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conehealth.com Fall 2014 • Vol. 11 No. 3

T h e p u l s e o f n u r s i n g a T C o n e h e a l T heditors

3rd annual nursing research symposium Keynote address by Dr. Courtney lyder

page 3Nursing BeatMission sTaTeMenT

To communicate and celebrate

the dynamic power of

nursing innovations and

enduring values.

Lisa Boland, RN, MSN, NEA-BCManager, nursing outreach and retention,

setting the pace editor

Sarah Clark, RN, MSN, CCRNsimulation Coordinator

Jennifer L. Fencl, DNP, RN, CNS-BC, CNOR Clinical nurse specialist, operative services

Belinda Hammond, RN, MSN, CEN, CCRNClinical nurse educator, Critical Care

Thresa Haithcock Isley, DNP, RN, APRN-BCClinical nurse specialist

Nancy Summerell, RN, MSNClinical nurse educator, eD academy

Editor-in-ChiefSarah Lackey, RN, MSN, CCNSMagnet program Coordinator

nDnQi site Coordinatorrapid response Team, relief

marketiNg supportDeborah Humphrey, MA

Director of Communications

desigNerMary Jo Helms, CreativeMode

Theresa Brodrick, phD, rn, Cns, Cna executive Vice president & Chief nursing officer

anne Brown, rn, Msn, pCCn Director, nursing/patient servicesWesley long hospital

Dennis Campbell, rn, Ms, Bsn, nea-BC Vice president, nursing/patient servicesBehavioral Medicine services

laVern Delaney, rn, Msn, Mha/MBa Vp, nursing /patient servicesalamance regional Medical Center

Waqiah ellis, rn, Msn, ne-BCDirector, nursing/patient servicesMoses Cone hospital

Debbie grant, rn, Msn, Cenp Vp, nursing practice, education and Community outreach

Tracy Diffenderfer, rn, Bsn, Msn, Cnor executive Directoroperative services and anesthesia

Mona easter, rn, Bsn, MBa Vice president, nursing/patient servicesannie penn hospital

Karin henderson, rn, Msn, Cenp executive Directororganizational integration

Joan lopresti, rn, Ms, Bsn, nea-BC Director, nursing/patient services, Moses Cone hospital

annette osborne, rn, Msn Vp nursing/patient servicesMoses Cone hospital

sue pedaline, Dnp, rnC, Ms Vp nursing/patient services,Women’s hospital

Cheryl somers, rn, Msn, nea-BC executive Director, emergency services

Youland Williams, rn, Msn, nea-BC executive Director, nursingoncology services

Cone health nurse executives

1200 North Elm Street, Greensboro, NC 27401conehealth.com/nursing

Reinventing Care MAGNETTrANsforMATioNAl lEAdErship

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Happy New Year! What an incredible

year we had in 2014!

first, Cone health was re-

designated Magnet for the third

time as a health system. as you

all know, we were one of only

three health networks in north

Carolina to achieve this important

designation three times in a row. This is a true

testament to your excellence in nursing. Just a few months

after this honor, 26 of our nurses were named to the state’s

great 100, making Cone health the most recognized team in

north Carolina – for the fourth consecutive year!

These accomplishments truly reflect the outstanding

work you do every day for our patients and communities.

Congratulations on these well-deserved honors, and thank

you for your contributions!

as we move into 2015, i am energized by the fabulous

opportunity we have for another great year. Most

significantly, this includes our opportunity to make a

real difference for our patients as we work together in

reinventing Care across Cone health.

as nurses, each of you will be a driving force in redesigning

how and where we care for women, children, behavioral

health and surgical patients in greensboro. Working together

with physicians and patients, we will develop a new model to

provide the very best, high-quality and cost-effective health

care long into the future.

as you know, we estimate this $100 million project will

include:

• Moving Women’s Hospital to a separate and distinct area

on The Moses h. Cone Memorial hospital campus by early

2019.

• Redesigning behavioral health care to include: 1) opening a

new outpatient facility in 2016 and 2) replacing Cone

health Behavioral health hospital, likely by late 2019.

• Renovating and expanding surgical areas at Wesley Long

hospital, as one part of our continuing planning process

related to operative services.

as nurses and key care providers, you will be invited to

participate in everything from planning the care design and

the flow of the new facilities to sharing your specific ideas

about what will go where in our patient rooms and operating

suites. Your input is critical to this process.

These are very exciting times for all of us as Cone health

caregivers. i look forward to learning more from you as we

work together to provide the most exceptional care possible

for our patients and our communities. as always, thank you

for all you do every day!

respectfully,

Theresa Brodrick, phD, rn, Cns, Cna

i recently heard a story – a written essay read aloud – on national

public radio. The essayist had heard one side of a phone

conversation while she rode home on a commuter train at

the end of the day. she described her impressions of the

speaker, the conversation, and the way the information was

delivered. The phrases sounded scripted, practiced and stale.

she wondered about the person on the other end of the

conversation, and how the call was being received.

i was heartened to hear that at the end of the essay, the author took

another perspective – that of the caller. she asked herself questions about the possible

situation, what mental state the caller was in, what the relationship between the two might

be, and what circumstances led up to the conversation. she asked some key questions that

would lead to more understanding of the overall situation, not just what she was directly

observing.

This issue of Nursing Beat is devoted to nursing research. any kind of research activity is

searching for answers. The search for what is really true is complex. We have to open our

minds and consider all sides of an issue. When we start down that road – the one where we

genuinely ask questions – we have to be ready to let go of cherished ideas in favor of proof,

and beyond that, change our practice accordingly to benefit the people we serve. it is an

exciting path to take, and we must have the courage to be open to what we find.

Cone health has some very fine structures in place to assist anyone in quality improvement,

evidence based practice, and nursing research projects. opportunities to stretch our

thinking with nationally known speakers occur yearly at the annual research symposium. The

work of Cone health’s nursing research Council to provide tools, mentoring and guidance

has helped nurses produce locally, regionally, nationally and internationally acclaimed

nursing science. Cone health nurses contributed 26 articles to nursing journals in 2014.

like the person listening in on the commuter phone call, we have to broaden our vision and

consider what might be happening outside the obvious. What does the other side of that

situation look like? Can we put ourselves in different shoes? Can we consider the possibilities

outside the flow of our daily routine? The gateway to innovation in our practice and in our

work environment resides in us. read, think and research! v

sarah lackey, rn, Msn, CCns, editor-in-Chief

Magnet program Coordinator, nDnQi site Coordinator

rapid response Team, relief

[email protected]

Cone healTh Cone healTh

We serve our communities by preventing illness, restoring health and providing comfort, through exceptional people delivering exceptional care.

from the Editor

send your presentations, promotions, graduations, accolades and honors to lisa Boland at [email protected]

Check the nursing website at Cone Connects>Departments and Teams>nursing>Celebrations or

https://sharepoint.conehealth.com/nursing/celebrations.aspx. v

When we start down that road – the one where we genuinely ask questions – we have to be ready to let go of cherished ideas in favor of proof, and beyond that, change our practice accordingly to benefit the people we serve.

