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Nursing Work Groups and Contacts Ginette Rodger • grodger@ ottawahospital.on.ca Communication Work Group Chair: Sue Eggleton • Ext. 71546 Vol. 8 No. 2 • Summer 2006 A TOH Librarian Dedicated to Nurses I In November 2005, Lory Picheca joined The Ottawa Hospital Library team as a librarian devoted to the information needs of nurses. Her office is at the Civic Campus but she serves all TOH nurses. Library services for nurses include: • Medical literature searches • Database training (Medline, Cinahl, EBM research, etc.) • Statistics gathering, fact checking and citation confirmations • Table of Contents and other current awareness services • Over 50 nursing journals • Access to electronic resources from your home (call the Library for details) • Article reproduction and delivery to the location of your choice • Libraries located at the General and Civic campuses • Consumer Health Library at the Civic Campus (D100A) In 1990, Lory moved to Ottawa to attend Carleton University’s Canadian Studies program. In 2002, after working several years in federal libraries, she completed her Masters in Library Science. Lory looks Lory Picheca forward to answer your research questions and to help the TOH nursing staff in their research and educational endeavors. How do nurses register with TOH libraries? Visit any library in TOH. At the front desk of the library you will be asked to supply very basic information, I n s i d e t h i s i s s ue… address, phone number, dept name and possible Peer Advisory email address. Work Accommodation Lory Picheca: 613-798-5555, ext. 19544 Guardian Angels [email protected] Lory works at TOH on Wednesdays and Fridays. [email protected] 613-798-5555, ext. 14450 Nursing Quality Improvement Work Group Co-Chairs: Marlene Mackey • Ext. 16979 Gail Marcogliese • Ext 12687 Nursing Informatics Reflective Group Contact: Gabi Avni • Ext. 16897 Linda Harper • Ext. 14708 Nursing Research Work Group Chair: Diane Fillion • Ext 71366 Nursing Policy, Procedure, Protocol Work Group Co-chairs: Susan Madden • Ext 13945 Lucie Bussière • Ext. 71510 Nursing Professional Practice Committee Chair: Ginette Rodger • Chief Nursing Executive • grodger @ottawahospital.on.ca Nursing Week Work Group Co-chairs: Nancy Jacobs • Ext. 88236 Ginette Rodger • grodger@ ottawahospital.on.ca ONA Local 83 Contact: 731-1314 • ottawahospitallocal83 @sympatico.ca Corporate Nursing Clinical Practice Committee Co-Chairs: Evelyn Kerr • Ext. 16060 Angie Stackhouse Recruitment, Retention, Recognition Work Group Co-Chairs: Cheryl-Anne Smith • Ext. 17894 Nancy Jacobs • Ext. 88236 Education Work Group Contact: Riek van den Berg • Ext. 78439 Sue Phillips • Ext 13378 Management Work Group Co-Chairs: Barbara Crawford-Newton • Ext. 78438 Carolyn Welch • Ext. 72597 Advanced Practice Nurse Work Group Co-Chairs: Sheryl McDiarmid • Ext 78711 Colleen MacPhee • Ext 19112 From the Desk of the Vice-President Professional Practice and Chief Nursing Executive T Ginette L. Rodger Vice-President Professional Practice and Chief Nursing Executive “We have developed a visibility plan for next year.” The summer is at our door already. The last few months have been a busy time for all of you and for the nursing professional practice department at The Ottawa Hospital. We have reviewed the accomplishments of the last year and all Work Groups and Committees are now planning next year. Hundreds of nurses were involved in deciding what should be our next steps to enhance our professional practice environment. The Corporate Nursing Clinical Practice Committee (CNCPC) and the Retreat of Directors, Managers, Educators and Advanced Practice Nurses have told us that even if your satisfaction has increased by 14% for the support we provide to you, we still need to be more visible on the units and services. So we have developed a visibility plan for next year. We have also developed a plan that will look at the nurses satisfaction survey completed last year part of the Employee and Physician Satisfaction Survey. In collaboration with the ONA Executive, we have developed a plan to address some issues that had the lowest satisfaction scores such as feedback on performance, recognition for great work and educational support. You will also be aware during the summer months that we have been successful at getting additional funding from the Nursing Secretariat of MOHTLC for $1.9 million that will allow us to employ more graduates and provide some time for late career nurses to contribute to projects and support new graduates. TOH was also designated an RNAO Best Practice Spotlight Organization and for the next three years, we will be able to provide support to you as we implement additional best nursing practices in our Academic Health Science Centre. The summer months are