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JANUARY FEBRUARY 2013 - Regional West Medical Center

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<strong>JANUARY</strong> ● <strong>FEBRUARY</strong> ● <strong>2013</strong>


Compiled by<br />

| Jordan Colwell, MHA, BSN, RN<br />

Contact<br />

| Jordan Colwell, MHA, BSN, RN<br />

P 308.630.1450<br />

E Jordan.Colwell@rwmc.net<br />

4021 Avenue B<br />

Scottsbluff NE 69361<br />

rwhs.org<br />

Find us on<br />

Facebook/<strong>Regional</strong><strong>West</strong>


Table of Contents<br />

Letter from the Editor 4<br />

Shared Governance Council Chairs 5<br />

Skin Care Note 6<br />

Calendar of Events 6<br />

Magnet Moment 7<br />

Professional Developement 8<br />

Safety Sense 10<br />

Shared Governance 10<br />

Shared Governance Updates 11<br />

Service Excellence 12<br />

Breakfast with Shirley 13


F. Jordan Colwell<br />

F. JORDAN COLWELL, MHA, BSN, RN<br />

Survey Preparedness/Magnet Coordinator<br />

Welcome to the first Magnetic Times for <strong>2013</strong>. I hope<br />

you had a great holiday season and have your New Year’s<br />

resolutions set and ready to achieve! First and foremost,<br />

I would like to take this time to say thank you to Karla<br />

Edwards for her submissions to the Magnetic Times. As<br />

many of you know, Karla has left for a new opportunity in<br />

her career. Best of luck, Karla!<br />

The article I would like to draw everyone’s attention to is<br />

“Put ‘Caring About People’ Back In Healthcare” by Gwen<br />

Faust, MS, RN. There are two factors in health care today<br />

that have made our jobs more demanding and time<br />

consuming. They are increased regulatory and reporting<br />

requirements which impacts the overall health of patients.<br />

The article goes on to elaborate what caring looks like and<br />

what caring does not look like.<br />

What caring looks like:<br />

When you administer a pain medication to a patient,<br />

provide instruction on when the next dose is due, not<br />

to wait if he or she is in pain, and most importantly,<br />

encourage the patient to request the medication and<br />

take it before the pain becomes intolerable and/or<br />

unmanageable.<br />

What caring does not look like:<br />

A physician rounds and he informs the patient he or she<br />

will be discharged that day. The nurse was not present<br />

during rounds and has not been informed of the plan for<br />

discharge. Therefore, the patient has to provide the nurse<br />

with the information so that he or she can investigate.<br />

The patient experience will create a lasting impression<br />

about the staff and organization. What impression do you<br />

want to create?<br />

Yours in Health,<br />

Jordan Colwell<br />

4


<strong>2013</strong> Shared Governance Council Chair and Co-Chair<br />

Care & Practice Council Meets 3rd Thursday of each month in the Keith Room 2 to 3:30 p.m<br />

Chair Janelle Schroeder, RN (Quality) schroej@rwmc.net<br />

Chair-elect Brooke Borgman, RN (Cardiac Cath Lab) brooke.borgman@rwmc.net<br />

Management Advisor Sarah Shannon, RN (Director of RCU and Float Pool) shannos@rwmc.net<br />

Quality & Safety Council Meets 3rd Thursday of each month in the Keith Room 9:30 to 11 a.m.<br />

Chair Liz Ossian, RN (3 East-<strong>Medical</strong> Oncology) ossiane@rwmc.net<br />

Chair-elect Christy Jay, RN (Surgery) jaycca@rwmc.net<br />

Management Advisor Margo Ferguson, MT (ASCP) (Director of Quality Resource) fergusm@rwmc.net<br />

Nurse/Physician Council Meets 3rd Thursday of each month in the SB II 7 to 8 a.m.<br />

Chair Paulette Schnell, RN (Community Health) schnelpt@rwmc.net<br />

Chair-elect Sheli Goodwin, RN (Home Health) goodwis@rwmc.net<br />

Management Advisor Nancy Hicks-Arsenault, RN (Director of ER, PCU, ICU) nancy.hicks-arsenault@rwmc.net<br />