INSIDE THIS ISSUEMessage from the Cnonurses need More swaggerBedside nurses and nursing researchinnovation spotlight graduationsone size fits allsymposium Winners CircleQuality improvement evidence-Based practiceevidence-Based and research poster awards

Thriving with interdisciplinary partnershipsCertificationsContributing to nursingThe outcomes of Magnet re-Designationfrom the editor

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Cone Health was granted its 3rd magnet designation as a health care system in august 2014.

in her announcement call, Deb Zimmerman, chair of the

Commission on Magnet, shared the six exemplars from

Cone health that will be included in the Magnet learning

Community. This repository for information and innovation

is maintained by the american nurses’ Credentialing Center

(ANCC) to make available to other Magnet facilities and

participants the activities and outcomes that are driving

nursing forward.

The exemplars were:

1. Cone health is a world-class organization in ensuring open

communications, particularly in the manner in which leaders

guide transitions during periods of planned and unplanned

change. Zimmerman specifically cited the listening and

learning opportunities that give rise to dialogue between

those leading the organization and those providing patient

care.

2. Cone health’s educational programs for nurses are

exceptional. The new graduate nurse academy has played

a significant role in Cone health achieving a retention rate

of 92 percent for new nurses, a far greater rate than the

national average.

3. Cone health is a role model for establishing partnerships,

such as the Congregational nurse program, to address

health care needs in the community.

4. Cone health is exceptional in the way that nurses assume

leadership roles in interdisciplinary collaborations such as

the manner in which sickle cell patients and those newly

diagnosed with diabetes receive multidisciplinary care, and

falls prevention efforts.

5. Cone health has expertise in providing interdisciplinary

collaboration across multiple settings in the continuum

of care. for example, the care that is provided to stroke

patients across three emergency Departments helped Cone

health outperform national stroke association targets.

6. in so many areas, innovation is vibrant at Cone health.

Zimmerman specifically cited the Mother-Baby unit for

innovatively helping new moms allay their fears about their

ability to breastfeed.

another Magnet

accomplishment—Theresa Brodrick, CNo for Cone

health, and Marjorie Jenkins, Director of nursing

research, were selected

to deliver a podium

presentation at the national

Magnet Conference in

Dallas in october 2014.

Their topic was: “goodbye

Manual Tracking: adapt

Your existing system to

support Data Collection

and patient Care.” v

The outcomes of Magnet Redesignation

Dr. Jenkins and Dr. Brodrick presenting at the national

Magnet Conference

326

it was difficult to get a good photo of Dr. Courtney lyder,

the keynote speaker at the Cone health 3rd annual

nursing research symposium. he just would not stay in

one place. “nurses need more swagger,” he admonished

his audience, as he demonstrated just what he was talking

about, sashaying from one side of the room to the other,

addressing every segment of the audience with, indeed, a

swagger in his gait.

his point? While nurses are assuming greater responsibility

and being held more accountable in health care today,

the public’s understanding of nursing has continued to

be limited in scope. Depiction of nurses in the media is

often inaccurate, and, quite frankly, out-of-date. as we

face the turbulent times of health care reform, nurses are

more than ever in a position to improve patient quality and

safety. nurses need more swagger – we need to broadcast

our role and value inside and outside the health care arena.

patient protectionDr. lyder started the audience thinking of our nursing

role in the current climate of health care by pointing out

a much forgotten phrase in the signature health care

legislation we are now in the midst of enacting: “The

Patient Protection and Affordable Care Act. “

from the first day of nursing school we learn that the

most important duty of the nurse is to protect the patient.

safety for the patient is linked to Quality. our strategy

must always include thinking outside the box because

we don’t always have the answers. We have to ask the

questions, and we need data from research to lead change.

Dr. lyder emphasized that no one knows exactly what

will happen in the future; we do know that if we work

collectively and come prepared with data, we will advance

health. That is, if we can increase our swagger.

Continued on page 4

On the cover: Dr. Courtney Lyder, ND, ScD(Hon), FAAN was the keynote speaker for the 3rd Annual nursing research symposium.

above: Dr. lyder inspired, educated, and amused the participants of the 3rd annual nursing research symposium.


By Nancy Summerell, RN, MSN, CEN and Sarah Lackey, RN, MSN, CCNS

MAGNETTrANsforMATioNAl lEAdErship

Nurses Need More Swagger: Keynote address by Dr. Courtney lyder

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Nurses Need More Swagger, Continued


“Don’t work hard, just do your job.”

– Dr. Courtney lyder

Janice Smith, RN, BSNAnnie Penn Hospital – Cone Health Most patients who are admitted to intensive care units

(ICU) are later transferred to general hospital units prior

to being discharged home. iCu nurses suspected that the

evaluation of their care was being aggregated with the

evaluation of the medical-surgical unit in after-discharge

patient satisfaction surveys. This combination makes it

difficult for the iCu nurses to determine what they need to

address from the patient perspective.

The purpose of this study was to determine if a visit

from an iCu nurse to patients who had been transferred

from the iCu will increase patient and nurse employee

satisfaction.

prior to project initiation, anonymous staff surveys were

conducted related to staff perception of satisfaction with

follow-up after patient discharge. The survey consisted

of five questions that were developed by the iCu shared

governance members. a link to the survey was emailed

to staff through the hospital’s intranet and was repeated

at the end of the project. Then education related to the

purpose and the process of the study was conducted for

all iCu staff during shift huddles.

The criteria for patients to be visited included those who

were admitted into the iCu for longer than 24 hours and

then discharged to the medical unit for longer than 12

hours. at the time of transfer, a survey with the patient’s

name, new room number and time of transfer was placed

near the nursing shift assignment log. The iCu nurses

utilized the “Critical Care family satisfaction survey”

to follow up with the patients. The visiting nurse would

review the survey with the patient and/or family members.

This method provided immediate feedback that could be

shared with the staff on any improvements that could be

made for future patients. This also provided an opportunity

to answer any questions about the care the patient

had received while in the iCu. When the patient was

discharged, the discharging nurse left a survey with the

patient’s name, room number and discharge time near the

nursing shift assignment log. of the 81 patients who met

the study criteria, 31 were seen (38 percent)

a comparison of the press ganey scores from the previous

three quarters demonstrated an improvement in the mean

patient satisfaction scores. The employee surveys revealed

an increased positive attitude toward the patient visits and

increased job satisfaction. v

Increasing ICU Patient and Nurse Satisfaction Through follow-up Visits

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Courtney Lyder’s tips to think about:• Pack and carry your own baggage. As nurses, we

love to take what others want us to take. We need

to learn to pack our bags, take what is ours and

leave others to carry their own bags.

• Put your oxygen on first.

• If we do not work together, we will go nowhere fast.

• There are no mistakes in life, only opportunities to

grow and learn.

• The only limits on your life are those you set for

yourself.

• Time is your most precious commodity and it

cannot be placed on layaway – live a life of purpose.

• Don’t go where you wish not to go.

• The quality of your life is the quality of your

contributions.

• Avoid people who pluck and blow.

Dr. Courtney H. Lyder is Dean of the uCla

school of nursing, professor of nursing, Medicine

and public health; executive Director, uCla patient

safety institute and assistant Director of the uCla

health system.

a fellow of the american academy of nursing and

the new York academy of Medicine, Dr. lyder has

written more than 200 journal articles and book

chapters. During his academic nursing career, he

has received more than $22 million in research

and training grants. he is an expert in gerontology

concentrating his clinical research on chronic care

issues of older adults. he has focused research

on identifying erythema in darkly pigmented skin,

pressure ulcer prevention, wound healing, and

quality and patient safety issues.

professional story, professional successparticipants at the symposium got to know Dr lyder

as he told his professional story. his introduction to

nursing research started when a professor inspired him

to work as a research assistant. The landmark studies he

participated in led to the development of the Braden scale

for assessing pressure sore risk-something we all use

every day. his most recent work? he served as the lead

investigator for pressure ulcer incidence and prevalence

in u.s. hospitals, work that assisted the u.s. government’s

decision to stop paying for hospital-acquired pressure

ulcers.

