Association of California Nurse Leaders. ACNL's 2014 Annual Report

Transcription

1 DirectLink I N S I D E T H I S I S S U E : Association of California Nurse Leaders S U M M E R President s Message 2 CEO Report 6 Quality & Patient 8 Safety Resource Health Policy Update 10 Nursing Mourns Loss 11 of Dianne Moore 2016 ACNL Annual 12 Conference Developing Nurse 14 Leaders Foley Leads Rwanda 16 Delegation Harren Elected to 17 CHA Quality Board Summer 2015 DirectLink The summer issue of DirectLink contains several informative articles about current issues in nursing leadership and health care. ACNL President Susan Herman describes her view of leadership and key ACNL initiatives. CEO Patricia McFarland explores strategies to increase the numbers of RNs on boards. Myra Lang provides an update on legislative issues. Jami de Santiago unveils highlights of ACNL s 2016 Annual Conference. Judy Dahle and Ellen Gorbunoff discuss nurse leadership development. Also, members of ACNL s Quality, Safety and Patient Experience Committee have created an index of resources and references for your use, and are planning a webinar on medication accuracy this month. ACNL members in the news: Mary Foley plans a delegation to Rwanda to improve infection prevention and control; and Kathy Harren has been appointed to CHA s Quality Institute Board. And on the national front, learn about OSHA s areas of emphasis for hospitals. All this and more in this issue of DirectLink! OSHA Areas of Emphasis ACNL Webinar: Medication Admin Accuracy CINHC/CA AC Regional Meetings ACNL's 2014 Annual Report 2014 was a year of many significant accomplishments as nurse leaders made their voices heard in several key arenas. These achievements lay the foundation for ACNL's strategic initiatives in Learn more about the work of ACNL's Board, committees, staff and members by reviewing ACNL's 2014 Annual Report. Read 2014 ACNL Annual Report

2 P A G E 2 President s Message Leading with Courage! By Susan Herman, DNP, RN, NEA-BC, CENP 2015 ACNL President ACNL Colors: Purple signifies passion, wisdom, and healing. Apricot is the color of the nursing profession It is truly an honor for me to serve as ACNL s 2015 President! As we look to the future, we must also value the work of leaders who came before us. It is through their vision and leadership that ACNL is the robust organization we are today. Although our organization began in 1978, it was in 1996, under the presidency of Terry Bream that the Association of California Nurse Executives transformed itself into the present Association of California Nurse Leaders, and its logo and colors were created. With inclusivity as the goal, nurse leaders was the term chosen in recognition that all nurses are leaders. Fundamental to ACNL's logo is the state of California, surrounded by a series of spheres. These spheres represent the multiple levels of influence benefiting nurse leaders as members of ACNL. In addition, the spheres symbolize stepping stones that signify a member's advancement and the ability to build upon the strengths of others, while achieving individual and shared goals. ACNL s colors of purple and apricot were also carefully selected. Purple is associated with passion, wisdom, healing, dignity and creativity, while apricot signifies the practice of nursing. My journey to this position as your president has also been one that strong leaders have helped influence, guide and support. In 2005, I attended my first ACNL annual conference and heard Mary Lopez give her presidential speech. It was a transformative experience for me, and I decided that I too wanted to become president of ACNL. I wasn't sure how this was going to happen but it became my goal. In her presidential speech, Mary also stated that every nurse should replace themselves, since someday we will retire and need good nurses to take care of us. I m happy to report that my oldest daughter became a pediatric oncology nurse. So although that piece of Mary s advice had been accomplished, I continued to ponder the question of how I could become a future president of ACNL. (Continued) D I R E C T L I N K

3 S U M M E R P A G E 3 My ACNL Journey A year after that annual conference, I attended a California Hospital Association meeting in San Francisco and happened to sit next to Jackie Lowther. We talked about the need for a Northern California chapter of ACNL to serve leaders in the South Bay. With the help of several ACNL past presidents, including Beth Gardner and Nancy Carlson, we created ACNL s South Bay Chapter. From there I joined several ACNL committees and co-chaired a few. With the confidence that others had in me, I was elected to ACNL s Board of Directors, representing Northern California. I felt I was getting closer to my dream of becoming president, and then had the courage to run for the position. I lost the first election, but did not give up! Over these past 10 years, I have learned that it takes a lot of courage to not give up on your goals or dreams. Because of this lesson, I have chosen Leading with Courage...Committed to Excellence as the theme for my presidential term. Courage is a quality great leaders possess. Our profession was founded by one of the most courageous people in history Florence Nightingale. Florence showed great heart, perseverance and determination by following her calling to improve the health of those in greatest need. Her vision and strong voice changed how society viewed nurses. Florence was very persuasive in influencing public policy to achieve beneficial health care reforms. She not only improved the hospital environment, she worked tirelessly as a statistician until her death, conducting extensive research and analyzing data to improve outcomes. She certainly was and still is an outstanding role model for nurses all over the world. Another individual that ACNL members are familiar with is Jim Collins, author of the book Good to Great. In Good to Great, Collins described what it took for 11 elite companies to achieve greatness and sustain it for at least 15 years. In summary, highly successful companies have great leaders who know what the people in their organization are passionate about, what drives their economic engine and what they can and cannot do to be the best the Hedgehog concept. Another important component is to start with the Who by having the right people on the bus to achieve the What. Who are the right people to have on the bus? I say they are transformational leaders. This concept was developed by James MacGregor Burns who stated that transformational leadership can be seen when leaders and followers work together to advance to a higher level of morality and motivation. According to Burns, the transformational leader can inspire followers to change expectations and perceptions, and achieve common goals. (Continued) 2015 Presidential Theme: Leading with Courage... Committed to Excellence!

