Patient Care ServicesFiscal Year 2015Annual Report

Table of ContentsIntroduction from Katie Boston-Leary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

PCS Goals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Clinic Nurse Satisfaction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

National Database of Nursing Quality Indicators RN Survey

with Practice Environment Scale Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Patient Satisfaction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-9

Professional Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-11

UHCC Nurse Active in Regional & National Organization . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Culture of Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Nursing Quality Indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

NDNQ1 Database Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14-15

Nursing Shared Governance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Nursing Saving Governance’s Story on Professional Image . . . . . . . . . . . . . . . . . . . . . . . . . . 17-18

Confidence/Trust in Nurse Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Recognizing Certified Nurses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Clinical Ladder Professional Recognition Program Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Daisy Award Winners Are Recognizing Extraordinary Nurses . . . . . . . . . . . . . . . . . . . . . . . 22-23

Nominees for the 2015 Nurses Week Awards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24-25

Journey to UHCC Nursing Foundation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26-27

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Message from Katie Boston-LearyUnion Hospital Nursing is proud of what we have achieved this past year through effective collaboration and strong relationships with our care partners and supporting teams .

This is the first edition of our annual nursing report to showcase all of our successes for the past year, to further the profession of nursing and to address some of the larger efforts toward providing safe effective and high quality patient care . We are committed to applying the hospital values of

integrity, caring and compassion, shared learning and leadership to every aspect of our practice and communication .

We have accomplished a lot this past year and we have reached new heights with new challenges and new opportunities . As an organization, we have received many accolades and awards thanks to the exceptional care that is being provided at the bedside .

We experienced an increase in clinical ladder applications, poster and podium presentations at the local and national stage, and certifications that most certainly spotlights Union Hospital at a local and national level .

There were also challenges with snow events, high acuity, high volume, turnover and, how can we forget, Ebola! However, we mustered through staying true to our mission and values, and we cannot wait for what’s in store for next year! We also experienced challenges with maintaining our shared governance structure, but we were able to develop our Nursing mission, vision statement, tag line, professional practice and care delivery models at an all-day offsite retreat with 50 nurses’ engagement and participation .

We had 100 percent participation in our first National Database for Nursing Quality Indicators (NDNQI) RN Satisfaction Survey that will serve as a baseline for improving the work environment for our nursing team . The results were shared and action plans were developed at unit-based councils with trends being managed at larger councils .

Our vision for next year involves continuing our march toward nursing excellence with our Pathway to Excellence Re-designation (remember we are the first in our state!), which is due in April of 2016 .

I hope that you enjoy reading about our many achievements, innovations and goals for the future and that you will

find this inspiring, bucket-filling and battery-charging!

Thanks for all that you have done to contribute to a very successful and rewarding year!

Go Union Nursing!

Katie Boston-Leary, MBA, MHA, BSN, CNOR, NEA-BC Chief Nursing Officer & Senior Vice President of Patient Care Services

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PCS Goals

Goals Doesn’t Meet Standards

Meets Standards

Exceeds Standards Comments

Pt experience

Improve patient experience by establishing a Rounding Strategy & Standardize Bedside Shift Report

0

X

1

2

Metrics Nurse Communication Scores HCAHPS (Improvement) See Customer Service section for details100% compliance with standardized BSR – not met .Partial credit

Improve health/communities

Improve Care Coordination by 1) Standardizing Discharge Process 2) Increasing Community Hours/

Involvement & Engagement with a homeless shelter and the local Pregnancy Shelter

0

1

X

2

Metrics

100% Implementation of new Discharge Process – PI group with reps from input and output involved in workgroup and improved scores which is reflected under customer service sectionHCAHPS scores improvement on Discharge QuestionNoted improvement of scores surpassed 80th percentileCommunity Involvement - MSU, SSU, Peds

Reduce Cost of Care

Reducing the cost of delivering care with the implementation of A3s: 1) Performance Improvements with

Falls, 2) Improvement of OR First Case

Starts 3) Supply Waste Reduction 4) 90 minute ED to floor

0

X

1

2

Metrics

Fall Reduction by 15%First Case Start Improvement by 110%Supply Waste Reduction by 0%ED to floor 90 minute window with 16% improvementPartial credit

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Clinical Nurses SatisfactionTracking and analyzing nurse satisfaction data is an integral part of improving healthcare delivery within Union Hospital of Cecil County (UHCC) . Understanding the concerns and challenges faced by Clinical Nurses (CNs) and also the perspective of CNs is essential when considering how to better support the largest portion of the workforce at UHCC .