Courtney lyder is inspired, inspiring and challenges us

to be so too. as a national health care leader and noted

researcher in patient safety, wound care and geriatric

nursing, his message to us is timely, relevant, and

demonstrated by his work and his presentation. v

TThe infrastructure set up by the nursing research Council

makes participating in quality improvement projects,

evidence-based practice projects and nursing research easy.

Many bedside clinical nurses have been involved in nursing

research in the Cone health network. We interviewed some of

them to share their perspectives.

Nancy Caddy, rN3-BC, BsNpediatrics, the moses H. Cone memorial Hospital

nancy Caddy has been a nurse in the pediatrics department

since 1985 and began working with quality initiatives early in

her career. This led her to become a member of the nursing

research Committee, and later the nursing research Council.

nancy values nursing research, stating, “in order to be an

advocate for your patient, you need to look at the data.”

nancy is intrigued to see where nursing research will take

her practice next. she incorporates research into her practice

daily. nursing research drives how neonatal sepsis is identified

and treated, how asthma is managed acutely, and how

bronchiolitis protocols have decreased patients’ length of stay.

she says, “There is always new information, better ways of

doing things. nurses need to stay up to date because things

are always changing.” nancy credits the pediatric Clinical

nurse specialist, Candace matthews, rN, aprN, CNs, and the

pediatric physician teaching service for helping to maintain

up-to-date patient care in the pediatric areas.

nancy attended the 3rd annual Cone health nursing research

and evidence-Based practice symposium in october of this

year. she was excited to see what other hospitals are doing.

she spends time reading the posters of different research and

quality initiative projects that are happening across the state.

nancy states, “nurses should be involved in research. it’s the

right thing to do for our patients and our profession.”

Continued on page 6

By Sarah Clark, RN, MSN, CCRN

Bedside Nurses and Nursing Research: the lifeline to patient Care

above: new graduate academy participants await their presentation to the nursing research Council. Their burning question: “What are the preceptors’ and academy nurses’ perceptions of the emergency Department academy?”

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Endoscopy, Annie Penn HospitalNicole Small, RN, BSN, CNOR, RNFA flexible endoscopes must undergo a specific process between patients, including manual pre-cleaning, leak testing and an automated high-level disinfecting washer cycle. The society for gastroenterology nurses and associates, the association for the advancement of Medical instrumentation , the association of perioperative registered nurses and the Centers for Disease Control and prevention all have evidence-based guidelines for flexible endoscope reprocessing. flexible endoscopes were also listed as one of the Top Ten health Technology hazards by eCri institute. literature highlights the difficulty in properly cleaning flexible endoscopes and the need to ensure this multistep procedure is performed properly. in looking at our process, staff decided that our method of tracking flexible endoscope reprocessing could be improved.

our former process included placing the automated endoscope reprocessor print out strips on each daily schedule. our new process is to have two staff verify that the disinfection process is completed successfully and to compare the print out data with scope number to ensure they match. The data strip is then attached to the scope and verified again prior to using the scope on a patient. once verified, the strip is removed from the scope and placed on the daily schedule along with the patient’s label.

This new process has been shared with other endoscopy departments within the health network. v

Got Dirty Scopes? an evidence-Based practice project

Crissy Dodson, PhD, RN, BC-ADM and Jenny Simpson, RN, MSN, BC-ADM

The use of insulin pens for inpatient management of hyperglycemia was implemented throughout a multi-hospital system requiring nurses be educated on insulin pen utilization. a literature review revealed only one study in which nursing perceptions of the use of insulin pens in the hospital were assessed post-implementation. a quasi-experimental, pretest-posttest study was conducted to explore nurses’ perception of the use of insulin pens in the hospital. The study consisted of a pretest that was sent out two months prior to insulin pen training and a posttest sent out six months after insulin pen implementation.

Data analysis included descriptive statistics and paired t-Tests that were conducted with 91 matched surveys completed by inpatient nurses. all responses related to

insulin pen utilization had a significant positive change (p<0.0001). The least positive change was the nursing comfort level with an insulin pen versus a vial/syringe, and confidence that the patient received the correct dose. When educating patients, the nurses felt insulin pens took less time than the traditional vial and syringe approach. This study revealed that inpatient nurses perceived insulin pen as a better alternative than vial/syringe overall.

Despite the positive attitude toward insulin pen utilization, this multi-hospital system converted back to vial/syringe due to cost and safety issues. although insulin pen use was suspended, this method of insulin delivery is often preferred by patients being discharged home. nurses’ perceptions regarding teaching insulin administration to patients could influence patient compliance at home. further research regarding improving transition of care between the hospital and home for patients is warranted. v

Perception of Insulin Pen Utilization in the hospital setting among nursing

nursing research Council members discuss research proposals at their monthly meeting.

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Surgical site infections (SSI) are the most common type of hospital acquired infection for the surgical population. ssis significantly impact morbidity and mortality rates. While the literature reflects risk factors for ssi, the literature does not demonstrate complete agreement regarding risk factors specifically focused on patients undergoing spinal surgery. The purpose of this project was twofold:

1. To complete a quality improvement project to focus on identifying the specific ssi risk factors for the patient population who underwent spinal surgery.

2. To identify if an evidence-based practice ssi risk assessment tool that could be implemented pre- and intraoperatively to identify patients undergoing spinal procedures at highest risk for developing a ssi would be beneficial.

using similar methodology discussed in previous studies focusing on neurosurgery, an audit tool was completed for every patient identified as developing an ssi following neurosurgery (case patient) occurring in a one-year timeframe. for each case patient, the tool was also completed for three non-infected patients (match control) that were randomly selected from patients who underwent neurosurgery during the same timeframe.

in this patient sample, the strongest predictors of ssi were the type of intraoperative prepping solution utilized (p= .009) and how skin closure occurred (p= .006). In addition, the placement of drains (p= .001), glue utilized to repair dural tears (p = .041), and misappropriate antibiotic administration (p=.026), also demonstrated an increased risk of developing an ssi.

Being able to proactively identify patients at highest risk for a neurosurgical (or any) surgical site infection is powerful information for an organization to help drive quality and safe patient care. This information will be used to develop a pre- and intraoperatively risk assessment tool to identify patients undergoing spinal procedures at highest risk for developing an ssi. v

Examining neurosurgical surgical site Infections

Jennifer L. Fencl, DNP, RN, CNS-BC, CNORFelecia G. Wood, PhD, RN, CNL, Faculty AdvisorDebbie Green, DNP, RN, CENP, Clinical AdvisorSat Gupta, Ph.D; Vangela Swofford, RN, BSN, ASQ-CSSBBMelissa Morgan, RN, BSN, CIC

Marlienne Goldin, RN, BSN, MPA

essay published in the international Journal for Human Caring, 2014, 18 (3), 65.

