ANNUAL REPORT 2012 Professional Nursing Staff Organization UVA Nurses We Make the Difference.
Reflections Dear Nurse Colleagues, There is no person better positioned to understand what patients and their families need than the nurse at the point of care. This fact is at the heart of the shared governance model and in 2012, we took a number of steps to better realize its potential. With the foundation of more than 20 years of shared governance history, our refreshed shared governance initiative began to take shape in 2011. It began with a retreat that brought together a generation of former PNSO presidents with the current nursing leadership. It gained momentum throughout 2012 as we put in place a variety of measures designed to ensure not only that nurses are heard clearly but also that every nurse who wants to make a contribution can do so. By the end of the year, every unit had the fundamentals of a well-functioning and well-supported practice committee. Along with having a voice comes the responsibility to use it to speak out on behalf of patients and their families and equally important to act on the policies that we as nurses had a hand in developing. An integral part of shared governance is accountability, a commitment to do our best for patients every time. One way of looking at the work we did this year was to create a culture of accountability. Accordingly, the ultimate measure of our success is our nurse-sensitive indicators. Although many shared governance initiatives were put into practice only near the end of the year, we are already seeing a difference. Thanks to the leadership and accountability of many nurses throughout the organization, we are well on our way to eliminating hospital acquired pressure ulcers. This is a tremendous achievement given the complexity of care we provide. We have also started to see decreases in blood stream infections, patient falls and the use of restraints. We hope to see these improvements continuing throughout 2013. All these efforts will strengthen our position as we turn our energies in 2014 to reestablishing our Magnet certification. They also reflect a recommitment to the excellence in care our patients and their families deserve. Dear Fellow PNSO Members, As we say in our new vision statement, UVA nurses are leaders empowered to make a difference. This year, we systematically rebuilt our shared governance model to provide nurses with the skills and tools they need to act on this vision. Our goal was to create greater consistency across the medical center in how we implemented the model and to encourage greater participation by nurses. Recognizing that grassroots involvement is the key to shared governance, the Shared Governance Redesign Workgroup focused on the unit level. As part of this effort we required each unit to have a shared governance committee addressing the four components of shared governance quality, research, professional development and clinical practice. We supported the work of these committees by holding orientation sessions for their chairs and cochairs that focused on the principles of shared governance and on leading effective meetings. We also developed a shared governance toolkit, a monthly tip sheet and an orientation binder. We also concentrated this year on building our base of engaged nurses. We encouraged Clinician IIs and IIIs to chair the local shared governance committees and assigned coaches from the Shared Governance Redesign Workgroup to provide guidance. We also created a series of PNSO committees for management, APNs and research that we hope will provide more opportunities for nurses to become involved. In addition, we introduced a night shift committee so that these nurses can also participate in shared governance. Through broader involvement, we hope not only to provide better care to patients but also to cultivate the next generation of PNSO leaders. Shared governance requires a commitment to a shared sense of purpose. We underscored this point with the video we created to introduce our new vision. A diverse group of nurses from around the Medical Center took turns reading phrases from the vision, the words of one reader flowing seamlessly into those of the next. Our shared governance re-design continues into 2013 as we identify the best structure for ambulatory participation. If our revitalized shared governance committees can help us replicate this close and intuitive collaboration, we will have gone a long way to realizing the ideal of shared governance. Lorna Facteau, DNSc, RN Tanya Thomas, BSN, BA, RN, OCN Cover: Sonya Silver & Sharon Williams are registered nurses with UVA Home Health Continuum; recognized repeatedly with the National Home Care Elite Agency Award. Special thanks also to the family of our featured patient, Mrs. Averil Robinson. She was an alumnus of UVA, a registered nurse and champion bridge player.