Since the inception of the shared governance structure, both Nursing Leadership and CNs have evolved to understand that matters such as nurse satisfaction must be owned by and managed in partnership at the point of care . In order to achieve sustainable results, the very satisfaction that is measured, tracked and analyzed must include the CN’s involvement . It is an attribute of Nursing Leadership at UHCC to engage the bedside nurse in this process .

The measure of nurse satisfaction at UHCC is the National Database of Nursing Quality Indicators (NDNQI) RN Survey with Practice Environment Scale (PES) . UHCC achieved a 100 percent survey response rate for eligible nurses for this survey in September 2014 . This fiscal year was the first time the survey was utilized . Previously, UHCC used a general employee satisfaction survey developed by the Avatar Company, but Nursing Leadership determined that using a tool more specific to nursing practice would be more beneficial . The NDNQI survey allows UHCC to discern nursing-specific satisfaction results and is easier to compare against national benchmarks, such as the Practice Environment Scale endorsed by the National Quality Forum .

The PES has been separated into its five subscale components:

1 . Nurse participation in hospital affairs

2 . Nursing foundations for quality of care

3 . Nurse manager ability/leadership

4 . Support of nurses, staffing and resource adequacy

5 . Collegial nurse-physician relations

Results for each component are displayed at the unit level . The national mean benchmark statistics for like units of Non-Magnet Hospitals (NMH) accompany UHCC survey results for easy comparison . The survey was completed again in October 2015 .

The structures used to track and analyze nurse satisfaction data are multifaceted, touching many branches of UHCC’s shared governance structure . First, the data is received and reviewed by the Nursing Leadership . The data is then reviewed by Chairs of all Unit Councils and Core Councils . The information is then returned to all Unit Councils for review and analysis . Both hospital-wide and unit-specific data are analyzed at this level . It is at this crucial step when CNs are empowered to compare data, assess the effectiveness of action plans based on previous surveys and, in partnership with Nurse Managers, create new action plans that can be evaluated by the next survey . These action plans are shared with Clinical Directors and the Chief Nursing Officer .

The overall department results of the NDNQIRN Survey with PES results demonstrated that UHCC CNs are highly satisfied (see next page for results) .

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National Database of Nursing Quality Indicators RN Survey with Practice Environment Scale Results

Benchmark Measure Non-Magnet Hospitals (NMH) UHCC’s Overall Scores

Mean Practice Environment Scale Score 3 .02

Collegial Nurse-Physician Relationships 3 .03

Staffing and Resource Adequacy 2 .85

Nurse Manager Ability, Leadership, and Support of Nurses 3.07

Nursing Foundations for Quality of Care 3 .06

Nursing Participation in Hospital Affairs 3 .08

Job Enjoyment Scale T-Score 60 .34

< 10% Percentile

11%-25% Percentile

26%-49% Percentile

Mean (within .05 scores <10) (within 2 .00 scores >10) OVER MEAN

51%-74% Percentile

75%-89% Percentile

90%> Percentile

Measurement considered five subscale components . As illustrated in the Table 1 .1, these components include:

• Collegial nurse-physician relations nurse ranked in the 25th-50th percentile when compared to NMH .

• Support of nurses, staffing and resource adequacy ranked in the 50th-75th percentile when compared to NMH.

• Nurse manager ability/leadership ranked above the 50th percentile when compared to NMH .

• Nursing foundations for quality of care ranked near the 50th percentile when compared to NMH .

• Participation in hospital affairs ranked in the 75th-90th percentile when compared to NMH .

Overall, PES ranked in the 50th-75th percentile when compared to NMH . In addition, the Job Enjoyment Scale ranked in the 50th-75th percentile when compared to NMH.

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Patient SatisfactionPatient satisfaction is of the utmost importance to UHCC . UHCC Patient Care Service (PCS) departments pride themselves in providing excellent nursing care to all of their patients and supporting the Triple Aim by improving the patient experience of care .

