Caring Headlines — July 16, 2015 Jeanette Ives Erickson (Continued)

Headlines CaringJuly 16, 2015 TThehe BBarbaraarbara AA.. DDunderdale,underdale, RRN,N, LLectureecture oonn tthehe FFutureuture ooff NNursingursing

Gwen Sherwood, RN, professor and associate dean of Academic Affairs for the School of Nursing at the University of North Carolina at Chapel Hill, returns as this year’s Dunderdale visiting scholar

See story on page 4

The newsletter for PPatientatient CCareare SServiceservices Massachusetts General Hospital Jeanette Ives Erickson

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cross the country, hospitals are strategizing ways to improve systems, increase There are many effi ciency, and decrease levels of care, costs while ensuring patients receive uninterrupted, high- and matching the quality care. One area of focus that has emerged as part of this effort is a Jeanette Ives Erickson, RN, senior vice president patient to the A for Patient Care and chief nurse closer look at patient progression throughout the appropriate level is continuum of care — ensuring that the right care of a hospital room. Being able to sleep in their is delivered at the right time and in the right lo- own beds, eat the foods they’re accustomed to, and key. Many patients cation. The goal is to help patients achieve their be close to family and pets can have a positive im- highest level of health and functionality so they pact on recovery and quality of life. And with ad- are discharged to can resume their lives with equal or greater com- vances in technology and communication, it’s eas- long-term acute- fort than when they were admitted. ier than ever to provide care at home that once There are many levels of care, and matching necessitated hospitalization. care, rehabilitation, or the patient to the appropriate level is key. Many With national forecasts projecting a 17% in- patients are discharged to long-term acute-care, crease in the number of patients who’ll receive skilled nursing facilities. rehabilitation, or skilled nursing facilities. But care at home over the next fi ve years, it’s import- But one option that one option that might be being under-utilized in ant that MGH clinicians be knowledgeable about our efforts to match patients to the correct level the kinds of services available from home health- might be being under- of care is home health care. care agencies, including nursing care, physical and utilized is home More and more, home health care is a viable occupational therapy, nutritionists, social workers, option for patients with a wide range of needs and home health aides. Many home health agen- health care. due to illness or injury. Most patients prefer to be cies provide wound care, IV infusions, maternal- in their own homes versus the unfamiliar setting child healthcare, and population-specifi c care for a continued on next page

Page 2 — Caring Headlines — July 16, 2015 Jeanette Ives Erickson (continued)

growing number of chronic illnesses. Patients with eCare. That means that once MGH goes live in Alzheimer’s or dementia; brain injury; cancer; dia- April of next year, we’ll all be part of the same betes; heart conditions; neurological disorders; pul- electronic health information system, able to At a time monary disease; and stroke may be candidates for share medical records, billing information, care home health care. notes, and all relevant communication about when more and We’re fortunate to be part of the Partners Health- patients within our system. Care System with access to our own home health Data shows that MGH makes fewer referrals more patients are care program. Partners HealthCare at Home (PHH) to home health care agencies than other aca- seeking care, it’s was recognized as one of the top home-care agencies demic medical centers across the country. And in the country last year by HomeCare Elite (an an- of all MGH patients referred to home-care vital that we utilize nual listing of the most successful home-care pro- agencies in our geographic area, only 39% were viders in the United States, published by the Na- referred to Partners Health Care at Home. all the resources tional Research Corporation and DecisionHealth). At a time when more and more patients are at our disposal to Partners HealthCare at Home is a full-service seeking care, it’s vital that we utilize all the re- agency that offers expert care to patients from birth sources at our disposal to ensure optimal pro- ensure optimal to end of life. It’s the second largest home-care progression and high-quality care throughout the vider in New England with more than 470,000 cer- entire continuum. Home health care is a viable progression and tiﬁ ed visits and 450,000 private-care hours in more option for many patients. And it doesn’t hurt high-quality care than 200 cities throughout eastern Massachusetts. that one of the top home care agencies in the PHH liaisons are available on-site at MGH to help country is in our own back yard. throughout the facilitate referrals and help you decide whether For more information about Partners Health- PHH might be the right choice for your patient. Care at Home or to arrange an in-service for entire continuum. As part of the Partners HealthCare network, your area, call the PHH Referral Service Center Home health care PHH has just gone live with their portion of Partners at 781-290-4200. is a viable option for many patients. In this Issue And it doesn’t hurt The Barbara A. Dunderdale, RN, Lecture on the Carol A. Ghiloni Oncology Nursing that one of the top Future of Nursing ...... 1 Fellowship ...... 11 home care agencies Jeanette Ives Erickson ...... 2-3 Creating a Welcoming Environment • Utilizing Home Health Care for Patients with Disabilities ...... 12 in the country The Barbara A. Dunderdale, RN, Lecture on the Hand Hygiene ...... 13 is in our own Future of Nursing ...... 4-5 Professional Achievements ...... 14 back yard. Ramadan at MGH ...... 6-7 Announcements ...... 15 Clinical Narrative ...... 8-9 • Sarah Brooks, RN Fielding the Issues ...... 16 • Selecting New Glucometers Still Alice: Understanding Alzheimer’s ...... 10

