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Nursing
News
Brief
An update on
professional nursing
at Beth Israel Deaconess
Medical Center
Fall 2007
Reducing hospital-acquired infections
Measures of success at BIDMC
T
hese results are
spectacular!” says
BIDMC President
and CEO Paul Levy.
“We have some fabulous data!” comments Pat
Folcarelli, RN, PhD, director of professional practice
development.
“We have seen such a
sharp drop in patients’ needs
for ventilators that it has
caused us to re-forecast our
bed needs,” notes Jane Foley,
RN, director of operations
and co-chair of the Ventilator-associated Pneumonia
(VAP) Steering Committee
with Michael Howell, MD,
director of critical care
quality.
These BIDMC leaders
are commenting on the success of a series of initiatives
designed to reduce the rate
of hospital-acquired infections at BIDMC. Nurses
have been critical players on
a variety of interdisciplinary
teams that are tackling issues
such as ventilator-associated pneumonia and central
line-associated bloodstream
“
infections. In addition,
efforts on the part of all
caregivers to improve hand
hygiene practices – a broadbased measure that can help
reduce many different types
of infections – are starting to
show results. Sharon Wright,
MD, director, infection control/hospital epidemiology,
notes, “The combination of
these initiatives has substantially reduced a patient’s risk
of contracting hospital-acquired infections at BIDMC.
These efforts would not be
possible without the commitment of staff and the
administration to improving
patient safety.” Howell adds,
“This is a testament to the
relentless work by the people
at the bedside. Meticulous
critical care saves lives. It’s
hard to do, but it works.”
Protecting five million
lives from harm
This work at BIDMC is
part of a national campaign,
launched by the Institute for
Healthcare Improvement
(IHI), designed to protect
patients from five million
incidents of medical harm
over a two-year period
(December 2006 – December
2008). It is an expansion of
IHI’s 100,000 Lives Campaign, which is estimated
to have saved 122,000 lives
in 18 months by encouraging hospitals to implement
a series of evidence-based
interventions. (The BIDMC
“Triggers” program is one
such intervention.) Two of
the cornerstones of the IHI
campaigns are preventing
ventilator-associated pneumonia (VAP) and preventing central line-associated
bloodstream infections.
“The combination
of these initiatives
has substantially
reduced a patient’s
risk of contracting
hospital-acquired
infections at BIDMC.”
Sharon Wright, MD
Reducing ventilatorassociated pneumonia
As detailed in the
spring 2007 issue of this
newsletter, staff at BIDMC
have been working hard
to increase the implementation of the “ventilator
bundle” – a series of steps
for ventilated patients that
have been shown to reduce
• continued on next page
NURSING NEWS / BETH ISRAEL DEACONESS MEDICAL CENTER
VAP cases/1,000 ventilator days
VAP rates, matched by month
60
50
40
40
30
30
20
20
10
10
VAP cases / 1000 ventilator days
00
FY06
FY07
February
February
March
March
April
April
The work to protect patients from ventilator-associated
pneumonia (VAP) is showing impressive results. In addition
to lower rates of infection, data are showing that BIDMC
patients are spending less time on ventilators and less time
in the ICU since the VAP prevention efforts were launched.
Data source: BIDMC Critical Care Quality and BIDMC Infection Control/Hospital
Epidemiology
complications. The steps
include elevating the head
of the bed, giving patients
regular breaks from sedation, doing a daily assessment of readiness to wean,
and implementing measures
to prevent stress ulcers and
deep vein thrombosis. Compliance with all the steps
of the ventilator bundle has
risen to nearly 100 percent
as unit-based “champions”
and experts such as Luci
Lima, RN, and Jean Gillis,
RN, educate staff and help
monitor care.
The results? A decrease
in the incidence of VAP, and
trends showing that patients
are spending fewer days on
the ventilator and less time
in the ICU. A rough estimate, recently noted by Levy,
is that these efforts translate
to 96 lives saved per year,
and save the hospital $12
million.
Central line-associated bloodstream infections
3rd quarterCentral
2007Line Associated Blood Stream Infections 3rd
Quarter 2007
2.00
2.00
Rate of Central Line Infections
1.80
1.80
1.55
1.60
1.60
1.40
1.40
1.20
1.20
0.99
1.00
1.00
0.80
0.80
0.60
0.60
0.40
0.40
0.20
Rate
0.20
of Central Line Infections
0.00
0.00
BIDMC Performance
BIDMC Comparison
BIDMC Performance
BIDMC Comparison*
A lower score is better
A lower score is better.
