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Headlines aringMarch 19, 2020 CPACU Skills Day preparing staff to meet the needs of an expanded patient population in the peri-operative setting

See story on pages 4-5

Pam Wrigley, RN (right), staffs the eCare Blood Administration station at recent PACU Skills Day training event. Nursing & Patient Care Services General Hospital Debbie Burke Exemplary response to the coronavirus outbreak

As the coronavirus (COVID-19) possible environment, and to pro- continues to affect communities tect yourselves, as well. around the world, our MGH Inci­ dent Command­ Team has been I want to thank associate chief hard at work overseeing our response nurse, Theresa Gallivan, for the to this rapidly changing situation. great job she’s doing as inpatient operations section chief on our AI want to take this opportunity to Incident Command­ Team. thank everyone for the professional way you’ve stepped up to meet the I ask that you continue to conserve increased demand for care and ser- resources (respirators, masks, per- Debbie Burke, RN vices. sonal protective equipment, and senior vice president for Nursing & Patient precaution gowns); and that you Care Services and chief nurse There’s no way to know how exten- take the time to read daily updates sive the outbreak will be, but I have to stay abreast of changes in prac- the coronavirus page on Apollo for the utmost confidence in all of you. tice and policies. up-to-date information. I know you have the skill and exper­­ tise to ensure our patients receive Please direct any questions to your the highest quality care in the safest managers or supervisors, or go to Debbie Burke

In this Issue Raising Awareness about Delirium...... 9 PACU Skills Day...... 1 Patient Experience Feedback...... 10 Debbie Burke...... 2-3 • Exemplary Response to the Coronavirus DAISY Awards...... 11 PACU Skills Day...... 4-5 Practice Update...... 12

Pediatric Book Drive...... 6 Tuesday Take-Aways...... 13

Social Worker in Japan...... 7 Announcements...... 14-15

Celebrating Purim...... 8 Changes to Dialing 911...... 16

(Debbie Burke’s photo by Joshua Touster )

Page 2 — Caring Headlines — March 19, 2020 Debbie’s Photo Gallery

(Above and at right): Thank-you and happy Social Work Month to our colleagues who care for the social and psychological needs of patients and families. You are making a difference!

(At left): Congratulations to our newly board-certified physical therapy clinical specialists (l-r), Alexandra Smith, Lisa Moran, Lauren McGlone, Audra Wallace, Monica Warren, and Amanda Barry, who celebrated at the APTA conference in .

(At right and below): Congratulations to the Blake 13 Newborn team (right) and the White 9 Medical team (below) on receiving Excellence in Action Awards — well deserved!

March 19, 2020 — Caring Headlines — Page 3 Peri-Operative Care

(Above): Skills Day team leaders (l-r): Susan Barisano, RN; Laura Cameron, RN; John Graham, RN; Carol McMahon, RN; and Madeleine McGarry, RN. A staff-driven training event to ensure PACU nurses have the skills necessary to care for an expanded patient population

Page 4 — Caring Headlines — March 19, 2020 PACU Skills Day — by Janet Dauphinee Quigley, RN, nursing director

The Post-Anesthesia Care Unit (PACU) Stations: recently underwent a re-organization that expanded its patient population to in- • TR bands fem-stops clude patients from all surgical specialties, Temporary pacing Interventional Radiology, and patients re- • covering from cardiac interventional pro- • Micro infusion pumps cedures. PACU nurses now provide pre- Port-o-Cath access operative patient preparation, recovery • Tcare, extended care, and preparation for • Defibrillation review discharge home. and re-certification To ensure that PACU nurses are equipped­ • Bladder scanner with the necessary skills to accommodate Precautions this shift in practice, the unit held a spe- • cial Skills Day — a staff-driven training • PVRs event, coordinated by team leaders: Susan • Blood administration Barisano, RN; Laura Cameron, RN; John Graham, RN; Madeleine McGarry, RN; (eCare) and Carol McMahon, RN.

Based on feedback from their nursing col- leagues, skill stations were created to ad- dress specific gaps identified by staff.

Training was available to all three shifts: 8:00am-12:00pm; 2:00-4:00pm; and 7:00- 9:00pm. Each station accommodated five participants at a time and ran for 30 min- utes. More than a hundred nurses at- tended.