UHCC has established structures and processes to identify significant findings and trends in overall patient satisfaction . The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction survey constitutes one of these structures . The results from the HCAHPS survey are shared to develop action plans in hospital quality structures and in shared governance structures . Quality is a piece of UHCC’s Care Delivery Model and the Professional Practice Model . It is the belief at UHCC that quality care equates to patient satisfaction .

HCAHPS Results

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Professional DevelopmentUHCC understands that professional development is an important aspect to maintaining a culture of nursing excellence throughout the organization . The Chief Nursing Officer has set the expectation that nursing leadership fully support and encourage CNs in their pursuit for professional growth and development .

The organization has a long tradition of supporting its nursing staff by providing tuition/registration reimbursement for professional development and professional certifications . Nurses at all levels are encouraged to attain specialty certification in their area of practice and to participate and present in external local, regional, national, and international conferences and meetings .

To that end, the PCS Department supports professional nurse development through such vehicles as flexible scheduling and tuition reimbursement for certification courses, and registration reimbursement for conference participation .

UHCC presentations at regional, national and international conferences:

The list below presents the title and subject, presenters, date and venue of UHCC presentations at the regional, national and international levels .

1. “Patient Medication Education: It’s Impact on the Discharged Medical/Surgical Patient” Poster Presentation; Sigma Theta Tau 43rd Biennial Nursing Research Convention; Las Vegas, NV; November 2015; Cathleen D . Butenewicz, MSN, RN-BC .

2. “Patient Medication Education: It’s Impact on the Discharged Medical/Surgical Patient” Poster Presentation; Sigma Theta Tau International’s 26th International Nursing Research Congress; San Juan, Puerto Rico; July 2015; Cathleen D . Butenewicz, MSN, RN-BC .

3. “Community Outreach: Neonatal Abstinence Syndrome (NAS) Education to Mothers on Methadone” Poster Presentation; Pediatric Nursing -31th Conference; Chicago, IL; July 2015; Lisa Jager, BSN, RN, CPN & Vanessa Thomas, RN .

4. “Reducing Readmissions through Care Coordination and Discharge Process Improvements” Podium Presentation; 2015 Nurse and Home Care Forum; Foxborough, MA; June 2015; Katie Boston-Leary, MBA, MHA, BSN, RN, CNOR, NEA-BC and Nancy Larson, RN, MBA .

5. “A Journey to Become a World Class Stoke Program” Podium Presentation; 2015 ANCC Pathway to Excellence Conference; Louisville, KY; May 2015; Barbara Truitt, BSN, RN .

6. “Dress Code Enhances the Professional Status of Nursing: Empowering Nurses to Adopt a Standardized Uniform” Poster Presentation; 2015 ANCC Pathway to Excellence Conference; Louisville, KY; May 2015; Ralisha Grimsley, BSN, RN; Katie Boston-Leary, MBA, MHA, BSN, RN, CNOR, NEA-BC, and William Hudson, BSN, RN, CNML, OCN .

7. “A Nurse as the Chief Information Officer (CIO) – What is the Organizational Impact” Poster Presentation; 2015 ANCC Pathway to Excellence Conference; Louisville, KY; May 2015 . Anne E . Lara, Ed .D ., RN, CNE, CPHIMS .

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8 . “Journey to Excellence: A Designated Primary Stroke Center” Storyboard Presentation; Maryland Patient Safety Conference; Baltimore, MD; March 2015; Barbara Truitt, BSN, RN .

9 . “UHCC Stroke Program” Podium Presentation; MSCC/QIC; Baltimore, MD; November 2014; Barbara Truitt, BSN, RN .

10. “A Road Map to a Successful EMR Implementation in Surgical Service;” Podium Presentation; 2015 OR Manager Conference; Orlando, FL; February 2015; Katie Boston-Leary, MBA, MHA, BSN, RN, CNOR, NEA-BC and Jami Squitieri, BSN, RN .

11. “An Evidenced Based Project: Normothermia in the Surgical Patient” Poster Presentation; Maryland Nurses Association 111th Annual Convention; Annapolis, MD; October 2014; Deborah Coutu, BSN, RN .

