excellence - MedStar Health · experience, such as instituting bedside report, or continuing quality and safety initiatives, like preventing central line-associated blood stream infections

2016 NURSING ANNUAL REPORT

ON THE ROAD TO THE FUTURE

excellence

excellenceexcellence

DEAR COLLEAGUE,

The pursuit of excellence is a hallmark of high-performing organizations. At MedStar Washington Hospital Center, the 2,400 associates in the Department of Nursing seek excellence in all they do, every day.

As you will see in this annual report, achieving excellence requires constant focus and support. Whether we are starting a new initiative to improve the patient experience, such as instituting bedside report, or continuing quality and safety initiatives, like preventing central line-associated blood stream infections (CLABSI), excellence means we keep refining our approach so we can sustain top outcomes.

Excellence is even more crucial when we are challenged by healthcare trends, such as the national nursing shortage, which affected so many healthcare systems in FY16. It is thanks to the critical thinking skills and high standards of our talented nurses and nursing affiliates that we were able to continue to exceed so many benchmarks and reach so many of the goals of the Department of Nursing

Strategic Plan.

This year, many of our important nurse-centered programs reached a new level of engagement, which helps keep the voice of nursing front and center in the pursuit of excellence. The establishment of

our fifth Collaborative Governance Council (Quality and Safety) and the launch of the Coordinating Council that orchestrates collaboration between the groups was a true milestone for the department. Just as important: the role played by many MedStar Heart & Vascular Institute critical care nurses, who formed a vital team that assured that our new state-of-the-art Intensive Care Units gave patient needs the highest priority.

Excellence requires many such teams working in concert, with a mutual dedication to high standards. This annual report shows how nurses at the Hospital Center achieve these objectives, every day.

SUSAN ECKERT, MSN, RN, NEA-BC, CENPSENIOR VICE PRESIDENT/CHIEF NURSING EXECUTIVEMEDSTAR WASHINGTON HOSPITAL CENTER

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IN SPECIALIZED CARE

NURSING AT THE HEART OF A NEW HOSPITALWhen the Nancy and Harold Zirkin Heart & Vascular Hospital opened at the end of FY16 at MedStar Washington Hospital Center, the new intensive care floor reflected the voice of a unique council of nurses with expertise in critically ill cardio-vascular patients.

The MedStar Heart & Vascular Institute (MHVI) Critical Care Nursing Council, consist-ing of 14 nurses from three different critical care nursing units, began meeting almost two years before the Heart Hospital opening. Kelly Nye, BSN, RN, then a staff nurse in the Cardiovascular Recovery Room, asked her managers if she could put together a council. “They agreed, and we sought out volunteers who were willing

to come in on their time off and wanted to have a voice. It just grew from there.”

During the two years, she says, “management allowed us to be the driving force behind the change. Who better to make decisions that would directly impact nurses at the bedside?”

When Nye was promoted to leadership, CVRR colleague Liz Nixon, RN, stepped in to co-chair with Leigha McGuin, BSN, RN, a weekend night nurse on 3H.

“From the beginning, nurses were able to say what we needed, what we use and what we could use to offer the best patient care,” says McGuin. “We really had a voice in everything from where things went to how the work flow would change.”

“We knew that combining the different cultures of the different units, the different schedules and float patterns, would take some planning,” adds Denise “Deni” Estrada- Palma, RN. “We began working with our new colleagues, with the nurse practitioners and physician assistants as well, so that the group functioned as a team before we arrived.”

The group met socially several times, and regularly

toured the construction site to update their plans and recom-mendations.

As a result, “in the weeks leading up to the move, many staff volunteered to come in on their days off, stay late and even come in on the weekends to stock carts, label items and create functional work environ-ments,” says Nye. “They really stepped up and came together as a team.”

PRACTICE MAKES SAFEThe week prior to moving into the new MedStar Heart & Vascular Institute critical care units on 2NE and 2NW, approximately 130 nurses from CVRR, 3H, 4G and the hospital float pool attended a four-hour training block. This training spanned over one week, referred to as “Sim Week.”

“The primary focus was to get the staff acquainted with the new work environment without the added stress of patients, says Kelly Nye, BSN, RN, patient care manager on 2NW. “The unit size alone, which was much bigger than anything we were used to, created new challenges for our staff.”

Several stations were set up to include training on new defibrilla-tors, pacers, new progressive ICU beds, the high tech boom systems, a brand new HaemoBank™ system, where staff could retrieve blood products emergently on the unit, and a new medical materials supply system (Logi-D).