The chart shows the rate of central line-associated bloodstream infection in the
ICUs per 1,000 patient days. The bar on the left is the rate for the 3rd quarter
of 2007. The “BIDMC comparison” is the mean infection rate for fiscal year
2006 for all ICUs.
Data source: BIDMC Infection Control/Hospital Epidemiology
NURSING NEWS / BETH ISRAEL DEACONESS MEDICAL CENTER
Preventing central lineassociated bloodstream
infections
Equally impressive
are the outcomes of work
designed to reduce infections associated with central
venous catheters. With the
leadership and advocacy of
Wright; Josef Fischer, MD,
chairman of the Roberta and
Stephen R. Weiner Department of Surgery; Mark
Zeidel, MD, chair of the
department of medicine; and
Dianne Anderson, senior vice
president of clinical operations, the intense focus on
preventing central line-associated bloodstream infections
is starting to show results.
The Central Line Work
Group, with representatives from surgery, medicine,
infection control/hospital
epidemiology, nursing, critical care, emergency medicine, radiology, and other
specialties and units has been
working to ensure that all the
elements of a “central line bundle” are in place. This consists
of improved hand hygiene,
maximal barrier precautions
upon insertion of a line,
chlorhexidine skin antisepsis,
optimal catheter site selection, and daily review of line
necessity.
A new nursing role was
created to augment the hospital-wide, multidisciplinary
work focused on this issue.
Parenteral/enteral venous
access (PEVA) consultants
were put in place to help
monitor practice associated
with central line placement
and care. Blanche Murphy,
RN, has been one of two
nurses in the role since its
inception. She says that in
Hand Hygiene %
the early phases of the projtion that is helping to make
ect, the PEVA nurses spent
the program a success.
most of their time circulatInformation collected
ing throughout the hospital,
on every central line by
checking on central lines
the unit-based champions
and educating staff about
factors into a robust team
the proper standards. “It
effort to monitor compliance
was continuous education,”
with standards and infecshe says, combined with
tion rates, and to find and
an assessment of whether
correct root causes when
the standards in place were
infections do occur. Data on
effective. Colleagues from
central lines are reviewed by
information systems came
staff from infection control
on board to create ways to
and the Central Line Work
PEVA nurses travel to units throughout the medical center to assess
more efficiently track the
Group. If an infection is
the needs of patients with central lines. From left, PEVA nurses
location of patients with cen- found, audits of the case are
Andrew Mackler, RN, and Blanche Murphy, RN, consult with Robin
tral venous lines in place.
conducted that involve the
McLaughlin, RN, RRT, clinical nurse, and Julius Yang, MD, PhD,
Wright says that changes primary nurse caring for the
hospitalist. McLaughlin is the unit’s nurse educator and a central line
in standards and processes
patient and the team that
nurse resource.
related to central line inserinserted the central line. If
the ICUs and key departtion and care that have been
needed, infection control and swiftly identify a problem,”
ments throughout the mediimplemented over several
risk management convene
notes Foley, adding that the
cal center that insert or care
years have been crucial elea large, multidisciplinary
rapid identification enabled
for central lines, and others
ments in the work to reduce
group to review particular
the team to begin corrective
too numerous to mention. It
line infections. Chlorhexicases. Foley says the value of action at once.
dine prep was introduced;
this ongoing analysis became
All involved in the work is an ongoing team effort.”
Murphy adds, “We did this
a new central line kit was
evident this past spring when emphasize the importance
as a medical-center wide
created containing not just
there was a slight uptick in
of teamwork and collaborainitiative, which is somethe line and needles, but also the rate of central line infection in its success. Notes
thing to be proud of, and it
all the necessary personal
tions. The audit process reWright, “There are many
protective equipment and
vealed a variation in practice people involved in this work has had an impact. We have
lowered the bar of tolerance
barrier precautions; and a
that may have been respon– including nurse managers
checklist and “time out”
sible. “We were able to very
and physician directors from on this issue.”
procedure were implemented
as part of the central line
BIDMC average hand hygiene rates
insertion process as a way to
1.0
1
ensure that standards such
0.8
as proper line placement and
0.8
maximal barrier precautions
0.6
0.6
were being used.
