & Education 24

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Nurse Research: Melodie Schaffer, MSN, RN, CAPA, CPAN, Clinical Research Nurse Study Coordinator at the Foley Cancer Center (FCC) and Denise Simpson, MSA, CIC, CPHQ from the Quality & Safety Department, recently completed a retrospective observational study to develop a process to follow-up with patients who have undergone new chemotherapy treatment and address the following statement: Do Foley Cancer Center patients undergoing new chemotherapy treatment have questions about their care after leaving the office? The study was carried out in collaboration with the unit’s Nurse Supervisor, Holly Fox, RN and FCC nursing staff.

Two nursing led research studies were started in 2018 and are currently ongoing. Katelynn Brown, BSN, RN, RN-BC is conducting a descriptive study titled “Is There a Relationship Between Nurse Burnout and Past Life Experiences” to add to the body of knowledge of potential reasoning for nurse burnout and hopefully identifying areas that nurses can be better supported.

Additionally, Betsy Hassan, DNP, RN, NEA-BC, CPPS is the principle investigator for a statewide descriptive study titled “Perceived Empowerment of Nurse Leaders” which aims to better understand how nurse leaders in the state of Vermont perceive their level of empowerment. This will potentially serve as the baseline for implementing a Nurse Leader professional development program for transformational leadership and structural empowerment of nurses throughout the state of Vermont.

Professional Development Presentations Gert Mayes, MSN, RN, RN-BC, CNOR, and Lisa Schauwecker, BSN, RN, OCN, CRRN, RN-BC presented Evaluating Liposomal Bupivacaine for Postoperative Pain Management at the 8th Annual Nurses at the Wheel Research Conference in Warwick, Rhode Island.

Tom Rounds, BSN, RN, CEN, presented Maintaining Excellence in the ED through Construction and Beyond at the Studer What’s Right in Healthcare Conference in Nashville, Tennessee.

Alison Eastman, RN, presented on a panel discussing Opioid Prescribing Statutes in the Northern New England States the at the Northern New England Society for Healthcare Risk Management in Concord, New Hampshire.

Eva Zivitz, MSN, RN, CHPN presented Comprehensive Palliative Care in the Rutland Region at the Acute Care Problems Presenting to Primary Care Providers CME Symposium in Rutland, Vermont.

“Know that when all is done it will be one of the proudest accomplishments of your career as it was for mine, for it made a difference. I highly suggest getting involve in research and not waiting for the opportunity to come to you” - Lisa Schauwecker, BSN, RN, OCN, CRRN, RN-BC

Scholarships: Trang Ho, BSN, RN, RN-BC & Danielle Gray, RN, RN-BC, both from Rutland ENT & Audiology, were recipients of the 2018 Carol P. Welch Scholarship. This scholarship in honor of Carol and her mentorship as a 34 year employee and nursing leader at Rutland Regional Medical Center. This scholarship is awarded annually to any Rutland Regional nurses that are pursuing continuing educational opportunities.

“As a nurse, it was rewarding to provide answers, interventions, and emotional support for patients undergoing chemotherapy treatment. There were a broad range of conversations; everything from medication education to providing a free thermometer to someone who could not afford to purchase one. Many patients expressed thanks; not only for the assistance, but for taking the time to check in on them and to make sure they were doing ok. I believe this exemplifies the RRMC promise to listen, respect, and care... always.”

- Melodie Schaffer, MSN, RN, CAPA, CPAN

Jolana Washburn, BSN, RN, CCRN, ICU Clinical Nurse & Alyssa Williams, RN, PCU Clinical Nurse were both recipients of the 2018 Rutland Area Community Scholarship. The goal of the scholarship is to inspire, empower and create opportunities for individuals to achieve their dreams of a career in healthcare. The scholarship is awarded annually to five candidates that are working toward furthering their goal of a career in healthcare.

