Standard Rollout Process
Emergency Department Wellness Committee
6/3/2010
Mission Statement:
The overall mission of the Wellness Committee is to advocate and
build a healthier environment while increasing energy and
decreasing stress. To promote wellness and positive energy in a
holistic way by enriching those in our department.
The target implementation date is
set for June 1, 2010.
All staff working in the
Emergency
Department
Meet with
Stakeholders
Must Haves
( x ) Incorporate evidence based practice
( x ) Flow Chart Process
( x ) Identify metrics for evaluation
( x ) Identify who needs education on initiative
( x ) Assign Accountability and clear timeline
( x ) Develop plan for sustained success
( x ) Identify Methods of Content Delivery (Figure 1)
Perform
SWOT
Analysis
(Figure 1)
MUST PICK AT LEAST 7 WAYS FOR AT
LEAST 7 DAYS
Develop
Action Plan
DEBRIEF
Communicate
Plan
What Changes
need to be made?
Implement
Action Plan
( ) Webinservice
(X) Post metrics and measurements
( ) Spindle Report x 7 days
( ) Formal inservice to staff
(X) Electronic Communication
( ) Add to Annual Competencies
( ) Add to Initial Orientation
( ) Cover in Staff Meetings
(X) Cover in Unit Board Meeting
(X) Send out in Friday Communication
(X) Communicate to Physicians
(X) Post flyers on initiative in unit
(X) Recruit unit champions / product experts
from staff to promote initiative
(X) ED Newsletter
Adjust Action
Plan
©2009 Karin League & Brent Lemonds
Vanderbilt Medical Center
2/12/2016 Page 1
CURRENT STATE
GAP
FUTURE STATE
Emergency Department
Staff currently undergo high
levels of stress and
decreased energy levels
due to high patient acuity,
overcrowding, boarding
inpatients and Post
Traumatic Stress.
A healthier environment
with increased energy and
decreased stress. With
continued promotion of
wellness and positive
energy in a holistic way that
enriches those staff
members in our
department.
Due to multiple patient
conditions the department
frequently experiences foul
odors.
Minimized and decreased
foul odors within the
department through
diffusion of therapeutic
essential oils.
2/12/2016 Page 2
STRENGTHS
High level of staff interest to enhance
the environment and promote
wellness
Increase Energy
Decrease Stress
Eliminate Foul Odors
Promotes Further Education
Supports Vanderbilt’s Mission
Statement
Shows our ongoing commitment and
dedication to our staff
Increases Staff Wellness
Supported by Evidenced Based
Practice
Improves air quality by decreasing
airborne pathogens
Advantage of using Certified Pure
Therapeutic Grade Essential Oils
No synthetic/perfume additives
Unlikely risk of adverse effects
OPPORTUNITIES
Pilot Wellness initiative study with
measurable outcomes.
Furthering Education
Development of a Wellness Model
that can be used by other
departments
Fortifying relationships
Developing Leadership for staff
promotion
Staff Retention
Creates a more appealing place to
work
2/12/2016 Page 3
WEAKNESSES
Lack of Education and Understanding
Change of Mindset
THREATS
Closed Mindedness
Resistance to Change
Lack of Education and Understanding
Evidence Based Practice
Many hospitals are now incorporating the use of Essential Oils. For example,
Harris Methodist Fort Worth Hospital uses 33 different Therapeutic Grade
Essential Oils that are dispensed by their pharmacy. Studies show they relieve
stress and anxiety for patients and staff, findings also show they can reduce pain
and facilitate sleep for the patient.
HOSPITALS AND OTHER INSTITUTIONS EMPLOYING ESSENTIAL OILS: A SAMPLING
Desert Samaritan Medical Center – Mesa, Arizona
Fountain Valley Hospital – Fountain Valley, California
Orange Coast Memorial Hospital – Fountain Valley, California
Saddleback Medical Center – Laguna Hills, California
Midway Hospital – Los Angeles, California
Children’s Hospital and Health Center – San Diego, California
San Diego Hospice – San Diego, California
California Pacific Medical Center – San Francisco, California
O’Connor Hospital – San Jose, California
Aspen Valley Hospital – Aspen, Colorado
Memorial Hospital – Colorado Springs, Colorado
St. Anthony Hospitals, Centura Health – Englewood, Colorado
Gunnison Valley Hospital – Gunnison, Colorado
Griffin Hospital – Derby, Connecticut
St. Francis Medical Center – Hartford, Connecticut
Windham Community Memorial Hospital – Willimantic,
Connecticut
Holy Cross Hospital – Sunrise, Florida
Northside Hospital – Atlanta, Georgia
North Hawaii Community Hospital – Kameula, Hawaii
Advocate Good Shepherd Hospital – Barrington, Illinois
St. James Health and Wellness Institute – Chicago, Illinois
Advocate Healthcare – Oakbrook, Illinois
Deaconess Hospital – Evansville, Indiana
Riverview Hospital – Noblesville, Indiana
Memorial Health System – South Bend, Indiana
Charlton Health System – Fall River, Massachusetts
St. Luke’s Health Care System – New Bedford, Massachusetts
Morton Hospital and Medical Center – Taunton, Massachusetts
Tobey Health Systems – Wareham, Massachusetts
Barbara Ann Karmanos Cancer Institute – Detroit, Michigan
Bronson Methodist Hospital – Kalamazoo, Michigan
Mercy Hospital Group – Port Huron, Michigan
St. John’s Health – Warren, Michigan
2/12/2016 Page 4
Children’s Hospital – St. Paul, Minnesota
Regions Hospital – St. Paul, Minnesota
St. Peter Community Hospital – St. Paul, Minnesota
Woodwinds Health Campus – Woodbury, Minnesota
Barnes-Jewish Hospital – St. Louis, Missouri
St. Luke’s Hospital – Chesterfield, Missouri
Bergen Mercy Medical Center – Omaha, Nebraska
St. Rose Dominican Hospital – Henderson, Nevada
Wentworth-Douglas Hospital – Dover, New Hampshire
Cooper Hospital/University Medical Center-Camden, New Jersey
St. Barnabas Health Care System – Hackensack, New Jersey
Mountainside Medical Center – Montclair, New Jersey
Bellevue Women’s Hospital – Albany, New York
St. Peter’s Medical Center – Albany, New York
Northern Westchester Hospital Center-Mount Kisco, New York
Columbia Presbyterian Medical Center – New York, New York
Morgan Stanley Children’s Hospital – New York, New York
New York-Weill Cornell Children’s Hospital-New York, New York
Hugh Chatham Memorial Hospital – Elkin, North Carolina
Iredell Memorial Hospital – Statesville, North Carolina
Children’s Hospital Medical Center – Akron, Ohio
Highline Community Hospital – Burien, Washington
Elmbrook Memorial Hospital – Brookfield, Wisconsin
Alliance Community Hospital – Alliance, Ohio
Cleveland Clinic Health System – Chagrin Falls, Ohio
UHHS Bainbridge Health Center – Chagrin Falls, Ohio
University Hospitals’ Health System – Cleveland, Ohio
Mercy Health Center – Oklahoma City, Oklahoma
Harris Methodist Fort Worth Hospital-Fort Worth, Texas
St. Charles Medical Center – Bend, Oregon
Mid-Columbia Medical Center – The Dalles, Oregon
Elk Regional Health Center – Elk, Pennsylvania
St. Peter’s Hospital – Jeanette, Pennsylvania
Windber Medical Center – Windber, Pennsylvania
References
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Carson, C.F., Hammer, K.A., and T.V. Riley. “Melaleuca alternifolia (tea tree) oil: A review of antimicrobial and other
medicinal properties.” Clinical Microbiology Reviews 19, (2006): 50-62.
Faoagali, J., George, N., and J.F. Leditschke. “Does tea tree oil have a place in the topical treatment of burns.” Burns 4,
(1997): 349-51.
Carson, C.F., Cookson, B.D. et al. “Susceptibility of methicillin-resistant staphylococcus-aureus to the essential oil of
melaleuca-alternifolia.”Journal of Antimicrobial Chemotherapy 35, (1995): 421-4.
Klevens, R.M., Morrison, M.A., et al. “Invasive methicillin-resistant staphylococcus aureus infections in the United States.”
Journal of the American Medical Association 298, (2007): 1763-71.
Warnke, P.H., Becker, S.T., et al. “The battle against multi-resistant strains: Renaissance of antimicrobial essential oils as
a promising force to fight hospital-acquired infections.” Journal of Craniomaxillofacial Surgery, May 25, 2009.
Caelli, M., Porteous, J., et al. “Tea tree oil as an alternative topical decolonization agent for methicillin-resistant
staphylococcus aureus.” Journal of Hospital Infection 46, (2000): 236-7.
Lehrner, J., Marwinski, G., et al. “Ambient odors of orange and lavender reduce anxiety and improve mood in a dental
office.” Physiology and Behavior 86, (2005): 92-5.
Field, T., Field, T., et al. “Lavender bath oil reduces stress and crying and enhances sleep in very young infants.” Early
Human Development 84, (2008): 399-401.
Spirling, L.I., and I.R. Daniels. “Botanical perspectives on health peppermint: more than just an after-dinner mint.” The
Journal of the Royal Society for the Promotion of Health 121, (2001): 62-3.
Kite, S., Maher, E., et al. “Development of an aromatherapy service at a cancer centre.” Palliative Medicine 12, (1998):
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Maddocks-Jennings, W., and Jenny M. Wilkinson. “Aromatherapy practice in nursing: literature review.” Journal of
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Baratta, M.T., Dorman, H.J., Stanley, G.D., et al. “Antimicrobial and antioxidant properties of some
commercial essential oils.” Flavour and Fragrance Journal 13 (1998): 235-44.
Nakamura, A., Fujiwara, S., Matsumoto, I., et al. “Stress repression in restrained rats by (R)-(-)-Linalool
inhalation and gene expression profiling of their whole blood cells.” Journal of Agricultural and
Food Chemistry 57, no 12 (2009): 5480-85.
Warnke, P.H., Sherry, E., et al. “Antibacterial essential oils in malodorous cancer patients: clinical observations in 30
patients.” Phytomedicine 13, (2006): 463-7.
Eccles, R., Griffiths, D.H., et al. “The effects of D and L isomers of menthol upon nasal sensation of airflow.” The Journal
of Laryngology and Otology 102, (1988): 506-8.
Warnke, P.H., Becker, S.T., et al. “The battle against multi-resistant strains: Renaissance of antimicrobial essential oils as
a promising force to fight hospital-acquired infections.” Journal of Cranio-Maxillofacial Surgery 37, (2009): 392-7.
Brady, A., Loughlin, R., et al. “In Vitro activity of tea-tree oil against clinical skin isolates of methicillin-resistant and
sensitive Staphylococcus aureus and coagulase-negative staphylococci growing planktonically and as biofilms.” Journal of
Medical Microbiology 55, (2006): 1375-80.
Caelli, M., Porteous, J., et al. “Tea tree oil as an alternative topical decolonization agent for methicillin-resistant
Staphylococcus aureus.” Journal of Hospital Infection 46, (2000): 236-7.
Groves, Bob. “Healing’s Sweet Scent.” The Record August 1, 2006.
Edwards-Jones, V., Buck, R., et al. “The effect of essential oils on methicillin-resistant Staphylococcus aureus using a
dressing model.” Burns 30, (2004): 772-7.
Warnke, P.H., Sherry, E., et al. “Antibacterial essential oils in malodorous cancer patients: Clinical observations in 30
patients.” Phytomedicine 13, (2006): 463-7.
Bagg, J., Jackson, M.S., et al. “Susceptibility to Melaleuca alternifolia (tea tree) oil of yeasts isolated from the mouths of
patients with advanced cancer.” Oral Oncology 42, (2006): 487-92.
Hammer, K.A., Carson, C.F., et al. “Antimicrobial activity of essential oils and other plant extracts.” Journal of Applied
Microbiology 86, (1999): 985-90.
Kivanc, M. and A. Akgul. “Antibacterial activities of essential oils from Turkish spices and citrus.” Flavour and Fragrance
Journal 1, (2006): 175-9.
Wheeler, Jo L., “The Science and Art of Aromatherapy.” Journal of Holistic Nursing 17;5 (1999).
2/12/2016 Page 5
Vanderbilt Wellness Committee
Essential Oil Protocol
All Staff working within the
Emergency Department will be
able to seek a member of the
wellness committee to access the
therapeutic essential oils for use.
TOPICAL
INGESTION
DIFFUSION
Direct Application, Reflex
Therapy and AromaTouch
Therapy with Essential Oils
available for multiple uses.
GRAS (Generally recognized
as safe for human
consumption) Essential Oils
available for multiple uses.
Essential Oils will be diffused
throughout the department.
Air Freshening Protocol will be
initiated for foul odors.
Wellness Committee Essential Oils Usage Guidelines
1. Essential Oils will be available for staff use only. They are not for
patient use.
2. Members of the Wellness Committee will access the Essential Oils
for employee use.
3. Staff participation is voluntary.
4. Essential Oils are provided for use in the workplace, not for
employees to take home.
5. Essential Oils are donated to the Emergency Department, they are
not for purchase.
6. There will be an air freshening protocol when there is a foul odor.
2/12/2016 Page 6
Identify metrics for evaluation:
-Enhance the workplace environment.
-Increase energy.
-Decrease Stress.
-Decrease foul odors in the department.
Identify who needs education on initiative:
Wellness Champions
Wellness Committee members
Staff
Physicians
Assign accountability and clear timeline:
Action
Person Assigned
Timeline
Status
Initial Meeting with Brent
Lemonds, Administrative
Director, Emergency
Services
Tonya McBride, Teresa
Sturges
April 15, 2010
Completed
Meet with Dr. Ian Jones,
Medical Director, Adult
Emergency Services
Tonya McBride, Teresa
Sturges
April 15, 2010
Completed
Meeting with Dr. David Hill,
Chief Medical Advisor,
Chairman; Scientific
Advisory CommitteedoTerra International, Dr.
Ian Jones and Brent
Lemonds
Tonya McBride, Teresa
Sturges, Candise Hillman,
Ali Grubbs, Dawn Hawley,
Ruthie Curbow.
May 11, 2010
Completed
Initial Wellness Committee
Meeting
Tonya McBride, Teresa
Sturges, Candise Hillman,
Ali Grubbs, Ruthie
Curbow. Dr. David Hill
May 11, 2010
Completed
2/12/2016 Page 7
Action
Person Assigned
Timeline
Status
Meet with Janice Sisco,
Manager Adult Emergency
Department
Tonya McBride, Teresa
Sturges
May 13, 2010
Completed
Identify and Recruit
Committee Members and
Super-users
Tonya McBride, Teresa
Sturges, Dawn Hawley,
Candise Hillman, Ali
Grubbs
May 13, 2010
Completed
Electronic communication to
update the Wellness
Committee members
concerning current progress
and rollout timeline
Tonya McBride, Teresa
Sturges
May 15, 2010
Completed
Development of Wellness
Committee mission
statement, Standard Rollout
Process and SWOT
Analysis
Tonya McBride, Teresa
Sturges, Candise Hillman,
Ali Grubbs, Morgan Vero,
Lauren McCartney, Diana
Alward, Ruthie Curbow.
May 19, 2010
Completed
Draft of The Standard
Rollout document
Tonya McBride, Ali
Grubbs
May 19, 2010
Completed
Development of PowerPoint
Presentation introducing
The Wellness Committee
Tonya McBride, Teresa
Sturges
May 24, 2010
Completed
Unit Board Presentation
Ali Grubbs
May 25, 2010
Completed
Potty News Flyers
Teresa Sturges, Tonya
McBride
May 26, 2010
Completed
Secure location for monthly
Wellness Committee
meeting
Tonya McBride, Alma
Catlin
May 27, 2010
Completed
Introduction of Wellness
Committee through Friday
Communication
Janice Sisco
May 28, 2010
Completed
2/12/2016 Page 8
Action
Person Assigned
Completion of Final Draft of
The Standard Rollout
Document.
Tonya McBride, Teresa
Sturges, Candise Hillman,
Ali Grubbs
June 3, 2010
Completed
Education of basic Essential
Oil Use to all Wellness
Committee members
Tonya McBride, Teresa
Sturges
June 4, 2010
Pending
Electronic Communication
to all staff introducing The
Wellness Committee with
PowerPoint Presentation
attachment
Tonya McBride
June 4, 2010
Pending
Begin data collection,
surveying staff for a period
of 2 weeks prior to going
live, to establish
measurable outcomes
Survey Task Force
June 7, 2010
Pending
Go live with essential oil
usage/diffusion
Wellness Committee
Members
June 21, 2010
Pending
Feature Wellness
Committee in ED Newsletter
Diana Alward
June 30, 2010
Pending
Continue data collection
with post survey, to
establish measurable
outcomes
Survey Task Force
July 31, 2010
Pending
Debrief and adjust action
plan
Wellness Committee
Members
July 23, 2010
Pending
2/12/2016 Page 9
Timeline
Status
Development for Sustained Success
Monthly Wellness Committee meetings that will include
educational training.
Establish Wellness Committee guidelines for proper use of
Essential Oils.
Pilot Wellness initiative study with measurable outcomes to
structure a beneficial wellness program.
Monthly educational updates for staff.
Committee Members will be available as a resource to staff.
An Essential Oil Formulary will be readily available in the
department.
Debrief and adjust action plan based on measured outcomes.
2/12/2016 Page 10
DIFFUSION
Identify Methods of Content Delivery: See figure 1 for summary.
Change Theory:
Stetler Model TheoryThis theory integrates Evidenced Based Practice with research.
There are five phases: 1) Preparation
2) Validation
3) Comparative evaluation and decision making
4) Translation and Application
5) Evaluation
http://74.6.239.67/search/cache?ei=UTF-8&p=Stetler+Model+Theory&fr=yfp-t152&u=courseweb.edteched.uottawa.ca/nsg6133/Course_Modules/Module_PDFs/StetlerMarram.pdf&w=stetler+model+theory+theories&d=DwzyEd29TeE2&icp=1&.intl=us&sig=gA
rTsgbpYybXu1qZMKbNfw--
Knowledge Translation
-provides a framework that may be helpful in considering the challenges that clinicians are likely
to face when attempting to implement evidence based practice.
- exchange, synthesis, and ethically sound application of knowledge within a complex system of
interactions among researchers and users to accelerate capture of the benefits of research.
Rogers Diffusion of Innovations-Behavioral theory that describes the process the user goes through in the adaptation/rejection
of new ideas, practices, and technology.
2/12/2016 Page 11