0.4
0.4
Murphy and her PEVA
0.2
ICU Average
0.2
consultant colleague, An1
Hand0Hygiene %
drew Mackler, RN, have
0
Floor Average
0.8
been training unit-based
8
9
7
10
13
12
11
6
ne
od
od
od
od
iod
od
od
iod
eli
i
i
i
i
r
i
i
r
s
r
r
r
r
r
r
e
0.6
BaBaseline Pe Period 6 Pe Period 7 P Period 8 Pe Period 9 Pe
Pe
Pe
staff on the day-to-day 80%
line
Pe
Compliance
Period 10
Period 11
Period 12
Period 13
(Goal)
surveillance that Murphy
0.4
Period
Number
Period
Number
believes is a critical compoICU Average
Average
0.2
Staff are working toward 100% compliance with hand hygiene standards.
nent of the program. These
Hand Hygien
0
(The “80% goal” takes into account the potential range of error in the
Floor Average
Average
staff, known to the spirited
measurement tool being used.) Staff in ICUs and on the general units are
Murphy as “Peve-ettes,”
moving steadily toward the goal.
80%
Compliance
Baseli
80% Compliance
(Goal)
provide ongoing education,
(Goal)
Data source: BIDMC Infection Control/Hospital Epidemiology
surveillance, and data collec-
NURSING NEWS / BETH ISRAEL DEACONESS MEDICAL CENTER
Clinical
Narrative
Life lessons
In this clinical narrative, John Deckro, RN, clinical nurse on 11 Reisman,
shows how he uses reflection, intuition, and lessons from past patient care
experiences to care for families in transition.
T
“None of us are
perfect. Yet in
accepting and
supporting each
other, we may have
the opportunity
to find beauty.”
John Deckro, RN
here is a tree that
I often walk by
on my way to
work. It sits alone, quite majestically, next to a sidewalk
that leads to the Beth Israel
Deaconess east campus. At
times, it speaks to me. I was
pondering Sister Maggie one
morning on my stroll to the
medical center. The first rays
of the sun had just broken
over the buildings and were
bathing the crown of the tree
in a golden light. I knew that
Sister Maggie had passed.
Sister Maggie had been a
favorite of mine: feisty, with
a sharp mind and wit. She
belonged to an order of Roman Catholic nuns who ran
a nursing home in Boston.
She spoke fondly of her
many nieces and nephews,
NURSING NEWS / BETH ISRAEL DEACONESS MEDICAL CENTER
and related one story about
a nephew who had been
getting into trouble. Sister
had asked the residents of
the nursing home where she
worked to pray for him, and
he had turned around.
Sister Maggie was diagnosed with myelodysplastic
syndrome; I cared for her
during what became her terminal admission. Members
of her religious order and
her biological family were in
constant attendance. Reflecting on the final day, I was
still troubled by the look
of anguish on one young
visitor’s face. He had seemed
mildly agitated and overwhelmed with grief. I never
had a chance to speak to
him. Was he the nephew for
whom Sister and the residents had prayed? Had he
needed a few minutes alone
with her that he didn’t get?
I have witnessed that the
power of regret can cripple
for a lifetime.
These thoughts came
back to me as I cared for
another patient and family.
Mrs. P. was a 42-year-old
woman dying of renal cell
carcinoma. She and her husband had a 17-year-old son.
Her husband had a “tough”
appearance that was unsettling to some. One morning, Mr. P. stopped me in
the hall to ask how his wife
was doing. Despite his gruff
exterior, he was clearly in
pain, lost in the wilderness
of grief.
I spent some time talking with this man about
something I had learned at
a conference on end-of-life
transition: the five “essentials” of communication that
can help families at such
a time. These are “Please
forgive me,” “I forgive
you,” “Thank you,” “I love
you,” and “Goodbye.” Mr.
P. seemed to hear me – he
leaned slightly forward, and
he held my gaze. We talked
about his son and the support he needed.
Soon, more family
members gathered in Mrs.
P.’s room. Remembering
Council
Updates
Sister Maggie and the young
man who may have been
her once-wayward nephew,
I said gently but directly to
those in the room that if
anyone needed time alone
with Mrs. P., they should ask
the others for privacy.
Mrs. P. became sicker
each day. Once, I found
her son and husband alone
with her. Mrs. P.’s husband
almost smiled and said that
his son was just having some
words with his mother. I
quietly excused myself.
Not long after, Mrs. P.
passed away. That evening,
her husband sought me out.
He was struggling to keep
in control. Unexpectedly, we
hugged. He told me that he
had “taken my advice” and
wanted to thank me.
There is a tree that I
often walk by on my way to
work. At times, it speaks to
me. One day, I found myself
admiring the symmetry
and beauty of it, but then
became increasingly aware
of its “flaws”: gashes in the
bark, missing leaves, asymmetrical branches. I began
to think about how boring
the world would be if every
tree was perfectly uniform;
beauty itself seemed to lie in
the variances, the shades of
light and dark, the so-called
imperfections. None of us
are perfect. Yet in accepting
and supporting each other
– in giving voice to our emotions during life’s transitions
– we may have the opportunity to find beauty.
