Strong
NURSING
Annual Report 2007
contents
Pillars of Excellence
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Service
Quality
People
Finance
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Growth . . . . . . . .
Systems . . . . . . . .
Awards . . . . . . . .
Publications/Presentations
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21
I would like to take this opportunity to recognize the excellence of
nursing practice at the University of Rochester Medical Center.
Each day nurses strive to achieve the extraordinary. Working
together with other members of the health care team, nurses have
made exceptional progress in realizing improvements in our
quality and safety agenda that ultimately benefit the way
we provide care for patients and families. Throughout the
institution, Strong Nurses have played leadership roles
in several high-impact strategic initiatives. These
remarkably successful initiatives include the clinical
documentation pilot project, recertification by the
Joint Commission, completion of the renovation
of three critical care areas, expansion of the ED
Observation Unit - 2, and introduction of the unitbased safety nurse initiative.
The dedication and commitment of our nurses to
patients and their families is unparalleled. It is a
privilege to work with nurses and other members of the
patient care team, who at all times, place the patient first
and demonstrate genuine caring on a daily basis. During 2007,
Strong Memorial Hospital achieved a significant increase in our
patient satisfaction scores to the 63rd percentile. We are well on
our way to achieving our goal of reaching the 90th percentile as a
result of the superb efforts of our nursing leadership and direct care
staff. The contributions of our nurses continue to generate
advances in the delivery of nursing care as evidenced by the
refinement of our professional practice model, the many
accomplishments of the Professional Nursing Council and the
scholarly productivity of the Clinical Nursing Research Center.
This has been an exciting and productive year and the coming
months will bring additional challenges and opportunities. The
University of Rochester Medical Center's 2007-2012 strategic plan
provides a blueprint for transforming the medical center into a
nationally respected magnet for research, teaching, patient care and
community service.
We are fortunate to work in an environment where nursing vision,
creativity and innovation are integral elements of clinical practice.
As you review the many individual and collective accomplishments
of the past year, I know you will be as proud as I am of the
excellent work that is accomplished on a daily basis by Nursing at
the URMC.
Pat Witzel
Associate Vice President, Chief Nursing Officer
2
Service
Building a Culture around Service
In 2007 Ambulatory Care Service Nurse Leaders
continued working on creating a culture of service
excellence. This leadership group developed a 10 question
comment card survey to provide real-time input from
patients to ensure the Ambulatory Service Areas were
meeting customer expectations. The customer comment
cards contain 10 key questions from the outpatient Press
Ganey survey and are administered at the unit level once
or twice monthly. This began in March of 2007.
The results of the comment cards are reviewed by area
leadership with any issues of concern to patients identified
and addressed. Positive patient feedback, as well as issues
requiring improvement are regularly communicated with
faculty and staff and posted in work rooms/break-rooms
for all to review.
Ambulatory Patient Comment Cards showed that
overall satisfaction with the visit was at 90% or greater
with the exception of wait times for the exam rooms/
provider (in the 85-90% range for the majority of our
areas). A plan was put in place to keep customers
informed about the status of delays every 15 minutes from
the point of check in and to ensure that service recovery
protocols were being utilized. Managers also began
rounding regularly with staff and patients, to facilitate
problem solving. The goal is to respond rapidly and
effectively to keep patients informed of delays and create
a more customer friendly experience for patients while
they are here for visits or procedures. Progress has been
made, and there are continued efforts to identify and
address the issues that lead to delays for our patients.
Cardiac Rehab Team
3
Strong Surgical Center Nursing Staff
Professional Image Committee Update
The Professional Image Committee was formed to examine
the ways in which nurses are recognized and how they are
perceived by patients and families, as well as by other
members of the health care team.
A secondary goal was to gain knowledge of how nurses
themselves feel about their attire and how their attire relates
to their professional image.
Participating units include 6-1600 Transplant, 7-1600
Cardiovascular ICU, 6-3600 Trauma, 8-3400 Respiratory
Step-Down, 4-1600 Pediatric General Care and SSC, Strong
Surgical Center. Nurses on these pilot units were asked to
participate in a six month trial of wearing specific colors of
scrub uniforms (combinations of white, black, and khaki).
A set of complimentary scrub uniforms in the pilot colors
was provided to each nurse on the participating units at no
cost. At the end of the 6-month period, nurses will respond
to such questions as:
■ How easy was it for you to recognize the nurse
from other people who provided care on the
pilot unit (6-36, 8-34, 7-16, 4-16, 6-16 or SSC)?”
■ “What could have been done to make Strong
Nurses appear more professional in the way
they dressed? (List all).”
Patients and families will also be interviewed to get their
feedback about the uniform pilot.
Results will provide the Professional Image Committee
with insight related to both nurses’ and non-nurses’
perceptions of professional attire, professional image, and
identification of nurses by others.
The committee has benchmarked with other Magnet
institutions on nursing staff attire related to patients’ ability
to easily identify nurses. This information, along with staff
nurse input, will provide knowledge on perceptions of
nursing professionalism, and nursing attire preferences and
identification of nurses by our patients.
The Wilmot Cancer Center
Patient and Family Advisory Council
The Wilmot Cancer Center Patient and Family Advisory
council (PFAC) was formed in 2006, evolving from a long
standing sub-committee of the James P. Wilmot Cancer
Center Board of Directors. Borrowing from the Patientcentered care concept at the Dana Farber Cancer
Institute as well as benchmarking information from other
Cancer Centers, the revised committee was established in
June 2006, with 12 patient/family representatives and 5
staff representatives. The committee serves as a vehicle to
provide input into the operations of the Cancer Center
from a patient and family perspective. This has allowed a
true partnership between Cancer Center leadership and
the recipients of our care.
The Wilmot Patient and Family Advisory Council
received the 2007 Excellence Award from the University
of Rochester Medical Center Board and was recognized
for its input into operations and work to improve patient
satisfaction through participation in leadership meetings.
This group of cancer survivors, family members and
key staff quickly set its sights on ways to provide an
“extension of clinical staff’s personal touch” for people
with cancer and their families. The formation of the
council demonstrates the Cancer Center’s commitment
to patient-centered care and has helped create a true
partnership between cancer center leadership and the
people who receive care.
The PFAC conceived of and developed a “Rounder”
program, whereby volunteers (many of them current and
former patients or their family members) round or visit
with patients who are waiting for a clinic visit, or having
treatment in the Chemotherapy/Infusion center or in
Radiation Oncology. The rounders undergo specialized
training and have resources available to help find an
answer or convey a concern. Rounders solicit suggestions
for how we can improve care or services and, in
many cases, keep patients company during therapy—
particularly if they are alone.
Patient and Family Advisory Council
In the past year, these friendly volunteers have
connected with more than 2,000 patients in the Cancer
Center’s outpatient treatment areas. As a result of the
Council’s input into decision-making and its innovative
“Rounders” program, the Cancer Center’s patient
satisfaction scores have improved by 5 points, a dramatic
increase, and the upward trend continues.
As the James P. Wilmot Cancer Center prepares to
open a new building, the PFAC is busy planning for an
Ambassadors program, which will pair every new patient
with a volunteer to help them through their first day in
the Cancer Center. These volunteers will escort patients
through the center, answer common questions and
serve as a caring, friendly resource during a difficult and
stressful time.
The Strong Commitment: Changing the Patient Experience
In 2005, Medical Center leadership reprioritized the
need to transform the organization's culture to one of
service excellence. Six service teams were created,
involving over 125 staff, each charged with increasing
patient and employee satisfaction. Teams focused on
Communications, First Impressions, Patient Satisfaction,
Staff Morale, Learning Center, and Measurement and
Accountability. Through the work of these teams
The Strong Commitment emerged, a comprehensive,
hospital-wide service excellence initiative. This initiative
was officially rolled out in January 2006, with each
SMH employee required to sign a contract agreeing to
live by the newly developed ICARE values and expected
behaviors of Integrity, Compassion, Accountability,
Respect, and Excellence (ICARE). Managers are held
accountable for each of these indicators and The Strong
Commitment standards have been incorporated into
staff evaluations.
“Strong Commitment Champions” were identified
in each department to oversee the startup and
continuation of all learning initiatives. Staff excellence
is acknowledged via “Strong Stars”, an awards program
initiated in response to requests for increased employee
recognition. Over 250 individuals are recognized each
month by patients, families and/or co-workers. “Strong
Stars” receive a certificate and are invited with their
direct supervisors to attend a monthly appreciation event.
During 2007, approximately 500 SMH nurses became
Strong Stars.
In spite of significant challenges, true progress is
occurring in an environment that continues to function
beyond its capacity. Inpatient satisfaction scores have
risen from the 17th percentile rank second quarter 2006,
to the 63rd percentile rank 4th quarter 2007. More
importantly, SMH continues to sustain the public's
confidence and trust.
