2019 - 2020 Nursing Annual Report

Advancing Nursing Excellence Welcome to Einstein’s Nursing Annual Report for 2019-2020

Gina Marone, MSN, RN, NEA-BC Percival Magat, BSN, RN, CRRN, WCC Vice-President & Chief Nurse Executive Chair of Network Council & Clinical Nurse: MossRehab at Jefferson Bucks Hospital During 2019-2020, the nurses at Albert Einstein Medical Center (AEMC) gained significant national recognition for nursing excellence. Dear Colleagues,

Notably, AEMC earned Magnet® recognition – the highest honor My name is Percival Magat, BSN, RN, CCRN, WCC and I am a healthcare organization can receive for nursing excellence – in a Clinical Nurse at MossRehab Jefferson Bucks Hospital. In August 2019. Awarded by the American Nurses Credentialing October 2018, I was pleased to accept the role as your Network Center’s Magnet® Recognition Program, Magnet recognition is one Nursing Council Chairperson. On behalf of Nursing, I want to thank of the benchmarks used to measure the quality of care patients our Immediate Past Chairperson, Trish Brown, BSN, RN, for her receive and is considered the gold standard for nursing care. leadership and contributions to the Council and Nursing Staff. You worked so hard to earn this well-deserved recognition. I have been a nurse for 18 years, and I completed my Bachelor of Beyond Magnet, you distinguished yourselves in a number of other ways Science degree in Nursing at the University of Santo Tomas in Manila, as well. For example, MossRehab is a 2019 Press Ganey NDNQI Award Philippines, in 2002. My clinical background includes Med-Surg, Nursing for Nursing Excellence® winner. USA Today in March 2019 reported Home Administration, Wound Care, and Rehabilitation Nursing, where that Einstein Medical Center Philadelphia has the lowest overall severe I currently work. I have been working at MossRehab since 2010, and complication rate of Philadelphia maternity hospitals, 0.5 percent. it has been a great experience to be part of a Magnet Institution.

Patient safety is a priority for all of us. You reduced Hospital During my career here, I have been actively engaged in shared acquired pressure injury (HAPI) rates in the acute care population. governance, and I was the rehab Cluster Chair for a year. I am very Critical care and step down demonstrated a 29.1% and 25.4% thankful to Nursing Leadership for allowing us to practice shared decrease in HAPI incidence respectively in fiscal year 2019. governance. I believe that shared governance gives bedside nurses like me the chance to have an equal voice in the decision-making process. You also created opportunities to ensure a safer work environment Shared Governance motivates us to take ownership in delivering the best for nurses. For example, you disseminated important information nursing care based on evidence, which improves patient and employee about safer electrosurgical practices, which helped gain approval satisfaction simultaneously. With the guidance from our CNE Gina Marone, for purchase of smoke evacuation systems in the OR. Network Council was successful in enhancing communication between nursing staff in different clusters, and ensuring that we are providing As a result of the hospital’s excellent stroke performance, the person-centered care and evidence-based care across our network. American Heart Association and American Stroke Association recognized Einstein Medical Center – Philadelphia with the 2019 Thank you to all nursing staff from leadership to frontline nurses. Your status of “Get with the Guidelines Stroke Gold Plus Elite.” kindness, dedication, and healing touch is what makes the nurses in this institution stand out. Thank you for continually putting our patients Your accomplishments during the past year have been remarkable. first and treating them with empathy and compassion. Thank you for I hope you take tremendous pride in what you have achieved. being a rock when waters get rough. Today, I am more grateful than ever to be a part of a strong organization with empowered nurses The challenges in 2020 due to COVID-19 have demonstrated your deep who put themselves at risk daily and dedicate long hours of work in professional commitment to saving lives and healing our community. fighting the ravages of this pandemic. Keep up the great work! You have all done extraordinary things including being the eyes and ears of our patients when they could not speak for themselves and their Sincerely, family could not be present. You are our heroes and we honor you. I am confident as we look to the future and embrace our new normal that Einstein Nursing will continue to embrace any challenge before us.

2 WELCOME WELCOME 3 Table of Contents

Albert Einstein Medical Center (AEMC) Our Nursing Theory AEMC’s Mission, Vision, and Values Locations

Transformational Leadership Nursing’s Mission, Vision, and Values Nursing’s Strategic Plan Nursing’s Philosophy Mother Baby Exemplar National Pressure Ulcer Advisory Panel

Structural Empowerment Nurse Residency Program Surgical Smoke Safety SCI Patient Education Video COVID-19 Response Certified Nurses Nursing Recognition & Awards

Exemplary Professional Practice Professional Practice Model and Care Delivery System MossRehab NDNQI Award Winner Stroke Care Excellence Multimodal Behavior Plans for TBI Patients Nurse-Driven Protocol on Indwelling Urinary Catheters Calibrated Drapes in Labor and Delivery Sensory Room

New Knowledge, Innovations & Improvements QSEN Competencies Baby Friendly Cell Phone Containment Neonatal Abstinence Syndrome

Empirical Outcomes Magnet® Recognition

4 CONTENTS CONTENTS 5 Albert Einstein Medical Center

Our Nursing Theory

In 2005, the registered nurses on the network Nursing council selected Watson’s Theory of Human Caring as the framework for nursing. The theory was chosen for multiple reasons. First was the relevance of caring across multiple practice settings. Second, values in this theory were ones the nurses wanted to adopt, promote, and advance. The key principles Albert Einstein Medical Center of the theory as defined by Watson were closely aligned with many of our organizational values and culture. For example, two tenets of the Mission, Vision, and Values theory are the formation of a humanistic-altruistic system of values and sensitivity to self and others. This directly relates to the mission and vision of the hospital and the core values of respect, affinity, and empathy.

After the theory was selected and in the process of being advanced, a dialogue was held at the November 2007 network Nursing council meeting. Vision: The purpose was for the group to envision what they wanted nursing practice to look like in the future. Key concepts were identified for incorporation Einstein Brilliance and Compassion into the mission, vision, and philosophy of nursing. During the January 2008 strategic planning retreat, further input was obtained from the nursing in All We Touch. leadership team and the Mission, Vision and Philosophy was created.

In October 2010, Einstein Healthcare Network was invited by Dr. Jean Watson to become a Watson Caring Science Institute (WCSI) Affiliate based on formal presentations by a select group of Einstein Healthcare Network registered Mission: nurses and leaders at the October 2010, International Caritas Consortium on how the theory lives within our organization. The only criteria missing was an With humanity, humility and honor, to official site visit from Dr. Watson. The site visit was March 2011, and Einstein Healthcare Network has been successfully re-designated in heal by providing exceptionally intelligent 2012 and 2013. As registered nurses began to understand, integrate, and practice the theory at a deeper level they recognized a need to have a Mission, and responsive healthcare and education Vision and Philosophy that was aligned with Watson’s (2008) revised theory, for as many as we can reach. Nursing: The Philosophy and Science of Caring. The revised Mission, Vision, Philosophy was created with input from registered nurses across Einstein Healthcare Network in October 2013. We have transitioned from being a WCSI Affiliate in 2018, but we continue to practice Watson’s Caring Theory. Values:

Respect, affinity, and empathy.

6 ALBERT EIINSTEIN MEDICAL CENTER ALBERT EINSTEIN MEDICAL CENTER 7 LOCATIONS

KEY To To To T To To To To Allentown,A PA Upper Gwynedd Doylestown, PA Langhorne, PA Collegeville North Wales Colmar Doylestown, PA Einstein Healthcare East BUCKS Network Main Norriton COUNTY Locations Primary Care Abington Blue Bell MossRehab Specialty Care World-renowned for inpatient and outpatient rehabilitative programs for Norristown PA TURNPIKE MossRehab brain and spinal cord injury, stroke, Clubhouse Programs neurological disorders, amputation and MONTGOMERY Jenkintown orthopedic conditions. It offers inpatient Far Northeast King of Plymouth COUNTY MossRehab and outpatient services at locations Prussia Meeting Lafayette Driving Program throughout Philadelphia, Montgomery Hill and Bucks Counties, including MossRe- Conshohocken RIDGE PIKE hab Bucks, MossRehab Doylestown, GERMANTOWN PIKE Elkins Park MossRehab Inpatient Locations MossRehab Frankford, MossRehab Wadsworth Tabor, and MossRehab Elkins Park. Cedarbrook MossRehab To Paoli Outpatient Centers Einstein Medical Center Elkins Park Pennypack Full-service medical and surgical specialty Logan hospital in suburban Montgomery County, Germantown Lawndale AAmbulatory Care Centers offering orthopedics, bariatrics, urology Burholme SCHUYLKILL Mayfair and other services. Olney Both at 60 Township Line Road RIVE Elkins Park, PA 19027 Bryn Mawr R

Bala 1 Cynwyd PHILADELPHIA TACONY PALMYRA BRIDGE 30 Einstein Center One BETSY ROSS BRIDGE 9880 Bustleton Avenue, Philadelphia, PA 19115 Einstein Medical Center Philadelphia Offers easy access to primary care and specialty services in Northeast Philadelphia 5501 Old York Road, Philadelphia, PA 19141 Center City and Lower Bucks and Montgomery Counties. 772-bed tertiary-care teaching hospital located in North AWARE RIVER Outpatient surgery services include cancer Philadelphia. The hospital has an accredited Level I Regional DEL care, breast surgery, ophthalmology gastro- Resource Trauma Center and one of the busiest emergency University departments in Philadelphia. EMCP is the largest independent City enterology; general surgery; orthopedics; BENJAMIN FRANKLIN pain management; and urology. academic medical center in the region with residency and BRIDGE fellowship training programs in many specialties, and offers Old City advanced treatment in heart and vascular care, stroke, radiation To Marlton, NJ Primary and Specialty Care oncology, breast health and more. Einstein offers quality primary and specialty services, including internal medicine, family practice, obstetrics/gynecology, pediatrics, Willowcrest cardiology, gastroenterology, nephrology, orthopedics and others. Hospital-based short-term sub-acute rehabilitation and nursing facility located on the campus of Einstein Medical Center Philadelphia. Services include: To Surgical Care diagnostic testing, intravenous medication therapy, total parenteral nutrition, and To Rehoboth South To Wilmington, DE Beach, DE WALT WHITMAN Woodbury, NJ Advanced outpatient and inpatient surgical care, using traditional transfusion therapy, physical, occupational, and speech therapies. Philadelphia BRIDGE as well as minimally invasive techniques in cardiology, orthopedics, bariatrics, liver/kidney/pancreas transplantation, neurosurgery and other specialties. 8 LOCATIONS LOCATIONS 9 Transformational Leadership

Nursing’s Mission, Vision, • Creating a superior experience for our patients, families, and communities. and Values • Caring science, innovative models of care delivery, and integration of Our Vision: research and evidence-based practices. Advancing the art and science of Nursing. • Peer review as necessary for Through that vision, we aspire to bring to our professional growth and development. patients and community Einstein Brilliance and Compassion in All We Touch, which is the • Education and lifelong learning. vision for Albert Einstein Medical Center. • Change and the opportunities it creates.

Our Mission: The mission of Nursing is a commitment to creating caring, healing environments with authenticity and intentionality for all we reach and touch through practice excellence, innovation, scholarship, and expressions of caring practices. With humanity, humility and honor, to heal by providing exceptionally intelligent and responsive healthcare and education for as many as we can reach is the mission of Al- bert Einstein Medical Center. The mission is grounded in the Jewish concept of repairing and healing the world. In doing so, we respect the opportunity to be involved in our community and in people’s lives.

We Value: • Each other as our greatest resource in achieving our mission. • Professionalism in our discipline. • Diversity for enriching our communities. • A culture of safety that protects our patients and ourselves. • Teamwork which supports and strengthens interdisciplinary collaborative practices. • Our patients and their families as active participants in their care.