MedStar Health’s SiTEL (Simulation, Training and Environment Lab) was enlisted to help design and implement a clinical training scenario with an emergent patient situation that required the staff to locate and use the new technology and equipment. One patient scenario involved excessive bleeding, cardiac arrest and rapid return to the Cath Lab, another consisted of a bleeding open heart surgery admission that deteriorated to a cardiac arrest requiring the patient’s chest to be opened at the bedside with a rapid return to the OR. “The practice definitely made our transition safer for our patients,” says Nye. “We absolutely learned where to go to get help.”

excellence new cardiovascular ICU rooms44

units moved over three years to build the Nancy and Harold Zirkin Heart & Vascular Hospital16

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Building the Nancy and Harold Zirkin Heart & Vascular

Hospital required moving 16 functioning units over the course of three years.

“When we started out, we’d take six or seven hours just to get the patients from one location to another, and that was after months of strategizing and checklists and having many different departments

involved,” notes Silvester Stokes, business manager for the Department of Nursing.

After three years, he smiles, “we could move 30 patients in two hours.”

Shifting units required extra attention to maintaining a healing patient care environ-ment while minimizing patient discomfort from construction noise. A team tasked with providing solutions gave out earplugs and headphones

that connected directly into televisions in the room.

Although the new Heart & Vascular Hospital is now complete, the moves will continue as the Hospital Center updates other units that were first constructed in the 1950s. Plans for FY17 include restructuring an immediate care unit to provide overflow space for the Emergency Department, and refurbishing several intensive care units.

U N I T S O N T H E M O V E

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IN PROFESSIONAL DEVELOPMENT

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CREATING A LEADERSHIP ACADEMYRecognizing the well-docu-mented fact that positive rela-tionships with nurse managers are vital to nurse retention, the Department of Nursing launched a Leadership Academy in FY16 to provide management skills, personnel engagement and work-life balance workshops for the Hospital Center’s 158 nurse leaders. “Today’s young leaders are highly motivated, well-educated critical thinkers,” says Susan Eckert, MSN, RN, NEA-BC, CENP, senior vice presi-dent and chief nursing executive. “They are open to new ideas and life-long learning. The Leadership Academy grew out of a desire to engage our leaders, along with all our nurses.” Among the initial workshops in FY16:• Work-Life Balance, led by

Caren Lewis, MSHA, BSN, RN, Vice President, Anesthesia and Perioperative Services

• Nursing Professional Develop-ment Models used at MWHC: An Overview, led by Michael Clarke, MSN, RN, NEA-BC

• Finance Update: Decoding Reimbursement, led by busi-ness consultant Jessica Jones

nurses graduated from the Vizient® /AACN Nurse Residency program240

292nurses

million dollars in tuition reim-bursement for3.3

TUITION REIMBURSEMENT GROWTH

FY14 FY15 FY16 FY14 FY15 FY16

292272258

Nurses $ Million

$1.7$1.46

DEDICATED TO PROFESSIONAL DEVELOP-MENT & ENGAGEMENTNurses at MedStar Washington Hospital Center received a new professional resource in FY16, a nurse educator dedicated to their professional development and engagement.

For nurse educator Sara Groff, BSN, RN, CMSRN, the new position’s focus on supporting nurses who want to take advantage of the life-long learning, education support, bonus programs and career planning available here is a way to help colleagues make the most of their experiences at the Hospital Center.

Nurse recruitment and retention became a major focus in the Department of Nursing in FY16, tied to the early arrival of a long-predicted nursing shortage. Long-standing professional development programs were strengthened and improved, including the Hospital Center’s Vizient®/AACN Nurse Residency Program. In addition to adding an additional residency program coordinator to manage the more than 400 new-to-practice nurses who participated in FY16, the curriculum was revised to include more simulation train-ing, on-line modules, touch points with leaders throughout the year, and a redesigned completion ceremony. Additional professional development added in FY16:• Resources dedicated to key areas for for specialty patient

populations• New certification preparation classes, including Heart Failure and

Oncology• Simulation training in partnership with the George Washington

University School of Nursing• Combined first year residency/bridge programs in Emergency

Department, Critical Care, OR and Cardiac nursing• Developed and implemented the askNED mobile app to alert

nurses to education opportunities, practice updates, and to provide immediate access to the Department of Nursing policy portal and direct email contact with nurse educators.

“This is a great opportunity to support professional growth,” she says. “My overall goal is to build a practice environment that makes our quality staff —leaders and bedside nurses —want to stay here.”

