4NE Hosts 102-Year-Old Heart Patient - Washington Hospital Center

WASHINGTON HOSPITAL CENTER
e
NEWS FROM THE
DEPARTMENT OF NURSING
Volume 2, Issue 5 February 4, 2011
“Incredibly Inspiring” Says Staff
4NE Hosts 102-Year-Old Heart Patient
Eulis T. Saunders, 102, poses with
staff on 4NE.
In this Issue
2 A Message from Tonya Washington
3 Nursing Mini-Town Hall Meetings
4 Advance Directive Training
5 Viewpoints
National Heart Month didn’t exist when Eulis T. Saunders
was born. The 102-year-old congestive heart failure patient
didn’t seem to care what the fuss was about when the 4NE
staff poured into his room to pose for a photograph to celebrate the
beginning of the month-long celebration; he just wanted to chat.
Born in Raleigh, N.C., in 1909, Mr. Saunders said his family grew
everything they ate, and he’s enjoyed good health most of his life.
He’s got some trouble with his heart, but still lives alone and is
sharp as a tack, say his caregivers on 4NE. DeAnne Zwicker, DrNP,
Gerontology, said staying mentally and physically active go a long
way toward keeping people like Mr. Saunders healthy. She said,
“It’s important for acute care nurses to keep older adults physically
and cognitively functioning while in the hospital by helping them
maintain their baseline physical functioning and engaging them in
conversation regardless of their cognitive status.”
One of his nurses, Catherine Herman, RN, said, “He’s incredibly
inspiring. While his daughter-in-law cooks for him at home, he’s
still independent and is the most positive person I’ve ever met. He
compliments the hospital food and says it looks beautiful when his
tray arrives. Mentally and physically, he’s amazing.”
6 Fashion Show Photos
7 4H Doubles Their Success
8 Hypoglycemic and Glucose Testing
Continued on page 8

2
A Message from Tonya Washington
Dear Nursing Colleagues,
Recently the Bioethics department, directed by Nneka Mokwunye, PhD, has been
reinforcing Washington Hospital Center’s Patient Rights and Responsibilities in
preparation for The Joint Commission’s impending visit. While it’s important for
each of us to know and internalize these for a number of reasons, highlighting
them today gives me an opportunity to reinforce how integral nurses are to
protecting these rights on behalf of our patients.
✦ All patients have the right to confidentiality, privacy and access to their protected
health information. Nurses play a key role in protecting patient privacy. Be sure
you give patient information only to authorized recipients, according to the
D.C. Hierarchy of Decision Makers. If you don’t have one of the at-a-glance
Hierarchy badge cards, ask Dr. Mokwunye or her team for one.
✦ All patients have the right to be safe and secure. As a caregiver, it’s fundamental that you ensure
patients don’t fall from their beds and that restraints are appropriate. Nurses take safety one
step further: when family members or visitors aren’t acting in the patient’s best interest, call
Protective Services right away.
✦ All patients have the right to make decisions regarding acceptance or refusal of medical care. If
they are unable to make their own decisions, they have the right for a family member or surrogate
to make those decisions. Nurses frequently are asked to witness informed consent documents.
While a physician discusses the matter with the patient, a nurse verifies that the patient has
no questions and witnesses the patient’s or guardian’s signature.
✦ All patients have the right to have an advance directive and to have their directive followed to the
extent appropriate. Patients have the right to assistance facilitating their advance directives.
During discussions with patients about advance directives – and such a discussion should
occur with every patient – a nurse confirms the patient or family member has no more
questions and follows up to ensure the document is provided to the hospital. If the patient or
family needs more information, the nurse should request a social worker consult.
✦ Patients have the right to file complaints and have those complaints addressed in a timely
manner. If a patient or family member has a complaint of any kind, the nurse gives the
patient information on how to contact the Hospital Center’s Patient Advocacy office.
✦ Patients have the right to have their spiritual needs addressed. Our nurses do a terrific job of
calling Spiritual Care providers on behalf of our patients. Because addressing the patient’s
spiritual needs are so integral to successful medical care, nurses should call Spiritual Care as
early as possible to help evaluate a new case.
✦ Patients have the right to clear communication. Medical care can be extremely confusing to
patients. Doctors change, treatments change, rooms change and nurses change. Nurses and
CCFs play a vital role in clearly communicating to patients what’s going on and ensuring
continuity of care.
continued on page 3

