Making nursing remarkable

2013 – 2014 nursing annual report

Novant Health Clemmons Medical Center • Novant Health Forsyth Medical Center Novant Health Kernersville Medical Center • Novant Health Medical Park Hospital Table of contents

2013 hospital statistics 3

Transformational leadership 4

Structural empowerment 10

Exemplary professional practice 27

New knowledge, innovations and improvements 33

Moving forward 39 Making nursing remarkable • 3

2013 hospital statistics

Novant Health Clemmons Novant Health Kernersville Medical Center Medical Center • Opened phase one in April 2013 with emergency room • Discharged 2,375 patients services, diagnostic imaging, lab and surgical services • Had 9,879 patient days • Treated 6,564 emergency department patients • Treated 29,047 emergency department patients • Performed 423 surgeries • Performed 2,732 surgeries • Achieved triennial accreditation from The Joint Commission • Achieved triennial accreditation from The Joint Commission

Novant Health Forsyth Medical Center Novant Health Medical Park Hospital • Discharged 43,929 patients • Discharged 787 patients • Had 235,750 patient days • Had 6,322 patient days • Delivered 6,135 babies • Performed 9,847 surgeries • Treated 89,321 emergency department patients • Named as one of the nation’s top performers on • Performed 25,234 surgeries key quality measures by The Joint Commission • Achieved The Joint Commission Disease-specific Certification for the Advanced Palliative Care Program • Achieved triennial accreditation from The Joint Commission • Earned a three-year Commission on Accreditation of Rehabilitation Facilities (CARF) accreditation for adult inpatient hospital programs and stroke specialty program at Novant Health Rehabilitation Center, In-patient Rehabilitation 4 • 2013 – 2014 nursing annual report

Transformational leadership A message from the chief nursing officer

Dear colleagues and friends, It is indeed a time of celebration.

Together, we journeyed into 2014 with great anticipation and many successes, highlighted by the third Magnet re-designation of Novant Health Forsyth Medical Center and the inaugural Magnet designation of Novant Health Kernersville Medical Center and Novant Health Medical Park Hospital. The accomplishments and achievements are many and sometimes, perhaps, too quietly noted. So, it is with Cindy Jarrett-Pulliam heartfelt appreciation that this annual report is dedicated RN, MSN, NE-BC, FACHE to the nursing staff of Novant Health.

As healthcare reform gains traction, the demand for the professional nurse with advanced expertise will grow to an unprecedented high. The environment requires that we continue to seek innovative ways to deliver care and practice at the top of licensure. Our accountability for outcomes is expected to be shared to and by all with transparency. As a result, Novant Health has responded by improving patient outcomes through research, strengthening shared governance, improving nursing care models and implementing a state-of-the-art electronic medical record and virtual system.

As you read, enjoy these reflections on the remarkable experience, in every dimension, every time. Celebrate our commitment to professional nursing, patient care and excellence.

With joy and gratitude,

Cindy Jarrett-Pulliam, RN, MSN, NE-BC, FACHE Vice president and chief nursing officer Making nursing remarkable • 5

2014 Magnet Designation

Forsyth Medical Center and continued competence of nursing personnel; and received Magnet designation attention to the cultural and ethnic diversity of patients for excellence in nursing and their significant others, as well as to the care providers services by the American in the system. Nurses Credentialing Published research has shown that hospitals with Magnet Center’s (ANCC) Magnet designation have positive outcomes for patients, nurses Recognition Program for the and the workplace. Patients receiving care at Magnet third time. This designation is extra special since Kernersville hospitals have been recorded as experiencing lower Medical Center and Medical Park Hospital are included. mortality rates and greater satisfaction during their stay Magnet designation is the nation’s highest form of and are able to go home sooner. “Our incredible nursing recognition for nursing excellence and is one of the team members are often a part of our patients’ most benchmarks used to measure the quality of care significant life experiences. I am proud of our team and the patients receive. Magnet designation, which leads to our team members “Magnet designation was a goal from the day we opened enjoying a higher degree of job satisfaction, leading our doors more than three years ago,“ says Jo Crowley, transformation and delivering the best outcomes with MA, BSN, RN, ONC, NE-BC, senior director of patient evidence-based practice,” says Sean Sanz, senior vice care services of Kernersville Medical Center. “The team president and chief operating officer of NHFMC. at NHKMC is committed to the remarkable experience and the success that comes from involving the staff in decisions that drive that remarkable care. We are very proud to be a newly designated Magnet facility in 2014 and look forward The Magnet vision to maintaining the standards of quality care and staff empowerment that enabled us to achieve this goal.” “Magnet organizations will serve as the fount of knowledge and expertise for the delivery of nursing During the four-day site visit, four Magnet appraisers care globally. They will be solidly grounded in core visited more than 60 units at NHFMC (including Novant Magnet principles, flexible, and constantly striving Health Hawthorne Outpatient Surgery Center and Novant for discovery and innovation. They will lead the Health Orthopedic Outpatient Surgery Center), NHKMC, reformation of healthcare; the discipline of nursing; and NHMPH and interviewed hundreds of staff. The and care of the patient, family and community.” Magnet appraisal team found, “a very engaged nursing – The Commission on Magnet Recognition, 2008 staff with patients at the center of their work.”

The Magnet Recognition Program provides a framework Novant Health nursing vision to recognize excellence in: the management philosophy Novant Health nursing will be a world-class driving and practices of nursing services; adherence to standards force for transformational change through a patient- for improving the quality of patient care; leadership of the centered, evidence-based approach to care in an chief nurse executive in supporting professional practice authentic, collaborative and healing environment. 6 • 2013 – 2014 nursing annual report

2014 nursing goals

Novant Health nursing services will:

1 Transform clinical care to deliver on our promise and the remarkable patient experience,

Retain and develop staff at the bedside to support the advancement 2 into leader roles for those who are capable and desire it,

3 Enhance competency to adapt and drive transformational change,

4 Accelerate the adoption of a nursing foundation comprised of nursing theory, Novant Health professional practice model and a shared governance model to elevate nursing best practice throughout Novant Health, and

5 Optimize nursing efficiency across Novant Health. Making nursing remarkable • 7 8 • 2013 – 2014 nursing annual report

Professional leadership activities

Novant Health nurses are earning a well-deserved national Association of Women’s Health, Obstetric and Neonatal reputation for being leaders in their profession. Many serve Nurses, Triad NC region in leadership roles in a variety of professional organizations • Bindy Hankins, BA, RN, RN-C – secretary/treasurer that are committed to furthering nursing practice. • Debbie Wright, BSN, RN-C – coordinator Academy of Oncology Nurse Navigators Emergency Nurses Association, North Carolina Eastern • Sharon Gentry, MSN, RN, AOCN, CBCN – Piedmont Chapter co-chair for annual conference (2012 – 2014) and • Kalah Mueller, RN – secretary member of leadership council (2010 – to present)

North Carolina Great 100 American Association of Neuroscience Nurses, Triad Chapter • Kelly Swauger, BSN, MHSA, MAOL, RN, NE-BC – co-chair, selections committee • Gladys Campbell, MSN, RN, CNRN – 2013/2014 nominating committee Hospice of Winston-Salem/Forsyth County American Nurses Credentialing Center • Sharon Gentry, MSN, RN, AOCN, CBCN – professional advisory committee • Dale Callicutt, MSN, RN-BC, CCRN – chair, cardiac-vascular content expert panel Journal of Oncology Navigation and Survivorship • Kelly Swauger, BSN, MHSA, MAOL, RN, NE-BC – co-chair, nurse executive content expert panel • Sharon Gentry, MSN, RN, AOCN, CBCN – section editor for breast cancer (2011 – present) Association of Perioperative Registered Nurses, Winston-Salem Chapter Kybele Worldwide • Andrea Blakemore, BSN, RN – board member • Nancy Pearson, MSN, RN, NE-BC – perinatal nurse team leader and administrative team leader/consultant • Vicki Clark, BSN, MHA, RN, CNOR – vice president National Association of Orthopaedic Nurses, Triad Chapter Association of Rehabilitation Nurses, Greater NC Chapter • Becky Lasley, BSN, RN, ONC – secretary/treasurer • Janie Roland, BSN, MHA, RN – board member at large North Carolina Magnet Coalition • Leslie Robbins, MSN, RN – 2014 chair Making nursing remarkable • 9

North Carolina Nurses Association Susan G. Komen Northwest North Carolina • Daria Kring, PhD, RN, NE-BC – leadership academy • Sharon Gentry, MSN, RN, AOCN, CBCN – outreach class of 2014 committee, speakers bureau and community profile team • Nancy Pearson, MSN, RN, NE-BC – team lead and speakers bureau for nurse bullying committee The Oncology Nurse • Sharon Gentry, MSN, RN, AOCN, CBCN – editorial board NC Piedmont Triad Oncology Nursing Society (2008 – present) • Sharon Gentry, MSN, RN, AOCN, CBCN – board member (1990 – present) and Oncology University of North Carolina of Greensboro Nursing Foundation representative • Cindy Jarrett-Pulliam, MSN, RN, NE-BC – nursing advisory board Sigma Theta Tau International • Daria Kring, PhD, RN, NE-BC – chair, conference planning committee 10 • 2013 – 2014 nursing annual report

Structural empowerment

Solid structures and processes provide an innovative environment where strong professional practice flourishes and where the mission, vision and values come to life to achieve outcomes that are important to our organization.