always busy at TOH but many of you will be able to take some rest and relaxing time. I wish you and your family a great summer holiday. Professionally yours, Dr. Ginette Lemire Rodger, RN Vice-President Professional Practice and Chief Nursing Executive A Nurse to Know Chris Murphy, RN, has completed the Canadian Association for Enterostomal Therapy ET Nurse education program and is now an ET nurse. ET nurses work with patients for pre and post op teaching for ostomy surgery and as consultants to nurses and doctors for patients with non-healing wounds. TOH now has 4 ET nurses, Nicole Denis RN ET MScN and Connie Schulz RN ET at the General Campus and Sue Sarrazin RN ET BScN and Chris Murphy RN ET at the Civic Campus. One ET is available daily at each site. Look for this new section “A Nurse to Know” in future issues as we highlight the bedside nurses who make this hospital work! The Ottawa Hospital Nursing News Summer 2006 The Guardian Angel Program T This exciting new program allows the community to support the Hospital while recognizing the incredible work that staff and physicians do every day. How can nurses help ensure that funds to recognize nurses go to nursing funds? Three funds support TOH nurses in the work that they do. They are described below, along with how the interest is used from the funds. For more information about the Guardian Angel Program, visit www.ohfoundation.ca/ways/ guardian_angel/index_e.asp, check out the INFONET or call Barb Younghusband at 613-798-5555, ext. 19830. Name Account # How we use the money Nursing Bursary Endowment Fund 200125 This fund supports nurses who are continuing their formal education through a bursary program. In 2005–2006, this fund provided four bursaries of $1,500 each for nurses studying at the baccalaureate and master’s levels. Nursing Research Endowment Fund 9728061 This fund supports nurses doing research to improve the care that they provide to their patients. Through our nursing research awards program, nurses can apply for small grants to help them with a research project. In 2005–2006, this fund supported three nursing research projects. Nursing Education Endowment Fund 9728062 This fund supports nurses who continue to learn by attending conferences and workshops. In 2005–2006, this fund supported 10 nurses attending the national cancer nursing conference as well as 37 nurses attending the national critical care nursing conference. Applying for Professional Leave and/or Funding A At least eight weeks before the event, you identify an educational/professional event that you would like to attend. available to support the request. Your manager puts this information on the form and signs it. 1 You find out the costs and other specific information. 5 Your manager sends the form to the corporate coordinator of nursing education*. 2 You obtain the form (NUR82) from your manager. 3 You fill out the form (NUR82) and give it to your manager. 4 Your manager identifies if he/she can grant professional leave and if there is money Summer 2006 6 Nursing Education determines how much money can be given, according to the policy and how much is available. 7 You and your manager get a The Ottawa Hospital Nursing News letter indicating the amount of leave and the amount of money, as well as the steps you have to follow to get the money. 8 After the event, you send the forms and receipts to Nursing Education*. 9 Nursing Education processes a cheque request and sends it to Finance. 10Finance sends a cheque to your home address. Quality Improvement Work Group T The second Least Restraints / Fall Program prevalence study took place at TOH on Thursday March 9, 2006. Data was collected on 1,071 patients from all inpatient campuses. Results will be shared and will be used to highlight the need for ongoing patient safety programs. In addition, TOH is one of RNAO’s Spotlight Organizations that will be implementing Best Practice Guidelines over the next three years. Fall prevention will be one of the nine guidelines involved. Policies and Procedures on InfoNet! Health Information for Patients and Their Family The Ottawa Hospital’s two consumer health libraries provide patients and their families with access to: • Reliable information on a variety of health, wellness and medical topics; • Books, videos and DVDs for loan; • Computers with Internet connections Come Visit Us! http://10.249.5.254:7000/ patient/services/chlib/civic-f.asp T The PP&P workgroup would like to announce that Corporate Nursing Policies can be accessed on InfoNet. This will give all nursing staff access to the accurate policies in a timely manner. You can access these policies by using the InfoNet icon. The route to follow is InfoNet/Policies and Procedures/keyword. The search engine will look in all three areas, Nursing; Administrative, Infection Prevention and Control for the keyword entered and find the related policies. All policies including the keyword will appear. We thank IS and Lellina Palanza NPPD for their hard work in making this change possible. Susan Madden and Lucie Bussière Co-chairs PP&P workgroup Consumer Health Library Civic Campus Main Building, Room D100A (take the “C” elevators to the 1st floor) 1053 Carling Ave., Ottawa ON K1Y 4E9 Hours: Mon.