10 TRANSFORMATIONAL LEADERSHIP TRANSFORMATIONAL LEADERSHIP 11 Nursing’s Strategic Plan The conceptualization of our philosophy is ty resources that can help them address these In March 2019, USA Today published the based on Caritas Process™ 4 Developing and issues before, during, and after pregnancy severe complication rates for all maternity Our Core Purpose Statement: Sustaining a Helping Trusting Caring Relation- and 3) provides group healthcare services for hospitals in 13 states, including Pennsylvania. ship. Relationship includes relationship to self, women during pregnancy (Centering Pregnan- The paper used hospital billing data and the To provide exceptional nursing care that honors relationship with colleagues, relationship with cy®) and to their babies (Centering Parenting®) formula created by the U.S. Centers for the humanity and dignity of each person while patients, and relationship with community. so that women are supported in a way that Disease Control and Prevention to calculate advancing nursing as a profession. overall rates, plus those for African American To allow for caring moments, we need to have increases their caregiving abilities, promotes women and low-income (Medicaid) patients. an authentic presence, seek genuine human personal empowerment, and builds community. Envisioned Future Goal: The median rate of severe complications for connection, listen to hear the story of another, Additionally, we have an epidemiologist on staff the 13 states was 1.4 percent. Pennsylvania’s The Nursing Service Organization will drive the and be present for another. in OB, and we have two outpatient social work- median rate is 1.1 percent. Einstein Medical recognition of Albert Einstein Medical Center ers in both OB and Pediatrics to assist patients Center Philadelphia has the lowest overall se- (AEMC) as the premiere network by being a with insurance, intimate partner violence and vere complication rate of Philadelphia maternity leader in nursing innovation, caring science, Mother Baby Exemplar housing instability, and food insecurity. We are hospitals, 0.5 percent. scholarship, and community integration. The City of Philadelphia is home to some of also part of the Pennsylvania Perinatal Quality the most recognized medical institutions in the Collaborative, focusing on Maternal Mortality, During the time measured by USA Today, Vivid Descriptions: nation, yet its citizens are among the poorest Opioid Use Disorder, and Neonatal Abstinence Einstein Medical Center Philadelphia had • AEMC Nursing will be recognized as and sickest in the state and country. There are Syndrome. AEMC uses Baby Friendly practices 11,162 deliveries. The Philadelphia Inquirer an influential determinant for choice deep pockets of poverty and significant health that help and teach mothers to make informed notes: “Most of Einstein’s maternity patients of care within the community. disparities affecting minority communities. feeding choices, and as members of the Penn are African American or low income, or both, Since 1997, the Philadelphia region has Safe Sleep Collaborative, we provide parents but there is no significant disparity between • The Nursing Service Organization will seen 19 hospitals end maternity services. and caregivers with education on Back to their rates and the overall rate.” Einstein be a major contributor to clinical Philadelphia’s infant mortality rates reflect Sleep. Medical Center Philadelphia’s rate for low- excellence and the financial goals of this crisis course. The infant mortality rate in income mothers is 0.5 percent, and for black Albert Einstein Medical Center Philadelphia of 8.3% is the highest among mothers it is 0.6 percent. • Continuing to use evidence-based large cities and substantially higher than the practices and caring science, AEMC national rate of 5.9%. Philadelphia also has nurses will be trusted leaders in the one of the highest rates of infant deaths from optimal delivery of patient-centered care. unsafe sleeping practices. • Our Nursing Service Organization will As one of the six remaining hospitals providing attract and retain nurses committed to obstetrical care in Philadelphia, Albert Einstein exemplary professional practice and the Medical Center (AEMC) has shouldered the cultivation of the next generation of burden for many of the area’s deliveries. We are nurse leaders. successfully impacting pregnancy and mortality outcomes through a number of initiatives and Nursing’s Philosophy interventions. At Albert Einstein Medical Center, we believe Einstein Medical Center Philadelphia is one of Nursing is both a discipline and a practice three Healthy Start sites in Philadelphia that profession. As a discipline, we have a domain has agreed to form one Community Action of knowledge, which has been developed over Network to work across the city with various time by nursing theorists, leaders, scholars stakeholders to reduce infant mortality. The and professional organizations. As a practice purpose of Healthy Start is to improve preg- profession, we use the theoretical structures of nancy outcomes and reduce infant mortality. this knowledge to inform education, practice Einstein’s Healthy Start program 1) screens and research. pregnant women and non-pregnant women Watson’s Theory of Human Caring is the over- during pre-conception and inter-conception to arching nursing theory that informs the mission, identify psychosocial stressors before, during vision, philosophy and professional practice and after pregnancy, 2) connects those women model for the Nursing Service Organization. with positive screens to services and communi- 12 TRANSFORMATIONAL LEADERSHIP TRANSFORMATIONAL LEADERSHIP 13 National Pressure Ulcer Advisory Panel An Interdisciplinary Approach to Creating the Pressure Injury Prevention Plan 2.0 Incomplete data and lack of standardization of clinical practice and accountability had been contributing factors for static outcomes in our hospital acquired pressure injury (HAPI) rates for years. An interdisciplinary committee co-led by Director of Nursing Quality Lisa Rodzen, DNP, MBA, RN, NEA-BC and Wound Care Nurse Specialist Patricia Hayes, MSN, RN, CWCN, and sponsored by Chief Nurse Executive Gina Marone, MSN, RN, NEA-BC was formed to review current practice and review best practice in the literature. Based upon the committee’s findings, the Pressure Injury Prevention Plan 2.0 was created. The Iowa model was utilized to guide this performance improvement project. HAPI incidence for fiscal year 2019 (July 1, 2018- June 30, 2019) decreased compared to fiscal year 2018, following implementation of the Pressure Injury Prevention 2.0 Plan. Compared to FY2018, the organization achieved a 17.49% organizational reduction in HAPI incidence. The critical care and step down divisions demonstrated a 29.1% and 25.4% decrease in HAPI incidence respective- ly. Additionally, there was a 25.3% reduction in medical device related pressure injuries. The results of this performance improvement project supported the emphasis on a leader- ship-supported, accountability-guided, stan- dardized clinical approach utilizing incidence data to decrease HAPIs in the acute care pop- ulation.

14 TRANSFORMATIONAL LEADERSHIP TRANSFORMATIONAL LEADERSHIP 15 Structural Empowerment

Nurse Residency Program safer environment were discussed. The use of free online “Living with a Spinal Cord Injury” recommended smoke evacuator systems was series is to help individuals and their The Nurse Residency Program at Albert not within the current budget. caregivers learn to not only adapt, but to thrive, Einstein Medical Center provides a robust A multidisciplinary pre- and post-survey was when faced with the daily challenges of living evidence-based curriculum designed to with an SCI. The videos showcase individuals support the newly-graduated nurse in their developed and distributed. The pre-survey was given prior to an informational session with SCI sharing their personal stories and life professional journey from an advanced learner experiences while our own clinicians provide to a competent leader at the bedside. During with facts about surgical smoke and safer smoke practices. A total of 42 surveys education and expertise on how to navigate the 12-month program, Nurse Residents the sometimes scary and complex challenges develop clinical nursing leadership abilities at were completed. In the pre-survey, 69% of participants answered incorrectly when asked that many people face on a daily basis after the point of care through skill lab practicums, sustaining a SCI. critical thinking, prioritization and delegation about OSHA’s standards for surgical smoke exercises. Additionally, they develop a practices. Although many team members knew In April 2019, Moss Elkins Park held a “red knowledge base to support excellence in care surgical smoke was dangerous, they assumed carpet” event to celebrate the release of the delivery and positive patient outcomes. that the institution was compliant with a video series. More than 50 attendees Our renowned simulation center offers Nurse specific standard set by OSHA. celebrated the official release of the videos Residents the opportunity to enhance their Surgical Smoke Safety As a result of this initiative, the team created through our website and social media. technical skills through interactive experience. The Association of periOperative Registered supportive evidence to gain administrative Beth W. Jacobs, RN, CCM, CRRN, MossRehab We also foster inter-professional collabora- Nurses recognizes that surgical smoke is approval to obtain the smoke evacuation Spinal Cord Coordinator worked with a tion and networking through work on evi- unsafe and recommends the use of smoke systems. multidisciplinary committee on 1 North and a dence-based practice projects. Importantly, evacuators. Inhalation of surgical smoke can Desiree Grant, BSN, RN shared her evi- video production company, Imageworks Film Nurse Residents receive the type of mentoring cause hazardous effects equivalent to smok- dence-based practice work “When the smoke & Video, to create the videos with help from a and support that is imperative for successful ing 27-30 cigarettes daily. OSHA reports that clears: A closer look at surgical smoke safety” generous gift from David & Barbara Loeb and personal and professional development. over 500,000 workers are exposed to surgi- at the Association of Operating Room Nurses their family. In 2019, the Commission on cal smoke annually, however OSHA does not Global Surgical Conference and EXPO in Magnet highlighted an exemplar of the series. currently regulate electrosurgical smoke. This Nashville, TN in May 2019. affects the entire surgical team. Recently, OR personnel have linked their newly diagnosed illnesses to environmental hazards of the Oper- SCI Patient Education Video ating Room. Still, many healthcare institutions do not have policies in place that enforce best One of the Spinal Cord Injury (SCI) Unit’s edu- practices. cational videos, “Managing Emotional Health after a Spinal Cord Injury,” was selected in A novice OR nurse with support from manage- May 2019 as the Bronze winner of the presti- ment and an Educator developed an education gious Telly Award in the general-non-broadcast program to inform OR personnel about the health and wellness category. Established in dangers of surgical smoke, encourage safer 1979, The Telly Awards is the premier award electrocautery practices, and promote better honoring video and television across all health for surgical patients and staff. A litera- screens, receiving over 12,000 entries from all ture review was done to investigate the effects 50 states and 5 continents. of surgical smoke. Current practices and meth- ods for reducing harm were also investigated. The Spinal Cord Injury (SCI) Unit at MossRehab Elkins Park created a series of ten education- A meeting was held with the primary investi- al videos for its SCI Patient Education Videos gator, OR Nurse Manager, and OR Director. Project addressing medical, emotional and During the meeting, concerns about creating a social topics of SCI care. The purpose of this

16 STRUCTURAL EMPOWERMENT STRUCTURAL EMPOWERMENT 17 COVID-19 Response that Albert Einstein Medical Center needed to be prepared for an extremely sharp increase In early 2020, our nurses began preparing in patients seeking testing, treatment and for the global pandemic COVID-19 to hit our intensive care. community. Challenges included keeping our nurses safe from this highly infectious disease, As of March 30, 2020, our community is still preventing the potential spread of COVID-19 days away from reaching the peak level of to our other patients, and determining how to coronavirus cases but the excellence in nurs- address the same supply shortages that ing we have demonstrated time and time again healthcare providers across the country and makes our team well-prepared to respond. around the globe were facing. Nursing knew #EinsteinStrong

18 STRUCTURAL EMPOWERMENT STRUCTURAL EMPOWERMENT 19 Certified Nurses *As of March 2020 *As of March 2020 Certified Nurses