The key components of structural empowerment are: • Collaborative relationships with community organizations • Professional engagement • Commitment to professional development • Teaching and role development • Recognition of nurses by the organization Making nursing remarkable • 11

Focus on retention pays off Today’s healthcare environment demands efficient use of resources. Research shows that turnover rates are high for new nurse graduates as a result of a stressful work environment coupled with inadequate support during the transition from student to professional practice. It was identified in 2012 that 37 percent of the new RNs at Forsyth Medical Center were voluntarily leaving within their first two years of service. In 2013, NHFMC nursing leadership partnered with human resources to focus on retaining RNs during their first two years of employment with Novant Health.

The goal of the onboarding process is to ensure a knowledgeable workforce that offers safe and remarkable care and makes a long-term commitment to the organization.

Initiatives to improve the onboarding process included: • Gathered feedback from RNs regarding their onboarding experience and identified opportunities to improve. • Worked with nursing leaders and educators to create the remarkable RN onboarding experience. These changes started with the interview process and progress through the first two years of employment. Changes included pre-hire activities, increasing leader communication efforts and optimizing the preceptor program. • Identified nurse managers as the “chief retention officer” As a result the 2013 retention focus, NHFMC successfully of their departments. They were trained to have an reduced its voluntary turnover of new RNs leaving within increased awareness of possible flight risk of staff, assess their first two years from 37 percent to 10 percent. NHFMC data and feedback and use employee engagement tools nursing leadership continues to explore and identify to create retention strategies for their department. additional retention strategies and efforts in 2014. 12 • 2013 – 2014 nursing annual report

Popcorn and Pearls presenting the most pertinent education with encouragement to access the other educational Another excellent way to empower nurses is to use opportunities that were available between sessions. multiple strategies to support a lifelong learning culture that includes professional collaboration and the promotion In February 2013, NHKMC educators began offering of role development. This is exactly what the educators Popcorn and Pearls; popcorn was the incentive they used and nursing leaders at NHKMC did to provide professional to attract the nurses and, once there, they were given development opportunities for their nurses. pearls of knowledge. They learned a lot from their first few sessions and over the last year have refined the program Nursing processes, procedures, equipment and best practice into something that staff and leaders are excited about. change on a daily basis. Nurses at NHKMC do not focus on a specific patient population as nurses on more specific units Popcorn and Pearls is offered every other month in two- may. Instead, they have a much broader patient population hour sessions. Each class consists of one main topic and creating a wide variety of education needs. The educators three to six shorter topics that either the staff request or used multiple educational methods including just in time the leaders request. The goal is to have very little lecture training, formal classes, bulletin boards, individual training, time and opt for more role playing, simulation, games and and in-services; however, these were not optimal for nurses hands-on activities. on the unit providing direct patient care. During the first session, 76 percent of the ED staff attended It was difficult to track who had received education and the and 53 percent of the medical-surgical staff attended. educators felt that they were missing lots of staff when there Nurses left saying, “I learned something new and this was pertinent education coming out daily. Leaders meet on a was a great session.“ They particularly like the case regular basis to discuss issues or concerns and would often studies. Topics and activities have included Novant Health suggest “staff need education” on multiple topics. At the nursing’s professional practice model, chest tube care and same time, nursing, pharmacy, respiratory and other set-up, rapid-infuser demonstration, certification review departments would send a plethora of education daily. questions, simulation of an imminent birth and use of newborn equipment, post-op care of the bariatric patient, If the nurses were “educated” on all the topics, no time a courtroom simulation discussing how to avoid would be left to take care of patients. The educators documentation risks, restraint documentation, code blue and leaders began to review the process. Can nurses documentation, review of a new online nursing resource experience optimal learning while providing patient care? and Magnet preparation. What if we offered an education session on a regular basis when the staff was not providing patient care? Staff’s The nurse managers decided that this is an opportune time schedules consist of working 36 hours per week – that to conduct staff meetings as well so they are scheduling meant four hours remained that would not be considered their meetings either before or after the Popcorn and Pearls overtime if it were used for education. sessions. This gives their staff at least four opportunities to attend the education sessions and staff meetings. The unit leaders agreed to support education by paying staff to attend education sessions on their days off. The leaders The feedback from staff has been great! This innovative requested that multiple times be offered during different pay solution to providing staff development has proven to be periods so that they could balance their unit productivity. very effective and efficient. Educators agreed to provide concise educational sessions Making nursing remarkable • 13 14 • 2013 – 2014 nursing annual report

Educational accomplishments (January 2013 to June 2014) Nursing excellence requires a commitment to professional development and lifelong learning. Through support, encouragement and innovative educational opportunities, we have been able to assist staff in advancing their education.

Bachelor of science in nursing • B.J. Kerley, BSN, RN, • Samara Alikakos, BSN, RN, CMSRN – NHFMC ECU CMSRN – NHFMC renal • Carolyn Kravontka, BSN, • Vanessa Allen, BSN, RN - RN – NHFMC ICU NHFMC pulmonary • Jennifer Lenchik, BSN, RN – • Susan Ammann, BSN, RN – NHFMC mother baby NHMPH PACU • Brittany Miles, BSN, RN, • Jamie Bucknall, BSN, RN, Ajile Peterson, BSN, RN CEN – NHFMC ED RN-BC – NHFMC cardiac • Anna Miller, BSN, RN – Leah Davidson, BSN, RN pre and post NHFMC NICU • Jessica Burnette, BSN, RN – • Ashley Moore, BSN, RN NHFMC gastroenterology – NHFMC ED • Amber Clapp, BSN, RN – • Iris Neas, BSN, RN – NHKMC ED NHFMC pulmonary • Amy Collins, BSN, RN – • Sherri Ogden, BSN, RN, NHFMC labor and delivery Andera Waller, BSN, RN CEN – NHFMC ED • Quang Dang, BSN, RN – • Ajile Peterson, BSN, RN – NHFMC 6th north telemetry Tia Exline, BSN, RN, CCRN NHFMC pulmonary • Brandi Presnell, BSN, RN – NHFMC CICU • Traci Danley, BSN, RN – NHFMC radiology • Wendy Pruitt, BSN, RN, CMSRN – NHFMC general surgery • Leah Davidson, BSN, RN – NHFMC CVSU • Cristy Rizos, BSN, RN – NHFMC ED • Christina Dehart, BSN, RN, CMSRN – NHFMC pulmonary • Heather Rodman, BSN, RN, OCN – NHFMC oncology • Crystal Dollard, BSN, RN – NHFMC gastroenterology • Tayler Sapp, BSN, RN – NHFMC 6th CTSU • Jennifer Dollyhigh, BSN, RN – NHFMC ICU • Danielle Simpson, BSN, RN – NHFMC CICU • Tia Exline, BSN, RN, CCRN – NHFMC CICU • Melanie Smitherman, BSN, RN – NHFMC CVSU • Martha Harrelson, BSN, RN, RNC-NIC – NHFMC NICU • Jamie Strom, BSN, RN, CEN – NHFMC ED • Carol Hartsog, BSN, CNRN – NHFMC neuro ICU • Hien Tran, BSN, RN – NHFMC oncology • Brittney Heath, BSN, RN – NHFMC cardiac pre and post • Allison Van Nest, BSN, RN – NHFMC renal • Jennifer Hemric, BSN, RN, CCRN – NHFMC CVSU • Chasity Wagoner, BSN, RN – NHFMC pulmonary • Kimberly Henson, BSN, RN, RNC-OB – NHFMC labor • Andera Waller, BSN, RN – NHFMC innovations and delivery • Charity Williams, BSN, RN – NHFMC labor and delivery • Jessica Hoffman, BSN, RN – NHFMC behavioral health adult psych • Tina Williams, BSN, RN – NHFMC CPPU • Amy Holdren, BSN, RN – NHFMC ED • Joy Jessup, BSN, RN – NHFMC dialysis Making nursing remarkable • 15

Master of arts in nursing Master of science in nursing/nurse practitioner • Phyllis Brooks-Miller, MA, • Megan Hulen, MSN, NP – NHFMC heart and vascular BSN, RN – NHFMC renal • Abigail Millikan, MSN, NP – NHKMC ED

Master of health Doctor in nursing practice administration • Chirrl Lambeth, DNP, NNP-BC – NHFMC NICU • Lori Johnson, MHA, BSN, • Rodney Nash, DNP, CRNA – NHFMC anesthesia services John Rincic, MHA, RN, CCRN RN, CMSRN – NHFMC • Andrea Underwood, DNP, FNP-BC – NHFMC ED Surgical Services • Matoka Love-Maxey, MSN, Professional certification MHA, CCRN, RN-BC – It is important for all nurses to understand the value NHFMC CVSU of nursing certification. Credentialing advances the • John Rincic, MHA, RN, profession of nursing by encouraging and recognizing CCRN – NHFMC CICU professional achievement.