–Fri.: 8:30 a.m.–12:30 p.m. and 1:00–3:30 p.m. Tel.: 613-798-5555, ext. 13315 Fax: 613-761-5292 Email: consumerhealth @ottawahospital.on.ca Recruitment, Retention and Recognition Workgroup Ninon Bourque Patient Resource Library General Campus Specializing in cancer-related information Cancer Centre, Main Floor 503 Smyth Rd., Ottawa ON K1H 1C4 Hours: Mon.–Fri.: 8:30 a.m.–12:30 p.m. and 1:00–3:30 p.m. Tel.: 613-737-8899 ext.70107 Fax: 613-761-5292 Email: consumerhealth @ottawahospital.on.ca I In the fall of 2005, the biennial Quality of Work life survey was conducted. There were 29 responses, up from 23 in 2003. There were 59 recommendations made by nurses at TOH, all falling within the CNAC report. 64.4% are completed. The top recommendations from the 2005 survey were: Education, Scheduling, Workload, Recognition Culture, Vacation, Non-Nursing Tasks and Parking. A presentation was shown at the Nursing Week Luncheon on May 12, 2006, and will be shown to CNCPC. The Ottawa Hospital Nursing News Summer 2006 The Impossible… Happens A Story of Work Accommodation H Have you ever wrapped your dominant thumb with tape and couldn’t bend it nor feel someone touch it? As a nurse, I thought accidents at work happened to other people. Then one day, while moving a patient, I crushed my right thumb. I am right-handed. After reporting this to my team leader, I went to the emergency room, incident report in hand, expecting to get stitched up and go back to work. My hand was bandaged and instead of being able to get back to my patients, I received a work accommodation slip. At Occupational Health and Safety Services, I learned that I could not go back to work and that I would need occupational therapy. What is work accommodation? It is what employers/WSIB do to get you back to work early but let you heal in the meantime. Without missing work, my tasks were adjusted to my capabilities. I was lucky that my manager cared enough to give me challenges and helped me realize that I could be a nurse away from the bedside too. My last visit with the plastic surgeon determined that I had reached maximum recovery. At that time, WSIB placed permanent restrictions on my work. A meeting with Occupational Health, my manager and a union representative confirmed that the future was up to me. Even if I had to follow WSIB rules, the initiative to make the situation successful had to come from me. I saw an Employee Assistance Program counselor, which was of great benefit. I was then placed in a modified work role that didn’t exceed my physical limitations. I was encouraged to apply for other positions. Occupational Health sent me for a “physical demand assessment” and helped guide me in my decisionmaking. I also took advantage of free education programs. This experience was life changing! Through it all, I needed understanding and support from people who surrounded me. So, if this happens to a colleague, be compassionate and if it happens to you, be patient… the impossible happens. Sue Eggleton Changing Disability to Ability I “I wanted to be a nurse since the seventh grade, When I graduated, I thought I had it made, Until one day a patient fell, And my life became a living hell. Lying awake at night, I wonder what my future holds, I’m scared; I’m really not very old, Will there be a job for me? How do I get where I need to be?” When you can no longer do the job you were doing before your illness or injury struck, you need to know what your options are. TOH has a work accommodation program for employees who can no longer perform the duties of their current jobs. The first step in the work accommodation process is to determine your abilities, either through WSIB (a work injury) or, if your illness or injury did not occur at work, by your Summer 2006 doctor or by a functional capacities evaluation performed outside the hospital to determine your physical strengths. In most cases, workers are accommodated in the jobs they performed prior to their illness/injury with modifications to meet their restrictions. When that is not possible, we try to find work within your clinical program, i.e. if you are a nurse in the Birthing Unit, we would look for a vacant job for you anywhere in the OBS/GYN portfolio, across campuses. If there is no work available within your specialty, we then begin a job search for vacant positions in the hospital. At this point, the Occupational Health and Safety