Name Certification Name Certification Name Certification Name Certification Griffin, Charlene A. ACNS-BC (Adult Health CNS) Simonis, Melissa CBC (Certified Breastfeeding Counselor) Gerard, Kristen CCRN (Critical Care RN) Slifer, Teresa CCRN (Critical Care RN) Thomas, Elizabeth ACNS-BC (Adult Health CNS) Som, Jenny CBC (Certified Breastfeeding Counselor) Grant, Kathryn CCRN (Critical Care RN) Sliwinski, Aidan CCRN (Critical Care RN) Accordino, Ashley CBC (Certified Breastfeeding Counselor) Stair, Cheyenne CBC (Certified Breastfeeding Counselor) Guendelsberger, Viktoria CCRN (Critical Care RN) Smith, Jaron CCRN (Critical Care RN) Allen, Ayesha CBC (Certified Breastfeeding Counselor) Stokes, Rasheen CBC (Certified Breastfeeding Counselor) Haines, Mary Kate CCRN (Critical Care RN) Smith, Jessica CCRN (Critical Care RN) Banks, Stephanee CBC (Certified Breastfeeding Counselor) Taylor, Latisha CBC (Certified Breastfeeding Counselor) Haney, Eileen CCRN (Critical Care RN) Smith, Kirsten CCRN (Critical Care RN) Bianchi, Liza CBC (Certified Breastfeeding Counselor) Vizza, Denise CBC (Certified Breastfeeding Counselor) Harris, Samira CCRN (Critical Care RN) Stone, Lisa CCRN (Critical Care RN) Bishop, Audrey CBC (Certified Breastfeeding Counselor) West, Ashley CBC (Certified Breastfeeding Counselor) Hayes, Caitlin CCRN (Critical Care RN) Stone, Manuela CCRN (Critical Care RN) Blumenthal, Tara CBC (Certified Breastfeeding Counselor) Williams, Vivie CBC (Certified Breastfeeding Counselor) Jacobson, Carolyn CCRN (Critical Care RN) Thomas, Frances CCRN (Critical Care RN) Bongart, Jacqueline CBC (Certified Breastfeeding Counselor) Wojciechowski, Cheryl CBC (Certified Breastfeeding Counselor) Janse Van Rensburg, CCRN (Critical Care RN) Toczylowski, Jacqueline CCRN (Critical Care RN) Febe Brown, Sarah CBC (Certified Breastfeeding Counselor) Yoh, Kristen CBC (Certified Breastfeeding Counselor) Vanore, Catherine CCRN (Critical Care RN) Johnson, Rebecca CCRN (Critical Care RN) Camacho, Johanna CBC (Certified Breastfeeding Counselor) Zhitnitsky, Rimma CBC (Certified Breastfeeding Counselor) Weber, Mary Ellen CCRN (Critical Care RN) Kennedy, Caitlin CCRN (Critical Care RN) Cameron, Diana CBC (Certified Breastfeeding Counselor) McGrath, Nancy CBN (Certified Bariatric Nurse) Wechter, Kim Marie CCRN (Critical Care RN) Kull, Carol CCRN (Critical Care RN) Capella, Elizabeth CBC (Certified Breastfeeding Counselor) Albertson, Diane CCRN (Critical Care RN) Werner, Nicole CCRN (Critical Care RN) Lahart, Daniel CCRN (Critical Care RN) Colon, Melinda CBC (Certified Breastfeeding Counselor) Axelrod, Anthony CCRN (Critical Care RN) Wexler, Jourdan CCRN (Critical Care RN) Lawal, Erica CCRN (Critical Care RN) Davis, Tonisha CBC (Certified Breastfeeding Counselor) Benjamin-Mlynarczuk, CCRN (Critical Care RN) Weymouth, Joan CCRN (Critical Care RN) Susan Lerch, Ashley CCRN (Critical Care RN) Elliott, Deborah CBC (Certified Breastfeeding Counselor) Williams, Brianna CCRN (Critical Care RN) Bennov, Rachel CCRN (Critical Care RN) Leva, Anita CCRN (Critical Care RN) Fernandez, Loren CBC (Certified Breastfeeding Counselor) Woodruff, Ira CCRN (Critical Care RN) Booth, Gwynne CCRN (Critical Care RN) Losowski, Taylor CCRN (Critical Care RN) Gibson, Patricia CBC (Certified Breastfeeding Counselor) Bartoletti, MaryLynn CCRN-K (Critical Care RN Knowledge Burns, Ava CCRN (Critical Care RN) Luhn, Gregory CCRN (Critical Care RN) Professional) Gonzalez, Sonia CBC (Certified Breastfeeding Counselor) Campbell, Patrick CCRN (Critical Care RN) Markey, Mary CCRN (Critical Care RN) Hopkins-Pepe, Loraine CCRN-K (Critical Care RN Knowledge Johnson, Crystalle CBC (Certified Breastfeeding Counselor) Professional) Cannon, Patty CCRN (Critical Care RN) McKay, Dana CCRN (Critical Care RN) Keller, Lauren CBC (Certified Breastfeeding Counselor) Miller, Sandi CCRN-K (Critical Care RN Knowledge Capili, Glenn CCRN (Critical Care RN) Miller, Teresa CCRN (Critical Care RN) Professional) Kocotis, Erin CBC (Certified Breastfeeding Counselor) Chungag, Kenneth CCRN (Critical Care RN) Molloy, Patricia CCRN (Critical Care RN) Griffin, Charlene A. CCTN (Certified Clinical Transplant Lee, Diana CBC (Certified Breastfeeding Counselor) Nurse) Cleave-Milillo, Carolynn CCRN (Critical Care RN) Molloy, Patrick CCRN (Critical Care RN) Martinez, Bianca CBC (Certified Breastfeeding Counselor) Storbrauck, Rebecca CDE (Certified Diabetes Educator) Collins, Kevin CCRN (Critical Care RN) Murray, Dara CCRN (Critical Care RN) Masterson, Colleen CBC (Certified Breastfeeding Counselor) Abbamondi, Jennifer CEN (Certified Emergency Nurse) Concepcion, Charis CCRN (Critical Care RN) Nesbitt, Latoya CCRN (Critical Care RN) Mattioli, Maria CBC (Certified Breastfeeding Counselor) Banberger, Raelynne CEN (Certified Emergency Nurse) Conley, Amanda CCRN (Critical Care RN) Olyansky, Gregory CCRN (Critical Care RN) McCrumn, Faye CBC (Certified Breastfeeding Counselor) Belmont, Charles CEN (Certified Emergency Nurse) Cunningham, Patrick CCRN (Critical Care RN) Ouch, Sundaly CCRN (Critical Care RN) McLaughlin, Kerrianne CBC (Certified Breastfeeding Counselor) Blackwell, Rhunette CEN (Certified Emergency Nurse) Curley, Stacy CCRN (Critical Care RN) Pasos, Jennifer CCRN (Critical Care RN) Miller, Amy CBC (Certified Breastfeeding Counselor) Brown-Young, Erica CEN (Certified Emergency Nurse) Delaney, Christopher CCRN (Critical Care RN) Patel, Kaval CCRN (Critical Care RN) Nuñez, Priscilla CBC (Certified Breastfeeding Counselor) Cleary, Carla CEN (Certified Emergency Nurse) Dikon, Colleen CCRN (Critical Care RN) Poindijour, Myriam CCRN (Critical Care RN) Nyce, Phyllis CBC (Certified Breastfeeding Counselor) Crowe, Erin CEN (Certified Emergency Nurse) Dinkins, Aleta CCRN (Critical Care RN) Powroznik, Marie CCRN (Critical Care RN) Obermeier, Megan CBC (Certified Breastfeeding Counselor) Difranco, Theresa CEN (Certified Emergency Nurse) Dogan, Jesse CCRN (Critical Care RN) Rabena, Chelsea CCRN (Critical Care RN) O’Gara, Irene CBC (Certified Breastfeeding Counselor) Eubanks, Keenya CEN (Certified Emergency Nurse) Donnelly, Chad CCRN (Critical Care RN) Rosenberg, Melissa CCRN (Critical Care RN) O’Neill, Sarah CBC (Certified Breastfeeding Counselor) Filemyr, Katherine CEN (Certified Emergency Nurse) Donohue, Erin CCRN (Critical Care RN) Sample, Laurell CCRN (Critical Care RN) Patel, Sonali CBC (Certified Breastfeeding Counselor) Fortuna, Giovanna CEN (Certified Emergency Nurse) Egan, Brendan CCRN (Critical Care RN) Sanou, Hakeem CCRN (Critical Care RN) Portman-Stenson, April CBC (Certified Breastfeeding Counselor) Gilmore, Kristen CEN (Certified Emergency Nurse) Field, Evan CCRN (Critical Care RN) Sciarrone, Jessica CCRN (Critical Care RN)

20 STRUCTURAL EMPOWERMENT STRUCTURAL EMPOWERMENT 21 Certified Nurses *As of March 2020 *As of March 2020 Certified Nurses