We’re Listening
Nursing Mini-Town Hall Meetings Bring Improvements
Over the last few months, Interim
Chief Nursing Officer Tonya
Washington, RN, has been holding
mini-town hall meetings with nurses
throughout the hospital. Her goal for the
meetings is to get to know all of you, find out
if there are any barriers in getting your job
done in the safest and most efficient manner,
understand what Washington Hospital Center
can do better to make your work life better,
learn if any processes are not working and
need to be fixed, and find out what you are
hearing from our patients about how to make
their experience better.
In a letter to all nurses on Feb. 3, Tonya said,
“I’m pleased to share that I got what I asked
for! You gave me quite an earful, and I was
listening. You identified people issues, process
issues and technology, equipment and space
concerns.”
From the issues raised in the meetings, some
problems were fixed the same day. Some took
a few weeks, while others required more time
(but she is still focusing on them). Following
is a list of fixes that have been put into place.
1. IT now has a team of technicians who
make rounds weekly on each nursing unit
to ensure that the MC70s are in the very
best working condition for you.
2. A Nutrition Services associate now inventories
and checks each unit’s floor stock,
A Message from Tonya Washington continued from page 2
helping to maintain availability of snacks
and supplemental meals during off hours.
3. Boxed lunches are now available for
delivery for late admits seven days a week.
Please call Central Patient Transport at
ext. 7-2600 to request a boxed lunch, and
they will deliver it to your unit.
4. Medical Materials now delivers supplies
seven days a week.
5. Pharmacists have now been assigned to
each nursing unit to assist with medication
management.
6. We have started our process redesign of the
Central Staffing Office and Bed Management
department.
7. We continue to hire more registered nurses
and patient care technicians.
8. We are continuing to address and fix the
hot water issue in the Critical Care tower.
9. Additional lighting will be installed in
Parking Lot 8 on Feb. 15.
10. Bed repairs are now being done as needed.
Please notify your nursing director if you
have a patient bed in need of repair.
Tonya concluded, “As your interim chief
nursing officer, I am committed to actively
listen to and address your issues and concerns.
I will be sharing more updates with you as
progress is made.”
✦ Patients have the right to be free of pain. Because you are in such close contact with your
patients, assess their pain on a regular basis. When pain is observed, request a pain or
palliative care consult.
As always, my door is open to discuss any of these matters with you, and I know Dr. Mokwunye
and everyone on her team also welcome your questions and observations.
Sincerely,
Tonya Washington, RN, MSN
Center
eNURSE
3

4
Perfecting Our Processes
Handling Home Medications
Medications brought into the hospital and not authorized for use by the patient shall be placed
in a Pre-Admission Medication Envelope and secured in a locked drawer on the nursing unit.
1. The nurse accepting the patient shall
complete the envelope form. The patient
shall sign and date the form in the specified
box. The white copy shall be placed in the
Medical Record in the section with the
Patient Valuables form, and the pink copy
given to the patient. If the patient cannot
sign or accept the copy of the document,
the nurse shall make a notation in the
patient signature section.
2. The nurse shall write the location of the
medications on the label attached to the
envelope (identifying that the patient has
home medications) and affix it to the
out side of the patient’s chart.
3. The envelope shall be stored on the home
unit in a locked drawer. Licensed personnel
may transfer the envelope to another location
with the patient by completing the
transfer log section of the form on the
envelope copy as well as the white Medical
Record copy. The location shall also be
Advance Directives
Are you Joint Commission-ready?
If you work in Admissions, Nursing or
one of Washington Hospital Center’s many
outpatient clinics, you are required to be able
to communicate with patients about advance
directives. Patients have the right – and you
have the duty to help them – to make their
health care wishes known during their care at
the Hospital Center.
The “Advance Care Planning: Making Health
Care Choices Known” learning module on
SiTEL provides awareness and understanding
of advance care planning and tools to help
patients complete an advance directive. The
training module takes about 15 minutes.
No preregistration is needed. At a time
available to you between Feb. 4 and March 4,
go to SiTEL and review the easy-tounderstand
information at your own speed.
Access SiTEL at Starport > Education
updated on the label on the outside of the
patient’s chart.
4. When the patient is discharged, the discharging
nurse shall obtain the Patient
Medication Envelope from the home unit,
or latest location documented, and return
the medications to the patient.
5. If a patient is discharged without the home
medications, the unit personnel shall call
the telephone number identified on the
envelope. If the medications are not picked
up by the patient or patient’s representative
within 30 days, they shall be returned to
the Pharmacy for disposal.
6. If the patient expires while hospitalized, the
medications shall be returned to the Phar -
macy for disposal.
From Standard Practice 260.12: Utilization
and Handling of Patients’ Nonhospital Based Drugs (e.g.,
Home Medications), Drug R elated Services, Herbal
Products or Nutritional Supplements.
and Training > MeL powered by SiTEL.
Go to www.whc.sitelms.org/login.php if off
campus. You need your MedStar logon id and
password for access.
For additional information or to schedule
a department-wide training on advance
directives, contact Virginia A. Brown, clinical
ethicist, Center for Ethics, at ext. 7-0247 or
virginia.a.brown@medstar.net.
Associates who wish to have an Advance
Directive of their own can also attend a twohour
workshop on Monday, Feb. 21, at 10 a.m.
in Siegel Auditorium. “Advance
Directive/Durable Power of Attorney for
Health Care” will be presented by Nneka
Mokwunye, PhD, director, Center for Ethics.
This free workshop requires pre-registration;
contact Ruby Price at ext. 7-6213.