• Queta Thomas, BSN, Certification is a profession’s official recognition of Tracey Whitley, MSN, RN, MHA, RN – CICU achievement, expertise and clinical judgment. It is a RNC-OB, C-EFM mark of excellence that requires continued learning Master of science in nursing and skill development to maintain. • Gari Leigh Adams, MSN, RN, CEN – NHFMC nursing practice, education and research NHFMC implemented several programs to support nurses in obtaining their certification. In 2013, nurses • Amy Barber-Kennon, MSN, RN – NHKMC ED nursing could apply for the Archie K. Davis funds to be used resource team for any type of certification prep materials. NHFMC • Nancy Bryan, MSN, RN, RNC-OB, C-EFM – NHFMC spent more than $20,000 from this fund on certification labor and delivery prep materials and classes. • Jenna Campbell, MSN, RN, OCN – NHFMC nursing practice, education and research In 2013 and 2014, the professional practice and development council endorsed a “pass and pay” • Dana Dalton, MSN, RN, RN-BC – NHFMC renal strategy. Nurses who paid for the exam and passed • Amanda Doub, MSN, RN, CMSRN – NHFMC nursing would be reimbursed. NHFMC spent more than $9,000 practice, education and research in 2013 to pay for certification exam registration fees • Heather Hanna, MSN, RN – NHKMC nursing administration and spent more than $7,000 in the first half of 2014. • Kathy Henry, MSN, RN, CHPN – NHFMC acute In 2014, Novant Health is participating in a program palliative care to encourage nurses to pursue certification. ANCC’s • Matoka Love-Maxey, MSN, MHA, RN, CCRN, RN-BC – new Success Pays program reduces test-taking anxiety NHFMC cardiac vascular surgery unit and removes a financial barrier to testing. So far this • Sheri McVay, MSN, RN, CPAN – NHKMC year, 21 nurses have successfully passed their ANCC nursing administration certification using this program and 81 additional nurses • Kerri Reid, MSN, RN, CMSRN – NHFMC ECU are pursuing their certification using this program.

• Tracey Whitley, MSN, RN, RNC-OB, C-EFM – NHFMC Congratulations to all the nurses who have achieved nursing practice, education and research this important career milestone in 2013 and the first half of 2014! 16 • 2013 – 2014 nursing annual report Making nursing remarkable • 17

Certification accomplishments (January 2013 to June 2014)

Cardiac-vascular nursing • Emily Stone, BSN, RN, board certification (RN-BC) CCRN, CCRN-CMC – • Enrique Dela Cruz, BSN, NHFMC ICU RN, RN-BC – NHFMC 6th • Marquita Tabron, BSN, north telemetry RN, CCRN, CCRN-CMC – • Pamela Hanson, RN, RN-BC – NHFMC ICU NHFMC heart and wellness • Christina Watford, BSN, • Caroline House, BSN, RN, CCRN – NHFMC Deborah Harberger, BSN, Robin Austin, BSN, RN, RN, RN-BC– NHFMC nursing practice, education RN , CAPA CMSRN, CPAN 6th north telemetry and research • Amanda Parks, RN, RN-BC – NHFMC 6th diabetic • Joshua White, RN, CCRN – NHFMC CICU

• Stephanie Starling, MHA, BSN, RN, NE-BC, RN-BC – Certified critical care registered nurse with subspecialty NHFMC nursing administration cardiac medicine (CCRN-CMC) • Laurie Wall White, MSN, RN, RN-BC – NHFMC nursing • Emily Stone, BSN, RN, CCRN, CCRN-CMC – NHFMC ICU practice, education and research Certified critical care registered nurse with subspecialty Certified ambulatory perianesthesia nurse (CAPA) cardiac surgery (CCRN-CSC) • Deborah Harberger, BSN, RN, CAPA – NHMPH PACU • Tyrone Hall, BSN, RN, CCRN, CCRN-CSC – NHKMC ICU

Certified case manager (CCM) Certified emergency nurse (CEN) • Clarissa Lowery, BSN, RN, CCM, CRRN – NHFMC • Mary Boyd, BSN, RN, CEN – NHFMC ED rehabilitation • Barbara Eldridge, BSN, RN, CEN – NHFMC nursing Certified critical care registered nurse (CCRN) practice, education and research • Whitney Benfield, BSN, RN, CCRN– NHFMC ICU • Daniel Lackey, BSN, RN, CEN – NHFMC EAU • Sarah Bodenheimer, BSN, RN, CCRN – NHFMC nursing • Brittany Miles, BSN, RN, CEN – NHFMC ED practice, education and research Certified medical-surgical registered nurse (CMSRN) • Lauren Boyd, BSN, RN, CCRN – NHFMC CICU • Pat Atkins, RN, CMSRN – NHMPH nursing • Ashley Conaway, BSN, RN, CCRN – NHFMC CICU • Robin Austin, BSN, RN, CMSRN, CPAN – NHKMC • Sharon Cox, BSN, RN, CCRN – NHFMC ICU nursing administration • James Dellinger, BSN, RN, CCRN – NHFMC CICU • Lauren Betson, BSN, RN, CMSRN – NHFMC pulmonary • David Duplisea, RN, CCRN – NHFMC CICU • Sherri Dye, BSN, RN, CMSRN – NHFMC GI • Tia Exline, BSN, RN, CCRN – NHFMC CICU • Tonya Elder, BSN, RN, CMSRN – NHFMC women’s • Tyrone Hall, BSN, RN, CCRN, CCRN-CSC – NHKMC ICU specialty care • Jennifer Hemric, BSN, RN, CCRN– NHFMC CVSU • Kathryn Hellinger, RN, CMSRN – NHMPH nursing • Kristel Hurst, BSN, RN, CCRN – NHFMC CICU • Katie Hough, BSN, RN, CMSRN – NHFMC renal • Matoka Love-Maxey, MSN, MHA, RN, CCRN, RN-BC – • Shayna Johnson, RN, CMSRN – NHFMC ECU NHFMC CVSU • Cheryl Jones, RN, CMSRN – NHFMC renal • Kevin Stanley, BSN, RN, CCRN – NHFMC ICU • Crystal Merritt, RN, CMSRN – NHFMC pulmonary • Hope Moore, RN, CMSRN – NHFMC oncology 18 • 2013 – 2014 nursing annual report

• Elizabeth Owens, RN, Oncology certified nurse CMSRN – NHMPH nursing (OCN) • Carrie Rogers, MSN, RN, • Ashley Dennis, BSN, RN, CMSRN – NHFMC nursing OCN – NHFMC oncology practice, education • Iris Landingham, RN, and research OCN – NHKMC oncology • Tracy Scotto Rinaldi, BSN, • Trish Strickland, RN, RN, CMSRN – NHFMC OCN – NHFMC oncology Susan Akers, BSN, RN, PCCN general surgery Nadine Hardin, BSN, RN, RN-BC • Kathryn Spencer, BSN, Progressive care certified nurse (PCCN) RN, CMSRN – NHFMC • Susan Akers, BSN, RN, PCCN – NHFMC nursing practice, innovations education and research Certified post anesthesia • Lindsay Smith Lane, BSN, RN, PCCN – NHFMC nursing nurse (CPAN) practice, education and research • Sheri McVay, MSN, RN, CPAN – NHKMC nursing Medical-surgical nursing board certification (RN-BC) Angela Funderburk, BSN, administration • Stephanie Caudle, BSN, RN, RN-BC – NHFMC renal RN, RN-BC • Julie Cooke, RN, RN-BC – NHFMC pulmonary Family nurse practitioner board certification (FNP-BC) • Dana Dalton, MSN, RN, RN-BC – NHFMC renal • Athena Brummett, MSN, FNP-BC – NHFMC • Angela Funderburk, BSN, RN, RN-BC – NHKMC neonatology administration medical-surgical • Abigail Millikan, MSN, FNP-BC – NHKMC ED nursing • Nadine Hardin, BSN, RN, RN-BC – NHKMC medical-surgical resource team • Malaya Jester, BSN, RN, RN-BC – NHFMC renal