Name Certification Name Certification Name Certification Name Certification Harmon, Marilyn CEN (Certified Emergency Nurse) Stone, Lisa CMC (Cardiac Medicine Certification) O’Hagan, Patricia CMSRN (Certified Medical-Surgical RN) Shepherd, Barbara CNOR (Certified Nurse Operating Room) Hurwitz, Beth CEN (Certified Emergency Nurse) Alex, Soumya CMSRN (Certified Medical-Surgical RN) Payne, Bethany CMSRN (Certified Medical-Surgical RN) Smith, Cheryl CNOR (Certified Nurse Operating Room) Iezzi, Rebecca CEN (Certified Emergency Nurse) Armstrong, Nancy CMSRN (Certified Medical-Surgical RN) Pecoraro, Nicole CMSRN (Certified Medical-Surgical RN) Stefano, Jo-Ann CNOR (Certified Nurse Operating Room) Kelly, Kathleen CEN (Certified Emergency Nurse) Austin, Tonya CMSRN (Certified Medical-Surgical RN) Randolph, Chevelle CMSRN (Certified Medical-Surgical RN) Yerkes, Annette CNOR (Certified Nurse Operating Room) Kelly, Kristy CEN (Certified Emergency Nurse) Braga, Michelle CMSRN (Certified Medical-Surgical RN) Randolph, Chevelle CMSRN (Certified Medical-Surgical RN) Young, Mina-Kathlen CNOR (Certified Nurse Operating Room) King, Jacquline CEN (Certified Emergency Nurse) Brennen-Jacoby, Rose- CMSRN (Certified Medical-Surgical RN) Reyes, Petagaye CMSRN (Certified Medical-Surgical RN) Zoolalian, Linda CNOR (Certified Nurse Operating Room) ann Kristan, Julia CEN (Certified Emergency Nurse) Richardson, Abigail CMSRN (Certified Medical-Surgical RN) McGrath, Nancy CPAN (Certified Post Anesthesia Nurse) Conners, Allison CMSRN (Certified Medical-Surgical RN) Lawson, Margaret CEN (Certified Emergency Nurse) Saji, Mini CMSRN (Certified Medical-Surgical RN) Newns, Diane CPAN (Certified Post Anesthesia Nurse) Conwell, Tania CMSRN (Certified Medical-Surgical RN) Maher, Kimberly CEN (Certified Emergency Nurse) Salazar, Eunice CMSRN (Certified Medical-Surgical RN) Wells, Elizabeth CPHQ (Certified Professional in Health- Cunningham, Elizabeth CMSRN (Certified Medical-Surgical RN) care Quality) Marvelous, Jennifer CEN (Certified Emergency Nurse) Sandford, Matthew CMSRN (Certified Medical-Surgical RN) Daley, Stepheney CMSRN (Certified Medical-Surgical RN) Gaynor, Cyrstal CPN (Certified Pediatric Nurse) McDonald, Krista CEN (Certified Emergency Nurse) Santos, Ruby CMSRN (Certified Medical-Surgical RN) D’Antonio, Colleen CMSRN (Certified Medical-Surgical RN) Gillard, Colleen CPN (Certified Pediatric Nurse) Michener, Barbara CEN (Certified Emergency Nurse) Schwoebel, Marguerite CMSRN (Certified Medical-Surgical RN) Elefante, Glenda CMSRN (Certified Medical-Surgical RN) Burke-Markley, Christine CPPS (Certified Professional in Patient Miller,, Monica CEN (Certified Emergency Nurse) Simmons, Santina CMSRN (Certified Medical-Surgical RN) Safety) Flint, Adrienne CMSRN (Certified Medical-Surgical RN) Misuro, Sarah CEN (Certified Emergency Nurse) Simoes, Ines CMSRN (Certified Medical-Surgical RN) Atkinson, Cynthia CRRN (Certified Rehabilitation RN) Grant, Carolyn CMSRN (Certified Medical-Surgical RN) Moody, Erin CEN (Certified Emergency Nurse) Smith, June CMSRN (Certified Medical-Surgical RN) Barainyak, Lindsay CRRN (Certified Rehabilitation RN) Hollerbach, Priscilla CMSRN (Certified Medical-Surgical RN) Regan, Stephanie CEN (Certified Emergency Nurse) Sweet, Jamie CMSRN (Certified Medical-Surgical RN) Bartos, Kathleen CRRN (Certified Rehabilitation RN) James, Mary Beth CMSRN (Certified Medical-Surgical RN) Renfroe, Cassie CEN (Certified Emergency Nurse) Uzdevenes, Terri L. CMSRN (Certified Medical-Surgical RN) Bethel, Lisa CRRN (Certified Rehabilitation RN) James, Simi CMSRN (Certified Medical-Surgical RN) Rossmair, Mark CEN (Certified Emergency Nurse) Valentine-Charles, Rey- CMSRN (Certified Medical-Surgical RN) Bongart, Nicole CRRN (Certified Rehabilitation RN) Joby, Vineetha CMSRN (Certified Medical-Surgical RN) nalese Ryan, Jill CEN (Certified Emergency Nurse) Carpenter, Michael CRRN (Certified Rehabilitation RN) John, Princes CMSRN (Certified Medical-Surgical RN) Zanine-Gauss, Denise CMSRN (Certified Medical-Surgical RN) Samuelson, Miriam CEN (Certified Emergency Nurse) Cline, Evelyn CRRN (Certified Rehabilitation RN) Johnson, Elizabeth CMSRN (Certified Medical-Surgical RN) Simon, Holly CNL (Clinical Nurse Leader) Scerrone, Deborah CEN (Certified Emergency Nurse) Colcher, Melanie CRRN (Certified Rehabilitation RN) Joo, Min CMSRN (Certified Medical-Surgical RN) Hudson, William CNML (Certified Nurse Manager and Smith, Ellen CEN (Certified Emergency Nurse) Leader) Cortez, Nicole CRRN (Certified Rehabilitation RN) Joyce, Kelly CMSRN (Certified Medical-Surgical RN) Snyder, Susan CEN (Certified Emergency Nurse) Quirong-Jones, Nida CNN (Certified Nephrology Nurse) Danko, Janina CRRN (Certified Rehabilitation RN) Julius, Tisa CMSRN (Certified Medical-Surgical RN) Spoerl, Gene CEN (Certified Emergency Nurse) Alessandroni, Stephen CNOR (Certified Nurse Operating Room) Dietz, Lindsay CRRN (Certified Rehabilitation RN) Kelly, Donna CMSRN (Certified Medical-Surgical RN) Swierczynski, Kerry CEN (Certified Emergency Nurse) Baker, Theresa CNOR (Certified Nurse Operating Room) Eckert, Sherri CRRN (Certified Rehabilitation RN) Longmore,Kristen CMSRN (Certified Medical-Surgical RN) Tailor, Marlynn CEN (Certified Emergency Nurse) Chavez, David CNOR (Certified Nurse Operating Room) Florkowski, Timothea CRRN (Certified Rehabilitation RN) Luu, Chau CMSRN (Certified Medical-Surgical RN) Tillery, Maya CEN (Certified Emergency Nurse) Gonzalez, Evelyn CNOR (Certified Nurse Operating Room) Foley, Kathryn CRRN (Certified Rehabilitation RN) Mangoni, Evelyn CMSRN (Certified Medical-Surgical RN) Trojecki, Theresa CEN (Certified Emergency Nurse) Kondrack (Pomian), CNOR (Certified Nurse Operating Room) Forrest, Michelle CRRN (Certified Rehabilitation RN) Mathew, Sherine CMSRN (Certified Medical-Surgical RN) Christine Wagner, Tiffany CEN (Certified Emergency Nurse) Gallagher, Florence CRRN (Certified Rehabilitation RN) Matthews, Catherine CMSRN (Certified Medical-Surgical RN) Lash, Rebecca CNOR (Certified Nurse Operating Room) Welch, Daniel CEN (Certified Emergency Nurse) George, Elis CRRN (Certified Rehabilitation RN) McCarron, Dana CMSRN (Certified Medical-Surgical RN) Levin, Robert CNOR (Certified Nurse Operating Room) Welch, Daniel CEN (Certified Emergency Nurse) Gogna, Parvesh CRRN (Certified Rehabilitation RN) McCloskey, Kelly Ann CMSRN (Certified Medical-Surgical RN) Metzger, Terese CNOR (Certified Nurse Operating Room) Weniger, Kelly CEN (Certified Emergency Nurse) Goodman, Shari CRRN (Certified Rehabilitation RN) McDonnel, Loretta CMSRN (Certified Medical-Surgical RN) Nicholson, Simone CNOR (Certified Nurse Operating Room) Wright, Mary CEN (Certified Emergency Nurse) Gutierrez, Maria CRRN (Certified Rehabilitation RN) Miley, Stephanie CMSRN (Certified Medical-Surgical RN) Phelts, Stella CNOR (Certified Nurse Operating Room) Dougherty, Jane CLC (Certified Lactation Consultant) Ha, Jeong CRRN (Certified Rehabilitation RN) Morse, Jessica CMSRN (Certified Medical-Surgical RN) Samuel, Sheejamol CNOR (Certified Nurse Operating Room) Gervasoni, Pamela CLC (Certified Lactation Consultant) Hart, Kara CRRN (Certified Rehabilitation RN) Mulinga, Koki CMSRN (Certified Medical-Surgical RN) Schwartz, Karen CNOR (Certified Nurse Operating Room) Benjamin-Mlynarczuk, CMC (Cardiac Medicine Certification) Hicks, Lorraine CRRN (Certified Rehabilitation RN) Susan Nana, Safira CMSRN (Certified Medical-Surgical RN) Sebastian, Sherly CNOR (Certified Nurse Operating Room)

22 STRUCTURAL EMPOWERMENT STRUCTURAL EMPOWERMENT 23 Certified Nurses *As of March 2020 *As of March 2020 Certified Nurses

Name Certification Name Certification Name Certification Name Certification Irlich, Eileen CRRN (Certified Rehabilitation RN) Schultz, Maureen CRRN (Certified Rehabilitation RN) Benjamin-Mlynarczuk, NPD-BC (Nursing Professional Develop- Gulla, Susan RN-BC (Medical-Surgical Nursing) Susan ment) Jacob, Teny CRRN (Certified Rehabilitation RN) Shleyfer, Marina CRRN (Certified Rehabilitation RN) Johnson, Shelley RN-BC (Medical-Surgical Nursing) Hopkins-Pepe, Loraine NPD-BC (Nursing Professional Develop- Janda, Megan CRRN (Certified Rehabilitation RN) Sincavage, Lisa CRRN (Certified Rehabilitation RN) ment) Kwasnjuk, Jeanne RN-BC (Medical-Surgical Nursing) Jandrisevits, Jaclyn CRRN (Certified Rehabilitation RN) Slook, Andrea CRRN (Certified Rehabilitation RN) Hannon, Mary OCN (Oncology Certified Nurse) Lawlor, Kathy RN-BC (Medical-Surgical Nursing) Juritsch. Deborah CRRN (Certified Rehabilitation RN) Stone, Patrice CRRN (Certified Rehabilitation RN) McLaughlin, Christine OCN (Oncology Certified Nurse) Mouzon, Naja Renee RN-BC (Medical-Surgical Nursing) Kling, Karyn CRRN (Certified Rehabilitation RN) Suong, Aurore CRRN (Certified Rehabilitation RN) O’Brien, Margaret OCN (Oncology Certified Nurse) Walker, Ka’deidra RN-BC (Medical-Surgical Nursing) Kuriakose, Rinju CRRN (Certified Rehabilitation RN) Taylor, Carol CRRN (Certified Rehabilitation RN) Simoes, Ines OCN (Oncology Certified Nurse) Young, Deborah RN-BC (Medical-Surgical Nursing) Langley, Shelly CRRN (Certified Rehabilitation RN) Troy, Andrea CRRN (Certified Rehabilitation RN) Arocena, Mary Lou PCCN (Progressive Care Certified Nurse) Tate, Beverly RN-BC (Psychiatric-Mental Health Nursing) Lynch, Joann CRRN (Certified Rehabilitation RN) Valentin, Juan CRRN (Certified Rehabilitation RN) Benny, Raji PCCN (Progressive Care Certified Nurse) Williams, Angelia RN-BC (Psychiatric-Mental Health Magat, Percival CRRN (Certified Rehabilitation RN) Wible, Elaine CRRN (Certified Rehabilitation RN) Bish, Catherine PCCN (Progressive Care Certified Nurse) Nursing) Magee, Lisa CRRN (Certified Rehabilitation RN) Hayes, Patricia CWCN (Certified Wound Care Nurse) Difranco, Theresa PCCN (Progressive Care Certified Nurse) Zheng, Hanling Wang RN-BC (Psychiatric-Mental Health Nursing) Malgapo, Gertrude CRRN (Certified Rehabilitation RN) Rudolph, Shane CWCN (Certified Wound Care Nurse) Ehnow, Christine PCCN (Progressive Care Certified Nurse) Brill, Theresa RNC-OB (Inpatient Obstetric Nurse) McStravock, Colleen CRRN (Certified Rehabilitation RN) Crocker, Patricia MNN (Maternal Newborn Nurse) Fairchild, Deborah PCCN (Progressive Care Certified Nurse) Byrd-Jerry, Kimberly RNC-OB (Inpatient Obstetric Nurse) Mohammed, Kareema CRRN (Certified Rehabilitation RN) Joseph, Philomina MNN (Maternal Newborn Nurse) Famawa, Thomas PCCN (Progressive Care Certified Nurse) Gilliam, Annitia RNC-OB (Inpatient Obstetric Nurse) Montford, Frances CRRN (Certified Rehabilitation RN) Lodise, Jane MNN (Maternal Newborn Nurse) Gereaghty, Patricia PCCN (Progressive Care Certified Nurse) Henderickson, Danielle RNC-OB (Inpatient Obstetric Nurse) Njoku-Anderson, Julie CRRN (Certified Rehabilitation RN) Watt-Cyrus, Charissa MNN (Maternal Newborn Nurse) Graf, Natalie PCCN (Progressive Care Certified Nurse) Horner, Karen RNC-OB (Inpatient Obstetric Nurse) Norton, Robert CRRN (Certified Rehabilitation RN) Faust, Judith NEA-BC (Nurse Executive, Advanced) Javardian, Maria PCCN (Progressive Care Certified Nurse) Joseph, Sherrie RNC-OB (Inpatient Obstetric Nurse) Novick, Stephan CRRN (Certified Rehabilitation RN) Marone, Gina NEA-BC (Nurse Executive, Advanced) Koshy, Maneejo PCCN (Progressive Care Certified Nurse) Juliani, Patrice RNC-OB (Inpatient Obstetric Nurse) O’Connell, Doreen CRRN (Certified Rehabilitation RN) Pollock, Marilyn NEA-BC (Nurse Executive, Advanced) Lombardi-Snyder, Cath- PCCN (Progressive Care Certified Nurse) erine Lark, Cheryl RNC-OB (Inpatient Obstetric Nurse) O’Connor, Shannon CRRN (Certified Rehabilitation RN) Rodzen, Lisa NEA-BC (Nurse Executive, Advanced) McCollum, Mary Ellen PCCN (Progressive Care Certified Nurse) Mather, Patsy RNC-OB (Inpatient Obstetric Nurse) Odom, Tiffany CRRN (Certified Rehabilitation RN) Tomlinson, Lisa NEA-BC (Nurse Executive, Advanced) Richardson, Clifton PCCN (Progressive Care Certified Nurse) Ramos, Linsay RNC-OB (Inpatient Obstetric Nurse) Palmer, Michele CRRN (Certified Rehabilitation RN) Eckenrode, Michael NE-BC (Nurse Executive) Sayen, Catelin PCCN (Progressive Care Certified Nurse) Rice, Joyce RNC-OB (Inpatient Obstetric Nurse) Pedicone, Marianne CRRN (Certified Rehabilitation RN) Jackson, Theresa NE-BC (Nurse Executive) Voshchilo, Irina PCCN (Progressive Care Certified Nurse) Shields, Dana RNC-OB (Inpatient Obstetric Nurse) Pina, Jillian CRRN (Certified Rehabilitation RN) McCulley, Susan NE-BC (Nurse Executive) Williamson, Muibat PCCN (Progressive Care Certified Nurse) Trautz, Bridget RNC-OB (Inpatient Obstetric Nurse) Pinder, Lisa CRRN (Certified Rehabilitation RN) Seminara, Margaret NE-BC (Nurse Executive) Xi, Xiaoping PCCN (Progressive Care Certified Nurse) Valentin, Alicia RNC-OB (Inpatient Obstetric Nurse) Powell, Theresa CRRN (Certified Rehabilitation RN) Ball, Elaine NIC (Neonatal Intensive Care Nurse) Wittman, Marianne PCCN-K (Progressive Care Certified West, Melinda RNC-OB (Inpatient Obstetric Nurse) Purathoottu, Noby CRRN (Certified Rehabilitation RN) Castillo. Carla NIC (Neonatal Intensive Care Nurse) Nurse Knowledge Professional) Difranco, Theresa SCRN (Stroke Certified RN) Puthran, Sandhya CRRN (Certified Rehabilitation RN) Cody, Lisa NIC (Neonatal Intensive Care Nurse) Kwak-Ko, Grace RN-BC (Cardiac-Vascular Nursing) Hushen, Patricia SCRN (Stroke Certified RN) Rathappillil, Tinu CRRN (Certified Rehabilitation RN) Donahue, Eileen NIC (Neonatal Intensive Care Nurse) McBrien, Dorothy RN-BC (Cardiac-Vascular Nursing) Palacios, Sarah SCRN (Stroke Certified RN) Rigous, Rachelle CRRN (Certified Rehabilitation RN) Feldstein, Mary Ann NIC (Neonatal Intensive Care Nurse) Meldrum, Bryan RN-BC (Cardiac-Vascular Nursing) Gilmore, Kristen TCRN (Trauma Certified Registered Rivera, Maria CRRN (Certified Rehabilitation RN) Hagerty, Philomena NIC (Neonatal Intensive Care Nurse) Ross, Jana RN-BC (Cardiac-Vascular Nursing) Nurse) Roadcap, Lori CRRN (Certified Rehabilitation RN) Hartley, Christine NIC (Neonatal Intensive Care Nurse) Tomlinson, Lisa RN-BC (Cardiac-Vascular Nursing) Markey, Mary TCRN (Trauma Certified Registered Nurse) Roberts, Adamma CRRN (Certified Rehabilitation RN) Malloy, Mary Ann NIC (Neonatal Intensive Care Nurse) Cuevas, Yamile RN-BC (Medical-Surgical Nursing) Reeves, Turena VA-BC (Vascular Access Certification) Rotz, Kathleen CRRN (Certified Rehabilitation RN) McCabe-Menefee, Jerri NIC (Neonatal Intensive Care Nurse) Dolan, Christine RN-BC (Medical-Surgical Nursing) Magat, Percival WCC (Wound Care Certified) Scarpitti, Danielle CRRN (Certified Rehabilitation RN) McGinnis, Maureen NIC (Neonatal Intensive Care Nurse) Eluwa, Susan RN-BC (Medical-Surgical Nursing) Sieruc, Barbara WCC (Wound Care Certified) Schmidheiser, Lisa CRRN (Certified Rehabilitation RN) Sauer, Sharon NIC (Neonatal Intensive Care Nurse) Farber, Cheryl RN-BC (Medical-Surgical Nursing)

