SVMH

Issue 3, Summer 2006

Words of Wisdom
Benjamin Disraeli

Nurse
Performance Improvement Initiatives
Medication Safety Team The multi-disciplinary Medication Safety Team (MST) includes 36 members who represent nursing leadership, educators, all nursing units, pharmacy, respiratory therapy, and physical therapy as an ad hoc member. The MST was originally chartered in 1992 under the leadership of Anne Robinson, BSN, Director of Quality Management, and Bob Johnson, former Director of Pharmacy. In response to growing patient safety concerns and the JCAHO medication safety standards of 2004, the MST was restructured in January 2006. Today, all disciplines involved with medication use processes are part of the team, chaired by Terry Pettitt, the Director of Pharmacy and facilitated by Sherry Herbert, BSN, Pharmacy/QMS PI Coordinator. The charter and purpose of the team is to improve the safety of the medication use process while reducing the potential for medication errors. PI representatives, listed here, completed training in data collection, statistical methods, analysis of results, and development of strategies to improve medication use processes. Each quarter, the Team measures the effectiveness of medication safety initiatives in the prescribing, ordering, transcribing, preparing and administration processes. The team also analyzes medication errors for patterns, trends and root causes in order to implement improved medication use processes. The MST plays a critical role in improving patient safety measures as they relate to medication use, but it takes everyone involved to make it a true success. If you have any questions about the Medication Safety Team, please contact Sherry Herbert at extension 2753. Performance Improvement Representatives
Mark Augustin Deb Avilez Chad Christer Nancy Groebli Maria Gutierrez Andrea Huston Luz Jimenez Karina Kessler Glorinda Pastorius Debbie Ralph Hal Rightmeyer Teresa Salah Sandy Samoske Suzette Urquides MSR PACU RT MSCV HC/HCHA Float Pool SRMC NICU ICU/CCU, Level II, 4/5 Tower Pediatrics ED/CDU CCC Surgery Cath Lab

Action may not always bring happiness; but there is no happiness without action.

Inside this issue

Magnet Update . . . . . . . . . . . . . . . . . . . . . . . . 2 Whats New . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Personal Fitness and Well-Being . . . . . . . . . . 3 Nurses in Profile . . . . . . . . . . . . . . . . . . . . . . . 4 Welcome New Nurses . . . . . . . . . . . . . . . . . . . 4 Nurses in Education . . . . . . . . . . . . . . . . . . . . . 5 Status Board . . . . . . . . . . . . . . . . . . . . . . . . . . 6 FAQ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Nurses in Life . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Department Focus . . . . . . . . . . . . . . . . . . . . . . 8

SVMH Nurse is a quarterly publication

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Magnet Update
Four of us were proud to represent you at the National Magnet Conference in Miami in March. Agnes Lalata, RN, BSN, Director of 3rd Floor, Diane Mesiroff, RN, AHN, Comprehensive Cancer Center, Vivian Waters, RN, MPA, Nursing Administrative Supervisor and I joined 2,000 nurses from around the U.S. The conference featured presentations by nurses from Magnet hospitals and a variety of general and break-out sessions. Seven hospitals, including El Camino Hospital, Mountain View, were recognized for earning Magnet status this year. We not only came away with great ideas, but are even more enthusiastic, and confident, about achieving Magnet status. It was rewarding to compare our hospital to others seeking or at Magnet status and to see that, in many aspects, were already there!