4 P A G E 4 Together we must all be courageous leaders! In the 1980s, James Kouzes and Barry Posner developed a transformational leadership model, The Leadership Challenge, distilling five core practices and behaviors of an exemplary leader. They are: model the way, inspire a shared vision, challenge the process, enable others to act and encourage the heart. These five practices continue to be an effective, evidence-based course of action for transformational leaders to achieve extraordinary outcomes. It has been proven that followers feel more engaged, committed and satisfied, when led by those possessing these qualities. Therefore, during these uncertain and often chaotic times in health care, it is important to stand on the shoulders of those who came before us, focus our work on what we do great and get the right people on the bus. We must be transformational leaders who create a shared vision, to challenge the way things are done, recognize the contributions of others, enable others to participate and continue to model the way for our followers. Challenges and Opportunities for ACNL 2015 will continue to be a transformative year for ACNL with several key strategic goals to accomplish. In achieving these goals, we must remember to focus on what we do well: strengthening nurse leaders through education and scholarship, using our voices to advance professional practice and health policy and collaborating with strategic partners. Key initiatives include: collaborating in the development of a new policy on curriculum standards and clinical requirements; contributing to the creation of a whitepaper on redesigning nursing education and another about nurse leader participation in technology. We must also emulate Florence Nightingale by contributing to the nursing leadership community and our profession, as we strive to improve the health and wellbeing of our society. One way ACNL will accomplish these important goals is through our continued work with the California Action Coalition to implement the IOM s Future of Nursing Recommendation #7 (To prepare and enable nurses to (Continued) 2014 ACNL President Margarita Baggett passes the gavel to 2015 President Susan Herman at ACNL s 2015 Business Meeting in Anaheim. D I R E C T L I N K

5 S U M M E R P A G E 5 lead change to advance health) by developing evidence-based leadership competencies, expanding our mentoring program and creating a senior healthcare leadership academy. Lastly, as we stay committed to achieving excellence, we must have the resources we need to build on our existing work and create new models and relationships to move forward. This year, we will continue planning and begin to implement our essential philanthropic work. Together we all must be courageous leaders! Like the lion in the Wizard of Oz we all have courage within us! But there is no reason to go to Oz. Instead we just need to find and display the courage within us on a consistent basis. As Eleanor Roosevelt said: "Courage is more exhilarating than fear and in the long run it is easier. We do not have to become heroes overnight. Just a step at a time, meeting each thing that comes up, seeing it not as dreadful as it appeared, discovering we have the strength to stare it down." Many heartfelt thanks go out to our membership for all of your outstanding contributions to ACNL both in the past and present. I also want to express a very special thank you to our CEO Patricia McFarland for giving me the courage to take on new and different challenges, to see qualities in me that I didn't always see in myself and in consistently striving to achieve excellence for ACNL!

6 P A G E 6 CEO Report Strengthening Your Voice: Nurses on Boards By Patricia McFarland, MS, RN, FAAN ACNL CEO More than 80% of respondents to ACNL s Nurses on Boards survey indicated their interest in serving on a board. The baton has been passed! Are you ready for the next leg of the leadership marathon? Are you committed to being the change that will drive improvements in our health care system? Donna Shalala, Co-Chair of the illustrious Institute of Medicine s Future of Nursing Initiative, Advancing Health, Leading Change, said following the publication of the report: it s nursing s time to swagger! Are you ready to swagger? This is our time, not only to lend our voices to the conversations, but to lead these conversations! As our nation s most trusted profession (consistently ranked #1 on the Gallup Poll), we have the opportunity and, might I add, the responsibility to serve. Within each of us is the power to implement change. Change that can and will promote the health of all Californians! Data from ACNL s Nurses on Boards survey indicate that more than 80 percent of respondents are interested in serving on boards. ACNL members are committed to using their voices to influence discussions about issues impacting the health of our communities. The survey further showed that, while the overwhelming majority of respondents are interested in sharing their voices, they are also asking us to provide education and resources. Resources that will ensure their success. To this end, the Nurse Leadership Development Committee s subgroup for Nurses on Boards will be collaborating with the California Action Coalition s Recommendation #7 team (To prepare and enable nurses to lead change to advance health) to provide California nurse leaders with needed resources to flourish on boards. In late 2013, BJ Bartleson, VP of Nursing and Clinical Services, California Hospital Association; Mary Dickow, Director, California Action Coalition; and I attended a two-day meeting in Seattle hosted by the National Future of Nursing Campaign. The goal of the meeting was to help states develop a plan to get more nurses on boards. (Continued) D I R E C T L I N K