24 STRUCTURAL EMPOWERMENT STRUCTURAL EMPOWERMENT 25 Nursing Recognition & Awards SPU - EMCP - Caring Spirit Team Award

Rehab Shared Governance Leadership Award Juan Valentin, BSN, RN, CRRN - 2TIPS Maryann Malloy, MSN, RNC-NIC Dian Wint, CNA - MossRehab Lindsay Barainyak, BSN, RN, CRRN - 3rd Fl Nursing Prism Award CRU Acute Care Rehab Teams at EMCP & EMCEP Lisa Magee, RN, CRRN - MossRehab Bucks 2 TIPS Evening CNAs - 2TIPS - Caring Spirit Team Award Nursing Community Service Award 2019 Caring Spirit Awards Subacute/LTC Willowcrest Cluster Emergency Critical Care Courtney Hunt, BSN, RN - Willowcrest Lynne Garlotta, RN - ED EMCEP Susan Ackiewicz, MSN, RN - NSU Alaina Leslie, LPN - Willowcrest V. Hawkins Sellers RN Excellence Inspiration Kim Kane Schmid, BSN, RN - ED EMCEP Michael Su, RN - Levy 4 Aparna Roney, CNA - Willowcrest Award Lucy King, Environmental Services Melissa Frazier, PCA - SSU Marquita Corbin-Lane, HUC - Willowcrest Percival Magat, BSN, RN, CRRN, WCC Ruby McCafferty, HUC - ED EMCP Jessica Sciarrone, BSN, RN - SICU - T. Campbell Caring Spirit Award Women and Children’s Cluster Deborah Hodgdon, MSN, RN - ED EMCP - M. Smith-Catanzaro Caring Spirit Award Surgical ICU Staff - Caring Spirit Team Award Miranda Lorman, BSN, RN - Labor and Delivery Angel Acevedo, BSN, RN - NICU Surgical Services Heart and Vascular Terri Jasner, BSN, RN - Lifter 3/4 Maureen Aitken, BSN, RN – PACU EMCEP Kristen Gerard, BSN, RN - CCU Annitia Gilliam, RN & Katrina Dunlap, OBT - Santashe McGough, ASN, RN - GI Suite Lilibeth Witner, BSN, RN - CCU Labor and Delivery - Caring Spirit Team Award Margaret Dennison, HUC - PACU Minh Nguyen, BSN, RN - Telemetry Cynthia Porchea Craig, BSN, RN - Labor and Denise Zanine-Gauss, RN, CMSRN - SPU Cody Falatko, RN - Telemetry Delivery - M. Webb Caring Spirit Award Tyra Tucker Davis, BSN, RN - Telemetry - J. Joseph Caring Spirit Award Behavioral Health Tim Robbins, BSN, RN & Carrie Malaczwski, Shinzy Mathew, BSN, RN - Levy 9 BSN, RN - VAD - Caring Spirit Team Award Karimah Armstrong, BHA - Tower 7 Medical/Surgical Hanling Zheng, BSN, RN - Tower 7 Catherine Matthews, RN - Levy 7 Charles Leach, BHA - Crisis Response Center Karen Martin, PCA - Tower 4 Wanda Darby-Jones, RN, Kia Durham, RN, Dan Mooney, RN, Reena Raju, RN, Denise Richard- Michelle Braga, RN - 5th floor son, RN - LTSR - Caring Spirit Team Award Danielle Robinson, RN - Tower 6