Nurse
levels to have a greater voice in the decision-making process. We also learned about Magnet Partners, a program we have since implemented here. Partners embrace the Magnet ideals and philosophy as they act as information liaisons for other nurses, serve on committees where nursing needs representation, attend in-services on the Forces of Magnetism, and are role models who live the Forces. Our new Partners are: Esther Bronson, RN, NICU; Kathy Finnigan, RN, AHN Float Pool; Olga Monarrez, RN, Endo; Tanya Osborne-McKenzie, RN, ICU; Debbie Ralph, RN, Peds; and Michele Savala, RN, SRMC. If youre a RN and want to be a Partner, call Betsy Mount, RN, ext. 2072, Kate Chilkott, RN, ext 2072. or me. The Magnet Steering Committee welcomed new members: Jamie Bodenheimer, RN, MSON; Frances Bullman, RN, OR; Luz Jimenez, RN, SRMC; Lori Mendoza, RN, AHN Endo; Jose Monarrez, RN, ICU; Debra Reid, RN, Case Management; Normita Reyes, RN, SSOP; Suzette Urquides, RN, Cath Lab; and Kirsten Wisner RN, SRMC. While theres always work to do in attaining Magnet status, we very proud of each of you for your leadership, commitment and involvement that has brought us so far so quickly. Any time you have suggestions, questions or want to get more involved, please let me know. Doreen Faiello, RN, MHA
Senior Administrative Director Patient Care Services, Support Services Magnet Project Coordinator Extension 3217, Pager 772-1234

It is my distinct honor to serve as Magnet Coordinator and Chair of the Magnet Steering Committee. So many things have happened since the last issue of SVMH Nurse and heres a brief update.

One idea that was really exciting, from Alaska Medical Center, is the role of President of Nursing. The President is a staff nurse, elected by his or her peers, to represent them at the Nursing Leadership Forums. This enables staff nurses at all

Whats New
Barcelona nurses visit SVMH In response to a growing need in Barcelona hospitals for nurses with advanced management and supervisory skills, Gail Pieper, RN, MSN, Senior Administrative Director, Patient Care Services; and Judy Snyder, RN, C, MS, Director, Education and Patient Care Systems, spearheaded this innovative program. Two nurses from Barcelona, SpainAna Miguel Prieto and Juan Jos Sanchez Requenabegan a two-week educational and mentoring experience May 1. Ana and Juan were paired with mentor Rosa Gonzalez, RN, Assistant Head Nurse in Medical/Surgical/Cardiovascular. It was a wonderful experience for all of us, says Judy, and we hope to do it again in the future.

Left: Ana Miguel Prieto, RN (left) and Juan Jos Sanchez Requena, RN (right) with Rosa Gonzalez, RN.
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Words of Wisdom
When a team outgrows individual performance and learns team confidence, excellence becomes a reality. Joe Paterno

Personal Fitness and Well-Being

Eating for Energy As health professionals, we understand the importance of healthy eating. But, understanding doesnt always make it so. Busy schedules, family commitments, long shifts and challenging days, can cause even the strongest of us to slip off the nutrition wagon. Not to mention leave us with little, if any, energy to spare. Here are a few tips that just might help. Eat like an athlete If you need to fuel up for a demanding shift, carbohydrates provide a good dose of energy. Before a marathon, tennis match or basketball game, athletes stock up on carbs to get them through. Try a meal or snack that includes pasta, pancakes, potatoes or whole grain bread. Feast on fruits For a quick boost of energy, grab fruits that are high in natural sugar, and as a bonus, have no fat. Yummy bananas, grapes, strawberries, melon and raisins can really pack an energy punch. Pay attention to potassium Lack of potassium can increase fatigue. If youve been active, especially when youve perspired heavily, take a minute to replenish potassium. Try apricots, cantaloupe, oranges, or the trusty banana.

First CIDR Fest held in March The teams of the Clinical Interdisciplinary Documentation Redesign (CIDR) project are tasked with rebuilding our patient documentation system. Our first CIDR Fest, held March 29, helped increase awareness of Project CIDR and the six teams, each tasked with a different focus. Teams include: Documentation, Auditing and Testing, Education and Communication, Device, Reporting, and Systems Integration. An overwhelming majority of team members (80 percent!) are staff nurses. Each team ran a booth that showcased information on team leaders and members, specific goals and highlights of projects initiated to date. One-page descriptions were distributed to the 186 participants. An overview of Project CIDR was followed with presentations by each team and a question and answer session. CIDR Fest was considered a huge success by everyone involved.