team works closely with you to determine what areas in the hospital would meet your abilities. As you must be qualified for the positions that are identified, you The Ottawa Hospital Nursing News need to start considering educational programs to gain the required knowledge to work in these areas. Nursing Professional Practice can assist you with information on expected nursing vacancies at TOH as well as various nursing education programs. Human Resources Learning and Development also supplies many free courses that will help increase your skills, including computer and French classes Update your CV-it is the first impression managers will have of you. In summary, consider at your abilities and interests and determine the kind of work you want to do. Next, develop an action plan to get there. I will be there to help you along the way as well as the Human Resources, Nursing Professional Practice and Learning and Development teams. Shauney Donoghue TOH Peer Advisor Manual If yes, accept* the situation and refrain from gossip. If no and unable to accept* the situation, you may need the assistance of a: x Peer Advisor * x Clinical Manager x Nurse Educator x Union Representative x Occupational Health & Safety (EAP)* 1 EAP Plus (Employee Assistance Program): This program is a voluntary, confidential, and professional service for employees and their eligible family members. The program offers professional guidance to help employees and their families find solutions to personal, family, social and work-related problems and to improve their general well-being. 1-800-387-4765 *Acceptance: Implies that you are comfortable with the outcome and / or process and experience no stress related symptoms either in your work life, home life or health as a result. Evaluate process and outcomes… may need to start Develop a strategy with the help of others and deal with the incident and/or the individual involved. *Glossary of Terms Peer Advisor: x A Nurse who has received specific training to assist you in resolving conflicts x Can help you develop a strategy to resolve conflict x Will maintain your privacy and confidentiality If no, review the situation and find a strategy…seek advice from: x Peer Advisor * x Clinical Manager x Nurse Educator x Union Representative x Occupational Health & Safety (EAP) * If yes, Congratulations! Remember your success, forgive and forget! Accept* that there are differences and accommodate Confront the individual and achieve resolution? Accept* that there are differences and accommodate If yes, accept* the situation and refrain from gossip. Avoid the incident and the individual? Develop a strategy to resolve the issue? Vent about the issue without reaching a solution or strategy? When you disagree or experience conflict with someone do you… COMMUNICATION O R N E R The Ottawa Hospital Nursing News Summer 2006 Pandemic Influenza Planning at TOH T The prospect of an influenza pandemic sweeping the globe is receiving great attention. This would occur when all four of the following criteria are met: • A new influenza A virus is detected • Human-to-human transmission happens easily • The new virus causes serious clinical illness and death • The population has little or no immunity to the virus Pandemics are unpredictable in timing, but experts agree we’re overdue. A likely source may be the “bird flu” or avian influenza virus, which normally infects birds and, sometimes, pigs. The H5N1 avian influenza strain, on rare occasions, has infected humans who’ve been in close contact with sick or dead poultry. There is concern H5N1 might mutate into a strain contagious among humans. TOH Pandemic Influenza Committee was formed November 2005. A representative has met with departments to assist them in developing corporate plans to deal with an outbreak to protect staff and to maintain acceptable activity levels to also treat other illnesses. These plans will be reviewed to produce a comprehensive Master Plan, which will coordinate all departments’ plans and closely align with regional, provincial and national plans. Pandemic information is being shared to staff through open forums. The Ottawa Civic Hospital School of Nursing Alumnae T The Newsletter “Spokes Speak” is published twice a year – March and October and the editor Debby Ferrar B.Sc.N., R.N. can be reached at [email protected]. E-mails must be headed under “Spokes Speak” or “Alumnae” or leave phone messages at 613-831-1264. Fall Dinner is held every October. Annual Reunion, a three-day event, is held on the first weekend in June. Individual classes (from 1925 to 1974) hold their reunions every five years and those who wish to attend on their non-reunion years can do so. The Annual Reunion consists of a Friday night banquet for all classes. On Saturday, the individual classes hold their various individual