Division of Nursing. Annual Report 2014

Transcription

1 Division of Nursing Annual Report 2014

2 An Introduction to the 2014 Nursing Annual Report Welcome to the 2014 Nursing Annual Report. It is a year we can take great pride in as nurses. Despite turbulent times and radical changes in the external health care environment, the nursing care and nursing outcomes at St. Joseph Hospital continue to improve. Our shared governance council structure continues to ensure frontline clinical nurses involvement and input in decision making. Those clinical nurses, supported by their nursing leaders, are driving improvements in care alongside their physician colleagues. The improvement work in Infection Prevention is nothing short of remarkable. Improvements at the beginning of life are being driven by our Perinatal Safety team and sacred moments are being protected by our End of Life work group. Nursing research projects are flourishing, as are evidence-based practice projects across the campus. Our nurses are presenting their work through professional organizations both locally and nationally. Leadership development is a key priority, with frontline nurses and rising stars benefiting from the classes, coaching and experiential learning. Our nurses are being recognized for the experts they are. We had two nurses as state finalists in the Gem Nursing Excellence Awards, as well as a nurse leader recognized as one of the Top 100 Most Influential People in Orange County for her work in behavioral health. Nurses are choosing to stay at St. Joseph Hospital much longer than the average hospital s nurse tenure. Our average nurse tenure is 12.5 years. Nurses come to us because of our Magnet reputation, but they stay with us because of our remarkable culture; where people care about patients and families, and go above and beyond to deliver compassionate care. Where nurses are going back to school to learn, grow and contribute positively to the world. Where personal growth is even more abundant than the professional growth that surrounds us. And, where nurses care for each other and care about the remarkable legacy that the Sisters of St. Joseph of Orange have entrusted to us. I consider myself very fortunate to work amongst some of the finest nurses in the country. My thanks to each and every one of you for all you do for our patients, families and each other. Katie Skelton, RN, MBA, NEA-BC Vice President Patient Care Services Chief Nursing Officer

3 St. Joseph Hospital Mission, Vision and Values Our Mission To extend the healing ministry of Jesus in the tradition of the Sisters of St. Joseph of Orange by continually improving the health and quality of life of people in the communities we serve. Our Vision We bring people together to provide compassionate care, promote health improvement and create healthy communities. Our Values The four core values of St. Joseph Health are the guiding principles for all we do, shaping our interactions with those whom we are privileged to serve. Dignity We respect each person as an inherently valuable member of the human community and as a unique expression of life. St. Joseph Hospital Nursing Philosophy The Philosophy of Nursing at St. Joseph Hospital is rooted in the Mission, Vision and Values of the Sisters of St. Joseph of Orange. It is comprised of the following eight belief statements: 1 Nursing is highly valued for the role it plays. Nurses serve as advocates for patients and families throughout the continuum of care. 2 St. Joseph Hospital fosters an environment that provides continuous learning, professional development and scholarly inquiry. 3 Nursing practice exemplifies excellence through the use of continuous improvement, evidence-based practice, research and innovation to achieve the best possible outcomes for patients. 4 Through our culture of caring, compassion, competence and collaboration, nurses deliver world-class patient and family-centered care to the diverse populations we serve. St. Joseph Hospital Professional Practice Model 5 We are a diverse nursing organization that celebrates our strengths, mentors our novices, recognizes our experts and works collaboratively with all members of the health care team. 6 Nurses are informed, engaged, knowledgeable and accountable for clinical nursing practice decisions. 7 Nursing practice at St. Joseph Hospital is founded in the 10 Caritas Processes of Watson s Human Caring Theory. This philosophy provides the framework that prescribes our transpersonal relationships with our patients, our coworkers and our community. 8 St. Joseph Hospital is recognized in the community as a premier setting for nursing practice. This collaborative, collegial environment sets the standard. The St. Joseph Hospital Professional Practice Model is a dynamic process that integrates the Core Values of Dignity, Service, Excellence and Justice with several key components and domains of professional practice that guide and support the delivery of patient and family-centered, compassionate care. Service We bring together people who recognize that every interaction is a unique opportunity to serve one another, the community and society. Excellence We foster personal and professional development, accountability, innovation, teamwork and commitment to quality. Justice We advocate for systems and structures attuned to the needs of the vulnerable and disadvantaged, promoting a sense of community among all persons.