Alaris PCA PumpsNurses go the extra steps The new Alaris PCA (patient controlled analgesia) pumps required an extra step to limit the maximum dose for one hour. We launched an internal information campaign to ensure that all nurses took the extra step required. When completing data set changes in April, we saw that 100 percent of our nurses had complied. You cant ask for better than that. We are so proud of our nurses for once again, making patient safety a priority.

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Welcome New Nurses
Kimberly Brown, Critical Decision Unit Andrea Bentson, ER Caroline Cockburn, ER Deborah Lomanto, ER Sharon McCoy, ER Maria Ramirez, ER Jason Patterson, ER Randall Yates, ICU Bernadine Safi, SRMC Leslie Francisco, Level II Emmanuel Ruiz, Level II Kimberley Henry, Level II Marian Fox, Med Surg Shauna Maloney, Med Surg Amanda Dziurda, Med Surg Charina Carpio, Med Surg Jamie-Lynn McLean, Med/Surg Rehab Cynthia DiTomasso, Med/Surg Rehab Antionnette Mapa, Med/Surg Rehab Anna Santos, Med/Surg Rehab Min Li, Med Surg Shumin Ning, Med Surg Ulysess Serafica, Med Surg Sigrid Stokes, Mother/Baby Josephine Kocher, Mother/Baby Patricia Hornbeck, Mother/Baby Cheryl Tabin, Mother/Baby Lydia Newton, Outpatient Bernadette Lucas-Burch, Radiology Shanna-Lee Monto, Surgery Welcome to the nurses who have joined our staff over the past few months.

Nurse
Nurses in Profile
Shawna Helmuth, RN III, IBCLC Director of Lactation Services Shawna Helmuth, RN, this years Nurse of the Year, joined the hospitals nursing staff in June 1988 shortly after graduating from MPC. Starting out on the second floor in gynecology, she transferred to labor and delivery as soon as an opening became available. There, she was cross-trained to work in labor and delivery, GYN and OB operating and recovery. I love families, birth, labor and delivery, says Shawna. Facing my own challenges with breast feeding after the birth of my first child, I wanted to help other moms. And she dedicated herself to that effort. She completed the Certified Lactation Educator program through UCLA in 1994. Lactation became even more important to me so I completed the process and became an International Board Certified Lactation Consultant in 2000. To me, this certification is as important as my nursing degree. The Lactation Services Program was launched in 2002 and Shawna is now its director. In addition to working with mothers in the hospital, she facilitates a weekly support group and serves as a trainer and consultant to physicians, nurses and other staff. She has participated in the Monterey County Healthy Mothers Healthy Babies Breast Feeding Promotion Committee Facing my own challenges with since 2000 and has been the co-chair for nearly two years. breastfeeding after the birth of my first The community-wide effort involves well over 200 people child, I wanted to help other moms. dedicated to promoting breast feeding in Monterey County. She is also spearheading an effort to gain a Baby Friendly Hospital designation for Salinas Valley Memorial, a designation held by only 55 hospitals in US. In July 2005, Salinas Valley Memorial received its Certificate of Intent acknowledging a commitment to promote and protect breast feeding and attachment for women and families who deliver at our hospital. Women, especially first-time mothers, need support and information, says Shawna. When they have questions, we want to help them find the answers so they can be confident and successful in breast feeding their babies.

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Salinas Valley Memorial nurses Chris Davis, RN, (center) and Angela Rahn, RN (right) demonstrate proper equipment use during the recent training session.