Said PACU leaders, Janet Dauphinee Quigley, RN; Cheryl Ryan, RN; Katie Daly, RN; and Teri MacDonald, RN, “We are so proud of our PACU team. They went above and beyond to ensure we con- tinue to provide the safest, highest quality patient care.”

One attendee was heard to say, “This is ridiculously fabulous!”

For more information, contact Cheryl Ryan, RN, at 617-643-7706.

March 19, 2020 — Caring Headlines — Page 5 Inter-Disciplinary Support Supporting our kids Respiratory Care and Perfusion hold book drive for pediatric patients — by Jeliene Larocque, ECMO coordinator

Inspired by their ECMO colleagues Many MGH ECMO specialists The story out of Des Moines inspired in , the departments of Respir­ have spent time reading to babies MGH clinicians to hold a book drive atory Care and Perfusion at MGH and children while providing in the hope that other departments came together to support pediatric ECMO care. ECMO (extracorpo- will also step up and participate. patients by picking up the mantle of real membrane oxygenation) is a the #booksforparker campaign. Staff form of life-support similar to the Thanks to everyone who has donated of the two departments collected heart-lung bypass machine used in books! To learn more about #books- books to donate to patients in the cardiac surgery. It mimics the func- forparker, go to: www.weareiowa.com/ Pediatric ICU, Emergency Depart­ tion of the heart and lungs, allow- news/local-news/dane-pratt-mercyo- Iment, and Radiology. ing patients to rest and heal. ne-reads-to-patient-books-for-parker/.

Page 6 — Caring Headlines — March 19, 2020 Social Work

(At left): social worker, Jennifer, D’Alotto, addresses Forum for Japan Cancer Patients. (Below): D’Alotto and her hosts in Japan. (Bottom): Conference participants. (Photos provided by staff) by (Photos provided

My name is Jennifer D’Alotto, and I’m an oncology social worker with the Bone Marrow Transplant, Leukemia, and Survivorship pro- Bringing grams. In January, I attended the Forum for Japan Cancer Patients in Tokyo, hosted by the Comprehensive­ Academy for Advanced Oncol­ social-work Mogy, an offshoot of the Tokyo Biochemical­ Research Foundation. The forum was an opportunity for patients and families to network and share ideas about issues related to cancer treatment. I was invited knowledge to speak about genomic testing and cancer treatment at MGH, and the advocacy, support, and resources available to patients here.

The forum was held at a time when Japan is preparing for a new can- and expertise cer compulsory-education requirement, scheduled to roll out in April. Many of those in attendance were self-identified individuals who had to Japan seen a need and were there seeking solutions. Their circumstances may have varied, but their enthusiasm for improving the experience — by Jennifer D’Alotto, LICSW of patients and families was shared by all.

I was proud to represent MGH and humbled by the creativity and dedication of this incredible group of advocates.

March 19, 2020 — Caring Headlines — Page 7 Spiritual Care

Rabbi Benjamin Lanckton (left) leads festive Purim service in the MGH Chapel. Revelry, ‘hamentashen,’ and a good time were had by all.

Purim: a celebration of triumph — by Rabbi Ben Lanckton, staff spiritual care provider

The celebration of Purim, a Jewish holiday commemorating Reverend Alice Cabotaje, chanted another in Tagalog; and a failed plot against Jews of ancient Persia, typically involves Lanckton chanted his chapters in Biblical Hebrew, com- public revelry, food, wine, costumes, gifts, charitable giving, plete with different voices for all the characters. and special cookies called, hamentashen. Like most Jewish holidays, Purim revolves around the re-telling of a story — Lanckton and music therapist, Hannah Shefsky, offered the this one is ‘Megillat Esther.’ On March 10, 2020, Rabbi Purim Kiddush blessing over grape juice and hamentashen, Benjamin Lanckton, festively dressed as Dancer the Kosher whose triangular shape is said to represent Haman’s hat. Reindeer, led this year’s Purim service in the MGH Chapel. T The department of Spiritual Care provides services in the Costumed speakers read from a translation of Megillat MGH Chapel every Tuesday and Thursday at 12:15pm; Esther, a scroll of the Hebrew Bible, or Old Testament, watch all-user e-mails for topics. while members of the congregation sounded noisemakers called, ‘graggers’ every time the villain, Haman, was men- The Jewish Passover preparation service will be held, tioned. Clinical pastoral education resident, Christine Park, Tuesday, April 7th, at 12:15pm. For more information, call chanted a chapter in Korean; Spiritual Care director, Rabbi Lanckton at 617-724-3228.