4
Quality
Beacon Award
CVICU Nursing Staff, NPs, Cardiac Surgeons and medical team
In the spring of 2007, the Strong Heart and Vascular
Center’s CVICU was awarded the prestigious American
Association of Critical Care Nurses (AACN) Beacon
Award for Critical Care Excellence.
Beacon Award units have met rigid criteria for
excellence by demonstrating high-quality standards and
exceptional care of patients and patients’ families.
Nursing units that attain Beacon status help set the
standard for what constitutes an excellent critical
care environment.
The dedicated leadership team of the CVICU
has worked diligently to promote the culture necessary
for recognition via this national award. The CVICU has
demonstrated excellence in all six categories the AACN
has defined as necessary for attaining Beacon status:
■ Placing high value on recruiting and retaining
highly skilled nurses.
■ Valuing mentoring and coaching as valuable
development tools.
■ Working hand in hand with the Center for
Cardiovascular Research.
■ Measuring patient outcomes.
■ Maintaining a family focus
■ Valuing leadership and organizational ethics
The CVICU supports the community and region
with the area’s premier Critical Care Transport Team, the
region’s only Artificial Heart Program as well as the
region’s only Cardiac Transplant program. Not only has
the center provided the community with state of the art
health care, it has built healthy work environments for its
dedicated staff.
With strong leadership, the SMH CVICU staff
are involved, supported and empowered to provide
the region’s most highly skilled comprehensive
cardiovascular services.
Reduction in LOS Initiatives
Daily goal sheets have been in use in the MICU since
January 2003. These goal sheets provide a checklist of
nursing prompts that identify patient care priorities during
morning rounds by nurses, physicians, residents, and the
care coordinator. Improving communication among team
members helps to ensure a safe environment of care for
critically ill patients, decrease length of stay, and reduce
average ventilator days.
The success of this initiative has resulted in a
reduction in length of stay (LOS) by an average of 2.9
days/month, a rate of <1.1/1000 ventilator-associated
pneumonia (VAP) days and a reduction of ventilator days
by an average of 2 days/month, for all of the Adults ICUs.
5
Transforming Patient Care via a
Fall Prevention Program
Reducing harm from falls and implementing a fall
reduction program help to meet the 2007 National
Patient Safety Goals. In addition, the Institute for
Healthcare Improvement (IHI) medical/surgical group
has assembled a Fall Prevention Task Force to develop
an evidence-based fall prevention program. The aim of
this initiative is to reduce the number of patient falls to
less than 1 per 1,000 patient days and to reduce injury
from falls to less than 1 per 1,000 patient days.
Review of data from the National Database for
Nursing Quality Indicators (NDNQI) revealed that
several of SMH’s medical and surgical units’ rates of
falls with moderate to severe injury were above the
national benchmark.
A Fall Prevention Task Force with representation
from 5-1400 Medical/Surgical Short Stay, 5-1600
Neurology, 7-1200 Thoracic/Plastics and nursing
leadership was formed to address inpatient falls. After
examining the current fall risk assessment process and
reviewing the literature, the task force determined that
both the risk assessment tool currently in use and those
recommended in the literature tend to over-predict
patients at risk of fall. As a result, the task force decided
to develop an evidence-based fall risk assessment tool
and introduce interventions in response to individual
patients’ fall risk score.
In consultation with Dr. Gail Ingersoll, Director of the
Clinical Nursing Research Center, testing the reliability
and validity of the fall risk assessment tool was initiated.
On study units, the fall risk assessment tool is currently
being tested with 220 admitted patients at potential risk
of fall and 35 patients who sustained actual falls. Risk
scores will be compared for those groups to determine
if there is a clear indication of which range of scores
predicts who will and will not fall.
The table to the right contains the risk factor
assessment items and the scores assigned to each. Patients
scoring 0-5 are considered at low risk for falls and those
scoring 6-14 are considered at high risk. Interventions
for patients identified at risk for falls incorporate specific
nursing interventions, including the use of assistive
equipment to maximize patient safety.
Risk Factor
Risk Points
History of falls
3
Confusion/Disorientation/Depression
3
Altered Elimination
3
Altered Mobility
2
Anticipated discharge to a
Skilled Nursing Facility.
2
Receiving sedation causing medications.
1
Sum of Ratings
Data will be analyzed by staff of the Clinical Nursing
Research Center prior to extending data collection to
patients on 5-1400, 5-1600, and 7-1200. Revisions to
both the fall risk assessment tool and intervention
guidelines will be made. Classes will be provided for
staff working on the pilot units and evaluation will be
ongoing, with modifications throughout the pilot study
period. After successful implementation of the Fall
Prevention Program on the pilot units, plans are to
implement this program hospital wide.
Wound-Ostomy Certified Nurses
Wound-Ostomy Certified Nurses (WOCNs) are
available for consultation for all services, including the
Emergency Department, Adult Service, Critical Care,
and Pediatrics. The WOCNs meet with members of the
Adult Wound/Skin Team monthly in a round-table
discussion to teach about prevention of pressure ulcers,
skin assessment, new products, and to review case
studies among the Adult Medical/Surgical Population.
Unit-specific Wound/Skin Resource Manuals have been
developed via this forum.
Patient rounding occurs on the ICUs daily. The
WOCNs, the ICU Wound/Skin Team member, and the
Care Coordinator assess each patient and modify the
prevention and treatment plan as needed. ICU-specific
skin initiatives are designed and discussed during a
twice-monthly meeting with the WOCNs and the
Critical Care Educator.
The WOCNs also are available for consultation in
the ambulatory out-patient clinics, where they advise on
solutions to problems with stomas and/or peristomal skin
and wounds.
6
Quality
continued
Margaret D. Sovie
Center for Advanced
Practice Nursing
UNIVERSITY OF ROCHESTER MEDICAL CENTER
The Margaret D. Sovie Center for
Advanced Practice Nursing
The Sovie Center has been in existence at SMH since
November 2006. Named in honor of Margaret Sovie,
a former Director of Nursing at Strong, and a pioneer
in advanced practice nursing, the Center serves
as the nucleus for innovation and opportunity in
APN professional practice at SMH. The functional
units of the Center include regulatory guidance and
credentialing, education, professional development and
coaching, research and evidence-based practice, and
practice model innovation.
The Sovie Center promotes an organizational
structure that supports communication andcommitment
to nursing practice. With one of the largest nurse
practitioner groups in the nation, SMH continues to be
recognized as a leader in advanced practice nursing.
Central Line Infection Improvement Project (CLIIP)
The goal of CLIIP is to reduce and/or eliminate
catheter-related bloodstream infections. The project
consists of a multidisciplinary team from Intensive
Care Units, ED, OR, Interventional Radiology,
PICC Service, BMT and Pediatrics. The project is
Co-Chaired by Michael Apostolakos, MD, Medical
Director/Adult Intensive Care and Mary Wicks, RN,
MPA, Associate Director of Nurses/Adult Intensive
Care Nursing Service.
The CLIIP project focuses on four areas: catheter
insertion, catheter maintenance, education and
data collection and analysis. This evidence-based
improvement project will follow these important
principles when inserting or maintaining any vascular
access device: scrupulous hand hygiene, aseptic
technique during catheter insertion and care, vigorous
friction during skin prep and whenever a clinician
makes or breaks a connection, ensuring catheter
patency and removing unnecessary catheters. Success
will be measured by a catheter-related bloodstream
infection rate that is at or below the benchmarks set
by the National Health Safety Network.
CVICU Huddles Up to Safe Patient Handoff
The Cardiovascular ICU 7-1600 has initiated a new
process to accurately transfer information or “hand off”
care from the OR to the ICU team. 1
The “Huddle” takes place for postoperative
patients arriving to the CVICU directly from the OR.
The core team members required for the Huddle
include the admitting RN, nurse practitioner,
respiratory therapist, attending anesthesiologist,
anesthesia resident, and cardiac surgery fellow. Other
team members may include the cardiac surgeon,
cardiac perfusionist, or the IABP technician who was
present in the OR during the case.
The hallmark of the Huddle is uninterrupted
verbal reporting to the entire team to ensure that all
members receive the same information. An
opportunity for clarification and questions by any
member is encouraged at the end of the verbal report.
Full attention to the individual who is speaking is
given during the Huddle. The transfer of various
monitoring lines, and other admission processes are
postponed until after the Huddle is completed in order
to minimize distractions. In order to maintain
consistency for the Huddle Handoff, the team members
report off in a specific order. A detailed description of
the patient’s history, operative procedure, and
operative course is given.
The team agrees that this new method for handing
off care takes less time and is more efficient than
the previous method. The handoff team is well
organized in providing a detailed post-operative report,
and the accepting team receives a standardized and
concise report.