Among the services Groff provides to nurses who have been here 18 months or longer:

• Pinpointing certifications opportunities and classes

• Assisting with Clinical Advancement Program applications

• Expanding the Leadership Academy program

• Providing individualized information about education, career development and tuition support

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When Olakunle Ayanwale (above, middle) started

work as a patient care techni-cian on unit 1C, he didn’t really have a career plan. That was 2009, and, he says, “I just knew I wanted to move up. I wasn’t sure where.” By 2010, however, he was enrolled part-time in

college, earning prerequisites to get an associate nursing degree. “I was inspired by the caring nurses I saw working here.”

The next five years, he says, were not easy. Working full time and going to school presented challenges. “I could not have done it without the support

of my nursing director, Evelyn Ougo,” he says. “She worked with me on my schedule. She would sometimes sit me in her office and tell me how to get things done. I cannot tell you how helpful those words were.”

Last year, Ayanwale—known as “Idris” on the unit—received his degree and RN license, and returned to work on 1C—this time as a nurse resident. Even as he works full time on the geriatric medical/

surgical unit, he is enrolled in a program to get his Bachelor of Science in Nursing, and is aiming for a Master’s degree in nursing informatics.

“I am so thankful to everyone on this unit—they all supported me and encour-aged me.” Now Idris is the one encouraging others: his success has inspired eight other PCTs on the unit to enroll in nursing programs.

SUPPORTING PROFES-SIONAL DEVELOPMENTApplications to the Clinical Advancement Program (CAP) professional development recognition program doubled in FY16, and bonuses rose to more than $16,000 in the most recent quarter. The CAP application was also simplified, and dead-lines standardized, based on participant suggestions.

At the top of the record number of applicants: Zainab “Sara” Turay, RN, who started at the Hospital Center in 1998 and currently works on Mother/Baby units 5D and 5F and previously worked in Obstetrics/Gynecology. Wherever she works, “I have always been involved” she says. “I like to be ‘in the know.’” Among the numerous professional develop-ment activities that earned her the highest score in CAP: the

Nursing Professional Develop-ment Council, Wound Resource Nurse, Safety Coach, volunteer for the Biocontainment Unit, unit champion for Language of Caring, and M.O.S.T (Maternal Obstetric Safety Training).

Turay looks forward to earning a CAP bonus next year, too. Already on her list: working on Pathway to Excellence and earning her Mother/Baby certification.

I N S P I R E D . . .A N D I N S P I R I N G O T H E R S

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5,859 Number of times the new askNED app, developed by the Nursing Education Department, was accessed in FY16

IN SKILL AND RECOGNITION

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NEW RECOGNITION: THE CHIEF NURSE EXECUTIVE AWARDThe Chief Nurse Executive Award, a new nurse recognition program started in FY16, honors nurses who exemplify best nursing practices at MedStar Washington Hospital Center. Nurses are nominated by peers and then chosen by the chief nursing executive in one of four categories: Resource Nursing, Patient Care, Mentoring/Coach-ing and Leadership. There is also a category for a Nursing Affiliate, defined as a Hospital Center colleague who is cele-brated for their support for nursing. A total of 34 associates from the Department of Nursing’s seven service lines received the CNE Award in FY16.

EXCELLENCE IN NURSING AWARDWashingtonian Magazine honored four nurses from MedStar Washington Hospital Center at its 2016 Excellence In Nursing Awards dinner in May at the Carnegie Library. Pictured above, from left: Rachel Rosenberg BSN, RN, of 2H was a finalist in the Critical Care category; Tijeerah Henderson, BSN, RN, of the NICU, was a finalist in the Mothers and Children category; Dionne Ross, BSN, RN, nursing director for the Cardiac Cath Lab and the Electrophysiology Lab, was a finalist in both Critical Care and Nursing Leadership categories; and Pramila Jaladanki, BSN, RN, of the Nurse Responder Team, was a finalist in Critical Care.

NICHE AWARDFor the fourth year in a row, MedStar Washington Hospital Center received Exemplar Status, the highest designa-tion possible, from the NICHE (Nurses Improving Care for Healthsystem Elders) organiza-tion. NICHE designation demon-strates a hospital’s organizational commitment and continued progress in improving quality, enhancing the patient and family experience, and supporting the hospital and other healthcare organizations’ efforts to serve its communities.

As an academic medical center, MedStar Washington Hospital Center seeks nurses with the critical thinking skills, training and the educational background to thrive as they provide care in a fast-paced environment with leading-edge services.

Training is available for all nurses at the Hospital Center. In addition, the Nursing Education Department provided training in seven specialty bridge programs (Intermediate Care, Critical Care, Emergency Department, Operating Room, Obstetrics, Neonatal Intensive Care and Post-Anesthesia Care Unit) for 237 nurses.

To make information about classes, policies and opportunities easily available, the Nursing Education Department created and launched a mobile app, askNED, which was downloaded by 692 nurses.