Inpatient obstetric nursing (RNC-OB) • Amanda Lineberry, RN, RN-BC – NHFMC ECU • Kim Henson, BSN, RN, RNC-OB – NHFMC labor • Jessica Lundquist, RN, RN-BC – NHFMC pulmonary and delivery • Travis Radcliff, BSN, RN, RN-BC – NHKMC medical-surgical • Lois Leech, RN, RNC-OB – NHFMC high-risk maternity • Ginny Reynolds, BSN, RN, RN-BC – NHKMC • Katina Miller, BSN, RN, RNC-OB – NHFMC labor medical-surgical and delivery Neonatal intensive care nursing (RNC-NIC) • Damaris Petrone, RN, RNC-OB, CCE – NHFMC labor and delivery • Kayla Shew, RN, RNC-NIC – NHFMC NICU • Lynette Sechriest, RN, RNC-OB – NHFMC labor • Janna Pinckney, MSN, NP, RNC-NIC – NHFMC and delivery neonatology administration • Rhonda Smith, RN, RNC-OB – NHFMC labor and delivery

Orthopaedic nurse certification (ONC) • Vadim Cebotari, RN, ONC – NHFMC orthopedics • Tracy Delehant, RN, ONC – NHFMC orthopedics • Erian Hoffpauir, BSN, RN, ONC – NHFMC orthopedics Making nursing remarkable • 19

Nurse executive board • Celeste Conner, RN – certification (NE-BC) NHKMC surgical services • David Beasley, MHA, BSN, (2014) RN, NE-BC, CCRN – • Kristen Maguire, BSN, RN, NHFMC ICCU CMSRN – NHFMC • Cheri Hardy, DrPH, MPH, gastroenterology (2014) BSN, RN, NE-BC – NHFMC diabetes administration NC Great 100 David Beasley, MHA, BSN, RN, Celeste Conner, RN • Sandy Hunter, MS, BSN, RN, • Debra Bryant, RN, RNC-OB, NE-BC, CCRN NE-BC, CCRN – NHFMC C-EFM – NHFMC labor and nursing administration delivery (2013) • Nancy Pearson, MSN, RN, NE-BC – NHFMC labor • Mitzie Trammel, MS, and delivery BSN, RN, CCRN – NHFMC ICU (2013) • Stephanie Starling, MHA, BSN, RN, NE-BC, RN-BC – NHFMC nursing administration • Susan Hill, MSN, RN, NP – NHKMC emergency • Scottie Wilson, MHA, BSN, RN, NE-BC- NHFMC services (2014) nursing administration Kristen Maguire, BSN, RN, CMSRN Greater Winston-Salem Nursing professional development (RN-BC) market remarkable 45 – 2013 • Ginger Burkhead, MSN, RN, RN-BC, CMSRN • Cindy Amos, BSN, RN – NHMPH outpatient surgery Psychiatric–mental health nursing board certification (RN-BC) • Adrian Bailey, BSN, RN, CMSRN – NHFMC • Ellen Knight, BSN, RN, RN-BC – NHFMC nursing practice, pulmonary education and research • Amy Barber-Kennon, MSN, RN – NHKMC ED Awards and honors Debra Bryant, RN, resource team (January 2013 to June 2014) RNC-OB, C-EFM • Melissa Bowman, RN, Nursing contributions to the organization and community RN-BC – NHFMC pulmonary are recognized for their positive effect on patients and families. Nurses are acknowledged in various ways for • Cindy Brackman, RN – these accomplishments, enhancing the image of nursing NHKMC nursing in the organization and community. administration • Debra Bryant, RN, RNC-OB, Elizabeth Ward professional C-EFM – NHFMC labor nurse award and delivery

• Lori Johnson, MHA, BSN, Mitzie Trammel, MS, BSN, • Mary Calloway, RN – RN, CMSRN – NHFMC RN, CCRN NHFMC infusion center PERK unit (2013) • Crystal Collins, RN, RN-BC – NHFMC pulmonary • Rick Lee, MSN, RN, • Kevin Colston, LPN – greater Winston-Salem market NE-BC, CEN – NHFMC clinical research nursing administration Rick Lee, MSN, RN, NE-BC, CEN (2013) • Adam East, MSN, RN, NP – greater Winston-Salem market • Lesa Smith, MSN, RN, CCRN, RN-BC – NHFMC nursing • Lea Davidson, BSN, RN – NHFMC CVSU practice, education and research (2013) • David Duplisea, RN, CCRN – NHFMC CICU 20 • 2013 – 2014 nursing annual report

• Kathy Frantz, BSN, RN – • Jenna Campbell, MSN, NHFMC patient placement RN, OCN – NHFMC • Candace Hendley, BSN, nursing practice, education RN, CCRN – NHKMC and research nursing administration • Bobbi Clark, RN – NHFMC • Kristel Hurst, BSN, RN, community wellness CCRN – NHFMC CICU and education • Daria Kring, PhD, RN, • Donnette Cobb, BSN, Kristen Foley, BSN, RN, OCN Paula Marion, BSN, RN NE-BC – NHFMC RN, CCRN – NHCMC nursing practice, education operating room and research • Katie Cochran, BSN, RN – NHFMC cardiothoracic surgery • Kendra Lawson, RN – • Joanne Crowley, MA, BSN, RN, NE-BC, ONC – NHKMC emergency services NHKMC administration • Pamela Leland, BSN, RN – • Amanda Doub, MSN, RN, CMSRN – NHFMC NHMPH nursing nursing practice, education and research administration • Kelly Fincher, RN – NHKMC emergency services Curtis Jenkins, RN • Loretta Matthews, BSN, RN, • Kristen Foley, BSN, RN, OCN – NHFMC oncology CHPN – NHFMC manager palliative care program • Bridgette Freeman, RN – NHFMC orthopedics • Patsy Michalak, RN, CMSRN – NHFMC pulmonary • Jennifer Hawes, RN, CHPN – NHFMC acute palliative care • Teresa Phibbs, RN, CMSRN – NHMPH nursing • Wendy Hicks, MSN, RN – NHKMC medical surgical • Kerri Reid, MSN, RN, CMSRN – NHFMC experienced care unit • Susan Hill, MSN, RN, NP – NHKMC emergency services • Robin Robertson, RN, IBCLC – NHFMC neonatology • Lisa Horton, RN – NHFMC general surgery • Stephanie Starling, MHA, BSN, RN, NE-BC, RN-BC – • Curtis Jenkins, RN – cardiothoracic surgery NHFMC nursing administration • Sole Johnson, MSN, RN, CEN – NHFMC nursing practice, • Jennifer Turrentine, BSN, RN – NHFMC behavioral health education and research • Andrea Underwood, MSN, FNP-C – NHFMC • Lauren Kiger, BSN, RN, CCRN – NHFMC ICU emergency services • Kristen Maguire, BSN, RN, CMSRN – • Carol White, RN, CMSRN – NHMPH nursing NHFMC gastroenterology • Heather White, RN, CCRN, RN-BC – NHFMC CICU • Paula Marion, BSN, RN – NHCMC emergency services • Venus Ybanez, MSN, RN, CNRN – NHFMC orthopedics • Crystal Merritt, RN, CMSRN – NHFMC pulmonary • Dana Morris, BSN, RN, RNC-OB, C-EFM – NHFMC Greater Winston-Salem market remarkable 45 – 2014 nursing practice, education and research • Samara Alikakos, BSN, RN, CMSRN – NHFMC renal • Nina Nakhle, RN – FMC neuroscience • Lisa Allen, BSN, RN, CMSRN – NHFMC gastroenterology • Rebekah Phillips, BSN, RN – NHFMC EP lab • Katherine Amen, BSN, RN, RNC-NIC – NHFMC • John Rincic, MHA, RN, CCRN – NHFMC CICU nursing practice, education and research • Catrina Simmons, BSN, RN, CPN – NHFMC women’s • Robin Austin, BSN, RN, CMSRN, CPAN – NHKMC specialty care nursing administration • Tracey Whitley, MSN, RN, RNC-OB, C-EFM – NHFMC • David Beasley, MHA, BSN, RN, CCRN – NHFMC ICCU nursing practice, education and research • Lauren Betson, BSN, RN, CMSRN – NHFMC pulmonary Making nursing remarkable • 21 22 • 2013 – 2014 nursing annual report