Caritas nurses practice caring science theory using core concepts of Jean Watson’s Theory of human Caring. Caritas nurses cultivate the soul and spirit of their patients as well as attend to their emotional and physical needs. They know that caring encompasses more than treating the disease process. This article describes an example of caritas nursing in action.

During a woman’s third trimester of her first pregnancy, she developed hypertension and labor was induced at 38 weeks. The mother began having grand mal seizures during the vaginal delivery, and post-delivery experienced two more seizures. The newborn was healthy and stable but the mother was transferred from the Women’s hospital to the neuro-

surgical intensive care unit in another hospital across town. The patient did not experience further seizure activity after admission to the iCu.

The iCu nurses were aware that this new mother had not been able to see her baby, and they knew how important this was. The iCu charge nurse contacted the newborn nursery staff at the Women’s hospital, and by using iphones and face Time, the mother was able to see her baby boy in real time! The newborn nursery nurses turned him so he could be viewed from all angles. They unwrapped him to show the mother his 10 perfect fingers and toes.

Celebrating a new life in a neuro-surgical iCu is not a common occurrence. Through cellular phone technology, nurses were able to share in a birth and make an impact on a new family’s life event. This is an illustration of caritas nurses taking time out of their task-filled days to touch a life. v

Celebrating New Life in a Neuro-Surgical ICU: exemplar of Caritas nursing

diane Celano, rN-BC, BsNDepartment 5W, The Moses H. Cone Memorial Hospital:

Diane says, “nurses are

the front line. We see how

things can be improved.

We should always be

searching for new,

innovative ways to take

care of our patients.” Diane

put these words into action

when she joined the nursing research Council two years ago.

When she first became a registered nurse, Diane attended a

dinner hosted by the nursing research Committee that paired

nurses with partners in academia to discuss common areas of

interest in research. Diane was energized and inspired to lead a

project in her department.

Diane was caring for a patient with cellulitis and applied

lavender compresses as ordered. The wounds healed so quickly,

she became excited about the patient outcome in response to

this innovative treatment. Wondering about the use of lavender

as a healing agent and a nursing intervention, she completed

the literature review as the first step in developing and

performing a research study about aromatherapy and wound

healing. This study was used in writing the Magnet document

(2013) to demonstrate clinical nurse involvement in innovative

therapies and techniques.

Diane sees the benefits of doing nursing research and is also

realistic about the challenges. she says time to commit to

research is her biggest barrier. one of the biggest supports for

Diane is her relationship with the Clinical Nurse Specialist (CNS)

Brenda murphy, rN, msN, gNp-BC, for her area. “if you are

really interested in research, get to know your Cns.”

Diane has been a nurse for about four years and is passionate

about education. after earning her associate Degree in nursing,

Diane earned her Bachelor of science in nursing. she is

certified in gerontology and participates in other network-wide

committees, including “nurses improving Care for healthsystem

Elders” (NICHE), Shared Governance, and Pulmonary

Continuous process improvement. Diane says, “i hate to see

people limit themselves. it’s good to stir things up a little.”

Continued on page 7

Bedside Nurses and Nursing research, Continued

Diane Celano, 5W, Moses Cone hospital

donna Heslep, rN, msN, oCN1C, alamance regional medical Center

Donna has been with alamance regional Medical Center for

11 years, working on unit 1C, the oncology unit. as chair of the

policy and procedure Council, she is quite familiar with using

research to identify best practices. Donna’s interest in nursing

research increased when she earned her Masters of science

degree in nursing and when she began working on her

project to become an rn4 through the professional nurse

Advancement Program (PNAP).

Donna’s pnap project examined the timing and frequency of

patient falls. Donna states, “as i looked at this project, there

were so many factors to be examined. i began to identify so

many quality initiatives and research projects that could be

done around falls prevention.” Donna is very passionate as

she discusses the possibilities of improving patient outcomes

through research.

as chair of the policy and procedure Committee, Donna was

very involved in the policy integration project that merged

the alamance regional policies with Cone health. she says

this was a daunting task, but was also very affirming for her.

since all of the policies were founded in evidence-based

practice, the policies were not very different and were easy

to reconcile.

Donna says, “it’s all about changing. if nurses question if we

should be doing a certain procedure or practice, then maybe

we should do a study. research is just asking a question.”

kalah mueller, BsN, rN, mpa, emergency departmentThe Moses H. Cone Memorial Hospital

Kalah Mueller has been a registered nurse for almost two

years. she joined the nursing research Council within three

months of being hired into the emergency Department

at The Moses h. Cone Memorial hospital. Kalah says, “i’ve

always been the person who wants to figure out how things

work and why things are how they are.” nursing research

helps satisfy this need for Kalah.

Kalah enjoyed attending the 3rd annual Cone health nursing

research and evidence-Based practice symposium in

october of this year. The closing speaker, patricia Quigley,

phD, Mph, arnp, CCrn, was very engaging and motivating.

Kalah stated, “she made me look at how we do things on my

job. i have changed how i think about what we do and why.

research can be a scary process, but in the end you’re going

to benefit your coworkers, yourself or the patient directly.”

Kalah encourages nurses to be involved in research. she

offers advice to nurses who are reading research. “The

process is sometimes very long. Don’t get caught up in the

methodology if it intimidates you. read the results and

discussion first. Then you can go back and see how the

literature review guided the research to its outcome. focus

on the results, instead of the process. That is what counts for

our patients.”

Continued on page 8

“it’s all about changing. if nurses question if we should be doing a

certain procedure or practice, then maybe we should do a study. research

is just asking a question.” -Donna heslep, 1C, alamance regional Medical Center

Cone healTh

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Kelly Southard, RN, BSN, MBAPatricia Duke, RN-BCChris Judge, RN-BC, BSN

enclosed nursing stations on inpatient psychiatric units may subtly influence patients’

feelings of imprisonment and lack of control. The purpose of this study was to explore

the experiences of an open nurses’ station from both patients’ and nurses’ perspectives.

This qualitative descriptive study explored the experiences of 29 patients and nurses

who witnessed the transition between an enclosed nursing station to an open nursing

station on one inpatient psychiatric unit. open-ended interviews with nurses and

patients were conducted in which participants were asked, “Tell me about a time when

you were aware of the open nursing station or the enclosed nursing station.” each

patient and nurse was interviewed once in a private setting for approximately one

hour. The interviews were recorded and analyzed for common themes.

The open nursing station resulted in patients’ experiencing an increased access

to nurses. The unit became a comforting environment in contrast to the enclosed

station where feelings of imprisonment and powerlessness were common. nurses

acknowledged increased awareness of patients’ presence on the unit, communicated

in a more personal fashion and met patients’ needs more efficiently. however, nurses

identified concerns about patient confidentiality and frequent patient interruptions.

removing physical barriers from nursing stations has a positive impact on the

nurse-patient relationship and improves patient perceptions of feeling cared for and

respected. an open nursing station gives patients easy access to their nurse and allows

nurses to meet patient needs more quickly. attention should be paid to creating a

workspace that protects patient confidentiality and decreases nurse interruptions

when performing activities such as charting. v

nurses’ and patients’ experiences of an open vs. enclosed Nursing station in an acute Care psychiatric setting: Are Structural Changes Important?

The open nursing

station resulted in

patients experiencing

an increased access

to nurses. The unit

became a comforting

environment in

contrast to the

enclosed station

where feelings of

imprisonment and

powerlessness were

common.