Nurses in Education
Nurses take lead in patient and EMT education Our nurses not only provide excellent beside and outpatient care for our patients, they help them understand and prepare for treatment and recovery. And they share their knowledge and expertise with other medical professionals who can help improve outcomes. In this issue of SVMH Nurse, were featuring a training session held for EMTs/Paramedics in transporting critically ill and premature infants to our NICU. Were also highlighting some of the patient education efforts spearheaded by our nursing staff. Several paramedics and EMTs from throughout Monterey County participated in the half-day session held in February. Coordinated by Dr. Susan Johnson, Director of WESTMED Ambulance, the program was one of the monthly training sessions that target these professionals. After Greg Glasscock, MD, PhD, a Stanford neonatolgist on our medical staff, presented information on the physiology of these tiny patients, Sharon Roberts, RNC, MSN, CNS, Director of the NICU, Rose Maniwang, BSN, RNC, Assistant Clinical Director, and Karina Kessler, BSN, RN Assistant Head Nurse, along with several other NICU nursing staff, led hands-on demonstrations in life-saving techniques. The NICU staff showed them how to keep infants dry and warm, perform chest compressions, put in a line and use a bag mask. All of these functions are critical to stabilizing the baby while in transport to the hospital. The NICU also reviewed items that could be assembled in a kit and carried on ambulances. The kit includes items, specialized for infants, such as sterile drape-bags that keep babies warm and dry, resuscitation medications, lines, masks and syringes. The kit serves the same purpose as a crash cart. It keeps all the critical materials in a single, easy-to-access place. Participants were very enthusiastic about the training and plan to start creating and using these kits.

Words of Wisdom
Most of our obstacles would melt away if, instead of cowering before them, we should make up our minds to walk boldly through them. Orison Swett Marden

Here are highlights of some of our nurse-led patient education programs: As part of our Comprehensive Cancer Centers Breast Care Program Carol Maynard, RN, ONC, a Breast Health Specialist, meets with newly diagnosed breast cancer patients and helps them through the treatment and recovery process. Joint Replacement Orientation. Sylvia Woody, RN, ONC, Rebecca Pullen, RN, ONC, and Amanda McDougall, RN provide information to patients who are scheduled for joint replacement surgery, covering what will happen during their hospital stay. Lactation education is provided by Shawna Helmuth, RN III, IBCLC. She works with mothers in the hospital, facilitates a weekly support group and serves as a trainer and consultant to physicians, nurses and other staff. Through our Wound Care Program, Clinical Manager Chris Cagle, RN, BSN, Marcy Klein, RN, Kimmy Kemp, RN, Carolann Barsotti, LVN, and Janet VerVaecke, RN, MBA provide education to patients regarding prevention and treatment of wounds. In Cardiac Rehab Shirley Chung, RN, MA, and Shirley Brown, RN, teach patients how they can manage and improve their health through exercise, diet and lifestyle changes.

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Status Board patient care information at your fingertips

In November 2005, Tricia Dixon, RN, Helen Jewell, RN and Rita Cabaccang, RN, BSN, Nurse Infomatics, spearheaded the launch of an exciting tool for nursing staff. A Meditech program, the Status Board is essentially an electronic patient care management system. Several functions are already in place, and others will be added over the coming months. Currently, with a single password-protected log-in, nurses can access information including patient name, age, gender, location, doctors, lab results and diet. From that screen, users can go to other areas of the Meditech system to access nurses notes, process intervention, review orders that a unit assistant has entered, and view vital signs as well as intake and output over the previous 24 hours, or other selected timeframe. Nurses can create their own lists of patients or search by a specific unit. The data is automatically updated every thirty seconds, highlighting results that havent yet been read. The system is designed so that charge nurses view information on all of their units patients and bedside nurses can form lists of patients in their care. So whats next? Physician orders and medications as well as monitor interface for Level II, Heart Center, ICU and Towers. Stay tuned.

Nurse
FAQ

If you have a question you would like answered in a future issue of SVMH Nurse, please send a MOX to any member of the Magnet Steering Committee.

Q: Are patient rooms air conditioned? A: The corridors and nurse stations on 2, 3 and 5 Main have air conditioning, but the patient rooms do not. The entire 4 floor
th

(Main and Tower) has been air conditioned since it was remodeled about seven years ago. However, cooler air from the corridors gets pushed into patient rooms. All areas of floors 2, 3 and 5 in the Towers are also air conditioned. As major construction is performed in the future, climate controlled/air conditioning will be added.

