2014 Mercy Medical Center Baltimore Annual Report

2014 | Nursing Annual Report

Mercy Medical Center

Mercy Nurses lead the quest for Magnet Redesignation

Mercy Medical Center’s

Awards & Recognition Ranked #2 Hospital in Maryland – U.S. News & World Report, 2014-15

TopRNtoBSN.com

30 Most Nurse-Friendly Hospitals in the United States

On the Cover 2014 Magnet Champions Front L to R: Nina Dinglas, Brian Bontrager, Katelynn Dougherty, Cathy Ballance Middle L to R: Alicia Osorio, Deborah Dicus, Pat Lavazza, Andrea Staiti, Ettienne Zantop, Corrine Sakyi, Karen Coates, Christine Ewing, Erika Muller Top L to R: Gwynneth Jarrell, Allison Beckham, Virginia Alinsao, Wendi Poole, Phyllis Wenderoth

▲ Throughout the Annual Report, you will see evidence of how Mercy nurses follow our Professional Practice Model.

LETTER FROM KIM BUSHNELL

Dear Nursing Colleagues, I am pleased to invite you to celebrate the success of our Nursing Division as presented in our 2014 annual report.

In the past year, we were recognized as one of the top 30 most nurse-friendly hospitals in the U.S.! Throughout the report, you will see highlights of some tremendous steps in our quest for Magnet redesignation. You will also see confirmation of amazing growth in evidence-based practice and research at Mercy. Our nurses have shared their evidence-based best practice initiatives with local, state and national audiences through poster and podium presentations at a variety of nursing and healthcare conferences. Our nurses’ dedication to our profession is further exemplified by the continuous increase in specialty certifications and our Clinical Advancement Program (CAP), which you will see listed at the end of this report.

As you read through the annual report, it will become obvious that Shared Governance is alive and well at Mercy. However, you all have something worth sharing. So, I invite everyone to the table to make decisions regarding the future of healthcare. Your input and engagement is vital to our continued success and I value hearing from each of you.

Please continue to bring positive energy and enthusiasm to everything you do. It really does make a difference in the lives of our patients and each other. While we have achieved many great things, we are still on a journey to excellence. Let’s take the time to celebrate our achievements and each other, but never lose sight of how we can make things better for ourselves and the patients who depend on us for exceptional care.

Thank you all for the incredible work you have done this past year. I am so proud of you and wish you continued success for 2015.

Kim Bushnell, DNP, RN Vice President of Patient Care Services and Chief Nursing Officer

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Business of Healthcare Leadership Development Shared Governance

Transformational Nurse Partner Highlights Leslie Scott, Director of Value Analysis has been a key player in helping Mercy nursing move forward in 2014. We would like to thank Leslie for her help in some key areas. In 2014, Nursing embarked upon a study that looked at post operative patients and the benefits of inhaling a blend of essential oils that include lavender, ginger, spearmint and peppermint in preventing postoperative nausea and vomiting. Leslie facilitated the implementation process and her team made sure we had all the supplies needed to be successful.

Leslie Scott

In addition, she took on the task of helping us acquire new PCA (patient controlled analgesia) pumps throughout the hospital and did an outstanding job leading the process to help us choose our new dressing change supplies. Leslie and the value analysis team work hard to find the right products for our patients and the staff who are providing direct care. We are proud to have her as part of our team.

Kris Olszewski Joined Mercy as a staff nurse in Labor & Delivery.

Since that time, she has worn many hats at Mercy. In the early 2000’s, Kris became the Documentation Manager and led nursing through the implementation of the computerized paper EMAR and the computerized Meditech documentation system. Eventually Kris transitioned to her role as an IT Analyst where her main focus became nursing documentation. One of Kris’s first projects was the implementation of the Centricity Perinatal System for the Maternal Child Health areas. Kris worked tirelessly with nurses and physicians to build the documentation.

Currently, Kris is focused on all nursing computerized documentation, which includes Responder 5/Nurse Call and Tracker Board in the ED. She works with many areas to gather data for reports. She is a person that everyone goes to for help and information. We are so thankful for Kris and her leadership in informatics.

T W O

Kris Olszewski

Clinical Redesign MAGNET STORY: TL3EO - The CNO influences organization-wide change beyond the scope of nursing.

MAGNET STORY: SE1EO(b) - Improvements resulting from contributions of clinical nurses in interprofessional decision-making groups at the organizational level.

Kim Bushnell, Chief Nursing Officer (CNO) formed an interdisciplinary team called A2D (Admission to Discharge) to look at ways to clinically redesign and improve efficiency in the physical therapy evaluation process at Mercy. Utilizing Kim’s experience with Lean Kaizen, a methodology for eliminating waste and improving efficiency, Kim created a interprofessional redesign team consisting of leaders from nursing, rehabilitation medicine, radiology and social work.

Kim and her team were able to increase PT evaluations completed within 4 hours of order entry from 24% to 73%. This resulted in $250,000 cost savings for our hospital.

When Maternal Child Health moved to Bunting in 2012, they experienced an increase in volume, which significantly increased the triage wait time to an average of 53 minutes. To improve work design flow processes, nursing staff collaborated with other inter-professional decision makers at Mercy. As a team, they developed a rapid response, acuity assignment system. The new system reduced wait time from 53 to 8 minutes by enhancing the triage process in this area.

MAGNET STORY: NK6EO - Nurses are involved in the design and implementation of work flow improvement and space design to enhance nursing practice.

An increase in Emergency Room patients seeking treatment at Mercy led to patients leaving without being seen (LWBS). This inspired our ER nurses to create the ER Purple Team to provide a separate area to fast track these patients. The nurses along with property management, clinical planning, ED leaders, Nurse Educators, and medical providers took charge of the work flow redesign process. As a result of this interprofessional collaboration, an operational improvement was achieved by reducing the left without being seen (LWBS) rate from 3.2% to below 2%.

Resource Utilization MAGNET STORY: EP9 - Nurses are involved in staffing and scheduling based on established guidelines, such as ANA’s Principles for Nurse Staffing, to ensure that RN assignments meet the needs of the patient population.

In the fall of 2014, B16’s volume was increasing and a need to move the spine patient population to B14 was identified. A special team of nurses committed to the care of spine patients materialized and the transition process began. Through several schedule changes to accommodate training and the actual move, the nurses of B14 and B16 rose to the occasion and made the transition seamless for our patients. Thank you to B14 and B16 nurses for their flexibility and adaptability, which were essential to the success of this transition.

MAGNET STORY: EP5(b) Nurses’ involvement in interprofessional collaborative practice that ensures care coordination and continuity of patient care.