4 Redesignation What is Magnet? Magnet Model The five components of the ANCC Magnet Model. A designation granted by the American Nurses Credentialing Center (ANCC) for nursing excellence, quality patient care and innovations in nursing practice. The nation s highest honor for Excellence in Nursing and quality patient care. The ANCC Magnet Recognition Program recognizes health care organizations that provide the very best in nursing care and professionalism in nursing practice. The program also provides a vehicle for disseminating best practices and strategies among nursing systems. Our Magnet Redesignation Process As an organization approaches the fouryear anniversary date of Magnet recognition, the Magnet Recognition Program will again examine evidence that the organization has sustained continued excellence in nursing services. St. Joseph Hospital s Magnet Redesignation process involves the following steps: We are collecting evidence from October 2011 through September This required data shows how we exemplify the five components of the Magnet Model. FY14 Nursing Characteristics Characteristics of Magnet Organizations American Nurses Credentialing Center. All rights reserved. Reproduced with the permission of the American Nurses Credentialing Center Magnet Organizations St. Joseph Hospital 2014 RN turnover 10.8% 6% This evidence will be submitted on Oct. 1, The appraisers will read and score our documents. A three-day site visit will be scheduled with three appraisers to verify, clarify and amplify the documents they review. Average length of employment of RNs (years) Percentage of RN decision makers with graduate degrees (MSN or >) Percentage of RN decision makers certified by a nationally recognized organization % 48% 62.1% 92% If the site visit is successful, the ANCC will designate St. Joseph Hospital as a Magnetrecognized organization for another four years. Percentage of direct care RNs certified by a nationally recognized certifying organization 35.4% 49% Associate degree, nursing 38.5% 38% Diploma 7.4% 5% Bachelor/university degree, nursing (clinical RNs only) 50.5% 51% Master/graduate degree, nursing (clinical RNs only) 3.6% 6% Source: Average Magnet Organization Characteristics. American Nurses Credentialing Center website. Updated February 26, Accessed April 27, 2015.