Page 8 — Caring Headlines — March 19, 2020 Raising Awareness Raising awareness about delirium What is delirium? How is delirium different Delirium is a sudden state of confu- from dementia? sion or inattention, or a change in Delirium comes on suddenly (hours one’s ability to think clearly. It occurs to days) and can often be reversed if in one in three hospitalized patients addressed promptly. Some people 65 years old or older. with delirium are agitated while others appear sleepy. Some experi- Delirium is most common in very ill ence both periods of agitation and patients, such as those in intensive lethargy. #delirium #WDAD2020 #MGH care units or those with underlying medical problems, but it can occur Dementia comes on slowly, usually in any patient in any setting. over years, and is not reversible. Facebook page: facebook.com/ Patients with dementia often show massgeneral. What are the effects of signs of memory loss and difficulty delirium? performing daily tasks, which can For more information, contact: worsen with time. Liza Nyeko, at 617-643-5484 Patients who develop delirium are • Colleen Gonzalez, RN, at more likely to stay in the hospital • The Blum Center’s March 6th 617-643-5478 longer, be discharged to a rehab or presentation on delirium can be Sophie Ryan, MD, at nursing home rather than home, • viewed on the Mass General 617-732-7432 and have trouble participating in their recovery, giving them a higher risk of poor outcomes. Delirium can be prevented It’s important to recognize patients with delirium early and employ Some patients with delirium suffer preventive strategies to those at high risk of developing delirium. from confusion for weeks or months Preventive strategies include: hydration; nourishment; sleep; keeping after discharge and require ongoing active (body and mind); and avoiding unnecessary medications. care. What are we doing to manage delirium? Since 2018, the MGH Delirium Steering Committee and its work groups have been developing strategies to: • help providers identify, assess, document, prevent, manage, and monitor delirium using proven best-practices • promote mobility while keeping patients safe from falling • employ activity carts and partner with volunteers to help keep patients engaged • educate staff about changes and improvements as they occur • educate patients and families about how to recognize signs and symptoms of delirium so they can alert the care team

March 19, 2020 — Caring Headlines — Page 9 Patient Experience Listening to our patients You can help improve the care experience

Beginning this spring, MGH will introduce a new way of reaching out to patients after visits to better understand their care experience.

We encourage patients to respond by e-mail, phone, or text.

Your feedback is highly valued and helps us make MGH even better.

Page 10 — Caring Headlines — March 19, 2020 Recognition DAISY Award recipients ? ? ? ? ? ? Will someone from your unit be one of the first to be selected? Nominate your nurse or nurse colleague for a DAISY Award today

Scan code to nominate a nurse, or e-mail: [email protected]

March 19, 2020 — Caring Headlines — Page 11 Practice

February 28, 2020 Validated March 12, 2020 For up-to-date policy and practice information related to the coronavirus, go to: https://apollo.massgeneral.org/coronavirus/

Periodically, the PCS Office of Quality & Safety issues practice alerts and updates to communicate new information or changes to policies, procedures, or practices. Alerts and updates are generated by trends identified in safety reports, feedback from staff and leadership, or changes in regulatory requirements. For more information about individual practice updates or alerts, contact the PCS Office of Quality & Safety, or go to the Excellence Every Day portal page at: http://intranet.massgeneral.org/pcs/EED/EED-Alerts.asp.

Page 12 — Caring Headlines — March 19, 2020 In preparation for the Joint Commission visit, the PCS Office of Quality, Safety & Practice sends out weekly resources that are quick and easy to read by staff. These ‘Tuesday Take-Aways’ should be distributed to staff and are also available on the Excellence Every Day portal page at: www.mghpcs.org/eed/rr/.

March 19, 2020 — Caring Headlines — Page 13 Announcements

National Health Climate change Conversations Blum Center Care Volunteer and health 2020: with Caregivers Events the public health Week challenge of our time for families, caregivers, Thursday, March 19, 2020 honoring our volunteers patients, and staff MGHfC Parenting Series: and their commitment to Saturday, April 4, 2020 “Setting the Stage for service Open to all disciplines, an educational series Healthy Eating Habits” sponsored by the Dementia April 19-25, 2020 student rate available. A one-day symposium Caregiver Support Program Tuesday, March 24th Look for special events presented by the MGH April 21, 2020 Shared Decision Making: recognizing our more Institute of Health 5:30–7:00pm “Coronary Heart Disease” than 1,300 volunteers Professions’ nurse-led Center who provide services in O’Keeffe Auditorium for Climate Change, Climate Wednesday, March 25th more than 50 programs Justice, and Health. “Legal and Financial Planning throughout the hospital. Following a Dementia Postponed“Delirium, Dementia, and • Examine the intersection Depression: Which is it?” of climate change Diagnosis,” presented by For more information Steven Cohen of Pabian & and health care and Monday, March 30th about activities planned opportunities for research, Russell, LLC. for the week, or volunteer education, and advocacy “Top 10 Sleep Questions” opportunities at Mass • Discuss policy implications Admission is free; seating is General, e-mail: for public health limited; light refreshments; Programs are free and open [email protected], Examine the role of health parking vouchers available. to MGH staff and patients. or call 617-726-8540. • professionals in engaging RSVP to: 617-724-0406, or All sessions held in the Blum in climate issues email: dementiacaregiver Patient & Family Learning For detailed information, go [email protected]. Center from 12:00–1:00pm. to: info.mghihp.edu/. Leading across For more information, call Events are live-streamed professions: building 617-643-8809. and recorded on the Mass General Facebook page at: trust and re-framing facebook.com/massgeneral. conflict in inter- Albert H. Brown professional teams For more information, Medical Nursing New Biomed call 617-724-3823. Thursday, April 30–Saturday, May 2, 2020 Visiting Scholar Website Open to all disciplines, Friday, April 24, 2020 The re-designed website is special rates available. 7:30am–4:00pm a resource for staff who use New hours This immersive workshop O’Keeffe Auditorium medical devices supported aims to expand your skills as Developing a Therapeutic, by Biomed. The new site for outpatient an inter-professional leader. Compassionate, and Safe offers a more user-friendly Pharmacy menu, on-line service requests, Participants will learn to: Response to Managing Disruptive Patient Behavior FAQs, and more. The outpatient Pharmacy • apply models of trust to in the Wang Building is now understand your own The new site integrates open: inter-professional team/ Presentations held the Model Shop web environment throughoutMay the day,be featuring pages, providing one site Monday through Friday • create a plan to enhance keynote speaker, Colleen for all Biomed services. 8:30am–7:00pm trust in your team Snydeman, RN, executive (Note: although the URL postponeddirector, PCS Office of • develop strategies to has changed, accessing the Reminder that staff can use flatten power hierarchies Quality, Safety & Practice, site is the same — under at 2:15pm. the dedicated professional • re-frame how you think Partners Applications, click phone line (617-643-4276) about conflict Biomed Site, then select To register, go to: www. to contact the Pharmacy, • test your skills in relational MGH Clinical Biomedical Monday through Friday. dynamics mghpcs.org/KnightCenter/ Engineering Website.) index.asp. • learn to leverage conflict Weekend hours: to empower higher Visit the new website during Saturday 9:00am–3:00pm functioning teams Contact hours awarded for St. Patrick’s Day week and each session. Sunday 9:00am–12:30pm For detailed information, go you could be a winner! Click on St. Patrick’s Day-themed For more information, call to: info.mghihp.edu/leading- For more information, 617-724-3100. across-professions-2020. icons to be entered in a call Brian Cyr, RN, at raffle to win a gift card to CE credit available for some 617-726-3130. MGH eateries! disciplines.

Page 14 — Caring Headlines — March 19, 2020 Patient Safety ACLS Classes Dermatology

Culture Survey Certification: Bootcamp Published by (Two-day program) Caring Headlines is published once a We want to hear June 5-6, 2020 month by Patient Care Services. Day one: Starr Center from you! Publisher June 11, 2020 Simches Research Building Debbie Burke, RN, senior vice “Speak Up for Patient 8:00am–3:00pm 2nd floor president for Patient Care Safety” by completing the Day two: The department of Managing Editor MGH/MGPO Survey on June 12th Dermatology is offering a Susan Sabia Patient Safety Culture. 8:00am–12:00pm 2-day conference providing Editorial Advisory Board: Providers and employees a crash course on the most Disability Program Manager should have received an prevalent topics related to Zary Amirhosseini email from SurveyMonkey Re-certification: Editorial Support April 8, 2020 skin cancer, skin disorders, Marianne Ditomassi, RN ([email protected] via and issues related to hair SurveyMonkey) with a link to 5:30–10:30pm Mary Ellin Smith, RN and nails. Informatics the confidential survey. Ann Marie Dwyer, RN CPR Training ($100) This is an opportunity to Target audience is: Medical Interpreters June 11th nurse practitioners Carmen Vega-Barachowitz, SLP share your views on our 2:00– 5:30pm • culture related to patient • social workers Materials Management safety and transparency. Your Locations to be announced. • psychologists Edward Raeke candid responses inform our Some fees apply. For informa­ • physicians Nutrition & Food Services tion, contact Jeff Chambers physician assistants Donna Belcher, RD efforts to ensure all clinicians • Susan Doyle, RD and staff feel comfortable at [email protected]. 16 CME credits Office of Patient Advocacy reporting errors and speaking To register, go to: Robin Lipkis-Orlando, RN up when something isn’t http://www.mgh.harvard. To register, go to: https:// Office of Quality & Safety right. We are committed to edu/emergencymedicine/ mghcme.org/courses/ Colleen Snydeman, RN making Mass General the assets/Library/ACLS_ course-detail/dermatology_ Orthotics & Prosthetics safest possible environment registration%20form.pdf. bootcamp. George Reardon for everyone who comes PCS Diversity through our doors. For more information, call Deborah , RN 866-644-7792. Physical Therapy Completing the survey Occupational Therapy automatically enters you in a Michael Sullivan, PT drawing to win raffle prizes Police, Security & Outside Services and weekly drawings for Joe Crowley Coffee Central gift cards. Public Affairs Colleen Delaney For more information, Respiratory Care contact Jesse Russell at: Ed Burns, RRT [email protected]. Social Work Ellen Forman, LICSW

Speech, Language & Swallowing Disorders and Reading Disabilities Carmen Vega-Barachowitz, SLP Spiritual Care Carmen Vega-Barachowitz, SLP The Institute for Patient Care Gaurdia Banister, RN Please check before attending events. Training and Support Staff Gino Chisari, RN Volunteer Services Many activities are being canceled or Jacqueline Nolan

Distribution postponed due to the coronavirus Jacqueline Nolan, 617-724-1753 Submissions All stories should be submitted to: [email protected] For more information, call: 617-724-1746 Next Publication April 23, 2020

March 19, 2020 — Caring Headlines — Page 15 Safety/Awareness No more dialing 9 before calling 911

In response to a new federal law re- For all other calls outside the All 911 calls made from a Mass General quiring businesses to simplify access hospital phone system, dialing 9 land line are flagged and reported to Police to 911 emergency services, Mass then 1 is still required. & Security. You may receive a follow-up General has updated its telecommu- call from Police & Security subsequent to nications systems so that callers no In light of this change: calling 911. longer have to dial 9 before dialing • be vigilant when dialing out- 911. Effective immediately, callers side the hospital to avoid ac- This change is intended to make it easier using hospital land lines can dial 911 cidentally calling 911 for employees to reach 911 in the event of directly to reach emergency assis- • if you do accidentally call 911, an emergency. For more information, call tance. (Dialing 9-911 will continue don’t hang up. Tell the opera- Tom Mahoney, Police, Security & Outside Ito work.) tor you dialed 911 by mistake Services, at 616-724-7694. “911, what is your emergency?”

First Class US Postage Paid Headlines Permit #57416 March 19, 2020 , MA Returns only to: Volunteer Department, GRB-B 015 MGH, 55 Fruit Street Boston, MA 02114-2696

Page 16 — Caring Headlines — March 19, 2020