26 STRUCTURAL EMPOWERMENT STRUCTURAL EMPOWERMENT 27 Nicole Pecoraro, BSN, RN, CMSRN and Dee Morrison, Maryann Malloy, MSN, RNC-NIC, NEA-BC and Sharon Sharon Sauer, MSN, RNC-NIC, Maryann Malloy, MSN, Nursing Achievements MSN, RN, ACNS-BC presented their work Hemodialysis Sauer, MSN, RNC-NIC of Neonatal Intensive Care Unit RNC-NIC, NEA-BC and Agnes Salvador, MD were se- Professional Organizations Central Venous Catheters: Increase Surveillance, Speak presented their research study outcomes Comparison lected to give their poster presentation Antibiotic Stew- Up! at the National Association of Clinical Nurse Special- of Traditional Finnegan Neonatal Abstinence Scoring ardship in the NICU at the Eastern Society of Pediatric Susan McCulley, MSN, RN, NE-BC was elected as a ists Conference in Orlando, FL in March 2019. Tool (FNAST) with the Maternal Opioid Treatment Human Research in Philadelphia, PA in March 2020. member at large to the 2019/2020 Board of the South- Experimental Research (MOTHER) NAS Scale at the eastern Pennsylvania Organization of Nurse Leaders Sharon Sauer, BSN, RNC-NIC, Maryann Malloy, MSN, Academy of Neonatal Nursing Conference in Orlando, FL Beth Hurwitz, MSN, AGCNS-BC, CEN was selected to (SEPONL). RNC-NIC, NEA-BC, Dorothy Wyatt, Ph.D. NNP-BC, in September 2019. give her poster presentation Content Validation for ED Nazli Kuter, MD & Agnes Salvador, MD FAAP gave a Falls Tool at the National Association of Clinical Nurse Loraine Hopkins Pepe, PhD, RN, NPD-BC, CCRN-K poster presentation Comparison of traditional Finnegan Carla Cleary, MSN, RN, CEN, Clinical Educator, Specialists in Indianapolis, IN in March 2020. has been elected into the Fellowship of The College of Neonatal Abstinence Scoring Tool (FNAST) with the Ma- Emergency Department presented Increasing Sepsis Physicians of Philadelphia. Dr. Hopkins Pepe will be ternal Opioid Treatment Human Experimental Research Bundle Compliance with the Use of a Sepsis Bedside Beth Hurwitz, MSN, AGCNS-BC, CEN and Raelynne formally inducted into the Fellowship in either May or (MOTHER) NAS Scale at the 2019 Eastern Society for Tool in the Emergency Room Setting at the Emergency Bamberger, BSN, RN, CEN were selected to give their November of 2020. The College of Physicians provides Pediatric Research Scientific meeting in Philadelphia, PA Nursing 2019 Conference in Austin, TX in September- poster presentation Trauma Documentation PI Process at various programs and lectures, including current topics in March 2019. October 2019. the New Jersey Emergency Nurses Association Confer- in medicine, the biomedical sciences, and general public ence in March 2020. health issues. Sharon Sauer, BSN, RNC-NIC, Maryann Malloy, MSN, Maryann Malloy, MSN, RN, NEA-BC and Sharon RNC-NIC, NEA-BC, Dorothy Wyatt, Ph.D. NNP-BC, Sauer, RNC-NIC, BSN presented their poster Nurse Residents Rachel Garraway, BSN, RN and Nazli Kuter, MD & Agnes Salvador, MD FAAP gave a Implementing Best Practices to Advance the Care of Brittany Pembleton, BSN, RN had their poster Use of Publications poster presentation Comparison of Traditional Finnegan Infants with Neonatal Abstinence Syndrome at the 24th Calibrated Under-Buttocks Drapes to Improve Estimation Neonatal Abstinence Scoring Tool (FNAST) with the Ma- International Caritas Consortium in San Francisco, CA of Postpartum Blood Loss in Vaginal Deliveries accept- Loraine Hopkins Pepe, PhD, RN, NPD-BC, CCRN-K, ternal Opioid Treatment Human Experimental Research in October 2019. ed to the 2020 Vizient/AACN Nurse Residency Program Director of Nursing Education and Professional Devel- (MOTHER) NAS Scale at the Pediatric Academic Societ- Annual Conference in New Orleans, LA in March 2020 opment and Gerry Altmiller, EdD, APRN, ACNS-BC, ies 2019 conference in Baltimore, MD in April 2019. Elaine Flynn, MSN, RN, CRRN, Tricia Golbitz, MSN, FAAN, Faculty Consultant had their manuscript Why RN, and Lisa Pinder, BSN, RN, CRRN presented their Raelynne Rowlett, BSN, RN, CEN and Beth Hurwitz, Quality and Safety Education for Nurses (QSEN) Matters Desiree Grant, BSN, RN shared her evidence-based poster Challenge Accepted: TBI Unit’s Response to Hos- MSN, AGCNS-BC, CEN had an abstract accepted for in Practice published as the editorial in the Journal of practice work When the smoke clears: A Closer Look at pital-Associated CAUTI’s at the Association of Rehabil- a CE poster presentation Evaluation of Trauma Docu- Continuing Education in Nursing in May 2019. Surgical Smoke Safety at the 2019 Association of Op- itation Nurses REACH Conference in Columbus, OH in mentation using Peer Review Process at the Society of erating Room Nurses Global Surgical Conference and November 2019. Trauma Nurses (STN) 2020 Annual Conference in Atlanta, EXPO in Nashville, TN in April 2019. GA in April 2020. Podium Presentations Flo Gallagher, MSN, RN, CRRN, Lisa Magee, RN, Simone Nicholson, MSN, RN, BSN, RN, CNOR, OR CRRN and Lisa Pinder, BSN, RN, CRRN presented their Parese Fasciocco, BSN, RN, CWON, Patricia Hayes, Loraine Hopkins Pepe, PhD, RN, NPD-BC, CCRN-K, MSN, RN, CWCN and Lisa Rodzen, DNP, MBA, RN, Director of Nursing Education and Professional Devel- Nurse Manager and Barb Shepherd, DNP, MSN, RN, poster Inpatient Care Collaboration: Keep it Simple by CNOR, GI Suite Nurse Manager presented their poster Standardizing at the 2019 Association of Rehabilitation NEA-BC had an abstract selected for a CE poster opment gave a podium presentation A Feasibility Study presentation Taking a Deep Dive into Standardizing of a QSEN-based Orientation Program for Newly Hired Standardization of Endoscopic Cleaning Procedures: A Nurses REACH Conference in Columbus, OH in Novem- quality improvement project at the 2019 Association of ber 2019. Pressure Injury Processes at the Wound, Ostomy and Registered Nurses at the 2019 QSEN International Forum Continence Nursing (WOCN) Annual Conference in in Cleveland, OH in May 2019. Operating Room Nurses Global Surgical Conference and EXPO in Nashville, TN in April 2019. Maryann Malloy, MSN, RN, NEA-BC and Sharon Cleveland, OH in June 2020. Agnes Salvador, MD, Manuel Peregrino, MD, David Sauer, RNC-NIC, BSN presented their poster Robert Haney, BSN, RN, CAPA, Rob Levin, MSN, RN, Implementing Best Practices to Advance the Care of Donna Moser, BSN, CHFN, Charlene Choate, MSW, Schutzman, MD, Gail Cameron, MD, Michael Janeczko, Tim Robbins, BSN, and Behnam Bozorgnia, MD had MD, Maryann Malloy, MSN, RNC-NIC, NEA-BC, Uvaraj RRT, CNOR and Maureen McClellan, RN presented Infants with Neonatal Abstinence Syndrome, which was their poster OR Shared Governance Helps Eliminate awarded 3rd place, at the EBP & Research Symposium their work Reducing Heart Failure Readmissions Utilizing Periasamy, Dorothy Wyatt, NNP, DNP, and Kathleen ReDS™ Technology accepted for a poster presentation Lechowicz, PA were selected to give a podium presen- Cleaning of Foley Bags Post Discharge Nationwide at in Hunt Valley, MD in November 2019. the 2019 Association of Operating Room Nurses Global at the American Association of Heart Failure Nurse’s tation Impact of Apnea Countdown on Premature Infants’ Safiya Hosein, MD,Priscilla Nuñez, MSN, RN, MPH, (AAHFN) National Conference in Boston in June 2020. Length of Stay at the Eastern Society of Pediatric Re- Surgical Conference and EXPO in Nashville, TN in April 2019. CBC, Clinical Educator in Women and Children’s Ser- The abstract will also be included in their professional search in Philadelphia, PA in March 2020. vices, Andrew Paoletti, MS, Kate Stampler, DO, and magazine “Heart and Lung”. Gerry Altmiller, EdD, APRN, ACNS-BC, ANEF, FAAN Robert Haney BSN, RN, CAPA presented The B-Link Elizabeth Gurney, MD had a poster presentation on an had an abstract accepted for a podium presentation System: A British Best Practice Becomes a Nursing-Led interdisciplinary education initiative related to contracep- Working with Multi-generational Teams: Unlocking Agen- Innovative Program in the United States at the American tion and breastfeeding that was accepted at the 2020 cy at the 2020 ANCC National Magnet Conference in Society of PeriAnesthesia Nurses conference in Nash- CREOG and APGO Annual Meeting in Orlando, FL in Atlanta, GA in October 2020. ville, TN in May 2019. February 2020. Maryann Malloy, MSN, RNC-NIC, NEA-BC, and Lisa Rodzen, DNP, RN, MBA, NEA-BC, Patricia Hayes, Sharon Sauer, BSN, RNC-NIC of Neonatal Intensive MSN, RN, CWCN, Parese Fasciocco, BSN, RN, CWON Poster Presentations Care Unit presented Implementing Best Practices to Ad- and Gina Marone, MSN, RN, NEA-BC had a poster Lisa Rodzen, DNP, MBA, RN, NEA-BC and Gina Ma- vance the Care of Infants with Neonatal Abstinence Syn- An Interdisciplinary Approach to Creating the Pressure rone, MSN, RN, NEA-BC presented a poster Medical drome at the International Association of Human Caring Injury Prevention Plan 2.0 accepted and presented at the Device Related Pressure Injuries: Incidence Data Enables (IAHC) 40th Annual Conference at Clemson University National Pressure Injury Advisory Panel (NPIAP) 2020 Prevention at National Pressure Ulcer Advisory Panel Greenville, SC in May-June 2019. Annual Conference in Houston, TX in February 2020. (NPUAP) in St. Louis, MO in March 2019. 28 STRUCTURAL EMPOWERMENT STRUCTURAL EMPOWERMENT 29 Dr. Joyce M. Black Presentation Emergency Nurses Association (ENA) Lantern Award, which will be selected by early June Gina Marone, MSN, NEA-BC, RN, Vice Pres- 2020. ident and Chief Nurse Executive welcomed Joyce M. Black, PhDm RN, FAAN in January Grants 2019 in Gouley Auditorium where 120 Einstein nurses and clinical partners gathered to listen to Gina Marone, MSN, RN, NEA-BC, VP & Chief Pressure Injury in Vulnerable Patients: Evidence Nurse Executive is the project leader for for Prevention. Dr. Black an expert well-known an innovative program Bridging the Gap in for her work with the National Pressure Ulcer Providing Intimate Partner Violence Services Advisory Panel on staging wounds and deep that was awarded an Einstein Society Innovative tissue injury is a member of the American Program Grant. Academy of Nursing. Dr. Black’s presentation Amina Harris, MSN, MBA, RN, Director of spanned prevention; documentation, staging, Nursing, Willowcrest is a project team member culture, and health and economics. for the Willowcrest Transitional Suite innovative program that was recently awarded an Einstein 2019 Certification Recognition Society grant. Gina Marone, MSN, RN, NEA-BC, VP and Angela Cantwell, MSN, RN, Clinical Director, Chief Nurse Executive welcomed Einstein Behavioral Health is a project team member for Nurses with specialty certifications to the annual Bridge to Recovery: CPS Navigator for Psychia- Certification Recognition Session in Gouley try Hospital Discharges which was just awarded Auditorium in March 2019. Nurses at Center an Einstein Society innovative grant. One, EMCP, EMCEP, MossRehab, and Willow- crest hold 420 certifications from certifying specialty nursing boards. Brenda Douglass, Nurse Residency Program DNP, APRN, FNP-C, CDE, CTTs, Director of the Nurse Resident Johnna Pogwist, BSN, RN tied Doctorate of Nursing Practice Program at Drexel for 1st place in Einstein’s Research week (2019) University was guest speaker. poster presentation for her evidence-based practice initiative Implementation of a Turning Unit/Cluster/Site Clock for Pressure Injury Prevention. In 2019 and 2020, MossRehab was named In 2019-2020, the Nurse Residents from a “Top Workplace” by The Inquirer and Daily cohorts (#4, #5 & #6) of our Nurse Residency News. Program, headed by NRP Coordinator Susan Benjamin-Mlynarczuk, MSN, RN, On May 2, 2019 Einstein Medical Center’s Sur- NPD-BC, CCRN-CMC, completed and gical Unit Safety Program (SUSP) was award- implemented a total of 33 evidence-based ed a Pennsylvania Patient Safety Authority I AM practice initiatives throughout the network. PATIENT SAFETY award. Our EMCEP Surgical Program was one of only 11 winners from Penn- Celebrate Caring Award sylvania healthcare facilities from 153 nomina- tions in this annual prestigious contest. Kem Giron, BSN, RN from Tower 5 was chosen to receive Independence Blue Cross Celebrate Beth Hurwitz, MSN, AGCNS-BC, CEN, Steve Caring Award. Kem was among the few recog- Chapman, MS, MBA, BSN, RN, Chuck nized from more than 1,000 nominations. Kem Belmont, BSN, RN-CEN, Monica Miller, was recognized for her work on shared gover- BSN, RN-CEN, Michael Kowalski D.O., nance, community service, and peer support. Sarah Misuro, BSN, RN-CEN, Marlies Meinhold, BSN, RN, and Jyll Kurczewski, BSN, RN applied for Einstein’s Emergency Department to be considered for the

30 STRUCTURAL EMPOWERMENT STRUCTURAL EMPOWERMENT 31 Mental Illness) at The Philadelphia Museum of Domestic Violence Shelter Colon Cancer Awareness Month Community Involvement Art, Philadelphia, PA. In December 2019, Women’s and Children’s The GI suite celebrated Colon Cancer Stop the Bleed Program Service staff at EMCP collected and donated Awareness month in March 2020. Outside of Heart Walk In January 2019, Cathy Markey, MSN, RN, supplies for families of the Domestic Violence the cafeteria, GI tech staff, nursing staff and CCRN, CEN, TCRN and Stephanie Sailes, BSN, In November 2019, as part of its ongoing shelter and collected knit hats and blankets Kathleen Jaffe, RN, MSN, GI Nurse Manager RN conducted a Stop the Bleed program at partnership with the American Heart for patients on the Mother/Baby unit for EMCP set up a table and handed out Gratz College. That same month, Carla Cleary, Association, Einstein Heart & Vascular the holidays. information to the staff and visitors of Albert MSN, RN, CEN and Cathy Markey also con- celebrated our collective efforts in the fight Einstein Medical Center regarding criteria for against heart disease. Einstein raised more than ducted Stop the Bleed Program training for 36 Think First for Teens Program colon cancer screening. The staff were there to Parole Officers at the PA Board of Probation $82,000 to support heart disease and stroke answer any questions and to provide additional and Parole Office in Philadelphia. In September research in the Greater Philadelphia area In February 2020, Cathy Markey, MSN, RN, information to all that stopped by the table. 2019, Cathy Markey presented to the 7th Police through Heart Walk t-shirt sales and individual CCRN-K, CEN, TCRN and Donna Long, M.Ed., A banner was on display for the entire month District Advisory Board meeting on Injury Pre- donations. More than 16,000 walkers and CTRS, CBIS presented a Think First for Teens of March addressing colon cancer awareness. vention and Stop the Bleed. participants attended the annual event. program to 90 high school students at Mastermann High School. Wash ‘N Tune Event Annual Day of Remembrance Service In April 2019, Beth Jacobs, RN and a number In November 2019, Women’s and Children’s of PTs provided support for the Spinal Cord Services staff at EMCP raised funds and held Specialty Program’s 4th annual Wash ‘N Tune the 22nd Annual Day of Remembrance Service. event to clean and complete minor repairs to wheelchairs for individuals living in the Project Home community. Twenty-nine participants and 19 volunteers participated in the 2 ½ hour event In November 2019, staff from Willowcrest held in our Moss Outpatient Center at Tabor collected and donated supplies to the homeless Road. Three team members of the Spinal Cord in conjunction with “Project Home” at 1515 Specialty Program are on the board of Fairmount Ave, Philadelphia, PA. directors for The Greater Philadelphia Chapter of the United Spinal Association. Julia Ward Howe School In November and December 2019, all the National Walk to School Day Med-Surg units at AEMC collected and donated In October 2019, Cathy Markey represented gloves, hats, scarves, and packaged snacks Einstein along with colleagues from St. Chris- for this school at 5800 North 13th Street, topher’s Hospital in this outreach program for Philadelphia, PA. children at Cauyga Elementary School. Stenton Family Manor Holiday Caring Southeastern PA Health Literacy Month Project Symposium In November and December 2019, Network In October 2019, Cathy Markey participated Council (AEMC Nurse Shared Governance as a speaker in a panel discussion on Health Leadership) collected and donated toys and Literacy at Doylestown Health. supplies for Stenton Family Manor, a homeless shelter for families and children at 1300 E Tulpehocken St, Philadelphia, PA. Out of Darkness Walk In October 2019, the staff of Tower 7 and Levy 9 at EMCP organized and participated in a walk for Suicide Awareness (NAMI- National Alliance