1.
Adamski, P. (2007). Implement a handoff
communications approach. Nursing Management,
38, 10-12.
7
Nursing Practice Safety Nurses
Nursing Practice is fortunate to have eighty-five safety
and infection prevention nurses, who, in addition
to providing patient care, assume responsibility for
collaborating with the Hospital’s Safety Prevention
and Infection Control Committees to:
1. Promote safe care delivery practices that focus on
patients and employees.
2. Ensure nursing staff adherence to the scientifically
accepted principles of the infection
prevention/control program.
3. Assist in the monitoring of staff performance
related to prevention of hospital-acquired
infections.
4. Work with their nurse managers to achieve
targeted outcomes reflective of safe and effective
delivery of care.
Safety Nurses attended an intense training course
during November 2007 which provided content involving
infection prevention and employee safety theories.
During November and December safety nurses were
busy providing flu immunizations to staff as part of the
hospital’s initiative to increase flu immunization rates.
Safety nurses will continue to work with the nursing
management teams in order to:
■ Raise staff awareness of the importance of and need
for safe practices.
■ Provide educational opportunities for staff that
address learning needs and competencies related to
safety and infection control/prevention.
■ Gather data to document unit adherence to safety
and infection control/prevention standards and
achievement of goals.
■ Assure compliance with infection prevention and
isolation precautions.
Nursing Practice is confident that with the creation
of the safety nurse role within the clinical setting,
improved patient outcomes associated with decreased
hospital acquired infections, decreased hospital acquired
pressure ulcers, and enhanced safety in the environment
will result.
Clinical Nursing Research Center
Research Internship
A one-year research internship experience for nursing
staff, leadership and advanced practice nurses (APNs),
now in its 3rd year of existence, was introduced in 2005
as part of Nursing Practice’s federally funded critical care
transformation process.
The internship is designed to expose nurses to
research and Evidence Based Practice (EBP) principals
and to provide them with a mentored opportunity to
complete a clinically relevant EBP or research project.
Interns receive one paid education day per month for a
full year in order to participate. Morning sessions are devoted
to classroom instruction on research and EBP. Afternoon
sessions are spent on independent work on the intern's
clinical project. The Director and Assistant
Director of the Clinical Nursing
Research Center (CNRC) are
available to meet with interns to
discuss their projects and to
provide recommendations. Interns
learn to search the literature and
to critically evaluate evidence for
application to practice and to their projects. The
culmination of the internship is a formal presentation
on the last day of the internship and a poster session
open to the public in the afternoon.
2006/2007 Interns
Susan Ciurzynski, RN, MS
Advanced Practice Nurse, Pediatrics
Jeanne Kirby, RN, BSN
Nurse Manager, 4-3600
Pediatric Rapid Response Team Activation
Criteria: A Feasibility Study
Elizabeth Garton-Park, RN, BSN A Comparison of Pain Rating Scales in A
Staff Nurse, Post Anesthesia Care Unit Phase I PACU
Highland Hospital
Deborah Harris, RN
Staff Nurse, 2-9200
The Effect of Omega-3 Fatty Acids on
Mood Disorders
Jennifer Harris, RN, MS
Advanced Practice Nurse,
Adult Services
Effect of an Equipment Focused Falls
Prevention Program on Care
Delivery Outcomes
Michelle Kuleszo, RN, BSN
Staff Nurse, 8-3600
Nurses' Perceptions About Providing
Aggressive Life Saving Care to Patients
with a Low Likelihood of Recovery in a
Surgical Intensive Care Unit
Ann Miller, RN, MS
The Effect of Vein Transillumination on
Staff Nurse, Clinical Research Center Venipuncture Accuracy
Catherine Reda-Cheplowicz, RN Nausea Control and Peppermint Oil.
Staff Nurse, Cancer Center,
Does the Inhalation of Peppermint
Highland Hospital
Oil Help Control Chemotherapy-Related
Nausea and Decrease the Use of
Anti-emetic Medications?
Cathy Snider, RN, BSN
Staff Nurse, Ambulatory Services
Changes in Primary Care: Changes in
Primary Care Nursing
Carol Williams, RN, BSN
Staff Nurse, Cancer Center
Impact of Neutropenic Precautions on
Quality of Life
Cherri Witscheber, RN
Staff Nurse, 8-1600
Development and Testing of An
Evidence Based Adult Pressure
Ulcer Risk Calculator
8
People
Clinical Placements
Nursing Recruitment
The Office of Nursing Recruitment had a very busy year
during 2007. A total of 481 new staff members were
hired through nursing recruitment; over 1000 applicants
were interviewed. These hires were comprised of 416
RNs, 25 LPNs, and 35 summer students. A total of 247
Graduate Nurses (GNs) were hired from the December
2006 and May 2007 graduating classes. Nursing
recruitment staff members met with 173 nurses who
were seeking an internal transfer. Of these 173 nurses,
80 nurses made a transfer. The recruitment office visited
16 local/regional colleges and held 8 open houses which
brought in over 100 applicants.
During 2007 the recruitment office arranged over
1000 observation/shadow experiences for nurses seeking
new positions. The observation/shadow program is a
popular draw for prospective employees. All graduate
nurse candidates must observe/shadow before accepting
a nursing position. Nurses with clinical experience area
also are strongly encouraged to observe/shadow before
accepting a position in Nursing Practice. This allows
prospective nurses (both new and experienced) to
determine whether a specific clinical area is the “right
fit”. The observation/shadow program also has assisted
with hiring nurses to unique areas that have had
challenges in attracting nurses in the past.
9
The Department of Nursing Practice is actively involved
in the education of nursing students through clinical
placements for undergraduate nursing students (RN/LPN)
and graduate nursing students. Clinical placements are made
in response to the number and type of requests submitted
by local schools of nursing. For undergraduate students, each
clinical group has an average of 8 students on a base unit.
In addition, each week one or two of students
go to specialized units for observational experiences.
In 2007, there were almost 1200 undergraduate students
that came to Strong Memorial Hospital for a clinical
experience. Students completed clinical experiences in
Adult Services/Cancer Center (N=633), Behavioral Health
(N=116), Obstetrics (N=162) and Pediatrics (N=288)
Of the students noted above ~105 students completed a
Senior Practicum. These senior practicum experiences
provide students with a more focused clinical opportunity
(80-120 hours) and students work one to one with an
assigned preceptor.
Graduate nursing students (~25) from the University of
Rochester, Nazareth College and St. John Fisher College
also came to SMH to complete clinical requirements for
their Nurse Practitioner/Clinical Nurse Specialist degrees.
Magnet Redesignation
Strong Memorial Hospital was awarded Magnet status
in 2004. The awarding of Magnet status signifies that
an organization has met criteria of administrative,
professional practice, and professional development
excellence that encompass the 14 Forces of Magnetism.
These forces include quality of nursing leadership,
organizational structure, management style, personnel
policies and programs, professional models of care, quality
of care, quality improvement, consultation and resources,
autonomy, community and the hospital, nurses as
teachers, image of nursing, interdisciplinary relationships,
and professional development.
Organizations that achieve Magnet status are
designated as such for a period of four years. SMH is
currently applying for redesignation. Multiple staff
members and leadership have contributed to our Magnet
application and once again Gail Ingersoll is writing the
document. The redesignation process is conducted in
the same manner as the original appraisal, including
reapplication, submission of new documentation, and a
site visit by Magnet appraisers. Awards are made when
members of the Commission on Magnet Recognition
agree that the evidence provided reveals Magnet-defined
excellence in provision of nursing services. SMH
continues on the journey of Magnet Recognition.
Professional Nursing Council
The Professional Nursing Council-SMH’s shared
governance model was established to guide the continuing
development of nursing practice at Strong Memorial
Hospital. The Professional Nursing Council provides
advice to the Chief Nursing Officer and provides for staff
nurse input in decision making relative to the practice of
nursing. The purposes of the organization are to:
■ address the nursing practice needs at
SMH of all members of the nursing staff.
■ identify and problem solve issues that
affect nursing practice staff.
■ provide an integrating structure for
professional nursing practice.
■ participate in the development of and
promulgation of the standards of nursing
practice in conjunction with the medical
center quality assurance programs.
■ promote quality nursing care of
patients and families.
■ influence, contribute to and support
the professional education of students
and staff.
■ encourage and support scientific inquiry
for the continual improvement of nursing
practice and health care.
■ promote the continuing development
of professional nursing within Strong
Memorial Hospital.