A summary of recent shared governance council activities appears below. Full minutes of council meetings are
posted on the portal in the “Nursing” section of the
“Patient Care Services” tab. Speak to your manager for
more information on becoming part of shared governance.
Nursing Research and Education Council
Laurie Bloom, RN, Lauren Call, RN,
and Denise Corbett-Carbonneau, RN (co-chairs)
Several nurse-led research projects were reviewed. Members discussed the Geriatric Resource Nurse program and
updates to the Clinical Entry Nurse Residency program.
Ideas on bringing evidence-based practice presentations to
the unit were discussed. Each meeting included a journal
club discussion.
Quality and Safety Council
Janet Lewis, RN, Robin McLaughlin, RN,
and Kim Sulmonte, RN (co-chairs)
The council reviewed PICC/lab drawing standards; new
transport guidelines; pharmacy policy and guideline
changes; the new restraint policy; fall prevention work;
patient handoff guidelines; and POE programming for flu
season. The council approved the plan for improvements
following The Joint Commission visit. Issues related to
occupational exposures were discussed.
Practice Council
Kerry Carnevale, RN, Chris Garabedian, RN,
and Jennifer Lane, RN (co-chairs)
Presentation topics included patient transport; the new
restraint policy and flow sheet; pain management documentation; pharmacy updates; vascular wound care; The
Joint Commission survey results; fall/injury prevention;
and bed transport utilization. The council reviewed and
approved many policies.
Recruitment and Retention Council
Suzanne Joyner, RN, and Lauren Stone, RN (co-chairs)
The council welcomed new members and a number of international visitors. Its focus continues to include improving the physical work environment, enhancing BIDMC
websites, and assisting with nursing publications. Presentations and discussions centered on National Nurses
Week, nursing salaries, employee survey results, and the
New Graduate Nurse to Critical Care program.
NURSING NEWS / BETH ISRAEL DEACONESS MEDICAL CENTER
Retirement
Karen Kimball, RN, reflects on
a 42-year career
I
“I loved working
with people…
maybe making
life a little easier
or a little more
comfortable.”
Karen Kimball, RN
n July, Karen Kimball,
RN, a 1965 graduate
of the New England
Deaconess Hospital School
of Nursing, was honored
by colleagues, friends, and
family at a tea marking her
retirement from clinical practice. The bulk of Kimball’s
career was spent as a float
nurse at the Deaconess Hospital and Beth Israel Deaconess Medical Center, giving
her a broad and varied view
of nursing practice over the
42 years of her career.
Kimball recalls with
amusement many of the routines and care practices that
are parts of a bygone era,
including:
• White uniforms, stockings,
and caps – When Kimball
began practicing, this was
mandatory attire for a nurse,
and the uniform was always
a dress. “Somewhere in the
’70s, pant suits were allowed,” Kimball says. (She
remembers being thrilled
when caps were no longer
required!)
• Med tickets and trays – A
“med ticket” was a small
card, on which a medication order was transcribed
by hand. The ticket included
the patient’s name, room
number, and the medication
name and dose. The nurse
NURSING NEWS / BETH ISRAEL DEACONESS MEDICAL CENTER
Karen Kimball, RN (left), visited with colleagues and well-wishers at a
tea held in her honor in July. She is shown here with Marsha Maurer,
RN, vice president of patient care services and chief nurse.
put all the tickets for all the
medications being given at
a particular time of day into
specially designed slots in
a large “med tray,” poured
the medications from stock
bottles into small cups, and
placed the cups into holders
on the tray in front of the
appropriate med tickets. The
nurse then carried the tray
from room to room to dispense medications. “Imagine
the potential for error in
that system,” says Kimball,
praising the advances of unit
dosing and provider order
entry.
• No specialty units or resuscitation – Kimball shares
that critical care units and
even patient resuscitation are
relatively modern advances.
She recalls, “There were no
ICUs, no code carts. If the
patient deteriorated, you
just called the doctor and
managed things the best you
could.”
• Monitoring glucose in
urine – Imagine a time when
there were no glucometers,
and it typically took hours
for lab tests to be completed
and reported back (via paper
report) to the clinicians. This
meant there was no reliable way to monitor blood
glucose throughout the day
in brittle diabetic patients.
Safety Corner
Instead, clinicians depended
on the level of sugar found
in a patient’s urine – measured by the color it turned
in a test-tube solution – as a
crude measure of blood glucose when trying to adjust
insulin doses.