“nurses are the front line. We can see how things can be improved. We should always be searching for new, innovative ways to take care of our

patients.” - Diane Celano, 5W, Moses Cone hospital

8


21

Bedside Nurses and Nursing research, Continued

“research can be a scary process, but in the end you’re going to benefit your coworkers, yourself or the patient directly.” - Kalah MuellereD, Moses Cone hospital

angela thomas, rN, msN-L, CCm

angela thomas, rN, msN-L, CCm, became a Care Management

Coordinator for the Triad healthcare network in 2012. as part of her work

for her master’s degree, angela was required to review many research

articles. angela says she was amazed to see how much information was

available and immediately saw the advantages of using research findings

in her role as a nurse. angela states, “i did not realize i would enjoy

research as much as i do and all of the advantages of using the data.”

angela’s interest in research driving patient outcomes prompted her to

join the nursing research Council in January, 2014.

as a case manager, angela works with individuals in the community,

teaching them to manage their diseases effectively at home. she says

she “meets the patient where they are” and uses best practices from

research to decrease hospital admissions and readmissions. Triad

healthcare network uses evidence – based practices in every aspect

of the program. angela states, “The tools we use are evidence based.

They are studied to ensure we will gain good patient outcomes.” angela

gains immediate satisfaction when she provides education and she sees

patients light up and say “i understand now!” The follow up with these

patients allows her to see how the patients have progressed. angela says,

“They are so excited that they feel so much better.”

angela is a strong advocate for using research to guide patient care.

she stresses, “We are not reinventing the wheel continually. We use

information others have already contributed to the body of knowledge.

i use research to better serve our patient population.” angela has seen

how research is “able to affect the outcome of a patient’s life.”

These are just a few of the nurses who have successfully made nursing

research part of their nursing practice. While their experienced and

activities may vary, there is one message that is the same: nursing

research, whether doing it or using it, is the best thing for our patients. v

MAGNETNEw kNowlEdGE, iNNovATioNs

ANd iMprovEMENTs

CoNtriButiNg to

NursiNg sCieNCe

Cassandra S. Galloway, RN, MBA/MHA

health care reform has triggered new models of care delivery

across the nation. in our health network, unlicensed assistive

personnel (UAP) roles were combined to impact health

care costs as well as delivery of care. This change left uap

employees feeling devalued. The need to reassure these

important members of the direct care environment was

identified. in order to sustain quality patient care, measures

were taken to develop activities to reach out to these

employees and re-engage them in the health care team.

initially, roundtable discussions were held that focused on

supportive dialogue in an effort to revitalize the groups’

perspectives and to offer support for role challenges.

additionally, the sessions were used to gather input for staff

development needs that would sustain the work engagement of

the uap.

professional development offerings in the form of grand

rounds were developed and presented on a rotating schedule.

These included all six campuses with varying time offerings.

Nurse Technicians (NT) and Nurse Secretaries (NS) were the

initial target audiences for these grand rounds; the audience

grew to include Emergency Medical Technicians (EMTs),

Certified Medical Assistants (CMAs), and Monitor Technicians

(MTs).

The duration of the grand rounds sessions was 1.5 hours. guest

speakers represented areas such as human resources, pharmacy

and executive offices. Topics covered a wide range of interests,

including but not limited to precepting peers, learning styles,

geriatrics, and roundtables with executive leadership.

since its inception in 2010, the program has grown to a

consistent class attendance of 10 to 20 participants in each

of the sessions. The evaluations have been positive, and the

participants continue to request professional development and

education related to their work environment.

unlicensed personnel are valuable contributors to the health

care team. Their roles directly impact patient care and

outcomes. Creative staff development activities and educational

programs are key components to help uap continue their role

in providing quality patient care. education also keeps them

engaged and feeling valued as an important member of the

health care team. v

Making the Connection: Discovering the Benefits of professional Development for unlicensed assistive personnel.

Clarification

The following clarification is offered for the article “advancing in education: how to Choose,” in Volume 11, no. 2, summer

2014 of Nursing Beat:

page 8, in the bullet list aprn category, Clinical nurse specialists were to be included as an advanced practice nurses

along with the nurse practitioner, Certified nurse Midwife, and Certified registered nurse anesthetist. By providing

more detail about the Cns role, it was inadvertently left off the list.

Taryn Hutton, RN, BSN, SCRN stroke Certified registered nurse MCh - 4 north neuroscienceDelcine Johnson, RN, CMSRN Certified Medical-surgical registered nurseMCh – 5 West Med/surg TelemetryKristi Johnson, RN, BSN, CEN Certified emergency nurse MCh – peds eDAuriel Jones, RN, BSN, WCC Wound Care Certified Wh – Birthing suitesKristin Jones, RN, BSN, CMSRN Certified Medical-surgical registered nurseWh - Med/surg iCu unitRachel Keslar, RN, BSN, CEN Certified emergency nurse Wlh - emergency roomKukku Kolangayil James, RN, BSN, SCRNstroke Certified registered nurse MCh - 4 north neuroscienceAmy Loflin, RN, BSN, CEN Certified emergency nurse MCh – 2 south surgical iCuDeborah Malick, RN, BSN, MBA, CNML Certified nurse Manager & leader MCh – 3 south intermediate CareAlemu Mengistu, RN, MSN, NP-C family nurse practitioner MCh - Div 2000 - Cardiac DeptMegan Millikan, RN, BSN, CBIS Certified Brain injury specialist MCh – 3 Midwest neuro-surgical iCuAshley Misenheimer, RN, BSN, RCISregistered Cardio invasive specialist MCh - Cath labSamantha Murrill, RN, MSN, NP-C family nurse practitioner MCh - emergency DepartmentCarol Myers, RN, CMSRN Certified Medical-surgical registered nurseWlh - intermediate Care/urologyBrenda Norman, RN, CEN Certified emergency nurse aph - emergency roomNancy Oakley, RN, CEN Certified emergency nurse MCh - CarelinkPhilomena Obasogie-Asidi, RN, SCRN stroke Certified registered nurse MCh - 4 n neuroscience

Joy Olczak, RN, BSN, CCRN Critical Care nursing - adult MCh – 2 heart Coronary intensive Care/stepdownMarsena Pardee, RN, MSN, CMSRN Certified Medical-surgical registered nursesW – Clinical nursing supportCorey Paris, RN, CCRN Critical Care nursing - adult aph - flexible resourcesJessica Pennell RN, BSN, SCRN stroke Certified registered nurse MCh - 4 north neuroscienceNikki Potter, RN, BSN, SCRN stroke Certified registered nurse MCh – 3 Midwest neuro-surgical iCuStefani Previtte RN, BSN, CCRN Critical Care nursing - adult, MCh – 2 heart Coronary intensive CareJennifer Rasch, RN, MSN, NP-C family nurse practitioner Wh - oB/gYn MedicineMisty Rich, RN, BSN, RNC-LRN low risk neonatal nursing Wh – Mother/BabyJoyce Robarge RN, MSN, CPNP-PC primary Care Cert peds np hsD - Dev & psych CenterBettie Rutherford, RN, RNC-MNN Maternal newborn nursing Wh - Mother/BabyHeather Satterfield, RN, BSN, SCRN stroke Certified registered nurse MCh – 3 Midwest neuro-surgical iCuHeather Satterfield, RN, BSN, CBIS Certified Brain injury specialist MCh – 3 Midwest neuro-surgical iCuTerri Setzer, RN, MSN, NP-C family nurse practitioner reh - Dr najeeb rehman practiceShae Lee Shaffer, RN, BSN, CCRN Critical Care nursing - adult, Wlh - iCu/stepdownBrooke Shaw, RN, BSN, CMSRN Certified Medical-surgical registered nurseWlh - intermediate Care/urologyMark Sibenge, RN, BSN, CMC, CCRNCMC/Cardiac Med subspecialty MCh – 3 Midwest neuro-surgical iCuWesley Smith, RN, CEN Certified emergency nurse MCh - Carelink