With 82 percent of all nurses having a BSN degree, the Hospital Center surpasses the national average. Among the other notable accomplishments of the Hospital Center nursing workforce:

• Approximately 50 percent are ACLS certified• 16 percent are certified in their clinical or role specialty• 30 percent belong to their professional organization

Percent of nurses at the Hospital Center who have worked here more than 10 years31.7

A GROWING DEMOGRAPHICIn 1970, less than four percent of the national nursing workforce was male. By 2015, according to the Kaiser Family Foundation, males had reached nine percent of all nurses nationwide.

Reflecting national trends, the percentage of male nurses at MedStar Washington Hospital Center grew from nine percent in FY15 to more than 11 percent in FY16. The number of male nurse leaders: 17 of 168.

CLINICAL INSTRUCTION Class Attendance

FY15 FY16

2,704 3,081

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With the expansion of ambu-latory clinics affiliated with

MedStar Washington Hospital Center— there are now 47 clin-ics with 178 nurses and medical assistants —“We realized there was a lot of inconsistency of practice,” says nurse educator Angela Renkema, BSN, RN. “About a year and a half ago, we began looking at how to establish competencies for ambulatory nursing practice, which hasn’t really been done

on a large scale like this before.”Renkema and the Nursing

Education Department looked first at suture removal, because many surgical patients arrive at the clinic days after a procedure for this follow-up. “We created a competency tool and then trained a number of ambulatory nurses who then trained the others in their clinic. We created a basic standardized process.”

The team then moved on to vaccination—all medical

assistants who worked in the ambulatory settings had to take a class so they could administer flu and other routine vaccines —and the list grew from there. “We started with basics, then created checklists for the skills needed for specialty clinics. An Ob/Gyn nurse will need compe-tency in cystoscopy, but medical oncology will need to have certain skills in infusion. There are many different areas.”

In addition, all ambulatory

clinics now have “Safe Lift” equipment and all ambulatory nurses and medical assistants take a class at the Hospital Center in proper use of the equipment. “Any of our ambula-tory nurses are welcome to take classes through the Education Department,” says Renkema. “Ambulatory practices are grow-ing, and we want to be certain our nurses are skilled in best practices.”

A N E W E X P E R T I S E : A M B U L AT O R Y N U R S I N G

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IN QUALITY AND SAFETY

excellenceexcellenceBoth patient and associate safety initiatives drove improvements in care at MedStar Washington Hospital Center for FY16. The year began with a “Protect the Line” initiative that focused on central line-associated blood stream infections (CLABSI). Hospital Center executives and clinicians teamed to round weekly on units, check on central line monitoring and keep associates focused on the steps involved in CLABSI prevention. In response to national headlines about increasing violence against care givers, the Hospital Center created a multi-disciplinary Workplace Violence Prevention Committee that reviewed policies and procedures, initiated new protections and began training programs designed to protect both associates and patients.

Among the quality and safety improvements in FY16:

• Hired a dedicated clinical specialist focused on patient and associate safety• Performed audits on all units to validate supply and use of C.diff prevention packets.• Conducted thorough audit of the Patient Safety Event system to capture and quantify workplace

safety incidents• Initiated a Behavioral Emergency Response Team (BERT) as part of the Department of Nursing Strategic

Plan initiative to focus on behavioral difficulties with patients and families • Enhanced nurse director/physician director dyad model to support monthly clinical dashboards

IT TAKES A TEAM

Lina Pizarro, BSN, RN, (left), and Chee Chan, MD – 1EIMCWhen physicians provided a lunch for the nurses on 1EIMC, it was a celebration of the team work

that helped the intermediate care unit achieve one full year without a central line-associated blood stream infection (CLABSI). It was also, acknowledges Lina Pizarro, BSN, RN, nursing director for the unit “a direct result of the constant communication between the nurses and the physicians here.” That communication, she notes, starts at the top. “Dr. Chan and I are talking several times a day. We text, we phone . . . it’s seamless after five years.”