Evidenced-Based Practice Council Meets 3rd Thursday of each month in the Keith Room 3:30 to 5 p.m<br />

Chair Alicia Kunz, RN (Education) alicia.kunz@rwmc.net<br />

Chair-elect Carrie Herr, RN (Outpatient Surgery) carrie.herr@rwmc.net<br />

Management Advisor Susan Backer, RN (Pt. Safety Officer/Clinical Nurse Specialist) backers@rwmc.net<br />

Professional Practice Council Meets 3rd Thursday of each month in the Keith Room 12:30 to 2 p.m.<br />

Chair Lenna Booth, RN (Cardiac Cath. Lab) boothl@rwmc.net<br />

Chair-elect Nina Palomo, RN (Interventional Radiology) palomom@rwmc.net<br />

Management Advisor Diana Baratta, RN (Director of <strong>Medical</strong>-Surgical Services) diana.baratta@rwmc.net<br />

Night Shift Meets the fourth Wednesday of each month in the Monument Room.<br />

Chair John Furman, RN (House Supervisor) furmanj@rwmc.net<br />

Chair-elect Matt Blaylock, RN (ICU/PCU Staff nurse) matt.blaylock@rwmc.net<br />

Management Advisor Stephen Matthews, RN (ICU/PCU) stephen.matthews@rwmc.net<br />

5


Save the Date<br />

Event Date Time Place<br />

By Rachelle Noe, RN<br />

Did you know there is pressure ulcer<br />

prevention information in each patient<br />

admission packet? This is patient [and staff]<br />

education on how to prevent pressure ulcers<br />

during their hospital stay. This information<br />

is also useful after dismissal. So when your<br />

patient or their family member asks you<br />

for information regarding pressure ulcer<br />

or pressure ulcer prevention, you have an<br />

additional resource and can refer them to<br />

their admission packet information.<br />

The ‘Information on Pressure Ulcer’ fact<br />

sheet includes:<br />

• Risk factors<br />

Residency Class Feb. 27 8 a.m. to 5 p.m. Building 211/Harms<br />

PLAS-Provider Course Feb. 26-27 7:45 a.m. to 5 p.m. South Plaza 1202<br />

Trauma Nurse Core Course (TNCC) Feb. 21-22 7:30 a.m. to 5 p.m. Building 211/Harms<br />