• Sharon Cox, BSN, RN, CCRN – NHFMC ICU • Enrique Dela Cruz, BSN, RN, RN-BC – NHFMC 6th north telemetry • Kristen Dishen, RN, BSN – NHFMC labor and delivery • Lori Dixon, BSN, RN, CCRN – NHFMC CVSU • Dawn Rachelle Duffey, RN, RNC-OB – NHFMC labor and delivery • Kelly Duffey, BSN, RN – NHFMC NICU • Matilde Duke, BSN, RN – NHFMC rehab • Amy Dwiggins, BSN, RN, RN C-OB – NHFMC labor and delivery • Kezia Egnatz, BSN, RN – central scheduling and staffing office (CSSO) • Fang Fang, BSN, RN – NHFMC renal dialysis • Lyndsi Flynn, BSN, RN – NHFMC mother baby • Karen Fox, BSN, RN, LCCE – NHFMC surgical admission center • Mary Catherine Frantz, BSN, RN – NHFMC patient placement • Amy Fulp, BSN, RN – NHMPH PACU • Ruby Gaither, BSN, RN – NHNHFMC 6th north telemetry 2013 career ladder – level III • Gillian Gatewood, BS, RN – NHFMC rehab • Ashley Adams, BSN, RN, CCRN – NHFMC ICU • Roxanna Goughnour, RN, RNC-OB, C-EFM – NHFMC • Samara Alikakos, BSN, RN, CMSRN – NHFMC renal high-risk maternity care • Anne Ambs, BSN, RN – NHFMC ICU • Rita Grefiel, RN, BSN, CNOR – NHFMC operating room • Cindy Amos, BSN, RN – NHMPH outpatient surgery • Paula Grisham, RN – NHFMC Hawthorne • Adrian Bailey, BSN, RN, CMSRN – NHFMC pulmonary outpatient surgery • Susan Bennett, BSN, RN – NHFMC recovery room • Missy Halliday, BSN, RN – NHFMC labor and delivery • Lauren Betson, BSN, RN, CMSRN – NHFMC pulmonary • Phyllis Handy, LPN – NHFMC ED • Linda Black, BSN, RN – NHFMC ED • Lindsey Henkel, RN, RNC-MNN – NHFMC mother baby • Christina Branscome, BSN, RN – NHMPH PACU • Donna Higgins, BSN, RN – NHFMC Hawthorne • Angela Briles, BSN, RN – NHFMC endoscopy outpatient surgery • Jill Brown, BSN, RN, RNC-OB – NHFMC high-risk • Diane Hill, BSN, RN, RN-BC – NHFMC 6th diabetic maternity care • Amanda Hinson, RN – NHFMC mother baby • Katie Callahan BSN, RN – NHMPH outpatient surgery • Jennifer Hudson, BSN, RN – NHFMC NICU • Katie Cochran, BSN, RN – NHFMC CTSU • Elizabeth Hughes, RN – NHFMC CTSU • Susan Collins, RN, RN-BC – NHFMC 6th north telemetry • Amy Inman, RN, CMSRN – NHFMC gastroenterology • Kevin Colston, LPN – clinical research • Rhonda James, RN, RNC-MNN – NHFMC mother baby • Kristie Comer, BSN, RN – NHFMC NICU • Ellen Johnson, RN, CCRN, RN-BC – NHFMC CICU • Julie Cooke, RN, RN-BC – NHFMC pulmonary • Jessica Johnson, BSN, RN – NHFMC ED Making nursing remarkable • 23

• Kimberly Johnson, BSN, RN – NHFMC rehab • Marquita Tabron, BSN, RN, • Nicole Kale, RN, CCRN – NHFMC ICU CCRN – NHFMC ICU • Crystal Kennedy, RN, CMSRN – NHFMC pulmonary • Cynthia Thompson, BSN, RN, CMSRN – NHFMC • Sharon Kiser, BSN, RN – NHFMC general surgery gastroenterology • Iris Landingham, RN, OCN – NHFMC radiation oncology • Crystal Thorpe, BSN, • Edgar Lim, BSN, RN – NHFMC CICU RN, CMSRN – NHFMC PERK unit • Gerri Lineberry, RN, CMSRN – NHFMC PERK unit Mary Cortez-Gann, RN • Ashley Timmons, BSN, • Dean Ludwig, RN, CNOR – NHFMC open heart surgery RN – NHKMC ICU • Jennifer Mathay, BSN, RN, RNC-OC – NHFMC labor • Kathy Trivette LPN – NHFMC endoscopy and delivery • Karen Walker, BSN, RN, CCRN-CMC – NHFMC CICU • Kellie McGowan, BSN, RN, CCRN – CSSO • Cassandra Welch, RN, CMSRN – NHMPH • Sheri McVay, BSN, RN – NHMPH PACU outpatient surgery • Beverly Middlebrooks, RN, GCRN – Forsyth • Donna Welch, BSN, RN – NHFMC oncology orthopedic outpatient surgery • Heather White, RN, RN-BC, CCRN – NHFMC CICU • Kerry Middleton, BSN, RN – NHFMC CTSU • Meagan Widener, BSN, RN, RNC-MNN – NHFMC • Myra Mock, BSN, RN – NHFMC PACU mother baby • Tess Monterroyo, BSN, RN – NHFMC gastroenterology • Stephanie Witt, BSN, RN – NHFMC CICU • Tamiko Moore, BSN, RN – CSSO • Monica Moorefield, BSN, RN – NHFMC general surgery 2013 career ladder – level IV • Junine Morrison, BSN, RN – NHFMC ICU • Emily Barnes, BSN, RN, RNC-NIC – NHFMC NICU • Elizabeth Otto, RN, RNC-NIC – NHFMC mother baby • Bonnie Brown RN, BSN, CNN – NHFMC renal dialysis • Elizabeth Patterson, RN, BSN – NHFMC ob-gyn recovery • Rebecca Brown, BSN, RN – NHFMC Hawthorne outpatient surgery • Rebecca Pendry, BSN, RN – NHFMC women’s specialty care • Joy Burgess, MHA, BSN, RN – NHFMC endoscopy • Judy Petticord, LPN, NHFMC – endoscopy • Lori Corder, BSN, RN, CMSRN – NHMPH clinical nursing • Rose Poulose, RN, CMSRN – NHFMC 6 west diabetic • Mary Cortez-Gann, RN – NHFMC oncology • Brandi Presnell, BSN, RN – NHFMC CICU • Rebecca Cranfill, BSN, RN, RN-BC – NHFMC CVPP • Linda Queen, BSN, RN – NHFMC adult behavior health • Angela Davis, BSN, RN, CMSRN – NHFMC vascular access therapy team • Lourdes Racelis, BSN, RN – NHFMC infusion center • Sophia Debrew, BSN, RN, CMSRN – NHFMC • Lindsey Roberts, BSN, RN – NHFMC labor and delivery general surgery • Aquilla Rousseau, BSN, RN, CMSRN – NHFMC vascular • Nelda Everidge, BSN, RN – NHFMC Hawthorne access therapy team outpatient surgery • Laila Samson, BSN, RN – NHFMC renal • Sandra Feist, BSN, RN, RNC-NIC – NHFMC NICU • JD Sheppard, BSN, RN – NHFMC PACU • Lauren Flogel, BSN, RN, RNC-MNN – NHFMC • Cassandra Sink, BSN, ED – NHFMC endoscopy mother baby • Natalie Snow, RN, BSN – NHFMC NICU • Kimberly Gilmore, BSN, RN – NHFMC oncology • Felicia Snyder, BSN, RN – NHFMC general surgery • Emily Hensley, BSN, RN, CCRN – NHFMC CICU • Sarah Snyder, BSN, RN – NHFMC general surgery • Tommy Hodgin, BSN, RN, CTRN – critical care transport • Jamie Strom, BSN, RN, CEN – NHFMC ED 24 • 2013 – 2014 nursing annual report