12. “Untying the Knots: Sustaining the Favorable Outcomes of Restraint Reduction in the Critical Care Unit” Poster Presentation; Maryland Nurses Association 111th Annual Convention; Annapolis, MD; October 2014; Katelyn Henley, RN, WCC .

13. “We Educate Before We Medicate: With Extraordinary Results!” Poster Presentation; Maryland Nurses Association 111th Annual Convention; Annapolis, MD; October 2014; Katie Boston-Leary, MBA, MHA, BSN, RN, CNOR, NEA-BC & Karen Cebenka, RN .

14. “Collaboration in Community Health Education: A Key to Improve Patient Outcomes” Poster Presentation; Pediatric Nursing – 30th Conference; Baltimore, MD; July 2014; Lisa Jager, BSN, RN, CPN and Vanessa Thomas, RN .

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UHCC Nurse Active in Regional and National Organization• Union Hospital Representative on MONE UHC/AANC Maryland Nurse Residency Collaborative

• Union Hospital Representative on the Maryland Action Coalition

• Union Hospital Representative on the Magnet Coordinators Network in Maryland

• Union Hospital Representative on the Philadelphia Area Magnet Consortium

• Union Hospital Representative on the Maryland Stroke Center Consortium

Co-Chair Barbara Truitt, BSN, RN

• Union Hospital Representative on the Chesapeake Health Education Program, Inc . (CHEP) Board

• Union Hospital Representative on The American Nurses Credentialing Center Commission on Pathway to Excellence®

Commissioner Simrat Shergill, BSN, BS, RN

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Culture of SafetyAt UHCC, interdepartmental collaboration is vital to the comprehensive approach for proactively assessing risk and preventing and reducing errors throughout the facility . The PCS plays a key role in this process . From direct care staff at the patient bedside to the role of the nursing leadership, nursing staff is vigilant in ensuring the best possible outcomes and safest care for our patients .

Enhancements in UHCC Culture of Safety

UHCC has structures, processes and procedures that promote its culture of safety, including:

• Safety Speak Up & Be Safe: Safety Hotline

• Agency for Healthcare Research and Quality’s (AHRQ) Safety Survey

• New IV Pumps

• 9:30 Leadership Safety Huddles

• Simulation Training on Just Culture

• Quality & Safety Council

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Nursing Quality IndicatorsUHCC extensively examines all nursing-specific indicators and data, and performs benchmark comparisons to national and state data . UHCC has utilized the NDNQI database system for storing nursing-sensitive data for comparison to benchmarks .

Submitted quarterly to the NDNQI database, the UHCC data is collated by NDNQI, and quarterly reports are generated and shared with nursing leadership . Nursing leadership then reviews the trends in data relative to the benchmarks chosen, and this information is delivered to the staff nurses for discussion, feedback and action-plan formulation .

CNs are involved in every aspect of collecting and reviewing patient quality data and disseminating relevant information . CNs may identify patient quality issues in the clinical setting through observation, performing surveys or audits, or through attention to national standards of patient care or regulatory standards . In each unit, they are also provided with a Unit-Based Dashboard to follow trends in quality data . This structure represents a combination of unit-specific data and fiscal year goals set forth by UHCC based on the previous years’ performance and national outcomes benchmarks in the Triple Aim framework by improving the patient experience of care and reducing the per capita cost of health care .

The nursing committee meets on a monthly basis to share information, which is then dispersed to staff . Nurses may identify issues or concerns requiring attention in any of these venues . CNs can give direct feedback and formulate interventions to improve patient quality at UHCC . In addition, department-based, hospital-wide, and system-wide interdisciplinary committees review and analyze quality indicators related to their clinical areas .

NDNQI Database Results

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Nursing Shared GovernanceNursing leadership at UHCC values the input from the CNs and considers it a significant resource for improving both work environment and patient care throughout the organization . Input from CNs directly impacts the Culture of Excellence at UHCC .

Nurse leaders utilize a variety of means to gather input from CNs . Through incorporating this information from the point of care, truly innovative approaches to problem solving and performance improvement can be generated . Nurse leaders at all levels of the organization acknowledge that those providing direct care at the point of service are the best people to make accurate and sustainable change for improvements .