The departments of interventional radiology and radiation oncology successfully collaborated under the leadership of Deb Phillips to coordinate a radioembolization treatment plan. Deb managed a large multidisciplinary team of care providers, which included interventional radiology, radiation oncology, hepatology, medical oncology, nuclear medicine and transplant surgery. Their collaboration ultimately led to the successful treatment of patients who were suffering from hepatocellular carcinoma (HCC), the most common primary malignancy of the liver. This process required a lot of teamwork, but Deb and her group were able to make it a successful procedure for patients who require this type of treatment at Mercy.

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Business of Healthcare Leadership Development Shared Governance

Shared Governance Shared Governance Chairs Front row: Nikasha Uqdah, Joyce Batcheller-Magnet Consultant, Kim Dorsey Back row: Tim Mayer, Rachel Witter, Kristen Chavis, Patty Hengel, Nikki McCarthy, Tess Bailey Not pictured: Lori Chrest

QUALITY IMPROVEMENT COUNCIL

Shared Governance Council Chairs recently reflected on their top accomplishments in 2014. Here is what they were most proud to report:

1. The development of the CAUTI reduction surveillance tool.

PRACTICE COUNCIL

3. Quality Summit

1. We established a streamlined template with guidance to write, create and update practice documents.

EDUCATION COUNCIL

2. We updated and improved the document library to increase usability and accountability.

1. Nursing Grand Rounds – Topics of Fecal Transplantation, Speech Pathology and Care of the Stroke Patient, & Crisis Management.

3. We had lively discussions about practice issues and approval of new policies, which lead to the improvement of nursing practice in all units, departments and divisions.

2. Decreased CLABSI rates.

2. Education roll out of bed bugs, lice and scabies, presentations on personal property and preceptor class (x2).

3. NST approved and added as member of our council.

NIGHT COUNCIL 1. We conducted unit presentations.

2. Improved communication for the night shift improved staff morale and teamwork among the units.

3. We discussed issues that are unique to the night shift and worked together to successfully resolve them.

F OUR

INFORMATICS COUNCIL 1. Chart audits ( 10 per unit per month) 2. PDA and Carefusion updates 3. Evidence based “plan of care” changes and updates

A NOTE FROM THE SENIOR VICE PRESIDENT OF OPERATIONS

Due to healthcare reform, the hospital industry experienced incredible changes over the course of 2014. I want to thank you all for weathering that storm with us, while maintaining an

2014 Sisters of Mercy

Nursing Awards Winners

environment of peace and calm for our patients and the community we serve.

Benjamin Dunning (Community Impact)

During this time of great transition, Mercy nurses worked together and developed creative strategies to maintain our level of exceptional care, while adjusting to the financial challenges as they presented.

In the past year, I have seen Mercy nurses as healthcare innovators rising to the challenges we face. These challenges have included, but are not limited to, implementation of new practices such as Mobilab to improve patient safety and Ebola training to increase staff safety. In addition, initiatives such as cross training and new triage processes have strengthened our clinical redesign initiatives for more effective and efficient

Brittany McCormick (Nurse Visionary)

care. While at the same time, we continued to conduct research and share our findings through publication and podium presentations around the nation.

In the days and months ahead, we will need to remain a step ahead of change. I am confident with the dedicated team of nurses at Mercy, we will become even better problem solvers and use it to our advantage as leaders of change.

Susan Finlayson, DNP, RN Senior Vice President of Operations

Stacey Adkins (Nursing Leadership) Not Pictured: Deb Phillips (Compassionate Caregiver) FIVE

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Clinical Ladder Charge Nurse and Preceptor Workshop National Certifications and Advanced Degrees NST Development

Education and Community Corner MAGNET STORY: SE7 - The organization facilitates the effective transition of registered nurses and advanced practice registered nurses into the work environment.

Nurse Residency Program (NRP)

MAGNET STORY: TL2(a) - Nurse leaders and clinical nurses advocate for resources to support nursing unit and organizational goals.

Moving Towards Mobile The Center for Clinical Excellence recently initiated a new e-learning program in order to streamline the learning process for required staff education. They found it was taking staff long periods of time to complete required education and the retention of key facts was minimal. After a considerable amount of research on what methods would work best for our facility, several new programs were acquired, including Articulate Storyline, C3 Softworks and new mobile tablet devices. In addition, changes were made to move orientation to an online format to break up the boredom of sitting and listening to speakers all day. Other e-learning strategies included using QR codes to provide real time information, infographics to communicate large amounts of information and staff made videos to improve outcomes. Stay tuned as we continue to bring education to the bedside in 2015.

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Mercy celebrated the first group of Nurse Residency Program (NRP) graduates in the fall of 2014. New nurses are offered up to a 12 week orientation, depending on their progress and specific needs. In addition to the unit-based orientation, they attend 12 monthly four hours classes, which incorporate an interdisciplinary approach to the content delivery. Some of the classes focus on professional communication, patient safety, cultural competence, ethical decision making, pain management, EBP and professional role development. Another feature of this new curriculum is “Tales from the Bedside� in which new graduates are encouraged to discuss issues they might have and if there are any trends identified to be communicated anonymously to Kim Bushnell. This allows for the new grad to feel comfortable and confident in voicing their opinions or thoughts without fear of repercussion. There are multiple layers of support from mentors, educators, preceptors, managers and NRP facilitators.

Since the fall of 2013, 54 new graduate hires have participated in the NRP cohort at Mercy with minimal turnover.

MAGNET STORY: SE5 - Nursing education opportunities are provided for those interested in a nursing career.

High School Outreach Program Mercy partners with local area high schools through a formalized high school outreach program. Monica Nelson, MSN, RN is the coordinator who works with high school guidance counselors from 8 area high schools to offer students an opportunity to work in the hospital for a one week internship program. Mercy accepts 8-10 students based on meeting certain criteria to be eligible. During the summer of 2014, nine students participated. Their participation has resulted in the current employment of 6 RN’s, one nursing support tech and one patient service representative.

A NOTE FROM THE PRESIDENT & CEO

Dear Mercy Nurses,

OVER

7,000 HITS

MAGNET STORY: SE10EO - Nurses participate in the assessment and prioritization of the healthcare needs of the community.

B-more Safe App After Mercy Nurse Deb Holbrook was asked to review Yeardley Love Foundation materials, she was inspired to create an App and website which would meet the needs of the community, either proactively, prior to an assault, or reactively to an assault. Deb along with Mercy Nurses Erin Lamar and Jessica Draughon created the Bmore Safe App in an effort to proactively reach high school and college students to provide information on emergency access, crisis hotline numbers and appropriate facilities if needed. The App was designed for ease of use. Instructions were simplified and relevant to individuals who were assaulted to allow the victim to be able to process during this crisis mode. After a lot of hard work by Mercy nurses, the mobile app was formally launched and is used locally, nationally and internationally.

It seems like yesterday when Mercy joined the elite list of hospitals nationwide whose Nursing Departments have achieved “Magnet Status.”