PRESSURE ULCER PREVALENCE Patient outcomes (Target for FY16: 1.5%)

FY11 FY12 FY13 FY14 FY15 FY16

4.0% 3.1% 2.1% 2.0% 1.7% 1.6%

FALLS Patient outcomes: FY16 is at benchmark for Inpatient Falls Target ≤ 1.6

FY11 FY12 FY13 FY14 FY15 FY16

2.6% 2.1% 2.0% 1.8% 1.8% 1.6%

67

Nursing Executive Safety Rounds completed in FY16

90

percent reduction in Serious Safety Events in two years

SERIOUS SAFETY EVENTS Related to Nursing Care

FY12 FY13 FY14 FY15 FY16

30 33 20 9 2

Maria Elena Ruiz, MD, (left) and Quincy Nicole Smith, BSN, RN – 2DAs one of the busiest medical-surgical units at MedStar Washington Hospital Center, the nursing staff on 2D cares for patients with every-thing from tracheostomies

to trauma. Even with its busy atmosphere and breadth of patients, 2D hits many quality and safety benchmarks. The dyad, says nursing director Quincy Nicole Smith, “is a partnership and a commitment. We are both equally invested in safe patient care, maintaining high clinical and performance standards, and developing our resolutions as a team, especially our tough issues.” What makes it work? “Regular meetings — three to five a month,” says Smith. “I can always reach Dr. Ruiz, she is present and involved, and she supports our staff and our leadership.”

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A NEW RAPID RESPONSEIn FY16, MedStar Washington Hospital Center launched a forward-thinking rapid response team, dedicated specifically to behavioral interventions. “We identified a while ago that when we have psychiatric issues on medical units, the behaviors can become difficult for clinicians who do not have psychiatric training,” notes Lourdes Griffin, PhD, assistant vice president, Medicine and Psychiatry. “There was a desire to create

an alternative for the clinician so they did not need to call in public safety officers when a patient was in a behavioral health crisis.”

The solution: the Behav-ioral Emergency Response Team, or BERT. Five units piloted the program this year. When unit staff cannot de-escalate a behavioral situation, they call a special BERT code that triggers an immediate visit from the team: a psychiatric nurse, a psychiatric social worker and a

behavioral tech trained in psychi-atric de-escalation respond to the unit to assist the unit staff with patient management. BERT is able to call on psychiatrists, hospitalists and public safety officers, as needed. The BERT team is available seven days per week/24 hours per day.

In just three months, the pilot produced dramatic results. “In March, prior to the imple-mentation of BERT, Public Safety was called 60 times to respond to ‘disorderly patients on the

pilot units.’ After implemen-tation of the BERT response, public safety officer calls went down to 12 per month,” says Griffin.

Nurses appreciate the support. “The BERT responders offer a wealth of experience and have been invaluable in helping to manage the environment on the unit,” says Kathy Nasman, BSN, RN, nursing director on 2C. The BERT program is expected to expand throughout the Hospital Center in FY17.

For Mark Marino, MSN, BSN, RN, CPPS, clinical specialist

for safety, both patient safety and associate safety are vital to MedStar Washington Hospital Center’s reputation as a safe facility. “For example, safe lift equipment ensures a patient is comfortable and safe while being moved, as well as protect-

ing our associates from injury,” he says. Pictured above with Kathleen Timmons, director of public safety and his co-chair on the Workplace Violence Prevention Committee, Marino includes everything from phys-ical environment assessments and equipment to de-escalation training and associate harass-

ment prevention as part of the safety picture. The broad formula works. Among the safety accomplishments in FY16:

• Implementation of Vanish-Point® syringes that signifi-cantly reduced needle stick injuries

• OSHA Physical Environment Assessment started

• New Safe Patient Handling/Safe Lift equipment installed, including in ambulatory clinics

• Crisis Prevention Institute Training in De-Escalation techniques begun for nursing associates

• Improved tracking and trending of Patient Safety Event reports

• Safety Contracts that better manage or discharge disrup-tive patients with abusive behaviors

• Identification badges replaced to reflect first name only

A S S O C I AT E S A F E T Y C H E C K U P

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IN PATIENT CARE

excellenceexcellenceTwo of the largest initiatives of the FY16 Department of Nursing Strategic Plan involved improvements in patient care. The first: a hospital-wide rollout of bedside shift report, where the patient is involved in the conversation between nurses and, if possible, physicians at change of shift. The second: beginning extended patient communication and interaction training for associates, titled “Language of Caring,®” to more uniformly express the Hospital Center’s “Above All, Patients First” mission of care.

Another patient care improvement in FY16 involved enhanced use of digital media for patient education and communication:• New white boards in each room for patient communication• Enhanced use of digital media for patient education

BETTER AT THE BEDSIDE “How are you this morning?” asks Ernestine “Tina” Leonidas, BSN, RN. Leonidas (pictured above on the right in the first image), admitted the patient to unit 3C and cared for her through the night. Now she stands at the foot of the bed with nurse Felicia Nyarko, BSN, RN (above left in fourth image), who is taking over on the day shift, and the mobile computer (“W.O.W.” for workstation on wheels) contains all the patient’s charts and vital information. Also observing: nursing resident Lesley Fonjungo, BSN, RN. The nurses confirm the patient’s identification, then Leonidas introduces Nyarko, and gives an update to the patient and the day nurse simultaneously. They reconfirm each item with the patient, and note when they expect the gastroenterologist will be coming by to talk with

her. After checking that the bed and call button function and asking if the patient would like to use the restroom, the nurses take the W.O.W. outside to finalize their handoff.