The Nursing Leadership Forum and the Unit-based Councils provide a way for CNs to present input regarding patient care improvements to nurse leaders . In addition, Core Councils serve as venues for CNs to provide input through open dialogue and by evaluating evidence-based practices that generate new and innovative improvements .

Nursing Shared Governance’s Outcomes

• ED standardizing the SNF handoff/report process

• Evaluating evidence-based practices for use of a tympanic thermometer in the ED

• ED implemented a peer interview process

• Continuation and expansion of Community Outreach Project: NAS infants and family education

• Peds Safety Contract – preventing infant drops/falls

• Creation of a postpartum hemorrhage supply toolkit and medication kit

• Creation of stat C-section preparation kits

• Publishing and content development of Nursing Newsletters

• Development of an online nursing portal on the Intranet titled “U-Connect”

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Nursing Shared Governance’s Story on Professional ImageTo achieve our goal in promoting the professional image of over 300 clinical nurses, our Professional Development Council (PDC) implemented a hospital-wide dress code of standardized uniforms for clinical nursing staff . With much debate over pros and cons of uniform standardization in the acute care setting, our PDC believed that standardizing the image of nursing at UHCC would promote the professional image of our clinical nursing staff and Certified Nursing Assistants (CNA) and increase the patient identification of the primary clinical nurse .

Furthermore, our PDC determined that standardization would improve upon the patient’s perception of the professional image of nursing . By strengthening the professional image of nursing at UHCC guided by the evidence of patient’s preferences, the PDC was instrumental in shifting the impression of the “Bedside Nurse” to that of the “Professional Clinical Nurse .”

In January 2014, our Chief Nursing Officer and members of the PDC discussed the need to enhance the professional image of our clinical front-line nursing staff . This discussion generated a platform for developing a professional nursing image standard that was both patient and family centered .

In February 2014, the PDC, with the support of our Chief Nurse Officer and HR Director, developed standards in revising the UHCC uniform policy to assert the professional image of nursing based on image perceptions of staff, patient, and family . It was concluded that the idea of uniform standardization be introduced to clinical nursing in phases:

Phase 1: House-wide idea introduction

Phase 2: Color selections

Phase 3: Presentation of standardize uniforms via a fashion show

After four months of implementing a nursing-wide uniform transformation, a polling survey was conducted in regards to the suitability and favorable aspects of the new standardize nursing uniformity . A majority of the feedback was positive with minor requests to include uniform accessories correlating with the change in color . Other requests in uniforms included fleece jackets and scrub jackets with embroidery options, and the option to maintain individuality of footwear .

This feedback was incorporated into the final agreement, where it was agreed that staff could purchase and wear the same color fleece and scrub jackets that represent their practice, that

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footwear would be left to the options of the each individual nurse and that long sleeve undershirts could be of any color the individual chooses as long as it was of solid color with no prints .

Motivated by the departmental changes made in nursing, additional ancillary departments also chose to standardize their staffing uniforms . Our Respiratory Department chose the colors of Hunter Green and Black representing the element of oxygen, and our Phlebotomy Department chose the color of Burgundy to represent the element of hematology/blood .

Following the uniform premier and color selection, a survey was conducted in June of 2014 with 165 Clinical Nurses participation . Results of the survey indicated that 80 percent of nurses favored a shade of Blue uniform over the choices of Green or Grey . Of this 80 percent, 53 percent favored the color Galaxy Blue over Navy Blue as their desired choice of uniform color . CNA results were in support of Grey as their color choice in uniforms with greater than 90 percent selecting Pewter Grey .

In July 2014, a uniform vendor was interviewed and selected to host several uniform sales in August and September . Funding was allocated specifically for the interchange of uniforms based on the employee hired . After the change of staffing uniforms, a target date of October 1, 2014 was set as our Go-Live Professional Image Day .

As of March 2015, a standardized dress code was in effect for direct patient care areas . The organization’s Chief Nursing Officer provided her support of the PDC’s decision by designating Galaxy Blue as the color only to be worn by Clinical Nurses, Pewter Grey only to be worn by Certified Nurses Assistants, Burgundy to be worn by Phlebotomy and Hunter Green tops with Black pants to be worn by respiratory departments .