5 Transformational Leadership Today s health care environment requires a new way of thinking. St. Joseph Hospital nurses are empowered to think outside the box and drive transformational change. As a result, St. Joseph Hospital remains strong and well positioned for the future. Nursing Strategic Plan The Nursing Strategic Plan currently spans FY The plan supports St. Joseph Hospital s overall strategic plan and flows directly from the following three outcome goals: Perfect Care Sacred Encounters Healthiest Communities The Nursing Strategic Plan also provides the framework for continuous improvement to develop new ways of thinking and delivering care, and to blend the art and science of the nursing professional body of knowledge with a transformational leadership style that is focused on the best possible outcomes for patients. In an effort to educate nursing staff on the components within the Nursing Strategic Plan, the RN Guide to the Nursing Strategic Plan was developed. This guide identifies the hospital s three outcome goals. The guide is designed as a report card for staff nurses to assess their individual contributions toward meeting the goals. Leadership Development Program St. Joseph Hospital s Leadership Development Program utilizes the Essentials of Nurse Manager Orientation (ENMO) developed by the American Nurses Credentialing Center and the Association of Nurse Executives. Cohorts of new leaders are engaged in the 18-month program, which integrates the web-based ENMO curriculum with coaching and mentoring group meetings led by nursing directors. Each participant benefits from participation in the expert coaching and peer mentoring as evidenced by the project presentations at the end of the program. ENMO Coaches, Graduates and Projects Completed 2014 Pam Hockett, MSN, RN, OCN Abigail Pimienta, BSN, RN, CCRN, Clinical Coordinator DSU/SDU Darlene Warren, MSN, RN, CEN, Manager Orthopedics Lisa Gontang, BSN, RN, PCCN, Clinical Coordinator, Pulmonary Renal Timotea Lara, NP, MSN, RN, Oncology MDC, The Center for Cancer Prevention and Treatment Ria Ann Gonzaga, AD, RN, Admit Discharge Team Carmen Ferrell, MSN, RN, CCRN Soudi Bogert, BSN, RN, CCRN, Manager, Operations Hub Magnet Program Coordinator Rhona Tristan, BSN, RN, Clinical Coordinator DSU Rebecca (Cook) Wile, MSN, RN, CCRN, Clinical Nurse III, MICU Christine Phipps, MBA, RN, CNOR Nicole Machuca, BSN, RN, RNC- OB, Clinical Coordinator, Labor & Delivery Lavinia Dobrea, MS, BSN, RN, BA, OCN, Manager, Oncology Research, CCPT Cintia Perez, MSN, RN, CNN, Educator, Renal Center Carmen Walker, NP, MSN, RN, Clinical Coordinator, Radiation Oncology RN Satisfaction/Engagement NDNQI Sub-Scales Creating a Healthy Work Environment: Shared Governance Discharge before 1100 Employee Engagement: Striving for Unity Outpatient Palliative Care Clinic Structure vs. non-structure: A smoother change Admit Discharge Team DSU: Creating our own DSU culture by changing our nursing practice A focused attack on Hospital Acquired Infections (HAI) in Critical Care Skin to Skin in the OR Department Guidelines Overhaul Policies and Procedures Renal Center Total Body Irradiation Results from the October 2013 NDNQI RN Satisfaction Survey responses are represented in the accompanying table. 24 nursing units participated in the survey. The table identifies the number of units that outperformed the NDNQI mean. The next RN Satisfaction Survey will be conducted in August St. Joseph Hospital RN Satisfaction Number of Units Outperform NDNQI Median Job Enjoyment 11 Task 12 RN-RN Interaction 18 RN-MD Interaction 13 Decision-Making 13 Autonomy 13 Professional Status 16 Pay 15 Professional Development 19 Supportive Nursing Management 13 Nursing Administration 17 Satisfied with My Job 10 Outperformed Did Not Outperform

6 Structural Empowerment The Nursing Strategic Plan provides the framework for continuous quality improvement. The plan challenges nurses to develop new ways of thinking and delivering care, and to blend the art and science of nursing with a transformational leadership style that provides the best possible outcomes for our patients. Nursing Awards and Recognition Recognition of nurses at all levels is a key component to the culture of excellence at St. Joseph Hospital. Nurses find ways to celebrate and honor the contributions they make every day to patients, their families and the health care community. Recognition promotes empowerment, involvement and continuous improvement. The following nurses received local, state and national recognition. St. Joseph Hospital Values in Action Awards Excellence Award Gemma Seidl, MSN, MHA, RN Nurse Week Awards Transformational Leadership Kathy Dureault, MSN, RN, CPAN Structural Empowerment Beth Winokur, PhD, RN, CEN Exemplary Professional Practice Darby Servais, BSN, RN, RNC-OB New Knowledge, Innovations and Improvements Carmen Ferrell, MSN, RN, CCRN Andrea Toledo, BSN, RN, RNC St. Joseph Hospital Foundation Scholarships Nurse Recipients Alice Paone, RN, Nursing Scholarship Lucy Sousa, AD, RN Thu Tran Pham Hughes, AD, RN Jay Swanson, AD, RN Madeline Colette Seeds, RN, Advanced Practice Nurse Scholarship Jacob Chai, MSN, RN Dominick Gentile, MD, Renal Center Scholarship Cintia Perez, MSN, RN, CNN Larry K. Ainsworth Leadership Scholarship Julie Marshall, AD, RN, PCCN Local Awards and Recognition 100 Most Influential People in Orange County Jeannine Loucks, MSN, RN-BC NurseWeek Magazine GEM Nursing Excellence Award - State Finalists Kim Rossillo, BSN, RN, PCCN Auggie Maggio III, BSN, RN, PCCN, SCRN, Clin III Fairhaven Memorial Care Award Pratibha Seth, BSN, RN, CMSRN Total Percent of RNs with BSN or Graduate Degrees: 60.7% Total Percent of RNs with Certification: 55.7% 27 Nurses hold Leadership roles in Professional Nursing Organizations 5 Nurses serve as Adjunct Faculty for Nursing Programs 327 Nurses Participate in Local, State, or National Professional Organizations St. Joseph Hospital Nursing Certification State Awards and Recognition