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Words of Wisdom
Proceed upon the fact that nothing is too difficult for you to accomplish. Vernon Howard

Nurses in Life
Connie Rose, RN

I went for the adventure, thinking it would be a one time thing. But, I got hooked.
My first mission to Guatemala was in 1991, with Hospital de la Familia, a group that originated in the Bay area, says Connie Rose, RN. I went for the adventure, thinking it would be a one time thing. But, I got hooked. Since then, she has volunteered on more than two-dozen missions to Guatemala as well as Ecuador, Peru, Argentina and other Central and South American countries. In 1996, just after her son left home for college, Connie decided to leave home too. She sold her house, put her belongings in storage and left for Guatemala, where she lived and volunteered for a year with a Child Sponsorship Program. Soon after coming home, she turned around and went back for another year. Graduating from the nursing program at Baltimores Johns Hopkins Hospital in 1972, Connie Rose, RN worked in hospitals in California over the years. She joined Salinas Valley Memorial in 2003 and worked at the Joyce Wyman Outpatient Surgery Center. Today, she is a staff nurse in Diagnostic Imaging. Im honored to be able to use my Spanish and my OR nursing skills on missions with opthomologic, orthopedic, GYN and ENT surgeons, says Connie. For many people, this is their only chance to have these procedures and theyre so appreciative. Its both humbling and inspiring. Connie Rose, RN, on a 2004 Interplast (Rotarys partnership with plastic surgeons) mission to Peru. When stateside, she devotes much of her time securing supplies and preparing for missions. Ending a mission is a bit sad because the need continues, says Connie, but I know there will always be another trip. I just have to keep supporting my habit by working.

Q: When a forced cancellation is necessary, how do Q: If I reduce my hours before I retire,would I lose my pension benefits? you determine who gets cancelled first? A: Heres how retirement benefits are calculated: Years of credited service in an eligible category (full-time A: Based on patient census and the needs of each unit, Each Plan year that you are a participant in the Plan and are or part-time);
the administrative supervisor determines if additional nursing staff is needed for a shift. Forced cancellation, a cancellation made by SVMH rather than the nurse, is based on position, years of service and the cluster to which they belong. For more information, please refer to the California Nurses Association contract. credited for a minimum of 1,000 paid hours in a benefited status, you would be eligible for a full year of service. To be eligible for apension benefit at age 65, which is the normal retirement age,you must have satisfied 10 years of service with the hospital. The monthly payment you would receive at retirement is based on:
Earnings history; Age at retirement; and Selected payout option.

For more information contact Gladys Gaboury, Vice President of Human Resources at 755-0759.


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Department Focus
Float Pool It takes a nurse with a sense of adventure, adaptability, a dedication to patients and the love of a good challenge to work in the Float Pool, says Kathy Finnigan, RN, AHN, Float Pool. They have to meet the minimum competencies for every unit they work in and tend to be very strong in their skill sets. The forty-nine-member team includes RNs, LVNs, CNAs and unit assistantssome full-time and others per diem. The majority of Float Pool staff is assigned to specific clusters and specialized within those units. Three RNs in the Float Pool including Molly McCarty, RN, BSN, PHN who was working Float before the official nursing unit was establishedare trained and qualified to work in all clusters. The Float Pool provides a unique opportunity for nurses to experience various clusters and units of the hospital before they make a commitment to a specific area. They also experience different aspects of nursing and tend to progress through the system from CNA and LVN to RN, while others go on to earn advanced nursing degrees. At this time, six of the Float Pools CNAs and one unit assistant are enrolled in nursing programs, three LVNs are in RN programs and two RNs are in a BSN program. Members of the Float Pool have a unique perspective, says Kathy. Because they travel between units and clusters, they see how documentation and other changes might impact on and work in multiple areas. Theyre also well positioned to see how systems that work in one area might benefit another. Theyre a real asset to our hospital. The Float Pool, half of which is comprised of per diem employees, covers all three eight-hour shifts. Typically, staff calls in or stops by thirty minutes prior to the start of the shift to receive an assignment. Every day is an adventure, says Kathy. Were proud that we have so many talented and responsive members of this vital nursing unit.

Words of Wisdom
Whether you believe you can do a thing or not, you are right. Henry Ford

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