The forthcoming strategic plan discussed by the PDC is to re-evaluate the ongoing efforts of the transformation within 12 months of implementation . During this time, an online survey will be held to discuss any challenges and reassurances that may have arisen over the six months of execution period .

Through our journey, we found that standardized uniforms enhanced professional image . Standardized uniforms helped patients and other health professionals more easily identify staff . Additionally, the standardized uniforms produced a sustainable increase the measured confidence and trust patients have in nurses, as noted in the graphic on the next page .

Today, our CNs proudly wear their uniforms and appreciate how important professional attire is to the workplace . As a result, the DPC developed a standardized image poster entitled “What’s My Role In Your Healthcare?” which has made caregiver recognition effortless for the patients, their families and the health care team, while enhancing the care provider’s image of self .

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Confidence/Trust in Nurse Results

NCR Picker question for “Confidence/Trust in Nurse” rose from 77 .7 in the 4th Quarter FY14 to 83 .1 in the 1st Quarter FY15, higher than the national norm . We had sustainability in our next two quarters in patient satisfaction scores was higher than the national norm; our score was 82 .6 and 88 .4 NCR Picker question for “Confidence/trust in Nurse .”

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Recognizing Certified NursesHistorically, nurses who achieve certification at UHCC are honored during a Certification Day Tea on day and night shifts . During this celebration, nurses have the opportunity to network with their peers in all areas of the hospital .

List of National Certificated NursesNames to come.

Clinical Ladder Professional Recognition Program

The Clinical Ladder Professional Recognition Program was redesigned in 2014 and 2015 by CNs through a shared governance process in order to celebrate and reward the growth and development of CNs . The Clinical Ladder Program is based on Nursing Theory by Patricia E . Benner, RN, PhD, FAAN, who first developed a model for the stages of clinical competence in her classic book, “From Novice to Expert: Excellence and Power in Clinical Nursing Practice.”

The Clinical Ladder Program promotes the professional values of excellence in patient care, personal responsibility, respect for self and others, innovation through teamwork and dedication to caring, as well as the organizational values of integrity, compassion, shared learning and leadership .

Moreover, the RN Excellence Criteria points for the program is based on the 14 characteristics of Magnet facilities originally described in the 1983 study . These characteristics are known as the Forces of Magnetism . These Forces are grouped into five components that represent the framework that distinguishes Magnet organizations in 2008 .

The Clinical Ladder Program allows nurses to apply and be recognized for their clinical excellence and expertise . Through a peer-reviewed process, nurses can advance through a clinical nurse leveling system . Shared Governance and the framework of the Triple Aim is also rewarded and recognized through the Clinical Ladder Program . Nurses who make a difference by implementing new ideas or practices may use these examples in their Clinical Ladder portfolio to demonstrate their special contribution to quality patient care . Nurses who receive clinical advancement are recognized individually during a special award ceremony .

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Clinical Ladder Professional Recognition Program Results

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DAISY Award Winners Are Recognizing Extraordinary NursesThe DAISY (Diseases Attacking the Immune System) Award was established by the DAISY Foundation in memory of J . Patrick Barnes who died at age 33 of ITP, an auto-immune disease . The Barnes family was awestruck by the clinical skills, caring and compassion of the nurses who cared for Patrick . In response, they created this national award to express their gratitude to nurses everywhere . Anyone can nominate a nurse for the DAISY Award . The Award committee selects one nurse who exemplifies the provision of extraordinary care and compassion .

Every quarter a winner receives a nominee pin, a DAISY Award recipient pin, a Healer’s Touch hand carved statue and an award certificate . In addition, the selected nurse’s unit receives a banner to post for the month and freshly baked cinnamon rolls for everyone on the day the award is presented .