Safety First
The Journey Toward a High-Reliability Culture
Washington Hospital Center recently
partnered with Healthcare
Performance Improvement (HPI), a leading
healthcare safety consulting firm, to analyze
our organizational culture and develop
strategies for enhancing the delivery of safe,
high-quality patient care.
HPI presented an overview of its findings at
the hospital’s Leadership Day Away retreat in
December and has provided focused briefings
to senior leaders, executives and board
members.
An implementation team made up of 60
physicians, managers and associates from
throughout the hospital will guide the
Viewpoints
organization on its journey toward a highreliability
culture focused on patient safety.
The team, which met for the first time earlier
this month, will work closely with executive
leadership and our HPI consultants to develop
ways to enhance the process of care at all levels.
“Ultimately, achieving and sustaining our goal
of making the Hospital Center a recognized
leader in healthcare excellence will take the
commitment and concerted effort of all who
work and practice here,” said Kevin McGraw,
quality resource coordinator. “As we move
forward, each of us will have a role in creating
an environment in which safe, patientcentered
care always comes first.”
Q&A What do you like best about working with heart patients?
“Most of the patients on
my unit are short-stay. I get
to see the rewards of my work
when I see my patients get
better and able to walk out
and go on with the rest of
their lives.”
Alexandra Nemcosky, RN
4C
“We really get to know
our patients and their
families because they’re here
frequently and for long-term.
The best part is when
there’s a happy ending
with a patient getting a
new heart.”
Jenna Spinillo, RN
4D
“From a medical viewpoint,
they are very interesting.
The heart affects everything –
the circulatory system,
and what I like to call the
plumbing and electrical.
And I love seeing the
incredible variety of treatments
we can do to
help patients.”
Robert Buschmann, RN
4D
Center
eNURSE
“Working with heart
patients is intense and can
be unexpected. It’s also really
exciting to see positive
patient outcomes.”
Hollie Lassley, RN
4NE
5

6
Palatable Change
RN Uniform Fashion Show and
Color-Selection Vote
(L-R) Michelle Lakeman, RN,
and Kimberly Timperlake, RN,
in teal. Osarenoma Odigie,
RN, in dar k green. Miriam
Brathwaithe, RN, in maroon.
Birdie Merriweather-Tynes,
RN, in light blue.
(L-R) Kimberly Timperlake, RN, Birdie
Merriweather-Tynes, RN, Ernestine R. Tallah, RN,
Osarenoma Odigie, RN, Vinit Jha, RN, and Rachel
Bisengo, RN, pose before taking to the runway
to model the four new color options for
nurse uniforms.
Throughout the week, nurses from
all over the hospital volunteered to
model the new uniforms. Sunday,
Feb. 6, is the last day to cast your ballot
for your favorite color. Results will
be announced in the Feb . 11
Center eNurse.

$200 for 200 Days
4H Doubles Their Success
Nurses on 4H ICU have twice the reason to celebrate.
On Monday, Jan. 31, the 4H unit
celebrated a huge success when they
became the first ICU at Washington Hospital
Center to receive recognition for achieving
200 consecutive days with no central lineassociated
blood stream infections (CLABSI).
“The team on 4H embraced the concept of
minimizing line infections for many months
prior to the achievement of 200 days,” said
Kathy Lee, RN, 4H nursing director. “Making
this goal is a joint effort among the physicians
who insert the lines and record them in
Device Tracker, the nurses who care for the
lines – changing the dressings and tubing –
and the techs who keep the line cart stocked.”
The Hospital Center’s incentive – $100 for 100
Days – is the brainchild of the Vascular Access
Device Committee. Committee member
Nancy Donegan, director, Infection Control,
said, “More than the money, I think these
units love receiving the big visible sign, which
is a tribute to the collective and complex work
they performed to achieve this goal.”
Nurses in the News
Several of the Hospital Center’s seven ICUs
have achieved the 100 Days recognition and
are working toward 200.
According to the Centers for Disease Control,
CLABSIs affect approximately 250,000
patients in the U.S. each year. Attributable
costs to treat the infections can range from
$11,900 to $56,000 per patient.
Hospital Center Nurses Featured in Publications
ADVANCE for Nurses recently featured
two Washington Hospital Center nurses
in published articles.
Karen Elliott, RN, assistant nursing director,
Emergency Department, was featured in the
Jan. 18 edition in a story about managing
safety for staff and patients in the ED.
To read the article, go to
http://nursing.advanceweb.com/Archives/Arti
cle-Archives/Ready-for-Anything.aspx
Karen Moriarty-Poole, RN, nurse clinical
liaison and stroke coordinator, was featured
in the Jan. 24 edition in a story about new
research that shows fatality from stroke is
higher in patients admitted on weekends,
regardless of the severity of their stroke.
To read the article, go to
http://nursing.advanceweb.com/pa-nj-de-vamd-dc-oh-wv-ky-mi-research-magazine/Regi
onal-Content/Articles/Stroke-Care-247.aspx
Center NURSE
4H ICU poses with $200 check
from the Vascular Access
Device Committee delivered
by Janis M. Orlowski, MD,
MACP, chief medical officer.
Pictured are (L-R)
Dr. Orlowski, Lois Lamich, RN,
Brenda Perez, RN, Milmer
Hyman, ACT, Rochelle Felix,
RN, Bibi Ibidan, RN, and
Kathy Lee, RN.
7