Welcome to the world of bedside report, where the patient gets a status update and meets each caregiver at change of shift. “If the patients are alert and aware, they really appre-ciate us talking next to them, because it helps them know what is going on and gives them a chance to ask questions,” says Leonidas.

Bedside report, piloted in FY15, rolled out throughout the Hospital Center in FY16. Nurses credit the technique with increasing patient satisfaction scores and reducing patient anxiety. “We had to adapt the process to the different rooms and situations,” says Leonidas, “but it’s working really well.”

100% Department of Nursing

participation in Language of Caring training launch

100% of inpatient units audited

for bedside report compliance six months after launch

“NICE WORDS WORK”Benedict Misterio, RN, above, knows how important it can be to put patients at ease. As one of MedStar Washington Hospital Center’s intravenous therapy (IVT) specialty nurses, “I’m usually using a needle on the patient,” he says. “They aren’t always happy to see me.” Indeed, Misterio walks five miles a day visiting units and procedure areas to draw blood or insert semi-permanent peripherally inserted central catheter (PICC) lines. So when he was picked to be the Language of Caring unit champion for IVT, Misterio liked that he became responsi-ble for reinforcing professional

development rolled out in FY16 designed to help all associates at the Hospital Center better connect with and demonstrate their caring to patients. The Language of Caring program teaches associates to begin interactions with a message from the heart before getting down to business. “Nice words work,” Misterio finds. “Instead of looking at you like, ‘What are you doing here?,’ the patients warm up to you when you start by acknowledging their feelings and show them you know they are anxious.” Once they are comfortable, “everything is easier. Even IV therapy is a much better experience.”

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focus at MedStar Washington Hospital Center, and the Hospital Center’s 124 unit clerks play a vital role in that care as part of the nursing team. From managing patient requests and organizing life on the unit to helping in a crisis, unit clerks can make all the difference to nurses, patients and other staff members as well.

Idi Marrah, above, the night unit clerk on 2E and 2EIMC, is one example of such difference. When a patient on the stroke unit became agitated, refused medication and lashed out at his nurse, Marrah stepped into the room. “He wanted to go home, and he was not happy,” Marrah recalls. “I apologized for his bad day, asked what I could do to help. I listened.” When the patient had calmed down some-what, Marrah told the patient

that he was there because he wasn’t well, and if he cooper-ated and took his medication, he might recover more quickly. “The patient said I could give him his meds. I told him I can’t, but I would wait next to him while the nurse did.”

Marrah received a Hospital Center SuperStar award for his help. “Sometimes I haven’t had as much going on as the nurses do, so I can bring in a new perspective,” he says. “I do what I can to help.”

A B O V E A L L ,PAT I E N T S F I R S T

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someone who says ‘I could not have done it without her,” says Beverly James, BSN, RN, patient care manager of the Third Floor Operating Room (TFOR). She’s talking about patient care technician Ashley Poindexter, a five-year veteran of the TFOR team who cares for those going through gynecology, orthopedic and eye surgeries as outpatients.

PAT I E N T C A R I N G

She helped so much.” “She was one half of the dynamic

duo who took care of me.”Glowing comments arrive

almost every day for patient care technician Ashley Poindexter, above. “Patients tell me Ashley makes them feel cared for and safe,” says Myra Sumpter, BSN,

RN, Third Floor Operating Room (TFOR) patient care manager.

A five-year veteran of the TFOR team who cares for those going through gynecology, orthopaedic and eye surgeries, Poindexter helps patients before and after their procedures. She supports OR nurses by alerting

them to sudden changes in a patient’s status and she won a Nurses Choice award from her colleagues for her excel-lent teamwork. Inspired by her coworkers, Poindexter is pursuing a nursing degree, and aspires to be a Certified Registered Nurse Anesthetist.

