Sparrow Nurses 2018 Nurses Annual Report

Sparrow Nurses | 2018 Nurses Annual Report 1 Table of Contents 2018 Sparrow Nurses Annual Report

6 | Professional Practice Component Transformational Leadership Shared Governance Advance Practice Nurses Doctoral Prepared Nurses Care Delivery Evidence-based Practice ISMAILA LASISI, BSN, RN Nursing, Sparrow Specialty Hospital Professional Development Certified RNs Back to School Collaborative Practice Herbert-Herman Cancer Center 20 | Process Component EBP & Critical Thinking at the Bedside (Clinical RNs) 21 | Primary Outcomes Component Sparrow Hospital

32 | Strategic Outcomes Component National Leader in Quality & Patient Experience Carson City Clinton Ionia Sparrow Specialty

KATY SALTEAR, BSN, RN, RNC-NIC, NNTS Regional Neonatal Intensive Care Unit, 2 Sparrow Nurses | 2018 Nurses Annual Report Sparrow Hospital Sparrow Nurses | 2018 Nurses Annual Report 3 Sparrow’s Nursing leadership

Sparrow’s Nursing Leadership would like to thank all of our academic partners, especially Michigan State University and Lansing Community College. A special thank you to our Nursing union partners: Michigan Nurses Association (PECSH-MNA); International Union of Electronic, Electrical, Salaried, Machine-Furniture Workers-Communications Workers of America AFL-CIO, CLC Local 84444 (IEU); and Healthcare Michigan Service Employees’ International Union, Nursing Unit (SEIU).

CHIEF NURSING OFFICER, SPARROW HOSPITAL INTERIM CHIEF NURSING OFFICER, SPARROW CARSON HOSPITAL Alan Vierling, DNP, MSN, RN CHIEF NURSING OFFICER, SPARROW IONIA HOSPITAL Linda Reetz, MBA, BSN, RN, NE-BC

CHIEF NURSING OFFICER, SPARROW SPECIALTY HOSPITAL CHIEF NURSING OFFICER, SPARROW CLINTON HOSPITAL Tina Gross, MSN, BAS, RN, SANE Beth Anne Daugherty, BSN, RN, MPH, CRRN As a Nurse with 33 years of clinical experience, Shared governance provides structural TRANSFORMATIONAL LEADERSHIP Professional I am proud to be a frontline Caregiver who support for all nursing work at Sparrow > Shared Governance is also very active in the Nursing Practice Hospital. It gives Nurses the opportunity Practice Research Council and other committees that to impact and influence the work they give Nurses a voice! do every day through involvement at the Component unit, hospital, and system levels. Nurses REGINA BUHR, RN at the bedside are in a prime position to Outpatient Services, Sparrow Clinton understand both the Patient and staff needs to improve processes and make significant positive impacts on Patient Shared governance reflects the values care and their work environment. Through of partnership and accountability of key shared governance, the bedside Nurses’ stakeholders on issues that affect Patient voices are heard, and a high level of value care, safety, and the environment of care. is placed on those recommendations. The The model fosters a culturally sensitive influence of shared governance can be seen approach, where Caregivers have a voice that through staff empowerment, champion matters in decisions touching their work. The group work, committee involvement, and practice of shared governance is pivotal in the quality improvement projects that are Sparrow Nursing Council’s Champion Groups staff-led throughout many units here at and various committee workgroups, where Sparrow. Specific examples of hospital-level practice, education, quality, and EBP/research shared governance include the Research are defined and sustained. Collaboration with Council, Professional Development Council, the frontline staff, through mutual respect and Practice Council, Quality Council, and the pursuit of excellence, is our daily work and Nursing Leadership Council. REGINA BUHR, RN, (left), and RACHEAL MUNRO, BSN, RN, CPN process to keep Caregivers on the second tier Cancer and Infusion Center, Sparrow Clinton

of the Sparrow pyramid. SARAH COLLINS, MSN, RNC-NIC Regional Neonatal Intensive Care, Sparrow Hospital MARY KISTING, MS, RN, CCNS, CCRN-K Nursing Education, Sparrow Hospital

6 Sparrow Nurses | 2018 Nurses Annual Report Sparrow Nurses | 2018 Nurses Annual Report 7 TRANSFORMATIONAL LEADERSHIP TRANSFORMATIONAL LEADERSHIP > Advance Practice Nurses > Doctoral Prepared Nurses

As an Advanced Practice Nurse (Clinical Nurse Specialist), I work to improve healthcare outcomes through specialized knowledge and skills related to clinical practice, education, quality improvement, safety, and evidence- based practice.

RACHEL JUSTICE MSN, RN, ACNS-BC, CMSRN Nursing Education Sparrow Hospital I feel better equipped having my Doctor of Nursing Practice (DNP) to help frontline (bedside) Nurses implement evidence into their daily practice. I am also in a position to lobby for policy changes and to be the voice of our busy Nurses and Patient Care Technicians. Having this terminal degree enables me to share my experiences and educate new Nurses. It has also prepared me to facilitate and manage complex organizational change to improve CATHERINE S. BRENNAN, MS, RN, CNS, (far left), Nursing Education, Sparrow Hospital the safety and care delivery processes our Patients receive. DONELL SNYDER, BSN, RN, CCRN, (second from left), Nursing Education, Sparrow Hospital AMANDA TOMASIK, MSN, APRN, ACCNS-AG, CCRN, (second from right), Nursing Education, Sparrow Hospital CHASTITY WARREN, DNP, MSN/ED, RN, CCRN-K LYNN RAYNOR, MSN, RN, CNOR, (far right), Surgical Services, Sparrow Hospital Nursing Education, Sparrow Hospital

8 Sparrow Nurses | 2018 Nurses Annual Report Sparrow Nurses | 2018 Nurses Annual Report 9 Having my bachelor’s CARE DELIVERY in nursing makes me PROFESSIONAL DEVELOPMENT feel thankful that Evidence-based Practice > Sparrow invested in me; what a gift!

MIRANDA STONEMAN KRISTIN PETERS, RN, BSN, CVN, (left) BSN, RNC, C-EFM Having my bachelor’s Cardiac Progressive Care, Sparrow Hospital OB Services, Sparrow Hospital degree has allowed LAURA TIMM, BSN, RN, CCRN, (right) NeuroTrauma, ICU, Rapid Response Team, me to influence future Sparrow Hospital generations of Nurses.

SARAH DEKONINCK, BSN, RN Cardiac Stepdown, Sparrow Hospital

Having my bachelor’s Having my bachelor’s in nursing in nursing makes me helps me put the pieces together feel accomplished! I am to better provide evidenced- excited to see where based care. my degree will lead me. JENNIFER BURNS, BSN, RN, CLC, C-EFM Labor and Delivery, Sparrow Hospital AMANDA POHL, BSN, RN Infusion Clinic, Sparrow Ionia

10 Sparrow Nurses | 2018 Nurses Annual Report Sparrow Nurses | 2018 Nurses Annual Report 11 PROFESSIONAL DEVELOPMENT PROFESSIONAL DEVELOPMENT > Certified RNs

Being certified makes me feel more Having my bachelor’s in nursing competent in my daily nursing practice makes me feel that I have extended and more confident in the nursing care knowledge to properly care for SHARA HOLMES, RN-BC that I provide to our Patients. Patients while in our care. Adult Psych, Sparrow Hospital

STEPHANIE RYAN, BSN, RN Infection Prevention, Sparrow Carson Being certified has equipped me with an advanced knowledge base, allowing me to provide the best possible care MELISSA DULIC, BSN, RN, PCCN, CCRN to my Patients. Intensive Care, Sparrow Hospital

Becoming certified validated my knowledge and skills, but most importantly improved the autonomy of my nursing practice.

ASHLEY MEYERS, BSN, RN-BC, PCCN-K Nursing Education, Sparrow Hospital

12 Sparrow Nurses | 2018 Nurses Annual Report Sparrow Nurses | 2018 Nurses Annual Report 13 BRITTANY ANDERSON, RN, CCRN-CMC CONNIE PHELPS, RN, CNOR KRISTIN PETERS, BSN, RN, CVN Cardiac Intensive Care, Sparrow Hospital Operating Room, Sparrow Clinton Cardiac Progressive Care, Sparrow Hospital I became certified because I wanted to increase my knowledge base to provide better care to my Patients.

LISA PEASE, RN, OCN Herbert-Herman Cancer Center, Sparrow Hospital

Becoming a Certified Biotherapy/ Chemotherapy Oncology Nurse ensures my Patients have a skilled and knowledgeable professional who can address all aspects of their care from beginning to end.

CHERIE HAUETER, RN, OCN Herbert-Herman Cancer Center, Sparrow Hospital Being certified makes me Being a certified Nurse Being certified makes me feel feel confident and satisfied makes me feel a sense of empowered both personally in my role as a Critical Care accomplishment to better and professionally. It holds PROFESSIONAL DEVELOPMENT Nurse. serve my Patients. me accountable and inspires > Certified RNs me to do and be better, not just for myself but for my colleagues, students, and Patients.

14 Sparrow Nurses | 2018 Nurses Annual Report Sparrow Nurses | 2018 Nurses Annual Report 15 PROFESSIONAL DEVELOPMENT > Back to School The most exciting thing about going back to school is acquiring new knowledge The most exciting thing about going back to and skills for future practice.

school was learning more LUCAS EISELER, BSN, RN about the business part of Float Team, Sparrow Hospital nursing and expanding my knowledge of those areas of the healthcare field.

SANDRA WARD, BSN, RN Sparrow Medical Group St. Johns

Being certified and The most exciting going back to school, thing about going makes me feel back to school is empowered. gaining knowledge and improving myself MONICA WILSON, BSN, BS, RN, CCRN so I can provide better Inpatient Rehabilitation care for my Patients. Mary Free Bed at Sparrow

LAURA TIPPS, BSN, RN Emergency, Sparrow Clinton 16 Sparrow Nurses | 2018 Nurses Annual Report Sparrow Nurses | 2018 Nurses Annual Report 17 PROFESSIONAL DEVELOPMENT COLLABORATIVE PRACTICE > Back to School > Herbert-Herman Cancer Center

The most exciting thing about going back to school is gaining knowledge I will need in the future to help my current Patients now. I love to learn, and I am excited about the possibilities that will open for me once my degree is finished.

KYLEE MCKAY, BSN, RN Cardiac Stepdown, Sparrow Hospital

Going back to school to help progress my career has been very challenging and just as equally rewarding. It’s great to have some of the latest technology and Working towards my MSN-FNP has made me stronger exceptional multidisciplinary teams collaborating to and helped me become a better Nurse. ALEXIS COOK, BSN, RN-BC provide the best care for our Patients at the Cancer Center! Herbert-Herman Cancer Center, Sparrow Hospital TYLER GRESHOW, BSN, RN-BC HEATHER APOLINAR, RN, BSN, (left), 6 West, Sparrow Hospital Surgical Med/Surg, Sparrow Hospital CASEY WOOD, RN, (center), Sparrow Specialty Hospital

18 Sparrow Nurses | 2018 Nurses Annual Report Sparrow Nurses | 2018 Nurses Annual Report 19 Process Component Primary Outcomes Component Having my bachelor’s in nursing means EBP & CRITICAL THINKING I am better prepared to lead. AT THE BEDSIDE (CLINICAL RNS) AMY CARPENTER, BSN, RN, CCRN Nursing Education, Mary Free Bed at Sparrow > 2018 Sparrow Hospital

CAUTI rate = 0.601 Fall rate = 0.348 Pressure injury rate = 1.44%

Strategic Outcomes Component

> 2018 Sparrow Hospital

BSN or higher rate = 51% Frontline certification rate = 32%

CHERYL KAY, BSN, RNC-OB,C-EFM, (far left), Nursing Education, Sparrow Hospital JOHN STURTEVANT, MSN, RN-BC, (middle), Nursing Education, Sparrow Hospital KATIE COUSER, BSN, RN, CNOR, (second from right), Surgical Services, Sparrow Hospital JENNIFER THOMPSON-WOOD, MSN, RNC-OB, C-EFM, ACNS-BC, (far right), Women’s Services, Sparrow Hospital

20 Sparrow Nurses | 2018 Nurses Annual Report Sparrow Nurses | 2018 Nurses Annual Report 21 Strategic Outcomes Component > Sparrow Carson (continued)

NATIONAL LEADER IN QUALITY & PATIENT EXPERIENCE > 2018 Women’s Choice Award® for America’s Best > Achieved 81% score for participation in the > Participated with community and schools to Hospitals for Emergency Care Michigan Surgical Quality Collaborative (MSQC). give away backpacks, school supplies, and bicycle > Hosted the 2nd Annual VIP event called “It Takes > Nursing-led teams developed for Sepsis, helmets for kids distributed to Montcalm and > Sparrow Carson a Village”; This event celebrated a Patient’s Transfers, and Readmission Performance Gratiot County schools. experience with a positive outcome from a STEMI Improvement Teams; Efforts focused on achieving > Implemented new processes using Humi Packs event. The event highlights ALL of the people who National Standards for the local populace. and red totes for transporting dirty instruments We received SEVEN 5-Star Patient experience awards from PRC: Nursing Education contributed to the Patient’s positive outcome. > Partnered with local Nursing programs: to Sterile Processing for the SMG Clinics as well INITIATIVES: > Special Care Unit program implemented on Davenport University, Baker College, and as in the hospital. HHHHH 5-Star performance Emergency Department for Overall Quality of Care Medical Surgical Floor; Allows for higher acuity Montcalm Community College. > Implemented a new aid in the sterilization Patients to remain closer to home for specialized > Gained approval for the RN to BSN program; process, securing all hinged and ratcheted ACLS: 100% care; Nurses attending advanced critical care instruments in an open position for processing. HHHHH 5-Star performance Inpatient ICU/Med Surg Overall Hospital Rating (HCAHPS) — Unit Specific Sparrow tuition assistance to increase our of Clinical RNs certified on training classes. The program is expected to be BSN RNs. ICU/ms, ED, and Surgical Services fully operational by March 2019. > 39% BSN and higher RNs. HHHHH 5-Star performance Inpatient Overall Hospital Rating (HCAHPS) — All Inpatient Units > Art of the Patient Experience program being > In 2018, Sparrow Carson only had one (1) CAUTI Achieved NCI: 100% taught to expand our “Speak Up” and Patient % and zero (0) CLABSI. 96 Bar Code Scanning HHHHH 5-Star performance Inpatient HCAHPS — Care Transitions of Response Team staff certified Satisfaction Improvement initiatives; Our next for medication compliance step after Team STEPPS was introduced. > Nursing Education instituted the sitter program to increase safety for Patients as well as Caregiver > Nursing Unit-Based Councils spearheaded fall HHHHH 5-Star performance Inpatient HCAHPS — Communication about Mediations satisfaction. reduction measures, Severe Sepsis Recognition Training, and instituted a Wellness Center for > Nurse educators collaborated with Lab to HHHHH 5-Star performance Inpatient HCAHPS — Discharge Information hospital Caregivers. implement rapid transfusion protocols. > Continued preparation/program development for > Hosted a large community event/picnic 96% with education on what Carson has to offer HHHHH 5-Star performance Inpatient HCAHPS — Responsiveness of Staff State Trauma Designation Level IV. Compliant to the Carson City region, as well as Doctors > Achieved 96% Bar Code Scanning for volunteering their time to talk to the community medication compliance. and answer questions.

22 Sparrow Nurses | 2018 Nurses Annual Report Sparrow Nurses | 2018 Nurses Annual Report 23 > Sparrow Clinton > Sparrow Ionia

> 24% of SCH Nurses are certified registered Nurses > Sparrow Medical Group St. Johns was the first practice in the United States > Received Pathways Designation in April > No inpatient fall with injury for one year. No > 58% of SCH Nurses have a BSN or higher level associated with a critical access hospital to earn The Joint Commission’s Gold Seal 2018. inpatients fall without injury for six months. 54.9% of RNs of Approval® for Primary Care Medical Home (PCMH) Certification. In 2018, the > 2018 Sparrow Clinton Hospital Nurses completed > Sparrow Ionia has a Four Star CMS Rating. > Survival Flight Code simulation and Code prepared at the BSN practice became the first to nationally recertify as a PCMH. the application and documentation of SCH’s second > Sparrow Ionia ED received Governor’s Narrator Education was very successful. or higher level Pathway designation. > Sparrow Medical Group St. Johns received the MPRO Governor’s Award of Excellence Award for ED Arrival to Admit > Reassessment of pain audits 100%. Excellence for Immunization. The award recognizes outstanding achievements in > 2018 Top 25% Overall Quality of Care (Emergency and ED Transfer Communication. > Continued preparation/program improving the quality of health care. Department) > SMG Ionia received Governor’s Excellence development for State Trauma Designation > Sparrow Clinton Infusion/Cancer Center hosted the Awards for Improvement of Heart and Level IV. 4th Annual Celebration of Life dinner. 5 Five-Star HCAHPS Awards, Five-Star = TOP 10% Diabetic Management and Governor’s > 54.9% BSN and Higher RNs. Excellence for Outstanding Achievement > Increased Culture of Safety Climate from 49% to 65%, > 8.8% certification rate. > 2018 Top 10% HCAHPS — Overall Hospital Rating (Inpatient) in Improving Antibiotic Stewardship: which is the 86th percentile. Outpatient Settings. > Nursing Education instituted the sitter > Sparrow Clinton Hospital Nurse-led teams developed > 2018 Top 10% HCAHPS — Responsiveness of Staff (Inpatient) program to increase safety for Patients as > SMG Saranac Governor’s Excellence for for stroke, communication, hospital-wide CPR, well as Caregiver satisfaction. Outstanding Improving Heart Health and transfers, and readmission performance improvement > 2018 Top 10% HCAHPS — Communication with Nurses (Inpatient) Governor’s Excellence for Outstanding > RN collaboration with MS HUC to get initiatives. 95-110% of all inpatient discharges to have > 2018 Top 10% HCAHPS — Communication about Medications (Inpatient) Achievement in Improving Antibiotic > Sparrow Clinton Hospital direct care Nurses presented Stewardship: Outpatient Settings. scheduled follow-up appointments. four poster presentations nationally at the 2018 ANCC > 2018 Top 10% HCAHPS — Discharge Information (Inpatient) > SMG Portland received Governor’s > Formulated a working together team for the Pathway to Excellence conference related to CPR Excellence for Outstanding Achievement right door (local CMH). in Schools, Pathway to Excellence as a System, Fall in Improving Antibiotic Stewardship: > Sparrow Hospital led EMS/Hospital Services Prevention, and Sustaining Patient Satisfaction in the Increased Culture of Safety Climate Outpatient Settings. fair at the Ionia Portland Football game. Emergency Department. FROM 49% to 65% > Nurse Sensitive Indicators: Zero CAUTI, Zero > Sparrow Ionia RNs performed Accu-checks > Sparrow Medical Group St. Johns achieved designation CLABSI, and Zero Pressure Ulcers. and blood pressure readings at Ionia Expo. as a Blue Cross Blue Shield of Michigan Patient which is the 86th percentile Centered Medical Home for the 10th consecutive year. 58% of SCH NURSES have a BSN or higher level 24 Sparrow Nurses | 2018 Nurses Annual Report Sparrow Nurses | 2018 Nurses Annual Report 25 > Sparrow Specialty Hospital

> 2018 Top Ranked Hospital for Patient Satisfaction > Achieved 99% Bar Code Scanning for patient decile results in “Improvement Readiness” and according to PRC for “Physician Understanding identification and 98% medication compliance “Safety Climate” and top quartile in “Teamwork” and Caring” > Nursing Education Initiatives: > Participated in journey to identify safety and > Hosted the 2018 Second Annual Patient and > ACLS: 100% of clinical Caregivers certified security risks associated with environment of care, Family Education Fair, which had over 200 > Initiated RN education for Ostomy Care such as limiting visiting hours, history of violence attendees. The fair focused on educational topics Workshop with a goal of 100% participation flag for patients in EPIC, and magnet on the door. such as Advanced Directives, Gift of Life, Stroke by 2019. > Successful Code Silver “Active Shooter” drill in Awareness and Safety Medication Disposal. > 2018 Annual Competency Fair with 100% 2018. > 2018 Patient Influenza Vaccinations 100% participation. RN Caregivers led the event assessed and appropriately given; national by selecting the topics of greatest interest Certified RNs: 8% average per LTACH Compare is 79.8%. and need. Nurse-led presentations regarding Sepsis, Documentation, Serious Safety Events, > Center for Disease Control and Prevention Gift of Life, Restraints and 2018 National National Healthcare Safety Network focus on Patient Safety Goals RNS PREPARED AT infection prevention practices show healthcare > Nursing-led teams developed for Sepsis and workers assessed and appropriately given the BSN or higher level: 43% CLABSI reduction Influenza vaccine. SSH had 97.2% participation Shared governance provides structural with the national average per LTACH Compare > Partnered with local Nursing programs: Michigan is 80.2% State University, Baker College, and Lansing TOP PERFORMING support for all nursing work at Sparrow Community College > SSH Nursing Unit Based Council is a shared affiliate for Caregiver Hospital. It gives Nurses the opportunity governance program that give Nurses the > Provided RN to BSN program tuition assistance to opportunity to take part in solving problems increase our BSN RNs. Engagement survey with to impact and influence the work they and identifying future goals. Primary goals for > Presented SSH’s “Pre-Code Team” program at 100% participation do every day through involvement at 2018 included identifying Nursing certifications the Annual Nursing event and held a Mock Code available to LTACH nurses and identifying topics event. the unit, hospital, and system levels. for 2019 Skills Fair. > Culture of Safety Survey conducted with top Highly Active UBC SARAH COLLINS, MSN, RNC-NIC Regional Neonatal Intensive Care, Sparrow Hospital

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