(Cover photo by Michelle Rose)

July 16, 2015 — Caring Headlines — Page 3 Nursing

The Barbara A. Dunderdale, RN, Lecture on the Future of Nursing — by Jane Keefe, RN, program development manager

t was standing room only in O’Keeffe was failing, and over the course of the next 30 hours, Auditorium, June 25, 2015, for the 2nd Blackman bled to death. Sherwood returned again this annual Barbara A. Dunderdale, RN, Lecture year as the Dunderdale visiting scholar, accompanied by on the Future of Nursing. Dunderdale, an Lewis Blackman’s mother, Helen Haskell, founder and alumna of the MGH School of Nursing, is president of the non-profi t organization, Mothers Gwen Sherwood, widely known and highly regarded for her Against Medical Error. Haskell has worked tirelessly to work as a staff nurse, nursing director, mentor, establish and cultivate this coalition of parents whose RN, professor and patient advocate, and most recently, as se- mission it is to promote safety in the healthcare system. nior major gifts offi cer in the Development Offi ce Sherwood and Haskell veered from traditional lecture Iwhere she’s raised millions of dollars to help advance format, sharing an abbreviated version of the Lewis Black- associate dean of the mission of MGH. The Dunderdale Lecture on continued on next page Academic Affairs the Future of Nursing was established in appreciation of for the School Dunderdale’s years of service and contributions to the of Nursing at MGH community. Gwen Sherwood, RN, pro- the University of fessor and associate dean of Academic Affairs for the North Carolina School of Nursing at the University of North Carolina at Chapel Hill, at Chapel Hill, was the inau- gural Dunderdale visiting returned again scholar last year. Her address this year as the at that time was set against the backdrop of a case study Dunderdale involving the tragic death of Lewis Blackman, a healthy, visiting scholar. 15-year-old boy who died following elective surgery at a large teaching hospital. Those caring for Blackman had missed critical signs that he (Photos by Michelle Rose)

Page 4 — Caring Headlines — July 16, 2015 Nursing (continued)

man video, then delving deeper into the Offi ce of Quality & Safety, facilitated a lunch-time discus- case, interview-style, exploring the vari- sion with Dunderdale, Sherwood, and Haskell on the role of ous failures that led to Blackman’s death. safety narratives in our journey to foster a just culture at They talked about “nurses’ work,” and MGH. Discussion focused on some of the unique challenges Sherwood and the importance of identifying system we face at MGH as a major academic medical center. break-downs; not relying on work- Associate chief nurse, Theresa Gallivan, RN, pointed out Haskell’s take-away arounds; communicating effectively to that in any academic medical center, medical residents rotate coordinate care; engaging patients and in and out of service at regular intervals. Nurses are largely message was that, families in decisions that affect their responsible for ensuring continuity and overseeing the care; and welcoming them into bedside breadth of care. “Safety belongs rounds and hand-overs. Dunderdale noted that fostering a just culture where in- Earlier in the day, Sherwood and quiry and the reporting of adverse events are encouraged en- to all of us, but it Haskell had an opportunity to dialogue ables staff to collaborate with nurses and other clinicians in begins with me. It with staff on the Ellison 18 Pediatrics providing the safest, highest quality care possible. Unit and the Pediatric Intensive Care This year’s Barbara A. Dunderdale, RN, Day and Lecture is the integrity of Unit. Staff shared how they prepare for, provided a wonderful opportunity to engage and dialogue respond to, and learn from errors and with internationally recognized leaders in quality and safety. the people and near-misses. The discussion reinforced our commitment to continue to After one session, Sherwood com- identify errors and system failures, to regard these events as the organization mented, “There is truly something dif- learning opportunities, and to make continuous improve- ferent about the culture and care at ment part of our daily practice. that makes the Mass General. It’s just incredible. I Sherwood and Haskell’s take-away message was that, hope you’re all proud to be part of it.” “Safety belongs to all of us, but it begins with me. It is the difference.” Jana Deen, RN, senior director of integrity of the people and the organization that makes the Patient Safety in the MGH Center for difference.” Quality & Safety, and Colleen Barbara A. Dunderdale, RN, Day and Lecture on the Snydeman, RN, director of the PCS Future of Nursing is made possible through the generous gifts of donors and planned by The Norman Knight Nursing Center for Clinical & Professional Development. For more information about Barbara A. Dunderdale, RN, Day and Annual Lecture on the Future of Nursing, contact Jane Keefe, RN, at 617-724-0340. Photos (l-r): Gwen Sherwood, RN, professor and associate dean of Academic Affairs for the School of Nursing at the University of North Carolina at Chapel Hill; Helen Haskell, founder and president of the non-profi t organization, Mothers Against Medical Error; and Barbara Dunderdale, RN, former nursing director, currently senior major gifts offi cer in the Development Offi ce. Sherwood and Haskell during Lecture on the Future of Nursing. Audience member asks a question.

July 16, 2015 — Caring Headlines — Page 5 Observances

RRamadanamadan aatt MMGHGH a celebration of family and community

amadan, the ninth month of the lunar which Muslims observe by dressing in ﬁ ne clothes, going calendar, is the holiest time of year for to mosque to pray, and exchanging gifts. Muslims, who believe the Qur’an (the For the last 14 years, the MGH Muslim community Islamic holy book) was revealed to the has come together to share in a ritual Iftar — the meal Prophet Muhammad (peace be upon eaten at sunset to break the daily fast. Meticulously co- him) during this month. In adherence ordinated by Firdosh Pathan, RPh, the event has grown Scenes from the MGH with Islamic practices, Muslims over the years to where now hundreds of Muslims and celebration of Ramadan, abstain from eating or drinking non-Muslims anxiously await the elaborate Iftar, a feast include the breaking of the from dawn until sunset for the 29 or 30 days of Ra- of Middle Eastern foods and delicacies provided by fast and those who offered Rmadan (depending on the lunar calendar). During Nutrition & Food Services. Having outgrown its origi- remarks, including, Jeff Davis, senior vice president for this sacred time, Muslims make a special effort to nal locale in the Trustees Room, and then the Thier Human Resources (below); maintain good conduct, engage in contemplation Conference Room, this year’s Iftar was served al fresco and on opposite page (l-r): and self-restraint, and be charitable to others. The under the Bulﬁ nch tent. Deborah Washington, RN, festival of Eid-ul-Fitr marks the end of Ramadan, continued on next page director, PCS Diversity; Imam Loay Assaf from the Islamic Society of Boston Cultural Center; Samsiah Abdul Majid; Rabbi Ben Lanckton; and event coordinator, Firdosh Pathan.

Page 6 — Caring Headlines — July 16, 2015 Observances (continued)

Says Pathan, “These celebrations remind us that Services. The Masjid at MGH is located in Founders 109. Friday prayers are held in there’s only one God, one creator, and one human- the Thier Conference Room at 1:00pm. For more information about Ramadan, Iftar, ity; that we can all live together. Proud parents bring or the Muslim community at MGH, e-mail Firdosh Pathan or call him at 4-7878. their children and families. It’s a wonderful expres- sion of inclusion; a wonderful show of respect and appreciation to our Muslim community. It makes me proud to work at MGH.” If you work with Muslim colleagues or patients and would like to make them feel welcome, some phrases you may want to commit to memory include: • Assalamu alaikum: Peace be upon you • Wa’alaikum Assalam: Peace be upon you, too • Ramadan Mubarak, or Ramadan Kareem: Have a blessed Ramadan • Eid Mubarak: Have a blessed Eid The annual Iftar is sponsored by Human Resources and supported by the Chaplaincy and Patient Care

July 16, 2015 — Caring Headlines — Page 7 Clinical Narrative

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y name is Sarah Brooks, and I’ve worked in a variety of nursing roles for the past ten years on Ellison 16, a 36-bed general medical unit. Ms. W was a 24-year- old woman admitted with a sore throat; a new, dif- Ms. W was a fuse rash on her torso, neck, and upper legs; and de- Sarah Brooks, RN Mhydration due to an inability to eat or drink. Upon staff nurse, Ellison 16 24-year-old entering her room, I greeted Ms. W, her mother, affected skin until it eventually sheds off. The syn- and her boyfriend. As I checked her blood pressure drome is very painful and debilitating, often caused woman admitted and heart rate, I tried to get to know her by asking by an adverse reaction to medications. In this case, about the events leading up to her admission. She it was suspected that her reaction could be related with a sore throat; mentioned that she’d recently begun taking a new to the birth-control pills she’d recently started tak- birth-control medication. In my mind, I made a ing. a new, diffuse connection between the timing of the new medica- I didn’t have any experience caring for a patient tion and the onset of the rash and sore throat. with this disease, and the physician had very little rash on her Ms. W’s mother was noticeably anxious. She of- himself. Because of the unfamiliarity of the disease ten interrupted or spoke for her daughter, answering and the multitude of services consulting, it became torso, neck, and questions I’d asked Ms. W or asking questions of more important than ever to have excellent com- her own. Right away, I realized I didn’t have all the munication between the family and care team. I upper legs; and answers to their questions. I knew I had to consult found myself assuming the role of communicator to with the resident regarding the plan of care for Ms. ensure the goals of care were clear and that Ms. W dehydration due W. It was vital that all caregivers be on the same was receiving the treatment she needed. to an inability to page and communicate the same information to the At ﬁ rst, it was a little overwhelming. Due to the patient and family. disease process, Ms. W had burns inside her mouth, eat or drink. After leaving Ms. W’s room, I contacted the pri- on her lips, throat, eye lids, torso, back, legs, ure- mary resident. He explained that Ms. W had pre- thra, and vagina. She was at high risk for infection, sumed Stevens-Johnson syndrome, a life threaten- so she was placed in a private room with positive ing condition that affects the skin and mucus mem- pressure. She required eye drops every two hours, branes. The disease causes rash and blistering of the prednisone suppositories, intravenous ﬂ uids, oral continued on next page