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IN PATIENT SATISFACTION

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A BETTER WAY TO WAITIn FY16, a new Discharge Hospi-tality Center (DHC) opened at MedStar Washington Hospital Center to provide a safe and comfortable area for discharged patients to wait for a ride home. With reclining chairs, snacks, large-screen televisions, a dedicated restroom and patient care technician coverage, the DHC “supports patients who want more than simply lying in bed while waiting for their ride

A BETTER WAY TO OPERATE“I always think, what if this patient was a family member, or one of us? How do we want to be treated?,” says Jennifer Dabuet, BSN, RN, pictured above. That prompts her to make certain everything is in place for all surgeries in the Ear, Nose and Throat (Otolaryn-gology) and Oral Maxillofacial services in the Main Operating Room at MedStar Washington Hospital Center. Since she began working as the Clinical Lead Nurse in 2015, OR turnover times have decreased and patient satisfaction scores have increased. The secret: preparation. Dabuet prepares for posted cases days ahead, ensuring necessary instruments,

86,753 Nurse leader rounds on

patients in FY16

12,260 Post-discharge follow-up phone

calls to patients in FY16.

Satisfied patients reflect the “Above All, Patients First” mission of MedStar Washington Hospital Center. Among the initiatives in FY16 that touched on maintaining high patient satisfaction rates:• Replacement of mattresses in half of all non-ICU beds, with other half to come in FY17• New beds in ICU rooms• New patient room furniture (recliners, trays and tables)• Continuation of “Baby Friendly” designation effort. In FY16, 95 percent of associates in Labor &

Delivery, Mother/Baby and NICU/Nursery care units completed “Baby Friendly” education. Hospital- wide education involved informing the community about the benefits of breastfeeding and World Health Organization breastfeeding goals.

• “Clean To Occupy” efforts in the Emergency Department and Post Anesthesia Care Unit to reduce wait time for patients to be moved to a unit

to arrive,” says Doris Medina, BSN, RN, nursing director on unit 3C, pictured above, who manages the Center. The DHC also assists with day-of-dis-charge bed management, and has succeeded beyond initial expectations. “The number of patients utilizing the DHC has increased every month,” says Medina. “We went from three patients per day at the start to about 21 on average, and we continue to grow.”

implants and supplies are avail-able. She communicates with surgeons and clinical managers to schedule procedures in a way that allows sterile process-ing to provide for and turn around instruments as soon as possible without delays. She checks in with the management team in the evening, for conti-nuity of preparation and follow- ups. On the day of surgery, Dabuet sees to it that patients are appropriately prepared in the holding area and that the operating room and team assigned are all set. “It’s a good thing to prepare, prioritize and organize,” she smiles.“I hope to inspire others to give our patients the utmost care they deserve. At the end of day, we smile as we head home, know-ing that our preparation had a great impact on the patient’s surgery experience.”

IN EVIDENCE-BASED PRACTICE RESEARCH

excellenceNurses at MedStar Washington Hospital Center develop their approach to patient care using evidence-based practice (EBP). In addition to training in EBP during the first-year residency program (all residents participate in an original EBP project), the Nursing Education Department supports original research, with grants from the Center for Excellence in Nursing, and provides financial reimbursement for nurses who present their research at national conferences. The number of these academic endeavors increased in all categories in FY16.

The Nursing Education Department also conducts Nursing EBP and Research Grand Rounds on a variety of topics. Among the FY16 Grand Rounds:• Baby Friendly Hospital Initiative• Bladder Scanning Policies• CLABSI 2.0• Discharge Lounge• Fecal Incontinence• Medical Marijuana

• Nurses’ Health Study and Heart Disease

• Patient Involvement in Fall Prevention

• Unavoidable Pressure Ulcers• Verbal De-Escalation of

Agitation

POSTER PRESENTATIONPaige Simonson, BSN, RN, (below) presented her poster in March at the Vizient®/AACN Nurse Residency Program Annual Meeting in Bonita Springs, Fla. This was the evidence-based practice project Simonson completed with fellow nursing residents Sarah Richards, RN, Elizabeth Sawicki, RN, and Teresa Bullington, RN, during their residency program at the Hospital Center. The poster was one of only 30 accepted out of more than 200 submissions.

FY15 FY16

Scholarship Presentations 35 47

Scholarship Publications 11 15

EBP Research/Research Projects 9 14

Center for Excellence in Nursing Awards 12 15

INAUGURAL EVIDENCE-BASED PRACTICE CONFERENCEMore than 80 nurses from MedStar Washington Hospital Center and other hospitals in the Washington, D.C. area spent a day discussing nursing evidence-based practice research at The Catholic University of America Pryzbyla Center last October. The first-ever conference hosted by the Department of Nursing’s Evidence-Based Practice and

Research Collaborative Gover-nance Council featured talks on research topics, such as how to conduct an Iowa model evidence-based research project. The conference included poster presentations and small discussion groups, and offered research networking opportunities. The conference was supported by the Hospital Center’s Center for Excellence in Nursing.