Accomplishments and Outcomes Annual Nursing Excellence Awards UVA Nursing Numbers in 2012 The PNSO presents seven awards annually honoring different aspects of excellence in the nursing role. Award recipients are selected on the basis of peer nominations reviewed by the PNSO Awards Committee. Excellence in Caring Carolin Connelly, BSN, RN, PCCN Excellence in Clinical Practice Shelly Legg, BSN, RN, CMSRN Nurse of Distinction Lisa Farmer, BSN, RN, CAPA Practitioner of the Year Anika Thurston, RN Preceptor of the Year Gary Jones, RN Excellence in Nursing Research Amy Johnston, RN Transformational Leader Tina Knicely, BSN, RN, CAPA 293 nurses received educational assistance totaling $839,762, an average of $2,866 per person. 16% of direct care nurses are certified in their specialty practice area. 43% of nurse leaders are certified. RNs were supported to attend conferences with funds totaling $443,218. Lorna Facteau, CNO and Scott Croonquist, Associate CNO recognize deserving individuals for their support and contributions to nursing. Nurse Manager of the Year Brian Zwoyer, BSN, RN Friend of Nursing Kelly Bell, Finance / George Hoke, MD As chair of our Shared Governance Committee, I ve learned more about how we measure and compare our performance. It s exciting to use our structure to share new things with the rest of my team. Brenda Brenda Hudson, BSN, RN, PCCN Short Stay Unit (right) Kayla Reynolds, BSN, RN, PCCN 5 West
Clinical Career Ladder in 2012 Highest Degree Held by UVA Nurses 96 RN portfolios were evaluated by the peer review panel. 85 RNs successfully advanced: 0.3% 12.1% 7.1% 68 to Clinician 3 12 to Clinician 4 47.1% 33.4% 4 to APN 1 1to APN 2 n Diploma n Bachelor s n Doctorate n Associate s n MSN Having a Professional Development Committee on our unit provides us a formal process for education and implementation of improved practice standards. Robert Zuseen Castrillon, BSN, RN Robert Foreman, RN
As nurses, we are accountable to our patients and their families for providing the highest quality care possible; rooted in evidence-based practice. Sally Sally Miller, APN II, CNM, NP (left) Nancy Addison, BSN, RN, CCRN Nursing Research Innovators Clara Winfield, BSN, RN, CAPA was the recipient of the First Annual S. Burns Evidence-Based Practice Award for her project, What Is the Most Comfortable (Least Painful) Method of Anesthetizing a Peripheral Intravenous Site? The Research Mentor Program conducted 9 IRB approved studies and published 3 articles. The 2nd Annual Pamela F. Cipriano Nursing Research Fund recipient was Malinda Whitlow, MSN, NP, RN, CNL for her project titled An Innovative Way to Use Technology at the Bedside. 8th annual Evidence Based Practice Symposium showcased the findings of UVA nursing research and other practice-related improvement projects. There were 85 people in attendance, 22 posters and 17 podium presentations.
The goal of our local Quality Committee is to maintain a safe environment. It is rewarding to see nurses actively participate in practice improvements. Scott Scott Austin, RN Lindsay Staton, BSN, RN Investing in Best Practices 77 CAUTI Champions provided over 360 hours of hands-on training to inpatient nurses. The Nurse Sensitive Quality Indicator committee distributed 38 Days Since Last Event dry erase boards to our inpatient areas. These boards allow areas to tally the days since a quality indicator infraction. The Patient Falls committee recommended implementation of yellow socks and blankets to better identify patients at risk for falling. An investment of more than $18,000 was made to support this practice. Patient Fall rates improved in 2012. Based on the review of evidence and nursing recommendation, the institution invested $52,210 in Swab Caps to support best practices for cleaning IV ports on central lines. CLABSI rates improved in 2012.
2012 Nurse-Sensitive Indicators Keeping a close eye on our clinical outcomes is a key priority. Through our electronic Medical Center Quality Dashboard, unit-based quality bulletin boards and updates from the PNSO, nurses have ready access to know how we measure up. Being informed about our performance is the foundation for superlative outcomes. We continue to provide the best care to our patients through innovation, diligence and application of evidence-based practice. Number of Central Line-Associated Blood Stream Infections 30 25 20 15 10 5 0 25 21 20 19 Percentage of Patients with Hospital-Acquired Pressure Ulcers 3% 2% 1% 0% 2.6% 2.3% 2.0% 1.3% Percentage of Patients in Limb/ Vest Restraints 6% 5% 4% 3% 2% 1% 0% 5.3% 5.0% 2.8% 2.4% Total Falls 180 160 140 120 100 80 60 40 20 0 156 160 143 133 Number of Catheter-Associated Urinary Tract Infections 60 50 40 30 20 10 0 48 47 43 39 Pride in Practice Award Areas recognized with the Pride in Practice award are committed to providing exceptional patient care of the highest quality. Their dedication to the patient experience sets the standard. Congratulations! 1st Quarter, January March 2012 3rd Quarter, July September 2012 4 Central, Sustained Excellence in Overall Outcomes 4th Quarter, October December 2012 5 East, Most Improved for Patient Satisfaction MSICU, Most Improved for CAUTI and Patient Falls 2nd Quarter, April June 2012 3 East, Sustained Excellence in Overall Outcomes
Susan Levick, BSN, RN Infusion Procedural Center Keith Jackson, MSN, RN, PCCN 4 Central Dana Palmer, MSN, RN-BC, CNL 4 East The Vision of the UVA Professional Nursing Staff Organization is We Make the Difference. UVA nurses are leaders empowered to make the difference. We make the difference by leading in the provision of expert, compassionate care in partnership with the patient, family and healthcare team. We make the difference by leading innovation in the development of new nursing knowledge. We make the difference by leading in the education of new healthcare professionals and inspiring the pursuit of lifelong learning. We make the difference as internationally-recognized leaders for achieving the highest outcomes for our patients. We make the difference by constantly striving to optimize the health of the local and global communities entrusted to our care. UVA Nurses We Make the Difference! Brandon Moore, BSN, RN STBICU Katherine Willard, MSN, RN Radiology Professional Nursing Staff Organization PO Box 800135, Charlottesville, VA 22908-0135 www.nursingatuva.com 2013 by the Rector and Visitors of the University of Virginia Produced by UVA Health System Marketing Communications 4/13 750