functions. On Sunday, an Afternoon Tea is Summer 2006 held for all classes in the old Nursing Residence (now the Civic Parkdale Clinic) plus tours of our old alma mater “The Ottawa Hospital – Civic Campus” are offered to the alumnae members attending the reunion. Contact: Joan Fletcher R.N., President Ottawa Civic Hospital School of Nursing Alumnae Paterson Education Centre 1053 Carling Avenue Ottawa, Ontario K1Y 4E9 You can leave a message with Joan at 613-829-7395.) Any other Nursing Alumnae Associations wanting to send us information must contact the Co-Chairs of the Communication Work Group listed on the Nursing News Side bar. The Ottawa Hospital Nursing News Nursing News Edited and Coordinated by the Nursing Communication Work Group The Nursing News is a quarterly corporate newsletter written by nurses for nurses at The Ottawa Hospital to: inform nurses of new programs and processes, upcoming events, and new trends in Nursing in regards to patient care, education and research recognize individual nurses or groups of nurses for specific accomplishments including quality improvement initiatives, research projects, educational achievements, publications as well as presentations at internal and external conferences promote camaraderie amongst nurses throughout The Ottawa Hospital provide a venue for feedback on issues as appropriate. For information contact Chair Sue Eggleton – ext 71546 Members: Karen Charron Louise Gravelle Barb Kyd-Strickland Donna Leafloor Ursula Reichart Gillian Reid Thank you to Diane Ladisa, Communications Layout: TOH Printing Services Printing: TOH Printing Services Distribution: TOH Volunteer Services Imagine the Possibilities T The Ottawa Hospital is embarking on a new journey, transforming the way we deliver care. From bedside care to financial records to diagnostic equipment, the e-Health vision will result in an integrated view of our organization. And our nurses are at the heart of many of these initiatives. Here are just a few examples: determine the types and quantities of devices needed to support the implementation of both the Nursing Flow Sheet implementation and the Less Paper initiative. The goal is to stop the printing of all results currently available in vOACIS. This impacts all clinicians not just Med/Surg nurses. Last fall, the Nursing Flow Sheet Working Group was established to guide the implementation of the online vOACIS Med/ Surg Nursing Flowsheet (NFS). This group, comprised of nurses, educators, advanced practice nurses, managers, IS and Dinmar (the vOACIS vendor) reps, met several times to review the proposed screen designs for vital signs, intake and output, assessments and interventions. Work is progressing well. The goal is not to simply put the existing NFS online, but to transform the way in which clinical information is collected and displayed. Concurrently, the Access Working Group, primarily an IS/IT Working Group with some clinical representation, is completing extensive research to identify issues and considerations. Pilot studies will take place on several inpatient and outpatient units as well as in the Emergency Department to determine the make and model of access devices (computerson-wheels, wall-mounted devices, tablets, or desktop computers) that best suit our needs. Once the screen designs are completed, the next step will be for the IS and Dinmar programmers to develop prototypes (working models) for feedback from the NFS Working Group members. Final development and testing will follow with the initial implementation on 6NE this fall, and rollout to the remaining Med/ Surg units in 2007. One question that has been asked relates to the number of computers available for charting online. It is agreed that charting needs to be done at the point-of-care (or as close as possible to the time the event occurred). To accomplish this, sufficient computers are required. The Less Paper Working Group is conducting an analysis on each unit to A key factor in all of these initiatives is training. Four new computer-training rooms are being constructed. Approval has also been received to establish a clinical systems training infrastructure with permanently staffed positions. A training model will be developed to support intra-disciplinary training and post live support during the initial systems rollout as well as on an ongoing basis for new hires and transfers. Part of this model will include ensuring clinicians have basic computer skills before they are giving vOACIS online documentation training as well as extensive support during the immediate and post live phase. Watch for more e-Health updates in Nursing News and The Journal. Together we are transforming patient care! The Ottawa Hospital Nursing News Summer 2006 Medical Directives By Evelyn Kerr B Background – all medical orders or prescriptions