ANNUAL REPORT 2011 Professional Nursing Staff Organization
Caesar Dcroz Nutrition Services Amanda V. Woloszyn, PharmD, BCPS Pharmacy Services Tonya Chambers Environmental Services Partners in Practice. Leaders in Action. It s our interdisciplinary approach that provides our patients with an exceptional experience. For more than two decades, the Professional Nursing Staff Organization (PNSO) at the UVA Health System has worked hand-in-hand with all members of the healthcare team to create an environment where professional practice flourishes, where nurses are actively engaged in the governance of their practice and where the contributions of nurses are celebrated by all. Together with the healthcare team, nurses create a healing environment for patients and families by fostering healthy and safe work environments, involving patients in their own care and aligning our practice with our values. Jessica Kassay-McAllister, RN 4 Central Will Crowder, LCSW Social Work Toader Dumitriu Facilities Management Karen Hunley, CPT, ASPT Phlebotomy Huai Cheng, MD
Reflections Dear Fellow PNSO Members, This year marked a turning point for nursing at UVA. It was a challenging year in many respects a year of taking stock but it was also a year in which the power of nursing was never more evident. Nurses played a critical role in modernizing practice while working hard to improve our shared governance model. Altogether, we ended the year with a recommitment to excellence, better equipped to turn our aspirations into reality. Dear Nurse Colleagues, Over the last two years, we devoted a great deal of our time and energy to preparing for Magnet redesignation. We were naturally disappointed when we decided to postpone our submission until January 2014, but the process of self-assessment served its purpose. Magnet designation provides an opportunity to learn and improve. We now understand the gaps that prevent us from providing the level of care that we aspire to and have developed a disciplined approach to achieving excellence. For one thing, we have opened up the process. We realized that making progress on nurse-sensitive indicators requires the support and insight from professionals across the Medical Center. Our Magnet Steering Committee, for instance, now includes several chiefs, administrators and interdisciplinary leaders. We have also hardwired our mechanism for making every nurse aware of unit-specific data by posting dashboards in all our units. I believe strongly in the transparency of data. If we want every nurse in the Medical Center to take ownership for our metrics, we must make sure that they have access to them in the first place. In addition, we have appointed internal experts to act as champions for each of our major nurse-sensitive indicators. These experts are authorized to make sure that we use evidence-based strategies to improve patient outcomes and to mentor their colleagues about best practices. If I feel optimistic about our ability to make real improvements in our standards of care, it is because of the commitment of nurses I meet everyday in the Medical Center. This is a large and highly complex organization. Your willingness to thoughtfully and constructively highlight systemic issues and seek out ways to deliver superlative care will take us far. This is a time for us to Recommit to Excellence. It is an opportunity to reach our potential and deliver the quality of care our patients deserve. Nurses were central to the success of the inpatient EPIC implementation, not only by helping to shape the design of our system, but also by working hard to make go-live as successful as possible. Nurses continue to improve on the electronic medical record which helps us provide safer, better and more uniform care for our patients. Going forward, it will generate data that will be essential as we work to improve outcomes. We also broadened and decentralized our shared governance model. We included more administrative personnel in the Nursing Cabinet, enabling more stakeholders to be part of our deliberations and decision-making. We also began the process of strengthening the governance model at the unit level, to ensure that all bedside nurses will have access to a consistent mechanism for addressing research, education, practice and quality. At the same time, PNSO leaders made a concerted effort to involve more nurses in governance. It is clear that the desire to contribute is widespread. I was impressed by the helpful comments I received in the course of rounding, and I was gratified by the number of people who read my blogs. We also took the opportunity this year to engage with our interdisciplinary coworkers across the Medical Center. We initiated Schwartz Center Rounds, which provide an occasion for caregivers from multiple disciplines to come together to discuss the human aspects of healthcare. The events evidently struck a chord. More than 300 people attended our last session. Our decision to postpone Magnet designation until 2014 means that we have room to improve. My experience as president this year has convinced me that we have the talent, the skills, and, most of all, the desire to make changes that will enhance the care we provide our patients. Lorna Facteau, DNSc, RN Caroline McDaniel, BSN, RN Featured on the cover are the 2011 PNSO Nursing Excellence Award Winners, clockwise, left to right: Tracy Bryant, RN; 6 East - Excellence in Caring Lisa McNerny, RN; 8 West - Preceptor of the Year Lisa Letzkus, MSN, CCRN, CPC-AC; KCRC - Nurse of Distinction Pam Slade, BSN, RN, CCRN; CCU - Excellence in Clinical Practice Alison Patrizio, MSN, RN, CNL; 4 Central - Beginning Practitioner of the Year