• An early chemotherapy
pump – Kimball says that a
Deaconess physician fashioned an early IV pump to
use for chemotherapy. It was
a large stainless steel cart
with a wire hanging over
the top, from which six to
eight glass IV bottles filled
with chemotherapy were
hung. The tubes from all the
bottles were connected piggyback style to the patient
on one end and to a crude
pump mounted on the cart
at the other end. The pump
milked the tubing at a prescribed rate, delivering the
medication.
Kimball says she went
into nursing to help people,
and found that her career
fulfilled this aim, noting,
“I loved working with
people…maybe making life
a little easier or a little more
comfortable.”
Kimball’s plans for
retirement include spending
time with her five grandchildren and traveling the world
with her husband. Trips to
Arizona, Nevada, Florida,
the Caribbean, Romania,
England, Asia, Thailand,
Bali, Singapore, and Indonesia are already planned!
The Joint Commission 2007 unannounced
visit – a BIDMC success story!
By Pat Folcarelli, RN, PhD
O
n Monday, July 23rd, BIDMC had its first unannounced
Joint Commission survey visit. This visit marked the first
test of our plans to be ready every day for The Joint Commission, and we all rose to the challenge. At 7:30 a.m., the
survey team arrived in our lobby. They spent five days with
us and were generally highly complimentary and impressed.
In particular, they commented on our welcoming atmosphere, the helpfulness of staff, and the complexity of our
environment.
The team visited 53 locations, examined 50 medical
records, and interviewed 176 staff members. We were fortunate to have a low number of requirements for improvement,
which is well below the national norm! Some of the things
that we are improving as a result of the findings are:
•
•
•
•
•
initial pain assessment and reassessment
the medication reconciliation processes
code cart management
license verification of our nurse practitioners
gas cylinder storage
“The Joint
Commission team
commented on
our welcoming
atmosphere,
the helpfulness
of staff, and the
complexity of our
environment.”
Pat Folcarelli, RN, PhD
Over the next several months we will be monitoring our
implemented improvements and reporting on our progress
to The Joint Commission. We must demonstrate greater than
90 percent compliance with pain assessments and medication
reconciliation, and achieve 100 percent compliance with code
cart management. Auditing of these processes is well underway.
I know all of you are currently involved in this work,
and your efforts are showing! This will enable us to ensure
that the Joint Commission standards are implemented at all
times, which helps us to ensure the highest standard of care
for our patients – every day!
NURSING NEWS / BETH ISRAEL DEACONESS MEDICAL CENTER
Beyond BIDMC
Back from Iraq
Above: Peter Russo’s reunion
at Hanscom Air Force Base with
wife Gale (a BIDMC recovery
room nurse) and children Ava
and Michael. Below: Grethel
Papastavrou with son Petros
junior and husband Petros
senior after her graduation
from nursing school at UMass
Lowell.
T
heir tours of duty
in Iraq complete,
two BIDMC nurses have experienced a homecoming few can imagine – to
Boston, to their families, and
to nursing careers put on
hold while they served in a
distant war. In October, after
a year in Iraq, Peter Russo,
RN, was reunited with his
family. Later this year, he
will rejoin the operating
room team at BIDMC as a
clinical nurse. And this past
June, Grethel Papastavrou,
RN, graduated from nursing
school and became a clinical
nurse on the Farr 10 transplant unit. She had reached
a goal set in 2003 when
she entered nursing school,
intending to finish in 2005.
Papastavrou was deployed
six months later, and served
for a year and a half. Here is
a glimpse of each veteran’s
time in Iraq.
NURSING NEWS / BETH ISRAEL DEACONESS MEDICAL CENTER
Treating everyone
and everything
Russo, a reservist for 19
years, was deployed as an
army captain with the 399th
Combat Support Hospital
unit to a base in Tikrit. It
was his first deployment.
Describing it, Russo says,
“We basically fell into a fully
functioning hospital” including an OR. Russo’s team operated on US and Iraqi military personnel and civilians
– including Iraqi insurgents.
Russo relates, “We treated
everything from broken toes
to people blown up by IEDs.
Whatever came in the door,
we took care of. Helicopters
came all the time. It was like
the sun coming up, just an
everyday event.”
Their base was attacked
several times. But even more
difficult than the constant
threat, says Russo, was being
away from his family. His
twins were three years old
when he left. He spoke to
them almost every week.
Now, he states simply, ”It’s good to be home.
I’m proud to have served
my country.” Russo adds,
“While I was in Iraq I
received care packages from
the OR staff at BIDMC,
which boosted my morale.
The support I received was
unbelievable.”