7 Council/Special Interest Group Outcomes Nursing Councils Accomplishments Nurse Advisory Clinical Practice Nursing Research Infection Prevention and Control Patient Safety and Medication Safety Clinical Development Reviewed and updated Nursing Floating Policy from staff feedback and input to define 20+ year employees and registry usage. Compassionate Care Awards implemented two winners are recognized from patient and family letters, then selected by the Patient and Family Advisory Council and executive team each month. Reviewed staffing enhancements and unit openings to support patient volumes and care requirements. Reviewed stewardship challenges and St. Joseph Health benefit changes. Reviewed pros and cons of third-party representation. Unit representatives shared their department s best practice called, Sharing of Department Best Practice. Charter was changed to include all chair work group or designee to be members of CPC according to their work group term. Added Patient Experience as a standing agenda item. Completed the Nursing Peer Review algorithm and tool. 10th Annual EBP Conference, The Future of Healthcare, was held in October. 90 staff members attended. In 2014, four new research studies were approved by IRB and two research studies were published in peer reviewed nursing journals. 17 evidence-based practice projects were completed by nursing units throughout the organization. Posters were featured at internal, regional and national conferences. Coordinated the EBOLA Response Plan development and implementation through a multidisciplinary team including Infection Prevention, Employee Health, Nursing, Quality, Laboratory, Purchasing, Respiratory, Imaging, EVS, Engineering/Plant Operations, and Marketing and Communications. Coordinated efforts to ensure facility-wide standardization of High Level Disinfection (HLD). Improved HLD technology was researched and instituted in Ultrasound and Cardiology departments. Quarterly reporting of process monitoring will commence in Participated in St. Joseph Health s Infection Prevention Collaborative conference calls for planning and program development, including conversion to MEDITECH Upgrade and MedMined Surveillance program in June Eliminated the use of basal rates in narcotic-naïve patients. Education, provision and use of the adaptor to provide irrigation solutions in irrigation bottles (NOT IV Bags) for Wound Vac. Facilitated the revision and implementation the RN Self Review Tool. Continued support for Clinical Advancement: 74 CN III and 19 CN IV. Increased RN Certification rate to 55%.

8 2014 Nursing Council/Work Group Accomplishments Work Groups Accomplishments APN Practice Reviewed and updated Standardized Procedure for NP scope of practice Presented at the Association of California Nurse Leaders Annual Conference: Improving Hospital Outcomes Through the Proper Implementation of Nurse Practitioners Clinical Policy & Procedure Developed/New = 13 Reviewed/Revised = 93 EBP = 15 Nursing Communication Staffing & Productivity Code Blue Core Measures Critical Illness Diabetes Ethics ACEs End of Life Oncology Organ Donation Produced monthly issues of the Nursing Excellence newsletter showcasing St. Joseph Hospital nurses and nursing activities Increased nursing newsletter readership Reviewed and updated nursing web pages on internal and external websites Assisted with Operations Hub standard work for improved patient placement Reviewed and modified nursing standby guidelines for expanded implementation Reviewed the design and format of the daily productivity tool implemented in inpatient units Reviewed all code records and trained staff on improving Code Blue documentation Audited Code Cart Medication Charge sheets and Code Blue Record for Pharmacy to assess adequacy of charges going to Pharmacy Updated Code Cart Maintenance Policy and Code Cart Guidelines Inspection Form Educated and updated staff on Phillips Defibrillator/Monitor recalls AMI, HF and stroke teams collaborated on the Quality Tab in MEDITECH to assist physician documentation and adherence to recommended guidelines Stroke team sponsored revision of patient safety issues in the order sets with the June 2014 MEDITECH 5.66 Go-live SCIP worked to ensure the appropriate wound class was documented in the OR Helped educate nurses house-wide regarding appropriate blood usage Revised pneumonia order sets Changes to the Vaccine Standardized Procedure Established routine quarterly audits with specific educational plan offered to nurses Standardized patient diabetic booklets from the Center for Health Promotion: St. Joseph Heritage Healthcare House-wide adoption of standardized insulin syringe sizes (3/10cc & 1cc) for increased patient safety Improvement of individual department blood glucose readings and level fallouts Educated staff in the Kidney Center on POLST and Durable Power of Attorney for Healthcare Staff education for L/D on Ready Reference Grid to identify ethical issues based on our Ethical Religious Directives Facilitated family discussion to help a developmentally delayed adult make her own decisions about her cancer treatment Provided patient with a transitional living center resource following presentation at ACE meeting on domestic violence issues Finalized and distributed prayer booklets to serve as a tool for Moment of Silence Moment of Silence implementation Outreach education members attended local senior centers and provided education on AHCD, 5 Wishes and POLST Healing the Healer class Developed outpatient VTE patient education due to the risk of VTE on patients diagnosed with cancer who may never be hospitalized A pilot for inpatient referrals for oncology navigators was initiated and improved communication among navigators and inpatients Held discussions regarding the annual competency checklist for observed chemotherapy administration Improved Timely Referral rate for tissue donation (CIAD<1 hour) Increased staff education leading to increased number of referrals for potential organ donation Increased number of Organs Transplanted Per Donor (OTPD)