Joint Commission Fair Feb. 27 7 a.m. to 12 noon South Foyer<br />

Joint Commission Fair Feb. 28 1 to 5 p.m. South Foyer<br />

Nurse/Physicians Council Feb. 21 7 to 8 a.m. Keith Room<br />

Coordinating Council Feb. 28 8 to 9:30 a.m. Keith Room<br />

Quality and Safety Council Feb. 28 9:30 to 11 a.m. Keith Room<br />

Professional Practice Council Feb. 28 12:30 to 2 p.m. Keith Room<br />

Care and Practice Council Feb. 28 2 to 3:30 p.m. Keith Room<br />

Evidence-Based Practice Council Feb. 28 3:30 to 5 p.m. Keith Room<br />

Night Shift Council Feb. 21 16:00-17:00 Goshen<br />

Harms Advanced<br />

Technology <strong>Center</strong><br />

APRIL 30<br />

3 to 6 p.m.<br />

6:30 to 9:30 p.m.<br />

MAY 1<br />

9 a.m. to Noon<br />

• Prevention<br />

• Interventions<br />

• Referral to Wound Clinic (recently added)<br />

Harms Advanced<br />

Technology <strong>Center</strong><br />

APRIL 30<br />

3 to 6 p.m.<br />

6:30 to 9:30 p.m.<br />

MAY 1<br />

9 a.m. to Noon<br />

To register:<br />

RWHS employees please register on<br />

Swank Health.<br />

To contact:<br />

For questions contact Alicia Kunz<br />

Alicia.Kunz@rwmc.net<br />

Speaker: Juli Burney<br />

Multiple award winning teacher, humorist and author, Juli makes<br />

an amazing connection with her audiences. She is able to entertain<br />

with the ability of a headlining comedian while either motivating or<br />

training with ease as a nationally recognized speaker. Juli has been<br />

recognized by the state of Nebraska as Artist of the Year because of<br />

her ability to help improve people’s lives through humor and effective<br />

use of communication tools.<br />

6<br />

To register:<br />

RWHS employees please register on<br />

Swank Health.<br />

To contact:<br />

For questions contact Alicia Kunz<br />

Alicia.Kunz@rwmc.net<br />

Speaker: Juli Burney<br />

Multiple award winning teacher, humorist and author, Juli makes<br />

an amazing connection with her audiences. She is able to entertain<br />

with the ability of a headlining comedian while either motivating or<br />

training with ease as a nationally recognized speaker. Juli has been<br />

recognized by the state of Nebraska as Artist of the Year because of<br />

her ability to help improve people’s lives through humor and effective<br />

use of communication tools.<br />

She has worked in all 48 continental United States and Canada,<br />

and has been commissioned by a variety of associations from the<br />

National Endowment for the Arts to Fortune 500 companies to develop<br />

training programs that stick. She has filmed for Showtime and<br />

HBO, along with making numerous guest appearances on radio and<br />

television programs. Her humor is insightful, delightful, universal<br />

and enlightening.<br />

EDUCATION<br />

She has worked in all 48 continental United States and Canada,<br />

and has been commissioned by a variety of associations from the<br />

National Endowment for the Arts to Fortune 500 companies to develop<br />

training programs that stick. She has filmed for Showtime and<br />

HBO, along with making numerous guest appearances on radio and<br />

television programs. Her humor is insightful, delightful, universal<br />

and enlightening.


Magnet Moment | Nursing Peer Review 101<br />

By Liz Ossian, BSN, RN<br />

This year you may begin hearing about nursing peer review. Physicians<br />

already have a process for reviewing their care, and nationwide, hospitals and<br />

state nursing boards are increasingly implementing<br />

peer review as a method for improving nursing care.<br />

We should always be striving to improve the way we<br />

deliver patient care, and nursing peer review is one<br />

way we can be proactive in preventing future adverse<br />

outcomes. Our ultimate goal is safe, effective, high<br />

quality patient care.<br />

The review process is easy to understand. Cases can be<br />

identified through incident reports, risk management,<br />

staff referrals, and so on. These typically include cases<br />

in which the patient has an unexpected outcome,<br />

requires transfer to a higher level of care, or other<br />

unusual events.<br />

Once a case is identified, a group of nurses will look at the medical record<br />

to determine if nursing actions were appropriate for the patient. Was the<br />

standard of care met? This involves looking at both system and individual<br />

components to see if any changes should be made in order to improve future<br />

care. Nurses involved in the case will be interviewed to fully understand the<br />

events that occurred. By carefully examining the medical record and talking<br />

to the nurses involved, this group will be able to identify opportunities for<br />

improvement to prevent undesirable outcomes in the<br />

future.<br />

Example: Let’s say we have a patient who slowly<br />

accumulates fluid over several shifts. Eventually<br />

the patient is transferred to ICU because of cardiac<br />

arrhythmia or respiratory distress. What could have<br />

prevented this? Did we have an accurate list of their home<br />

medications? Was the patient weighed at least daily? Was<br />

I/O recorded according to unit policy? Did the nurse(s)<br />

follow established routines and policies? There are<br />

many questions that can be answered by looking at the<br />

available information and perhaps new recommendations<br />

can be made if we determine the event occurred in spite of<br />

our established protocols. Safe patient care with positive<br />

outcomes is what we all want!<br />

If you are interested in becoming a member of the Quality and Safety<br />

Committee or have any questions about nursing peer review, don’t hesitate<br />

to contact me!<br />

7


Specialty Certifications<br />

Keara Brunner, RN<br />

Certified Lactation<br />

Consultant<br />

Since I had the desire to<br />

help people, I decided<br />

to become a nurse at<br />

a young age. It helped<br />

that I didn't mind the sight of blood and having<br />

four brothers, one of them was always getting<br />

hurt. It probably also helped that nursing runs in<br />

the family. My grandma was a nurse along with<br />

my aunt, great aunts, and many cousins.<br />

I spend a lot of my extra time helping with the<br />

junior high youth group at my church. I also enjoy<br />

reading books, going to the movies, watching<br />

plays, snowboarding, and spending time with<br />

friends and family.<br />

I took my pre-nursing classes at Chadron State<br />

College, then moved to Scottsbluff where I<br />

attended UNMC College of Nursing and received<br />

my BSN. After nursing school I was able to get<br />

a job here at <strong>Regional</strong> <strong>West</strong> on 2 East-Ortho/<br />