Back in September 2011, when our Magnet Team took that famous phone call with the news, I was never more proud of the Mercy Nursing Team.

In that moment, I thought about all the Sisters of Mercy who had served our patients since 1874 and how that recognition for nursing excellence honored their memory and legacy. It was, and is, a defining moment in our history.

Now that we are preparing for Magnet Redesignation, I am certain that the themes you have chosen—Transformational Leadership; Structural Empowerment; Exemplary Professional Practice; as well as New Knowledge, Innovations and Improvements—will impress the evaluation team once more. It takes an incredible amount of hard work and teamwork to go through the Magnet process.

I am certain that Mercy Nurses will again lead the way and demonstrate the Quality of Excellence that has come to define.... the Quality of Mercy. My very best wishes with the next steps on the journey to Magnet Redesignation.

Sincerely, Tom Mullen President & CEO SEVEN

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Community Outreach Magnet Status Peer Review Work/Life Balance

DAISY AWARD WINNERS 2014 January...............................................Bonnie Wohlfort, IR March....................................... Katherine Polyakov, PACU June.......................................................Laura Carroll, ICU August.................................................. Janice Fisher, OPC October......................................... Christina Cornett, B15 December...............................................Julia Ruzin, NICU

Celebrating our 2014

Patient Service

ROSE AWARD WINNERS 2014

R E P R E S E N TAT I V E S

April.......................................................................... Megan Vogt, B12 August........................................................................Kaitlyn Welk, B16 September...................................................................Justin Jones, B12

EI G HT

Celebrating

Nurse’s Week 2014

Community Outreach Projects in

2014

totaled

1,086

volunteer hours!

The 2014 Nurses’ Week proved to be another fun-filled action packed week celebrating our Mercy nurses. Events included the following: • Magnet Champions rounded on the units to celebrate Mercy nurses and kicked off the week with balloons and hand-outs of the weekly schedule.

• Sisters of Mercy Nursing Awards • Senior Nurse Dinner • Murals – “Nurses Leading the Way”.

• Food Drive to benefit the Maryland Food Bank. Also held a bake sale and recipe book sale to benefit the Mercy Nursing Scholarship.

• Nursing Symposium lecture – Debbie Holbrook presented on Forensic Nursing and SAFE. • Snack baskets were delivered to the units for staff to enjoy.

• Ice cream rounds were made to the units during all three shifts.

• Stress relief hand massages were offered on the nursing units for the staff to enjoy.

• 1st annual Oriole Night held at the stadium.

• Gift of stadium blankets were distributed to all nursing staff.

Adopt a Family for Christmas Annual Holiday Party Baby Supply Drive Baer School Adoption Bake Sale for Babies Baltimore Reads Baltimore Running Festival Water Station Blankets for Warriors B-more Safe App Cancer Support Group Christmas Family Gift Wrapping Clothing Drive for Esperanza Center Commodore John Rogers School Supply Drive CPE Program Interviews Flu Drive Flu shots at homeless shelter Food Drive- Nurses Week Girl Scouts of America – teach CPR Health Education Committee Meetings Heat It to Beat It Fundraiser Hispanic Health Fair – BP screenings Johns Hopkins Professional Advisory Group Meetings Kingdom First MinistriesOutreach Pizza Party Kingdom First MinistriesOutreach Thanksgiving Dinner Marian House Collection Marian House Courtyard Gardening MD Food Bank Food Drive

Med Caps for Art with a Heart Miles for Mollie Mission Scholarship Committee Meeting Monthly MIndfulness Sessions My Sister’s Place Collection My Sister’s Place Food Drives Nursery Rhyme Christmas Tree Book Drive Nursing Bake Sale Our Daily Bread Pack the Backpack Pajama Drive for Kennedy Krieger Patterson High-Interview Practice Day Project Homeless Connect Roberta’s House Supplies Run to Remember Salvation Army Supply Drive Send a Family to the Beach Sinclair Lane Elementary School Supply Drive St. Francis Academy Supply Drive Typhoon Haiyan Clothing Drive Weekly Breastfeeding Classes Wreath Laying at Arlington

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Patient and Family Center Care Collaboration/Teamwork – Multiple Disciplines Quality Measures Electronic Health Record & Meaningful Use Bunting Move

MAGNET STORY: EP6 - Nurses incorporate regulatory and specialty standards/guidelines into the development and implementation of the care delivery system.

Neonatal Hypoglycemia

The Family Childbirth Children’s Center medical and nursing leadership teams meet regularly to discuss concerns and issues in their area. In late 2013, they decided to focus on the care of late pre-term infants. Looking at the latest in clinical recommendations, they decided to further focus on hypoglycemia. Together the nurses, along with Ann Johnson, a clinical education specialist in NICU and Pediatrics, developed a neonatal hypoglycemia protocol, which allows the infant to spend less time away from their mom, while still being monitored for signs of hypoglycemia.

Less time away from each other promotes the mother, infant bond.

This protocol was influenced by the revised AWHONN toolkit and AWHONN standards as well as American Academy of Pediatric Neonatal Hypoglycemia recommendations.

Skin Prevalence

Mercy Nurses continue to be below the national average for nosocomial pressure ulcers.

T EN

Above is a sample page from the new falls tracer tool MAGNET STORY: TL1EO(b) A nursing strategic plan initiative that resulted in an improvement of clinical practice.

Fall Prevention Within the nursing strategic plan, the goal was set to “exceed national benchmarks for clinical quality & safety.” A specific strategy was developed to reduce the total number of falls per 1000 patient days to 2.0 falls per 1000 patient days or below. Four changes were made to help meet this goal. Those changes include the implementation of a falls tracer methodology for environmental rounding, there was also an increase in the transparency of information and accuracy of reporting, incident reports were streamlined and duplication was eliminated, and there was also an increase in the accountability of patients calling for help when needed. All of these measures decreased falls to well below the goal of 2.0 per 1000 patient days since implementation.

Thank you A few words of appreciation expressed

by Mercy patients: Dear Susan Finlayson I have worked as both a nurse and a manager for over 30 years, and was impressed and grateful for MAGNET STORY: EP18EO(b) Workplace safety for nurses resulting from the safety strategy of the organization.

Be prepared

the fabulous care given to me by your staff.

My perspective until recently has only been on the healthcare side. As a nurse, I was very anxious about being a patient. Your staff was wonderful and I plan to share my experience with many colleagues

Workplace safety is always an important part of any job and nowhere was that more important than it was in 2014 with the risk of the spread of Ebola in the United States. Following the death of the first U.S. patient from Ebola at a Texas hospital, Mercy used a multidisciplinary task force to prepare our staff for treating a patient with a highly infectious disease. To measure the effectiveness of our training program, a survey was implemented before and after the training sessions. Prior to training, nurses rated their comfort level in caring for highly infectious patients at an average of 5.8 out of 10.