2014 4th Quarter Daisy Award Winner: Elizabeth Feika Musa, RN

From ICU/PCU for Extraordinary Nursing

2014 4th Quarter Daisy Award Nominees for Extraordinary Nursing

Name UnitErin Glynn 3 NorthRalisha Grimsley 3 NorthKelly Ramsey MICSimrat Shergill MSUNicole Stoler MSULauren Biggers MSUAlexander Cameron MSUKelly Schatz MSUSteven Culp MSUJennifer Ewing MSUKimberly Terranova PedsVanessa Thomas PedsKonnie Kenyah MSUAlesha Tunstall House SuperElizabeth Feika Musa ICU/PCU

2015 1st Quarter Daisy Award Winner: Adam Skomorucha, BSN, RN

From PEDS For Extraordinary Nursing

2015 1st Quarter Daisy Award Nominees for Extraordinary Nursing

Name UnitErin Glynn ObsAutherine Vissy Sterling ObsLee Anna Fullis Float PoolAdam Skomorucha PedsKerstin Vikari PedsAlaina Orellana ICUMorgan Cook ICUSean McCarthy EDShannon Barr EDJaclyn Sanders EDMatthew Buker EDGerald Miller MSUJackline Nanga MSUCourtney Patchell MSU

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2015 2nd Quarter Daisy Award Winner: Tobe Robinson, RNFrom MIC for Extraordinary Nursing

Names UnitsDiane Folger BHUMichelle Lauer BHUPat Pannill BHUPatricia Sager BHUMirinda Wainwright Chavez BHUCharlotte Kosiek ICU/PCULovella Luceno Price ICU/PCUAlaina Orellana ICU/PCUKelly Taylor ICU/PCURebecca Caffney SSUMaeve Hession SSUDorene Kennard SSULisa Ward SSUColette Armstrong MSUSandy Baker MSUKelly Beagan MSUAlex Cameron MSUSteve Culp MSUKatie Ferguson MSUKaren Henry MSU

Names UnitsAaron Kauffman MSUKonnie Kenyah MSUHeather Mills MSUCourtney Patchell MSURegina Rahn MSUSimmie Shergill MSUJerri Barnett OBSBridget Kelly OBSAmanda Montgomery OBSKatie Truitt OBSDonna Baker PEDSHeather Seramone PEDSVanessa Thomas PEDSGeorgie Braywood MICKim Gentry MICTobe Robinson MICJamie Snyder MICMatthew Buker EDRae Ann Matherly EDAmanda Simpler ED

2015 2nd Quarter Daisy Award Nominees for Extraordinary Nursing

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Nominees for the 2015 Nurses Week Awards

Duct Tape Award (for being able to fix just about anything/flexible)

The Seamless Award (the nurse you would most like to follow

at change of shift)Alaina Orellana ICU/PCU Andrea Hall ICU/PCUDanielle Newby ICU/PCU Carolsue McBride SSUJen Tower Float Courtney Patchell MSUKayla Bines ED Jamie Rebman MICKevin Maloney BH Jamie Snyder MICKim Copen ICU/PCU Sarah Hufford ICU/PCULovella Lucero ICU/PCU Stephanie Montgomery ICU/PCUMelissa Ring OBS Heather Wilson EDRenee Funk - Winner SSU Doug Fields EDRobin Garrett MIC Michelle Shaffer EDSarah Leatherwood ICU/PCU Theresa Wharton EDShannon Barr EDTerry Perkins MIC

Smiley Award (most positive attitude)

Running of the Bulls Award (biggest risk taker/leadership qualities)

Brenda Blackiston MIC Jen Wade MICCathy Hauser MSU Jen Zingo WoundErin Dollard ICU/PCU Jessica Istvan EDGina Waithe Surgical Svcs . Katie Sanner EDJanet Bryant ICU/PCU Kerry Zellman MSUKay Hill Surgical Svcs . Khaira Mitchell ICU/PCUKelsey Benner Surgical Svcs . Nick Guida EDMichelle Shaffer ED Ralisha Grimsley SSUNancy Tuer MIC Sarah Leatherwood ICU/PCURachel Stave ICU/PCU Shannon Barr EDRalisha Grimsley SSU Shanti Baynard ICU/PCURobin Chaplin EDVicki Good ICU/PCU

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EBP Guru (most up to date with evidence based practice) Unit Clerk of the Year

Bill Hudson PPC April Blucher EDDoug Fields ED Beverley Bragg Surg . Svcs .Jen Zingo Wound Brenna Klacka EDRobin Billings AHI Danielle Newby ICU/PCUSimmie Shergill MSU Dawn Spalding Surgical ServicesTheresa Wharton ED Kim Buchanan ICU/PCUTobe Robinson MIC Missy Duncan MIC