Neuro floor. I worked there for two years before<br />

I transferred to NICU, where I have now been for<br />

almost four years.<br />

The thing I like about being a nurse is the<br />

variety of people I get to meet and the people<br />

I get to work with. But what I like most about<br />

being a nurse is when you get to see how you<br />

have helped someone—that you have made a<br />

difference in someone’s life. I also like that I can<br />

most days honestly say that I enjoy going to work<br />

and look forward to my job.<br />

I decided to get my certification mainly because<br />

it was a requirement for my new job as NICU<br />

lactation counselor. I did want to get the<br />

certification and am very glad I did because<br />

it has been very helpful, not only for my job in<br />

the NICU but also with helping moms on the<br />

postpartum floor, along with family and friends<br />

who have had breastfeeding issues.<br />

Some advice I would give new nurses would be<br />

to encourage them to ask many questions and<br />

remind them it will take time to learn things<br />

because they won't know everything on their first<br />

day as a new nurse. Respect the experienced<br />

nurses because they can teach you a lot. The<br />

most important thing to remember is you will<br />

never know everything and there is always<br />

something new you can learn.<br />

Sundae Clay, RN<br />

Certified Rehabilitation<br />

Nurse<br />

Laura Wolfe, RN<br />

Certified Emergency Nurse<br />

I was raised in Scottsbluff and married my high<br />

school sweetheart. I<br />

have two children, a<br />

14 year old daughter<br />

and a one year old<br />

son. My hobbies<br />

include camping<br />

and fishing with my<br />

family, four-wheeling,<br />

and hunting. I<br />

graduated from UNMC College of Nursing in<br />

December 2001 with my BSN and worked in<br />

Dialysis for the first five years of my nursing<br />

career.<br />

After doing a nursing internship at a Level I<br />

Trauma <strong>Center</strong> in Tulsa, Okla., I realized that<br />

emergency nursing was my true dream and it<br />

just so happened that the ER here at <strong>Regional</strong><br />

<strong>West</strong> had an opening. The thing I love about ER<br />

Continued to page 9.<br />

8


Continued from page 8.<br />

nursing is the variety of patients we see and the<br />

skills we use. We see all ages of patients, we see<br />

illnesses (acute and chronic), injuries (including<br />

trauma), and we are constantly being challenged<br />

mentally by the split second life and death<br />

decisions we are frequently required to make.<br />

What I like most about being a nurse is being<br />

given the opportunity to make a difference in<br />

someone's life when they need it the most.<br />

I decided to obtain my emergency nursing<br />

certification in order to provide the best care<br />

possible to our patients. I also think patients<br />

recognize and appreciate when they know the<br />

nurses taking care of them have gone that extra<br />

mile and have worked hard to achieve certification<br />

status.<br />

If I could give a new nurse some advice it would<br />

be to never stop learning and never lose your<br />

passion for what you do.<br />

9


Susan Backer<br />

SUSAN BACKER, MSN, APRN‐CNS, ACNS‐BC<br />

Patient Safety Officer/CNS<br />

Think about your work responsibilities-what you<br />

do on the job every day. What is your role at the<br />

hospital? Is it direct hands-on care? Do you keep<br />

the environment safe and equipment repaired? Do<br />

you provide lab tests? Are you involved with coding<br />

and billing? The reality is each of us has either a<br />

direct impact or an indirect impact on the people we<br />

serve – our patients.<br />

Everything we do impacts the care and outcome of<br />

the patient. We may work in different departments<br />

but we are all here for one reason–our patients. We<br />

may not see each other or directly communicate<br />

with each other, but we are all part of a big team<br />

that takes care of people’s health care needs. As<br />