The PNC has 138 council members and is divided into 5
sub councils:
■ Clinical Practice Council
■ Quality and Safety Council
■ Financial Accountability Council
■ Professional Development Council
■ Research and Evidence Based Practice Council
In 2007, the council welcomed Licensed Practical Nurses
and Respiratory Therapy Representatives and increased
overall membership attendance at monthly meetings by
8%. The council also facilitated financial education for
nursing staff, coordinated all activities for National
Nurse's Week and initiated the Professional Image pilot to
gain insight into how nurses are recognized by patients
and families.
The Professionsal Nursing Council
Community Outreach
One of the aspects of the Magnet program is to
provide encouragement and guidelines to strengthen
nursing excellence through involvement in our
community. Nurses who work in the in-patient and
out-patient clinical areas participated in a wide variety
of community service activities throughout the year.
The vice chair of the shared governance Professional
Nursing Council (PNC) dedicates time to encourage
nursing participation in community service and to
coordinate quarterly activities.
In 2007, the PNC sponsored the following community
service activities:
■ Rochester Public Market Community Blood
Pressure Screening – Nurses were available
during market hours to check blood pressures for
Rochester citizens.
■ Pretty in Pink Day – Staff gave a monetary
donation and wore the color pink to work
as a focus on Breast Cancer Awareness.
All funds raised benefited the James P. Wilmot
Cancer Center.
■ Gardenscape 2007 – Staff volunteered at
this community event to raise funds for the
Epilepsy Foundation.
■ Daffodil Sales – the PNC coordinated daffodil
sales throughout the hospital to raise money for
the American Cancer Society.
■ Jeans for New Orleans – Staff gave a monetary
donation and wore jeans to work. All funds raised
were sent to the Hurricane Katrina Relief Fund.
10
People
The Critical Care Internship Program
The Internship program operates with funding and
advisement from the Critical Care Grant for Recruitment
and Retention. Since its inception in 2005, 49 out of
53 graduate nurses (GNs) have successfully completed
orientation. Four GNs transferred to Step-down or
another SMH unit.
Patient care units include the Adults ICUs, BurnTrauma 3-2800, Cardiovascular ICU 7-1600, Medical ICU
8-1600, and Surgical ICU 8-3600. GNs who intend to
work on the ICU Step-down units also participate in the
Critical Care Internship classes.
ECCO (Essentials for Critical Care Orientation)
Program, developed by the American Association of
Critical Care Nurses (AACN), is started during Weeks
8-10, and provides basic to advanced critical care
knowledge. GNs who have completed ECCO evaluated
the program positively in content, ease of use, and
applicability to clinical areas.
ICU Internship Program Design:
■ Orientation: 6-9 months with expert preceptors
and continued guidance and follow-up for 2 years
to ensure success
■ Program Focus:
- Clinical / Experiential learning
- Guided Learning
- Individual education & planning
- Collaborative Practice
- Progressive competency mastery
- “Specialty Series”
Nurses in the ICU Internship Program will have
opportunities to:
■ Be mentored by expert critical care preceptors
■ Learn basic to advanced assessment skills in
progression throughout their orientation
■ Participate in a blended education model with
computerized Essentials of Critical Care
Orientation (ECCO) coupled with focus /
discussion groups for questions and
continued learning.
■ Receive written feedback on performance and
progress toward meeting objectives every 2-3 weeks.
■ Participate in periodic meetings with the Education
Coordinator and preceptors to assure that the
objectives of program are being met and to discuss
goals and plans for the upcoming time period.
“The program provides GN’s with the structure and
support they need to develop the knowledge and critical
thinking skills to function in the ICU environment.”
Quote from Deb Hurley (former Nurse Manager for SICU
8-3600, now Clinical Nurse Leader SICU 8-36 and
Progressive Care 8-14).
The SICU has an 87% 1-year retention rate, 70%
2-year retention rate, and a 75% 3-year retention rate.
11
continued
Embracing Diversity:
Working Together to Provide Culturally Competent Care
The Diversity Task Force was convened during the fall of
2007 as an outgrowth of the Critical Care Grant
Transforming ICUs to Retain Staff and Improve Unit
Outcomes. When the intervention phase of the grant
ended, the task force became a sub-committee of the
Professional Development Council, where it was expanded
to include representation from across Nursing Practice and
the Department of Human Resources. The current focus
of the task force is on developing educational programs
that promote cultural competence and on creating a
service-specific
cultural assessment
tool and cultural
competency plan for
Nursing Practice.
One of the task
force’s first steps was
the development of a
quarterly cultural
educational series
featuring a specific
culture, ethnicity,
religion, or lifestyle.
The task force has
also partnered with Food and Nutrition Services to
provide food demonstrations and samplings, along with
recipes of food reflective of the presentation focus.
Continuing Nursing Education contact hours are provided
for those who attend.
Understanding Spanish Culture was presented by
Patricia Leadley of Interpreter Services and focused on
Latino and Hispanic cultures. Participants heard about
ways to better meet the needs of patients and families
from these cultures and sampled several dishes after the
presentation.
Each presentation in the Cultural Education Series
has been made available on the Nursing Intranet. Staff
can follow the links to the Professional Development
Council and click on the Diversity Task Force link.
Also underway are plans to revise the current
admission cultural assessment process. After reviewing
the literature, the task force determined that additional
information would help with assuring that patients and
families needs are met in the best manner possible. Lisa
Beckford, RN, nurse leader of the Neonatal Intensive
Care Unit (NICU) shared the cultural assessment tool
developed by the NICU’s cultural diversity committee,
which is presently undergoing revisions to make it
specific to individual service needs. Once completed,
the assessment tool will be tested on several units before
proposing its use throughout the hospital.
Med Schedule System
The current online version of the Med Schedule System
(MSS) was developed from March through September
of 2007. The system then was pilot-tested on 7-1200
Thoracic/Plastics in October of 2007. It is designed
for the nursing staff to be able to schedule 24/7. This
internet-based system allows for simultaneous access
from any internet-connected computer. The purpose is
to provide the individual nurse with more control over
his or her schedule via a user friendly interface. The
system has three phases that result in the finalized Unit
schedule: Initial Entry, Self Juggle and Administrative
(Admin) Juggle.
In the Initial Entry Phase, a nurse enters in his or
her desired schedule. The system automatically calculates
the weekly hours, pay period hours, time block hours,
weekend hours, shift percentage and number of conflicts.
The Self Juggle Phase gives the nurse the control
to change his or schedule to meet the Unit’s staffing
requirements. The staffing levels are color-coded to
indicate the overstaffed days (blue) and the understaffed
days (pale orange). An individual nurse can juggle (move)
him or herself from the heavier staffed days to the under
staffed days of choice.
The Administrative Juggle occurs when the
administrator goes in and moves nurses around to
meet the unit’s staffing requirements. They can see
which nurses participated in the Self Juggle Phase and
how many times each moved. The Admin Juggles are
highlighted in Yellow and also are tallied.
When finalized, the schedule is available online.
Individual nurses can go online to view the entire staff
schedule or just their own. The MSS system is currently
being rolled out on 7-1200 Thoracic/Plastics. NICU
3-3400 and MICU 8-3600 are currently in full use of the
system. 6-1400 Surgical Oncology, 3-2800 Burn Trauma
ICU, 4-2800 PICU, and Respiratory Therapy are starting
their first cycle in March 2008.
NDNQI: A Nurse Satisfaction Survey.
Pat Witzel, Chief Nursing Officer (CNO), believes
in that sentiment too and cares about nurses’ work
environment. To be able to continue growing and
improving that environment, the nursing department
conducted a RN satisfaction survey to help identify
controllable variables that directly affect your job and to
gather your opinion on how that information affects you.
This survey is offered by the National Database for
Nursing Quality Indicators (NDNQI). The survey took
about 20 minutes to complete and was confidential. The
Kansas City office of National Data Base for Nursing
Quality Indicators (NDNQI) received the submitted
electronic surveys. The Research Subjects Review Board
(RSRB), the governing agency that protects research
participants—those who were asked to complete surveys
for example—thoroughly reviewed the document for the
protection of confidentiality.
Full or part-time RN’s, regardless of job title, who
spend at least 50 percent of their time in direct patient
care and have been employed on their current unit since
June 3, 2007, were eligible to complete the survey. Unitbased per-diem nurses employed by the hospital were
eligible, but agency or contract nurses were not. Overall,
SMH scores were higher than all comparative hospitals.
Comparison of 2007
National Mean vs. SMH Mean
Interaction Nursing Data
Comparison of 2007
National Mean vs. SMH Mean
Professional Development
The word satisfaction brings a few words to mind: a sense
of accomplishment, an internal feeling of happiness and a
sentiment of pride. It evokes feelings of having done a
good job and motivates you and those around you to
continue working hard and to truly believe that you are
making a difference. It is the basis for enthusiasm and the
spark that is needed to encourage creativity and continued
personal and professional development. It is also our most
telling measurement that the nursing environment at
Strong supports the job you do, the time you spend and
the career you manage.