7 S U M M E R P A G E 7 While the original intent of the work was to increase the number of RNs on hospital boards, the California representatives knew that RNs could have as much, if not more, influence if we sat on boards that represented the continuum of health care services, in addition to community and hospital boards. With this in mind, we began to develop our goals for California. Ultimately, it is our goal to create a Nurses on Boards track in our ACNL Mentorship Program through LifeMoxie. We will utilize this platform to connect participating members with valuable tools and resources for board service. Earlier this year, the Los Angeles Chapter of ACNL held a workshop on this topic. I had the honor of facilitating a panel of engaged nurse leaders who for several years have served on hospital and community boards. Participants included Linda Sarna, Acting Dean, UCLA School of Nursing; Heidi Crooks, CNE, UCLA Health; Elissa Brown, APRN, CNS, adult mental health; and Katie Skelton, CNO, St Joseph s Hospital and a member of ACNL s Board of Directors. Unfortunately, Linda Burns Bolton, VP for Nursing at Cedars-Sinai Medical Center, Trustee of the Robert Wood Johnson Foundation, and President, American Organization of Nurse Executives, was unable to join us that evening. The program was so well received that participants asked us to host a similar program during ACNL s 2016 Annual Conference. I am pleased to say Jami de Santiago, Chair of the Annual Program Committee, embraced this suggestion. Katie Skelton and Judy Karshmer, Dean of Health Sciences at USF and ACNL s Board representative from academia, will be two of the seasoned leaders sharing their journeys as board members during this session. As I was preparing for the presentation at UCLA Medical Center and listening to the learned nurse leaders, key words kept resonating with me. In the end, I summarized the program using Pat s Ps for Board Appointments: Passion select a board or a cause that you are passionate about and get involved. Planning once you determine your passion, develop an action plan for moving your passion to action and involvement. Critical to the planning phase is the need to review your calendar to determine if you have time to serve. Board involvement takes a personal commitment of time, energy and sometimes money. Preparation skill acquisition will be critical for your success. What do you need to learn about the organization, finances or non-profit governance? Do your homework before your first meeting. Positioning you must be open to the possibilities and seek opportunities. Networking is critical to your success. You may need to serve on organizational committees before attaining a board position. (Continued) ACNL to offer a Nurses on Boards track through the LifeMoxie platform.

8 P A G E 8 Perseverance board appointments can take time stick with it and follow your passion. Participation once you are selected, participate. Board appointments are not about resume building. They are about contributing and giving back. Policy Development as a board member you will have the opportunity to develop policy. You will continue to learn, grow and drive the organization to success. Positive Change this is what we strive for as servant leaders driving positive change! I have the honor of serving on the Eskaton Board of Directors. Besides nursing, I am passionate about creating systems and services for our seniors. Eskaton is known for providing the full spectrum of services for the elderly in Northern California. Their tagline is what captured my heart Eskaton: Transforming the Aging Experience. Several years ago, my mother was a patient in one of Eskaton s rehab facilities. Our experience with Eskaton during this very difficult time was wonderful. So when a colleague asked me if I would be interested in serving, I enthusiastically said yes. My journey through the selection process took nearly six months. There were a number of interviews and a vetting process. I was formally elected by the members last May and reappointed last month. Serving on the Eskaton Board has been an educational experience for me, both personally and professionally. I have already successfully incorporated new ideas and practices at ACNL that I gleaned from my board service adding even more value to the experience. ACNL s Quality, Safety & Care Experience Committee Produces Valuable Resource Index for Members ACNL s Quality, Safety and Care Experience Committee has compiled indexes of state and national resources and references for quality and patient safety. Use the links below to access these valuable resources. National Quality and Patient Safety Resources and References California Quality and Patient Safety Resources and References D I R E C T L I N K