Among the first
Papastavrou, a sergeant,
had served in the Army
Reserves for four years when
her first deployment took her
to Iraq. The war had begun
just two months before her
supply unit arrived in Nasiriyah, in southern Iraq. Some
in the 439th Quartermaster Company were sent to
Baghdad to fight; Papastavrou was among the 160 who
stayed back, “in the middle
of a desert, setting up our
tents next to a bunker.”
Eventually, they served
guard duty and supplied
infantrymen with ammunition. But first, they had to
provide for the basic needs
of their company and those
to come by building walls to
secure the perimeter of the
base, and helping to install
everything from telecommunications to showers.
Papastavrou experienced
the daily sights and sounds
of bombings and crossfire.
(Her camp was not hit while
she was there, but was destroyed weeks after she left.)
She counseled fellow soldiers
– “I tried to be a big sister
to them” – while trying not
to think too much about her
own family, especially her
two-year-old son.
When she returned,
Papastavrou wanted to finish school right away and
start her nursing career. She
says, “I feel lucky to be a
nurse at BIDMC – every day
is a learning experience.”
And colleagues at BIDMC
feel lucky to welcome these
veterans back to the medical
center community.
Note: As we were going to
press, we learned that there
may be other veterans of
Iraq on the BIDMC nursing staff. If you have been
deployed, or know of a
colleague who has, contact
[email protected].
edu, and we will include a
notice in the next issue.
Dianne J.
Anderson
senior vice president,
clinical operations
Building on our successes
A
s we begin another fiscal year, it is a great time
to reflect on our achievements! This issue of
Nursing News Brief includes the story of our success
in infection control initiatives. This work involved so
many of our staff – far too many to name individually.
I want to thank everyone who cleaned their hands,
changed a central line dressing or flushed an intravenous catheter, or suctioned a ventilated patient. These
evidenced-based efforts have made it safer to be a
patient at BIDMC.
As you know, we have also had a very successful
year of growth. More and more patients want to be
cared for at BIDMC. Our thriving recruitment efforts
have enabled us to hire more clinicians to meet this
demand. In 2007 we hired 218 experienced nurses,
130 newly graduated nurses, 28 nurse practitioners,
nine nurse managers, and one nurse director. We had
so many new-graduate applicants that we were only
able to hire a small fraction of those who applied.
All of this is a direct result of your hard work,
and I want to thank you all for that. This year, we will
be focused on improving our patient, staff, and physician satisfaction, and on doing even better at reaching
quality and safety goals. While we had a great Joint
Commission survey, we will continue efforts to improve and to be ready every day for a future visit.
We will be involving our patients and families in
a stronger partnership to help improve our care. On
the inpatient units, we will focus on involving patients
in communications regarding their care by consistently using the white boards, and we will continue
our work on hand-offs to ensure the safe passage of
patients through our systems.
Thank you for your wonderful work this past
year. As always, I am pleased and proud to be associated with the care that you craft for our patients.
NURSING NEWS / BETH ISRAEL DEACONESS MEDICAL CENTER
Spotlights
Publications
Brodsky D, Mary Ann Ouellette. Introduction.** Rosanne
Buck. Immunizations.** Mary
Ann Ouellette. Dental care for
the preterm infant.** Mary
Quinn. Oral aversion.** Mary
Quinn and Kerr D. Resources
for clinicians and families. In
Brodsky D, Mary Ann Ouellette, eds. Primary Care of the
Premature Infant. St. Louis,
Mo: Elsevier; 2008:1-8, 277282, 283-284, 101-104, 289-312.
Dutcher JP, Szczylik C, Tannir
N, Benedetto P, Ruff P, Arlene
Hsu, Berkenblit A, Thiele A,
Strahs A, Feingold J. Correlation of survival with tumor
histology, age, and prognostic risk group for previously untreated patients with
advanced renal cell carcinoma
(adv RCC) receiving temsirolimus (TEMSR) or interferonalpha (IFN). Journal of Clinical
Oncology, 2007 ASCO Annual
Meeting Proceedings Part
I. 2007; 25(18S) (suppl June
20):5033.
Presentations
Elena Canacari, Moorman D.
Team training at Beth Israel
Deaconess Medical Center. Executive Symposium on Surgical
Patient Safety, Beaver Creek,
Colo.
Pat Folcarelli, Wright SB, Affeln
D, Carbo A, Cunningham K,
Birkmaier S, Howley LV, Hurley
J, O’Neill S, Sands K, and
Marsha Maurer. We did it for
our patients, our families,
our colleagues: a successful
voluntary flu campaign for
direct care providers. National
Patient Safety Foundation
Annual Meeting, Washington,
DC.
Charlotte Guglielmi. Staff
development: on a shoe string
and with no time. AORN 2007
Ambulatory Specialty Conference, Louisville, Ky.
10
NURSING NEWS / BETH ISRAEL DEACONESS MEDICAL CENTER
Professional activities of nursing staff
(listed in bold) occurring between
May 1, 2007 and August 31, 2007.
Nancy Littlehale. Female
cancer update: breast and
ovarian cancer. Nurse Practitioner Associates for Continuing Education, New England
Regional Women’s Health and
Older Adult Conference, North
Falmouth, Mass.
Mahmoud Kaddoura received a
certificate of advanced graduate studies in health professions education, with distinction, from Simmons College.
Barbara Sheppard and Marjorie Serrano. A shared solution
to achieve best practice: the
design and implementation
of a multidisciplinary critical
care information management
system. Boston Area Nursing
Informatics Consortium 5th
Annual Symposium, Waltham,
Mass.
Louise Riemer was certified as
a clinical transplant coordinator.
Lauren Stone. Preventing
catheter-related bloodstream
infections: the role of the PEVA
consultant. Association for
Vascular Access 21st Annual
National Conference,
Phoenix, Ariz.
Academic Degrees
Jennifer Barsamian, master
of science, Northeastern
University
Charlotte Guglielmi, master
of arts in ministry, St. John’s
Seminary, Boston, Mass.
Natalie Mailloux, master of
science, University of
Massachusetts Boston.
Certifications
Jennifer Barsamian was certified as an adult primary care
nurse practitioner.
Katharina Berger was certified
in gerontological nursing.
Linda Debeasi was certified in
gerontological nursing.
Elizabeth Gray-Chrzan was
certified as a clinical transplant
coordinator.
Sandra Petrosky was certified
in gerontological nursing.
Kimberly Sullivan was certified
as a clinical transplant coordinator.
Linda Walsh was certified as a
clinical transplant coordinator.
Tiffini Young-Kershaw was
certified in critical care.
Professional leadership
activities
Pat Folcarelli traveled with a
group from Harvard Medical
International to help lead a
nursing leadership event for
the Wockhardt Hospitals in
Mumbai, India. Nurse leaders
from various regions of India
gathered for the week-long
event to learn about managing unit performance.
Awards and honors
Four BIDMC nurses were
among those honored by the
American Heart Association’s
Greater Boston Division at a
ceremony Sept. 6. They are
among the members of the
Massachusetts Nursing Conference Committee, which
received the first annual Heart
of Our Mission Award for
“planning and executing every
aspect of [our] cardiac nurses
event, and for success in establishing the conference as one
of the most reputable credentialing events for cardiac nurses
in Massachusetts and surrounding areas.” BIDMC committee
members include Marie Bosak,
John Cotter, Linda Debeasi,
and Donna Williams.
Clinical nurse
advancements
Appointment
Nursing News Brief
Advanced to clinical nurse III
Lauren Carratu, RN
Donna Curran, RN
Jillian Dooley, RN
Kirsten Fuller, RN
Amanda Hibbard, RN
Christine Kelba, RN
Laurie Knight, RN
Jill Morris, RN
Evonne Panias, RN
Jolene Pecci, RN
Alex Poliansky, RN
Stacey Shepard, RN
Linda Veglia, RN
Sheryl Warren, RN
Advanced to clinical nurse IV
Katharina Berger, RN
Ann Burns, RN
Joseph Castro, RN
Lisa Corcoran, RN
John Deckro, RN
Mary Ellison, RN
Kelly Farren, RN
Martha Florance, RN
Amy Gaffney, RN
Elizabeth Kane, RN
Kimberly Maloof, RN
Barbara Mayer, RN
Michelle McGrory, RN
Susan Nessen, RN
Yasue Riley, RN
Barbara Skulsky, RN
Cedric Cooper, RN, has
been named nurse manager
of the infusion/pheresis unit
on Gryzmish 5. Cooper
brings a wealth of clinical
experience to the role. He
was a staff nurse for eight
years at Boston Medical
Center, and has worked for
four years as a clinical nurse
throughout BIDMC as a traveler. Early in 2007,
he served as interim operations manager of the
orthopedic ambulatory clinic. He holds an MBA
with a concentration in health care from Suffolk
University. Commenting on his new role, Cooper
says, “My focus as a nurse manager is on being
transparent, and acting as a coach, a resource,
and a team builder for the nurses on Gryzmish 5.”
Kudos
Writing/Editing:
Corrigan Kantz Consulting, Inc.