Accomplishments and Outcomes Addressing the complex medical issues our patients face requires close coordination among scores of professionals. That s why learning to be a productive team player is essential. Caroline Tierney, BSN, RN, 6 Central (right) Stephen Donahue, MD UVA Nurses by the Numbers 15.8% of direct care nurses have achieved specialty certification. 43% of nurse leaders are certified. Highest Degree Held by UVA RNs 12.10% 0.29% 10.1 years is the average time of service for a nurse at UVA. 8.24% 32.10% The nurse turnover rate for 2011 was 14.1%. Our goal is to be below 9.6%. 47.27% n Associate s n Bachelor s n Diploma n MSN n Doctorate
Chief Nurse Visibility Pride and Practice Award Lorna Facteau, Chief Nursing Officer, has increased her visibility by hosting 108 Patient Care Services Employee Forums allowing the voices of 720 RNs and area staff members to be heard. She sent out 7 NurseTalk videos to PNSO members and conducted over 48 hours of rounding. Lorna recognized over 70 RNs with the Patient First Award, fondly known as the Cupcake Award. Areas recognized with Pride in Practice 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 2011 Nerancy Neuro Intensive Care Unit - Best Overall Sustained Outcomes 2nd Quarter, April June 2011 6 Central Sustained Excellence in Nurse Sensitive Clinical Outcomes 3rd Quarter, July September 2011 7 Acute Sustained Excellence in Patient Satisfaction Continuum Sustained Excellence in Patient Satisfaction 4th Quarter, October December 2011 STBICU Most improved outcomes for CLABSI & HAPU Nurses support and encourage each other by acknowledging our capabilities, individuality and wellbeing. Fostering abilities and promoting confidence makes us all effective leaders. Jerimie Batac, BSN, RN, 5 Central (left) Karen Love, RN, BA, Operating Room
My patients are at the center of my work. My goal is to make sure they have everything they need, and hopefully make them smile, too. Bobby Casteen, RN, Pediatric Speciality Clinic Professional Development in 2011 157 national, regional and local presentations were made to share innovation. 21 articles and chapters were published. RNs were supported to attend conferences with funds totaling $362,122 in fiscal year 2011. 73 RNs sought advancement on the Clinical Career Ladder. 55 RNs successfully advanced. $636,940 was invested in educational assistance for 226 UVA RNs.
2011 Nurse-Sensitive Indicators Percentage of Patients with Hospital-Acquired Pressure Ulcers Total Falls Number of Central Line-Associated Blood Stream Infections 5% 4.7% 3.9% 3.1% 3.6% 250 164 167 174 200 35 33 21 15 20 4% 3% 200 150 30 25 20 2% 1% 100 50 15 10 5 0% 0 0 Percentage of Patients in Limb/Vest Restraints Number of Catheter-Associated Urinary Tract Infections 7% 6% 5% 4% 3% 2% 1% 0% 5.4% 3.4% 3.4% 6.2% 35 35 51 41 60 50 40 30 20 10 0 There s no question that nursing requires emotional, intellectual and physical stamina. You ve got to take care of yourself personally and professionally to care for patients over the long term. Michelle Gray-Smith, RN, 3 Central
Professional Practice Model UVA s Professional Practice Model depicts how our organizational goals, values and Exemplary Practice Clinical Practice, Ethics, Safety Transformational Leadership PNSO, CNO, Clinical Career Ladder Respect Stewardship Empirical Relationship Outcomes Nurse Based Sensitive Care Quality Indicators New Knowledge, Innovations, Improvements Nursing Research, Evidence-Based Practice, Technology Excellence Integrity Structural Empowerment Community Service, Nursing Congress, PNSO Cabinet, Professional Development the ANCC Magnet components fit together to promote best practices that lead to the highest quality outcomes. Relationship- Based Care is at the core of our model. This philosophy of care defines the relationships with ourselves, our patients and all members of the healthcare team that when integrated deliver an advantaged patient experience. The connection of these elements provides a model to guide nursing practice and value the relationships Empirical Outcomes Nurse-Sensitive Quality Indicators I Care I Heal I Build between nurses and patients. Professional Nursing Staff Organization PO Box 800135, Charlottesville, VA 22908-0135 www.nursingatuva.com 2012 by the Rector and Visitors of the University of Virginia Produced by UVA Health System Marketing Communications 4/12 0M