9 S U M M E R P A G E 9

10 P A G E 10 Health Policy Update Nurse Leaders Impacting Health Care Legislation By Myra Lang, MS, RN, CCRN, CMNL, NE-BC Chair, Health Policy Committee Nurse leaders are encouraged to make their voices heard on key legislation The 2015 California legislative session is addressing a wide range of important health care related issues, including public health protection, emergency worker safety, scope of practice and Medi-Cal funding. The top priority issues for nurse leaders this year include legislation allowing nurse practitioners and certified nurse midwives to practice to the full extent of education and training, and preserving our state s Board of Registered Nursing (BRN). ACNL s CEO, Board, Health Policy and Voice Committees closely track the progress of relevant bills impacting nursing and health care. If nurse leader input is needed, ACNL seeks out experts within our membership to present the testimony to educate elected officials about proposed legislation. ACNL provides these members with resources, such as talking points, to assist in ensuring ACNL s message is delivered effectively. Important issues being tracked by ACNL this session include: SB 277 Eliminates personal belief exemptions from vaccinations. Signed by Governor on June 30. AB 172 Would make an assault against a physician, nurse or other health care worker of a hospital or county jail, who is engaged in providing services within the emergency department, punishable by imprisonment in a county jail not exceeding one year, a fine not exceeding $2,000, or both. Passed the Assembly on June 2; now in Senate Public Safety Committee. SB Would allow nurse practitioners to practice to the full extend of their education and training. This would ensure access to care for millions of Californians. Passed full Senate on May 7. In Assembly Committee on Business and Professions, where Assembly Member Bonilla (chair) requested an amendment to include the ban on corporate medicine. The bill s author, Senator Hernandez rejected this amendment. This amendment is also not supported by ACNL, (Continued) D I R E C T L I N K

11 S U M M E R P A G E 11 the California Association of Nurse Practitioners and other nursing organizations. Without the amendment, SB 323 failed to pass the committee. Reconsideration of the bill was granted, but a hearing date is not yet set. SB Would sunset the Board of Registered Nursing (BRN) on January 1, Passed the Senate on June 1; currently in Assembly Business and Professions Committee, scheduled to be heard on July 7, however the author requested it be held over until the July 12 meeting. The Health Policy Committee monitors federal legislation as well as regulatory issues introduced by CMS and The Joint Commission. A key federal issue introduced in April 2015 is the Registered Nurse Safe Staffing Act. This legislation would require hospitals participating in Medicare to establish registered nurse staffing plans. The bill is currently in the Senate Finance Committee. California nurse leaders can impact important health care legislation by keeping informed of key developments and getting involved in the process. The Health Policy Committee, through the ACNL website, provides members with legislative tips and guiding principles. Members are encouraged to share legislative news and information at professional and work meetings. ACNL members are also encouraged to get to know their elected officials in order to position themselves to provide timely, relevant and professional feedback to our state and federal lawmakers. Through awareness, education and involvement, ACNL nurse leaders are positioned to advocate for access to quality health care for Californians. Resources: ACNL Legislative Tracker: California State Legislature: Click Here to View Tracker Nursing Mourns the Loss of Dianne Moore Dianne Moore, PhD, MN, MPH, CNM, RN, President of the American Nurses Association\California and longtime nurse leader in academia and service, passed away on June 28. This is a shock and loss to ANA\C and the larger nursing community. Our thoughts and prayers are with Dianne s family and friends at this difficult time. Vice President Corinne MacEgan BS, RN, CHPN has assumed the role of ANA\C President. Corinne is a staff nurse at Sharp Chula Vista Medical Center and former CNSA Communications Director.

12 P A G E 12 The Power of Us! A Force for Change! ACNL s 38th Annual Conference By Jami de Santiago, MS, RN Chair, Annual Program Committee Jan 31- Feb 3, 2016 Westin Resort and Spa in Rancho Mirage The Power of Us! A Force for Change! This dynamic theme for ACNL s 38 th Annual Conference recognizes the incredible work nurse leaders do every day. We believe this theme epitomizes the diverse talents and abilities of our membership and the great potential we have to lead positive change in healthcare! As we began the planning process for ACNL s 2016 Conference, Annual Program Committee members recognized that the 2015 Conference would be a difficult one to top speakers and events were top notch and the majority of participant evaluations ranked the program as excellent. Although the 2015 Conference is a tough act to follow, our AP team is committed to presenting a program that will WOW you and keep you coming to ACNL conferences each year. Our work is directed by the Board and our goals driven by ACNL s Strategic Plan. Our committee is charged with planning a conference that exceeds members expectations in content, networking and relevance to leadership practice. To us, this means developing a broad-based program providing topics on: practice innovation, health care reform, quality and patient safety and emerging trends in leadership. Your input, both on the 2015 program evaluations and through verbal feedback to committee and Board members, provides us with important information to improve each conference. Throughout the planning process, we strive to be good stewards of financial resources by bringing you a well thought-out program in the most cost-effective manner possible. We have some excellent negotiators when it comes to booking great speakers and using resources wisely. As a result, we have developed an outstanding program that will provide you with the knowledge, tools and resources to help you successfully meet the challenges of today s health care environment. Our venue for 2016 is a very popular one the Westin Hotel and Spa in Rancho Mirage. The resort provides a quiet atmosphere to get away from the daily grind and allow for learning and discussions on current issues facing us in our practice settings. (Continued) D I R E C T L I N K