Following the training, the nurses rated their level of comfort of 8.4 out of 10. This was accomplished through a series of drills to teach staff how to put on and remove their personal protective equipment, designated special areas with the appropriate supplies to treat these patients and the drafting and communication of a formal plan for how to treat these patients if and when they entered our facility.

and friends. Please thank your team again for me!

A happy patient

Dear Miss Bushnell, Your staff showed amazing compassion during my stay in the hospital. They are a credit to the nursing field and to Mercy Hospital. Please let them know how much I appreciate them.

An appreciative patient

According to Our Patients, Mercy Nurses are Excellent Communicators!

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Patient and Family Center Care Collaboration/Teamwork – Multiple Disciplines Quality Measures Electronic Health Record & Meaningful Use Bunting Move

Quality Summit 2014

A MESSAGE FROM FATHER TOM

Transformational leadership has been at the very core of the tradition of Mercy since the days of our founder Catherine McAuley.

Catherine, who lived her adult life in the early 19th century, was blessed with an incredible ability to look at a situation of need and respond in creative and innovative ways. This freedom, this creativity, continues to shine today in the culture of Mercy Nursing.

When the Sisters of Mercy decided to accept the invitation of the Doctors of what was then Baltimore City Hospital in 1874, they courageously went into the uncharted territory of urban healthcare.

They did so with faith, hope, and a lot of charity. From the 1874, Annals of the Mercy leadership we read: “If charity could appeal to the Sisters of Mercy, here was the opportunity; a more miserable, God-forsaken specimen of a hospital could not be imagined. Physical suffering and moral degradation united to make this institution something to be dreaded. The Sisters of Mercy took charge in God’s name.” Needless to say, things changed fast.

By 1897, the hospital established the first Pasteur Institute to treat rabies. By 1899, the Mercy School of Nursing opened its doors to enroll its first class. At the same time new buildings were constructed with the creative financing stream resulting from a benefit concert by the famous musician John Philip Sousa.

This momentum continues in the structural empowerment of our staff and in transformational leadership that creates an environment of innovation and evolution in the early 21st century. Exemplary professional practice, flexibility, and new knowledge continue today at C Othe N Tsame I N U Esite D where the Sisters arrived in downtown Baltimore long ago.

Father Tom Malia

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Evidence Based Practice Research Innovations in Practice Presentations and Publications

Social Worker, Sally Ratcliffe, Social Worker, Terri Pallazo, MSN, RN, Deborah Holbrook, MSN, RN, Dina Krenzischek, PhD, RN, CPAN, FAAN. n NICU: Determination of LOS and Days to Full Feed in Preterm Infants.

Ann Johnson, BSN, NNP-BC, Dina Krenzischek, PhD, RN, CPAN, FAAN. n PACU: Evaluation of Perianesthesia Staff Perceived Culture of Positivity and Satisfaction After Application of the Propel Performance Model.

Kristine O’Neil, BSN, RN, CPAN, Dina Krenzischek, PhD, RN, CPAN, FAAN, Tom Muha, PhD, MA.

Thank you to (L to R), Roy Hatch, Librarian, Dina Krenzischek, Director of Professional Practice and Ryan McDonald, Statistician for their work in making these projects possible.

2014 Research Studies n B12: Pilot Study: Difference in nurses and patients’ perceptions of the PFCC interventions and relationship of patient centered nursing interventions to desired outcomes. Tanja Gross, BSN, RN & Heidi Chroszielewski, BSN, RN. n M&B: L&D Nurse’s attitudes and perceived knowledge/ competency toward exclusive breast milk feeding and patient breast feeding outcomes: A pre and post interventional study.

Heather Hammond, MSN, RN & Tracy Mahmoud, BSN, RN. n B15: Exploratory Study to Examine Prevalence of Distress, Satisfaction, with Interventions and Relationships

with Demographics and Treatment Modalities Among Adult Oncology Inpatients in an Acute Care Setting. Fatima Bah, MSN, RN, Robyn Stemmer, MSN, RN & Dina Krenzischek, PhD, RN, CPAN, FAAN. n L&D: Using an Acuity Scale to Assess Patients for Obstetrical Triage. Jessica Tollefson, BSN, RN, Dina Krenzischek, PhD, RN, CPAN, FAAN, Robert Atlas, MD, & Laveda Roy, MSN, RN. n ED: Evaluation of HospitalBased Intimate Partner Violence Programs in Maryland. Samantha Illangasek, PhD, MPH, Tanya Araya,

n IR: Evaluation of Perceived Importance, Competence, Confidence, and Satisfaction in the Implementation of Moderate Sedation among Interventional Radiology Nurses. Patricia Tuck, BSN, RN, NEBC, Elizabeth Riley, MSN, RN, Dina Krenzischek, PhD, RN, CPAN, FAAN. n MCA2: Evaluation of the Effectiveness for Patients Comfort When Using Lidocaine with Sodium Bicarbonate, as a Local Anesthesia for Liver Biopsy Patients. Anurag Maheshwari, MD, & Deborah Hockett, BSN, RN. n NICU: Prevalence of Naso Gastric Feeding Tube Use in Pediatric Hospitals. Ann Johnson, BSN, RN, NNP-BC. n PCS: A taste of Research: Intro to Research Process. Beth Kilmoyer, DNP, RN-BC.

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Evidence Based Practice Research Innovations in Practice Presentations and Publications

Navigating the Course: Redefining the Nurse’s Role in Today’s Healthcare: 4th MMC EBP/Research Symposium

EBP Symposium The 4th annual Mercy Evidence-Based Practice (EBP) Research Symposium was held in October of 2014. Guest speakers included Kim Bushnell, DNP, RN-NEA-BC, Dr. Kim Noble and Dr. Patricia Morton. Some of the topics presented included the role of an executive nursing leader in developing a culture of excellence and how to start publishing results of EBP and research. A poster grand round was also held to exhibit 29 PI, EBP and research abstracts. The abstracts were peer reviewed by some of the MMC Center of Clinical Excellence!

F OURT EE N

Achievements 2014 Publications n Herd, Hope, May 2014, Establishing the Surgical Nurse Liaison Role to Improve Patient and Family Member Communication, AORN Journal, Vol 99. No. 5 n Hofmann, Tanya, October 2014, Perianesthesia Unit-Based Award of Excellence Strategic Work Team, ASPAN’s Breathline Online. Vol 34. No.5 n Krenzischek, Dina and ASPAN SWT, July 2014, ASPAN Clinical Information System (CIS) Implementation Resource Manual, ASPAN Resource On line, aspan.org n Stern, Michelle, Dec 17, 2014, Darkness in Light of the New Year, Plainviews, Volume 11, No. 20.