12
Finance
Financial Accountability Council
Financial Accountability Council Members
Charlie Andrews, Nursing Administration
Lorie Banker, 3-3400
Barbara Baron, AC2 Urology
Katie Borchers, 4-1600
Wanda Clements, ED
Maureen Freedman, 3-1600
Susan Henry, Infectious Disease
Michele Hobbs, EDOBS
Ann Marie Holler, 3-3400
Kristina LoBello, 5-1400
Sarah Ludlow, 8-3600
Peter McCann, 3-9000
Stacey McGahan, 8-1400
Kristen Moulton, 4-2800
Dan Nowak, Perioperative Nursing
Anne Odonnell, ED-Obs
Tina Pike, Value Analysis
Chelsey Rice, 7-1200
Cathy Thompson, 3-2800
Callie Toombs, 3-3400
Cathy VanHouten, Specialty Beds
Robert Wesley, 7-1600
Linda White, EDOBS
Diane Wilkinson, 6-3400
Pat Witzel, Chief Nursing Officer
Nina Woodson, SSC
13
The Financial Accountability Council (FAC), a sub-council
of the Professional Nursing Council, worked diligently in
2007 in providing educational opportunities and revising
retention plans.
FAC wrapped up the Winter 2007 with “Financial Facts
Every Nurse Should Know”, and held additional forums in
the Spring and Summer. Topics reviewed during these two
forums included the costs associated with the use of VACs,
(Vacuum Assisted Closure Devices), RN orientation,
pressure ulcers, specialty beds, linens, supply misuse
and common nursing supplies. The SMH inpatient RN
Longevity Policy also was reviewed. Posters were presented
to over 200 attendees.
FAC also addressed improvement of nurse retention by
revising the SMH Nursing Practice Administrative Policy
3.17: Longevity Program for In-Patient Registered Nurses.
Additional options included:
■ Shift of choice for 6-week block, twice a year.
(One slot per unit allows four staff members to
rotate through each year) and a
■ A choice of 3 non-University holidays off
(choices include Valentine’s Day, Martin Luther
King Day, St. Patrick’s Day, First Day of School,
Halloween, Veteran’s Day, Mother’s Day,
Father’s Day, and/or Easter).
The policy was also re-worded for improved clarity.
SMH General Growth Overview - CY 2007
Highlights from 2007 include a 3.4% increase in
patient discharges over the previous year, from 38,430
discharges in 2006 to 39,731 discharges in 2007.
Average length of stay (LOS) decreased from 6.9
days in 2006 to 6.5 days in 2007. This change is
attributable to the efforts of Nursing Practice in
provision of optimal patient care as well as
achievement of earlier discharge times during the day
throughout the hospital.
The Emergency Department demonstrated a 1.8%
increase (1,750 more patients) in visits during 2007
and an increase of 4.8% in patient admissions from ED
to the hospital.
Financial Facts
The hospital continued to invest in much needed
resources in 2007 by adding over 100 incremental
Nursing Practice FTEs were approved by administration.
Forty-eight percent of additional staff were
allocated to the Emergency Department and associated
Observation Units, while 34% went to Inpatient Units
and 18% to Perioperative Services.
Although the number of staff for our inpatient
units was increased, the Salary Cost per Patient Day
was maintained at a reasonable rate by continually
monitoring the department census and staffing. The
Cost per Patient Day for 2007 was $340 as compared
to $331 in 2006..
To assist in the daily financial activities of nursing,
a dedicated finance manager for the Department of
Nursing Practice was hired. One of the finance manager’s
major responsibilities is to supervise the preparation,
review and monitoring of the nursing departmental
operating and capital budgets, which begins at the level
of the nurse manager and unit direct care staff.
Nurse managers take an active role in building
their budgets both for salary and non-salary expenses.
Financial workshops targeted for nurse managers assist
them in a greater understanding of both the composition
of their budgets and methods for effectively tracking
their monthly expenses.
Leadership Internship Project:
Financial Gains through Nursing Education and
Product Management
In recognition of the need for administrative succession
planning, a new Leadership Internship Program for
staff nurses was offered for the first time in 2006-2007.
Interns spent one class day each month studying topics
relevant to nursing leadership and participated in
group projects designed to address a leadership issue of
importance to Nursing Practice. Each intern was paired
with an experienced mentor, while an additional mentor
provided oversight for group projects.
One team among this first cohort carried out a project
focused on nursing staff knowledge of costs associated
with product use. Team members examined unit budgets,
staffing patterns, and usage of products. High-cost
products were targeted for reduced use, proper use, or
replacement with more cost-effective items. Medical
suppliers, hospital stores, the value analysis committee,
nurse managers, and staff were queried regarding reasons
for product use and their decision-making related to
selection of products. Results of an impact analysis
demonstrated lowered unit budget costs with no change
in patient or staff satisfaction with product use and
availability. Implications include continued monitoring
of financial accountability and product management.
Melissa Derleth, RN, BSN (6-1600)
Ann Marie Holler, RN, BSN (3-3400)
Matthew Klapetzky, RN, BSN (3-2800)
Mentor: Dan Nowak, RN, MS
14
Growth
PRISM Project
The PRISM project for Pediatric Replacement and
Imaging Sciences Modernization serves as one of the
cornerstones of the Medical Center’s proposed five-year
strategic plan.
In response to a need for more patient care space,
URMC applied to the New York State Department of
Health for the largest clinical expansion in Strong
Memorial Hospital’s history. If approval is received,
construction will begin around July 2009, with
completion of the new building in 2012 and renovation
of the space in Strong Memorial Hospital in 2014.
The licensed bed capacity will increase by 123 beds,
from 739 to 862 beds, through addition of a six-story
tower adjacent to Strong Memorial Hospital. The
330,000-square-foot addition will house 56 beds for
Golisano Children’s Hospital, an additional 56 adult beds
for Strong Memorial, two floors for imaging sciences
including a dedicated area for pediatric patients, plus an
expanded pharmacy and other support space.
UNIVERSITY OF ROCHESTER MEDICAL CENTER
STRONG MEMORIAL HOSPITAL
Proposed
EXISTING HOSPITAL
PRISM
MECH
EMERGENCY
G
8
7
6
5
4
3
2
1
G
SURGERY
B
B
BEDS
ICU BEDS
BEDS
BEDS
2
Lobby 1
PEDIATRICS
PEDS ICU
OB/GYN
ICU
SURGERY
SURGERY
67 ADULT BEDS
4
3
2
HOSP. SVCS.
G
MAIN
ENTRY
MECH
Addition
ADULT BEDS (56 BEDS)
PEDS BEDS (56 BEDS)
IMAGING SCIENCES
(DIAGNOSTIC)
IMAGING SCIENCES
(INTERVENTIONAL)
MATS. MANAGEMENT/
PHARMACY/O&M
MECH
MPD
EMERGENCY
ELMWOOD AVENUE
Proposed
PRISM
ELMWOOD AVENUE
Location
Emergency
Department
Parking Garage
EAST DRIVE
Front
Entrance
Strong
Memorial
Hospital
UNIVERSITY OF ROCHESTER MEDICAL CENTER
STRONG MEMORIAL HOSPITAL
15
The proposal includes a vision that:
■ All new rooms created in the new PRISM tower
will be private rooms, reflecting new standards for
managing contagion and privacy.
■ Pediatric rooms will be considerably larger than
present rooms, enabling families to stay
comfortably with their children.
■ Each floor will be designed with higher ceilingto-floor heights to accommodate high-tech
equipment needs.
■ Two dedicated imaging floors will create areas for
imaging and treatment of children that are
separate from adults.
■ The pediatric inpatient care areas will connect
directly to the Pediatric Intensive Care Unit which
opened in January 2005.
■ The PRISM’s foundation will be constructed to
support the possible addition of three more stories,
creating an option to renovate other older
patient care areas.
Excerpts from Strategic Plan
University of Rochester Medical Center 2007-2012 Strategic Plan
The University of Rochester Medical Center has
renewed its commitment to achieve national prominence
by developing a strategic plan that defines priorities,
leverages opportunities, and fulfills the promise of
its founders to create Medicine of the Highest Order.
The 2007-2012 URMC Strategic Plan builds on the
success of the Medical Center’s previous strategic plan
by leveraging its blend of robust science, disciplined
teaching programs, and burgeoning clinical enterprise.
This plan uses education, science and technology to
create new knowledge that helps patients, advances
health care, and contributes to the economic vitality of
the Rochester region.
URMC was founded on the premise that each of
its missions —research, teaching, patient care, and
community health—is interrelated and serves to
strengthen the others.