13 S U M M E R P A G E 13 ACNL s 2016 Annual Conference features: Our keynote, Dr. Barry Posner, is a world-renowned scholar, author and leadership guru. He is co-author, with Jim Kouzes, of the phenomenal book, The Leadership Challenge. For more than 25 years, the K&P model has been a highly utilized resource for building effective leaders and is utilized in ACNL s Foundation for Leadership Excellence program. This session helps you take the next steps in your personal leadership journey. Dr. Louise Selanders is an internationally recognized nurse historian and Nightingale scholar. Her fascinating presentation about Florence Nightingale draws many parallels to today s health care environment. Matt Thornhill, founder and president of the Boomer Project, explores the boomer consumer the largest, wealthiest and most influential group in the nation. Learn strategies for making your organization age ready. More nurses on boards is a goal of the IOM s Future of Nursing Initiative and a hot topic in nurse leadership. ACNL Board members Judy Karshmer and Katie Skelton lead a panel of experts on board service. Get ready to take action to build your influence. A new session format called Flo Talks will feature short presentations on health policy subjects. More information to come about presenters and specific subjects. Dr. Diane Brown presents the latest findings from CALNOC. Discover innovations and best practices that improve patient outcomes. Our inspiring end note, Jeremy Poincenot, will describe his journey of triumph over adversity. Blinded by a rare disorder at age 19, Jeremy overcame this obstacle to win the World Blind Golf Championship. He will inspire you to overcome your own challenges in order to live a strong, confident life. Breakout sessions feature topics of interest for nurse leaders at all levels. Presentations include: the roles of PhD and DNP nurses, building your voice and influence, best practices by some of our 2015 poster presenters, and several other subjects of interest for nurse leaders from service and academia. Posters spotlighting best practices and innovation that can be readily implemented in your organization. A robust Exhibitor Day with the latest technology, products and services from our industry partners. Time for networking, camaraderie and fun with your colleagues! Don t miss this outstanding program! Please save the dates January 31 February 3, 2016 and plan to join us in Rancho Mirage for ACNL s 38th Annual Conference.

14 P A G E 14 Nurse Leadership Development Developing and Sustaining Nurse Leaders By Judy Dahle, MS, MSG, RN and Ellen Gorbunoff, MSN, RN-BC Leadership Development Committee Providing professional development for nurse leaders at all levels As members of ACNL, we strive to provide educational opportunities and professional development for members at all leadership levels. Through our Foundation for Leadership Excellence program, we have had great success providing education, support and resources to emerging and aspiring nurse leaders. Now in its 13th year, more than 1400 nurse leaders have graduated from the Foundations program. In addition, we have been most successful in providing support and sharing practical experience formally through our ACNL/LifeMoxie Mentorship Program and informally as coaches and mentors. Feedback from participants in the ACNL Mentorship program consistently affirms its value, both from the perspective of new nurse leaders and seasoned leaders serving as mentors. Unfortunately, healthcare constantly provides challenges to our daily activities and at times causes us to question our capabilities as nurse leaders. Sometimes, regardless of where we may be on the leadership continuum, we may wonder if we have the stamina to keep up with these challenges. How then, with these questions about our own roles, can we identify, develop and sustain new and existing leaders? As members of the Leadership Development Committee, we sought to find answers in the literature, from business to healthcare, only to find minimal resources. Instead, our answers came from within our own organization ACNL. We identified the need to develop partnerships and establish connections with others committed to developing and sustaining nurse leaders. Our first step was to call the circle by hosting a brainstorming session to align our goals with the work being done throughout the California Action Coalition (CA AC), and specifically around Recommendation #7 which has evolved into CA AC s Leadership Pillar. (Continued) D I R E C T L I N K