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Professional Development Perioperative Clinical Educator

By Carole “Gert” Mayes MSN, RN, RN-BC, CNOR, Clinical Educator

Some individuals struggle to find their life’s passion while others find it more easily. I discovered my passion, the nursing profession, even before I entered school. Since undergoing strabismus surgery at age 4, caring for my mother post ruptured appendix at age 10 (drains and dressings!), and learning surgery could fix other ailments, I have always known perioperative nursing was my life calling.

Throughout school I worked toward this goal. Science, health, biology, and even Latin classes enthralled me. Immediately after high school graduation, I entered the University of Cincinnati’s College of Nursing and spent the ensuing summer breaks working as a nursing technician in the labor and delivery department. While there, I learned instruments, prepared and wrapped delivery sets for sterilization, and observed my first surgery – a cesarean section. From that point I focused all my efforts on obtaining operating room experience during my undergraduate classes.

After graduating in 1989, I entered the field of operating room nursing in 1990 and never left. While I functioned in all the roles directly and indirectly related to OR nursing (i.e. circulator, scrub, post anesthesia care unit nurse, ambulatory care nurse, sterile processing, unit manager, and educator), I gained an in depth understanding of patient needs and professional practice recommendations that guide providing the best care possible. During these times I found myself seeking opportunities to improve patient care through staff development and personal development. I joined my professional organization, the Association of Perioperative Registered Nurses, earned my certification, and completed my Master of Science in Nursing with a focus on education.

After 18 years of personal growth at my facility in Idaho, I became restless. I needed another challenge. I explored other employment opportunities that would allow me to continue my professional journey. Rutland Regional Medical Center jumped out as an ideal employer after I saw their ad in my professional journal and as I researched the organization’s reputation and offerings. During the phone interview and in person interview, the atmosphere of this organization stood above all the rest with the welcoming atmosphere and opportunities available for professional development.

As a result, my husband and I plunged ahead and moved 26

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to the Rutland area in February 2007. Not once have I been disappointed with my choice.

I have continued to grow professionally moving from the staff role to clinical educator. Additionally, the opportunity to be recognized for my professional certification, support for continuing education, and ability to network at conferences has helped me grow exponentially. I’ve developed to such an extent I want to influence nursing practices. Consequently, I started my PhD in Nursing in 2015 with the support of my peers and leaders and now am conducting my research.

After obtaining my PhD in Nursing, I plan to actively pursue research focusing on evaluating and/or initiating new patient care activities so patients can receive the best outcomes possible.

So, join me on this wonderful and wild journey called nursing!

Professional Development: Nursing Councils In alignment with the Nursing Strategic Plan, Professional Practice Model, and Theoretical Framework, Rutland Regional Medical Center (RRMC) supports shared decision-making and governance throughout nursing with nursing councils and committees representing the nursing body in entirety. The Department of Nursing Excellence provides a context for nursing and all members of the health care team to understand and participate in the core elements of professional nursing practice by providing the framework for organizing quality, education, evidence-based practice, research, recruitment and retention, communication and leadership.

Through a shared governance council structure, the Department of Nursing Excellence supports the following nursing councils: Advanced Practice Nurse Council

Outpatient Nursing Shared Governance Council

Nursing Shared Governance Council

Staffing Council

Nursing Leadership Council

Nursing Coordinating Council

Advanced Practice Nurse Council The Advanced Practice Nurse Council is comprised of all Advanced Practice Registered Nurses (APRN) at RRMC. Membership is also open to any RRMC employed registered nurse that is currently enrolled in an APRN program.

The Council convenes quarterly and offers an opportunity for professional development through networking, CME offerings, Journal Club, and peer reviewed case studies. The Council also facilitates a mentorship program for APRNs that are new to the organization.

“The APRN Council keeps me connected with my peers and reminds me of how rich our resources are!”

- Ginger Gillette-Kent, MSN, ANP-BC, NEA-BC, Nurse Practitioner

“The APRN Council provides me with such a sense of community. I feel RRMC as an organization is supportive of APRNs and that they respect our role in today’s healthcare system.

The APRNs on the council have welcomed me with open arms and have shown me tremendous support and respect. I look to them as mentors and role models of all I hope to become as I begin practicing.”