Page 8 — Caring Headlines — July 16, 2015 Clinical Narrative (continued)

suctioning, and frequent pain medication. Because My experience with Ms. W, reinforced for me of the frequency of the medications, Ms. W wasn’t that nursing is not just about medicating patients, able to sleep for long periods. Sleep-deprived and in it’s about treating the whole person. There’s so severe pain, she became increasingly distressed. much more to being a nurse than medication-ad- To treat Ms. W’s pain, we initiated a PCA (pa- ministration. You have to know your patient on a tient-controlled analgesia). I consulted nurses in personal level and provide emotional support. As a As I’ve the Burn Unit for suggestions on how to make Ms. nurse, you’re at the bedside more than any other developed as W more comfortable. They were able to give me provider. You have the ability to make the biggest some much-needed advice and clinical support. difference in a patient’s life as they deal with serious a practitioner, I often found myself reading the recommenda- illnesses. And with experience, you’re able to antic- tions of other providers — from services like Ophtha - ipate the needs of your patient, go above and beyond I realize that lmology, Infectious Disease, Medicine, Gynecology, to provide comfort during sometimes traumatic and Dermatology. I wanted to understand the rec- hospitalizations. there’s a power ommendations and continue to teach and educate After Ms. W was discharged, the family reached Ms. W and her family. By monitoring the various out to me from home to give me an update on her we hold as recommendations, discussing them with the pri- clinical status and let me know how much better mary medical team, and educating the family, I she was doing. They thanked me for everything I’d providers — the helped coordinate the care among all the services done, and I was thankful that Ms. W reminded me assisting in Ms. W’s care. that we can make a difference in patients’ lives by power of I cared for Ms. W almost every time I came to simply spending a little extra time when it’s needed. work, which helped foster a strong relationship and As I’ve developed as a practitioner, I realize that empathy and build trust between us. When I wasn’t her primary there’s a power we hold as providers — the power of nurse, I became a resource for other nurses through empathy and benefi cence. This power is entrusted benefi cence. impeccable note-writing and detailed reporting to us as nurses so we can help instill emotional during hand-offs. strength as well as therapeutic care. Often nurses This power is But perhaps the most important thing I did for don’t realize the profound effect they have on pa- Ms. W was hold her hand at 2:00 in the morning, tients because they’re busy with daily tasks and rou- entrusted to listen when the family was sad or frustrated, and tines. I believe I’ve reached a point in my develop- took the time to do little things to make her feel ment as a nurse where I treat patients not just with us as nurses so better. I rubbed her back and helped her with her medications and interventions, but with love, kind- we can help suctioning. I stayed by her side when she was scared. ness, patience, and a listening ear. Ms. W reminded I made jokes, listened to her mother’s stories about me that to provide excellent care, you not only instill emotional when Ms. W was young. Just by doing these simple have to advocate for your patients, you have to pro- things, I was able to build trust and support Ms. W vide holistic care, and most importantly, listen. strength as well through this devastating time in her life. Comments by Jeanette Ives Erickson, RN, Because Ms. W trusted me, she allowed me to senior vice president for Patient Care and chief nurse as therapeutic work with her on becoming self-suffi cient again, which can be daunting when recovering from a Every day clinicians encounter diagnoses they may care. life-threatening disease. When her immune-com- never have seen before. Sarah made it her business promised state had improved and she was cleared to to fi nd out as much as she could about Stevens- leave her room, I was the fi rst to help her to the pa- Johnson syndrome; she reached out to experts on tient’s lounge. She hadn’t been able to leave her the Burn Unit so she could provide Ms. W with the room in weeks. Not only did I feel honored to be best possible care. She did everything in her power able to give her back some desperately desired free- to make Ms. W comfortable both physically and dom, but I gave her back some dignity and control. emotionally. And in so doing, she realized, as she so We went to the lounge and sat and talked like girl- eloquently put it, the power of empathy and benefi - friends having coffee instead of nurse and patient. I cence. And isn’t that the true gift of being a nurse. could see that her comfort was returning and her Thank-you, Sarah. confi dence in me growing.