15 S U M M E R P A G E 15 Fortunately, our CEO Patricia McFarland and ACNL s Health Policy Committee Chair Myra Lang are also the Co-Chairs for Recommendation #7. In collaboration with Pat McFarland, a graphic display of connection between ACNL programs, Nurse Leadership Development Committee work, CA AC and the California Institute of Nursing and Health Care (CINHC), our state nursing workforce center, was developed (see diagram on left). A more detailed presentation was delivered at ACNL s 2015 Annual Conference, exploring Recommendation #7 and the alignment throughout the state around nurse leadership development. We were not the only group with questions about the connections between ACNL, CA AC and CINHC. Beginning January 1, 2015, the CA AC Advisory Board and CINHC merged. Our state action coalition is now housed in CINHC. Mary Dickow will continue as the CA AC Director, while Mary Foley and Linda Zorn will co-lead the work. Judee Berg, an ACNL past president, will continue as the Executive Officer and President of CINHC. There is no question that there is overlap when it comes to the work of the California Action Coalition and ACNL. ACNL has, and will continue to take the lead to ensure Recommendation #7 is actualized through California. To date, funding for Recommendation #7 has been sponsored by ACNL, with the LifeMoxie mentorship platform funded by Kaiser Foundation. In 2016, the Kaiser Foundation is partially funding LifeMoxie, with ACNL absorbing an increasing share of the expenses. The key to the success of this work is the growing relationships with nurses across the state and CA AC and CINHC. The Recommendation #7 team has focused their work in several areas: student engagement, mentorship, developing leadership competencies and media training, with the goal of preparing nurses to sit on boards (see CEO Report on page 6 for more details). Through the ACNL/ LifeMoxie Mentorship Program, the vision is to establish four tracks, three of which address the emerging, seasoned and senior or executive leadership levels. The fourth track will be developed for nurse leaders interested in serving on boards. As ACNL rolls out plans for developing a senior leader/chief nursing officer academy, there is opportunity to expand the ACNL/LifeMoxie program even further. Nurse Leadership Development Team Purpose: Provide members with tools and knowledge necessary to enhance their professional development Coordinate educational programs within ACNL and with partnership organizations Assess current educational offerings for relevancy and opportunities for new programs

16 S U M M E R P A G E 16 Mary Foley Plans Delegation to Rwanda Focus will be on infection prevention and control Dr. Mary Foley, ACNL member and former president of the American Nurses Association, is planning a delegation to Rwanda in August to promote infection prevention and control. This will be her third trip to the country. Foley, Director of the UCSF School of Nursing s Center for Research and Innovation in Patient Care, was recognized with ACNL s 2011 Contributions as a Humanitarian award for her work in Rwanda. I have had the opportunity to visit Rwanda twice over the last three years, and I cannot wait to return! she said, enthusiastically. Foley s adventures in Rwanda began when she led a small nursing delegation to the country in During that trip, the delegation met nurses and other healthcare workers across the nation. Before we started our travels in-country, we learned about the great recovery of this small country as it moves forward, but will never forget, the genocide in We were struck by the sense of national unity and pride, and forward thinking policy initiatives that placed a value on healthy villages and families, she said. The group visited a variety of settings to better understand the country s healthcare system. They learned about Rwandan efforts to provide care at health centers, and had discussions with caregivers about stress, infection control and care of the newborn. These conversations inspired and encouraged Foley to come back to Rwanda in 2014 to support the nation s efforts to develop their healthcare system. Foley s second trip to Rwanda was the inaugural delegation of the Infection Prevention & Control program (IPC), in collaboration with the Global Engagement Institute (GEI). The delegation visited four hospitals and the School of Health (Continued) Mary Foley (left) has led two delegations to Rwanda. Her upcoming trip in August will focus on infection prevention and control.

17 Sciences. During these visits, and in conversations with key health leaders, Foley conducted an assessment of infection control needs as Rwanda implemented accreditation standards for their hospitals. The most important meeting was with the Rwandan Minister of Health, who reviewed the GEI concept paper and gave Foley permission to begin work with three referral hospitals. These were important steps to ensure the work will advance the health care goals of Rwanda and are compatible with their health initiatives. I was struck at every hospital by the courage and commitment everyone has to providing the best care they can. I am also struck by how open and sharing the people of Rwanda are, and how safe I feel when I am there, Foley emphasized. Foley is inviting individuals and institutions who have an interest to help with the scale-up of this unique initiative to join the IPC delegations. The next delegation will be Aug 5-15, 2015, with future delegations planned for March and August in The opportunity to combine good work, meeting good people and seeing the wonders of Africa are among the reasons to join GEI and me, as we work on infection control in Rwanda. said Foley. More Information About the IPC Program Delegation in Rwanda P A G E 17 Kathy Harren Appointed to CHA Quality Institute Board Kathy Harren, MSN, MHA, RN, Regional Director of Providence Health & Services Nursing Institute, has been has been appointed to the Board of Directors of the California Hospital Quality Institute. I m grateful for this opportunity to represent the voices of nursing leadership and of Providence at the state level, Harren said. It is the priority of nurse leaders to advance clinical care by participating in high-profile organizations that advocate for patient quality and safety. Harren joined the 14-member Board earlier this year. CHA s Quality Institute is dedicated to advancing and accelerating patient safety and improving quality patient care throughout California. It focuses on eliminating problem areas, optimizing care and treatment and enhancing the healthcare experience for patients and their families. Harren joined Providence Health & Services in 1989, holding various nursing and leadership roles at Providence Little Company of Mary Medical Center - Torrance, including chief nurse executive. In 2011, she was chosen to head the newly formed Providence Nursing Institute, established to advance quality patient care through professional development, education, technology and research. She is a past president of ACNL and Board Chair for the California Alliance for Nursing Outcomes (CALNOC).