• Kimberly Howell, BSN, RN, RNC-NIC – NHFMC NICU 2014 career ladder • Adrienne Jenkins, BSN, RN, RN-MNN – NHFMC ED (January – July) – level III • Lisa Jones, RN, RNC-NIC – NHFMC NICU • Mayra Asis, BSN, RN, RN-BC – CSSO • Deborah Lakey, BSN, RN, RNC–OB – NHFMC high-risk maternity care • Tracy Atkins, BSN, RN – NHFMC labor and delivery • Elizabeth Larrick, BSN, RN – NHFMC mother baby • Anne Ambs, BSN, RN – • Matoka Love-Maxey, MSN, MHA, RN, CCRN, RN-BC – NHFMC ICU NHFMC CVSU Mayra Asis, BSN, RN, RN-BC • Whitney Benfield, BSN, RN, • Glenda Martin, BSN, RN, CNN – NHFMC renal dialysis CCRN – NHFMC ICU • Tina Martin, BSN, RN, CEN – NHFMC ED • Suenetta Bess, BSN, RN – • Jennifer McBride, BSN, RN, CCRN – NHFMC ICU NHFMC ICU • TJ McGee, RN, OCN – NHFMC oncology • Ashley Boles, BSN, RN, CEN – NHFMC ED nursing • Edward Mueller, BSN, RN – NHFMC recovery room resource team • Elizabeth Nagel, RN, RNC-NIC – NHFMC NICU • Lauren Boyd, BSN, RN, • Cynthia Oldaker, RN, CRN – NHFMC Marsha Conklin, RN CCRN – NHFMC CICU radiology administration • Nancy Bryan, MSN, RN, RNC-OB, C-EFM – NHFMC labor • • Elana Rosinger, BSN, RN, CMSRN – NHFMC and delivery general surgery • Katie Callahan, BSN, RN – NHMPH outpatient • Carolyn Rudisill, BSN, RN, CCRN – NHFMC CICU • Nancy Chilton, BSN, RN – NHFMC hemodialysis • Rhonelle Sicat, BSN, RN, CEN – NHFMC • Alex Cockerham, LPN – NHFMC ED emergency department • Kristie Comer, BSN, RN – NHFMC NICU • Robbin Simmons, BSN, RN, CPAN – NHFMC PACU • Marsha Conklin, RN – NHFMC vascular access • Deeann Smith, BSN, RN, CMSRN – NHFMC general surgery • Linda Creed, LPN – NHFMC ED • Anne Spillman, BSN, RN, CMSRN – • Karen Cumbo, BSN, RN – NHFMC pediatrics NHFMC gastroenterology • Lea Davidson, BSN, RN – NHFMC CVSU • Deborah Stafford, BSN, RN, CMSRN – NHFMC women’s • Michelle Daye, RN – NHFMC ED specialty care • Jamie Dellinger, BSN, RN, CCRN – NHFMC CICU • Shannon Tedder, BSN, RN, RNC-OB – NHFMC labor and delivery • Rachelle Duffey, RN, RNC-OB – NHFMC labor and delivery • Mary Watkins, BSN, RN, RNC-OB – NHFMC labor and delivery • Amy Dwiggins, BSN, RNC-OB – NHFMC labor and delivery • Dana Whitaker, BSN, RN, CNRN – CSSO • Laurie Edwards, RN – NHFMC ICU • Leonard Williams, BSN, RN, CNN – NHFMC renal dialysis • Sara Egnatz, BSN, RN – CSSO • Susan Wood, BSN, RN, RN-BC – NHFMC CTSU • Tia Exline, BSN, RN, CCRN – NHFMC CICU • Venus Ybanez, BSN, RN, CNRN – NHFMC neurology • Jennifer Hemric, BSN, RN, CCRN – NHFMC CVSU • Jennifer Hudson Palmer, BSN, RN – NHFMC NICU • Melissa Flinchum, BSN, RN, CCRN – NHFMC ICU • Lindsi Flynn, BSN, RN – NHFMC mother baby Making nursing remarkable • 25

• Summer Goodman, BSN, RN – NHFMC ICCU • Cristy Rizos, BSN, RN – NHFMC ED • Lisa Horton, RN – NHFMC general surgery • Kayla Shew, RN, RNC-NIC – NHFMC NICU • Kimberly Johnson, BSN, RN – NHFMC rehab • Dena Shore, RN – NHFMC general surgery • Crystal Kennedy, RN, CMSRN – NHFMC pulmonary • Emily Stone, BSN, RN, CCRN, CCRN-CMC – NHFMC ICU • Lauren Kiger, BSN, RN, CCRN – NHFMC ICU • Crystal Thorpe, BSN, RN, CMSRN – NHFMC PERK • Carolyn Kravontka, RN – NHFMC ICU • Kathy Trivette, LPN – NHFMC endoscopy • Penny Kuria, MSN, MHA, RN – NHFMC PERK unit • Oneicesa Washington, BSN, RN – NHFMC NICU • Jessica Lundquist, RN, RN-BC – NHFMC pulmonary • Teresa White, RN, CMSRN – NHFMC general surgery • Jennifer Mathay, BSN, RN, RNC-OB – NHFMC labor • Sariya Yan Theng, BSN, RN – NHFMC NICU and delivery 2014 career ladder (January – July) – level IV • Tammy McConnell, BSN, RN – NHMPH PACU • Lauren Betson, BSN, RN, CMSRN – NHFMC pulmonary • Julia McKoy, BSN, RN – NHFMC mother baby • Julieanne Chapman, BSN, RN, CNOR – NHFMC open • Crystal Merritt, RN, CMSRN – NHFMC pulmonary heart surgery • Brittany Miles, BSN, RN, CEN – NHFMC ED • Sherry Coggin, BSN, RN, OCN – NHFMC oncology • Myra Mock, BSN, RN – NHFMC PACU • Angela Davis, BSN, RN, CMSRN – NHFMC • Carolisa Palmer, RN, CMSRN – NHFMC general surgery vascular access • Elizabeth Patterson, BSN, RN – NHFMC labor • Sophia Debrew, BSN, RN, CMSRN – NHFMC and delivery general surgery • Rebecca Pendry, BSN, RN – NHFMC women’s specialty • Rita Grefiel, BSN, RN – NHFMC operating room • Judy Petticord, LPN – NHFMC endoscopy • Jennifer McBride, BSN, RN, CCRN – NHFMC ICU • Rose Poulose, RN, CMSRN – NHFMC 6th diabetic • Sheri McVay, MSN, RN, CPAN – NHMPH PACU • Karen Reece, BSN, RN – NHFMC holding room • Cynthia Oldaker, RN, CRN – NHFMC • John Rincic, MHA, RN, CCRN – NHFMC CICU radiology administration 26 • 2013 – 2014 nursing annual report

• Elana Rosinger, BSN, RN, CMSRN – NHFMC • Leslie Berry, CNAII – NHFMC neuroscience general surgery • Christina Burton, RN – NHFMC NICU • Deeann Smith, BSN, RN, CMSRN – NHFMC • Deby Carter, RN – NHFMC Hawthorne outpatient surgery general surgery • Tia Exline, BSN, RN, CCRN – NHFMC CICU • Debbie Stafford, BSN, RN, CMSRN – NHFMC • Bridgett Fairclough, RN – NHFMC labor and delivery women’s specialty • Kerry Flippin, RN – NHMPH nursing • Karen Walker, BSN, RN, CCRN – NHCMC, CSC – NHFMC CICU • Toni Guess, MUS – NHMPH nursing • Dana Whitaker, BSN, RN, CNRN – CSSO • Cherie Hardy, DrPH, BSN, RN, NE-BC – NHFMC 6th diabetic • Leonard Williams, BSN, RN, CNN – NHFMC renal dialysis • Martha Harrelson, BSN, RN, RNC-NIC – NHFMC NICU Circle of excellence – 2013 winners • Shirley Haywood, MSN, RN – NHFMC renal • Tonja Artz, BSN, RN, CEN – NHCMC emergency room • Linda Lane, CNAII – NHFMC oncology • Sharon Clayton, RN – NHFMC cardiac non-invasive • Melany Madigan, RN – NHFMC dialysis • Tamiko Cowan, CNAI – NHFMC behavioral health • Maria Notine, RN – NHKMC ED • Christina Dehart, BSN, RN, CMSRN – NHFMC pulmonary • Ann Ray, MHA, BSN, RN, NE-BC – NHFMC CVSU/CTSU • Gerald Green, BSN, RN – NHFMC orthopedic • Mildred Ray, BSN, RN – NHMPH nursing outpatient surgery • Marquita Tabron, BSN, RN, CCRN – NHFMC ICU • Shelia Koone, MSN, RNC – NHFMC women’s center • Sue Lippow, RDCS, RT(R) – NHFMC cardiac non-invasive Nursing research awards • Matoka Love-Maxey, MSN, MHA, RN, CCRN, RN-BC – • 2013 Best PI Project: “Maximizing plasma pheresis NHFMC CVSU outcomes,” Jessica Brinkley, MSN, RN – NHFMC renal dialysis • Samantha Powell, CNAI – NHFMC ICU • 2013 Best Research Project: “Blood transfusion • Jennifer Ruiz – NHFMC nursing practice, education monitoring: what does the evidence say?” Joanna and research Cortez-Gann, RN; Kristen Foley, BSN, RN, OCN; • Heather Small, RN – NHFMC emergency room Kimberly DiCarlo Gilmore, BSN, RN; and Tammy McGee, RN, OCN – NHFMC oncology • Jodi Spargo, CNAI – central staffing office • Shanda Spears, BSN, RN – NHFMC ICU Professional practice model nurse of the quarter award • Jennifer Steele, BSN, RN – NHFMC express • First quarter 2013: Laurie Ann Moles, RN – NHFMC CICU admission unit • Second quarter 2013: Cecily Mason, BSN, RN – • Chasity Wagoner, BSN, RN – NHFMC pulmonary NHFMC gastroenterology • Crystal Webster, RN – NHFMC ICU • Fourth quarter 2013: Kristen McGuire, BSN, RN, CMSRN – NHFMC gastroenterology Circle of excellence – 2014 winners • First quarter 2014: Sara Egnatz, BSN, RN – CSSO • Teressa Adams, BSN, RN, CDE – NHFMC population health • Second quarter 2014: Tonya Crump, MSN, RN, CCRN – • Sonya Baskin, CNAI – NHFMC pulmonary NHFMC ICU Making nursing remarkable • 27