- Sarah Bache, BSN, RN, CLC, RNC-OB, Nurse Practitioner Student

Outpatient Nursing Shared Governance Council (ONSGC) The ONSGC is comprised of clinical nurse members representing each specialty from the ambulatory clinic setting. This Council was developed to promote the professional nursing role that is unique to the specialty outpatient clinic setting. The Council convenes monthly and offers networking, professional development, continuing education, and mentorship opportunities to all members.

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Professional Development: Nursing Councils Nursing Shared Governance Council (NSGC) The NSGC is comprised of clinical nurse members from both the inpatient and outpatient settings. The Council is facilitated by an elected President and Vice President.

It convenes monthly for a full-day meeting. Within the Council, there are three specialized committees responsible for sharing information and facilitating ongoing projects: Professional Development and Care Committee, Nursing Quality and Professional Practice Committee, and Research and Evidenced Based Practice Committee. The Council offers professional development opportunities through CEU presentations and Clinical Advancement Program (CAP) mentorship.

“This was an exciting year for the Nursing Shared Governance Council! We participated and provided wonderful CE offerings that included a variety of patient care, quality improvement, nursing practice, and professional development topics. Our Employee Wellness APRN worked closely with us as we learned ways to share gratitude and practice mindfulness. Council members worked with leadership from the Pharmacy to revise policies related to medication administration and management. The group actively participated in the development of the Professional Practice Model, Sharepoint nursing page, tobacco cessation program, and multiple EMR documentation changes. The Council has grown as we continue to onboard new members!�

- Jill Merrill BSN, RN, Vice President, Nursing Shared Governance Council

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Professional Development: Nursing Councils This year, the Nursing Shared Governance Council had the opportunity to support students in our community through the Adopt a Classroom program! The Council collected items that were donated for a third-grade classroom at Rutland Intermediate School. Each of the thirteen students will receive a backpack, pencil box, markers, pencils, colored pencils, glue sticks, and filler paper. In addition to the back packs, multiple boxes of snacks were shared in the classroom. The teacher has responded to the act of generosity in a note stating “I’m writing to again express my sincere gratitude for your generous donation to our classroom! My students will rest easy knowing they do not need to worry about acquiring school supplies. Thank you again!”

In September 2018, the Council partnered with the Nursing Excellence Department to introduce a new program that supported the formal practice of peer review and selfevaluation process for all nursing staff at RRMC. The new process provided nurses with information from their peers to positively impact annual goal setting for professional development through the utilization of a customized tool.

Peer review has always been a component of nursing practice and has allowed us to demonstrate our accountability to our patients, each other, and our profession.

Council’s 2018 CEU Series: January February March April May July August September October November December

HCAHPS and Patient Experience Compassion Fatigue Care of the Diabetic Patient Defensible Documentation CAR-T Cell Therapy Congestive Heart Failure Sexual Assault Nurse Examiner Program VNA & Hospice Language Access Programs Cardiac Rehabilitation Rutland Free Clinic

Resources and information for Nursing Shared Governance, professional development and educational opportunities are located in the Nursing Notes monthly e-newsletter and on the Nursing Portal through Sharepoint. If you are interested in becoming involved in any of the Nursing Councils, please speak with your leadership!

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Collaborative Relationships Veggie Van Go VeggieVanGo is a local community initiative through the Vermont Foodbank that aligns with the Healthy People 2020 goal to achieve health equity, eliminate disparities, and improve the health of all groups by providing healthy and fresh foods to students, patients, staff, and community members at risk for food insecurity. In addition to providing fresh foods free of charge, VeggieVanGo provides education about the importance of incorporating fruits and vegetables into a daily meal plan. As part of the initiative, VeggieVanGo works with healthcare providers to identify patients that are at risk for food insecurity and “prescribe” fresh fruits and vegetables to eliminate disparities and improve health of the community.

In August 2018, Jacki Becker, MSN, RN, FNP, Manager of Employee Wellness Center, learned about the VeggieVanGo program and the benefit it could offer to the Rutland community. She partnered with Human Resources Facilities, Security, Marketing, and Hospital Medicine to implement the program at Rutland Regional Medical Center! Jacki received the full support of the organization and since August VeggieVanGo has visited our campus monthly and has provided fresh food to hundreds of people in the community.

Rick Hildebrandt, MD, Medical Director of Hospital Medicine was interviewed by a representative from Vermont Senator Bernie Sanders office.

“Volunteering for the distribution was a truly rewarding experience for those of us who were able to do so, and we’ll be reaching out to others as the months go by to give all interested a chance to help out. Thank you to Rutland Regional Medical Center for coming together to serve our neighbors in need!”

- Jacki Becker, MSN, RN, FNP, Manager of Employee Wellness

Chuck Cacciatore, Chief of Security, provides monthly traffic control and event security.

Jacki Becker, MSN, RN, FNP and Elizabeth Kyhill, MSN, RN stand with Project Manager Dean Pierce in front of the door that he installed to separate the salt garage from the VeggieVanGo location. `

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Collaborative Relationships CUSP Implementation on WACU & Birthing Center The Comprehensive Unit-Based Safety Program was developed at the Johns Hopkins Armstrong Institute for Patient Safety & Quality and adopted by the Agency for Healthcare Research & Quality. The program provides tools and education to promote a culture of safety through the identification of defects, continuous learning from defects, and the improvement of teamwork and communication. In January 2018, Nurse Manager Jody McIntosh, MSN, RN, Nurse Manager, formed a CUSP team to pilot the program in the Birthing Center and on the Women and Children’s unit. Science of safety training was provided to all WACU and BC staff. The training included the completion of a validated Safety Culture Survey and each staff member participated in the Identifying Defects exercise by asking “How will the next patient be harmed?” The information collected was then analyzed by the CUSP team comprised of eleven interdisciplinary members. The team has been meeting monthly

since April 2018 and has already celebrated many successes such as replacing the light bulbs in the Omnicell to offer better visibility of medications; replacing the solid window covering in the nursery to a one-way decal that allows staff to see out into the unit; and replacing the children’s TV cart that was an infection control risk with 9 kid based channels on the upgraded cable system. The goal is to implement CUSP on all inpatient units throughout 2019 with the Intensive Care Unit currently in the process of implementing their team.

Inter-Disciplinary Rounding (IDR) reduced average Length of Stay The Impact of IDR on Average Length of Stay “We, at RRMC, are committed to superior care; care which is coordinated, collaborative, and patient and family centered. One strategy which we have employed in the last year is the introduction of Inter-Disciplinary Rounding (IDR). The IDR process has been extremely successful at RRMC. Our physicians, nurses, ancillary therapies, pharmacists, and dieticians are engaged and participative in the daily rounding process. As a result of IDR, we have successfully decreased the average length of stay (LOS) for our adult population from 4.13 days to 4.04 days. The decrease in LOS is testimony to the fact that coordinated and collaborative communication are key to superior patient outcomes.”

Average Length of Stay Measured in Days* Jul-Dec 2017

4.135 days

Jan-Jun 2018

4.12 days

Jul-Dec 2018

4.04 days 0

.5

1

1.5

2

2.5

3

3.5

4

4.5

5

*Calculated by Patient Census Activity from SCU, PCU, MOU & ED holding.

- Kathleen Boyd, MSN, RN, NE-BC, RN-BC, CCM, Director of Case Management, Utilization Management, Transitional Care, and Hospital Medicine Nursing Annual Report 2018 |

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Collaborative Relationships Surgical Care Unit Patient Satisfaction Scores Throughout 2018, the Surgical Care Unit consistently outperformed the organizational goal for patient satisfaction scores related to Communication with Nurses. This is due in part to the collaborative relationship between the SCU nurses and their nursing colleagues in the clinic setting. Together this team of nurses provides pre-operative, hospital discharge and post-operative education to patients in a dynamic way that provides patient-centered care.