we move into <strong>2013</strong> we are going to learn more<br />

about working effectively in teams, developing<br />

cross monitoring skills, and learning more about<br />

situational awareness and shared mental model.<br />

In 2012 we began developing skills that helped us<br />

put patients first, work together, and improve daily.<br />

Now it’s time to put all that together and practice<br />

working more effectively in teams.<br />

We have a lot planned this year to help us work<br />

better together. One activity is simulation, with a<br />

team currently working toward that end. There are<br />

two types of simulation, high fidelity and low fidelity.<br />

High fidelity simulation is practicing a scenario<br />

with the natural work team in the environment the<br />

scenario would occur, using the equipment and<br />

materials needed. Low fidelity simulation is didactic<br />

learning using hypothetical situations where<br />

participants are asked to describe a response to<br />

the situation rather than respond. In simulation we<br />

use the tools we’ve already learned, such as the<br />

communication bundle, speaking up for safety, and<br />

critical thinking.<br />

Teamwork is the theme for <strong>2013</strong>. I am excited to<br />

be involved in the next steps of our safety culture<br />

initiative.<br />

Together Everyone Achieves More.<br />

“Tell me and I will forget;<br />

Show me and I may remember;<br />

Involve me and I will understand.”<br />

--Confucius 450 BC<br />

10


Shared Governance Council Updates<br />

Care & Practice Council<br />

Fall Prevention Program "A" work day took place on Wednesday, Jan. 9 from 8:30 a.m. to 3 p.m. The goal of the workday was to design the<br />

evidence-based procedures and protocols as well as begin the education plan for the Fall Prevention Program at RWMC.<br />

Nursing Fatigue: The Council's recommendation is to hand off the project to the Evidence-Based Practice Council, who has an interest in this<br />

topic. Janelle and Alicia met to discuss the transition and review materials including the literature summary and PICOT question. Thanks to the<br />

EBP council for taking on this project and what great team work between councils!<br />

Quality & Safety Council<br />

Working on Nursing Peer Review. Developing recommendation for consideration. A draft policy has been developed. A pilot of the draft was<br />

conducted with two cases. During the pilot some areas of improvement were identified and the council is working to address those. Feedback<br />

from everyone involved in the pilot was extremely positive.<br />

Nurse/Physician Council<br />

The council is working to recruit some active physicians. We are struggling with attendance and will be working on strategies to improve.<br />

In the process of determining what project the council will take on for 2012-<strong>2013</strong> as well as some long-term goals. Considering a re-visit of SBAR,<br />

handoff.<br />

Evidenced-Based Practice Council<br />

Working on a survey for staff about evidence-based practice and what support staff need from the council. The survey will include questions<br />

about journal club. The council is working on a distribution plan. Please encourage your staff to participate in the survey process. Evidencebased<br />

practice education classes have had low attendance the last year. Will be seeking input on how the revamp/revise the class to improve<br />

attendance.<br />

Have taken on the Nursing Fatigue project from Care and Practice.<br />

Professional Practice Council<br />

Wrapping up work on the clinical ladder recommendations. Will begin working on a recommendation for improvements to the Low Census<br />

Policy as requested. Will also begin work on a social media statement. Will look into a concern brought forth about care conferences. The<br />

concern being who can call or organize a conference. The council will be working with leadership on this topic.<br />

Night Nursing Council<br />

The first council meeting had six staff in attendance. The Chair-elect for this council is Matt Blaylock. Next meeting is scheduled for February.<br />