Exemplary professional practice

Exemplary professional practice is demonstrated by effective and efficient care services, interprofessional collaboration and high-quality patient outcomes. Nurses partner with patients, families, support systems and interprofessional teams to positively impact patient care and outcomes. 28 • 2013 – 2014 nursing annual report

Medical Park Hospital awards Medical Park Hospital perennially ranks at the top of state and national standards for surgical and patient satisfaction. For surgical care, NHMPH achieved the designation of High Reliable from The North Carolina Center for Hospital Quality and Patient Safety for three years in a row. The criterion to achieve this designation requires a score at or above 90 percent for optimal care for four six-month time periods. NHMPH scored 98 percent for optimal care in the surgical care category.

NHMPH is also known for achieving high patient satisfaction scores when it comes to Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). NHMPH scores trended up in 2013 and achieved 99th percentile status on hospital rating. NHMPH100 is recognized as “best” nationally. 97.0 96.4* 96.0* 95.7* HCAHPS: Rate hospital 94.1 93.8 91.9 92.3* 100 90.9 90 89.7* 88.9* 97.0 87.5 96.4* 96.0* 95.7* 84.8 85.7 85.2* 87.5 94.1 93.8 92.3* 91.9 83.9 85.2* Positive 90.9 90 89.7* 83.3* 82.6* 88.9* 80 81.0* 81.5* 87.5 80.0* 84.8 85.7 85.2* 76.9* 87.5 83.9 85.2* Positive 83.3* 82.6* 80 81.0* 81.5* 70 80.0* Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. 76.9* 2012 2013

Novant Health Medical Park Hospital IP Total (88.3) NRC 90th Percentile (81.5) * Warning: n-size is under 30 70 Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. 2012 2013

Novant Health Medical Park Hospital IP Total (88.3) NRC 90th Percentile (81.5) * Warning: n-size is under 30

HCAHPS: Would recommend hospital to family

100.0* 100.0 100 96.4* 96.3* 97.1 96.3* 95.2* 93.9 91.9 92.3* 92.6* 91.2 100.0* 100.0 100 90.6 92.3* 90 90.6 96.4* 96.3* 97.1 91.3* 90.9 90.9* Positive 96.3* 95.2* 86.7 88.0* 93.9 87.5* 92.3* 86.2* 92.6* 91.9 91.2 84.4 85.2* 90.6 92.3* 90 90.6 91.3* 90.9 90.9* Positive 80 86.7 Jan. Feb. Mar. 88.0*Apr. May June July Aug. Sept. Oct. Nov. Dec. Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. 87.5* 86.2*2012 2013 84.4 85.2* Novant Health Medical Park Hospital IP Total (92.0) NRC 90th Percentile (84.9) * Warning: n-size is under 30 80 Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. 2012 2013

Novant Health Medical Park Hospital IP Total (92.0) NRC 90th Percentile (84.9) * Warning: n-size is under 30 Making nursing remarkable • 29

Nursing professional practice model Nursing is also aligned with Novant Health’s six vision elements that support the remarkable patient experience: A professional practice model is the overarching safety, quality, authentic personalized conceptual framework for nurses, nursing k • Persona wor l Exc relationships, voice and choice, easy for am el care and interprofessional patient care. e len • T ouncil • Sa c g C fet e me and affordability. These elements, on tin y/ • i na Qu D It is a schematic description that s di rkable Nu a i s r ma rsin li v a o e g ty e represented by the six diamonds in the p o R r C • s depicts how nurses practice, m R i • t o e y s s outermost circle, guide our nursing C r e e collaborate, communicate and a n t r r c practice now and in the future. a h

P • develop professionally to provide

•

the highest-quality care for those P During our Magnet site visit in

r p i o A h f served by the organization. e s e December 2013, the Magnet

r s r e e m s i m i d t o a a n D © e y appraisers noted “it was evident a l L r r l u e Our nursing professional practice k P  d g e a r y’ o in v b a s Q M s e that the professional practice model l ct ua ing r , model was designed and developed e ic lity-Car Nu n p e a • io a nd D ent s is fully enculturated and drives by the NHFMC/NHKMC/NHMPH tie evelopm en nt im exp ry d professional nursing practice.” professional practice and development erience, in eve council in 2011 and was adopted by the Care model innovations entire Novant Health nursing division in 2012. Novant Health has been focusing on transforming nursing Nursing’s professional practice model places the patient care and care delivery models since 2010 with the launch and family at the center of nursing practice, reflecting the of transforming care at the bedside (TCAB) and the ongoing commitment to providing remarkable nursing creation of bundle one initiatives. care. Gentle and caring nursing hands support the patient and family, representing the relationship-based care NHFMC, NHKMC and NHMPH were recognized by the provided to them. Duffy’s Quality-Caring Model is Magnet appraisers for the exemplary TCAB work that has the nursing theory that provides the foundation for occurred. One of the areas that the appraisers highlighted all nursing practice. was the success that has transpired following the implementation of team nursing on a majority of the The shared governance councils – safety and quality, nursing units. “Significant work has occurred in the research, nursing leadership, professional practice and organization for nursing to be the coordinator of care development, partners and coordinating councils – for patients,” commented the Magnet appraisal team. surround this core and provide the structure, collaboration, “By creating teams led by the registered nurse, he or she is development and communication for nursing practice. The able to spend more time performing those tasks that must outermost circle represents the organizational support for be performed by a registered nurse and then can delegate nursing and the alignment of nursing practice with the non-registered nurse tasks to other team members. corporate values of compassion, teamwork, personal Certified nursing assistants were taught additional skills excellence and diversity, and the vision of a remarkable so that the RN can delegate specific tasks to them.” patient experience in every dimension, every time. Several care model innovations have occurred in the women’s center. The mother baby unit developed structures that keep the couplet together with the same nursing team from delivery to discharge. This “The culture of the organization fosters teamwork transformation required significant resource changes, to assure nurses are able to achieve their desired which included combining nursing staffs from individual outcomes.” - 2014 ANCC Magnet Appraisers 30 • 2013 – 2014 nursing annual report

areas into a single team, assuring competencies and • The inpatient scope of care guiding the inpatient working with the pediatricians to complete newborn behavioral health unit was reviewed and revised. assessments in the patient rooms. During the Magnet site visit, Jennifer Rosecrans excitedly described the transformation of the behavioral The women’s center nurses were also recognized as health unit. The scope of care has evolved to include, the coordinators of patient care. The Magnet appraisers “nursing procedures, such as IV therapy and treatments. reported, “During the meeting with the physicians, there This enables patients with mental health concerns to was evidence of nurses (and nurse practitioners) being receive care for their medical needs as well as their the coordinators of care, particularly in women’s specialty psychotherapeutic interventions on the unit.” care and neonatology. In these areas, the nurse was the catalyst for coordination of patient care. The nurses • A minor up-fit and remodeling was done on the inpatient assume responsibility for coordinating care from admission behavioral health units to optimize inpatient capacity. to discharge. They also establish the plan of care and lead • Tele-psychiatry for the ED was implemented. the discussion during rounds.” • A behavior assessment team was created. This team Other areas where the is notified when behavioral health patients requiring Magnet appraisers medical clearance have obtained that clearance and recognized exemplary work can move to the inpatient psychiatric unit. were in the emergency • Inpatient behavioral health units’ reporting structures department (ED) and were realigned under the chief nursing officer. behavioral health. It was Realignment of behavioral health services within the determined that one of the division of nursing has led to sustained patient flow greatest barriers in the ED outcomes and strengthened the partnership between Jennifer Rosecrans, BSN, RN was the holding of behavioral behavioral health and inpatient nursing. health ED patients. The goal was to decrease length of stay (LOS) for behavioral health ED patients and thereby Using critical care protocols to improve the overall throughput at NHFMC. standardize evidence-based practice