Anna Smythe, RN, BSN, SCRN stroke Certified registered nurse MCh -4 n neuroscienceTina Stevens, RN, CNOR Certified nurse operating room MCh - operating roomDebbie Stowe, RN, BSN, SCRN stroke Certified registered nurse MCh - The stroke CenterMary Tice, RN, BSN, CNOR Certified nurse operating room MCh - operating roomTammy Todd, RN, CMSRN Certified Medical-surgical registered nurse arMC – Telemetry 2nd levelMarcel Turner, RN, BSN, CMSRN Certified Medical-surgical registered nurse, arMC - gen surgery 2nd levelDebra VanVooren, RN, BSN, RNC-NIC neonatal intensive Care nursing Wh - neonatal iCuCarey Warner, RN, BSN, CCRN, CMC CMC/Cardiac Med subspecialty MCh – 2 south surgical iCuJennifer Watkins, RN, BSN, CNML Certified nurse Manager leader MCh - 6 east Med/renalMary Welch, RN, MSN, PCCN progressive Care Cert nurse sW - Clinical nursing supportJohn Wilson, RN, BSN, RCIS registered Cardio invasive specialist’ MCh - Cath labDenise Wolfe, RN, CCRN Critical Care nursing - adult, MCh - rapid response Team

settiNg tHe

paCe


20 9

Cindy Beverly, rN, a nurse on

5n orthopedics at the Moses

h. Cone Memorial hospital

is a walking example of

nursing innovation. Cindy was

concerned about the safety

issues associated with patients

not being able to find their

call bells, and with all the tangling and disarray that can

occur with the many wires, tubings and cords that come

into a patient bed.

During a routine shopping trip, she saw a laundry clip

and had an idea for a type of safety clip that would hold

the patient call bell. after working with a designer and a

manufacturer, and persevering through months of details,

expense and setbacks, she piloted her Bee safe Clip on

Department 3 Midwest neuro/Trauma iCu. The nurses

loved it.

in october, Cindy presented her clip to the nursing

leadership Council, along with ordering information.

Cindy’s work is an inspiring example of what happens

when we ask the question “What if?” and persevere until

we have the answer in our hands, and in our practice. v

Innovation spotlight

Before the Bee safe Clip

after the Bee safe Clip

Lawson Order Number(Per Department Directors only)

Minimum Order: 1 Box = 25 Clips Yellow or red

red Clip - #109445Yellow Clip - #109444

Questions?Product Info:

Cindy Beverly at (336) 420-7125

Ordering Info: Nicole Baltazar Holbert at (336) 832-5680

Certifications

settiNg tHe

paCe

send graduations and certifications to [email protected] in order to be recognized.

Lorraine Ajel, RN, BSN, CMSRN Certified Medical-surgical registered nurseWlh - general surgeryShane Anderson, RN, BSN, CEN Certified emergency nurse sW - flexible resourcesWillie Baker, RN, CRRN Certified rehabilitation registered nurseMCh – 4 West inpatient rehabSarah Bower, RN, CEN Certified emergency nurse MCh - CarelinkKennitrish Bracey, RN, BSN, CMSRN Certified Medical-surgical registered nurseWlh - 5W gYn/surgical/BariatricsMegan Bradley, RN, BSN, WCC Wound Care Certified MCh – 2 West heart unitChristine Brannock, RN, OCN oncology Certified nurse Wlh - ChCC-Community outreachDawn Brown, RN 3 BSN-BCMedical – surgical CertificationErin Bull, RN, BSN, CMC, CCRN CMC/Cardiac Med subspecialty Wlh - iCu/stepdownGregory Calone, RN, BSN, CNRN, SCRN Certified neuroscience registered nurse MCh – 3 Midwest neuro-surgical iCuDennis Campbell, MS, RN, NEA-BC, CPHQCertification professional in healthcare Quality sW-Vp, nursing/patient services, Behavioral MedicineTammy Campbell, RN, BSN, CEN Certified emergency nurse Wlh - emergency roomAmber Carter, RN, SCRN stroke Certified registered nurse MCh - The stroke CenterDiane Celano, RN-BC, BSN geriatric resource nurse MCh - 5 West Medical TelemetryHolly Church, RN, BSN, CCRN Critical Care nursing - adultMCh – 2 heart Coronary intensive Care/stepdown

Teresa Citty, RN, BSN, CPAN Certified post anesthesia nurse MCh - Main paCuJill Cotrone-Shebestak, RN, CRRN Certified rehabilitation registered nurse MCh – 4 West inpatient rehabElizabeth Councilman, MSN, RN-BC Medical-surgical nursing Wlh - orthopedicsGlenda Davis, RN, BSN, CPHQ Certification professional in healthcare Quality sW - accreditation servicesRebecca Davis RN, BSN, CCRN Critical Care nursing - adult, Wlh - iCu/stepdownTeresa Davis, RN, CPN Certified pediatric rn MCh – 6 Midwest peds and piCuCheryl Denny, RN, BSN, CCRN Critical Care nursing - adult, Wlh - iCu/stepdownBarbara Deskins, MSN, RN-BC Medical-surgical nursing sW - Clinical nursing supportJessica Deutsch, RN, BSN, CMSRN Certified Medical-surgical registered nurseWlh - intermediate Care/urologyStephanie Dillon, RN, BSN, CCRN Critical Care nursing - adult, Wlh - iCu/stepdownVincent DiMattia, RN, BSN, CNOR Certified nurse operating room MCh - operating roomGina Dixon, RN, BSN, OCN oncology Certified nurse Wlh - ChCC-Multidisciplinary ClinicConstance Dupont, RN, BSN, SCRN stroke Certified registered nurse MCh – 3 Midwest neuro-surgical iCuJulie Farmer, BSN, RN-BC Medical-surgical nursing ThnM - Thn Care ManagementGinger Fountain, RN, CNOR Certified nurse operating room Wh - operating roomTerri Franklin, RN, BSN, OCN oncology Certified nurse Wlh - ChCC - Medical oncology