9 2014 Nursing Council/Work Group Accomplishments - continued Work Groups Accomplishments Falls Pain Implement Fall Risk Assessments in all patient care departments Continued with AB 1136 Safe Patient Handling Education Updated policy and procedures for the new St. Joseph Health Fall Risk Assessment implemented with MEDITECH 5.66 Pain website created to include continuing education, conferences and free CEUs from Medscape.org Researched best practice on pain range orders due to challenge of nurses medicating patients for anticipated pain with PRN orders Created monthly education flyers on pain awareness Perinatal Safety The Perinatal Safety group promoted the system-wide adoption of CMQCC membership a California collaborative that provides benchmarking capability on perinatal core measures Partnered with CHOC personnel to create a pre-viable infant algorithm to improve care and family support Adopted an evidence-based morbidity tool to review high-risk obstetric cases (low APGAR infant scores, transfusions and transfers to a higher level of care) data reviewed monthly for next steps Created a Women s Services policy for fire prevention/risk assessment in the OR Skin Assisted with education of peers about the use of Ricoh camera procedure with classification process Informed staff of ordering process change after MEDITECH Go-live for all wound and ostomy supplies Worked with staff to educate on rationale for separation of WO from RN assessment Nursing Shared Governance

10 Exemplary Professional Practice At St. Joseph Hospital, we re committed to offering Perfect Care to each patient we serve. To achieve Perfect Care, we work hard to improve existing processes and create new processes based on evidence-based practice. As a result, we have achieved patient outcomes that are among the best in the nation. Nursing-Sensitive Indicators Nursing-sensitive indicators reflect the structure, processes and outcomes of nursing care. The nursing-sensitive indicators reported include: Hospital Acquired Pressure Ulcers Stage 2 and Above Patient Falls with Injury Catheter Associated Urinary Tract Infections Central Line Associated Blood Stream Infections St. Joseph Hospital HAPUs St. Joseph Hospital FALLS St. Joseph Hospital CAUTI St. Joseph Hospital CLABSI

11 Overall Patient Satisfaction St. Joseph Hospital uses Professional Research Consultation (PRC) for tracking and evaluating the patient experience. The hospital also participates in Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), a public reporting tool that assesses major areas of hospital performance to support consumer choice. This survey was developed by the Centers for Medicare and Medicaid Services (CMS) and measures patients perspectives on the care they receive at hospitals. Patient satisfaction with nursing is compared to our PRC benchmark for questions related to: Care Coordination Patient Education Patient Engagement/Patient-Centered Care Pain Overall patient satisfaction results are displayed below quarterly over the past year. Care Coordination Patient Education Patient Engagement/Patient-Centered Care Pain