18 P A G E 18 OSHA Hospital Safety Inspection Areas of Emphasis Stem from Longtime Pressure from Advocates By Christopher Cole from Inside Washington News, Posted on June 29, 2015 The Occupational Safety and Health Administration's (OSHA) newly rolled-out areas of emphasis for compliance officers conducting hospital and nursing home inspections will focus on ergonomic issues, bloodborne pathogens, workplace violence, tuberculosis and slips, trips and falls. Washington sources say that these focus areas are the result of lengthy and intense pressure by health care worker advocates, particularly the nurses' lobby, to increase OSHA inspectors' concentration on inpatient facilities, OSHA leaders unveiled the changes in late June in an announcement that grabbed the attention of industry representatives and attorneys engaged in OSHA law, as it focuses on several emphases for which the agency lacks specific standards but has increasingly tried to address under the Obama administration. (View announcement) Worker safety advocates immediately lauded the initiative as going after a wide swath of problems in inpatient health care that they consider largely neglected over the years. Safe patient handling, the issue OSHA seeks to address by adding an ergonomics emphasis to the inspection regime, has especially come to the forefront in recent years. Bloodborne pathogens are the subject of a longstanding specific rule, but experts note that the issue has not always been a focus within inpatient care centers. A union source also points out that data collected during inspections focused on bloodborne pathogens and disease transmission under the directive could also be used to help buoy OSHA's plans for an infectious diseases rule. Other issues broached by the policy directive, perhaps most notably musculoskeletal disorders, are not the subject of a standard and have been longstanding sources of controversy. Industry experts believe the agency has become more emboldened to use the OSH Act general duty clause in cases where it believes ergonomic hazards have gone unaddressed, or where employers should have known and taken steps to reduce the dangers of workplace violence. Experts say what is notable about the new initiative is that even though some standards, including the one covering bloodborne pathogens, have long been in place and employers are expected to comply, OSHA is now specifically targeting inpatient (Continued) D I R E C T L I N K

19 S U M M E R P A G E 19 facilities under the policy. One source says organized nursing labor has for years been putting pressure on OSHA to take formal action to begin tackling the hazards, with nurses typically viewed as the most vulnerable worker population to the identified concerns. Also last year's Ebola scare in the United States gave nurses a louder voice and put much greater impetus on OSHA to elevate enforcement to prevent infectious disease transmission in hospitals, an attorney observes. Many people have asked me why OSHA is doing this now, says Valerie Butera, an attorney with Epstein Becker Green, in an . The Ebola crisis late last year gave nurses and nursing unions a platform with OSHA that enabled them to point out a great many workplace hazards in healthcare, and OSHA listened. I believe this, combined with the liberal use of the general duty clause by OSHA under the Obama administration, combined to cause OSHA to target inpatient healthcare facilities, she says. What is remarkable about this is that OSHA is redirecting substantial resources to target enforcement at inpatient care facilities, which have not been subject to much OSHA scrutiny in the past. And OSHA is not just focused on bloodborne pathogens anymore in fact, I suspect that musculoskeletal injuries will lead to the greatest number of citations in this initiative. According to Butera, developments including OSHA's successful exercise of the general duty clause in high-profile cases, such as the Walmart trampling case, have motivated OSHA officials to use the statutory section more aggressively, and they are feeling more confident about it. A different lawyer calls the policy with respect to musculoskeletal disorders ridiculous, telling Inside OSHA Online in an that OSHA is prohibited from issuing an ergonomics rule without Congressional authorization, and yet it openly announces that it will issue citations to employers that do not comply with its guidance. OSHA cites labor statistics as reasoning for the new inspection emphases and notes that similar issues were targeted under the recently concluded National Emphasis Program for nursing and residential care facilities. These focus hazards will be addressed in addition to other hazards that may be the subject of the inspection or brought to the attention of the compliance officer during the inspection, OSHA says. The goal of this policy is to significantly reduce overexposures to these hazards through a combination of enforcement, compliance assistance, and outreach. The agency states that the Bureau of Labor Statistics and OSHA s inspection history with the emphasis program have shown that inpatient healthcare settings consistently have exposures to the safety and health hazards addressed by the new enforcement memo. OSHA says that with regard to musculoskeletal disorders, between April 5, 2012 and April 5, 2015, OSHA conducted 1,100 inspections of nursing and residential care facilities under the emphasis program. Ergonomic stressors were evaluated in 596 of these inspections, which generated 192 ergonomic hazard alert letters... to employers and 11 citations of OSHA s general duty clause for hazardous ergonomic conditions. (Continued)