Clinical Advancement Program Promotions in 2014

(CAP)

February 2014 Maria Alvarez, RN Clinical Nurse IV (Bunting 14) Christine Doyle, RN Clinical Nurse III (Angiography) April 2014 Shannon Barry, RN Clinical Nurse III (Emergency Services) Angela Kachura, RN Clinical Nurse III (Emergency Services) June 2014 Angela Chaney, RN Clinical Nurse III (Critical Care) Nina Dinglas, RN Clinical Nurse III (Specialty Surgery) Nancy McCready, RN Clinical Nurse III (NICU) Rachel Skrbin, RN Clinical Nurse III (Operating Room) Dana Triplett, RN Clinical Nurse III (Angiography) August 2014 Hana Gebrewold, RN Clinical Nurse III (Bunting 14) Hillary Topping, RN Clinical Nurse III (PACU) October 2014 Teresa Johnson, RN Clinical Nurse IV (Critical Care ICU) Regina Kozak, RN Clinical Nurse III (PAT)

n Susan Finlayson in Wolf, G., Finlayson, S., Hayden, M., Hoolahan, S., & Mazzoccoli, A. (2014). The Developmental Levels in Achieving Magnet® Designation, Part 1.Journal of Nursing Administration, 44(3), 136-141. n Susan Finlayson in Wolf, G., Finlayson, S., Hayden, M., Hoolahan, S., & Mazzoccoli, A. (2014). The Developmental Levels in Achieving Magnet® Designation, Part 2. Journal of Nursing Administration, 44(4), 196-200 n Stacey Brull, 2014, Shared Governance with EASE Infographic. The Forum for Shared Governance. http:// sharedgovernance.org n Stacey Brull, 2014, Clinical Teaching Strategies in Nursing--book review. Journal for Nurses in Professional Development.

2014 Podium Presentations n Brull, S. and Finlayson, S. (2014). “Let the Games Begin” Stories”. National Magnet Conference. n Brull, S., Kilmoyer, B., and Krenzischek, D. (2014).

Think Data, Getting Magnet EO Stories. National Magnet Conference. n Krenzischek, D. (2014). “Think and Practice Magnet: What can ASPAN do for you?” American Society of PeriAnesthesia Nurses Annual National Conference.

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Evidence Based Practice Research Innovations in Practice Presentations and Publications

2014 Poster Presentations n Allen, M., Bennett, B., Grantland, M., Hood, E., Kachura, A., and Meyett, B. (2014, October). Alarm Fatigue in the Emergency Department: How can we fix it? EBP/Research Symposium. n Alvarez, G., Goodwin, J., Kartela, Z., Lanes, T., and Soliman, E. (2014, October).

Comprehensive Limited English Proficiency Program. EBP/Research Symposium. n Anderson, M., Cutting, S., Dinglas, N., Galiza, J., and Sleater, J. (2014, October).

Strategies of Fall Prevention in the Ambulatory Setting. EBP/Research Symposium. n Ackerman, K., Pendelton, D., and Nicholson, M. (2014, October). NICU Safety Rounds.

EBP/Research Symposium. n Bah, F. Irwin, J., and White, T., (2014, October). Medication Reconciliation – A Performance Improvement Initiative. EBP/ Research Symposium. n Bahadursingh, N., Benton, G., Cornish, L., Fletcher, T., Hare, D., Johnson, K., Mayo, J., Norman, J., Palm, B., Penaranda, C., Perzinski, A., Prince, W., and Steinberg, J. (2014, October). Fall Intervention Program: Performance Improvement Project. EBP/ Research Symposium. n Bahadursingh, N., Chroszielewski, H., Fletcher, T., and Norman, J. (2014, October).

Improving Staff Satisfaction through Evidence Based Teamwork Strategies on an Inpatient Telemetry Unit. EBP/Research Symposium. n Becker, M., Bowerman, M., Chavis, S., Jamias, M., and Wagner, V. (2014, March).

Let’s clean the air: There is no such thing as safe surgical smoke. AORN Annual Conference. n Becker, M., Bowerman, M., Chavis, S., Jamias, M., and Wagner, V. (2014, October).

Let’s Clean the Air: There is no such thing as safe surgical smoke. EBP/Research Symposium. n Becker, M., Bowerman, M., Chavis, S., Jamias, M., and Wagner, V. (2014, January).

Let’s clean the air: There is no such thing as safe surgical smoke. MONE Annual Conference.

S I XT EEN

n Bezold, N., Ciesielski, M., Gervasio, A., and Herd, H. (2014, April). Swabbing MRSA Screening in Preop setting “Taking MRSA to the bank”. Annual ASPAN Conference. n Bress, T., Chaney, A., Harry, C., Marshall, M., Riley, E., Triplett, D., and Trizna, J. (2014, October). Alarm Fatigue in Critical Care Setting.

EBP/Research Symposium. n Brull, S., Jefferies, J., and Kilmoyer, B. (2014, June). Transforming clinical nurse education through interactive e-learning technology.

University of Maryland Technology Conference. n Calder, S., Marasa, M., and Marshall, J. (2014, October). Effects of Music Among Oncology Patients. EBP/Research Symposium. n Cohen, C., Kostelec, T., Palazzo, T., and Taylor, W. (2014, January). Improving Patient and Staff Satisfaction in the Emergency Department using the Influencer Model.

MONE Annual Conference. n Cutting, S., Hawkins, A., Herd, H., Hofmann, T., Jarrell, G., Mackowiak, C., O’Neill, K., and Roberson, J. (2014, October). Don’t let your patient go away cold: Anesthesia Normothermia. EBP/Research Symposium. n Eberhard, M., Fiore, S., Schwarcz, R., and Zantop, E. (2014, October). The use of an Oral Care Bundle in Prevention of Ventilator Associated Pneumonia (VAP) in Adult ICU. EBP/Research Symposium. n Edwards, T., Stemmer, R., Trout, T., Rieben, M. , Howard, R., Lee, J. and Grosvenor, E. (2014, April). Throughput facilitation for patients undergoing spinal anesthesia “To Wiggle or Not to Wiggle.” Annual ASPAN Conference. n Ewald, A., Kim, I., Lee, D., Rainaldi, M., and Schaerer, L. (2014, October). Circadian Rythym. EBP/Research Symposium. n Gross, T., and Riley, E. (2014, January).