Smita Glosson, RN, BSN, MHA-MBA, NE-BCnurse executive Board Certified MCh - 5 West Medical TelemetryMarilenne Golden, RN,BSN, MHA, CNMLCertified nurse Manager leader MCh – 3 Midwest neuro-surgical iCuDeborah Gregory, RN, CBIS Certified Brain injury specialist MCh – 3 Midwest neuro-surgical iCuNancy Halpin, RN, BSN, CDE Certified Diabetes educator nutrition Management CenterKatie Halsey, RN, BSN, CNM Certified nurse Midwife MCh - peds eDCarol Harris, RN, MHA, CCRN, CMCCMC/Cardiac Med subspecialty MCh – 3 West CpCuGwendolyn Hawkins, RN, CNOR Certified nurse operating room MCh - operating roomLisa Hawks, RN, BSN, CPHRM Certified professional in healthcare risk Management Wh - risk ManagementTamika Hester, RN, BSN, CPAN Certified post anesthesia nurse Wh - paCuValerie Hilliard, RN, BSN, VA-BC Vascular access MCh - VasT and iV nursingSharon Hitchcock, RN, BSN, CNOR Certified nurse operating room MCh - operating roomFran Hobson, RN, MSN, CEN Certified emergency nurse Wlh - emergency roomTommy Hooks, RN, BSN, CEN Certified emergency nurse MCh - CarelinkSean Houle, RN, CEN Certified emergency nurse MCh - CarelinkLanisha Hunter, RN, BSN, CMSRN Certified Medical-surgical registered nurseMhC – 4 east Congestive heart failure

Certifications

Graduations

send graduations and certifications to

[email protected] in order to be recognized.

settiNg tHe

paCe


10

Regina Baldwin, RN, BSN unC-Charlotte Wlh - oncology

Jessica Branch, RN, BSN unC-Charlotte MCh - emergency Department

Bobby Brooks, RN, BSN Chamberlain College of nursing MChp - emergency Department

Jenny Burns, RN, BSN university of north Carolina at greensboro Wlh - intermediate Care/urology

Tymeeka Davis, RN, BSN, MSN Queens university at Charlotte sW – Care Management

Crystal Dollard, RN, BSN Winston salem state university MCh – 4 West inpatient rehab

Annie Hodges, RN, BSN Western Carolina university Wlh - intermediate Care/urology

Michelle Collins, RN, BSN Western governors university Wh - Mother/Baby

Ginger Morris, RN, BSN liberty university Wh - Maternity admissions unit

Jessica Phillips, RN, BSN east Carolina university MCh – 3 West CpCu

Tina Tate, RN, BSN Winston salem state university Bhh

Jenny Thacker, RN, BSN Western Carolina university MCh – 5 West Med/surg Telemetry

Jacqueline Thigpen, BSN-RN-BCWinston salem state university Wlh - flexible resources

Jamie Tracy, RN, BSN Western governors university Wlh - oncology

19

Aat the closing session of the 3rd annual nursing research symposium in october 2014, Dr. patricia Quigley cautioned the audience that “no important change will fit your system perfectly.” What did she mean by that?

the challenge of fall prevention

Dr. Quigley’s presentation, “innovations in fall and fall-injury prevention and reduction strategies for older adults” had four primary objectives:• To illustrate different perspectives of evidence-based practice.• To focus on what we can do related to fall prevention.• To separate and identify high-risk patients. • To use evidence-based practice to underpin all of our efforts.

fall prevention is a difficult problem to tackle. When trying to affect patient safety, it can be difficult, if not nearly impossible, to perform true science -- to isolate and control for one intervention when lives and safety are on the line. it is very challenging to try to isolate, control and then study our active environment, Dr. Quigley reminded us. for that very reason, there is not much in the literature that speaks to specific trials and studies pointing to one fall intervention. research overwhelmingly shows that programs with multiple approaches impact patient safety the most.

Continued on page 12

Dr. Quigley, phD, Mph, arnp,

Crrn, faan, faanp, is a

recognized expert in patient

safety, particularly in the

arena of fall prevention and

is the associate Director,

Visn 8 patient safety Center;

associate Chief for nursing

service/research. she works

for the Veterans affairs in

Tampa, florida.

“one size Fits all” does not exist

By Thresa Haithcock Isley, DNP, RN, ACNS-BC


ANd iMprovEMENTs

above: Dr. Quigley conversed with and encouraged symposium participants

The website can be found at: Cone Connects > departments and teams > Nursing/Nursing research https://sharepoint.conehealth.com/nursing/sitepages/nursing_research.aspx

steady, Continual progress

The inclusion of nursing faculty on our nursing research

Council was the first step in creating partnerships and

has given the Council the ability to advance nursing

practice in conducting and disseminating nursing

research. Department quality improvement projects have

often become well-developed nursing research studies

recognized around the nation for excellence. several of

Cone health’s nursing researchers have won top awards

for their studies at national conferences.

The nrC has been innovative in its approach to the

development of nursing research in the organization.

What started out as an objective to establish partnerships

with local universities and think differently about

research has become not only the foundation, but also

the catalyst for the Council to identify next steps for

continued progress. The nrC sponsored two “faculty/

staff engagement Dinners”. The purpose of the first dinner

was to make connections. as a follow up, the second

dinner enhanced the collaborative relationship with local

schools of nursing by exploring research opportunities,

and reestablishing the strong and dynamic connection

created at the first dinner. These dinners have provided

a unique opportunity to pair the clinical expertise of the

bedside nurse with the researchers from local schools of

nursing. When rns engage in questioning clinical practice,

and researchers are there to listen and advise, innovation

happens.

Through its redesign and reorganization of the nrC

website, the Council is prepared to meet and mentor any

potential nursing research participant in the organization.

The site is organized and informative, with contacts

and algorithms that take inquiring minds from the initial

questions about practice, through the organization and

presentation stages, and further into the research activities

themselves. v

screen shot of nursing research Council web page.

MAGNETTrANsforMATioNAl lEAdErship

Cone healTh

18 11

Cone healTh

Cone health nursing research, Continued

Cone healTh

identifying the best scienceeven though we cannot study falls prevention methods individually, we must continue to stay current in our literature review for this difficult problem. how do we identify the best science as we read? Dr. Quigley reinforced the importance of appropriate selection of articles, and of evaluating what we read for levels of strength in the evidence. at Cone health, we use the iowa Model to guide us when working through a literature review. Meta-analysis and randomized controlled trials are the “gold standard” in scientific literature.

turning blocks into puzzle piecesfrom her platform of experience in fall prevention research and practice, Dr. Quigley’s comment above—“no important change will fit your system perfectly”--means this: the successful unit, shift, nurse or any other group intent on making real change in patient safety will take information and fit it into their culture. Knowledge that stands alone is like a formless block. Knowledge that turns into wisdom must be shaped and molded within the existing culture like a puzzle piece. only then will evidence take on meaning and transform into practice.

What does that mean for your work group? v

The iowa model is available on the Cone health nursing research website:

Cone Connects/Departments and Teams/Nursing/Nursing Researchhttps://sharepoint.conehealth.com/nursing/SitePages/nursing_research.aspx

“One Size Fits All”, Continued

Cone healTh

12 17

By Jennifer L. Fencl, DNP, RN, CNS-BC, CNOR

Cone health nursing research: Thriving with Interdisciplinary Partnerships

What started out several

years ago as an invitation

to local university faculty

members to be a part of

Cone health’s nursing

research Council, has grown

into a true partnership

for collaborative nursing

research that continues to

thrive and expand outside

the walls of our health

network. Cone health has

successfully partnered with

local universities and health care organizations within our

state in a variety of ways to plant the seeds of research.

nursing research has flourished. Cone health’s nursing

Research Council (NRC) recently established several

interprofessional partnerships that will aid us in our efforts

to add to the body of nursing knowledge and science in a

meaningful way.

statistical support

The most recently established relationship is with the

Department of Mathematics at the university of north

Carolina at Greensboro (UNCG). In this partnership,

mathematics students gain real-world experience by providing

statistical support for nrC studies. Cone health nursing

research participants benefit from having strong statistical

analyses performed on their studies.