12 New Knowledge, Innovations & Improvements Through new knowledge and research, the Division of Nursing has made remarkable progress in improving nursing care, enhancing the patient experience and improving patient outcomes. In an effort to help reduce surgical site infections (SSIs), infection prevention leaders and work groups explored possibilities to help improve existing practice and outcomes. The xenon ultraviolet light (UV) disinfection system from Xenex was reviewed as a new technology that prevented the emergence or cross contamination of infectious organisms. In June 2014, St. Joseph Hospital began using this technology to disinfect all isolation rooms, procedural rooms, Labor & Delivery surgical suites, interventional radiology rooms, the Cardiac Cath Lab and operating rooms. St. Joseph Hospital was the first hospital in Orange County to use the Xenex robot. Research Studies in Progress Admit-Discharge Team - Kathleen Penzes, DNP, RNC, NEA-BC Cross-training Operative Room Nurses to Pre-operative Phase Care - Sharon Kleinheinz, MSN, RN, CNOR A Multi-modal Collaborative Nursing Practice Change to Enhance Nursing Management Outcomes - Trish Cruz, BSN, RN Coping and Impact of Isolation in an Outpatient Infusion Center - Linda Buck, MSN, RN, OCN NDNQI Nurse Satisfaction Survey - Kathleen Penzes, DNP, RNC, NEA-BC Patient/Family Perception of Nurse Appearance Study - Elizabeth Winokur, PhD, RN, CEN Exploring Factors that Motivate Nurses to Obtain a BSN Degree within a Magnet Organization - Amy Hayes, MSN, RN, PCCN Symptom Burden of End-of-Life illness in Elder Women in the Acute Care Setting - Lucia Gonzales, PhD, RN Research Studies Completed Evaluation of a Health Professions Academy for High School Students - Caroline Rae, MSN, RN Job Satisfaction for Certified Hemodialysis Technicians Offered a Clinical Ladder - Cintia Perez, MSN, RN, CNN Role Perception of Advanced Practice Nurses in the Community Hospital - Susan Dragoo, DNP, RNC-OB, WHNP, FNP-BC Health Literacy in Parents of Ill Children - Amber Wilson, BSN, RN, CEN, Clin IV Study of Attitudes and Factors Affecting Infant Care Practices SAFE-Study - Carol Suchy, MSN, RN, IBLCLC Research Studies Proposals Broset Violence Checklist ED Validation - Elizabeth Winokur, PhD, RN, CEN Chemotherapy Anxiety and Knowledge Survey - Kathy Keener, MSN, RN, OCN, Clin IV Published Articles St. Joseph Hospital Nurses who have published outcomes from nursing research or evidence-based practice projects. Published Articles Authored/Co-Authored by St. Joseph Hospital Nurses Liego, M., Loomis, J., Van Leuven, K., & Dragoo, S. (2014). Improving outcomes through the proper implementation of acute care nurse practitioners. Journal of Nursing Administration, 44(1), Winokur, E. J., Pai, D., Rutledge, D. N., Vogel, K., Al-Majid, S., Marshall, C., & Sheikewitz, P. (2014). Blood culture accuracy: Discards from central venous catheters in pediatric oncology patients in emergency department. Journal of Emergency Nursing, 40(4),