The centerpiece of the plan is nine high-priority
clinical and research programs. These are signature
programs in which, with strategic investments in people,
technology, and facilities, URMC can stake its national
reputation for innovation and excellence. The five
Integrated Disease Programs (IDPs) include Cancer,
Cardiovascular Disease, Immunology and Infectious
Disease, Musculoskeletal Disease, and Neuromedicine.
Innovative Science Programs (ISPs) include Stem
Cell and Regenerative Medicine, Biomedical Imaging
and Biomarkers, Nanomedicine, and Genomics and
Systems Biology.
The major goals for the 2007-2012 URMC Strategic
Plan include
■ Becoming one of the leading health care systems in
the Northeast and to achieve national recognition
for our high quality signature programs that develop
new therapies based on outstanding research.
■ Sustaining an interdisciplinary environment that
emphasizes fundamental discovery and fosters
innovation through the acquisition of
new technologies.
■ Ensuring translation of fundamental discovery into
cutting-edge patient therapies through the
education of clinicians and scientists.
■ Growing clinical volume by recruiting outstanding
health professionals and providing capacity for
complex procedures where specialized expertise and
high volume ensure the highest levels of patient
safety and quality.
■ Maintaining clinical margin and productivity that
sustains growth in the clinical and academic
missions of the Medical Center.
■ Engaging the community through economic
development (including technology transfer and
research partnerships) and to promote community
health through research programs that support
community-based interventions.
■ Ensuring that all education programs at URMC
are nationally outstanding and prepare students
for careers of excellence.
Expanding the Boundaries of Ambulatory Care
Ambulatory Care continues to expand programs to
areas beyond the geographic boundaries of Strong
Memorial Hospital. Early in 2007, Occupational and
Environmental Medicine opened its doors 7 miles from
campus, in a new setting at Calkins Corporate Park.
The Women's Institute opened a new building designed
for specialty women's services in the same office park.
Planning continues for relocation of the Pain Center to
its new setting above the Ambulatory Surgery Center in
the next year.
Onsite, the Neurology Outpatient Department (OPD)
moved to an expanded new location in the Ambulatory
Care Facility in November, 2007. Surgery OPD completed
renovations to add a new outpatient procedure room and
4 exam rooms at its current location. Additional moves
and expansion are expected in the ambulatory facility in
the next year.
Visit volume continues to grow across all ambulatory
care entities, exceeding 1 million visits annually across all
programs. Annual procedures exceed 400,000. Nursing
and clinical technologist staff are key to facilitating
patient throughput and assuring safety in patient care.
Over 12,000 procedures requiring patient sedation occur
annually in the ambulatory care setting, which indicates
the level of acuity of the patient population. We are
proud of the contribution of nursing staff to the continual
growth in volume.
16
Systems
Program expansions to
meet the needs of the community The New James P. Wilmot Cancer Center
In designing the new James P. Wilmot Cancer Center,
patients and nursing staff were consulted about what
is important to them during their encounters and
treatment. All interested constituents participated in
numerous design teams to advise leaders and architects
about features they would like to see in a state-of-the-art
cancer center. The design is a result of their feedback.
Ease of access and getting there:
■ Drive-up and drop-off point with valet parking
■ Easily accessible from the parking garage
■ Connected to first floor of Strong Memorial
Hospital near the main lobby
■ Dedicated and convenient parking for patients
undergoing daily radiation treatments
■ Three-story atrium point of reference—
All patient care services easily located from this
central design feature
■ Information desk at building entrance
Catherine A. Lyons, RN, MS, CNAA FNAP
Associate Director for Clinical Services for the
Jsmes P. Wilmot Cancer Center
Patient Resource Center:
■ A central source of information, education and
support for patients and their families
■ Located on the hallway that connects with
Strong Memorial Hospital
■ Houses library, computers and multi-media
capabilities for presentations.
■ Comfortable furniture conducive to conducting
our many support groups
Privacy:
■ The new chemotherapy and infusion center
offers options for varied degrees of privacy
depending on each patient’s preference for
greater or lesser interaction with other patients
■ Individual televisions at each station
Our most important design feature is the creative
and liberal use of light and glass throughout the
facility—from the atrium to the liberal use of windows
in the chemotherapy and infusion center. Light inspires
energy and hope and provides patients and staff with
the environment they deserve in a setting that will
well serve the Rochester community for years to come.
The new James P. Wilmot Cancer Center is
scheduled to open in May 2008.
17
Intensive Care Renovation Project
2007 marked the completion of the multi-year,
$12 million dollar intensive care unit renovation
project. Included were the Medical Intensive Care
Unit (8-1600), Surgical Intensive Care Unit (8-3600)
and a new Surgical Progressive Care Unit that also
contains 4 ICU beds (8-1400).
Planning and direction was carried out by a
multidisciplinary team, with a focus on patient and
family comfort, and increased room size. Medical ICU
and Surgical ICU rooms were designed to be large
enough to accommodate the patient and family, the
clinician and the equipment. The new rooms are 320
square feet with a separate designated family area
capable of seating four, and supporting open visitation.
Other features include dialysis connections in every
room, an increased number of isolation rooms, ceiling
lifts, decentralized nurses stations and redundant patient
monitoring screens within the core areas.
Patient care unit 8-1400, which houses both surgical
progressive care patients and intensive care patients, was
completely renovated, including the central nurses
station, and the medication and nutrition areas. The
addition of four new intensive care rooms on 8-1400 has
provided the hospital with additional ICU bed capacity.
Family Area within ICU Patient Rooms
The new Surgical and Medical Intensive Care Rooms
were designed to meet patient, family and clinicians’
needs. One of nursing’s goals is to restore the patient to
an optimal level of wellness as defined by the patient
and family; the design of the family area supports that
goal. Family areas within patient rooms include a couch,
side chair, small table and access to the internet. Family
members can be close to their loved ones, available to
the physicians and nurses to discuss patient care issues,
and can participate in some aspects of patient care, such
as helping to bathe. The size of the rooms and unique
design of the family space has enhanced our interactions
with the family,
increasing patient
and family trust.
New Ambulatory Surgery Center
Since the fall of 2007, a team of dedicated health care
professionals, including architects and facility planners
have been designing the new Ambulatory Surgery
Center (ASC). Nurses from the main Operating Room,
Post Anesthesia Care Unit, and the Same Day Surgery
Unit have played an integral role in creating the facility.
The surgery center is a 52,000 square foot building
housing ten surgical suites with a preoperative and
postoperative area designed to enhance patient privacy.
When considering the layout of the ASC, the team
wanted to be sure that patients and family members
were the main focus. The center will provide total
patient and family services under one roof, from
preoperative physical assessments to a pharmacy for
filling post operative prescriptions. Patients will be
provided assistance in crutch walking and post operative
exercises when prescribed by the surgeon. The ground
breaking will be in the spring of 2008.
Behavioral Medical Surgical Unit - 1-9300
The Behavioral Medical Surgical Unit (1-9300) is a
10-bed inpatient medical/surgical unit that opened in
March 2007. Its unique environmental design and
staffing model was developed to meet the treatment and
care needs of patients with an acute medical/surgical
condition who have co-morbid psychiatric or
behavioral problems that pose challenges on traditional
medical/surgical units. Admission diagnoses include
acute withdrawal, overdose, self-inflicted injuries, as well
as an acute exacerbation of chronic medical conditions
for patients with a psychiatric diagnosis.
Outcomes measures include decrease in restraint
use, decrease in 1:1 use, decreased LOS, and enhanced
staff satisfaction. Nurse Practitioners with expertise in
care of adults are available 24/7 to provide admission
physicals and medical consultation.
18
Awards
2007 Award Winners - National Nurses’ Week
Michelle Miller - 8-1200 - Excellence in Nursing Leadership Award The Excellence in Nursing Leadership Award recognizes a nurse who serves
in a leadership role in Nursing Practice. She/he inspires nursing staff to
achieve excellence in patient care, enjoys the respect of staff, colleagues
and patients, and exemplifies the highest standards of leadership, caring
and professionalism.
Shayne Hawkins - 5-1600 - Katharine Donohoe Neuroscience Award The Katharine Markey Donohoe Neuroscience Nursing award recognizes a
nurse who demonstrates excellence in clinical care, leadership, research,
education, or community service in caring for neuroscience patients.
Tara Wengert - 4-1600 - Excellence in Nursing Practice The Award for Excellence in Nursing Practice recognizes CAS members who
demonstrate exceptional competence and skill in patient focused nursing.
Their contributions to patient care consistently exceed performance criteria
and role expectations.
Stephanie VonBacho - Nursing Accreditation & Advancement Outstanding Contributions in Nursing Practice - The Award for Outstanding
Contributions in Nursing Practice recognizes a Nursing Practice employee
who is NOT a CAS member. This individual provides critical support through
their significant contributions to meeting Nursing Practice and SMH goals.