Rachel Walpole BHRobin Garrett MICTheresa McKnight SSU

CNA of the Year Nurse of the YearAllisonmarie Reynolds ICU/PCU Bridget Kelly OBSAmy Trotto OBS Charlotte Kosiek ICU/PCUBunny Minter MSU Erin Van Dyke EDChrissie Hilaman MSU Erin Weaver BHDarlene Warland SSU Jamie Snyder MICDawn Chapman MSU Jamie Squitieri Surgical Svcs .Greg Betts Surgical Services Kathryn Sanner EDHolly Weiser SSU Kim Copen ICU/PCUJuliette Miller MIC Mat Buker EDJustin Carney ED Megan Grunert EDKristie Norman Surgical Services Melissa Cohen MSUNequila Bouldin ED Michelle Shaffer EDPaula Thomas ED Ralisha Grimsley SSURalph Fisher ICU/PCU Renee Funk SSUStephanie Maichle MIC Sandy Sweeney NPSuprema Brown MIC Sarah Leatherwood ICU/PCUTayonia Jordan (TJ) ICU/PCUVelvet Dant ED

Duct Tape Award – Renee Funk, SSU

Smiley Award – Brenda Blackiston, MIC

E.B.P. Guru – Tobe Robinson, MIC

Seamless Award – Andrea Hall, ICU/PCU

Running of the Bulls – Ralisha Grimsley, SSU

Bobbie Stone Education Award – Sarah Leatherwood, ICU/PCU

Unit Based Council Award – ED Unit Councils

Core Based Council Award – Communication Council

Unit Clerk of the Year – April Blucher, ED

C.N.A. of the Year – Amy Trotto, OBS

Nurse of the Year – Sarah Leatherwood, ICU/PCU

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Journey to UHCC Nursing FoundationThe development of our Vision Statement, our UHCC Professional Practice Model with Nursing Theorist, our UHCC Care Delivery System, and our Tagline began in a planning session attended by over 40 nurses prior to the 1st Annual UHCC Nursing Excellence Summit in April 2015 . The initial work was completed at the Shared Governance Retreat in December 2014 .

At the Retreat, teams of nurses depicted Models, Care Delivery Systems and Taglines in light of how they envisioned the relationship of each to our nursing organization . The top three Models, Delivery Systems, and Taglines were chosen by the frontline clinical staff, the Shared Governance leaders and the hospital nursing leaders . They were then presented in focus sessions led by a Taskforce created by the Professional Practice Council in the UHCC Shared Governance structure .

The Taskforce included Ralisha Grimsley BSN, RN from SSU; Nicole M . Klein, RN, BSN from MIC; and Kevin Maloney, RN from Behavior Health . It reviewed current nursing theorists and created schematics of the UHCC Professional Practice Models from the drawings created during the December Retreat .

Once the Taskforce selected the three nursing theorists, they presented their findings to the Professional Practice Council for review and approval . Hildegard Peplau, Ida Orlando and Virginia Henderson were the final three nursing theorists selected by the Taskforce, and upon approval the Professional Practice Council agreed to move forward on the focus sessions conducted by the Taskforce . Over 15 focus sessions were completed in special meetings, in town hall meetings and various other standing meetings .

Once the focus groups were completed the Professional Practice Council and the Chief Nursing Officer agreed to have the 1st Annual UHCC Nursing Excellence Summit in April 2015 . UHCC Nursing Excellence Summit was attended with nearly 70 nurses . Over 50 percent were Clinical Nurses from the bedside . The purpose of the summit was to have the final Vision Statement for PCS, the final UHCC Professional Practice Model supported by a Nursing Theorist, the final UHCC Care Delivery System and Tagline . The result of their efforts is as follows:

Tagline:

Compassionate Care … Every Patient … Every Time.

Vision Statement:

As members of the UHCC nursing team, it is our collective vision to create an environment of high quality

patient and family-centered care by fostering a culture of nursing excellence. With every patient, every time

nursing excellence is upheld by professionals through advocacy, leadership, empowerment, accountability

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and compassion throughout the organization and extending into the surrounding community.

UHCC Professional Practice Model:

Nursing Theorist:UHCC Professional Practice Model supported by Virginia Henderson’s Need Theory .

UHCC Care Delivery System: