NURSES LIGHT THE WAY

nursing excellence 2020 NURSING EXCELLENCE

Letter from the Chief Nursing Officer Table of Dear Nurse Colleagues, I am excited to write to you as the new Vice President (VP) of Patient Care Services and Contents Chief Nursing Officer (CNO) of Cottage Health. The 2020 Transformational edition of Nursing Excellence showcases a remarkable year Leadership of nursing contributions: full of innovation, successes, leadership changes and response to calls to action. These 4 pages reflect our Magnet journey and are full of inspiring stories that remind us that there is no limit to what we can Structural accomplish when we work as a team. We are better together, Empowerment motivated by a shared goal to provide exemplary nursing care to our patients, families and community —­ no matter 10 the challenges we face. The World Health Organization (WHO) designated Exemplary Professional Practice 2020 the “Year of the Nurse and Midwife” to honor the 200th anniversary of Florence Nightingale’s birth. As we reflect upon the many nursing accomplishments at Cottage 24 Health in 2020, her teachings remain relevant in contemporary nursing practice throughout our COVID-19 pandemic response. In line with our organization’s core values of Excellence, Integrity and Compassion, nurses lit the way. We defined, implemented and refined nursing New Knowledge, Innovations care delivery to safely meet the needs of a new population. and Improvements Florence Nightingale’s Environmental Theory underpinned this care. Central to her theory 30 is the application of infection control and prevention guidelines and nursing management of the patient’s physical and psychological environments to positively impact patient outcomes. Her body of work was the first to recognize the nurse’s unique role as bedside caregiver to Empirical Outcomes ensure the balance of these paradigms to optimize patient health. This Nursing Excellence highlights the art and science of nursing care at Cottage Health, from implementing our 36 dedicated COVID-19 cohort units to creating novel roles in our Labor Pool to vaccinate our community. Flo would be so proud. Our Magnet Vision As 2020 came to a close, we also bid a fond farewell to Herb Geary, who retired after a distinguished 43-year nursing career, with more than 13 years at Cottage Health as our VP 42 of Patient Care Services and CNO. Herb’s contributions to the Cottage Culture leave an indelible mark on all of us and I look forward to working with you to continue his legacy of elevating the professional practice of nursing. THANK YOU to Glenn Finally, thank you for your dedication to providing excellent care to our patients, their Dubock and Monie de Wit families and each other in a time of unprecedented stress and uncertainty. Your loving and for their invaluable photo professional care is reflected in unparalleled Patient Satisfaction scores across our system contributions. and in the warm smiles that you wear behind your masks. Please know that your daily work has made a difference in countless lives. I am so grateful to you. Happy Nurses Week! REFERENCED With respect and admiration, American Nurses Credentialing Center (2017). 2019 Magnet Application Manual. Silver Spring, MD Laura Canfield, DNP, RN, CNS, SCRN, CNRN Magnet® and National Magnet Conference™ are trademarks of the Vice President, Patient Care Services & Chief Nursing Officer American Nurses Credentialing Center | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

2 Letter from the Magnet Program Manager 2020 proved to be a monumental year where we celebrated “Year of the Nurse” to honor Florence Nightingale’s 200th birthday. Florence stated, “I will do all in my power to maintain and evaluate the standards of my profession…” Cottage Health nurses rose to the challenge of the pandemic and elevated nursing. The pandemic spotlighted the resiliency, adaptability and compassion of nursing. Nurses excelled in many ways. Nurses were on the front line caring for COVID-19 patients, maintaining the care for non-COVID-19 patients, cross-training to new areas and developing new nursing roles. NURSING EXCELLENCE PUBLICATION COMMITTEE Back Row Left to Right: Susan San Marco, Dan Thomas, Sharilyn Vasquez, Nurses quickly learned to care Judy Corliss, Jan Ingram, for new patient populations, Katie Gorndt, Linda Reimer, workflows and technology. Sabine Keller and Jackie Baker While technology made it Front Row: Amy VandenHeuvel, possible for patients to connect with loved ones, it also provided Shelley Algeo and Kristen Walker staff a way to receive information through virtual meetings Not Pictured: Jennifer Wobig and education. Cottage Health experienced its highest Patient Satisfaction scores, in spite of the pandemic creating uncertainty for staff and patients. Our nursing staff became the patient’s family while in the hospital and provided a warm, caring environment. Each area of nursing demonstrated Cottage’s core values of Excellence, Integrity and Compassion. Nurses are being called superheroes. We may not wear a cape, fly or see through walls, but our superpower is the greatest of all. We have the power to change lives by providing the highest YEAR OF THE NURSE quality, compassionate care to all our patients and each other. This year’s edition of Nursing I am proud to be a nurse and even more proud to be a Cottage Excellence highlights stories from Health nurse. I am in awe of every nurse at Cottage Health and YEAR OF THE “Year of the Nurse.” These stories are wish everyone a Happy Nurses Week. NURSE indicated by this icon.

All group photographs in this publication with Jackie Baker, MSN, RN, NPD-BC, ONC individuals not wearing masks were taken before Magnet Program Manager the outbreak of the COVID-19 pandemic. | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

3 TRANSFORMATIONAL LEADERSHIP

Transformational Leadership CHARACTERISTICS: Visionary, Courageous, Strategic Planner, Influential, Empowering CO-CHAIRS: Penny Morgan Overgaard and Amy VandenHeuvel EXECUTIVE SPONSOR: Herb Geary MEMBERS: Christy Block, Dianna Hosley, Denise McDonald, Elyse DeMar Gualotuna, “ Identifies and Jackie Baker, Jenifer McClure, Lorie Loomis, Andrew Gajardo, Marc Dailey and Sabine Keller communicates ACCOMPLISHMENTS: mission, vision, 1. Developed education for emerging leaders and values, and 2. Increased visibility of Chief Nursing Officer ONGOING: asks for the 1. Succession Planning involvement of the workgroup to achieve the vision.”

ANCC Magnet

MAGNET COMPONENT COMMITTEE 2020 Left to Right: Penny Overgaard, Sabine Keller, Lorie Loomis, Denise McDonald, Herb Geary, Jenifer McClure, Jackie Baker, Elyse DeMar, Amy VandenHeuvel and Christine Block Not Pictured: Marc Dailey and Andrew Gajardo | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

4 Nurse Leader News

JULIE HARDIN, MSN, RN, CRRN Cottage Rehabilitation Hospital (CRH) Educator, Education and Nursing Professional Development Julie has been a valued member of the Cottage Health Education and Nursing Professional Development Department for over two years, where her focus has mainly been on Patient and Family Education. Julie earned her RN degree from Boise State University in 2006 and her Masters in Nursing Education from the University of Texas, Arlington, in 2019. Before joining the Education Department, Julie worked at CRH, focusing on chart review, data collection, reimbursements and staff education. Julie’s experience includes Rehabilitation, ICU/Telemetry, Mother/Infant Care and the Nursing Supervisor for Assisted Healthcare.

In her new role, Julie will be spearheading CRH staff education for Commission on Accreditation of Rehabilitation Facilities survey readiness. In addition to nursing, she is responsible for multidisciplinary education for therapy services. In this role, she will be a member of the CRH leadership team.

MELISSA HURTADO, BSN, RN Educator, Unlicensed Assistive Personnel, Education and Nursing Professional Development Melissa’s experience includes employment as a Certified Nursing Assistant and Medical Assistant. Upon receiving her nursing degree, Melissa worked at Community Memorial and Cottage Rehabilitation Hospital (CRH). Before transitioning to the Education and Nursing Professional Development Department, she held the Clinical Resource Nurse position at CRH. Melissa also functioned as a Relief Charge Nurse and primary preceptor for new graduate nurses.

SANDI HAZARD-MAROTTO, BS, RN Director, Pre/Post Surgical Unit (PPSU) and Post-Anesthesia Care Unit (PACU) Sandi received an Associate Degree in Nursing from Santa Barbara City College and a Bachelor of Science Degree in Health Care Management from University of La Verne. She started her nursing career at Cottage Health in 1973 as a new graduate. In 1976, Sandi became the Lead Nurse of the Medical Surgical Teaching Unit (5 West) for 24 years. She later worked as a House Supervisor for several years until her promotion to Manager of Pre/Post Surgical unit in 2001. In 2017, Sandi took on the responsibility of Manager of the PACU. Through her leadership over the last three years, Sandi has successfully brought the two department teams together to function well and support each other. Sandi also was instrumental in starting the pet therapy program.

TAMMY McDEVITT, MSN, RN, CEN, TCRN, CPEN Manager, Cath Lab, Interventional Radiology & Electrophysiology Tammy has been with Cottage Health for 12 years. A Santa Barbara local, she attained her Certified Nursing Assistant and Associate Degree in Nursing from Santa Barbara City College. She achieved her Bachelor of Science in Nursing in 2014 and her Masters of Science in Nursing from California State University, Dominguez Hills in 2019. Her previous roles have been as a nurse in the Emergency Department, Trauma Performance Improvement Nurse Coordinator, Trauma Services and the Clinical Educator, Med/Surg, Education Department. Tammy has helped establish best practices in streamlining emergency transfusions in the Emergency Department and developed code blue training during the COVID-19 pandemic. | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

5 TRANSFORMATIONAL LEADERSHIP

DANA PENA, BSN, RN Clinical Manager, Materials for Surgical Services Dana came to Santa Barbara Cottage Hospital in 2014 from Antelope Valley Hospital in Lancaster, California as a Clinical Nurse II. She has held positions as a Clinical Resource Nurse and Clinical Nurse Coordinator for SBCH Surgical Services. She specialized in Orthopedics and Neurosurgery as well as having circulated in various other specialties. Patient safety and teamwork are a high priority for Dana, as demonstrated by her participation on the task force for Cottage Health Advanced Total Joint Certification and the launching of the Mako robotic-arm assisted surgery for total joint procedures. Dana’s wealth of knowledge and ten years of experience in nursing are vital for this position as she continues to provide support to our patients, staff, physicians and community.

CAROLINE ROSEN, MSN, RN, BC-NE Director of Patient Safety and Accreditation Caroline came to Santa Barbara Cottage Hospital in 2007 as the Clinical Manager for Cardiac Telemetry. In her role she led highly visible CH initiatives and teams, engaging in innovative work on medication harm reduction through the Cottage Health Harm Error Reduction Action Team (HEAT) and acting as co-presenter for “Getting Back to Teaching with Teach-Back for Medication Education." In addition she was a leader in Cottage Health's United Way fundraising campaign. In 2015, Caroline became the Director of Nursing at Goleta Valley Cottage Hospital (GVCH). While at GVCH she was involved in regulatory surveys, and transformed quality assurance and clinical quality programs. Caroline represented GVCH as a clinical leader on system initiatives, with the Santa Barbara Healthcare Partners Coalition and as Chair of the GVCH Quality and Patient Safety Committee. In her new role, Caroline will work to advance the culture of safety and the high-reliability program. She will lead accreditation activities across all CH campuses and oversee the patient grievance process. She has been a longstanding champion of establishing Just Culture at Cottage Health.

SUMMER CLARY SALMAN , MSN, RN, FNP-BC Director, Clinical Education for Cottage Health Urgent Care After receiving a Master’s degree in Psychology from Texas A&M, Summer attended Del Mar College in Corpus Christi, Texas for undergraduate nursing studies. She obtained her MSN-Family Nurse Practitioner degree in 2012 from Marymount University in Arlington, Virginia. Summer has practiced in various inpatient and outpatient environments, including Pediatric Hospitalist, Family Practice, Pediatrics, Outpatient Psychiatry and Retail Healthcare. Summer has extensive experience in Urgent Care medicine and management. Her nursing education and leadership experience includes adjunct faculty member in undergraduate nursing studies and opening her own NP led Urgent Care Center in San Antonio, Texas in 2017. She has also served as legislative ambassador to the Texas Nurse Practitioner Association, working to further efforts at gaining NPs full practice authority in Texas.

AMANDA TUEL, MSN, RN, FNP-C Lead Nurse Practitioner, Cottage Health Urgent Care Amanda graduated from Arizona State University in 2009. Early in her career she worked as a float nurse in a Level 1 Trauma Hospital, gaining a broad set of skills. She obtained her MSN-Family Nurse Practitioner degree in 2015 and gained further knowledge as a Nurse Practitioner in the areas of Family Practice, Emergency Medicine, Urgent Care and Aesthetic Medicine. Amanda’s extensive experience and leadership skills have been instrumental to her success in her current nursing leadership role. She serves as a preceptor to NP students at the Urgent Care Centers and is currently involved in teaching | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage BSN and MSN students at the CSU Channel Islands campus in Goleta. 6 Kim Jordan Victoria McClain Clinical Resource Nurse, Nursing Resource Unit Administrative Nursing Supervisor, SBCH Nursing As a Nursing Resource Unit nurse, I am accustomed Administration to taking on unique roles and an ever- I went on a leave of absence this past January 2020 changing workflow. Early on in the pandemic, and came back to a whole new world of nursing my manager called me on a Saturday night several months later. In conjunction with Nursing YEAR asking if I would be interested in managing YEAR Administration, the Nursing Resource Unit (NRU) had OF THE OF THE NURSE a new project starting on Monday – the NURSE created multiple positions to support the needs occurring CH Labor Pool. For four months, I stepped within the hospital due away from the bedside to help meet the to the pandemic. COVID-19 hospital’s novel needs during a global pandemic units were created for Med/ and to keep CH employees working when we Surg and Critical Care with experienced dramatic reductions in traditional generous staffing ratios workloads and census. I had the opportunity to to care for these very sick see how our administration makes decisions and patients. As the numbers of implements new protocols pandemic-related admissions based on our county and rose, surge plans were created the federal government’s to accommodate increased Victoria McClain, Lynn Peterson, PCT latest guideline numbers of potentially infected and Julissa Valerej recommendations. I patients. The orchestration of learned about the supply many departments and key chain of PPE, how essential stakeholders working together making everything happen products are ordered and was nothing short of amazing. In addition to staffing 15 units delivered and worked throughout the hospital, the Staffing Department needed to alongside the employees in the storeroom and EVS assign NRU and other departments’ nurses and PCTs with low to ensure our employees were working in the safest census to the following areas created out of the COVID-19 environment possible. This role allowed me to learn pandemic: how to manage a schedule for upwards of 40–50 1. The Labor Pool employees per day at multiple locations. 2. Screeners at all Cottage Health facilities: six at SBCH, four at Working in the Labor Pool expanded my GVCH and two at SYVCH understanding of how a hospital system works and 3. Security Support Personnel 24/7 to support ED Triage in how every person plays a vital role in keeping it screening patients and supporting needs outside of the ED functioning. Employees working in various roles and departments came together. They worked side 4. Door Monitors for Acute Care and Critical Care COVID-19 units by side to screen staff and visitors at the hospital and with up to five positions running 24/7 at one time, to assist off-campus office entrances, fit-tested hundreds of with donning and doffing of PPE, restocking of supplies and employees with the newly available N95 mask and monitoring appropriate utilization of the PPE and protocols worked at the community COVID-19 testing site. I 5. Direct Admit Testing Unit (DATU) to run rapid Abbott tests before felt such a sense of pride to work for a hospital that admitting patients for emergent procedures for the OR, Birth made it a priority to keep its employees financially Center, Eye Center, Dialysis, Radiology, Interventional Radiology, secure while working through these challenging Cath Lab times. I also got to work with so many amazing 6. Visitor Triage Staff to screen and follow up on visitor exceptions people who went so far outside of their regular roles during restricted visitation to keep our staff, patients and community safe. At the most basic level, I was able to witness people As an Administrative Nursing Supervisor, it was my taking care of people. This, to me, is what I cherish responsibility to ensure that we were meeting the most about being a nurse and this year has only organization’s needs and that all these positions were staffed magnified the importance of coming together and appropriately. The increase in daily changes in protocols and caring for one another. the stresses staff experienced made it especially important for

me to support everyone. 2020 truly is the "Year of the Nurse" 2020 Health | Nursing Excellence | Cottage and we were able to serve our communities well. 7 TRANSFORMATIONAL LEADERSHIP

Cottage Health Nurses Mentoring Leadership Students Nurse Leaders mentored Bachelor of Science and Masters of Science in Nursing Leadership students from various schools, including California State University Channel Islands (CSUCI). The mentor/mentee relationship is a core component of the course, which focuses on leadership and organizational outcomes. The students participate in many projects and improvement initiatives, which benefit the student, the organization and ultimately the patient.

MENTOR STUDENT PROJECT/OUTCOME

Sara Domz, Patient Relations and Accreditation Julie Gilmore Improving Compliance with Obtaining Daily Weight Coordinator, Risk & Regulatory Department in Critical Care

Lisa Dugger, Diabetes Educator, Monica Reyes-Ambriz Optos Retinal Camera Patient Education Joshua Dillon Diabetes Wellness Guide Lindsey Macias Reinforcing Diabetic Survival Skills in the Inpatient Setting

Caroline Rosen, Director, Goleta Valley Claire Lindstrom Promoting Personal Protective Equipment Cottage Hospital Jessica Moreno Non-compliance with IV Tubing Labels

Lorie Loomis, Clinical Manager, Danielle Schmidt Increasing Medication Education on Side Effects Neurology/Urology

Jennifer Granger-Brown, Simulation Coordinator, Nicole Leger Accreditation of Gary M. Hock Family Patient Care Education and Nursing Professional Kiana Kawatachi Simulation Center Development Kathyvan Tran

Bliss Rayo-Taranto, Senior Quality Improvement Brennan Smith Stroke Readmission Specialist – Stroke, Quality Improvement

Steffanie Carty, Clinical Manager, Natalie Millikan Back to Basics Surgical Services (GVCH) Lizeth Aguayo Type and Screen for Elective Total Joint Surgery

Maggie Cote, Senior Sepsis Coordinator, Anabel Barela Sepsis Readmission Quality Improvement Carolina Soria Community Sepsis Education

Maggie Wordell, Educator, Katie Chapman Commission on Accreditation of Rehabilitation Cottage Rehabilitation Hospital, Education Facilities and Nursing Professional Development

Christine Block, Educator, Casey Fortier PALS with Resuscitation Quality Improvement Program American Heart Association Megan Debenon Analysis of Intra-Hospital Communication Tools Training Center Coordinator, within Cottage Health and Other Hospitals Education and Nursing Professional Development Through Collected Research and Literature Review

Julie Hardin, Patient/Family Educator, Tristan Racich Patient Education: Medication Side Effects Patient Education

Libby (Frances) Smith, Director, Women’s Services Heather Ballat Perinatal Loss Algorithm Jennifer Rios Cognitive Changes in Pregnancy Monique Enamorado Cross-Training on Women’s Services

Danilyn McLaughlin, Clinical Manager, Jennifer Ho PRN Pain Medication Orders Pulmonary/Renal/Infectious Disease

Vicki McPhail, Educator, Mother Infant Care Allie Ferris Eat Sleep Console Tool in Mother Infant Care Education and Nursing Professional Development Kristina Lash COVID-19 Pandemic and Postpartum Mental Health

Jackie Baker, Magnet Program Manager, Flora Kraus Scientific Writing Resource Availability | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage Education and Nursing Professional Development 8 Hugo Gaspar Evidence-Based Practice Tool Kit MENTOR STUDENT PROJECT/OUTCOME

Lindsay Picotte, Educator, RN Residency Gabe Mosse RN Residency Accreditation Training Program Coordinator, Education and Nursing Professional Development

Bridget Crooks, Clinical Manager, Ana Bautista Patient Satisfaction Using Ultrasound Guided Emergency Department (SBCH) IV Insertion

Stephanie Ramming, Clinical Nurse II, Wesly Van Wyk Mother Baby Quiet Time Mother Infant Care

Katie Loster, Clinical Educator, Med/Surg Jamie Larson Analysis of Intra-Hospital Communication Tools Tammy McDevitt, Clinical Educator, Med/Surg within Cottage Health and Other Hospitals through Education and Nursing Professional Development Collected Research and Literature Review

Penny Morgan Overgaard, Director, Sabrina Carper Improving the Adolescent Weight Management, Cottage Children’s Pediatric Clinics Metabolic, and Bariatric Surgery Program at Cottage Health Cassandra Carper Chief Nursing Officer Visibility

Diane Barkas, Clinical Nurse Specialist, Michelle Bina Outcomes and Expense of Continuous Renal Critical Care Replacement Therapy in Critical Care

Jane Sterling, Clinical Nurse II, Amanda Burgh Cross-Training on Women’s Services Mother Infant Care

Jan Fadden, Parish Nursing Eleanora Rose Gullickson Long-Term Mentorship Program for Homeless Population

IN 2020... Health Professionals NURSES WHO NURSES WHO NURSES CURRENT/ Institute (HPI) JOINED HPI COHORT: GRADUATED FROM ALUMNI OF HPI WHO Brenda Arkell, THE HPI PROGRAM: EXPANDED THEIR HPI is a seventeen course series of work- Chemical Dependency Vicki McClain, Nursing ROLE: based skill training classes designed to Residential Administration Tammy McDevitt, enhance professional development and Manager, Cath Bryant Doan, leadership over two years. HPI looks to NURSES WHO Lab, Interventional Telemetry PARTICIPATED IN Radiology & grow Cottage Health employees within the Francesca (Chessie) HPI MENTORING Electrophysiology organization. Speak to your Manager if Hughes, Orthopedics PROGRAM: you are interested in the HPI program. Kim Berry, Manager, Catherine Uhl, Clinical Employee Health and Gregory Shinn, Resource Nurse, MICU SBCH Emergency Safety Department Jessica Vinson, Clinical Nurse II, Neurology/ NURSES CURRENT/ Kelly Park, PACU Urology ALUMNI HPI WHO PRESENTED AT C3: Lorenzo Vasquez, Kerry O’Rourke, Tammy McDevitt, Pulmonary/Renal/ Clinical Resource Infectious Disease Education Department Nurse, Psychiatry and Emergency Department Lorin Blaver, SICU Addiction Medicine Blood Availability with HPI Maricris Lising, Kristen Jennings, Mother Infant Care Clinical Resource Jared Grode, Telemetry Nurse, Pediatric Making a Difference Martha Montanez, Outpatient with Care Boards Neurology/Urology Endocrinology Mimi Dent, Mimi Dent presenting at C3 with Cindy Martinez and Michelle Pollard, Laura Mozako, Clinical Birth Center Catelynn Kenner Pediatrics Resource Nurse, Bee Brief, Debrief: An Surgical/Trauma Ramona Pursel, Evidence-Based Practice Birth Center Sean Wolfe, Clinical Project

Resource Nurse, SICU 2020 Health | Nursing Excellence | Cottage 9 STRUCTURAL EMPOWERMENT

Structural Empowerment CHARACTERISTICS: Lifelong Learner/Teacher, Professionally Engaged, Commitment to Community, Nurse Role Model CO-CHAIRS: Shelley Algeo and Caroline Rosen MEMBERS: Diane Barkas, Rhonda Bernstein, Tia Caldwell, Judy Corliss, Daniel DeAlba, “ The conditions Selveda Ertas, Lindsay Picotte, Shawn Hodges, Ramona Pursel, Gina Randall, Jackie Baker under which and Julie Hardin ACCOMPLISHMENTS: care is provided, 1. Recognition for specific unit’s implementation, ongoing practices for Clean Routine Helping including material You Heal initiative resources, human 2. Updated Clinical Ladder policy ONGOING: resources, and 1. Develop a Clinical Ladder application packet organizational 2. Planning for transition for Advanced Practice Nurses characteristics that allow nurses the capacity to mobilize people and resources to get things done.”

ANCC Magnet

MAGNET COMPONENT COMMITTEE 2020 Left to Right: Gina Randall, Judy Corliss, Diane Barkas, Daniel DeAlba, Shawn Hodges, Shelley Algeo, Selveda Ertas, Ramona Pursel and Jackie Baker Not Pictured: Caroline Rosen, Julie Hardin, Tia Caldwell, Lindsay Picotte and Rhonda Bernstein | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

10 RN RESIDENCY PROGRAM - SPRING 2020 Cottage Health RN Residency Training Program & Transition Nurse Program This year marked the first year of the extended New Graduate Nurse Training Program. To better align with the American Nurses Credentialing Center (ANCC), leadership redesignated it as the RN Residency Training Program, extending it to nine months. The cohorts meet weekly for the first ten weeks of the program and then monthly for the next six months. We also held our Acute Care Transition (ACT) Program, where RNs who have been working in non-acute care RN RESIDENCY PROGRAM - FALL 2020 settings are provided the Cottage Health opportunity to transition into acute care during a six- week program. The program consists of classroom sessions and preceptorships—the classes offer multiple learning modalities, including interdisciplinary presentations, simulation- based skills and critical thinking exercises. Although 2020 posed many challenges, we continued to receive support for these programs. We were able to adhere to the social distancing guidelines and provide a safe learning environment to aid in the transition to practice. | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

11 STRUCTURAL EMPOWERMENT

TRANSITION NURSE PROGRAM 2020 New Certifications, Degrees and Promotions Nursing, like healthcare in general, has become increasingly complex. The knowledge-intensive requirements of modern nursing require extensive education, as well as a strong personal commitment to excellence. Board certification of nursing plays an increasingly important role in the assurance of high standards of patient care. NEW DEGREES Beth Calmes (Transfusion Suite) Kathleen Miller BACHELOR OF SCIENCE IN NURSING (BSN) (GVCH Outpatient Surgery) Jennifer Gamez-Sparrow Brittany Erway (Endoscopy) (Eye Center) Shelley Alexander (SYVCH ED) Amber Shields (SBCH Surgery) Ella Murray (SYVCH ED) Kimberly Bishop (Birth Center) CLINICAL RESOURCE NURSE (CRN) Lorraine Lombardo Heather Lowes (NICU) (PRID / 3 WC) Debbie Vangyi (NICU) Jennifer Wang (PRID / 3 WC) Charlotte Alexander (NICU) Kristen Koeller (PRID / 3 WC) Tamra Abel (NICU) Tracy Wilks (SYVCH Med/Surg) Christopher Edwards (Oncology) Vanessa Van Dyck (Oncology) Ember Bartsch (NRU) Tammy Cain Bryant Doan (Telemetry) (Nursing Administration) Mayda Garcia (Telemetry) Tiffany Miller (Telemetry) Shelley Alexander (SYVCH ED) Yumi Oh (GVCH Med/Surg) Vito Summa (SBCH ED) MASTER OF SCIENCE IN Brooke Facundus (GVCH ED) NURSING (MSN) Erin O’Brien (Pediatrics) Charlotte Alexander (NICU) Brandi Stanley (Birth Center) Chrystal Borrayo Amber Shields (SBCH Surgery) (SYVCH Med Surg) Nicolas Santibanez (SBCH ED) Karen Rose (NICU) Tyler Lauderdale (SBCH ED) Gena Topping (Trauma) Kim Madden Tami Perez (NRU) (GVCH Outpatient Surgery) Lindsey Macias (NRU) Chelsea Grattan (Birth Center) Kim Brondum Kelley Knowlton (SBCH MICU) (Nursing Administration) Seol-Hee Kim Cedar Grice (GVCH ED) (SBCH PPSU Pre Admit) Gina Randall (Pediatrics/PICU) Jessica Pacheco Montes Liza Golden (Telemetry) (SBCH PPSU Pre Op) Tara Guillemin Cori Mayne (Birth Center) (SYVCH Med/Surg) Leslie Roth (Birth Center) CRITICAL CARE NEW GRADUATES PROMOTIONS Ella Murray (SYVCH ED) Your balloons may deflate, Danielle Becker (Birth Center) CLINICAL NURSE Keri Djupstrom (GVCH ICU) but keep your colors COORDINATOR (CNC) Kaitlin Stout (SBCH SICU) Left to Right: Tristan Racich, Denise Sanchez, Greta Rhonda Bernstein (Oncology) Rennacker, Blake Yoder, Taylor Davis and Natalie Millikan Katherine Fabbre (SBCH SICU) Tami Perez (NRU) Angela Krego (SBCH SICU) Raquel Pritchard (SBCH Patrick Jensen (SBCH SICU) | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage Outpatient Surgery) 12 Karen Garcia (SBCH ED) CERTIFIED GASTROENTEROLOGY Shannon Cook (SBCH ED) REGISTERED NURSE (CGRN) Brittany Evans (SBCH MICU) Wendy Gillespie (Endoscopy) Emily McCool (SBCH MICU) CERTIFIED MEDICAL SURGICAL Cottage Health Nurse Ashley Mara (Mother Care and REGISTERED NURSE (CMSRN) Obstetrics) Danni Lafrican (PRID / 3 WC) Practitioners Lead the Way Alix Kitka (SBCH ED) Valerie Diaz (GVCH Med/Surg) to Improve Access to Care Matthew Kulon (GVCH ED) CLINICAL NURSE SPECIALIST Morgan Ward (CRH) (CNS) The decision to staff Cottage Urgent Care centers Kaitlin Esquer (CRH) Karen Rose (NICU) with board-certified Family Nurse Practitioners was an easy one, as Nurse Practitioners are DOCTORATE OF NURSING CERTIFIED POST ANESTHESIA PRACTICE (DNP) NURSE (CPAN) perfectly poised to offer high quality, accessible and affordable care to our community. The role of Laura Canfield Marie Butcher (GVCH Surgery) (Nursing Administration) Nurse Practitioners as healthcare providers within CERTIFIED REHABILITATION the communities they serve is well respected and REGISTERED NURSE (CRRN) dynamic. We are proud to be at the forefront in MANAGEMENT Jenna Escobedo (CRH) solidifying the recognition and impact of the nursing Bridget Crooks (Clinical Manager, Ceceilia Duremdes (CRH) SBCH ED) profession's invaluable contributions. Rozelle Nebran (CRH) Summer R. Clary (Urgent Care) Yosemite Olivo (CRH) Cottage Urgent Care currently employs over Amanda Tuel (Urgent Care) Karen Cosio (CRH) 22 Board Certified Family Nurse Practitioners Caroline Rosen (Director, Patient throughout our markets in Santa Barbara, Ventura, CERTIFIED RN FIRST ASSISTANT Safety and Accreditation) (RNFA) and San Luis Obispo counties. In addition to Dana Pena (Clinical Manager, Irene Mindo (GVCH Surgery) full-time and per diem positions, there are several SBCH Materials for Surgical Adam Voss (GVCH Surgery) leadership positions that Nurse Practitioners fulfill. Services) The community needs-driven mission statement Julie Hardin (Educator, CRH) CERTIFIED WOUND OSTOMY NURSE (CWON) of Cottage Urgent Care is to improve the health Katie Gorndt Karen Koppes of Santa Barbara and surrounding communities (Vice President, SYVCH) (SYVCH Med/Surg) by developing relationships with individuals and Kim Berry (Manager, Employee meeting them where they are with their healthcare Health and Safety) INTERNATIONAL BOARD CERTIFIED LACTATION needs. Cottage Health opened eight Urgent Care Melissa Hurtado CONSULTANT (IBCLC) Centers across the Central Coast and with four (Educator, Unlicensed Staff) Mary Beth Del Mese more centers scheduled for opening, Cottage Urgent Sandi Marotto (Mother Infant Care) Care is certainly off to a robust start. (Director, SBCH PPSU/PACU) NEONATAL INTENSIVE CARE Tammy McDevitt (Manager, Cath NURSING (RNC-NIC) Lab, Interventional Radiology Charlotte Alexander (NICU) and Electrophysiology) ONCOLOGY CERTIFIED NURSE NEW CERTIFICATIONS (OCN) Lauren Christian (Oncology) CARE OF THE EXTREMELY LOW BIRTH WEIGHT NEONATE Molly Ziegeler (Oncology) (C-ELBW) Geneva French (Oncology) Tamra Abel (NICU) ORTHOPEDIC NURSE CERTIFIED (ONC) CERTIFIED EMERGENCY NURSE (CEN) Francesca (Chessie) Hughes Melissa Zaragoza (SBCH ED) (Orthopedics) Amie Fowler (Orthopedics) Chelsea Schmid (SBCH ED) PROGRESSIVE CARE CERTIFIED Danielle Lynch (SBCH ED) NURSE (PCCN) CERTIFIED HOSPICE AND Charmaine Pegarro (Telemetry) PALLIATIVE NURSE (CHPN) Amy Benesh (Telemetry) Staff at Cottage Urgent Care San Luis Obispo, Marigold Center Lindsay High (Palliative Care) Amber Coons (Telemetry) Lynn Rapp (Palliative Care) Leslie McNabb (Telemetry) | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

13 STRUCTURAL EMPOWERMENT

Awards and Scholarships SCHOLARSHIP OPPORTUNITIES

The Santa Barbara Cottage Hospital Foundation Scholarship Program was created in 2015. To be eligible, students must be currently enrolled in the CSU Channel Islands BSN Program at Cottage Health. These scholarships supplement funding beyond the Santa Barbara Cottage Hospital Foundation (SBCH Foundation) Education Loan Program. Last year the nursing program awarded scholarships to 29 students totaling $217,500.

GUNNER SCHOLARSHIPS SCHOLARSHIP SUPPORT FROM LOCAL BENEFACTOR HELPS NURSING PROMOTE ADVANCED STUDENTS JOIN COTTAGE WORKFORCE NURSING EDUCATION WHY I GIVE: "Where else can one do so much for a dedicated group of healthcare The Gunner Scholarship students starting on their careers of service to the various communities in the was established by Richard world, including our own? The effect is widespread and lasting, and of increasing and Margaret Gunner. The importance. " – George Burtness scholarship supports CH nurses pursuing advanced degrees in nursing. Eleven awards were George Burtness, a longtime volunteer and supporter granted totaling $107,000 for of nursing scholarships at Cottage Health (CH), the 2020-2021 academic year. made a new one-million-dollar pledge to establish Applications will be accepted late the George L. Burtness Endowment in Nursing spring of each year; the deadline Education. When established, the new fund will will be announced annually by support and promote excellence and innovation in Cottage Health's Chief Nursing nursing education in perpetuity. This gift celebrates a Officer. The following nurses legacy of service and dedication to CH by Mr. Burtness and his family. In addition received the Gunner Scholarship: to sustaining nursing partnership programs at CH, this important new fund will • Melissa Aldecoa, MICU also support promising students committed to improving their lives and their community by pursuing a nursing career at CH. • Shelley Algeo, Education and Nursing Professional Development SCHOLARSHIP RECIPIENT TAYLOR CARSON

• Laura Canfield, Nursing Upon graduation from the CSUCI Nursing Program at Administration Cottage, Taylor Carson, a past scholarship recipient, was • Cathy Cleek, SBCH ED hired as a Clinical Nurse I into the Pulmonary Renal Infectious Disease Department. • Mimi Dent, Birth Center "The CSUCI Cottage Health Scholarship played a crucial • David Linzey, SBCH ED role in my early success as a nurse. First and foremost, • Taryn Miller, EDHU I could not have afforded nursing school without the • Maria Rivera, MICU scholarship's generous financial support. The additional financial security also provided me the freedom to network through internships • Danielle Rutz, CRH and volunteer opportunities. This helped foster meaningful connections at SBCH • Sofia Segerstrom, CRH and within the community. Personally, the scholarship helped foster my self- • Amy VandenHeuvel, Nursing confidence, which has continued to grow throughout my first year and a half as a Administration nurse on 3 Wood-Claeyssens. I am sincerely grateful for this scholarship and I am eager to continue learning and growing in the hospital that has supported me." – Taylor Carson | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

14 Cottage Rehabilitation Hospital's (CRH) LAURA CANFIELD Gunner Scholarship Recipient Nurses Cross-Training As the number of COVID-19 cases began to rise in our community and In the fall of 2020, Laura Canfield the county began shutting down, it was apparent that we were heading completed a Doctor of Nursing Practice into uncharted territory. In preparation for what we saw happening (DNP) program through Grand across the country and the world, Cottage Health went into surge Canyon University. DNP education planning mode. As part of the Education team, we were tasked with essentials prepare advanced practice developing a process to cross-train nurses from outside departments nurses to manage the complexities of onto the Medical-Surgical floors. With Melissa Hurtado's recent bedside the modern healthcare environment, experience and a thorough understanding of CRH workflow, she offered translate evidence into practice and to pilot this process with a group of CRH nurses. improve patient and system Members of Education and Nursing Professional Development outcomes. The drafted the necessary cross-training documents and Melissa began curriculum recruiting. CRH nurses included courses who volunteered completed in advanced a self-assessment form to analytics, document their clinical information experience and chose a systems, competency level. Melissa population health and healthcare contacted managers from advocacy, theoretical underpinnings, Oncology, Telemetry, system leadership, sustainable change Neurology/Urology and and many others. Practice-focused Surgical Trauma and doctorates require a comprehensive preceptors were identified quality improvement project immersion on all shifts. implementation that is reported in Melissa communicated to a dissertation or final DNP project. both the preceptor and the Laura worked with the Emergency preceptee the expectations Department and Surgical-Trauma and instructions for units on an Evidence-Based project Sofia Segerstrom, Melissia Hurtado and Jenna Escobedo completing competency to determine if or to what degree documentation. She implementation of a nurse bedside rounded during these report would improve Emergency orientation shifts and was available by phone. After a precepted 12-hour Department throughput. She received shift, each nurse either took or supported a patient assignment based a great deal of support throughout her on skill set and comfort level. doctoral journey, including Herb Geary, After orientation, Melissa followed up for feedback on the process her mentor, the Richard and Mimi including suggestions for improvement. Gunner Endowment Fund Nursing Scholarship, and so many of our nurses. Feedback received from preceptors was overwhelmingly positive and Laura has expressed many thanks for all a Telemetry nurse commented that she learned some new things from the support she received. her preceptee. The nurses reported having a meaningful collaborative experience. Overall, a total of sixteen CRH nurses cross-trained over three weeks from mid-April to early May. CH was more prepared for the second surge and these CRH nurses were an invaluable resource for the Med/Surg floors. The collaborative efforts from everyone involved reflect our commitment to Cottage’s core values of Excellence, Integrity and Compassion. | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

15 STRUCTURAL EMPOWERMENT

Community Events and Health Fairs CH nurses are committed to wellness and prevention in the community, aligning with the CH professional practice model. Extending their expertise and passion for helping others, nurses help to organize, promote and staff local health fairs, meeting community health and education needs to make a lasting impact on community wellness.

PARISH NURSING

COVID-19 SAFE FLU CLINICS

Parish Nursing staff provided 750 COVID-19 safe flu vaccines throughout the community. Due to the pandemic, most clinics were held outside, with some drive-up clinics as an option. Along with the vaccine, nurses also provided education on preventing the spread of the virus, including personal protection equipment, physical distancing and handwashing.

Jan Fadden and Cathy Mollkoy

VETERENS DAY CELEBRATION Cathy Mollkoy and Jan Fadden created a Veterans Day Celebration for the formerly homeless veterans at Johnson Court. Cathy prepared a full picnic lunch to honor these veterans for their service to our Sharon Head at First Presbyterian's Flu Clinic country.

SENIOR OUTREACH Jan Ingram provided the flu vaccine, blood pressure checks and food distributions for Pilgrim Terrace seniors. Due to COVID-19 restrictions and staff shortages, Jan helped to get meals to socially isolated seniors with staff member Jennifer Skinner.

Jennifer Skinner, Pilgram Terrace staff | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage member and Jan Ingram delivering food 16 to seniors TRAUMA SERVICES

COMMUNITY BABY SHOWER THINK FIRST Trauma Services RNs participated During Fall Prevention Week, Trauma Services collaborated with Therapy in a Community Baby Shower on Services to present "Think First to Prevent Falls." The class focused on fall January 25 at the Santa Barbara prevention education and physical exercises to improve strength, balance and Public Library. The RNs provided endurance. The presentation was available on YouTube Live. Trauma Services education to approximately 85 continues to provide a link to the presentation as a fall prevention resource. expectant parents/families about infant safe sleep practices and car seat safety.

Kristen Wenda Laura Molly Hawkins Lauren Sutherlin Milliken, OT Pagliaro, PT Grandcolas, OT

BIKE AND PEDESTRIAN SAFETY OUTREACH From January 15 -March 7, Injury Prevention RNs participated in Lauren Sutherlin and Molly Hawkins seven community outreach events related to bike/pedestrian safety geared to Santa Barbara youth and EMERGENCY DEPARTMENT (ED) their families. Before the state- AIRWAY SIMULATIONS mandated stay-at-home orders issued in March, we reached Trauma Services, John Anis, MD, over 900 people through these and the Gary M. Hock Family educational community events: Molly Hawkins and Lauren Sutherlin Patient Care Simulation Center provided a difficult surgical airway • Walk N' Roll to School simulation for 11 ED physicians. • 5th Grade Health Fair Goleta HEAT STROKE AWARENESS AT The remaining ED physicians will Unified SANTA BARBARA ZOO AND attend the training in 2021. PASEO NUEVO • La Patera Science Night Injury Prevention RNs utilized • Monte Vista Science Night a large thermometer display to • Solvang Touch a Truck helmet demonstrate the temperature distribution inside and outside of a vehicle. Education was provided to Molly Hawkins reading to students community members about the dangers of leaving children or animals in a vehicle. Even in cooler temperatures, serious injury or death from heat stroke can occur. This education was a way to inform the public while maintaining social distancing during the pandemic.

Robin Malone, MD, Lauren Sutherlin, Edward Cotner, MD and Molly Hawkins | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

17 STRUCTURAL EMPOWERMENT

On-Site And Off-Site Presentations Cottage Health nurses are committed to professional development, as demonstrated by exceptional participation in off-site and on-site classes. They collaborate to enhance the patient care experience while elevating the nurses knowledge and confidence.

LOCAL AND NATIONAL CONFERENCES CH nurses who had the opportunity to share their knowledge at a local or national conference:

PRESENTER PRESENTER PRESENTER PRESENTER PRESENTER Judy Corliss, Penny Morgan Vicki McPhail, Mimi Dent, Clinical Elizabeth Clinical Manager, Overgaard, Educator, Mother Resource Nurse, Robinson, Policy Endoscopy Director, Cottage Infant Care, Birth Center Writer, Nursing Education and Administration CONFERENCE Children's Pediatric CONFERENCE Clinics Nursing Professional Society of Association of CONFERENCE Development Gastroenterology CONFERENCE Women's Health, Pacifica Graduate Nurses and Association of CONFERENCE Obstetric and Institute, Santa Associates (SGNA) California Nurse Association of Neonatal Nurses Barbara Women's Health, (AWHONN) TYPE OF PRESENTATION Leaders (ACNL) Obstetric and Improving Swedish Cancer Podium and Poster TYPE OF PRESENTATION Neonatal Nurses Professional Practice Institute Poster TITLE OF PRESENTATION (AWHONN) Survivorship AWHONN National Effervescent Crystals TITLE OF PRESENTATION California Section Program Convention in the Treatment Clean Routine: Annual State of Food Bolus Leveraging Magnet Convention TYPE OF PRESENTATION Ridley-Tree Cancer Obstruction Principles to Improve TYPE OF PRESENTATION Podium and Poster Center Patient Care and Poster TITLE OF PRESENTATION TYPE OF PRESENTATION Outcomes TITLE OF PRESENTATION Bee Brief, Debrief: Podium

So Happy Together An Evidence-Based TITLE OF PRESENTATION Practice Project Baby Bridge: Reduce Journaling as a Way Mother-Baby of Healing Separation During Newborn Admission The Nurse: Wounded Healer with Ten Thousand Faces

Writing as a Way of Healing | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

18 MAGNET COMBINED Each year, Magnet Component Committee members meet in the fall to hear presentations from the American Nurses Credentialing Center (ANCC) National Magnet Conference. The 2020 virtual Magnet conference offered various topics, including the pandemic, diversity and the Magnet journey. Eight Cottage Health nurses had the privilege of participating in the conference and shared the knowledge gained with other Cottage Health nurses during the Magnet Combined meeting. The topics presented were the following: PRESENTER TOPICS

Penny Morgan Overgaard, Director, • Lessons learned from a Magnet leader during a crisis Cottage Children's Pediatric Clinics • Sustaining a positive practice environment during a leadership transition

Lindsay Picotte, Educator, • Cultivating innovation in an Advanced Practice RN fellowship RN Residency Training Program Coordinator, • How the pandemic inspired programmatic growth Education and Nursing Professional Development

Judy Corliss, • Nursing research Clinical Manager, Endoscopy • Value of certification • Nursing fellowship/transformational leadership • Culture of recognition

Susan San Marco, Director, Ridley-Tree Center • The influence of cultural competency on patient care outcomes for Wound Management and Skin Wound, • Creating an inclusive culture Ostomy Therapy Services

Julie Hardin, Educator, Patient/Family Education, • Competency-based education and outcome-based continuing education Patient Education • Competencies for Advanced Practice RNs

Jackie Baker, • Power of a thought Magnet Program Manager, Education • World Health Organization State of Nursing report and Nursing Professional Development • Resiliency and wellness

Mimi Dent presented on Nursing Research at the New Knowledge meeting in November. Sharilyn Vasquez plans to present at the Exemplary Professional Practice committee meeting in 2021. | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

19 STRUCTURAL EMPOWERMENT

Nursing/Pain Grand Rounds Nurse role models share their knowledge and experience resulting in collaboration, support and learning together. Grand Rounds facilitated by CH Clinical Nurse Specialists (CNS) covered various patient care themes.

NURSING GRAND ROUNDS PAIN GRAND ROUNDS October 21, 2020 November 18, 2020 CHALLENGES TURN INTO WINS FOR THE PALLIATIVE CARE AT COTTAGE HEALTH – 15 YEARS ON PEDIATRIC MULTIDISCIPLINARY TEAM Presenter names: CARING FOR A YOUNG ADULT Ellie Melton Presenter names: Sheila Gillette Constance Wilson Lori Mendez Gina Devris, MOT, OTR/L Lindsay High Carissa Guzman Cathie Nelson, LCSW, OSW-C Morgan Campbell Amy Jenneve Payton Josi Regina Medina, MSW, LCSW, ACM-SW Blanca Reynoso, UCT Rosalie Yeager, PT, DPT Not Pictured: Kylie Biever

Gina Devris Carissa Guzman Morgan Campbell

Left to Right: Lori Mendez, Cathie Nelson, Lindsay High, Sheila Gillette and Ellie Melton

Amy Jenneve Payton Josi Regina Medina

Blanca Reynoso Constance Wilson Rosalie Yeager | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

20 What's in a name? Conferences The Education Department has At the beginning of the year, CH nurses were able to attend 11 historically overseen competencies, various in-person conferences. After COVID-19, restrictions education and training. Over time, the prohibited live conferences. Many transitioned to virtual department has grown to include Magnet platforms, which allowed nurses to participate in national standard alignment, interprofessional conferences remotely. simulation, student clinical rotations and preceptorships and the Nurse Residency (formerly known as the New Graduate Nurse Training Program) and Transition Program. The simple title Education LIST OF CONFERENCES Department, which had been in existence for 30+ years, no longer reflected the The Qualitative Review [TQR] breadth of department services. International Meeting on Simulation in Healthcare [IMSH] The Association for Nursing Professional Electronic Fetal Monitoring Advanced Review Development (ANPD) identifies professional development as a specialty of The Counseling Team International nursing practice. Standards and research Cardiology Symposium define Nursing Professional Development (NPD) and are critical to quality patient Association of California Nurse Leaders [ACNL] and organizational outcomes. The Principles of Managing Pain (Webinar) NPD Practitioner (educator) facilitates Association of Women's Health, Obstetric and Neonatal Nurses professional role development that includes practice transitions, managing California Hospital Association Center for Post-Acute Care – change, acting as a champion for scientific Creating Care Partnerships: Beyond the Continuum inquiry and interprofessional collaboration, Studers' Emergency Department Workshop and advocating for the NPD specialty (ANPD, 2020). National Association of Clinical Nursing Specialists [NACNS] – Transforming Healthcare: Our Past, Our Present & Our Future Anti-Inflammatory Lifestyle (Virtual) Child Life (Virtual) National Mother Baby Nurse (Virtual)

American Nurses Credentialing Center Magnet Summit (Virtual) During a year-long process, education and nursing development department names Trauma Injury Coding Course ICD-10 (Virtual) were reviewed and recommendations were Pediatric Endocrinology Nursing Society National (Virtual) proposed to the Chief Nursing Officer. In Association for Nursing Professional Development (Virtual) December 2020, Education and Nursing Professional Development was approved Society of Gastroenterology Nurses and Associates (Virtual) by the Chief Operating Officer. This title American Psychiatric Nurses Association (Virtual) is a more accurate characterization of the range of responsibility of the Education team now and into the future. Although the name has changed, the goal remains Empowering You Through Learning. | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

21 STRUCTURAL EMPOWERMENT

PANDEMIC PARTNERSHIPS Clinical Nurse Specialists at Cottage Health Team Nursing in Critical Care The Clinical Nurse Specialist (CNS) is a registered nurse The pandemic has challenged our approaches for who has completed a master or doctoral degree in nursing managing care in the ICU. The need for increased within a specific population or setting. CNS is certified bed capacity and new staffing models inspired by the Board of Registered Nursing. Three of the CNSs leaders to be creative in staffing to ensure the best currently function in the CNS role of their specialty in possible care is delivered to critically ill patients. Adult Intensive Care, Pediatrics/Pediatric Intensive Care The American Association of Critical Care Nurses and Neonatal Intensive Care. The CNS is an advanced (AACN) provided critical care education for the practice nurse guided by their knowledge and evidence- non-ICU nurse to perform unfamiliar tasks with based practice to improve patient care, quality outcomes supervision from an ICU-experienced clinician. The and cost-efficiency. training included these electronic learning courses: "COVID-19 Pulmonary, ARDS, and Ventilation Resources" and "Why Prone? Why Now? Improving Outcomes for ARDS Patients.” Additionally, RNs reviewed CH specific standards, including Standards of Care, Neuro Module and Clinical Institute Withdrawal Assessment (CIWA) and management in ICU. Lastly, each RN completed a self-evaluation on topics ranging from routine patient care to ventilators and infusion Left to Right: Laura Canfield, Vicki Lekas, Diane Barkas, Lisa Dugger and Jennifer Ferrick. Not pictured: Elizabeth Robinson medication and titration. This assessment also served as CRITICAL CARE EDUCATIONAL STRATEGIC a competency PLANNING RETREAT Kim Runhaar and Erica Guzman verification Critical Care Education Council masked to plan education in MICU for the shift for 2021. orientation each cross-trained staff completed. The following departments' nurses participated in cross-training: Telemetry, Pulmonary/ Front Row Left to Right: Infectious Disease/Renal, PACU, PPSU, Radiology, Brandon Mack, Erica Ashley, Lesley Gardia, Eye Center, Anesthesia and Endoscopy. Kim Runhaar, Sarah Gray, Emma (the an MICU nurse, stated, "The key is the [cross- dog), Patti Wicklund trained] nurse. If they are comfortable with their and Sharon Morley scope of practice, comfortable asking questions...and Back Row: Vivian Elbert, comfortable knowing their limitations, it makes for a Carolina Karakashian, successful team." Paula Gallucci, Bobbi Evans, Donna Janega and Vanaja Selvaraj | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

22 COVID-19 Mock Codes Julie Hardin Jennifer Granger Brown, Simulation Coordinator; Cottage Rehabilitation Hospital Educator Katie Loster, Clinical Nurse Educator, Med/Surg; and Due to the COVID-19 pandemic, Cottage Health (CH) Tammy McDevitt, Clinical Nurse Educator, Med/Surg canceled all community education classes; subsequently, In early 2020, the COVID-19 pandemic created community members struggled to find appropriate health a healthcare crisis that placed an immense education. Nursing Professional Development (NPD) training burden on CH educators and clinicians. practitioners investigated various opportunities to YEAR provide distance learning. Working closely with OF THE We faced a new and immediate challenge of NURSE providing resuscitation where rescuers had to the Information Technology (IT) department, a YEAR balance their patients' immediate needs with OF THE virtual meeting platform was adopted. IT provided NURSE their own safety. The American Heart Association training to teach staff regarding the use of this new (AHA) released interim guidelines for resuscitation platform. The primary classes of focus were childbirth, in suspected and confirmed COVID-19 patients. breastfeeding and infant CPR classes. The Clinical Educators and An impressive collaboration between childbirth educators, Simulation Coordinator acted the Marketing Department, IT Department and NPD swiftly to incorporate the Practitioners developed a virtual tour of the Birth Center guidelines into practice. The and a curriculum for online classes. In pandemic presented a unique April, the virtual doors opened to the opportunity to establish public, providing a clear trajectory for collaborative partnerships the future of childbirth classes. In the between clinicians that past, some patients reported they were Jennifer Granger Brown previously had not worked unable to attend the in-person classes together. Clinicians from due to personal schedules and distance the Emergency Department, from the hospital. Providing multiple Respiratory Care, Internal virtual learning options fills the gap Medicine, Critical Care for these underserved clients. At this time, it is clear the and Medical-Surgical units pandemic has propelled us into a new world where we participated in a specialized will provide more virtual options to appeal to younger simulation training focused generations and fill the gap for those who cannot attend on hardwiring proficiency in-person classes. with the new AHA guidelines. Katie Loster Kolb's Experiential Learning Theory was used to develop Donna Janega the three-tiered training Service Director, Critical Care Services framework to accommodate When the CH Incident Command Center designated different learning styles. Thirty the Critical Care Unit on 3 Arlington, the trainings were conducted workflow changed for the team of critical over three weeks, with 270 care nurses, UCTs and physicians. To code responders trained. The accommodate more critically ill patients, three-tiered approach included MICU and SICU were combined and 2 Tammy reviewing the guidelines, McDevitt Wood-Claeyssens became another ICU video observation of an ideal COVID-19 unit. Nursing and other clinical COVID-19 code blue response staff demonstrated their courageous and and participation in two simulations with debriefing. resilient passion in caring for COVID-19 patients. Door Evaluations demonstrated that 95% of participants monitors ensured that staff followed the correct personal felt prepared to care for the resuscitation needs of protective equipment donning and doffing procedure. COVID-19 patients while simultaneously maintaining Patti Wicklund led education and orientation for the their own personal safety. The educators concluded team nursing protocol for Acute Care and Critical Care that this training framework was effective and can nurses. The team worked in new ways with Nutrition, be utilized in future disaster preparedness training in Environmental and Therapy Services to care for the patients while demonstrating exemplary teamwork.

other healthcare organizations. 2020 Health | Nursing Excellence | Cottage 23 24 | Cottage Health | Nursing Excellence 2020 “Nurses “Nurses ANCC Magnet and autonomy.” competence accountability, of capacity in thehighest functioning EXEMPLARY PROFESSIONAL PRACTICE Sensitive Indicators, Interdisciplinary Influence, Quality Improvement, Interdisciplinary Review, Indicators, Peer Sensitive Autonomy Sharilyn Vasquez, Katie Gorndt, Karen Rose andJackie Karen Vasquez, Rose Baker Sharilyn Katie Gorndt, Tammy Janega, Granger Donna Brown, Alexander, Shelley McLaughlin, Danilyn McDevitt, 1. 3. 2. 1. Professional Practice Exemplary ONGOING: ACCOMPLISHMENTS: MEMBERS: CO-CHAIRS: CHARACTERISTICS: Front Row: Tammy Janega,Jennifer Donna McDevitt, Ferrick andShelleyAlexander Jennifer Dunn LizLundquist, Dan-Rambaran, Marla Sharilyn Vasquez, Baker, Jackie De Karin Witte, Keepand Darcy Back Row, Jennifer DanilynMcLaughlin, Gorndt, Granger Brown, Left toKatie Right: Laura Canfield, MAGNET COMPONENT COMMITTEE 2020 Identification of best practices during a pandemic apandemic Identification practicesbest during of feedback to-face peer withface- not to move forward anddecided feedback nursingpeer staff regarding Surveyed Created acharter for the committee Updated Peer Feedback policy Marla Dan-Rambaran, Karin DeWitte, Karin Marla Dan-Rambaran, Jennifer Jennifer Jennifer Dunn, Ferrick, Laura Canfield, Darcy Keep and Liz LundquistLiz and Keep Darcy Canfield, Laura Professional Practice Value Model Passion, Nurse/Patient Satisfaction, Nurse

Patient Satisfaction HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS (HCAHPS) Cottage Health achieved our highest HCAHPS scores despite a year of an increased number of patients, restrictions on visitors, and many changes to procedures and workflow.

NOTABLE NEWS: Children’s Book Powered Air Regarding the Pandemic Purifying Elyse DeMar Gualotuna, Clinical Resource Nurse, Cottage Respirator Rehabilitation (PAPR) Hospital, wrote a children's book At the beginning of the while on maternity pandemic, nursing leadership leave. Elyse stated, identified that Cottage Health "My daughter needed more PAPR helmets was born during and a refresher course. PAPRs the coronavirus are required for high-risk pandemic. As a new mom, I felt we needed aerosol-generating procedures a book to help explain this time in history to such as intubation, and for our little one." staff unable to get a proper seal on N95 masks. Multiple departments (Infection Prevention and Control, Employee Health and Safety and Education and Nursing Professional Development) collaborated to create the training and trained superusers from each department. 2020 Health | Nursing Excellence | Cottage 25 EXEMPLARY PROFESSIONAL PRACTICE

Gina Randall Julia Gladstone Clinical Manager, Pediatrics and PICU Clinical Resource Nurse, SYVCH Emergency CARING FOR COVID-19 PEDIATRIC PATIENTS Department CARE OF A COVID-19 PATIENT IN THE At the beginning of the pandemic, CH concentrated on EMERGENCY DEPARTMENT AT SANTA the adult patient population as cases continued to rise. YNEZ VALLEY COTTAGE HOSPITAL Little data existed regarding the impact of COVID-19 on children, but as more data emerged, the emphasis On a busy day in the Emergency YEAR YEAR Department at Santa Ynez Valley Cottage OF THE shifted to include the pediatric population. Daily OF THE NURSE NURSE collaboration with Incident Command Center and Hospital (SYVCH), with one remaining the Director of Children's Services led to developing bed and limited resources, the staff was a plan to manage a pediatric COVID-19 positive patient. alerted by the greeter that we had a new The challenge was the location and how best to care for a patient arriving in COVID-19 positive pediatric need of immediate patient who may range from attention. Lethargic newborn to 18 years of age and gasping for and utilize the Pediatric and air, the patient was Pediatric Intensive Care Unit swiftly transferred (PICU) staff. Based on the to the only room Director's leadership and available. The advocacy, it was determined patient's oxygenation, to use negative-pressure on room air, was in rooms in the pediatric unit the 40s and rapid and PICU. intubation was needed. One nurse already wearing an N95 stayed with the patient, Environmental modifications while the other staff donned the proper became a primary focus to PPE. Once the patient was intubated and Rachel Troostand and Erin O’Brien meet both the emotional stabilized, the Critical Care Transport and physical needs of team rushed the patient to the designated children. Tape placed on the hallway floor in front of the isolation unit at Santa Barbara Cottage COVID-19 rooms delineated a visual barrier for staff. This Hospital (SBCH). Due to the quick visual clue reminded the pediatric nurses that stepping over response, the patient recovered and was the tape meant the nurse was now in a COVID-19 unit. Nurses discharged from the hospital in two to completed drills in donning and doffing PPE and implemented three weeks. a buddy system to check for correct PPE technique. The Pediatric and PICU team developed an adjunctive acuity tool to accommodate this change in staffing. Children confined to their room with their parents presented a unique challenge in keeping the children stress-free. A desk placed in the room of school-age children allowed for normalcy and school activity during the hospital stay. By allowing the COVID-19 positive pediatric patient to remain in the appropriate setting, the nurses were able to deliver safe, quality, efficient care that met the unique developmental needs of their patients. | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

26 Retirements Many thanks to our valued retirees for their dedicated service to Cottage. They will be greatly missed around the halls of CH, and we wish them the very best.

LEANNE SAAR, 50 YEARS EDRIE OHL, 36 YEARS Santa Barbara Cottage Hospital Santa Barbara Cottage Hospital Leanne began her career at SBCH Edrie was a new graduate nurse in 1969 as a nursing assistant at SBCH in 1983 and worked while attending the SBCC nursing most of her career in the Birth program. Before becoming an Center. She was certified in both integral part of the NICU team, she worked in Critical Inpatient Obstetrics and Electronic Care and the Emergency Department. She served as Fetal Monitoring. In the department, she was the a resource and mentor to her peers. The NICU staff known expert in gestational diabetes and updated will remember her calm demeanor during emergent all the unit policies before her retirement. She situations, positive encouragement and dedication. was knowledgeable on so many diverse subjects, consistently amazing us with her expertise and fun facts.

CHARLOTTE GUTIERREZ, 40 YEARS LI-FANE LIU, 35 YEARS Santa Barbara Cottage Hospital and Santa Barbara Cottage Hospital Goleta Valley Cottage Hospital Li-Fane began her nursing career Charlotte began her 40-year career in Taiwan in 1970 and came to the at CH as a CNA. After receiving United States in 1983. She joined her RN license, she worked in the SBCH in 1985 and worked in the Emergency Departments at both SBCH and GVCH. Float Pool, Med/Surg and Short- Charlotte left CH for two years to provide nursing care Stay, before coming to the NICU in 1996. Li-Fane was in Africa. In her new chapter, she enjoys swimming, immensely committed to the babies and families she bike riding and traveling with her husband, Rick. cared for. The NICU will miss her laugh, knowledge, skills and dedication.

STACIE OUELLETTE, 37 YEARS Santa Barbara Cottage Hospital Stacie started her nursing career at SBCH in 1982, spending the CHRISTINE BARBUTO, 21 YEARS majority of the time in the Birth Santa Barbara Cottage Hospital Center. She held an Inpatient Christine started working at SBCH Obstetrics certification and was the in 1998 as an experienced Labor resource for surgical education. She is most proud of and Delivery nurse and is certified sharing the birth experience with new parents and in both Inpatient Obstetrics and families and assisting new moms with breastfeeding. Electronic Fetal Monitoring, with Stacie also enjoyed helping precept new staff. Stacie a strong background in operating room skills. She was a childbirth educator and found fulfillment in was an expert in high-risk obstetrics and a strong teaching prepared childbirth classes. She met her team player. Christine was the resident "wise woman," husband of 37 years, Jim, at SBCH and all three of their always ready to give a kind word and form personal children were born at SBCH. She had a calm, soothing connections to her patients. manner with both her patients and peers and her famous granola will be missed. 2020 Health | Nursing Excellence | Cottage 27 EXEMPLARY PROFESSIONAL PRACTICE

DEBBIE TEMPLE, 18 YEARS ANNA SMITH, 13 YEARS Santa Barbara Cottage Hospital Cottage Rehabilitation Hospital Debbie has been a registered nurse Anna worked at Cottage since 1987. She came to SBCH as Rehabilitation Hospital for 13 years a traveler in the Critical Care Unit and at the Rehabilitation Institute at in 2001 and eventually signed on Santa Barbara before that. She was a as full-time staff. In 2007, Debbie nurse for 52 years. Anna was skilled transferred to Mother Infant Care after 20 years of in her specialty and became a Certified Registered Critical Care nursing. She especially enjoyed working Rehabilitation Nurse during her career. An everyday with babies. Debbie is loved by her co-workers and hero away from work as well, Anna volunteered for enjoyed time away from work with them on hikes and Meals on Wheels regularly. On one occasion, she biking. In retirement, she now lives in North Carolina averted a near-tragic event during a home meal and plans to travel and visit family and friends all over delivery when she discovered a gas leak and alerted the country. Her goal is to visit every state in the US, the client. Anna inspired her daughter to become a with only eight more to go. nurse. She plans to enjoy more time with her family in retirement.

WENDE CAPPETTA, 16 YEARS Santa Ynez Valley Cottage Hospital MARGARITE (MAGGIE) WORDELL, Wende holds Masters degrees in 13 YEARS both Nursing and Business and has Cottage Rehabilitation Hospital 44 years of healthcare experience. Maggie originated from Galway, Her experience spans clinical, Ireland, and earned her RN degree academic and administrative roles from the Lewisham Guys School in large multi-facility health systems and small rural of Nursing in London, England. environments. After spending some time at the She enjoyed a long career with Cottage Rehabilitation bedside, the past 30 years have been in leadership Hospital (CRH), starting with her role as a staff nurse positions in nursing, hospital operations, healthcare in 1988 when CRH was known as Rehabilitation ethics and compliance. Institute at Santa Barbara (RISB). She also worked Wende served as Vice President for Santa Ynez Valley as a Surgical-Orthopedic nurse at the now-closed Cottage Hospital. She has been an invaluable leader for St. Francis Hospital in Santa Barbara. Maggie SYVCH, guiding the hospital through the construction transitioned into Nursing Supervisor and Director of two new wings, seismic retrofit upgrades, of Staff Development roles for RISB until Cottage technology upgrades and the recruiting of several Health's affiliation. She was a Certified Rehabilitation qualified physicians. She brought great knowledge Registered Nurse (CRRN) and maintained her status in regulatory compliance and finance, which was as the Educator for CRH until her retirement in beneficial to the team. She was crucial in gaining the October. In addition to supporting transdisciplinary designation of "Critical Access Hospital" for SYVCH. clinical education, electronic medical record documentation and Basic Life Support Certification, The entire SYVCH team would like to thank Wende Maggie provided significant contributions to successful for her outstanding leadership for the past 16 years and regulatory processes, including critical support wish her the very best in her retired life. during the triennial surveys with the Commission on Accreditation of Rehabilitation Facilities (CARF). | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

28 RUTH BURTON, 12 YEARS SUSAN OTTO, 9 YEARS Santa Barbara Cottage Hospital Santa Ynez Valley Cottage Hospital Ruth has been a nurse for 25 years. and Santa Barbara Cottage Hospital She worked at Valley Hospital, Susan started her nursing career Marian, before joining Santa Barbara as an RN in 1978 at Santa Barbara Cottage Hospital's NICU team. The Cottage Hospital on the Med/ NICU staff will miss Ruth's spunk, Surg and Orthopedic units. sense of humor, caring spirit and She graduated from California State University, enthusiasm. Dominguez Hills with her BSN in 1998. After more than 20 years of varied and extensive experience at other healthcare organizations, she returned to Santa Ynez Valley Cottage Hospital DIANE HALDERMAN, (SYVCH). Susan arrived just after our new Med/ 12 YEARS Surg unit opened in 2011. Susan has been an asset to SYVCH and a mentor to many. She used her years of Santa Barbara Cottage Hospital experience to keep improving and staying current in Diane was a dedicated psychiatric caring for our patients. She took immense pride in nurse with 25 years of experience. the care she delivered and will be missed by staff and She recalls the 12 years working on patients alike. 5 Bath as the highlight of her career. Upon retirement, Diane moved to the East Coast to enjoy time with her eight grandchildren.

HEIDI RIGOLI, 9 YEARS Santa Barbara Cottage Hospital JULIETTE FISH, 9 YEARS Heidi has been a psychiatric nurse Santa Barbara Cottage Hospital at SBCH for nine years. As a lifelong Juliette worked for Cottage Health as learner, Heidi became an RN at the a Trauma Nurse Practitioner for the age of 50. She went on to earn her last nine years of her nursing career. certification in Psychiatric Nursing She returned to school in her 40's from the American Nurses Credentialing Center to become a nurse and fulfill her desire to help others. (ANCC). She attained her BSN while working as a During her tenure at Cottage Health, she states she psychiatric nurse on 5 Bath. In her retirement, she will was privileged to work with a terrific group of people. be caring for her husband and plans to pursue a career Juliette provided top-notch quality care to trauma as a writer. "Who knows? Maybe I'll become a reporter patients, helping them through very challenging when I'm 70!" Heidi says. times. Juliette's enthusiastic attitude, commitment to excellence and willingness to help others will be greatly missed.

KRISTEN YOUNG, 32 YEARS Pediatric Multispecialty Clinic

DEBORAH LARZOLO, 25 YEARS Santa Barbara Cottage Hospital

MICHELLE EULENHOEFER, 19 YEARS Santa Barbara Cottage Hospital

SUSAN BRADY, 12 YEARS Santa Ynez Valley Cottage Hospital | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

29 NEW KNOWLEDGE, INNOVATIONS AND IMPROVEMENTS

New Knowledge, Innovations and Improvements CHARACTERISTICS: Innovator, Adventuresome, Tolerant of Uncertainty, Confident, Risk Taker, Forward Thinking, Tech Savvy CO-CHAIRS: Dan Thomas and Libby Smith MEMBERS: Amanda Rogers, Deborah Short, Jackie Baker, Jared Grode, Mimi Dent, Patti Wicklund, Vicki Lekas, Vicki McClain, Susan San Marco and Tegan Hannah “Blending ACCOMPLISHMENTS: 1. Developed Care Board Video Presentation Guide research, 2. Launched Nursing Research Website evidence-based 3. Created an Evidence-Based Practice Tool Kit practice, and ONGOING: 1. Improving communication with staff innovation to improve outcomes.”

ANCC Magnet

MAGNET COMPONENT COMMITTEE 2020 Left to Right: Dan Thomas, Libby Smith, Vicki Lekas, Patti Wicklund, Deborah Short, Jared Grode and Jackie Baker Not Pictured: Amanda Rogers, Mimi Dent, Vicki McClain, Susan San Marco and Tegan Hannah | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

30 CH Launches the First Nursing New Way of Completing Life Research Training Program Support Skills The Nursing Research Training Program is a program Cottage Health implemented the new HeartCode of the Nursing Research Consortium. The program Complete programs aims to promote and (BLS, ACLS, PALS) that support nursing research enable staff to complete advancement across the their mandatory life continuum (novice to support certifications expert) through building independently. Staff collective knowledge of now have the ability to research at Cottage Health access the Resuscitation Jackie Baker Molly Hawkins and developing skills and Quality Improvement capacity to conduct high- (RQI)® manikins at quality nurse research in their convenience. Stephanie Guzman using the the hospital and community Additionally, the new RQI station through multimodal, hands- American Heart on learning opportunities. Association has changed This 18-month long course its online portion for adaptive learning and reduced is designed for the clinical the need for electronic simulations, making it easier Nichol Clark Maricris Lising RN to learn more about to navigate. Stephanie Guzman, SICU, was the first to nursing research. By complete her skills on the RQI manikin station. the end of the program, nurses will have designed, implemented, synthesized, NEW ROLE IN SANTA BARBARA COTTAGE and disseminated a research HOSPITAL EMERGENCY DEPARTMENT (SBCH ED) study from scratch; this will During the pandemic, SBCH ED leadership created Cathy Cleek Erin Nordholm be accomplished individually the Pivot Nurse role to ensure staff and patients or as part of a research safety. The function of team. For more information the position is to greet about the program, contact Rachyl Pines, Ph.D., Research incoming patients and Scientist I, or Jackie Baker, Magnet Program Manager. their families in the ED NURSES WHO PARTICIPATED IN THE TRAINING PROGRAM driveway and screen the patient for COVID-19. • Jackie Baker, Education and Nursing Professional Symptomatic patients Development enter the ED through a • Nichol Clark, Telemetry separate entrance and • Cathy Cleek, Emergency Department (SBCH) are placed in an isolation • Molly Hawkins, Trauma Services room. The nurse directs • Maricris Lising, Mother Infant Care Christy Philip, Pivot Nurse families to wait in their • Erin Nordholm, CRH cars or at home and lets them know the ED staff will call with updates. Each TRAINING PROGRAM MENTORS shift, the ED determines who will function as the • Laura Canfield, Vice President, Patient Care Services and Pivot Nurse and the role requires them to be triage- Chief Nursing Officer competent. The weather has been challenging for • Penny Morgan Overgaard, Director, Cottage Children's the nurses in this role as they are in full PPE. The ED Pediatric Clinics provided hydration and shade during warm weather • Diana Barkas, Clinical Nurse Specialist, Critical Care and found ways to keep staff warm when temperatures dropped. The Pivot Nurse role has been important to • Libby (Frances) Smith, Director, Women's Services safeguard ED staff and patients. • Karen Jensen, Retired Director of California State

University Channel Islands, Cottage Health Volunteer 2020 Health | Nursing Excellence | Cottage 31 NEW KNOWLEDGE, INNOVATIONS AND IMPROVEMENTS

RN TITLE/SUBJECT OF PROJECT

Lindsay Picotte, Educator, RN Residency New Graduate Retention Training Program Coordinator New Graduate Program Evaluation Methods Innovative Education and Nursing Professional Development Nursing Kyndra Alspaugh, Clinical Nurse Coordinator, Cerebral Salt Wasting in Patients with Subarachnoid Projects Neurology and Urology Hemorrhage Nurses at Cottage Jackie Baker, Magnet Program Manager Compassionate Care at the End of Life Health participate Jennifer Granger Brown, Simulation Coordinator Ellie Melton, Manager, Palliative Care in and lead various Pam Washburn, Director, Spiritual Care projects, including evidence-based Diane Barkas, Clinical Nurse Specialist, PIV Study in MICU Critical Care practice, quality Continuous Renal Replacement Therapy Database improvement and Critical Care Clinical Practice Collaboration research. Viral Infection and Respiratory Illness Universal Study: COVID-19 Registry and Validation of C2D2 (Critical Care Data Dictionary)

Karen Bradbury, Cardiac Liaison Nurse, Cardiac Outcomes Database SBCH Service Line Clear Communicator Product Testing

Laura Canfield, Vice President, Patient Care Services Survey Study for Med/Surgical Team and Chief Nursing Officer Improving Emergency Department Boarding Length of Stay with Nurse Bedside Report

Nichol Clark, Clinical Resource Nurse, Telemetry Self-Quarantine and Self-Distancing Survey

Cathy Cleek, Clinical Nurse Coordinator, VAN Triage Screening Tool Study Santa Barbara Emergency Department

Judy Corliss, Clinical Manager, Endoscopy Effervescent Crystals to Treat Emergent FBO Cathy Cleek, Clinical Nurse Coordinator, (food bolus obstructions) Santa Barbara Emergency Department

Mimi Dent, Clinical Resource Nurse, Birth Center Improving Nurse Management of the Second Stage of Labor

Jennifer Ferrick, Clinical Manager, NICU QI Project

Jared Grode, Clinical Manager, Telemetry TAVR Workflow

Julie Hardin, Educator, Patient Family Education Peer Feedback Survey for Education Department

Maricris Lising, Clinical Nurse Coordinator, Patient Hand Off Survey Mother Infant Care

Lindsey Macias, Clinical Nurse II, Reinforcing Diabetes Survival Skill Education in Nursing Resource Unit Inpatient Population

Vicki McPhail, Educator, Mother Infant Care EDI Scores and Pediatric Readmissions

Libby Smith, Director, Women's Services Birth Outcomes after Acute Wildfire Exposure

Sharilyn Vasquez, Clinical Manager, Surgical Trauma Patient Care Technician Pilot Study

Kerry O'Rourke, Clinical Nurse Coordinator Psychiatry and Addiction Medicine Nursing Mentorship Program

Dan Thomas, Director, Cottage Rehabilitation Hospital Fall Risk Assessment Tool

Penny Morgan Overgaard, Director, Employee Survey Cottage Children's Pediatric Clinics Nurses' Experience with Violence in the Workplace

Patty Long, Parish Nursing BassiNest Insert

Vicki Lekas, Clinical Nurse Specialist, Pediatrics Does the Use of Video Goggles or Headphones in MRI Decrease

| Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage Use of Anesthesia in Patients Age 4–17? 32 HIGHLIGHTS IN NURSING RESEARCH

Use of a Transparent Surgical Mask HIGHLIGHTS IN EVIDENCE-BASED in Acute Care PRACTICE The pandemic requires healthcare workers to wear masks. Standard surgical masks cover the face, making understanding speech difficult Sensory Needs and preventing lip reading. This can exclude the hearing impaired, Assessment Plan (SNAP) cause miscommunication and produce feelings of isolation. Karen Bradbury, Cardiac Liaison, designed a cross-sectional study to in Pediatric Patients investigate the use of a transparent surgical mask with a clear In response to Children's Services first window when working with the hearing impaired. The findings quarter 2020 HCAHPS/Press Ganey Scores, show that most patients and staff prefer the transparent mask due falling below the 75th percentile, Pediatrics to improved communication, feeling more connected with a better identified a Best Practice opportunity understanding of speech. By making the masks available for the for patients with Sensory Processing hearing-impaired patients, hospitals can prevent miscommunication Dysfunction (SPD). In collaboration with errors and improve patient experience and satisfaction scores. Therapy Services and CottageOne, Children's Services introduced an Evidence-Based Sensory Needs Assessment Screening Tool and a SNAP Individualized Care Plan. These new tools guide nurses to make the patient stay more comfortable and improve care for pediatric patients with SPD and their family's overall hospital experience.

Tessa Woodey, Karen Bradbury and Teresa Weddle

Nursing Mentorship Program The Psychiatry and Addiction Medicine Department launched a

Nursing Mentorship Program at the end of 2019. The Mentorship Gina Devris MOT, Tegan Hannah Program is a Shared Governance project designed to provide OTR/L support and education to our nursing staff. In psychiatry, nurses must learn and apply psychiatric theory, stages of development, addiction medicine, de-escalation techniques, therapeutic milieu management and therapeutic rapport, along with many other skills. The mentorship program was designed by utilizing input based on clinical supervision Gina Randall Julie LeBourveau Dana Espina and Nicole DeOliveira hours that therapists undergo as trainees and research on nursing mentorship. The objective of the program is to foster staff relationships, improve clinical and leadership skills and promote a team-focused milieu. This empowers staff to express their needs and desires, and invest in their career and personal development. | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

33 NEW KNOWLEDGE, INNOVATIONS AND IMPROVEMENTS

COLLABORATION BETWEEN UNITS TO CARE FOR COVID-19 POSITIVE MOTHERS COVID-19 Kits Patti Wicklund, Clinical Educator, Critical Care; Caitlin Natale, Clinical Resource Nurse, Birth Center; Nicole Dennis, Clinical Educator, Birth Center; Karen Rose, CH Population Health's goals are YEAR Clinical Nurse Coordinator, NICU; Irma Rodriquez-Danhneke, Clinical Nurse II, to improve health outcomes and OF THE Mother Infant Care; and Vicki McPhail, Clinical Educator, Mother Infant Care NURSE reduce health disparities in our Early on during the COVID-19 pandemic, the Birth Center was caring for patients and communities. To a mother in antepartum who was decompensating. The mother was tested help meet this goal, they supplied for COVID-19 and had a positive result. Due to the diagnosis, she was transferred Santa Barbara to 3 Arlington, the intensive care isolation unit. The Birth Center, NICU and Emergency Critical Care departments developed a workflow in case of an emergent delivery. Department As this was early on in the pandemic, the workflow frequently changed. During with COVID-19 each shift, the department's charge nurses did a workflow walkthrough to kits. These ensure everyone knew what to do during an emergency delivery. After receiving kits contain a excellent care at SBCH, the mother survived and was discharged home, where thermometer, she continued to gain more strength throughout the remaining weeks of her portable pulse pregnancy. She returned to the hospital to deliver a healthy baby, and Birth Center, oximeter, a card Mother Infant Care, NICU and MICU staff lined the hallways to say good-bye for recording to the new family. The new parents expressed gratitude to the staff as they went vital signs and home, this time with their new baby. Irma commented, “This is truly one of the an educational COVID-19 Kit best moments in my nursing career.” handout. Any COVID-19 positive or suspected positive patient discharged home to quarantine receives a kit and education on Mary Fulcher using the equipment and what Emergency Department Clinical warrants a return to the Emergency Manager, GVCH Department. The kit is beneficial for THE EVOLVED ROLE OF THE patients with limited resources. EMERGENCY DEPARTMENT NURSE During one patient follow-up call, IN COVID-19 the Pandemic Outreach Nurse The workflow of an emergency room had a concern about the patient's nurse has changed significantly due to condition. She reminded the family the impact of the pandemic. Patients Front to Back: Megan Swann, Mary Fulcher, about the portable pulse oximeter. Dawn Heimendinger, Angela Kroemer, Michelle are greeted by a nurse wearing full She asked them to place it on the ill McDuffee, UC, and Alex Padilla, ED Tech PPE outside in the driveway and are family member's finger and guided immediately masked and screened for them through the measurement COVID-19. Patients with symptoms reading. With the patient's oxygen of COVID-19 enter through the ambulance entrance, conveniently located level below 90%, the nurse advised adjacent to five negative-pressure isolation rooms. PPE and supply carts are set the family to return to the hospital up at all times to ensure the needed supplies are easily accessible for providing immediately. For this patient in need care quickly and safely. The Radiology Department utilized portable units of immediate care for respiratory to provide diagnostic procedures in the patient’s room whenever possible. failure, the nurse's intervention Admitting staff utilizes FaceTime on the iPads located in every isolation room to was crucial in achieving a positive verify patient demographics. Family members are no longer allowed to stay with outcome. patients during their visit and instead are asked for a phone number so updates can be provided.* Stable patients are assessed outside in a chair. While all care is being orchestrated for the patient, the family is being kept updated. Staff either go out to waiting cars or call families on the phone to provide important updates. Flexibility and innovation have been at the forefront of addressing the ED nurses' many challenges during this unprecedented year. *Story told during a time of maximum visitor restriction due to COVID-19. | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

34 Pandemic Outreach Nurse Dialysis During a Pandemic Shannon Cook, Clinical Resource Nurse, SBCH Emergency Department Anne Whiteside and Melanie Segundo, Amid the pandemic, Denise McDonald, Director of Emergency Dialysis Nurses and Trauma Services, and Bridget Crooks, Emergency Department At Santa Barbara Cottage Hospital, we have Clinical Manager, envisioned a program to follow up with COVID-19 a small group of nurses caring for the unique Emergency Department (ED) discharged patients. The aim was to population of acute and chronic inpatients have a dedicated ED nurse with an educational background and strong requiring dialysis. The COVID-19 pandemic assessment skills to call these discharged ED patients. The follow-up shook up our world with a sudden influx included providing test results, education and resources. Additionally, of patients requiring isolation. Instead of a contact number would be available for patients to call bringing the majority of our with any questions or concerns. The ED leadership created patients to our dialysis unit to the Pandemic Outreach Nurse's position and Shannon dialyze, we now have to transport Cook accepted this role and began to develop the program. our equipment to isolated rooms for one-to-one care. Our small YEAR The initial goal was to track and follow-up with all YEAR staff was stretched thin and OF THE OF THE NURSE discharged ED patients diagnosed with COVID-19 and any NURSE worked closely with 3 Wood- patients suspected of having the virus waiting for results. Claeyssens staff to devise a policy Shannon quickly realized the job was so much more as that allowed us to dialyze multiple it began to evolve from the initial vision. If the patient was positive, patients at once in their individual rooms. the Outreach Nurse must ensure that they understand quarantine Also, in response to the pandemic and CDC guidelines and see if they are doing well at home. Often Shannon guidelines, chronic dialysis patients diagnosed would spend 30-40 minutes speaking with patients to ensure they have and understand all of the information to keep themselves and their loved ones safe and have the most accurate, up-to-date information on the virus. Other duties of the position include close contact notification, educating the patient and family on monitoring symptoms, and follow up with a primary care physician. Additionally, she established a protocol to notify the COVID-19 negative patients of their results. In many cases, these patients have been isolated from family From left to right; Anthony Siasat, Lindsey Pierson, Anne Whiteside, Jessica Conway and Melanie Segundo and friends at home while awaiting test results. Since most testing platforms still have a sizable margin for false-negative results, if the patient was symptomatic with COVID-19 were unable to go to their despite a negative test, Shannon provided support to determine regular outpatient appointments. Hospital whether they should remain in quarantine. administration worked quickly and diligently While COVID-19 has many apparent signs and symptoms, secondary to secure the licensing required to perform issues of isolation and loneliness can have severe psychological outpatient dialysis. This required mass ramifications. This occurs when patients are quarantined, secluded coordination between patients, physicians, dialysis, management, the Emergency from family and friends. Shannon helped patients get in touch with Department, the Cottage Call Center, Transfer someone willing to drop off medication and essentials, schedule Center and the COVID-19 isolation units in follow-up doctor appointments, figure out emergent insurance and order for patients to receive their treatments. low-cost clinic options. The Outreach Nurses also helped keep pets With additionally purchased equipment, a few safe, provided education on cleaning the household, assisted with more hired employees, and most importantly documentation to employers and to find family members to care for the "all hands on deck" determination and the patient's children. Whether related directly or indirectly to the perseverance of our small team, we were illness, anyone who has questions can call the Outreach Nurse. The able to conquer the challenge. We continue goal of the position is to achieve the best possible outcome for the to efficiently, effectively and compassionately patient. While patient outcomes are a primary focus, the Outreach care for all patients affected by this unforeseen Nurse strives to increase patient and family satisfaction. pandemic. We are beyond grateful for the

hospital-wide effort and support that we have 2020 Health | Nursing Excellence | Cottage received throughout it all. 35 EMPIRICAL OUTCOMES

Santa Barbara Cottage Hospital Stroke Program Data DOOR-TO-TISSUE PLASMINOGEN ACTIVATOR (tPA) ADMINISTRATION

90% 80% 70% 60% 50% 40% 30% 20% 10% 0 Q1 2020 Q2 2020 Q3 2020 Q4 2020

0-30 minutes 31-45 minutes

AIM: To improve door-to-tPA administration timeliness to less than 45 minutes in 75 percent of patients receiving tPA. IMPROVEMENT STRATEGIES: • Immediate notification to NeuroHospitalist of the patient upon arrival to ED • Point of Care PT/INR in the ED • Changed the internal Stroke and Vascular Operations Committee (SVOC) goal for compliance from 100 percent to 75 percent to be a more realistic goal which is more in line with the Joint Commission goal of 50 percent • ED Direct-to-CT Project Improvement • ED added tPA and BP medications at the bedside, ready to be administered once ordered • tPA kit for inpatient code strokes prepared to be administered once ordered in CT • tPA added to Omnicells in CT Scanner and SICU ANALYSIS: Although we are meeting the goal for the door to tPA in less than 60 minutes, we are working on consistently improving door to tPA in less than 45 minutes to reach our goal. RESULTS: Following the implementation of these strategies, the door to tPA time was decreased to less than 45 minutes in 86 percent and less than 30 minutes in 71 percent of cases in the third quarter of 2020. | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

36 Stroke Dysphagia Screening GOAL: 100%

Trend SBCH 100%

90% GWTG Average 80%

70%

60%

50%

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

STATUS: Performance consistently above the American Heart Association Get with the Guidelines©–Stroke (GWTG), but not yet at the goal. AIM: To improve the completion of the dysphagia screening on all stroke patients to 100 percent. IMPROVEMENT STRATEGIES: • Data presented at SVOC meeting • Education provided to ED, 1RT, SICU and MICU by Clinical Educators, CNS and Stroke Coordinator • Focus on Clean Routine initiative • Follow-up emails provided to RNs and department leadership in the event of missed opportunities ANALYSIS: Opportunities identified: having the ED complete the screening before admission to the floor or administering oral medications. Other cases include patients diagnosed with stroke after admission for a non-stroke-related diagnosis or who did not present with stroke. RESULTS: Overall performance consistently trending above GWTG average but not yet at 100 percent goal. | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

37 EMPIRICAL OUTCOMES

RAPID ACUTE STROKE CARE: Improving Stroke Door-to-Computerized Tomography Scan (CT) Result Times

100% 90% 80% 70% 60% 50% <30 minutes 40%

30% Goal <45 minutes 20% 10% 0 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec (28) (30) (22) (14) (15) (47) (30) (34) (23) (33) (38) (43)

AIM: Improve the timeliness of Code Stroke door-to-CT results to 30 minutes or less in 80 percent of cases. IMPROVEMENT STRATEGIES: • Direct to CT via EMS Gurney for EMS Stroke Activation • Changed goal from less than 45 minutes to less than 30 minutes • Emergency Department providers received education to reduce over-ordering of Code Stroke CTs • Monthly report enhanced to track CTs in ED vs. Inpatient times • Enhanced report created in 2020 RESULTS: Since implementing strategies, door-to-CT results improved to less than 30 minutes in many cases. Further opportunities for improvement include routine monitoring of performance and timely feedback and education when necessary. The effectiveness of these improvement strategies will be reassessed routinely and modified as needed. | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

38 COTTAGE HEALTH SEPSIS DATA Sepsis Education

102% 100% 98% 100 % 100 % 99 % 96% 98 % 98 % 94% 96 % 96 % 92% 90%

91 % 88% 86% Q1 Q2 Q3 Q4

Compliant with education initiation within 24 hours Education compliance with daily education

AIM: Improve education to all admitted sepsis patients within 24 hours of admission on awareness and recognition during the hospital stay. The goal is 80 percent. IMPROVEMENT STRATEGIES: • New reports have been designed to run in CottageOne to identify sepsis patients daily • The Clinical Manager or designee will randomly audit 15-20 sepsis charts monthly for education compliance and report to the Sepsis Team • Shift-to-shift huddles were implemented to ensure continuity of education and communication • The data is reported out to the Sepsis Team every month at the 3 Wood- Claeyssens staff meetings • COVID-19 patients were included when diagnosed with sepsis RESULTS: Significant improvement was achieved and the goal was met in all four quarters of 2020. | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

39 EMPIRICAL OUTCOMES

Fluid Resuscitation for Septic Shock Patients in the Emergency Department (ED)

100% 90% 97 % 100 % 80% 87 % 85 %

70% 82 % 60% 50% 40% 30% 20% 10% 0 Q4 2019 Q1 2020 Q2 2020 Q3 2020 Q4 2020 18/22 45/52 29/29 28/29 17/20

AIM: Improve Fluid Resuscitation for all septic shock patients arriving through the Emergency Department. The goal is 90 percent. IMPROVEMENT STRATEGIES: • ED RN available for in-the-moment education for staff • ED physician champions review fluid outliers with appropriate ED MDs to encourage changes in their practice • Monthly review with ED RN sepsis champion Cathy Cleek who will provide feedback to frontline staff • Fluid Resuscitation data added to the abstractor's road map and throughput report in CottageOne to better capture this patient population RESULT: There was an improvement in fluid resuscitation in the second and third quarter of 2020. | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

40 Postoperative Pneumonia 3 RIDLEY-TREE Code and Rapid Response

2018 2019 2020 (YTD) (RRT) Survival Rates 2,213 Total Patients 2,235 Total Patients 1,808 Total Patients

% % % 2019

90% 99.5 99.7 99.8 Pneumonia Free Pneumonia Free Pneumonia Free 80% 70% 78 %

60% 73 % ALL SURGICAL PATIENTS 50% 40% 2018 2019 2020 (YTD) 5,755 Total Patients 5,760 Total Patients 4,549 Total Patients 30% 20% 28 % % % % 10% 0 % Codes % Codes % RRTs 99.5 99.5 99.7 Survived Survived to Survived to Pneumonia Free Pneumonia Free Pneumonia Free Initial Code D/C D/C

2020 The initial ICOUGH program was started 90% with two vascular surgeons’ patients with improvements made in their postoperative 80% pneumonia rates. The ICOUGH committee 70% expanded the protocol to all 3 Ridley-Tree 60% 78 % 68 % surgical patients. 50% AIM: Maintain less than or equal to 0.5 percent 40% postoperative pneumonia rate for all surgical 30% 40 % patients. 20% IMPROVEMENT STRATEGIES: 10% • Continue with pre-operative oral care and 0 % Codes % Codes % RRTs incentive spirometer training Survived Survived to Survived to • Add chlorhexidine to all pre-operative surgery Initial Code D/C D/C order sets • Postoperative out of bed and walking as soon as possible ANALYSIS: There is very little difference in the • Postoperative oral care three times a day percentage of codes surviving the initial code • Staff education and in-services and percent of RRT’s that survived to discharge in • Involve patients by using a tracking form 2019 and 2020. However, the number of codes that survived to discharge improved by RESULTS: Postoperative pneumonia rate is well 11 percent in 2020. below the 0.5 percent goal for 2020. Continue to audit ICOUGH elements and monitor our quarterly postoperative pneumonia rates. | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

41 OUR MAGNET VISION

Cottage Health’s Nurses Light the Way: Magnet Journey 2020 Magnet Quality Celebration We use the Magnet framework to advance nursing The virtual Magnet Quality Celebration kicked off on Friday, practice and professionalism at Cottage Health to September 18. Marketing created a video that featured the provide the highest quality of care for our patients, our 31 posters submitted, along with commentary by those who communities and each other. created the posters. The video was viewed by 248 Cottage Health staff and the poster website received 631 visitors. In 2012, we made a critical decision to continue on the Magnet Journey and not seek designation for SBCH. This 2020 POSTER WINNERS: decision allowed for continuing support for the Santa Barbara City College ADN Nursing Program. Securing MOST INFORMATIVE our workforce for the future is more about hiring locally Is This Scope Safe? Monitoring Quality Duodenoscope educated nurses than seeking out-of-state BSNs. The Disinfection and Surveillance Culture to Eliminate benefit to our health system has always been about the Associated Transmission of CRE during ERCP journey and not about the trophy. Santa Barbara Endoscopy While we are not seeking formal recognition, we are still Florwina Tarepe, Endoscopy Technician; Shanda Hill, following the American Nurses Credentialing Center Rebecca Diesbourg and Judy Corliss (ANCC) standards for Magnet Recognition Program® designation. This program promotes excellence in patient I NEVER KNEW, WOW care and fosters nursing professionalism. By not seeking Complementary Medicine: Healing Touch formal recognition, we have the flexibility to ensure we Electrophysiology Lab align Magnet standards with best practices, quality, vision Danielle Fiore and culture of Shared Governance at Cottage Health. MOST CREATIVE Sensory Needs Assessment Plan in Pediatric Patients a SNAP Decision! R S I N I N N U G A N E S D H Pediatrics S U E A I S LT L H Julie LeBourveau, Gina Randall, Gina Devris, MOT, OTR/L A C B A O R and Tegan Hannah L E G Structural Empowerment MOST RESEARCH POTENTIAL Rapid Acute Stroke Care: Improving Stroke Door-to-CT Result Times Quality and Stroke Coordinator Exemplary Transformational Empirical Professional Leadership Outcomes Bliss Rayo-Taranto and Lauren Fink Practice HONORABLE MENTION “MOST RESEARCH POTENTIAL” Use of a Transparent Surgical Mask in Acute Care New Knowledge, Innovations, and SBCH Cardiac Service Line Improvements Karen Bradbury

Let It Shine! Cross-Unit Learning: The Light for Collaborative Practice in Women’s Services Mother Infant Care Cottage Health’s Magnet inspiration Maricris Lising | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

42 Herb Geary, Amy VandenHeuvel, Sarah Awad, Herb Geary, Susan DeMarrais, Liz Lundquist, Lauren Beltran and Christine Rowland Jennifer Ferrick and Cindy Howe

Herb Geary and Lauren Fink

Jackie Baker, Rebecca Diebourg, Flowina Tarepe, Herb Geary, Robin Reitz and Andrea Cordiba Shanda Hill, Judy Corliss and Herb Geary

Lily Bui

Herb Geary, Gina Randall, Nancy May, Cyndi Gilbert, Nathan Howard, Herb Geary, Kelley Knowlton Kylie Bieber and Jackie Baker and Melissia Aldecoa | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

Jackie Baker, Danielle Fiore and Herb Geary Nancy Wooden and Herb Geary 43 OUR MAGNET VISION

CH Magnet Inspiration Through the Years

2007 2011

Board of Directors Implemented Care Boards for approval of the strategic patient rooms. nursing plan to place Two new committees were formed to reach SBCH on the Magnet our goal of meeting Magnet standards. The Journey. committees were the Nursing Peer Review First delegation of CH nurses attended the Committee and the Professional Practice Committee. National ANCC Magnet Conference. Santa Barbara Cottage Hospital participated in its first NDNQI CH nurses participated in a retreat to survey. explore options and strategies for CH to Nursing Grand Rounds launched. meet Magnet’s standards.

2008 2012

First Annual Nursing Research Committee was formed. Nursing Excellence Hired a Magnet Coordinator. was published and CH launched four Magnet Component distributed during Committees (Transformational Leadership, Nurse’s Week. Structural Empowerment, Exemplary CH launched a system-wide education Professional Practice, and New Knowledge program on conducting nursing research. Innovations & Improvements). Critical decision made to continue on the Magnet Journey and not 2009 seek formal Magnet designation.

CH furthered partnership with California State 2013 University Channel Islands. First Magnet Quality Celebration. Nursing entered in the final stages of Nearly every nurse in the CH system ClinDoc implementation. completed nursing Professional Portfolios.

2010

CH partnered with California State University 2014 Channel Islands School of Nursing to launch a CNO’s first Quarterly Newsletter. new BSN Program in our CH held the first Back to School day. community. New Knowledge partnered with CH Research The Professional Practice Model was Department. implemented. The Patients First Program was launched to improve patient satisfaction. | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

44 2015 2018

Implemented Nursing Peer Transformational Leadership created and Evaluation. disseminated a survey asking CNC’s to identify the leadership areas they find to Updated Professional be most challenging. Practice Model to reflect the new CH brand. New Knowledge updated and promoted the CH Journal Club tool kit. New Knowledge developed and implemented Peer Interview questions. Transformational Leadership created the 2019 Leadership Growth Opportunities brochure. Nursing led the very first Magnet Structural Empowerment defined the goal for Component Committee project in nurse certification – 50% of eligible staff in conjunction with unit-based Shared departments. Governance in implementing Clean Routine, Helping You Heal. 2016 Transformational Leadership developed an “Introduction to Financial Management and Reports” class Implementation of for Clinical Nurse Coordinators (CNCs). CottageOne. Structural Empowerment created flowcharts to outline steps Transformational for nurses to obtain professional certifications and to receive Leadership created their certification bonuses. orientation resources for CH’s NDNQI survey had the highest ever new managers. response rate of 73%. Structural Empowerment finalized and rolled New Knowledge created Care Board videos. out Certification Nurses’ recognition plaques. Transition to new Magnet Program Manager. New Knowledge identified and developed content to showcase nursing on the external Creation of CH’s Magnet Inspiration statement. Cottage Health website. 2020 2017 CH debuted the First Quarterly New Knowledge rolled out Magnet Vision Newsletter. new evidence-based care Transformational Leadership created boards to inpatient areas Leadership Series. at SBCH and GVCH. New Knowledge developed a Nursing Structural Empowerment Research website. developed methods to improve clinical nurse involvement in professional specialty organizations. Exemplary Professional Practice created a comprehensive ethics brochure outlining available resources for CH nurses. | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

45 YEAR OF THE NURSE

Rachel Brian Rebecca Diesbourg Clinical Nurse Coordinator, Clinical Nurse II, SBCH Endoscopy Services Neurology/Urology SILVER LINING OF WORKING IN THE MAKING NEW FRIENDS LABOR POOL 2020 has been a challenging year for It’s been a trying year, especially for those all of us here at Cottage Health. When who have dedicated their profession to COVID-19 began to impact the Santa the safekeeping of others. A fitting year to YEAR OF THE Barbara area, it was stressful and scary honor nurses, and if NURSE to be at work and care for patients. anything has become We have all found ways to manage more apparent, the and deal with this stress. I appreciate challenges of this all the resources that Cottage Health year demonstrated has made available to us and feel that how vital the this has been community around helpful. I have us is and goes far never been beyond our nursing more proud to profession. As be a nurse. the impact of the pandemic progressed, The nurses we canceled all non-urgent cases in our here on 1 department and we were reassigned to the Ridley-Tree Labor Pool and prepared to assist on other are an amazing floors. With so much uncertainty about group and we support and encourage what the coming months held, patients each other. We share the challenges needed extra support and our friends and of caring for our families and our family looked to us for guidance. We’ve distance-learning children. We have been immensely fortunate to have Dr. Fisk also become closer with our friends, and Dr. Fitzgibbons, our Infectious Disease especially on 3 Wood-Claeyssens. Specialists, who kept us up-to-date and Everyone across the organization provided the tools needed to be resources has been so flexible, positive and in our communities. The silver lining of upbeat, despite their stressful and working in the labor pool has been meeting constantly changing circumstances, so many great people. We branched out including working on different units. from our departments, met travelers from I have always had great respect for my different states, spent hours working with colleagues and our journey through and getting to know CH staff and people in this pandemic has only made that varied roles with whom we would never have stronger. I think that when we do crossed paths otherwise. It’s been a gift to finally get through COVID-19, the now walk through the halls and see familiar nurses here at Cottage will be the faces. A great acknowledgment for the World strongest team that anyone has ever Health Organization to designate 2020 “Year seen. Imaginary barriers between of the Nurse,” and it really does take a village. units have dissolved. We are all in this together. | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

46 Katherine Fabbre Gayle Mercado Clinical Resource Nurse, SICU Clinical Manager, Medical-Surgical WALK INTO WORK Unit, SYVCH On April 2, I was scheduled to work after some IT IS HARD TO CRY WITH A MASK ON time off during my children’s spring break. I COVID-19 has left its mark on our received notification from the charge nurse at society in many ways. The impact 0500 that I would be working in the COVID-19 most felt on my unit was in caring YEAR OF THE ICU that day, my first for our dying NURSE time in that unit. I felt patients. All of incredibly anxious about the intuition what I would be facing. and years of A lot had changed since experience I last worked, both in helping the hospital and in our families and lives in general. I had patients very little idea what those navigate changes at work were a “good” and how they would impact my day. On my drive death went out the window. New to the hospital that morning, I hardly saw any visitor restrictions in place can make other cars on the road; most people were under a patient’s death a gut-wrenching stay-at-home orders. It was a typical overcast experience for nurses. Families not Santa Barbara spring morning and my mood at bedside to comfort their loved matched the weather. I wondered if the way I felt one or each other at the time of their was in any way similar to what soldiers feel the passing is not only sad but can have first time they are on their way to a war zone. a lasting effect. Enforcing visitor I spent my drive trying to convince myself that restrictions is difficult for everyone I could handle whatever I would face and that and failure to follow the protocols I needed to summon the courage within me to could expose more people to the face the challenge. Then, on my walk from the virus. It is challenging for nurses parking garage to the hospital entrance, my heart to show their compassion and continuing to race, I looked down to see that a navigate grief behind a mask. We are thoughtful soul in our community had written living in unprecedented times with the message, “You are so brave – thank you,” in unfathomable choices. We leave you sidewalk chalk. I froze for a minute and felt a with a piece of wisdom gained: it is surge of gratitude for whoever that person was. hard to cry with a mask on. That simple but powerful message reminded me of the reason I was willing to join the fight and it gave me just what I needed to face the days, weeks and months ahead.

| Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

47 YEAR OF THE NURSE | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

48 “ Nursing is an art; and if it is to be made an art, it requires as exclusive a devotion, as hard a preparation, as any painter’s or sculptor’s work; for what is the having to do with dead canvas or cold marble, compared with having to do with the living body—the temple of God’s spirit? It is one of the Fine Arts; I had almost said the finest of the Fine Arts.”

- Florence Nightingale | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

49 | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

50 Professional Practice Model for Nursing

Our foundation is based on our core values of excellence, integrity and compassion

We stand for teamwork and collaboration

Caring and compassion for the patient and family is at the heart of what we do

We are guided by research and evidence-based practice to promote quality and safety

Our knowledge and collective vision drives our professional practice and benefits the community through wellness and prevention

OUTCOME STATEMENT: Nursing is a blend of art and science | Cottage Health | Nursing Excellence 2020 Health | Nursing Excellence | Cottage

51 FOR EVERYTHING YOU DO