Quarterly Communication with Nurses (Always) scores compared to organizational goal of 65% Always Score

Goal

100 90 80 70 60 50 40 30 20 10 0 Jan-Mar 2018

Apr-Jun 2018

Jul-Sept 2018

Oct-Dec 2018

“We are proud to see that we are performing well with the satisfaction scoring for nurse communication. Communication is essential to meeting the needs of our patients. One of the many benefits with our patient population is the education we provide in the pre-operative period. We are successful in our communication on SCU due to the strong relationships we have with the ancillary staff which includes departments such as pharmacy, physical therapy and occupational therapy and case management. This communication process starts in the physician’s office and continues throughout the patient’s experience, even after they have been discharged.”

- Karen Ferreira, BSN, RN, RN-BC, SCU Nurse Manager

Rutland Community Collaborative Community collaboration and care coordination are the core of ensuring the health of our community. The Rutland Community Collaborative (RCC) is comprised of healthcare leaders and providers from various professional organizations across the Rutland Region.

The mission statement of the initiative is: The Rutland Community Collaborative is committed to improve the overall health of the Rutland Community through appropriate utilization of healthcare services. Membership includes but is not limited to physicians, nurse practitioners,

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social workers, nurse case managers, transitional care nurses, public health professionals, and leaders. Many nurses from across our Community meet with other healthcare experts at the monthly Stakeholders meeting and the sub-group meetings to discuss opportunities and challenges with improving the health of our Community. There are nursing representatives at each of the six subgroups: Transitions of Care, Palliative and Hospice, Clinical Case Reviews, Behavioral Health, Data, and Patient Education-Engagement. The enthusiasm of the RCC participants, and commitment

to the health of our Community is evident at the many meetings I have the privilege of attending. Whether we are discussing patient engagement, education, quality metrics, social determinants of health, or palliative and hospice care, the conversational focus is patient and family oriented. With the assistance, commitment, and guidance of the RCC, and our Community nurse partners we will be successful in ensuring the health and success of our Community

Collaborative Relationships Emergency Nurses Week Community Outreach Luncheon Progressive Care Unit reduced travel nurse hours to zero

The Emergency Department celebrated Emergency Nurses Week with a week-long celebration that included a community outreach luncheon that was attended by the Vermont K9 Officers where the pups were served homemade turkey stew.

“2018 was an exciting year for the Progressive Care Unit as we welcomed 15 new nurses to the unit. As a result of their successful completion of orientation, we were able to reduce the number of traveler hours to zero by December 31st! This incredible accomplishment could not have occurred without the dedication of our knowledgeable preceptors. We are fortunate to have such a great team of nurses on this unit.”

- Alyssa Scott, BSN, RN, PCCN, Director of ICU & PCU

Patient Safety Associate to Psychiatric Technician Training Program

Travel RN Hours on PCU Travel RN Hours 900

Katelynn Brown, BSN, RN, RN-BC, Psychiatric Services Clinical Educator led the initiative to offer Psychiatric Technician training to all Patient Safety Associates (PSAs) as an opportunity to grow within their role and develop professionally. Through the program, participants were provided with specialized training and supervision within the Psychiatric Services Inpatient Unit to gain a wider knowledge base about the care and treatment of patients with mental illness. This collaborative relationship has provided improved care to our patients. When working

800 700 600 500 400 300 200 100 0

Jul 2018

Aug 2018

Sept 2018

Oct 2018

Nov 2018

Dec 2018

in the ED, the PSAs now have skills to de-escalate patients where previously a technician from the inpatient unit was called to assist. PSAs in the ED can now clearly speak to patient’s awaiting admission about the inpatient unit’s routines and protocols to reduce anxiety about the admissions process. It has also increased the number of trained professionals so that the ability to flex staffing to accommodate patient needs is enhanced, for example, if a patient is comforted on PSIU by having staff that they developed a rapport with in the ED.

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Collaborative Relationships Throughout the year, our nurses challenged themselves to find opportunities to give back to our community.