John will continue to recruit members for this council.<br />

► Continued to page 16<br />

11


Karla Edwards<br />

KARLA EDWARDS<br />

Former Director Service Excellence<br />

New survey questions<br />

Three new questions were added to our patient<br />

satisfaction survey in July. These questions, known as<br />

the Expanded HCAHPS questions, focus on how well staff<br />

transitioned the patient’s care from the hospital setting to<br />

home or another facility such as long-term care.<br />

The questions are:<br />

• During this hospital stay, staff took my preferences and<br />

those of my family or caregiver into account in deciding<br />

what my health care needs would be when I left.<br />

• When I left the hospital, I had a good understanding of<br />

the things I was responsible for in managing my health.<br />

• When I left the hospital, I clearly understood the<br />

purpose for taking each of my medications.<br />

Nationwide, approximately one in five Medicare patients<br />

discharged from the hospital are readmitted within 30<br />

days. That is in the neighborhood of 2.6 million seniors<br />

and at a cost of more than $26 billion a year. As of<br />

October 1 last year, hospitals are fined by Medicare<br />

for excessive readmits. CMS has added the three<br />

new questions to help hospitals pinpoint gaps and<br />

consequently decrease the number of readmits.<br />

What can you do?<br />

1. Remember, discharge planning begins at admission.<br />

Pre-admit, really. Ensure the patient is properly<br />

informed and there has not been conflicting<br />

information between the physician’s office and the<br />

hospital. Tell the patient what he or she needs to ask<br />

their physician prior to the procedure. Remember,<br />

this is foreign to them and they don’t know what they<br />

don’t know. They are relying on you to be the expert<br />

and lead the way.<br />

2. Explain the “why” to the “what” of their discharge<br />

instructions. That connects the dots, making them<br />

more apt to be compliant. It also helps them to<br />

explain the details to their family and friends and<br />

improves their understanding of their care once they<br />

leave the hospital.<br />

3. Look for teachable moments. Don’t try to cram<br />

everything they need to know into the two hours<br />

before dismissal. Every time you go into the patient’s<br />

room, take the opportunity to go over something<br />

they will need to know when they leave the hospital.<br />

Giving the information in small doses will help their<br />

retention. Don’t worry about repetition – that’s good.<br />

4. Identify potential barriers. Why might the patient not<br />

be able to care for himself or herself after leaving the<br />

hospital? How can you help them overcome these<br />

barriers? Assess patients for their knowledge, skill,<br />

and attitude related to their continued care. Are they<br />

in denial? Does it take two people but they live alone?<br />

How can you help?<br />

Our top box scores on these three questions from July<br />

through October are 45.1, 56.5, and 62.1 percent<br />

respectively. For example, what that means is 45.1<br />

percent of our patients said we always took their<br />

preferences in consideration when preparing for<br />

discharge. By using the four tips, you can greatly improve<br />

a patient’s chance of not having to come back to the<br />

hospital in the near future, and improve our scores at the<br />

same time.<br />

12


January<br />

Attending: Jackie Delatour,Michelle Dillon, Marcella Wildeman, Kathi Yost,<br />

Shirley Knodel,<br />

Questions, Concerns, etc.<br />

| Talked about the Nebraska Legislature and what was up and coming with<br />

Nurse Practitioners scope of practice.<br />

| A clarification was requested regarding the rumors that the hospital is for<br />

sale or has been sold. Shirley clarified that we are neither sold nor for sale.<br />

She explained that all hospitals out of necessity are looking at ways to<br />

contain costs, share costs, increase revenue. That in some cases means<br />

partnering with other systems for services such as IT and that we are in<br />

the beginning stages of exploring that. There was great interest among the<br />

group to explore other IT systems due to dissatisfaction with our current<br />

system.<br />

| Talked about the UNMC Nursing student clinical rotations and the different<br />

way these clinical rotations are structured now.<br />

| Talked about the Leadership class at UNMC and spending time with<br />

preceptors as part of the total clinical rotation.<br />

| Talked about the discussion regarding the Governor’s proposal on state<br />

income tax and state sales tax. There was sentiment among the group that<br />

the state income tax is a barrier to recruitment of new nurses. There is also<br />

concern that this does not result in cuts to healthcare.<br />

| Discussed the IT challenges we have here at the hospital and what future<br />

plans look like.<br />

| Discussed the possibilities of loan repayment for students that are going to<br />

school. Student works for Banner health and has tuition reimbursement as<br />

follows: Part-time 2500 and full-time 5000. Also loan repament for newly<br />

hired students.<br />

| Discussed that one new nurse in OB was told in a class presentation from<br />

HR that she would receive loan repayment as part of hire on and then<br />

when she hired on in 2010 she was told by HR, “We no longer provide loan<br />

repayment.” There was sentiment that loan repayment is a big recruitment<br />

draw.<br />

| Discussed the new nurse finance committee that will be part of our shared<br />

governance model.<br />

13


By: Alice Fillingham, BSN, RN, CEN<br />

The Students Have Become the Teachers<br />

CONGRATULATIONS TO OUR GRADUATES! The newest members of<br />

<strong>Regional</strong> <strong>West</strong> <strong>Medical</strong> <strong>Center</strong>’s Emergency Department and Intensive<br />