32 STRUCTURAL EMPOWERMENT STRUCTURAL EMPOWERMENT 33 2019 Reba Azoff Scholarship Recipients The Reba Azoff Scholarship Program that launched in 2015 is open to all nurses seeking to advance their education to complete a Bachelor in Science of Nursing degree, or to attain a graduate or doctoral degree in Nursing leadership or educa- tion.

BSN Candidates: Theresa Ragazzone, RN, CCU EMCP Jane Dougherty, RN, IBCLC, CCE, Mother Baby Unit

MSN Candidates: Timothy Daley, BSN, RN, Nurse Manager Tower 7 Jaclyn Jandrisevits, BSN, RN, CRRN, 1 West MossRehab Annette Yerkes, BSN, RN, CNOR, Nurse Manager EMCEP Surgical Services Tiju Thomas, BSN, RN, 2 TIP MossRehab Patricia O’Hagan, BSN, RN, CMSRN, PCU EMCEP Carolyn Cleave-Milillo, RN, BSN, CCRN, SICU

DNP/PhD Candidates: Maryann Malloy, MSN, RNC-NIC, NEA-BC, Nurse Manager Neonatal Intensive Care Unit

34 STRUCTURAL EMPOWERMENT STRUCTURAL EMPOWERMENT 35 Exemplary Professional Practice

Professional Practice Model MossRehab NDNQI Award National Client Conference, which took place in November 2019 in Orlando. Kara Hart, BSN, and Care Delivery System Winner RN, CRRN, Clinical Nurse on 1West, MossRe- MossRehab Nursing received the 2019 NDNQI hab, Elaine Wible, BSN, RN, CRRN, Clinical Care Delivery System: (National Database of Nursing Quality Indica- Nurse on 1West / Network Nursing Council We aim to provide exceptional tors) Award for Outstanding Nursing Quality. Chair-Elected, MossRehab, and Susan Mc- nursing care that honors the humanity This annual award is given to the best per- Culley, MSN, RN, NE-BC, Director of Nursing MossRehab/Acute Inpatients Einstein Medical and dignity of each person, while forming hospital in each of seven categories including rehabilitation. MossRehab achieved Center Elkins Park attended the conference. advancing nursing as a profession. Our this distinction by reaching the 95th percentile Magnet appraisers had also spotlighted Moss- nursing care delivery system, “Dynamic for each reporting period for the award year Rehab earlier in the year for best practice in Team Nursing,” reflects concepts from in NDNQI. Press Ganey award winners are nursing in education of patients and family and Jean Watson’s Theory of Human Caring/ recognized and honored at the Press Ganey culture. Caring Science, including the cultivation of sensitivity to one’s self and to others, the development of a helping-trust relationship, the systematic use of the scientific problem-solving method for decision making, and the promotion of interpersonal teaching-learning. There are eight essential features of Dynamic Team Nursing: Caring, Relationship, Influences, Holistic, Professional Practice Model: Effective, Accountable, Quality, At Einstein, our Nursing Professional and Evidence-Based Practice. Practice Model reflects how we commu- nicate, practice, collaborate, and de- velop, while integrating mission, vision, values, philosophy, and nursing theory with our practice. Watson’s Theory of Human Caring serves as the foundation of our nursing practice, education, and research, encircling and infusing all we do. The Caritas Processes™ give a voice and language to specific practices as we connect with patient, self, family, col- league, or community.

36 EXEMPLARY PROFESSIONAL PRACTICE EXEMPLARY PROFESSIONAL PRACTICE 37 Stroke Care Excellence agitation, poor safety awareness, and Nurse-Driven Protocol on nurse-driven protocol. A repeat survey was behavioral outbursts. distributed approximately 16 weeks after the The American Heart Association and Indwelling Urinary Catheters initial survey to evaluate the effectiveness of American Stroke Association recognized When addressing alterations in cognition Nurses at Albert Einstein Medical Center are the education presented. Einstein Medical Center Philadelphia with 2019 and behavioral changes following a TBI, the empowered through the nurse-driven protocol “Get with the Guidelines Stroke Gold Plus Elite” care team merges the unique needs of each To assess nurses’ general awareness of the for removal of indwelling urinary catheters status. Einstein Medical Center Philadelphia is patient with systematic, organized strategies nurse-driven protocol, respondents were asked to reduce urinary catheter dwell time and also the first organization in Pennsylvania and to develop patient-centered behavior plans whether they could locate the nurse-driven potentially reduce the risk of catheter acquired the first in the country outside of the pilot pro- to provide care and support. The multimodal protocol. Pre-education data revealed that urinary tract infections. gram to earn the Joint Commission’s advanced interventions may include formal PTA 76.9% of nurses knew where to find the certification as a Thrombectomy-Capable assessment/protocol implementation; team A research initiative was launched to provide protocol, compared to 95.7% of nurses post Stroke Center (TSC) in collaboration with the behavioral rounds; video monitoring system; education to the Telemetry nurses to increase education. Both before and after education, American Heart Association/American Stroke one-on-one patient care companions; safety awareness of the nurse-driven protocol approximately 21% of staff responded that Association (AHA/ASA). alarms; and team communication of and to increase perception of nurses’ they would prefer the physician order removal behavioral strategies and outcomes. The empowerment to discontinue indwelling versus using a protocol. Although 66.7% of the rehabilitation nurse is an important part of the catheters. This project would determine if staff responded that they are no more or less Multimodal Behavior Plans treatment team due to the constant interaction using additional written education would likely to use the protocol, 33.3% of respon- with the patient and direct observation of decrease the knowledge gap in using the dents reported that they are more likely to use for TBI Patients patient responses to interventions. indwelling urinary catheter protocol. the nurse-driven protocol post education. In the inpatient rehabilitation setting, the care of Behavioral plans are shaped to meet the An initial survey was provided to the Tower 5 Stanley Boc, BSN, RN and Alisa Behari, the complex traumatic brain injury (TBI) patient immediate behavioral needs of patients but Telemetry nursing staff to identify a baseline BSN, RN Tower 5 Telemetry presented their requires a comprehensive assessment, careful may be tailored as the patient status improves knowledge gap regarding the nurse-driven evidence-based practice quality project consideration of individualized cognitive and and the care of the patient evolves. When indwelling catheter protocol. Education was Nurse driven protocol on indwelling Urinary physiological needs, and a team approach designing individualized behavior plans, provided to the staff in the form of a bro- Catheter at the 2nd Cohort of Nurse to provide consistent and focused care. it is necessary that each piece of the puzzle chure, highlighting the important points of the Residents graduation on Feb. 19, 2019. The behavioral sequelae of TBI presents is included so the “big picture” clearly challenges for the patient care team to communicates the interventions, maintain safety while assisting the patient to expectations, and goals to allow for productively participate in therapy. consistent implementation. On our 30-bed Brain Injury Unit at MossRe- On November 6-9, 2019, Karyn Kling, BSN, hab at Elkins Park, the patients emerging from RN, CCRN presented her poster Multimodal Post-traumatic Amnesia (PTA) and those with Behavior Plan Development for Complex co-morbidities of cognitive or psychological TBI Patients at the 2019 Association of issues often exhibit alterations in behavior Rehabilitation Nurses REACH Conference such as: verbal and physical aggression, in Columbus, OH.

38 EXEMPLARY PROFESSIONAL PRACTICE EXEMPLARY PROFESSIONAL PRACTICE 39 Calibrated Drapes in L&D used to increase the accuracy of blood loss Sensory Room describe their feelings and what they found measurement until a unit has the time and re- most helpful. A research project on the Labor and Delivery sources to implement the full QBL approach. Patients often are admitted to the Tower 7 (L&D) Unit at Einstein Medical Center acute psychiatric unit in distress. Although Eight patients utilized the sensory room Philadelphia (EMCP) showed that using An assessment was conducted to evaluate there is a sensory room in the unit, it is over a 4-week period. Patients’ self-reported calibrated under buttocks drape with patients the accuracy of visual EBL. Five commonly underutilized. This room has the potential to feelings pre-intervention included anxiety, undergoing a vaginal delivery helps provide a used items were soaked with a predetermined provide a space for patients to experience sadness, uncertainty, nostalgia, and fear. more accurate determinant of blood loss amount of simulated blood. Participants were relaxation, discover coping skills, and practice Post-intervention they reported feeling the compared to the traditional visual estimation asked to visually estimate the amount of blood self-care. A review of the literature showed same or better. One patient did not respond methods used on the L&D Unit. on each item and record it. The difference that patients’ self-reported level of distress to the post-evaluation due to the acuity of between the estimation and actual amount was their emotional state. Two patients who were Postpartum hemorrhage is the world’s was reduced significantly after spending just calculated for each provider and each item, 20 minutes in a sensory room. unable to describe their feelings before using leading cause of maternal morbidity and and the sum of the difference was compared the sensory room were better able to afterward. mortality. Studies show that accurate to the cumulative amount of simulated blood An initiative was implemented on the acute The sensory room was described as having calculation of blood loss decreases rates of of all five items (900mL). In contrast, when psychiatric unit to give patients who express a “relaxing atmosphere” and providing “peace maternal morbidity and mortality by early using the calibrated drape for EBL, the psychological distress access to a sensory of mind.” Talking 1:1 with staff, the touch and initiation of lifesaving interventions. Association provider estimation was within 100mL of the room. Unit staff were informed of the sensory change, comfortable chair, essential oils, of Women’s Health, Obstetric, and Neonatal actual quantified measurement. room initiative. For the project, patients were rattle, and wall color were reported to be Nurses (AWHONN) recognizes quantified blood asked if they were interested in using the most beneficial. loss (QBL) methods as the most effective way The majority of providers at these deliveries sensory room with staff for 20 minutes. to measure postpartum blood loss. noted that the calibrated drape was easy to use Pre- and post-evaluations documented Kristin Raby, BSN, RN, Tower 7 presented and that they preferred using it over the ones patients’ responses when asked if they were her evidence-based practice quality project Due to current evidence-based practice without graduated markings. Overall, ongoing Utilizing a sensory room in an acute adult recommendations, a project was formulated experiencing psychological distress before use of the calibrated drape is feasible in the entering the sensory room, and if their level of psychiatry unit at the 2nd Cohort of Nurse to introduce a more quantified method using L&D of EMCP and its use significantly improved Residents graduation on Feb. 19, 2019. calibrated under buttocks drapes during psychological distress was the same, better, the ability of the provider to more accurately or worse afterwards. They were also asked to vaginal deliveries. Under buttocks drapes are estimate postpartum blood loss. an inexpensive and simple tool that can be

Rachel Garraway, BSN, RN and Brittany Pembleton, BSN, RN of Labor & Delivery presented their evidence-based practice quality project “Use of calibrated under- buttocks drapes to improve estimation of postpartum blood loss during vaginal delivery” at the 2nd Cohort of Nurse Residents graduation on Feb. 19, 2019.

40 EXEMPLARY PROFESSIONAL PRACTICE EXEMPLARY PROFESSIONAL PRACTICE 41 New Knowledge, Innovations & Improvements

QSEN Competencies After study completion, Dr. Hopkins Pepe Baby Friendly provided a podium presentation titled, “A In 2019, Loraine Hopkins Pepe, PhD, RN, NPD- Feasibility Study of a QSEN-based Orientation Einstein Medical Center Philadelphia earned BC, CCRN-K conducted a feasibility study Program for Newly Hired Registered Nurses” the prestigious international recognition as a of a Quality and Safety Education for Nurses at the 2019 QSEN International Forum in Designated Baby-Friendly hospital in 2018. (QSEN)-based orientation program for newly Cleveland, OH. Additionally, in May 2019, The hospital’s journey to “Baby Friendly” hired registered nurses. This feasibility study the Journal of Continuing Education in designation was a significant undertaking served two purposes: 1) to explore the feasibili- Nursing published an editorial co-authored that spanned eight years. This coveted and ty of integrating the QSEN competencies into a by Dr. Hopkins Pepe and Dr. Altmiller titled, hard-won achievement recognizes hospitals nursing orientation program; and 2) to explore “Why Quality and Safety Education for Nurses and birthing centers that offer an optimal newly hired RNs’ and nurse educators’ per- (QSEN) Matters in Practice.” level of care for breastfeeding mothers and ceptions of an orientation program framed by their babies. The Baby Friendly distinction QSEN competencies. In 2020, Dr. Hopkins Pepe was selected again was introduced in 1991 by the World Health to provide a podium presentation at the QSEN Organization and the United Nations As a prerequisite for this study, Gerry Altmiller, International Forum scheduled to be held in Children’s Fund. EdD, APRN, ACNS-BC, FAAN, Faculty Consul- Philadelphia in May 2020. Due to the national tant, provided clinical nurse educators with four pandemic, it is being rescheduled for 2021. hours of continuing education to increase their The title of the presentation was, “Enhancing Breastfeeding and Contraception Interdisciplinary Education Initiative understanding of the QSEN competencies and Engagement of Clinical Nurse Educators: their application to nursing practice. Using QSEN Competencies to Revitalize This study identifies evidence-based processes an Orientation Program in a Tertiary-care and strategies that can be used to invigorate Academic Medical Center.” This presentation orientation programs with quality and safety will describe the strategies implemented to education. Findings identified effective meth- engage and update clinical nurse educators ods to engage newly hired RNs. The structure about the QSEN competencies so that they of the QSEN competencies provided a process could transfer the knowledge, skills, and that enhanced the work of unit-based nursing attitudes mastered to the instruction they education staff in supporting direct care RNs. provide new hires.

Nursing leadership collaborated with Dr. Safiya Hosein and team on an interdisciplinary education initiative related to contraception and breastfeeding that was accepted for a poster presentation at the 2020 Council on Resident Education in Obstetrics and Gynecology (CREOG) and Association of Professors of Gynecology and Obstetrics (APGO) Annual Meeting in Orlando, FL in February 2020.

42 NEW KNOWLEDGE, INNOVATIONS & IMPROVEMENTS NEW KNOWLEDGE, INNOVATIONS & IMPROVEMENTS 43 Cell Phone Containment phones should be cleaned or restricted upon Neonatal Abstinence Interrater reliability included two nurses entering the NICU. scoring the infant simultaneously. Each nurse Reducing Bacteria in the Neonatal Intensive Syndrome was observed 3-5 times with a unit expert. Care Unit Based on this recommendation, an education module for NICU nurses was created to share Scoring Comparison of Infants with Neona- The team conducted 650 simultaneous Infection control is a top priority for Neonatal information regarding the bacteria that live on tal Abstinence Syndrome (NAS) using Mother observations of the Finnegan and the Mother Intensive Care Unit (NICU) nurses as they strive cell phone surfaces and the recommended Scale and the Finnegan score scores over a 6-month period on a cohort of to protect their patients and improve patient practices for how to clean and contain them. The Finnegan scoring tool is the most fre- 19 infants. In the study, the infants’ mean outcomes. Infants in the NICU are at high risk quently used tool to assess for neonatal drug gestational age was 38.1 SD 2.2 weeks. for neonatal sepsis due to having underdevel- After completion of the module, nurses were withdrawal. However, two concerns with the The number of infants treated was 12 (63%). oped immune systems. This risk is exacerbated asked to initiate the practice of cleaning their Finnegan tool are its length and the variability even further due to the need for the life-saving, phone with an alcohol wipe and placing it into Findings showed significant agreement in the scoring due to subjective assessments but invasive interventions that are commonly a clear plastic bag. Random audits were between the Finnegan and the Mother Scale. of some of the items. The Mother NAS score performed for this population. completed over a one month span throughout The Mother Scale is 19 items compared to all shifts to evaluate nurse compliance with the is a modified version of the Finnegan score FNAS 31 items. Differences include items One way to decrease risk of infection for recommended practice change. (FNAS) that has shown high correlation with weighted differently than Finnegan scale, with NICU infants is to minimize exposure to the Finnegan tool. A team from Albert Einstein some items eliminated and some items added. Forty-four NICU RNs completed the online potentially noxious bacteria in the environment. Medical Center decided to assess interrater The staff perceive the Mother scale to be learning module about cell phone bacteria. An extensive review of the literature revealed reliability scoring with the Finnegan and the shorter and less subjective. that cell phones are a reservoir for bacteria Of these, 38 were regular full time and part time Mother scores. such as Staphylococcus aureus, staff and six were per diem employees. A total Sharon Sauer, BSN, RNC-NIC and Maryann As part of a multi-stage QI project, we re-edu- Acinetobacter species, Escherichia coli, of 84 observations were performed and about Malloy, MSN, RNC-NIC, NEA-BC, Dorothy cated all staff on the Finnegan score and on the Klebsiella pneumoniae, Pseudomonas species, 70% of RN staff observed complied with the Wyatt, Ph.D. NNP-BC, Nazli Kuter, MD & new Mother tool using a multifaceted strategy: and Enterococcus species. Research that had practice of cleaning and containing their cell Agnes Salvador, MD FAAP presented their been conducted showed that cell phones could phone upon entering the NICU. • Interobserver reliability was used to poster Comparison of traditional Finnegan Neonatal Abstinence Scoring Tool (FNAST) be successfully decontaminated with the use of Sarah Doyle, RN, BSN presented her poster validate the staff correct utilization with the Maternal Opioid Treatment Human an alcohol based cleaning solution. Cell Phone Containment to Reduce Bacteria of both tools Experimental Research (MOTHER) NAS Scale in the Neonatal Intensive Care Unit at the 2nd Although there was no practice in place in the • Infants were scored utilizing both tools at the 2019 Eastern Society for Pediatric Cohort of Nurse Residents graduation in NICU for cleaning or containing bacteria on cell at the same time Research Scientific meeting in Philadelphia, PA February 2019. phones, research evidence suggests that cell • Staff added the infants’ areas in March 2019 and at the Pediatric Academic of concerns to handoff. Societies 2019 conference in Baltimore, MD in April 2019.

44 NEW KNOWLEDGE, INNOVATIONS & IMPROVEMENTS NEW KNOWLEDGE, INNOVATIONS & IMPROVEMENTS 45 October 2019: Einstein Publicly Announced Thanks to the Magnet as Magnet Designated Empirical Outcomes Document Team! Albert Einstein Medical Center was publicly announced as a new Magnet® Designated ® ers interviewed nurses, physicians, hospital Bill Hudson, MSN, RN, CNML, Magnet Magnet Recognition organization at the 17th Annual ANCC Magnet staff, patients, and community partners to clari- Program Director, coordinated all aspects Conference®. Gina Marone, RN, MSN, NEA-BC, fy and validate the information presented in the of the document preparation and the writing Vice President, Healthcare Services and Chief The Magnet Recognition Program application regarding exemplary professional process. In addition to Bill, members of our Nurse Executive, Dixie James, Vice President practice, empirical quality outcomes, innova- Magnet Document Writing Team include: is the highest national honor for of Strategy and Service Line Operations, and tion, transformational leadership, and nurse 30 RNs—mostly direct care nurses—attended • Jill Stunkard, MSN, RN nursing excellence. Administered structural empowerment and development. by the American Nurses Credential- the conference. • Angie Cantwell, MSN, RN Aug 19, 2019: Albert Einstein Medical Center November 2019: Magnet Pinning Ceremony ing Center, the program identifies Earns Magnet® Recognition • Jen Rodriquez, BSN, MHA, RN We held our AEMC Magnet® Pinning Ceremo- • Nancy Pokorny, MSN, MHA, RN health care organizations that pro- Gina Marone, MSN, RN, NEA-BC, VP & Chief ny for nurses on the morning of Nov. 22, 2019, Nurse Executive was notified that Einstein • Trish Brown, BSN, RN vide the best in nursing care and followed by a special luncheon. professionalism in nursing practice. Medical Center Philadelphia, Einstein Medical • Frank Walsh, BSN, RN Center Elkins Park, MossRehab, Willowcrest, • Amina Harris, MSN, MBA, RN and Einstein Center One achieved Magnet® designation by the American Nurses Creden- • Steve Chapman, MBA, MHA, BSN, RN June 1, 2018: AEMC Submits Magnet Docu- tialing Center’s Magnet® Recognition Program. • Beth Hurwitz, MSN, AGCNS, RN, CEN ment to ANCC Magnet recognition is one of the benchmarks • Chuck Belmont, BSN, RN, CHEP Albert Einstein Medical Center submitted to the used to measure the quality of care patients American Nurses Credentialing Center (ANCC) receive and is considered the gold standard for • Charissa Watt Cyrus, MSN, RN all of the documentation, gathered over four nursing care. Nationally, approximately 8% of • Maryann Malloy, MSN, RNC-NIC, NEA-BC years, that gives evidence to our nursing excel- hospitals attain Magnet status. • Marcia Gray, MSN, RN, CCRN, SANE lence. September 2019: Magnet Celebration • Flo Gallagher, BSN, RN, CRRN May 21-24, 2019: Site Visit On Sept. 16, 2019, we held a special two-hour • Loraine Hopkins Pepe, PhD, RN, NPD-BC, Appraisers from the American Nurses Creden- event with food, music and remarks from senior CCRN-K tialing Center visited us for a rigorous, four-day leaders to celebrate our Magnet designation. • Patty Duddy Magee, BSN, RN assessment. During the site visit, the apprais- • Sue McCulley, MSN, RN, NE-BC • Marilyn Pollock, BSN, MBA, RN, NEA-BC • Rachelle Rigous, BSN, RN, CRRN • Hazel Degale, MSN, RN • Lisa Rodzen, DNP, MBA, RN, NEA-BC • Myriam Poindijour, MSN, RN, AGCNS-BC, CCRN • Charlene Griffin, MSN, APRN, ACNS-BC • Siew Lee Grand-Clement, MSN, RN, CPHQ, CLSSBB • Karen Schwartz, BSN, RN, CNOR • Robert Haney, BSN, RN, CAPA • Michael Golasa, MSN, MHA, RN • Gina Marone, MSN, RN, NEA-BC, Behind every mask is a hero Vice President and Chief Nurse Executive

46 EMPIRICAL OUTCOMES EMPIRICAL OUTCOMES 47