for a procedure/ treatment/intervention, must exist in one of two forms – “direct order” or “medical directive”. It is the responsibility of the health care team to determine whether a procedure can safely be carried out by means of a medical directive or patient specific (direct) order. Development of a medical directive requires a collaborative and inclusive process involving all potential groups of health care professionals affected by the directive (directly or indirectly). The group of health care professionals who develop a medical directive shall determine which health care professionals may implement a medical directive. What is a Medical Directive? • Physicians authorize Medical Directives to a health care provider who has the knowledge, skills and judgment to manage the outcomes of enacting a medical directive. ( Nurses, RT’s, Pharmacists etc.) • A medical directive is a prescription for a procedure, treatment or intervention that may be performed for a range of clients who meet certain conditions. – A medical directive identifies a specific treatment or range of treatments (i.e. medications, diagnostic tests). Summer 2006 – Specific conditions must be met (clients to be included or excluded in a medical directive, and which health care professional can perform the medical directive). – Specific circumstances must exist before the directive can be implemented. For example, who will be involved in the development of the Medical Directive, each group impacted by the medical directive should be consulted, (i.e. lab, radiology, and nursing)? Who will be trained and what the training be? How will the Medical Directive be communicated? What does this mean to Nursing? In most instances, medical directives are put in place for nurses to manage situations without the presence of the physician. • For example, in situations where the nurse knows with great certainty the outcomes of the care to the patient. • Also, medical directives have been put in place in the event of emergency situations, where the nurse can administer a certain medication to a patient, as the physician may not be there to order it and the patient needs a particular medication as a life-saving measure. • A good example of a Medical The Ottawa Hospital Nursing News Directive is the administration of the flu vaccine and subsequent potential administration of Epinephrine. The CNO Medical Directives document 2000 states: The health professional who implements an intervention on the basis of a medical directive is responsible for: • Clarifying that informed consent has been obtained; • Assessing the client to determine whether the specific client conditions, and any situational circumstances identified in the directive, have been met; • Knowing the risks to the client of implementing the directive; • Possessing the knowledge, skill and judgment required to implement the directive safely; • Knowing the predictability of the outcomes of the intervention; • Determining whether management of the possible outcomes is within the scope of her/his practice; • If so, whether she/he is competent to provide such management, and if not, whether the appropriate resources are available to assist as required; • Knowing how to contact the physician responsible for care of the client if orders require clarification. Medical Directives (cont’d) CNO and CPSO support the use of medical directives. Correctly used, medical directives can be an excellent means to provide timely, effective and efficient client care, using the expertise of the physician who orders the directive, and the health practitioner who uses discretion and judgment when implementing it. It is important to remember that a medical directive, regardless of how generic its contents, is a medical order for which the physician has ultimate responsibility. You can access the policy on Medical Directives in your Administration Policy and Procedures Manual ADM II 200 or on InfoNet under “Policy and Procedures/Keyword”. A special thank-you to Karen Johnston for all your hard work and dedication in this endeavor. Thank You to the Generous Sponsors of Nursing Week 2006 External Sponsors Ananda Yoga & Massage Centre Avalon Family Hair Center Baxter Corporation CD Warehouse Changes for Women Chateau Laurier Hotel Chum FM Colonnade Development Diegel & Associates Global Health Care Hollister Limited Inspire Hair Studio & Spa Kit & Kaboodles Gift Baskets Le Domaine Bourget Estate Nu Skin Canada Ottawa 67’s Hockey Club Paul’s Boat Lines Ltd. Smith & Nephew Inc. Tae E. Lee Tae Kwon Do TD Canada Trust Uniform World Yarn Forward The Ottawa Hospital Departments Anesthesia Emergency Heart Institute Ophthalmology Orthopaedic Otolaryngology 10 Medicine Minimally Invasive Surgery Radiation Oncology Surgery Urology The Ottawa Hospital Nursing News Summer 2006