Care Unit staff have completed their first Critical Care Transition Course.<br />

These colleagues were either new graduate nurses or nurses new to a<br />

critical care department. This pilot course was created by Linda Fowler<br />

and Alice Fillingham with the guidance and encouragement of Director<br />

Nancy Hicks-Arsenault and ICU/ED management teams. This 12 week<br />

course was divided by systems and included lectures, case discussion,<br />

and simulation.<br />

Each course included a brief lecture on a system: what’s normal,<br />

what’s abnormal, and what would one really not like to see? The course<br />

objectives included combining real world application of what<br />

could go wrong, what one could expect, and consideration of worst<br />

case scenario. Lectures were followed by discussion of patients<br />

with conditions pertaining to that week’s topic. This was especially<br />

interesting as the ED staff could share their experiences and then ICU<br />

staff could complete the patient’s story throughout his or her critical<br />

care treatment. The case discussion with both sides of the story<br />

assisted in painting a more complete picture for our new colleagues.<br />

The experience also helped build departmental bridges. The final<br />

portion of each week’s course included hands-on use of equipment,<br />

troubleshooting, and simulation.<br />

The hands-on equipment education was reported to be the most<br />

valuable and we found some of our colleagues in the Critical Care<br />

14


► Continued from page 14<br />

Transition Course to be our super users for equipment in their<br />

respective departments. We then asked these individuals to share<br />

what they had learned with the staff at an equipment blitz. The<br />

students became the teachers and did a fabulous job presenting to<br />

the Critical Care Departments! We look forward to starting a second<br />

course in August and would like to offer this course to not only new<br />

hires but to seasoned ED/ICU employees who wish to gain additional<br />

knowledge in the field of critical care.<br />

We would like to recognize and thank our colleagues who completed<br />

this course for their professionalism and contribution to making the<br />

pilot course a success!<br />

15


► Continued from page 11<br />

Shared Governance Council Updates<br />

Coordinating Council<br />

CC Objectives 2012-<strong>2013</strong><br />

Shared Governance Redesign<br />

• Shared Governance Model Update<br />

• New Council: “The role of the Nursing Management Council is to manage resources as defined in the<br />

strategic plan and conceptual framework. The council examines the delivery of patient care as it is<br />

affected by the availability of human, fiscal, material, support, and systems linkage resources. This<br />

council promotes the responsible and creative use of resources so that expenses are controlled while<br />

exceeding the health care expectation of the patients and their significant others.” -Shared Governance<br />

Toolkit. Names for the council being considered include: Nurse-Finance Council and Resource<br />

Management Council<br />

• Communication between UPC and CC<br />

• LPN/CNA Membership: Care and Practice; Quality/Safety; Evidence-Based Practice Councils<br />

• Bylaws development<br />

• Contribution to Plan for Magnet Designation<br />

Coordinating Council is also working with Jordan Colwell and Education to identify content and appropriate<br />

speaker for Nurse’s Day.<br />

16


Emergency Exercises<br />

By David Edwards<br />

The “Emergency Management Coffee Break Training” is a bi-weekly<br />

publication for all employees regardless of skill level, emergency or<br />

disaster response expertise, or position. The objective of each lesson is<br />

to increase employee awareness and<br />

expose employees to <strong>Regional</strong> <strong>West</strong>’s<br />

Emergency Management Program.<br />

Why do we conduct emergency<br />

exercises?<br />

We use exercises to test our emergency<br />

plans. We do not want to discover a<br />

flaw in our plans during an actual event.<br />

Contrary to popular view, we do not<br />

conduct exercises because the Joint<br />

Commission says we must. We do it to<br />

prepare our employees and to test our<br />

plans.<br />

Exercises are not just the big full-scale<br />

event you see every year. Exercises also include workshops, seminars,<br />

and tabletop exercise. We do not announce every exercise. We purposely<br />

refrain from announcing some exercises so we can evaluate employee<br />

response.<br />

Not only do the exercises test our plans, they test our employees response,<br />

too. We expect employees to participate fully in exercises as long as we<br />

do not compromise patient care or safety. This means using the radios,<br />

simulating care of simulated patients, and generally responding as you<br />

would if this was a true emergency.<br />

Many times, we hear employees saying, “Well, this is only a<br />

drill, I would do this during a true emergency.” Any employee<br />

who believes this, is fooling himself. We know people perform<br />

as they practice, so practicing exactly what you would do in an<br />

actual event is the right thing to do during exercises.<br />

After we hold an exercise or experience an actual event, we<br />

develop an After Action Report (AAR). The AAR reviews the<br />

exercise or event and discusses major strengths and areas for<br />

improvement.<br />

If we find areas needing improvement, a Corrective Action<br />

Plan (CAP) is developed. The CAP outlines the items needing<br />

improvement and identifies the responsible person. It also lists<br />

an anticipated correction date. When the Joint Commission is<br />

onsite, they will ask about our corrective actions and changes<br />

we made to the EOP in response to the CAP.<br />

As always, if you have any emergency management questions, contact<br />

David Edwards, Emergency Preparedness Coordinator at Ext. 2099 or<br />

edwardd@rwmc.net.<br />

17


Safety and Occupational Health<br />

State Health Department Urges “Get A Flu Shot”<br />

The Nebraska Department of Health and Human Services is strongly<br />

recommending that all individuals age six months and older have a flu<br />

immunization as soon as possible if they have not done so already.<br />

Seasonal flu is now widespread and has resulted in many hospitalizations<br />

throughout the state. In Lancaster County, two deaths due to influenza have<br />

been confirmed by the state health department. Both the adult and child<br />

who died were not vaccinated against influenza.<br />

Uninsured children from six months to 19 years of age who qualify for the<br />

Vaccine for Children program are eligible for flu shots at no cost.<br />

“We want to emphasize that young children are at high risk for complications<br />

from the flu. All children age six months and older and all caregivers who<br />

have contact with them should get a flu vaccination,” said Sandy Preston,<br />

RN, <strong>Regional</strong> <strong>West</strong> Community Health Nurse and Immunization Coordinator.<br />

This year, the flu vaccine protects against two strains of influenza type A and<br />

one strain of type B.<br />

“Even those who have had the flu should get vaccinated once they are well.<br />

If not, they remain susceptible to getting one of the other strains of flu,” said<br />

Preston.<br />

You can schedule an appointment at <strong>Regional</strong> <strong>West</strong> Community Health by<br />

calling 308.630.2700, Option 1. Flu vaccinations are also available from<br />

local health providers and pharmacies.<br />

For more information about the flu or vaccinations, please call <strong>Regional</strong><br />

<strong>West</strong> Community Health at 308.630.1126.<br />

Flu Facts<br />

The flu is NOT a stomach/intestinal illness<br />

The flu is an infection of the nose, throat, and lungs caused by influenza<br />

viruses. It is a highly infectious disease that can cause mild to severe illness<br />

like pneumonia, and can lead to death.<br />

Symptoms<br />

• Fever, cough, sore throat, headache, fatigue, chills, achiness.<br />

• Everyone should consider getting immunized against the flu!<br />

• Those who are higher risk for complications from the flu should receive<br />

the flu vaccination. Those at high risk include:<br />

• Children under age five (especially six months to two years).<br />

• Household contacts of persons at high risk for flu complications,<br />

especially babies six months and younger who are at high risk but<br />

are too young be vaccinated.<br />

• Adults age 65 years and older,<br />

• People who care for those at high risk.<br />

• Pregnant women.<br />

• Health care workers.<br />

• People with asthma, neurological and neuro-developmental<br />

conditions, chronic lung disease, heart disease, blood disorders,<br />

diabetes, kidney disorders, liver disorders, metabolic disorders,<br />

obesity, a weakened immune system, and those under age 19<br />

who receive long-term aspirin therapy.<br />

• People living in nursing homes and other long-term care facilities.<br />

Reduce your flu risk<br />

• Vaccination is the best prevention. Full protection occurs about two<br />

weeks after vaccination.<br />

• Stay home if you have flu symptoms.<br />

• Avoid people who have symptoms.<br />

• Wash hands thoroughly and frequently.<br />

18<br />

• Cover your mouth and nose with a tissue or your sleeve when you<br />

cough or sneeze.

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