20 P A G E 20 Union officials characterize OSHA's involvement in the concerns at inpatient facilities as long overdue -- but still not enough. It's a step in the right direction, says an occupational safety and health staffer for one union affected by the issue. However, the staffer notes that despite the hazard emphases, actual numbers of hospital and nursing home inspections may not actually increase, and that resource constraints may make it difficult for field staff to concentrate on the sector. It doesn't seem to say they will do any more inspections in health care [but is] just highlighting to their inspectors hospitals have these major hazard areas that we know from the data. Still, the more pressure on OSHA's inspection resources, the less of these they're going to do, the source says. It seems like a small step but at least it's in the right direction. Worker advocates praised OSHA's move, with organized nursing labor at the forefront and emphasizing ergonomic concerns. Labor statistics have consistently shown that nurses, nursing assistants and other health care workers are at high risk of MSDs from manually lifting, transferring and repositioning patients, Debbie Dawson Hatmaker, executive director of the American Nurses Association (ANA), said in a June 25 statement. Manual patient handling is unsafe for patients and often results in painful, career-ending health care worker injuries. ANA hopes the enforcement memo will encourage hospitals to proactively address safe patient handling and mobility and create comprehensive programs to protect patients, nurses and other health care workers, says Hatmaker. While OSHA s action is a step in the right direction, ANA believes a federal ergonomic standard is necessary to protect health care workers and is working with Congress to introduce legislation that would establish such a standard. Public Citizen has also been highly engaged in safe patient handling and issued a June 25 statement underscoring ergonomics: We applaud OSHA for directing agency time and resources toward hospitals. Heightened inspection and enforcement actions likely will reduce injuries and slow the rate of musculoskeletal disorders in the hospitals that OSHA inspects, but it isn t enough, said Keith Wrightson, worker safety and health advocate for Public Citizen s Congress Watch division. The real answer to addressing these career-ending injuries is to enact a federal law to protect these workers that would reduce or eliminate heavy manual lifting in hospitals and other health care settings. A model law would incorporate written patient handling policies and require the use of mechanical devices to move patients, and would require institutions to keep accurate counts of musculoskeletal disorders sustained on the job, analyze the causes of such injuries and submit annual reports to regulatory agencies on the number of musculoskeletal disorders experienced by employees, Public Citizen says. D I R E C T L I N K

21 S U M M E R P A G E 21 ACNL Webinar: Prescription for Success! Medication Administration Accuracy Tuesday, July 21, :00-1:00 p.m. Brought to You by ACNL s Quality, Safety and Care Experience Committee Presenters: Medication Administration Accuracy Relies on Safe Practice Mary Foley, PhD, RN, FAAN Director-Center for Research & Innovation in Patient Care UCSF School of Nursing Discontinuing Mandatory Double Verification of Subcutaneous Insulin Improves Patient Safety and Nurse Satisfaction Chris Patty, DNP, RN, CPPS Medication Safety Specialist Kaweah Delta Health Care District Webinar Registration Or visit the ACNL website at Please Note: You must pre-register for the webinar in order to receive log-in instructions. This webinar will be recorded - if you are unable to participate in the live event, you can view the recorded presentation at a later time. This webinar is offered free of charge for ACNL members.

22 P A G E 22 Creating the Future of Nursing in California CINHC and CA AC Host Regional Meetings in July You are invited to join the California Institute for Nursing and Health Care (CINHC), the California Action Coalition (CA AC) and other thought leaders across the state to explore the value nurses bring to the evolving health care environment and innovative ways to provide education for future roles. CINHC and CA AC are hosting a series of meetings throughout California on the topics of nursing education redesign and academic progression. These meetings will inform a white paper and related work funded by the Gordon and Betty Moore Foundation and the Robert Wood Johnson Foundation. The goal is to gather input from diverse groups nurses, other health professionals, policy makers, public and community health representatives, business stakeholders, insurers, health systems, students and consumers. Please bring your voice and ideas to help redesign nursing education and identify new ways to promote health through nursing! More Information and List of Regional Meeting Dates and Locations For more than 37 years, ACNL has been developing nurse leaders, advancing professional practice, influencing health policy and promoting quality and patient safety. ACNL is a powerful voice for nurse leaders throughout California and serves as a statewide and national example of affecting positive change for nursing and health care. Positioning Nurse Leaders to Create and Influence the Future of Health Care 2520 Venture Oaks Way Suite 210 Sacramento, CA Phone: Fax: info@acnl.org www,acnl.org Our members are diverse in their experience and talents. Focusing on outcomes, ACNL seeks the active engagement and participation of all its members. Through this collective strength, nurse leaders can best meet the needs of their organizations, clients and communities, while at the same time, advance the profession and practice of nursing. ACNL: Leading with Courage...Committed to Excellence