Collaborative approach leads to reduction in CLABSI in a Progressive Care Unit. MONE Annual Conference.

n Herd, Hope. (2014, April). Taking MRSA to the Bank. ASPAN National Conference. n Jasion, J., Leslie, R., Oden, C., Rieben, M., Sims, B., Stemmer,R., Trout, T., and Wadman, D. (2014, October). Sensitivity toward the Overweight/Obese Patient. EBP/Research Symposium. n Johnson, A. (2014, October). Determination of Length of Stay and Days to Full Nipple Feedings in Preterm Infants Using a Medically Driven Feeding Model. EBP/Research Symposium. n Joly, L., Krenzischek, D., and Mahmoud, T., (2014, October). Effectiveness of a DVD to positively impact knowledge and behaviors of new mothers regarding newborn safe sleep practices. EBP/Research Symposium. n Joly, L., and Mahmoud, T. (2014, August).

Effectiveness of a DVD to positively impact knowledge and behaviors of new mothers regarding newborn safe sleep practices: An educational intervention evaluation. Maryland Nurses Association (MNA) Annual Conference. n Kachura, A. (2014, October). Family Witnessed Resuscitation. EBP/Research Symposium. n Kilmoyer, B. (2014, January). Another taste of nursing research: An introduction to the research process. MONE Annual Conference. n Lamar, E. (2014, October). Testing Common Skin Products to Determine Flourescence or Absorbtion of Alternative Light. EBP/Research Symposium. n LeCompte-Hofmann, T., and Voith, C. (2014, January). Benefits of using the PASERO Opiod Sedation Scale (POSS) in Phase I Post Anesthesia Care Unit. MONE Annual Conference. n Lerch, H., McCready, N., Pendelton, D., Thomas, T., Poole, W., and Wolf, A. (2014, October). Maintaining Zero: Using the Laminar Flow Hood in the NICU to prevent CLABSI. EBP/Research Symposium. n Owens, L. (2014, October). Device-Related Pressure Ulcers: They Can Be Stopped!

EBP/Research Symposium. n Riley, E., Stiffler, S., and Tuck, P. (2014, October). Radial Compression Device Protocol Improvement. EBP/Research Symposium.

Nursing Certifications ACNS-BC Adult Clinical Nurse Specialist,CPAN - Certified Peri-Anesthesia Nurse Tanya LeCompte-Hofmann Assisted Living & Delegating Nurse Certification Rekeya Leslie CAPA - Certified Ambulatory Perianesthesia Nurse Barbara Bryant CARN - Certified Addictions Registered Nurse Vallie-Jo Polcak CBN - Certified Bariatric Nurse, CNOR – Certified Nurse Operating Room Vicki Lutz CCRN - Critical Care Registered Nurse Susan Brown Aurica Cazac Angela Chaney Kimberly Dorsey Teresa Eder Jane Hauhn Katja Jaramillo Paula Jarvis Jeannette Jefferies Teresa Johnson Mary Locke Mary (Denny) Marshall Alan Martin Lindsay Peery Cathleen Stratton Mariamma Thomas Dana Triplett Juvel-Lou Velasco Cheryl Whittaker Ann Wilner CCRN – Critical Care Registered Nurse, CPAN Certified Post Anesthesia Nurse Beth Winters CCRN - Critical Care Registered Nurse, NE-BC Certified Nurse Executive Theresa Bress CCRN - Critical Care Registered Nurse, Wound Care Certified Denise Gajewski C-EFM - Certified Electric Fetal Monitoring Nurse Molly Bass Miriam Becker Ariella Borkan Talia Brinkley Tiffany Brown Shanay Campbell Lauren Collins Tenille Cox Lindsey Ditanna June Evans Mary Formby Michelle Gilmore Sarah Grove Lisa Harvard Elizabeth Johnson Deborah Johnson-Johns

Jennifer Jones Stacey Keiper Shula Kohengadol Narene Kong Kerri Kreisel Lisa Lemig Heather Mease Maria Michels Shannon Misiewicz Trina Neary Beth Phillips Torie Pugh Jane Queen Corrine Sakyi Juthamars Thewsuvat Lawcedrea Walker Dionne Watson Amanda Wegrocki Pamela Westbrook Gina Woke Sarah Yuhas CEN - Certified Emergency Nurse Tracy Barr Jennifer Christofersen Cynthia Cohen Jennifer Corrigan Marcia Grantland Mary Ellen Harvey Teresa Kostelec Gayle Melnick Maureen Peters Bonnie Wohlfort Certified Long Term Care Nurse, Case Management I Delegating Nurse Kimberly Smith Certified Neonatal Nurse Practitioner Ann Johnson Certified Public Health Nurse Melissa Anton CGRN - Certified Gastrointestinal Registered Nurse Catherine Kreisel Kathleen Maier CMSRN - Certified MedicalSurgical Registered Nurse Gina Feustle Catherine Mbanefo Zipporah Mwangi Suja Odolil Sun Young Park Gita Sharma Certified Nurse Educator Catherine Jamariss-Stauts CNOR - Certified Nurse Operating Room Melanie Becker Mercy Bowerman Sherry Chavis Shirley Jamias Mandi Jewer Kristin Kraus Sanay Pickett Rachel Skrbin Gerald Turner Wendelyn Wagner Phyllis Wenderoth

CPAN - Certified Post Anesthesia Nurse Juanita Baroya Hope Herd Karen Hoskins Gwynneth Jarrell Rebecca Killian Erundina Krenzischek Patricia Lavezza Kristine O’Neill Jennifer Smith Cynthia Voith CPAN - Certified Post Anesthesia Nurse, CAPA – Certified Ambulatory Perianesthesia Nurse Deborah Pennington Emma Ranger CPHIMS – Certified Professional in Healthcare Information Management April Saathoff CPHQ - Certified Professional in Healthcare Quality, CCRA Joan Lake CPN - Certified Pediatric Nurse Philomena Dsilva CRNI - Certified Registered Nurse Infusion Lori Engelke CRNI - Certified Registered Nurse Infusion, OCN – Oncology Certified Nurse Mona Guilfoil CRNP - Certified Registered Nurse Practitioner Amy Burrell CURN - Certified Urology Registered Nurse Rowena Mejia CWOCN - Certified Wound Ostomy Continence Nurse Lisa Owens Rosilin Joseph Tonnie Warfield FACHE - Fellow American College of Healthcare Executives Terri Palazzo FNE-A - Forensic Nurse Examiner – Adult Jocelyn Anderson Shannon Barry Cynthia Bochniak Shannon Bolden Amy Downes Glynis D’Silva Eleanor Dunlap Cassondra Francis Sarah Grove Elizabeth Johnson Deborah Johnson-Johns Nisha Kumar Benjamin Labovitz Erin Lamar Maria Nene Sherry Peerson Michelle Perry Jane Queen Caroline Schildbach Marsha Utz Theresa Waggoner