13 Evidence-Based Projects Medical Telemetry, Patient Education: Medication Side Effects March June 2014 Behavioral Health Services, Fall Reduction Implementation Labor & Delivery, Hypertension in Pregnancy: Focusing on the Big Picture Center for Maternal Fetal Health (CMFH), Nursing Interventions to increase rates of postpartum follow up for women with gestational diabetes. Renal Transplant Center, Improving the Transplant Patient Evaluation Experience General Surgery Unit, Surgical Site Infection Reduction Project Oncology, Effects of Chlorhexidine on Central Line Associated Blood Stream Infections Endoscopy, Inpatient Procedural Start Time Emergency Care Center, Door to bed in less than 30 minutes (DTB30) Chronic Dialysis, Influenza Immunizations Outpatient Surgical Services, How s Your Handoff Definitive Step Down Unit (DSU), Creating Our Own DSU Culture by Changing Our Nursing Practice. Critical Care, A Focused Attack on Hospital Acquired Infections (HAI) Orthopedic Unit, Effective Discharge Planning Orthopedic Unit La Amistad Clinic, Improvement of Laboratory Services at La Amistad Clinic Women s Services, Skin Irritation Prevention Inpatient PACU, Reducing PACU Length of Stay Podium/Poster Presentations St. Joseph Hospital actively encourages nurses to submit abstracts for presentations (poster or podium) at local, state and national conferences. Eight podium and 12 poster presentations have been presented at national conferences. Participation in a national conference not only serves as an avenue to disseminate knowledge and advance nursing research, but also provides St. Joseph Hospital nurses with growth opportunities and recognition for their contributions to EBP and nursing research. National Kidney Foundation Council of Advanced Practitioners Clinical Meeting (Podium), Interdisciplinary Transplant from the Pros, Wendy Escobedo, MSN, RN, CCTN AACN NTI Conference (Podium), Improving the End of Life Experience in Critical Care, Vivian Norman, MSN, RN, CCRN ASPAN National Conference (Poster), Reducing PACU Length of Stay, Kathy Dureault, RN, MSN, CPAN, Diana Brody, RN, CAPA, CPAN, Kibre Ghebre, RN, CPAN, Maday Letson, RN, CPAN, and Beth Villasenor, BSN, RN, CPAN, CAPA Inland Empire Regional PANAC (Podium), Obstetric Emergencies in Peri-operative Nursing, Susan Dragoo, DNP, RNC-OB, WHNP, FNP-BC Orange County Breast Feeding Coalition (Podium), Moving Toward a New Norm, Carol Suchy, MSN, RN, IBLCLC One Legacy Champions in Action (Podium), Giving Life to the Donation Process, Soudi Bogert, BSN, RN, CCRN 2014 Summer Institute on Evidence-Based Practice (Poster), Making the Evidence-Outcome Connection, Victoria Randazzo, PhD(c), MSN, RN, CCRN Sustaining the Context of Caring (Podium), Implementing Watson s Theory of Human Caring at St. Joseph Hospital, Vivian Norman, MSN, RN, CCRN 7th National DNP Conference (Poster), DNPs Impacting Health Care Outcomes, Susan Dragoo, DNP, RNC-OB, WHNP, FNP-BC ANCC National Magnet Conference (Poster), The Operations Hub, Kathleen Penzes, DNP, RNC, NEA-BC ANCC National Magnet Conference (Poster), Perfect Care Rounds, Trish Cruz, BSN, RN ANCC National Magnet Conference (Poster), Removing Barriers to Bedside Documentation: Patient Perceptions, Amy Hayes, MSN, RN, PCCN APNA National Conference (Podium), Bridging the Gap Between Crisis and Care: How to Effectively Integrate Psychiatric Emergency Care within a Community Hospital Emergency Department, Laura Derr, BSN, RN, CEN Sigma Theta Tau Odyssey Conference (Poster), Improvement of Utilization of Laboratory Studies at La Amistad Clinic, Theresa Ullrich, MSN, FNP- BC Sigma Theta Tau Odyssey Conference (Poster), Evaluation of a Health Professions Academy, Caroline Rae, MSN, RN Sigma Theta Tau Odyssey Conference (Podium), Blood Culture Accuracy: Central venous Catheter Discards, Elizabeth Winokur, PhD, RN, CEN Sigma Theta Tau Odyssey Conference (Poster) Exploring Factors that Motivate Nurses to Obtain a BSN, Amy Hayes, MSN, RN, PCCN Sigma Theta Tau Odyssey Conference (Poster), Patients Attitude/Perceptions to RN Use of In- Room Computers, Amy Hayes, MSN, RN, PCCN Sigma Theta Tau Odyssey Conference (Poster), Operations Hub, Kathleen Penzes, DNP, RN-NEA Sigma Theta Tau Odyssey Conference (Poster), Reducing Opioid-Induced Constipation Following RN Education, Denise Boyd, BSN, RN, OCN, CN IV

14 St. Joseph Hospital of Orange 1100 West Stewart Drive Orange, CA