Marc Williamson - ISD - Outstanding Contributions outside of Nursing
Practice - The Award for Outstanding Contributions in Nursing Practice
recognizes a Nursing Practice employee who is NOT a CAS member. This
individual provides critical support through their significant contributions to
meeting Nursing Practice and SMH goals.
Joanne Dehond - Peds ED - Outstanding Licensed Practice Nurse The Outstanding Licensed Practice Nurse Award recognizes a LPN who
demonstrate exceptional competence and skill in patient focused nursing.
Their contributions to patient care consistently exceed performance criteria
and role expectations.
Infectious Disease - Paul "Pat" Burdick Award for Excellence in care of
AIDS Patients.
Gina Cable - Peds Cardiology - Nancy Kent Nurse Practitioner The Nancy Kent Award recognizes a Nurse Practitioner in Nursing Practice.
She/he inspires nursing staff to work collaboratively, advances the practice
of nursing and places patients first and foremost.
19
Michelle A. Murphy - 5-1600 - Denise Hartung Clinical Excellence in
Nursing - This award recognizes nurse(s) who deliver health care to their
patients with compassion and respect. They serve as a role model to their
peers on the importance of setting high standards in creating a positive
environment that promotes customer service
Jennifer Boehly - 8-3600, SICU - Excellence in Liver Transplant
Nursing - The Excellence in Transplantation Nursing Award recognizes
excellence in nurses involved in the direct care of patients in the Liver
Transplant program.
Michele Atkinson - 3-2800, Burn Trauma - Excellence in Precepting This award recognizes a nurse who, over the past year, has provided an
outstanding contribution to the education and preparation of an orientee
and has had a positive impact on their training experience.
Heather O'Brien - Psychiatry - Nursing Professional Development/
Continuing Education/Staff - Life long learning is essential for nurses to
maintain and increase competence in nursing practice. The role of the
nurse in education and professional development influences the practice
environment and the advancement of the profession. This award recognizes
a nurse who demonstrates exceptional contributions toward nursing
continuing education and professional development.
Gail Ingersoll - Nursing Research Center - Nursing Professional
Development/Continuing Education/Staff - Life long learning is essential for
nurses to maintain and increase competence in nursing practice. The role of
the nurse in education and professional development influences the practice
environment and the advancement of the profession. This award recognizes
a nurse who demonstrates exceptional contributions toward nursing
continuing education and professional development.
Cathy Thompson - 3-2800 - Burn Trauma - Patient Care Award This award recognizes a nurse who exemplifies what a Strong Nurse is
and has gone above and beyond to make a patient's experience as positive
as possible.
Shannon Paul - 5-3400 - Patient Care Award - This award recognizes a
nurse who exemplifies what a Strong Nurse is and has gone above and
beyond to make a patient's experience as positive as possible.
Hospital Awards
Heather Menchel - received the Board Quality award (for Nursing)
in 2007
Emily Showers - Ann Phillips Hill Award - established in 2003 by the
family of Ann Phillips Hill to provide an incentive for nurses and staff to
offer new ideas to improve outpatient care, patient preparation for transition
to outpatient care and access to outpatient care for patients dealing with
long-term transplant related problems.
Regional/National Awards
Jane Deluca - March of Dimes Award - a graduate scholarship awarded to
recognize and promote excellence in the nursing care of mothers and babies
Carole Farley Toombs - Excellence in Leadership Advanced Award
from the American Psychiatric Nurses Association (APNA) - in recognition
for her leadership in systematically building clinical services in acute
psychiatric care at Strong Memorial Hospital through interdisciplinary
collaboration and innovation.
Catherine Lyons - National Academies of Practice - recognizes individual
practitioners and scholars who have made significant contributions to the
application and effectiveness of professional practice and its scientific base.
Martha Lightfoot - Multiple Sclerosis Achievement Award - recognizes
her outstanding care and her interest in individual patients
Toni Smith - Professional Leadership in Health Care 2007 from F.D.C.
Board of Directors and was inducted into the F.D.C. Hall of Fame.A Division
of First Church Devine, Non-Denominational, Inc. Hall of Fame established in
1975 to recognize individuals for their “significant contributions to the
evolution, development, and perpetuation of social reform throughout our
global community.”
Gail Ingersoll - Named Loretta Ford Professor of Nursing.
CVICU - Beacon Award for Critical Care Excellence at Strong Memorial
Hospital, presented by the American Association of Critical Care Nurses
Deborah Bacon - 6-1600 - Patient Care Award - This award recognizes
a nurse who exemplifies what a Strong Nurse is and has gone above and
beyond to make a patient's experience as positive as possible.
20
Publications l Presentations
Publications and Presentations 2007
Lord L. Safe enteral tube feedings and hydration in home care. Safe Practices in Patient
Care, 3(3), 6-11.
The number and type of dissemination activities by nurses at SMH has increased
steadily over the past five years, with staff nurses, nurse leaders, nurse managers,
advanced practice nurses, and senior executives involved in presenting, publishing,
and developing online educational programs for the purposes of sharing information
and innovative practices. Activities undertaken between 2007 and 2008 include
(names of SMH nurses bolded);
Lord L, & Pelletier K. (In press). Management of hyperemesis gravidum with enteral
nutrition. Practical Gastroenterology.
Borch M, Hattala P, Beron B, Rust K, Simmons B, Leonhardt A, Kiernan M,
Shaydert D, Davey A, & Yovanovich J. Laparoscopic radical robotic protastectomy:
a case study. Urological Nursing, 27, 141-143.
McAdam DB, & Cole L. (In press). Behavioral interventions to reduce the rumination of
persons with developmental disabilities. In F. Columbus (Ed.), Trends in eating disorders
research. Hauppauge, NY: Nova Science Publishers, Inc.
Carley J. Short story: Babies [online]. Available at http://helium.com.
McMullen AH, Pasta D, Wagener J et al. (In press). Pregnancy in women with cystic
fibrosis. Chest.
Carley J. Short story: Techniques to help cope with pain in labor [online]. Available at
http://helium.com.
Chimenti CE, & Ingersoll GL. (2007). Comparison of home health care physical therapy
outcomes following total knee replacement with and without subacute rehabilitation.
Journal of Geriatric Physical Therapy, 30, 102-108.
Earley MB, Bisognano J, & Baker M. (2007). Strategies for developing a successful
heart failure clinic. Cardiology, 36(9), 18-19.
Evans B, Ireland EK, & Apostalokas M. (2007, December). VAP project training
CD. Albany, NY: Hospital Association of New York State.
Giffi C. Peri-FACTS: HIV update; Health care among the disabled; ABO incompatibility;
First trimester screening; Updated guidelines for breastfeeding [online]. Rochester, NY:
University of Rochester.
McMullen AH, Yoos L, Anson E, Kitzman H, Halterman JS, & Sidora-Arcoleo
KS. (2007). Asthma care of children in clinical practice: Do parents report receiving
appropriate education? Pediatric Nursing, 33, 37-44.
Mick D. (2007). Gerontological issues in critical care. In R Kaplow & SR Hardin
(Eds.) Critical care nursing. Synergy for optimal outcomes (pp. 78-94). Sudbury, MA:
Jones & Bartlett.
Papadakos PJ, & Rossborough T. The team works 24/7. Critical Care Medicine,
35, 2209-2210.
Rideout K. (2007). Evaluation of a pediatric nurse practitioner model for hospitalized
children, adolescents, and young adults with cystic fibrosis. Pediatric Nursing, 33, 29-36.
Rera B (2007). Management of burn mass casualty incidents. In TG Veenema
(Ed.), Disaster nursing and emergency preparedness for chemical, biological, and
radiological terrorism and other hazards (2nd ed: pp. 221-236). New York: Springer
Publishing Company.
Goodwin Veenema T, Benitez J, & Benware S. (2007). Chemical agents of
concern. In T Goodwin Veenema (Ed,) Disaster nursing and emergency preparedness.
New York: Springer.
Sacco TL. (2007). Traumatic injury due to explosives and blast effects. In TG
Veenema (Ed.), Disaster nursing and emergency preparedness for chemical,
biological, and radiological terrorism and other hazards (2nd ed.). New York:
Springer Publishing Company.
Houser, J, & Mick, DJ. (2007). Ethical considerations in research. In J. Houser (Ed.).
Nursing research: Reading, using, and creating evidence. (pp. 53-73). Sudbury, MA:
Jones & Bartlett.
Sacco TL, Stapleton M+, & Ingersoll GL. Increasing family involvement
through family-facilitated support groups. Under review for publication.
