JANUARY FEBRUARY 2013 - Regional West Medical Center
JANUARY FEBRUARY 2013 - Regional West Medical Center
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 />
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► 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 />
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► 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 />
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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 />
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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.