2019 NURSING ANNUAL REPORTSentara Obici Hospital

TABLE OF CONTENTS

Message from CNE 2

Quality and Patient Sensitive Measures 3-5

Professional Practice 6-7

Professional Development 8-14

Healthy Work Environment 15-17

Scholarly Dissemination 18-19

Community Outreach 20

A MESSAGE FROM OUR CNE

Stephanie Jackson, DNP, RN, NE-BC

VP/Chief Nurse Executive

Sentara Obici Hospital

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I am pleased to share the 2019 Nursing Annual Report from the Sentara Obici Hospital campuses. This report highlights our significant accomplishments amidst a year of change and growth.

We outperformed the mean for the majority of the last 8 quarters on all Patient Sensitive Measures. What an amazing way to demonstrate Patient Centered Care!

We had a 76% participation rate on our Members of the Team nursing engagement survey and outperformed the national mean in the categories of Nursing Autonomy, Fundamentals of Quality Nursing Care, Interprofessional Relationships, Leadership Access and Responsiveness, Professional Development, and RN to RN Teamwork and Collaboration.

We met our goals to increase BSNs and certification rates and are on target to have 80% of our nurses BSN prepared by the end of 2020. Thank you for your commitment to lifelong learning and assuring the highest standards of care for our patients!

We recognized Novice and Experienced Nurse from each department with a Nurse Excellence Award during Week of the Nurse. Ten Extraordinary Nurses were honored with a Daisy Award.

We provided Community Support in collaboration with the March of Dimes, American Heart Association, American Cancer Society, United Way, and multiple flu shots drives.

We initiated scholarly work on HAI Reduction and disseminated knowledge on Healing Touch and the Discharge Unit. Congratulations to our poster presenters!

This year, we embodied our new professional practice model with the foundational culture of safety and accountability and conceptual framework of Relationship Based Care. Our scope of practice realized by the columns of the Parthenon includes Shared Decision Making, Coordination, Patient Outcomes, Innovation, Collaboration, and Evidence Based Practice. I am grateful and proud to live the nursing vision etched on the Parthenon roof, to provide an environment of health and healing, with the Obici team every day!

Thanks for all you do,

Stephanie Jackson, DNP, RN, NE-BC

Vice President/Chief Nurse Executive

QUALITY AND PATIENT SENSITIVE MEASURES

HAI, HAPI, Falls, Patient Experience

Bedside nurses influence patient outcomes through their day to day care of the patient. Sentara Obici tracks outcomes of the patient sensitive indicators (PSI). PSI are those metrics that the nurse directly impacts. There are many PSI that are tracked at SOH, such as: Falls with injury, Hospital Acquired Pressure Injuries stage 2 or greater (HAPI) Central Line Associated Bloodstream Infections (CLABSI), and Catheter Associated Urinary Tract Infections (CAUTI). These metrics are compared on a hospital wide level as well as nationally through the National Database for nursing Quality Indicators (NDNQI®.)

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QUALITY AND PATIENT SENSITIVE MEASURES

HAI, HAPI, Falls, Patient Experience

National Database of Nursing Quality Indicators (NDNQI®) nationally benchmarks nurse sensitive indicators. These measurementsallow nursing units to benchmark their performance with nursing units of similar composition nationally. Trends are measured for eight quarters which is equivalent to two years, the indicators measured are falls with injury, hospital acquired pressure injuries (HAPIs), central line associated blood stream infection (CLABSI), catheter associated urinary tract infection (CAUTIs), new events of methicillin resistant staphylococcus aureus (MRSA), and new events of clostridium difficile (C. diff). The table below shows Quarter 4 2017 to Quarter 3 2019 (some resulting periods are shorter if the metric has been measured less than 8 quarters.) Sentara Obici nurses are sustaining outperformance of the mean across the nation.

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QUALITY AND PATIENT SENSITIVE MEASURES

HAI, HAPI, Falls, Patient Experience5

Members of the Team (MOT) Nursing Satisfaction Chart- this annual survey is conducted so the staff can give feedback on Sentara Obici and Sentara BelleHarbour in general and on their areas of employment. The leadership team uses this tool to work on improving the staff experience which ultimately leads to exceptional care for our patients.

QUALITY AND PATIENT SENSITIVE MEASURES

HAI, HAPI, Falls, Patient Experience6

PROFESSIONAL PRACTICE

The Sentara Professional Practice Model was revised in 2019

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Sentara Nursing Goals:

Mission: to improve health every day through nursing excellence

Vision: to create an environment of health and healing

Values: People, Quality, Patient Safety, Service and Integrity

PROFESSIONAL DEVELOPMENT

BSN Rates, Certifications, Transition to Practice Programs, NRP, ED Internship, Periop 101

According to the American Nurses Credentialing Center, Board Certification of nurses plays an important role in the assurance of high standards of care for patients and their loved ones. Nursing, like healthcare in general, has become increasingly complex. Nursing certifications provides an opportunity for nurses to demonstrate their knowledge as well as a strong personal commitment to life long learning. Certified nurses at the bedside confirms our commitment to improve health everyday. 18.8% of our nurses are certified.

66.7% of Obici nurses have a BSN or higher which is a 2.2% increase over 2018. We currently have 15.3% of non-BSN nurses under contract to complete their BSN within the next few years which will put us at 82% BSN graduate or higher.

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PROFESSIONAL DEVELOPMENT

BSN Rates, Certifications, Transition to Practice Programs, NRP, ED Internship, Periop 1019

Certified NursesNurse Executive-Board CertifiedStephanie JacksonDeborah McDermottWendy BiandoJessica CarpenterMarianne WalstonJennifer MorrisonMiranda Powell

Certified Registered Nurse InfusionPam Deehan

Certified Nurse Manager and LeaderAmy Taylor

Certified Pediatric NurseAmber Hamilton

Certified Professional Healthcare QualityLatarsha WaddyAmanda Goodwin

Certified Radiology NurseRobin McClelland

Certified Nurse Operating Room Ruth Fowler Eric HayesNikeea Bullock Lynda MoserJennifer Stewart Scott ThompsonMary Mace Lisa Zabner

Certified Aromatherapy PractitionerLisa Story

Cardiovascular RN Level 1Bennetta Brinkley James Maccord

Family Nurse Practitioner AANPDe’Ja Simpson Cheree Faison

Accredited Case ManagerCheria GreeneSusan GriffinSerena Hendricks

Adult Nurse PractitionerApril Rawlings

Adult Gerontology CNSBrittney CurleSarah Taylor

Advanced Oncology Certified NurseWonda Moss

Ambulatory Care NursingMelissa MyrickBrenda GodwinVirginia Fly

Cardiac/Vascular NurseKimberly Katula Lisa Pendell

Case Manager CertifiedHattie Boone Tairn McCalleyKim Tidwell

CCRN Neonatal, Ped, AdultApril Kyer Kelly JordanAlice Callis Heather EleyLindsay Heatherly Cathy AllsbrookSherrill Tillman

Certified Diabetic EducatorChristine Dignan

Certified Healthcare Operations ProfessionalKerry Greene

Oncology Nursing CertificationValerie KylesMelissa BellRebeca LeeChristy Lynch

Orthopedic Nursing CertifiedKathleen KnightHeidi PittmanTracey StallardDebra HearnRakhsheed Siddiqui-LaneKelly Best

Progressive Care Nurse Metwyoine DunnMelissa MyrickLauren HeckenlaibleBennetta BrinkleyCharlene BrickhouseSheryl ArringtonBarbara Fleuridor

Medical Surgical Certified RNSamantha PaquetteBrenda Godwin

Neonatal Low Risk CertifiedDenise TarvesPaula Casper

Obstetric Newborn Maternal Certified NurseStephanie Clements

Certified Wound Care NurseVanessa Johns

Certified Wound Ostomy NurseStephanie EdwardsDee Council

Certified Emergency NurseVictoria PratkoLoretta MartinTerri BrylaJennifer MorrisonLauren LawlessCara JonesSarah Taylor

Certified Ambulatory Paranesthesia NurseMaricris King

Certified Case ManagerTairn McCalleyLisa ArringtonBarbara Kelly-Gibbs

Certified Heart Failure NurseRoss ReitzApril Rawlings

Certified Medical Surgical RNMonique Presley-KelsoEmily WrightMichelle SalvattoLona ReeseFaron JustinoJasmine LambKaylyn BrownLee KnillCatherine Cupp

Lactation ConsultantKaitlin GudgerStephanie ClementsPaula CasperBenny Baugham

National Healthcare Disaster ProfessionalLeslie Griffin

Certified Gastroenterology NurseSusan Williams

PROFESSIONAL DEVELOPMENT

BSN Rates, Certifications, Transition to Practice Programs, NRP, ED Internship, Periop 10110

Sarah Taylor, MSN, RN EDMegan Smith, BSN, RN 2CSUCamellia Kelly, BSN, RN 3WCSusan Williams, BSN, RN EndoscopyElisa Sobers, BSN, RN ICUJason Casteen, BSN, RN, SBLH EDCourtney Etheridge, BSN, RN 3 SurgTaylor Vick, BSN, RN 1MOCheree Faison, MSN-FNP, 1OSLisa Bradshaw, BSN, RN- Resource PoolDe’Ja Simpson, MSN, RN- 1MOBrenda Godwin, BSN, RN OPS/PACUMarie McCarson, BSN, RN 2CSU

These nurses earned their BSN or higher in 2019

PROFESSIONAL DEVELOPMENT

BSN Rates, Certifications, Transition to Practice Programs, NRP, ED Internship, Periop 10111

Nurses who Maintained or Advanced their Clinical Ladder

The mission of the Clinical Ladder Program is to provide a system for clinical advancement that permits career progression while encouraging the nurse to remain at the bedside. We believe that professional practice models enhance professional autonomy and accountability, increase nurse expertise and promote professional development. Further, we believe the system should recognize each nurse’s individual talents and encourage the development of these unique contributions. Each nurse is encouraged to pursue the highest level of career achievement desired, with tangible and intangible rewards for their desired practice level.

CLIN III Renewal or Advancement

Sandy BuckMegan KessingerBrandy DunnSamantha BrileyLisa StoryMichelle SalvattoLisa ZabnerTraci AndersonMaricris KingFaron JustinoKathlee StoetzelBeth Bryan

Clin IV Renewal or Advancement

Melissa MyrickBrenda GodwinHeather Eley

Up for Renewal or Advancement 1st half of 2020

Geralyn MillerShari AndersonCynita BaileyEmmitta HolemanNorma BlandKimberly KatulaGretchen Hinson-BudyLauren HeckenliableAnnette HagwoodBennetta BrinkleySchlonda Chavers

PROFESSIONAL DEVELOPMENT

BSN Rates, Certifications, Transition to Practice Programs, NRP, ED Internship, Periop 10112

2019 Nurse Excellence Awards- Novice

The Week of the Nurse is celebrated every year from May 6th through May 12th. Each year, Sentara Obici Hospital recognizes nurses who have been identified by their peers and leaders as being the embodiment of an exemplary nurse. Each unit/department was asked to choose a novice and an experience nurse. The Novice Nurse: (less than 2 years of experience in nursing or in the nursing specialty) In Patricia Benner’s work “Novice to Expert: Excellence and Power in Clinical Nursing Practice”, the Novice nurse represents the new nurse who requires clear direction and ongoing supervision. Over time, the assimilation of experiences and ongoing professional development activities promotes professional growth and the nurse moves towards becoming an expert nurse.

Brittany Askew, SDS Isabelle Black, AHRT Brittany Brooks, 1MO Catherine Cupp, CHOP Jodi Holt, OR Lynae Hutchinson, 3WC

Faron Justino, 2CSU Sara Luther, OPS/PACU Holly Monell, Nursery Lisa Pendell, OPIC Brittney Pierce, SOH ED Olivia White, ICU

Not Pictured:

Heather Boyce, 1OSShenna Burns, 3 Surg

PROFESSIONAL DEVELOPMENT

BSN Rates, Certifications, Transition to Practice Programs, NRP, ED Internship, Periop 10113

2019 Nurse Excellence Awards- Experienced

The Week of the Nurse is celebrated every year from May 6th through May 12th. Each year, Sentara Obici Hospital recognizes nurses who have been identified by their peers and leaders as being the embodiment of an exemplary nurse. Each unit/department was asked to choose a novice and an experience nurse. According to Brenner, the expert (experienced) nurse possesses a complex network of information and knowledge. Intuition develops much like a sixth sense- a perceptual awareness, an insight, a feeling… Expert nurses know what is right for the patient. They exhibit a distinct ability, a gut feeling assessment. They rely less on objective, universally valid principles and guidelines and more on their own clinical decision making ability.

Melissa Bell, Radiology Lauren Byrum, Risk Management Janet Darden, 1MO Pam Deehan, OPIC Honor Earley, Resource Pool Ginny Fly, OPS/PACU Juanita Payne- Education

Victoria Pittman, 3WC Kortni Stickels, OR Denise Tarves, Nursery Kim Tidwell, CHOP

Not Pictured:Traci Anderson, BelleHarbour EDSandy Buck, Cardiac RehabWallicia Chavis, 1OSMay Dunn, 2SDMonique Lowry, 2CSUTaylor Middleton, 3 MSMelissa Popadiuk, Sentara Obici EDMike Sipes, PsychHayley Wiggins, ICU

PROFESSIONAL DEVELOPMENT

BSN Rates, Certifications, Transition to Practice Programs, NRP, ED Internship, Periop 101

In 2019, we honored 10 extraordinary nurses and one nurse leader with a Daisy Award. This award, created in memory of J. Patrick Barnes, rewards and celebrates the extraordinary clinical skill and compassionate care given by nurses every day.

These exceptional nurses on our Sentara Obici campuses truly made positive impacts on their patient’s emotional and physical well being and have been recognized by their patients, patient families or coworkers for their extraordinary contribution to honor Sentara’s commitment to improve health everyday.

Thank you for your commitment. You are all truly the embodiment of an excellent nurse and we are grateful that you chose to work at Obici.

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HEALTHY WORK ENVIRONMENT

Nursing Satisfaction, Retention, MOT Engagement, Magnet, Beacon, NICHE, DAISY

HAI Reduction C. diff infections Yellow Belt ProjectCheryl Molina, MT (ASCP) Infection Preventionist

C diff and CAUTI were our highest rate of HAI over the last few years. We ended 2019 with 16 HAI C diff infections and 4 CAUTI’s.

After implementing the C diff forms in May 2019 to reduce Hospital acquired C diffs, Obici C diff rates decreased. In August, the C diff process was further refined when a daily HAI huddle was implemented. This resulted in a significant decrease in the amount of C diff infections as well as to help reduce the amount of CAUTI’s Obici was having.

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HAI Huddles as a tool to reduce HAI Karen Zastrow, MT, ASCP, CIC, infection Preventionist

Condition at start of YellowBelt Project and goals:Through 7/2019, we have had 4 CAUTIs (limit of 2), 1 CLABSI (limit of 1) and 14 C diff HOs (limit of 13)We will reduce the rate of infection by 50% by the end of 2019We will reduce the device utilization ratio

Actions:

Outcomes:

From 8/2019 to the end of 2019, there were 0 CAUTIs, 0 CLABSIs and 2 C difficile HO infections.

The CAUTI systemic inflammatory response (SIR) went from 1.505 to 0.876 (58% reduction).

The CLABSI SIR went from 0.324 to 0.196 (60% reduction).

The C difficile SIR went from 0.945 to 0.591 (63% reduction).

The device utilization rate (DUR) for foleys went from 0.105 to 0.108. The device utilization rate (DUR) for central lines remained the same at 0.119.

Night shift Charge Nurses to review patients with central lines and foleys, complete Huddle form and scan to CAUTI Reporting groupPatients with foley catheters, central lines and Bristol 6 or 7 stool will be reviewed in daily HAI HuddleAfter discussion during Huddle, an email is sent to CAUTI Reporting group for follow up action items

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Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

2019 C. diff Timeline

C diff form implemented

HAI HuddleImplemented

HEALTHY WORK ENVIRONMENT

Nursing Satisfaction, Retention, MOT Engagement, Magnet, Beacon, NICHE, DAISY16

HEALTHY WORK ENVIRONMENT

Nursing Satisfaction, Retention, MOT Engagement, Magnet, Beacon, NICHE, DAISY17

SCHOLARLY DISSEMINATION

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SCHOLARLY DISSEMINATION

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COMMUNITY OUTREACH

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Flu shots at Belle, United Way Day of Caring, the Strong Will Race and National Night Out

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