Contributors:
Dianne Anderson, RN
John Deckro, RN
Pat Folcarelli, RN, PhD
Marsha Maurer, RN
Design:
Colvin/Williams
Photos:
BIDMC Media Services;
Tony Brown/Imijphoto.com
(page 11, bottom); page
6 photo (left) courtesy of
Karen Kimball, RN; page 8
photo (top) courtesy of Peter
Russo, RN; page 8 photo
(bottom) courtesy of Grethel
Papastavrou, RN.
Shown on cover:
Amy Gorman, RN, obstetric
nursing
On Sept. 27, the BIDMC
Obstetrics Training Team
received the prestigious
2007 John M. Eisenberg
Award for Innovation in
Patient Safety and Quality at a National Level from the National Quality Forum (NQF)
and the Joint Commission. The award, conferred in Washington, DC, recognized the
team’s success at the “adaptation and application of the military and commercial aviation Crew Resource Management (CRM) principles to the field of obstetrics,” and the
significant decrease in major adverse obstetric events that resulted. Susan Crafts, RN,
and Jeanette Blank, RN, were instrumental in developing the curriculum and implementing the model.
Congratulations to all of the OB staff on this achievement! Shown above with the
award are Dennis O’Leary, MD, president of The Joint Commission; Ronald Marcus,
MD (BIDMC); Robert Hanscom (CRICO/RMF); Mary Salisbury, RN (BIDMC); Penny
Greenberg, RN (BIDMC); Steven Pratt, MD (BIDMC); Barbara Stabile, RN (BIDMC);
Benjamin Sachs, MD (BIDMC); Susan Mann, MD (BIDMC); and Janet Corrigan, PhD,
president and CEO of the National Quality Forum.
An update on professional
nursing at Beth Israel Deaconess
Medical Center
Nursing News Brief is published
three times a year by the division of patient care services at
Beth Israel Deaconess Medical
Center, and is distributed to
BIDMC professional nursing
staff and colleagues.
© 2007, Beth Israel Deaconess
Medical Center, all rights
reserved.
Please send comments
or suggestions to:
Pat Folcarelli, RN, PhD
Beth Israel Deaconess
Medical Center
330 Brookline Avenue
Boston, MA 02215
NURSING NEWS / BETH ISRAEL DEACONESS MEDICAL CENTER
11
Marsha
Maurer, RN
vice president
patient care services,
chief nurse
Dear Colleagues:
Fall is that time of year when many living things wind
down for a period of rest; paradoxically, it’s a time when
all of us gear up – for a new academic year, for the whirlwind of the holidays, for a time to refocus on what we
value and where we are headed. At BIDMC, my plan is to
engage all of you in this process of reflection and planning. I recently met with nurse managers and directors
to talk about what we value and where we see ourselves
going as a nursing division. I’d like to share some of what
we believe distinguishes nursing at BIDMC:
A clearly articulated commitment to professionalism
in nursing and to an expectation that every nurse will
engage in lifelong learning. As noted in the lead article of
this newsletter, our nurses have been important players
in the multidisciplinary work to reduce hospital-acquired
infections at BIDMC. Other examples abound. Our vision is that BIDMC will continue to lead our profession
in implementing evidenced-based clinical practice.
An organization in which every nurse takes pride and
ownership in delivering clinically exceptional and compassionate care. What do we mean by this? Our patients’
letters of gratitude often describe their nurses as “very
kind and compassionate.” While true, nurses know that
there is much more to it than being kind. There is a complex and comprehensive clinical assessment behind every
one of our patient encounters. Our vision is that we will
deliver this level of exceptional care, without exception.
330 Brookline Avenue
Boston, MA 02215
12
NURSING NEWS / BETH ISRAEL DEACONESS MEDICAL CENTER
Nursing practice in which every nurse is accountable
to, respectful of, and engaged in the collaborative team
process. We are working to ensure that attention to team
concepts is brought to a new level. Our vision is that we
will spread “teamly” behaviors throughout the organization, until we know of no other way to work.
Nurse leadership in larger systems issues. We felt
that our influence as nurses extends well beyond our
own discipline. Our vision includes nursing leadership
for the radical re-engineering of patient care processes to
optimize safe, high quality patient care delivery. Nurses
on 11 Reisman are currently engaged in such a re-engineering project. To date they have redesigned the unit
coordinator work station, laundry distribution, clinical
equipment storage, and the IV setup supply location.
Now I want to know – What do you think? I invite
you to watch for opportunities in the coming months to
share your ideas of who we are and where we are going.
I will be attending staff meetings in every patient care
area. We are re-launching our nursing seminars programs – evening gatherings where we combine a social
event with professional sharing. Ask your nurse manager
for more information, or watch your email for an invitation. We want to hear from you!
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