Center
eNURSE
John Sullivan
President
Dennis R. Wraase
Chairman of the Board
Washington Hospital Center
Kenneth A. Samet, FACHE
President and CEO, MedStar Health
Ty Kennon
Vice President
Public Affairs & Marketing
Inia Burginger
Director, Internal Communications
Public Affairs & Marketing
Graphic Design
Jennifer Rados
Contributors and Photography
Norma Babington
Hyun June Lee
Center eNurse is a weekly
feature publication produced jointly
by the Department of Nursing and
Department of Public Affairs &
Marketing for the associates of the
Department of Nursing.
Please send suggestions,
story ideas and comments to
RN.Feedback@medstar.net by
Monday for that week’s issue.
Call ext. 7-0069 with questions.
Washington Hospital Center, a
valued member of MedStar Health,
is dedicated to delivering exceptional
patient first health care. We provide
the region with the highest quality
and latest medical advances through
excellence in patient care, education
and research.
Washington Hospital Center, a private,
not-for-profit hospital, does not discriminate
on grounds of race, religion,
color, gender, physical handicap,
national origin or sexual preference.
8
4NE Hosts 102-Year-Old Heart Patient
Dionne Ross, RN, 4NE nursing director, said
considering his age, he’s in great shape,
walking down the hall and talking to everyone
he meets. She said she expects he’ll be back
home after his four-day stay and will continue
to be independent.
Mr. Saunders came to the Washington, D.C.,
area in 1929, and worked first in a local
cafeteria before joining the federal
government. He loves to share a story about a
Centered on Safety and Quality
Our patients are pleased that doctors… treat them with respect and courtesy.
From the 2009 Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Survey
Process Improvements
Hypoglycemia and Bedside Glucose Testing Changes
Providing care to patients who need
Accucheck testing requires a collaborative
approach among nurses, PCTs, laboratory
personnel and physicians. To ensure we are
providing care according to best practices,
starting Monday, Feb. 7, all MedStar Hospitals
will change how critically low glucose testing
by glucometer is reported.
At the recommendation of the MedStar Tight
Glycemic Task Force, all results < 40mg/dl will
now appear on the glucometer screen as “LO.”
A numeric value will not display on the meter
for any result < 40mg/dl, indicating that the
patient is severely hypoglycemic. If a meter
result shows “LO,” initiate the hypoglycemia
protocol and follow the “Repeat and
Treat” process.
continued from page 1
guardian angel — a woman in his
neighborhood — who coincidentally was
around the three times during his lifetime that
he needed to get to the hospital fast, but he
mainly credits “the good Lord” for his long
and healthy life. “You can’t do anything
without Him,” he said.
Mr. Saunders said he’s enjoyed the staff on
4NE. “They’ve been so nice, and they come in
here just to talk to me,” he said.
All hospital employees currently responsible
for Accucheck testing need to make sure they
understand this change in glucometer meter
reporting. Please ask your nursing
director and/or educator if you need
further clarification.
ATTENTION!
Effective Monday, February 7, 2011
All results < 40 mg/dl will now appear on
the glucometer screen as “LO” indicating
that the patient is severely hypoglycemic.
What do you do if the meter shows “LO”?
✦ Initiate the MedStar Hypoglycemia
Protocol
✦ Repeat and Treat every 20 minutes until
normal range (70–110mg/dl)
Miss an issue? Read past issues of Center eNurse online at
www.whcenter.org/eNurse