This collaboration has resulted in five successful studies,

with several more on the horizon. in addition, nursing

researchers from Cone health were invited to present at the

international Conference on advances in interdisciplinary

statistics and Combinatorics. Cone health’s nursing

research reached outside the walls of our health network

and outside the discipline of nursing.

government grant

another partnership in process is with the university

of North Carolina Greensboro (UNCG) and the North

Carolina A & T State University (NC A&T) Nanoscience and

nanoengineering Department. Diabetes coordinators are

working closely with several disciplines and are in the final

edits of their grant proposal to the national institutes of

health. Their study will examine outcomes of simultaneous

integration when diabetes and depression treatment are

integrated in the same care plan.

regional research symposia

Cone health is recognized as a leader in nursing research

in north Carolina. We have successfully led partnerships

with other large health care organizations across the

state in producing the annual nursing research and

evidence-Based practice symposium for three consecutive

years. These symposia engage national and international

speakers in nursing research and innovation, feature poster

presentations from a wide number of organizations, and

recognize good work in nursing science with research and

evidence based practice awards. The driving force behind

all these initiatives continues to be Cone health’s nursing

research Council, a shared governance council comprised

of nursing personnel from all levels across the network.


There is no limit

to research

opportunities

when rns ask

their burning

questions and

work together to

answer them.

16 13

3rd Annual Nursing Research Symposium

WINNERS’ Circle

Mission health, asheville, nC, won first place in the research poster judging for “ exploring the incidence of unplanned Perioperative Hypothermia (UPH) in the Ambulatory Surgery population “

accepting the plaque from Debbie grant is Dr. Vallire hooper.


photo above right: people’s choice winner for evidence-Based practice poster, “heavyweight” Champion fights for a Cause: Best practice in Daily Weight Monitoring for heart failure patients on Department 4e-Moses Cone.

evidence-Based and research poster awards are presented on page 16.

2014 Cone Health/AHEC Nursing Research and Evidence Based Practice Symposium

Research Poster Award Winners

Award Poster Title Facility/Presenters

1st Place Winner Exploring the Incidence of Unplanned Perioperative Hypothermia (UPH) in the Ambulatory Surgery Population

Mission Health Presenters:

Dr. Vallire Hooper Dr. Sheri Denslow

2nd Place Winner What’s Going On Under the OR Drapes? A Closer Look at Pressure Ulcers Acquired in the Perioperative Period

Cone Health Presenters: Dawn Engels

Melody Austin

3rd Place Winner A Measure of Perceived Fatigue Among Nurses in Western North Carolina

Mission Health Presenter:

Karen Renee Cochran

Evidence-Based Practice Poster Award Winners

Award Poster Title Facility/Presenters

1st Place Winner Improving Quality Outcomes in Hip Fracture Patients Through Development and Implementation of an Evidence Based Protocol

Cone Health Presenters:

Eva Hyde Linda Bryson

Nicole Baltazaar-Holbert

2nd Place Winner A Three-Tiered Bundle to Prevent Falls Cone Health Presenters:

Danyel Johnson Thresa Isley

Brenda Murphy

3rd Place Winner Reducing Maternal Mortality: Implementing a Hemorrhage Protocol in Obstetrics

Carolinas HealthCare System Presenters:

Ansley Stone Debbie Pasquarello

3rd Place Winner “Heavyweight” Champion Fights for a Cause: Best Practice in Daily Weight Monitoring for Heart Failure Patients on Department 4E-Moses Cone

Cone Health Presenter:

Laurie Freeman

research poster award Winners

AWArD poster titLe FaCiLitY/preseNters

AWArD poster titLe FaCiLitY/preseNters

evidence-Based practice poster award Winners

3rd annual nursing research and evidence-Based practice symposium

research: nursing research is generated when we find a gap in

the literature that does not answer the questions we have about

best practices. research follows a strict method of scientific

investigation with a goal to explore, understand and explain a

variety of phenomena vital to the scientific foundation of nursing.

The outcomes from nursing research studies drive nursing practice,

which impact patient care outcomes. Through scientific method,

new knowledge is discovered.

scientific inquiry is at the core of nursing research, which can

include clinical research, health systems and outcomes research,

and nursing education research.

example: one example of a nursing research study that filled a

gap in existing knowledge is the Karaoke Therapy research done

at Behavioral health hospital (Nursing Beat, Vol. 11, no 1, Winter

2014). There was no existing research that demonstrated the

use and effect of music among psychiatric patients in an acute

inpatient setting. results of the study showed a significant decrease

in anxiety levels, decreases in the need for prn medication

directly after karaoke, and increased participation levels in group

counseling sessions. This added to the body of nursing science. in

fact, the authors developed a poster presentation that won 1st place

in the “practice” section for posters at the american psychiatric

nurses’ association’s 28th annual Conference in indianapolis in

2014.

tying it all together

Quality improvement, evidence Based practice and research can

be directly related to each other, but are not the same. each has

a different, yet unique application and use. however, each of them

begin the same – with the need to answer a question or find a

solution. it is part of nursing practice to ask the questions that will

lead to better care for our patients and better work environments

in which to provide that care, whether that includes Quality

improvement, evidence Based practice or full nursing research. v

Iin the world of quality, data and information, these three

terms are often used interchangeably. The distinction can

be confusing. here is a simple run-down of each:

Quality improvement: a process of assessing the

current environment to increase/improve quality, safety,

performance, efficiency, processes, and/or outcomes.

Quality improvement (QI) is focused on a specific

area, and may or may not be generalizable outside the

practice setting for which it was developed. Qi is often

characterized as small scale, continuous efforts for

improvement.

example: an example of a Qi project is the implementation

of a specimen “time out” in the operating room.

perioperative specimens were being sent to the lab

mislabeled. sometimes information was missing and/or

incorrect. Through shared governance, the healthcare

team decided that all specimens passed off the sterile field

would have a specimen “time out” in which patient and

specimen information are verbally and visually verified by

the circulating rn and scrub person. During the time out,

this information is also compared to the paperwork and

specimen container. This represents a small, rapid cycle of

improvement, with a very focused and immediate solution.

evidence-based practice: the activity of translating the

current knowledge and research into everyday clinical

practice. Current research findings, clinical practice

guidelines and other practices based on evidence are used

for patient care.

example: The nurses at annie penn hospital unit 300

questioned if a team approach to processing admissions

would improve both patient and staff satisfaction. The

evidence for the practice was discovered in an article,

Changing the Way We Work, by Homola and Fuller (2008)

in the American Journal of Nursing. The nurses followed

the evidence-Based practice step-by-step guide provided

by the Cone health nursing research Council to outline

their project.


Quality improvement, evidence-Based practice and research: What is the difference?

By Jenn Zinn Fencl, DNP, RN, CNS-BC, CNOR & Sarah Lackey, RN, MSN, CCNS


ANd iMprovEMENTs

Kalah Mueller, emergency Department nurse at Moses Cone hospital.

an important part of

nursing practice is to ask the

questions that lead to better

care for our patients and

better work environments in

which to provide that care.

14 15

Quality improvement, evidence-Based

practice and research all begin

in one place – with a burning question.


editors cone health nurse executives · • redesigning behavioral health care to include: 1)...

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