FIFTH ANNUAL MEDSTAR HEALTH RESEARCH SYMPOSIUMMedStar physicians, nurses and researchers presented more than 200 posters and abstracts for the Fifth Annual MedStar Health Research Institute (MHRI) Symposium. The Hospital Center presented eight posters, and Dhaya Muthiah, BSN, RN of 2H won the nursing poster award for her poster, “Nurses’ attitudes, competency, and perceptions of the National Institute of Health Stroke Scale.”

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OPEN HOUSESThe Collaborative Governance councils held several open houses in FY16.

All councils joined in a Collaborative Governance Open House, held in the fall in the Center For Excellence in Nursing, to showcase the work

done by the councils and to attract new members. The half-day event was part of a larger effort to increase visibility and participation.

The Professional Development Council held a Certifications Open House, in conjunction with the American

Nurses Credentialing Center’s Certified Nurses Day in March. More than 40 nurses interested in earning professional certifi-cations gathered for the early morning event in CTEC, where they learned about specialty certifications courses, financial support and training programs.

The Department of Nursing Strategic Plan for FY16 called for the implementation of the final phase of the three-year development of a Collabora-tive Governance structure at MedStar Washington Hospital Center. The goal of the Collab-orative Governance structure is to have the voice of nurses directing many of the clinical and professional issues that arise in delivery of care.

The last two councils were added in FY16: a Quality and Safety Council and a Coordi-nating Council, pictured above, consisting of the leaders of all five Collaborative Governance councils (Evidence-Based Practice and Research, Nursing Practice, Professional Develop-ment, Informatics and Quality and Safety). In addition, meet-ings were standardized to the same time each month and new efforts to communicate the work of all the councils were started.

IN COLLABORATIVE GOVERNANCE

excellence excellence 2 new Collaborative

Governance Councils launched in FY16

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IN COMMUNITY INVOLVEMENT

excellence excellence

MARCHING FOR DIMESNurses in the MedStar Washington Hospital Center NICU (pictured above) received a plaque and a “Thank You” in FY16 from the March of Dimes, presented by Kate Leib, diretor of field services for the Maryland- National Capital Area Chapter of March of Dimes. “We know how much you do every day for these

babies, and then you also participate in our March for Babies,” said Leib (center, in blue jacket, holding plaque). “It’s our way of thanking those who care for these important patients.” The mission of March of Dimes is to improve the health of babies by preventing birth defects, premature birth and infant mortality.

RACING FOR A CANCER CUREMore than 50 MedStar Health associates participated in the Sprint Four the Cure through the Four Seasons Hotel Washington, DC. The annual event, which features a 5K run and walk as part of the fundraising challenge, supports cancer research at the Washington Cancer Institute at MedStar Washington Hospital Center. Senior Nursing Director Jane McGee, DNP, MS, BSN, RN, led the team that included (pictured above): senior nursing director Ariam Yitbarek, MSN, BSN, RN, as well as nurses from throughout the Hospital Center. More than $174,000 was raised to support cancer research.

WHEELS UP FOR THE HOLIDAYSWhen EP Lab nurse Donna Brown-Redding, BSN, RN, heard about the Christmas wishes of 30 local children identified by the Hospital Center’s Community Relations Department, she claimed not just a few names on the wish list, but the entire list. Then, she rallied her colleagues into action, not stopping until every child’s request was fulfilled. She even recruited her son, Kamron Redding, BSN, RN, who worked in the Cardiovascular Recovery Room, to rally his unit to contribute a new bicycle.

Virtually everyone Brown-Redding called upon at MedStar Washington Hospital Center rose to the occasion: Five bicycles, a laptop, clothing, books, art supplies, toys, gift cards and more were donated. The 17-year Hospi-tal Center veteran credits the team for giving from their hearts. “We’re in healthcare, it’s what we do,” she says. Brown-Redding won a MedStar Washington Hospital Center Presi-dent’s Award for making dreams come true.

MedStar Washington Hospital Center nurses were celebrated for their community involvement and fundraising in FY16. In addition to a nurses Speaker’s Bureau operated through the Hospital Center’s Community Relations office and a Community Outreach committee that provides health screenings and informational outreach to the community, nurses participate in a number of organized charitable events.

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Department of Nursing110 Irving Street, NWWashington, DC 20010IN NURSING AT MEDSTAR

WASHINGTON HOSPITAL CENTER

excellence excellence Total RNs at end of FY16

Technical staff

Percentage of RNs with BSN degree

Percentage of RNs with ACLS certification

Percentage of RNs who belong to their professional association

Evidence-based research projects as part of Vizient®/AACN Nurse Residency Program

Distinct professional development courses offered regularly throughout the year

Specialty bridge training programs

Nursing Executive Safety Rounds

1,777

286

82

50

30

46

28

7

67