Ingersoll GL. (In press). Outcome evaluation and performance improvement: An
integrative review of research on APN practice. In A. Hamric, J. Spross, & C. Hanson
(Eds.), Advanced Practice Nursing: An Integrative Approach (4th ed.). St. Louis: Elsevier.
Ingersoll GL. (2007). Transforming organizations to support evidence-based decisionmaking [Online]. Sigma Theta Tau International, Indianapolis, IN.
Ismail MS, Brand C, & Martin K. Benefits of early pharmacological treatment in
Alzheimer's disease. Psychiatric Times, 24(4), 49-54.
Kleinpell RM, Graves BT, & Ackerman M. (2007). An overview of the incidence,
pathogenesis, and management of sepsis. AACN Advanced
Critical Care, 385-393.
Kopin LA, & Pearson TA. (2007). In the clinic - dyslipidemia. Annals of Internal
Medicine, 147(5).
Kopin LA, & Pearson TA. (In press.). Multifactorial risk factor intervention. In J L
Durstine, GE Moore et al. (Eds.), Pollock's textbook of cardiovascular disease and
rehabilitation. Champaign, IL: Human Kinetics Publishing.
Lange JW, Ingersoll GL, & Novotny JM. (In press). Transformation of the
organizational culture of a school of nursing through innovative program development.
Journal of Professional Nursing.
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Sharp DL, Blaakman SW, Cole EC, & Cole RE. (2006). Evidence-based
multidisciplinary strategies for working with children who set fires. Journal of the
American Psychiatric Nurses Association, 11, 329-337.
Sidora-Arcoleo K, Yoos HL, McMullen A, & Kitzman H. (2007). Complementary
and alternative medicine use in children with asthma: prevalence and sociodemographic
profile of users. Asthma, 44, 169-175.
Smith TS, Ingersoll GL, Robinson R, Hercules H, & Carey J. (In press).
Recruiting, retaining, and achieving health career advancement for employees from
under-represented groups. Journal of Nursing Administration.
Smithers, J. (2007). Rationales for developing a perioperative web-based resource:
informatics in action. AORN Journal, 86, 239-248.
NOTE: This publication won an award by the AORN Journal
Stevens J, Iida H, & Ingersoll GL. (2007). Implementing an oral health program in a
group prenatal care practice. JOGGN.
Tuttle J, Campbell-Heider N, & David TM. (In press). Positive adolescent life skills
training for high risk teens. Journal of Pediatric Health Care.
Volpe E, Nelson L, Kraus RA, & Morrison-Beedy D. (2007). Adaptation and
refinement of HIV knowledge questionnaire for use with adolescent girls (HIV-KG AG).
JANAC: Journal of the Association of Nursing in AIDS care, 18(5), 57-63.
Witzel, P, & Chiverton, P. (2008). What CNOs really want. Nursing Management,
39, 36-47.
Ingersoll GL, & Witzel PA. Including staff nurses in nurse manager performance
review. Eleventh National Magnet Conference, Atlanta, GA, October 4 & 5, 2007.
Yoos HS#, Kitzman H, Henderson C, McMullen A, Sidora-Arcoleo K,
Halterman JS, & Anson E. (2007). The impact of the parental illness representation
on disease management in childhood asthma. Nursing Research, 56, 167-174.
Kuleszo M & Ingersoll, G. Nurses' perceptions about providing aggressive life
saving care to patients with a low likelihood of recovery in a surgical intensive care unit
(SICU) [poster]. Critical Care Nursing Symposium, Rochester, NY, September 2007.
Dissemination activities also include presentations at local, regional, national and
international conferences and workshops. Presentations provided by SMH nurses in 2007
and 2008 include:
Lambert A. Huddle up for a safe patient handoff in the CVICU unit [poster]. AACN
National Teaching Institute's World Congress, Atlanta, GA, May 2007.
Cahill J. Improving patient satisfaction [poster]. Nursing Management Congress 2007,
Chicago, IL, September 2007.
Dalton L, Hurley D, & McIntyre J. A risk assessment of SICU clinical microsystem
utilizing epidemiological principles [poster]. Critical Care Nursing Symposium, Rochester,
NY, September 2007.
Lambert A. Huddle up for a safe patient handoff in the CVICU unit [poster]. Critical
Care Nursing Symposium, Rochester, NY, September 2007.
Mick DJ. Stopping the snowball effect of illnesses for hospitalized geriatric patients:
How to minimize the incidence of cascade iatrogenesis. AHC Audio Conference,
May 2007.
Evans B. Patient mobility in the ICU [poster]. Critical Care Nursing Symposium,
Rochester, NY, September 2007.
Mick DJ. Transforming care at the bedside. Patient-nurse partnerships in evidencebased practice. Critical Care Nursing Symposium, Strong Memorial Hospital, Rochester,
NY, September 2007.
Freeland N, & Berry C. Keep the pressure off! Pressure ulcer prevention and
treatment strategies in the intensive care unit [poster]. Critical Care Nursing Symposium,
Rochester, NY, September 2007.
Mick DJ. Making the abstract concrete: Developing an award-winning abstract.
American College of Nurse Practitioners Clinical Conference, San Antonio, TX,
October 2007.
Freeland N, & Berry C. Achieving great gains in critical care nursing: raisingthe
bar and moving beyond [poster]. Critical Care Nursing Symposium, Rochester, NY,
September 2007.
Mick DJ. Resumes, CVs, and biosketches: Which one do I need and when? American
College of Nurse Practitioners Clinical Conference, San Antonio, TX, October 2007.
Flannery M, & Phillips S. Please call if you have a problem: Patterns of oncology
patients' telephone calls. Cancer Nursing Research Conference, Hollywood, CA,
February 2007.
Flannery M, Phillips S, & Haller M. Describing nursing triage of oncology patients'
telephone calls. Oncology Nursing Society, Las Vegas, NV, April 2007.
Hallinan W. From shock to shocking recoveries. AACN National Teaching Institute's
World Congress, Atlanta, GA, May 2007.
Hallinan W, Lambert A, Shannon D, Delahanty J, & Burgin S. The big freeze:
Operationalizing a therapeutic hypothermia team for sudden cardiac death patients
[poster]. Critical Care Nursing Symposium, Rochester, NY, September 2007.
Harris JL. Improving hand-off communication in an acute care hospital [poster].
Nursing Management Congress 2007, Chicago, IL, September 2007.
Ingersoll GL. Measuring improvements in programs designed to recruit and retain
nurses. National Database of Nursing Quality Indicators Data Use Conference, Las Vegas,
NV, January 2007.
Ingersoll GL. The future of perioperative nursing and nurses. AONE Educational
Meeting, Rochester, NY, April 9, 2007.
Ingersoll GL. Nurse manager competencies. Nursing Management Congress 2007,
Chicago, IL, September 19, 2007.
Ingersoll GL. Proposal writing. New York State Simulation Education User's Group,
Utica, NY, April 11, 2008.
Mick DJ. Taking the “burn” out of burnout: Strategies for career renewal. American
College of Nurse Practitioners Clinical Conference, San Antonio, TX, October 2007.
Peterson A. Transforming an ED boarding unit into an inpatient medical unit [poster].
Nursing Management Congress 2007, Chicago, IL, September 2007.
Sacco T, VanHoover S, Stapleton M, & Ingersoll G. Family support in the burn
trauma ICU: initiation of a family support group [poster]. Trends in Trauma &
Cardiovascular Nursing, Philadelphia, PA, April 2007.
Sacco T, VanHoover S, Stapleton M, & Ingersoll G. Family support in the burn
trauma ICU: initiation of a family support group [poster]. Critical Care Nursing
Symposium, Rochester, NY, September 2007.
Schlegel M, & Williams H. Essential skills: The role of communication in timely and
safe patient discharge [poster]. Nursing Management Congress 2007, Chicago, IL,
September 2007.
Tomeck P. Issues concerning feeding tube placement unit [poster]. Critical Care
Nursing Symposium, Rochester, NY, September 2007.
Witscheber C. Critical care pressure ulcer risk calculator [poster]. Critical Care
Nursing Symposium, Rochester, NY, September 2007.
Witzel, P, & Ingersoll, GL. (2007). Including staff nurses in nurse manager
performance review. Eleventh Annual Magnet Conference, Atlanta, GA, October 2007.
Witzel, P, & Ingersoll, GL. (2007). Using evidence to support clinical and
administrative decision-making. Transforming nursing data into quality outcomes.
National Database of Nursing Quality Indicators Data Use Conference, Las Vegas, NV,
January, 2007.
Ingersoll GL. US - China forum: Healthy people, healthy communities through nursing
contributions. Co-leader People to People Delegation,
Ingersoll GL, & Witzel PA. Using evidence to inform clinical and administrative
decision making. National Database of Nursing Quality Indicators Data Use Conference,
Las Vegas, NV, January 6, 2007
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