FNE-A - Forensic Nurse Examiner – Adult, CNM Nira Mitchell FNE-A - Forensic Nurse Examiner – Adult, CRNP – Certified Registered Nurse Practitioner, CEN – Certified Emergency Nurse Renee Reisinger FNE-A - Forensic Nurse Examiner – Adult, OCN – Oncology Certified Nurse, CCRP Sharon Smith FNE-P, Forensic Nurse Examiner - Pediatric Olivia Lawrence Eileen Meier FNP-BC - Family Nurse Practitioner Patricia Heinrichs NEA-BC - Certified Nurse Executive-Advanced Kim Bushnell Kathy Mucci Laveda Roy NE-BC - Certified Nurse Executive Stacey Brull Susan Finlayson Elizabeth Riley Robyn Stemmer Patricia Tuck OCN - Oncology Certified Nurse Mary Allison Beckham Terri Buzby Karin Colquitt Katelyn Dougherty Janice Fisher Holly Jean Freeman Jack Gaspari Julia Irwin Donna Landers Roshelle Lemon-Howard Madeline Lowery Rachelle Ann Lucerna Linda Macken Pauline Marshall Jennifer Moss Susan Sanderson Gale Sherman Patricia Spielman Elaine Spry Joanne Vendetti Susan Wagner Allison Watkins OCN - Oncology Certified Nurse, NE-BC (Nurse Executive) Judy Seipp PCCN - Progressive Care Certified Nurse Laura Chowdhry Heidi Chroszielewski Tanja Gross Barbara Major Theresa Moroney Margaret Witman RAC-CT - Resident Assessment Coordinator Certified Michelle Chase

RN-BC Informatics Nurse Beth Kilmoyer RN-BC Maternal Newborn Nursing Jaime Alleman Kristen Chavis Amanda Elder Lauren Franc Erica James Linda Joly Leslie Kempler Narene Kong Mary Lund Brittany McCormick Tamika Missouri Shawnt’e Purnell Christine (Michele) Ray Kimberly Saboy April Snyder RN-BC MedicalSurgical Registered Nurse Maria Alvarez Gabriella Ayine Jennifer Goodwin Theresa Llanes RNC-NIC - Neonatal Intensive Care Nurse Kyle Cassell Margaret Chagnon Kimberly Fishpawhart Theresa Furst Holly Lerch Tamara Mayo Nancy McCready Marilyn Nicholson Julia Ruzin Elizabeth Webster Rachael Zepp RNC-OB – Inpatient Obstetric Nursing Miriam Becker Talia Brinkley Tenille Cox June Evans Elizabeth Johnson Deborah Johnson-Johns Stacey Keiper Kerri Kreisel Heather Mease Maria Michels Shannon Misiewicz Juthamars Thewsuvat Pamela Westbrook Sarah Yuhas SANE- A - Sexual Assault Nurse Examiner – Adult Debra Holbrook Erin Lamar Margaret Lynn Brenda Meyett Jeanmarie Ricks Daniel Sheridan Linda Faye Spruill Caroline Tufts SANE- A - Sexual Assault Nurse Examiner – Adult, ENPC, TNCC, SANE-P Hillary Becker SANE- A - Sexual Assault Nurse Examiner – Adult, FNE-A, FNP Beverly Bye Wound Care Certified Nurse Barbara Palm Ronke Sanni

SEVENTEEN

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Evidence Based Practice Research Innovations in Practice Presentations and Publications

In recognition of our BSN, Master’s and Doctoral Degrees Patient Care Services BSN Ackerman, Kelly Adamafio, Peggy Addis, Jennifer Albin, Amanda Alleman, Jaime K. Alston, Sharone Alston, Tyra M. Alton, Sharon Altshuler, Kimberly Alvarez, Maria Gisell Anders, Kimberly Anderson, Janelle Anderson, Monica Andino, Alexis Aydlett, Patricia D. Ayine, Gabriella Bagay, Amelita B. Ballance, Catherine Bandzwolek, Amanda Barnhart, Kimberly Baroya, Juanita Barr, Tracy E. Barry, Shannon Bartko, Katherine Bass, Abbie Batty-Swett, Paris Baux,Arthur Beaty, Jenifer Becker, Hillary Becker, Melanie Becker, Miriam Beckham, Mary Allison Beerhalter, Brian Benzaquen, Danae Bernheimer, Lisa Bochniak, Cynthia Bodani, Seth Bondura, Angela Borkan, Ariella Bowden, Shaneca Bowerman, Mercelita I. Bress, Theresa D. Brinkley, Talia Brookhart, Maria Broseghini, Railene Brown, Kayla Brown, Tiffany S. Brown, Tyra S. Bryant, Barbara J. Burdette, Katrina Burley, Samantha Burns, Julie Butler, Shirnique T. Buzby, Terri L. Carter, Blossom Cascone, Jeffrey R. Cassell, Kyle Cawley, Andrea Cazac, Aurica Chaney, Angela Choo-Orbetta, Hyuanjeong (Amy) Christofersen, Jennifer Chroszielewski, Heidi Chumo, Edna Ciofalo, Nicole Clayton, Carly M.

Cohen, Shelby Collins, Lauren Collins, Doreen Conn, Sharon M. Conroy, Juanita L. Corkran, Kathleen Corrigan, Jennifer Cox, Tiara Cummins, Jennifer L.M. Czajac, Sean Davis, Melange S. Davis, Tyisha E. Deck, Lyndsay Devore, Tracey Dicus, Deborah Dillon, Amy Ditanna, Lindsey Dorsey, Kimberly A. Dougherty, Terri A. Duvall, Rebecca M. Eberhard, Melissa Eder, Teresa Ann Ehirim, Caroline Elder, Amanda R. Epstein, Esther Evans, Tamitcha Ewald, Ashley Fannon, Melissa Fasulo, Nicole Feldman, Karen Feustle, Gina Patricia Fletcher, Tania Lynn Formby, Mary Foster, Tiara J. Franc, Lauren A. Francis, Cassondra E. Francis, Patrick A. Fraser, Amanda Freeman, Holly Jean French, Alisa Frick, Kristen Fritz, Donna Fronduti, Michelle Gajewski, Denise Galiza, Cristina Joy Garfield, Amy J. Garris, Tanya Cecelia Geh, Theodosia Gilmore, Michelle N. Gonzalez, Melanie Gonzalez, Michelle S. Goodwin, Jennifer A. Gordon, Sarah N. Greer, David Greifzu, Monica Greisman, Donna M Gross, Tanja Michele Hand, Erin Hansen, Donna Hare, Daniel Harryman, Grace Hartman, Christy Hayman, Holli Hazel, Lachele Hemphill, Kelly S. Herd, Hope A. Hernandez, Jun Paul M Hill, Erin Hiltz, Rennert Hockett, Deborah L. Hutton, Stacia