July 16, 2015 — Caring Headlines — Page 9 Geriatric Care

SStilltill AAlicelice: uunderstandingnderstanding AAlzheimer’slzheimer’s — by Barbara Moscowitz, LICSW, and Colleen Grifﬁ n

On June 16, 2015, the MGH Geriatric Medicine Care- Key messages in her presentation included: giver Support Program hosted acclaimed author of Still • Alzheimer’s is not just a disease of the elderly; it Alice, Lisa Genova. Genova spoke to a large and en- affects individuals in mid-life, as well. Many who gaged audience with passion and clarity about her dual live with Alzheimer’s frequently navigate a fright- roles as granddaughter and neuroscientist, a situation that ening and lonely world precipitated her evolution into fi ction writer. Genova’s • We can connect with individuals with Alzheimer’s novels are about, “people living with neurological dis- at any stage of the disease. Emotion outlasts mem- eases and conditions that are feared, ignored, or misun- ory and language, and our presence has an impact Oderstood... Stories are a way into people’s hearts, and when this happens, we even when we think it may not have more than knowledge, we have real understanding, empathy, sensitivity, • Our job as caregivers is to learn how and when to the ability to be better caregivers, and maybe the motivation to get involved.” meet Alzheimer’s patients in their world, and Said Genova, “Looking back, my eighty-fi ve year-old, widowed grandmother stop trying to keep them in a world they no lon- had been showing signs of dementia for years. But she was a smart, independent ger understand woman who never complained. She navigated around her symptoms with great Genova’s goal is to encourage the conversation skill, and her nine children, their spouses, and her grandchildren were all con- about Alzheimer’s and awaken the public to this tent to look the other way, or pass off her cognitive mistakes to normal aging.” crisis that belongs to all of us. Just as we overcame When Genova’s grandmother was diagnosed with Alzheimer’s disease, Genova’s the fear of discussing cancer and HIV, the time has caregiving role within the family come to talk about Alzheimer’s. stimulated her scientifi c curiosity in For questions and comments please contact Alzheimer’s and ultimately led to the Barbara Moscowitz, LICSW, at bmoscowitz@part- discovery of her professional mission. ners.org

(Photos by Michelle Rose) (Photos by Acclaimed author, Lisa Genova, speaks at MGH Geriatric Medicine Caregiver Support Program, “Still Alice: Understanding Alzheimer’s.”

Page 10 — Caring Headlines — July 16, 2015 Oncology Nursing

CCarolarol AA.. GGhilonihiloni OOncologyncology NNursingursing FFellowshipellowship — by Mandi Coakley, RN, staff specialist

his year marked the 15th Carol A. Ghiloni Oncology with an opportunity to spend ten weeks at MGH Nursing Fellowship with fellows: Hannah Osborne a learning and observing in various settings within student at the William F. Connell School of Nursing at the Oncology Nursing Service. The experience is Boston College; Sara Hogan, from the University of an introduction to oncology nursing practice and Massachusetts, Amherst; Jennifer Merrill, from Simmons the many roles and career opportunities available College; and Carmen Porto, from the University of to them upon graduation. The fellowship was TMassachusetts, Boston. The Ghiloni Fellowship provides students created in 2001 to offer students an opportunity to learn about the specialty of Oncology Nursing with the hope of hiring them upon graduation. Fellows spent time on Lunder 9 and 10, Phillips House 21, and had observational experi- ences in Radiation Oncology, the Infusion Unit, the Operat ing Room, Pediatric Oncology, and the Yawkey outpatient disease centers. They at- tended educational offerings, learned about the HOPES programs, spent time with the Palliative Care Service, Blood Transfusion Service, Interventional Radiology, and took advantage of many other learning opportunities within the Cancer Center. The Carol A. Ghiloni Oncology Fellowship program receives funding from the Hahnemann Hospi tal Foundation and the Susan D. Flynn Oncology Nursing Training and Development Fund. For more information, call Mandi Coakley, RN, staff specialist, at 617-726-5334.

At left (l-r): Carol Ghiloni, RN; Cyndi Bowes, RN; Sarah Hogan; Hannah Osborne; Carmen Porto; Jennifer Merrill; and Mandi Coakley, RN. Above left: Osborne and Porto. Above right: Merrill and Hogan.

July 16, 2015 — Caring Headlines — Page 11 Awareness

CCreatingreating a wwelcomingelcoming eenvironmentnvironment fforor ppatientsatients wwithith ddisabilitiesisabilities it takes the whole village

A disability is a restriction or lack of ability to perform an activity as it would ordinarily be performed by most people. A disability can be physical, cognitive, mental, sensory, emotional, developmental, or some combination of the above. Disabilities can result from many causes and may be observable or not readily visible. Regardless of the speciﬁ c disability, individuals with disabilities adapt to their circumstances, living life as fully as possible in a world that is trying to become more inclusive.

The MGH In general: • Speak directly to the person with the disability • Always use ‘person-fi rst’ language. For example, and allow her to speak for herself Disability Program say “person with a disability,” not “the disabled” • When speaking to individuals with communi- • Avoid terms like “handicapped” or “mental retar- cation disabilities, take time, relax, and listen. is part of the dation” It’s okay to say, “I don’t understand” Offi ce of Patient • Don’t make assumptions about what a person can • Ask the person how he or she prefers to or cannot do communicate Advocacy, providing • It’s okay to offer assistance, but always ask fi rst to • When speaking to individuals with hearing clarify what, if any, assistance is needed disabilities, use an interpreter and address the support to patients • Don’t move someone’s crutches, walker, wheel- person, not the interpreter and visitors with chair, cane, or any other mobility aid without • When speaking to individuals with vision their permission disabilities, introduce yourself and your role and disabilities. For • Don’t pet or talk to a service animal without the be sure to let them know when you’re ending permission of the animal’s handler information, call the conversation or leaving the area Communication: Resources: Zary Amirhosseini, • Before you speak, make sure you have the atten- • http://[email protected] tion of the person you’re addressing • http://www.massgeneral.org/interpreters/ Disability Program • Face the person, and use a normal tone of voice • The Maxwell & Eleanor Blum Patient and Manager, at 617- (don’t shout) Family • Position yourself so that you’re on the same level • Learning Center’s Assistive Technology Center 643-7148 and can easily make eye contact • www.communityinclusion.org

Page 12 — Caring Headlines — July 16, 2015 Infection Control HHandand hhygieneygiene still the most effective strategy for preventing hospital-acquired infections — by Patti Shanteler, RN, staff specialist, and Judy Tarselli, RN, staff nurse (Re-printed from the February 19, 2015, Caring Headlines)

ccording to the World Health Organization, “Each year, (to keep the patient safe), and keep the patient’s hundreds of millions of patients around the world are germs inside the bubble (to keep everyone else safe). affected by healthcare-associated infections. Most health- Since germs are easily transmitted by touch, it’s im- care-associated infections are preventable through good perative to use proper hand hygiene before touch- hand hygiene — cleaning hands at the right time, in the ing anything inside the bubble and again after leav- right way.” Signiﬁ cant improvements have been made ing it. in hand hygiene since new guidelines were established Other tips to remember include: by the Centers for Disease Control and Prevention and Mid-task activities the World Health Organization, but healthcare-associated infections continue When a staff member needs to leave a patient’s Ato occur in hospitals across the country. room in the midst of providing care, gloves should At MGH, infection-prevention professionals routinely help educate staff, be removed (if worn) and hand hygiene should be raise awareness, and monitor hand-hygiene compliance by observing caregivers performed upon exiting the room and before return- interacting with patients and the patients’ environment. As a result, MGH meets ing to the patient. Visitors should do the same if or exceeds expectations for hand-hygiene compliance and has seen historically they step out of the room and return. low rates for some healthcare-associated infections. Despite that success, we Environmental contact only remain vigilant about proper hand hygiene and invite patients and visitors to do If a staff member enters the room to use a bedside the same. computer, adjust a monitor, or change an IV and Healthcare workers are re- doesn’t touch the patient, hand hygiene must still quired to use hand hygiene before be performed before and after those tasks as they’re and after contact with patients or all located within the patient’s environment. The the patients’ environment and at same applies to adjusting the bed, assisting with other times during patient care as food trays, handling the TV remote control, or described by the World Health touching any other surfaces in the patient’s room. Organi zation’s “Five Moments” for hand hygiene (see opposite page). Communication Devices A frequently asked question is, Electronic devices, such as cell phones, smart phones, “What is meant by, ‘the patient’s pagers, and hand-held computers, can also become environment’?” A poster devel- contaminated and transmit germs. If these devices oped by MGH Infection Control need to be used during an episode of patient care, (see insert at right) deﬁ nes the pa- staff should clean the device and disinfect their tient’s environment as everything hands after using the device before resuming care of contained within a, ‘giant imagi- the patient. nary bubble’ surrounding the pa- For more information about hand hygiene or its tient. The goal is to keep staff and impact on infection control, contact staff nurse, visitors’ germs out of the bubble Judy Tarselli, RN, at 617-726-6330.

July 16, 2015 — Caring Headlines — Page 13 Professional Achievements

Scott presents Shapley presents Callahan recognized Fern and King Chaplain Katrina Scott, Reverend Dean Shapley, Janet Callahan, PT, physical present presented, “Religious Issues at End presented, “Prioritized Spiritual therapist, was awarded the Bette GI Endoscopy staff nurses, Ellen of Life,” at the Bioethics Program at Care based on the Population Ann Harris Distinguished Alumni Fern, RN, and Janet King, RN, Yale University, June 18, 2015. Health Model,” at the annual Award, from the MGH Institute presented, “Stepping Forward conference of the Association of Health Professions, with pH Best Practices,” at the of Professional Chaplains, May 11, 2015. 42nd annual GI Nurses Course of in Louisville, Kentucky, the Society of Gastroenterology Callahan receives June 5, 2015. Nurses and Associates, in Baltimore, grant Hampton presents Maryland, May 14, 2015. Janet Callahan, PT, physical poster therapist, was awarded the NPF Ferber Rakestraw 2015 Community Grant Award, Jordan Hampton, RN, nurse from the National Parkinson certifi ed practitioner, MGH Student Health Nurses publish Foundation, on June 1, 2015. Natalie Ferber Rakestraw, PT, Center in Chelsea, presented his Lea Ann Matura, RN; Annette sports physical therapist, became poster, “A Collaborative Approach McDonough, RN; Ann Hanlon, RN; certifi ed as an orthopaedic clinical to Meet the Needs of Teen Parents and Diane Carroll, RN, authored specialist by the American Board of and Improve Academic and the article, “Development and Initial Devaney certifi ed Physical Therapy Specialties Health Outcomes,” at the annual Psychometric Properties of the Amy Devaney, PT, sports in June, 2015. conference of the School Based Pulmonary Arterial Hypertension physical therapist, became certifi ed Health Alliance, in Austin, Texas, Symptom Scale (PAHSS),” in a as an orthopaedic clinical specialist June 17, 2015. recent issue of Applied Nursing by the American Board of Physical Research. Therapy Specialties Drumm and Heffernan in June, 2015. present Debra Drumm, LICSW, director, Nurses publish Penzias publishes HAVEN, and James Heffernan presented, “Intimate Partners Julie Cronin, RN, clinical nurse Alexandria Penzias, RN, clinical Herget certifi ed Violence: a Men’s Issue,” at the specialist; Paul Arnstein, RN, clinical nurse specialist, Interventional Lenore Herget, PT, sports annual symposium on Men’s Health, nurse specialist; and Jane Flanagan, Radiology, authored the article, “The physical therapist, became certifi ed Conquering Men’s Health Issues: RN, nurse scientist, authored Next Generation: Introducing Pre- as a sports clinical specialist by the Best Practices for 2015, in the article, “Family Members’ Licensure Students to Radiology American Board of Physical Therapy Waltham, June 18, 2015. Perceptions of Most Helpful Nursing,” in the June, 2015, Journal Specialties in June, 2015. Interventions During End-of-Life of Radiology Nursing. Care,” in the May/June, 2015, Journal of Hospice and Palliative Nursing. Kirwan and Polonsky Nelligan facilitates Team publishes present discussion Jianbo Liu; Maxim Khitrov; Jonathan Gates, MD; Stephen Odom, MD; Christopher Kirwan, project Labrini Nelligan, executive Team publishes Joaquim Havens, MD; Marc de coordinator, Medical Interpreter director, Lunder-Dineen Health Felicity Astin, RN; Diane Carroll, Moya, MD; Kevin Wilkins; Suzanne Services, and Carla Polonsky, Education Alliance of Maine, RN; Todd Ruppar, RN; Isabella Wedel, MD; Erin Kittrell, RN; Jacques medical interpreter, presented, facilitated the panel presentation, Uchmanowicz; Lynne Hinterbuchner, Reifman; and Andrew Reisner, MD, “Shaping Best Practices: Grounding “MOTIVATE—Implementing RN; Eleni Kletsiou, RN; Agnieszka authored the article, “Automated Everyday Encounters in the Code of Change in Older Adult Oral Health Serafi n; and Alison Ketchell, RN, Analysis of Vital Signs to Identify Ethics,” at Paving the Way to Health Care,” at the 25th annual Geriatrics authored the article, “A Core Patients with Substantial Bleeding Care Access: a Day of Learning Conference at the University Curriculum for the Continuing Prior to Hospital Arrival: a Feasibility for Interpreters, at UMass Medical of New England, Professional Development of Study,” in the May, 2015, Shock. School in Marlborough, in Bar Harbor, Maine, Nurses Working in Cardiovascular June 19, 2015. June 12, 2015. Settings,” in a recent issue of the European Journal of Cardiovascular Nursing.

Page 14 — Caring Headlines — July 16, 2015 Announcements Published by Caring Headlines is published twice each month by the department of Patient Care Services at Massachusetts General Hospital Publisher Blum Center Events MGH Nurses Free one-day Jeanette Ives Erickson, RN “Chair Yoga” Alumnae Association bereavement senior vice president Wednesday, July 22, 2015 for Patient Care 12:00–1:00pm fall reunion and program for children Managing Editor educational program and families Susan Sabia Experience the health benefi ts of yoga from the comfort of This year’s theme: MGH, in partnership with Editorial Advisory Board “Historical Refl ections and Comfort Zone Camp (CZC), Chaplaincy your chair. Join Laura Malloy, Reverend John Polk LICSW, to learn healthful chair Nursing Innovations” is holding a free one-day bereavement program for children Disability Program Manager yoga techniques. Perfect for Friday, September 25, 2015 ages 5–17 and their families. Zary Amirhosseini anyone new to yoga, anyone O’Keeffe Auditorium Children who’ve experienced uncomfortable getting onto the 8:00am–4:30pm Editorial Support fl oor, or anyone who wants to the death of a parent, sibling, or Marianne Ditomassi, RN guardian are invited to register Mary Ellin Smith, RN learn ways to manage stress Sessions will include: “MGH Maureen Schnider, RN at your desk. Graduate Nurses Who Served in for a day of mentorship, support, the Military During the Vietnam and group activities. Parents are Medical Interpreters “Preventing Back-to-School Stress War”; “Veterans, Post-Traumatic encouraged to attend the parent/ Anabela Nunes with Mind Body Medicine” Stress Disorder and the Role guardian program held at the Materials Management of Equine Therapy”; “Nurses as same location. Edward Raeke Wednesday, August 5th Innovators,” and others. 12:00–1:00pm Saturday, July 25, 2015 Nutrition & Food Services Donna Belcher, RD For more information or to 8:30am–4:00pm Susan Doyle, RD Studies suggest that US teens, register, call the MGH Nurses MGH Institute of Health 12 to 18 years old, are more Professions Offi ce of Patient Advocacy Alumnae Association at Robin Lipkis-Orlando, RN stressed than ever. Chronic stress 617-726-3144. can prevent a young person’s Volunteers are also needed. Offi ce of Quality & Safety brain from developing properly, (Call 781-756-4840) Colleen Snydeman, RN leading to learning delays and For more information or to Orthotics & Prosthetics inability to manage emotions. It ACLS Classes register on-line go to www. Mark Tlumacki can also lead to health problems comfortzonecamp.org/MGH- later in life. Join Rana Chudnofsky, Certifi cation: PCS Diversity CZC., or call Todd Rinehart, Deborah Washington, RN training manager at the Benson (Two-day program LICSW, at 617-724-4525. Henry Institute for Mind Body Day one: lecture and review Physical Therapy Medicine, to learn about effective Occupational Therapy Day two: stations and testing) Michael Sullivan, PT techniques to reduce stress for parents and children. Day one: Police, Security & Outside Services September 11, 2015 Joe Crowley Programs are free and open 8:00am–3:00pm Public Affairs to MGH staff and patients. Colleen Marshall No registration required. Day two: All sessions held in the Blum September 21st Respiratory Care Ed Burns, RRT Patient & Family Learning Center. 8:00am–1:00pm Social Services For more information, Re-certifi cation (one-day class): Ellen Forman, LICSW call 4-3823. October 14th 5:30–10:30pm Speech, Language & Swallowing Disorders and Reading Disabilities Locations to be announced. Carmen Vega-Barachowitz, SLP Some fees apply. Service Excellence For information, contact Jeff Rick Evans Chambers at [email protected] Training and Support Staff To register, go to: Stephanie Cooper http://www.mgh.harvard.edu/ The Institute for Patient Care emergencymedicine/assets/ Gaurdia Banister, RN Library/ACLS_registration%20 Volunteer Services form.pdf. Jacqueline Nolan

Distribution Milton Calderon, 617-724-1755 Submissions All stories should be submitted to: [email protected] For more information, call: 617-724-1746 Next Publication August 20, 2015

July 16, 2015 — Caring Headlines — Page 15 Fielding the Issues SSelectingelecting nnewew gglucometerslucometers

Question: I’ve heard we’re looking at purchasing Question: Are clinical staff involved in the new glucometers. Is that true? evaluation and decision-making process? Jeanette: Yes. A work group is currently in the Jeanette: Clinical staff will play a key role in evaluating and process of evaluating glucometer options. The group helping to select the new glucometer. Staff on selected inpa- is co-led by associate chief nurse, Theresa Gallivan, tient units and ambulatory practices will trial glucometer RN, and director of PCS Informatics, Annabaker choices and provide feedback, which will be a big factor in the Garber, RN. Representatives from Nursing, PCS selection process. Informatics, The PCS Ofﬁ ce of Quality & Safety, The Norman Knight Center for Clinical & Profes- sional Development, Laboratory Services, and Question: Will staff be educated and trained on use of the Infection Control comprise the group. new glucometer? Jeanette: Yes. All vendors have a robust training program and on-site presence during implementation. And The Knight Question: How will the decision be made regard- Nursing Center will include glucometer training in all direct- ing which glucometer to purchase? care orientation programs. Jeanette: In our evaluation of glucometers currently on the market, we’re looking for options that meet the following criteria: Question: When can staff expect to see the new glucometer? • Does the glucometer accurately scan our current Jeanette: Once the new glucometer is selected, the process patient wristbands? of connectivity assessment, installation, and testing will begin. • Does the device feel comfortable in the hands of The new glucometers are expected to be fully integrated hospi- providers? tal-wide by the end of the year. • Is the touch screen easy to use? For more information, call Chris Donahue Annese, RN, • Which glucometers would staff prefer overall? staff specialist, at 6-3277.

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Page 16 — Caring Headlines — July 16, 2015