Here are just a few examples of the volunteer work that we did in 2018!

Dinner for Dismas House Nurse Leaders volunteered their time to prepare dinner for residents at the Dismas House in Rutland City. The Dismas House provides opportunities to reconcile former prisoners with their communities, build relationships within the community, and help build a sense of purpose and belonging for their residents. The group dined with the residents and had a great evening!

Come Alive Outside Rutland Regional Medical Center hosted the Come Alive Outside events again in 2018. During these events over 350 students from the community visited our campus to plant and harvest pumpkins and sunflowers. These events are designed to encourage students to learn about nature and to teach the importance of being active in the outdoors. The photos below are from the Come Alive Outside Harvest Event where nurses facilitated several of the activities. Tom Rounds, BSN, RN, CEN assisted students in recording measurements of their pumpkins. Kathleen Craig, MSN, RN, NEA-BC cheered on a student as she pedaled the smoothie bike. Andrea Borchlewicz, BSN, RNC-MNN, CLC and Amy Martone, RN, MBA, CPHRM helped students decorate seed packets to take home with them to plant.

Alzheimer’s Walk A team of RRMC employees led by Samantha Helinski MSN, RN, CWOCN participated in the Alzheimer’s Association Walk to End Alzheimer’s, the world’s largest event to raise awareness and funds for Alzheimer’s care, support and research.

The team goal was to raise $5000.00! MOU nurse (and fundraiser extraordinaire) Bonnie Corsi, RN, RN-BC hosted a Memory Tree, Hula Hoop Challenge, and Hawaiian Social Hour to help raise money for the team.

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Nursing Annual Report 2018

Great 2-4-6-8K Run, Walk, Relay The Annual Vermont Great 2-4-6-8K Run, Walk, Relay offered the community a chance to get outside and enjoy the downtown course that brought participants through beautiful historic Rutland. Nurses from throughout Rutland Regional Medical Center turned out to volunteer at this event where all proceeds raised from benefited the Foley Cancer Center.

Nurse Celebrities Throughout the year, Rutland Regional Medical Center partners with the Rutland Region Chamber of Commerce to promote community-wide events that benefit agencies in the Rutland area.

‘Newly’wed Game

Real Rutland Feud

Fred Garrow, MSN, RN, NE-BC, RN-BC, and his husband Gene Jennings were contestants in the Newlywed Game where local couples test their knowledge of one another & help raise monies to support the Rutland Community Cupboard, BROC, The Food Shelf and The Salvation Army.

Betsy Hassan, DNP, RN, NEA-BC, CPPS and Elizabeth Kyhill, MSN, RN participated on the Rutland Regional Medical Center team in the Real Rutland Feud. The Rutland Region Chamber of Commerce hosted the Real Rutland Feud based on the popular TV game show Family Feud where local businesses competed against each other in an effort to raise funds for the Regional Marketing Initiative.

Lip Sync Battle

Dancing with the Rutland Stars Professional Dancer Trang Ho, BSN, RN, RN-BC and Rutland Star Jody McIntosh, MSN, RN competed in the Dancing with the Rutland Stars. The popular dancing competition is modeled after the television show and benefitted the Friends of Pediatric Care at the VNA & Hospice of the Southwest Region.

Nurse celebrities Matt Morse, RN; Deb Hough, BSN, RN, CNOR; Brittni Racine, BSN, RN, RN-BC, ONC; Marlaina Williams, BSN, RN; Mary McGuire, BSN, RN; and Mary Fran Skaza, RN, CCM all participated on the RRMC Big Top Troupe team that won the Judge’s Choice at the 2018 Rutland Lip Sync Battle. All proceeds from the event benefitted the Wonderfeet Kids’ Museum.

Nursing Annual Report 2018

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ANCC Magnet Hospital DesignationÂŽ | Joint Commission Accredited | Leapfrog Hospital Safety A Rating Healthgrades Outstanding Patient Experience Award | Advisory Board Workplace of the Year | U.S. News & World Report Best Regional Hospital