Hyman, Teneshia Ignacio, J. Jonathan Irwin, Julia L. Jamias, Shirley Janowitz, Nicole Jarrell, Gwynneth Jasion, Jennifer Jenkins, Doris Jennings, Avorine Jewer, Mandi R. Johnson, Kelly Johnson, Ann S Johnson, Elizabeth Johnson, Teresa M. Joly, Linda D. Jones, Jennifer L. Joseph, Rosilin Julian, Sara Kachura, Angela Kammer, Aileen Karloff, Courtney Keene, Kelly Kent, Nicole Kleinfelter, Rachel Knight, Toya Kohengadol, Shula Kon, Leslie Kong, Narene Konopacki, Mary S Kostelec, Teresa M. Kozak, Regina Mary Kraus, Kristin H Kreisel, Kerri E. Kumar, Nisha Labovitz, Benjamin Lake, Joan Marie Lamar, Erin Langenhoven, Anneke Lawrence, Olivia Lee, Diana Lee, Joyce Lei, Yu Lemig, Lisa A. LemonHoward, Roshelle Lenderking, Katherine Leslie, Rekeya M. Lewis, Amanda Lewis, Sherie T. Linantud, Jennie-Marie Llanes, Theresa L. Locke, Mary E. Lomax, Natasha M. Lucas, Cynthia I. Lucerna, Rachelle Ann Lurz, Joanna Lynch, David Mackowiak, Connie G. Mahaffey, Ryan Mahmoud, Tracy Maier, Kathleen O. Mansaray, Kadijatu Mapile, Lilibeth S. Maranto, Angela Marasa,Mary Marchi, Kaitlin Markwordt, Jenna Marzocchi, Anthony J. Mason, Christa Mayo, Jennifer Mayo, Tamara M. McCarthy, Virginia N.

McCormick, Brittany L McKenna, Megan McMurray, Julie K. Megino, Antonio Meier, Eileen Meyett, Brenda Miller, Christopher P. Miller, Laura Stern Miller, Morgan Misiewicz, Shannon Missouri, Tamika C. Moffatt, Brittany Morlock, Marshelle A. Moroney, Theresa J. Morris, Cynthia Moser, Tonianne Muller, Erika Murdock, Cheryl Mwangi, Zipporah M Naguit, Ma Cecelia Nene, Maria Nicholson, Marilyn Y. Nylander, Jartu Odolil, Suja O’Hara, Shana O’Neill, Kristine ONeill, Siobhan Onejeme, Gloria O’Quinn, Megan Owens, Lisa Pacaaanas, Rebecca Padula, Christine Paesch, Ashley Palm, Barbara H. Paquin, Donna Jean Park, Sun Young Patterson, Jessica D. Peerson, Sherry Peery, Lindsay Perrin, Kristine Perry, Michele Peters, Maureen Phillips, Beth Pickett, Sanay Pirog, Rebecca Pleiss, Ashley Polk, Tiffani T. Pompey, Sarah Poole, Rebecca Pugh, Torie Purnell, Shawnt’e Queen, Jane Rainaldi, Meredith Ranger, Emma Reichert, Dottie Renfrow, Jennifer L. Rhein, Melanie Hope RheubottomClay, Kelly Roberson, Jillian Robinson, Atiya A. Rozanski, Bernadette Rutledge, Emily Ruzin, Julia Dryden Sakyi, Corrine Sanni, Muibat (Ronke) Santiago, Servillano Schildbach, Caroline Schwarcz, Rivka Scott, LaShawn S. Seets, Ann Cousins Seipp, Judith Meninge

Sharma, Gita Sheckels, Amy Dean Sherman, Gale Shin, Pomi Skinner-Brook, Jackie Slaysman, Sarah A. Smith, Kimberly Sow, Fatimatu Spadaro, Kathleen Spell, Sherry D. Spielman, Patricia K. Spruill, Linda Faye Stacco, Carly Staiti, Andrea L. Stanhope, Candace Stewart, Minette Stiffle, Suzanne Lee Strande, Jessica L. Stratton, Cathleen S. Sturm, Michael R. Summers, Michelle R. Sunday, Jenna Swearengin, Leah Thibeault, Jessica M Thomas, Tamara Thompson, Dorothy B. Topping, Hillary Trigger, Ashlyn R. Triplett, Dana Trizna, Jessica Tuck, Tiandra Tuck, Patricia R. Ukaegbu, Agatha N. Ukwuoma, Alexandra Uqdah, Nikasha H. Valdez, Venus Vassallo-Baum, Carla Velasco, Juvel-Lou Veney, Monique Ventura, Mark Lester Vilches, April Villalobos, Wilson E. Voith, Cynthia C. Wadman, Donna Waggoner, Theresa Walker, Lawcedrea Warfield, Tonnie Warren, Monica Watkins, Allison T. Watkinds, Amanda Weatherbee, Henrietta Webb, Kim D. Wegrocki, Amanda B. Wenderoth, Phyllis Westbrook, Pamela L. Wheat, Bonnie Will, Sharon T. Wilson, Patricia E. Witter, Rachel Woke, Gina Yelle, Allene C. Yuhas, Sarah B. Zantopp, Ettienne Zepp, Rachael L. MA Riley, Betty MS Saathoff, April MBA Mucci, Kathy

MSN Altenburg,Todd Anton, Melissa A. Bolden, Shannon Bristol, Sarah Bruton, Liane E. Burrell, Amy Chase, Michele K. Chrest, Lori M. Cohen, Cynthia Collard, Marguerite Collins-Deportillo, Leza Cooley, Christine Cox, Tenille DiLegge, Alexis Dinglas, Nina Ricci L. Dipietro, Mary Ann Dodson, Chandra Dorsey, Robin V. Dougherty, Katelyn D’Silva, Glynis Dunlap, Eleanor Dunning, Benjamin Fleming, Robyn Furst, Theresa A. Gebrewold, Hana Getsin, Inna Goad, Kathy Grove, Sarah Hammond, Heather C. Heinrichs, Patricia A. Jacinto, Norman Jalloh, Isatu Jamaris Stauts, Catherine Jefferies, Jeannette Johnson, Holli Lecompte Hofmann, Tanya Licharowicz, Karen M. Lipscomb, Trisha Lutz, Vicki Mitchell, Nira Mobley, Shantelle P. Moore, Donna M. Nelson, Monica Palazzo, Terri Pasion, Marlene G. Pennington, Deborah A. Queen, Phyllis Reisinger, Renee L. Ricks, JeanMarie Roy, Laveda Smith, Sharon Stemmer, Robyn L. Stewart, Sharone Thewsuvat, Juthamars Trojillo, Dones Tufts, Caroline Webster, Elizabeth Wilson, Theresa Wohlfort, Bonnie L. Zoch, Janine DNP Brull, Sedalia (Stacey) Bushnell, Kim Finlayson, Susan Kilmoyer, Beth Wilson, Jan PhD Anderson, Jocelyn Appling, Sue Sheridan, Daniel