The behavioral health strategic workflow analysis team The management of patients in the intensive care unit is delivered a multifaceted approach to decreasing the average complex. Many times, decisions regarding the best option LOS of behavioral health ED patients. The following process for the management need to be made in a short period of improvement initiatives were implemented: time. As a result, two patients with similar diseases and similar symptoms may receive two different therapies. • The opening of 10 behavioral health holding beds in the emergency observation area. Using multiple treatment approaches can create a host • A strong nurse manager for the inpatient behavioral of issues, including increased decision-making time, health unit was identified and placed, Jennifer Rosecrans, unpredictable outcomes and care teams not operating to the BSN, RN. full extent of their training. To reduce these variances and improve operational efficiencies, Novant Health launched • A leadership team was implemented in the behavioral a system-wide transformation of critical care services. health department. • An advanced practitioner specializing in psychiatric care During the last two years, a multidisciplinary team of was added to the ED. critical care providers identified 22 treatment protocols that could be effectively streamlined with standardized care protocols and order sets. Making nursing remarkable • 31

“The critical care council has endorsed a care delivery bundle of protocols will fit with its patient population model that has proven reliable and predictable,” explains and during which phase each should be implemented. Cheryl Crutchfield, BSN, MHA, RN, director of critical care NHFMC and NHKMC implemented the protocols in program development for Novant Health. “By standardizing the summer of 2014. the way we deliver critical care treatment across all of our hospitals, we can ensure patients receive the highest Clostridium difficile eradication standard of care, regardless of where they enter our system. We’ll be able to reduce patients’ length of stay, The achievement of exemplary practice is grounded in a ventilator usage, sedation time and even mortality rates.” culture of safety, quality monitoring and quality improvement.

But the benefits of this new operational philosophy extend Clostridium difficile (C-diff) is a gram-positive spore forming beyond patients. Critical care team members will also bacterium, isolated in 1935 and first described as a cause of experience better co-management of patients among all diarrhea in 1978 in a patient with pseudomembranous disciplines within the intensive care unit, clearly defined colitis. Clostridium difficile infection (CDI) is now among treatment plans for the most common critical care problems the most common causes of hospital-acquired infection and the opportunity to practice at the top of their license. along with MRSA and vancomycin-resistant enterococci (VRE). Recently, a new hyper-virulent strain has been Critical care team members are instrumental in the described that is thought to be a contributing factor implementation of these standardized protocols. “This has to this increase. been and continues to be an extraordinarily challenging endeavor,” explains Sandy Hunter, MS, BSN, RN, CCRN, After identifying an increase in C-diff cases with clustering NE-BC, director of critical care for NHFMC. “We have on two medical units, an interprofessional team was formed educated 300 nurses and physicians on this process and to address the issue. The team included representatives I could not have asked for a stronger, more dedicated from nursing, physician staff, clinical improvement, infection team to not only meet, but exceed expectations.” prevention, pharmacy, environmental services, food and nutrition and supply chain. The goal was to decrease There is a three-phase implementation scheduled for each the incidence of hospital-acquired C-diff on these two hospital. Each facility has the autonomy to select which medical units. 32 • 2013 – 2014 nursing annual report

After completing a thorough assessment of the units and the The team made several best-practice recommendations that current processes, the team developed and implemented can be used throughout Novant Health to decrease hospital multiple action steps. These action steps included: acquired C-diff infections. • Dedicating an ultraviolet machine to the two medical units. 1 Propagate use of blue caddies throughout • Educating EVS employees, UCICs and shared the organization. governance councils. Units with portable sinks are advised to 2 • Cleaning high-touch areas, such as door knobs, sinks, relocate patients to rooms with permanent over bed tables, faucets and counter tops, once per shift sinks when possible. in all C-diff rooms. Continue to monitor best practices for testing • Using new signage. 3 and diagnosing of hospital acquired C-diff. • Placing orange top wipes in the isolation caddies. Escalation of new pneumonia order set with revised • Moving C-diff patients to rooms that include sinks. 4 antibiotic orders to optimize antibiotic stewardship. • Placing blue isolation caddies on all units. Blue caddies are to be used for C-diff isolation rooms exclusively. Adoption of Bristol stool scale for objective 5 • Developing New Ask Me 3 patient education document. assessment and reporting of stool character. Investigate the possibility of covering soap • Distributing hand towelettes on all patient trays. 6 • Tracking number of days without infection. dispensers with same or similar shade of blue as caddies so that visual connection might be made. • Restructuring environment services leadership according to zones. 7 Monitor infection data for trends/outliers and • Soap and water washing every third room when rounding. recruit identified areas for participation in focused efforts. As a result of these interventions, there was a significant decrease in the number of hospital-acquired C-diff infections on the two medical units.

C-diff rate on two medical units

1.5

1.2

0.9 Rate

0.6

0.3

0 Aug. Sept. Oct. Nov. Dec. Jan. Feb. Mar. Apr. May June 2013 2014 C-di rate Linear (C-di rate) Making nursing remarkable • 33

New knowledge, innovations and improvements

Research and evidence-based practice remain a strong foundation of nursing services at Novant Health. Through the critical exploration of our daily work, we reject tradition and nurse-centric routines in favor of scientific evidence supporting new practices. In this way, we move from a technical discipline accustomed to working within established limits to a professional discipline accountable for improved patient outcomes. Daria Kring, PhD, RN, NE-BC Congratulations to all nurses that implement best practices at the bedside – you affect the outcomes of hundreds of patients every year! Congratulations to all nurses that share their projects at a state or national level – you affect the outcomes of untold patients throughout the country and beyond! Your work has resulted in 20 national presentations in the past 18 months, including nine posters and 11 podium presentations. Novant Health nurses are gaining a reputation for excellence well beyond the halls of our hospitals, because we are encouraged and expected to improve practice through the scientific process. We refer to this work as evidence- based practice; our patients know it as the remarkable patient experience.

Celebrating nursing’s accomplishments,

Daria Kring, PhD, RN, NE-BC Director, nursing practice, education and research 34 • 2013 – 2014 nursing annual report Making nursing remarkable • 35

Research projects of note Decreasing catheter-associated bloodstream infections in the neonatal intensive care unit Research by Novant Health nurses in recent years has Catheter associated blood stream infections (CABSI) are covered a wide variety of subjects that focus on patient preventable complications of central lines. In the neonatal themes. Here are some examples. population, these nosocomial infections significantly contribute to increase morbidity and mortality. A Blood transfusion monitoring: What does the evidence say? multidisciplinary neonatal intensive care unit (NICU) Joanna Cortez-Gann, RN; Kimberly Gilmore, BSN, RN; team developed a quality improvement project to reduce Kristen Foley, BSN, RN, OCN; TJ McGee, RN, OCN; and CABSIs in the NICU by 50 percent using National Brooke Kennedy, MSN, NP, OCN Healthcare Safety Network criteria with a long-term goal The purpose of this research was to examine vital sign of zero percent through the implementation of a central timing and frequency during blood administration to line maintenance bundle and increased staff compliance determine when changes in vital signs are seen during with central line protocols. A neonatal nurse practitioner reactions. Through retrospective chart reviews of every used the Fade Model to implement this project through blood transfusion reaction occurring at NHFMC from a multidisciplinary team, participation in the state 2006 to 2010 (n = 127), data was collected to understand collaborative of the National Catheter Associated Blood the correlation of vital signs to signs and symptoms. The Stream Infection Reduction Project, an evidence-based average time to blood transfusion reaction was 92 minutes. central line bundle, a focus group with nurses to identify Data suggests that vital sign monitoring is necessary at thoughts and perceptions related to CABSI reduction baseline, at 15 minutes from start time, one hour from start and unit protocol, and a revised protocol with education time, at completion and at one hour after completion. for the NICU staff. The NICU CABSI per 1,000 catheters Age is a factor (> 60 years old). Fever is most sensitive decreased from 5.69 in 2011 to 0.99 in 2012 to 0.48 in throughout the transfusion. Pulse is most sensitive at 2013. We have demonstrated significantly decreased reaction point. Males tend to have severe reactions. catheter associated blood stream infections. This reduction Because of this project, we are committed to our current has been sustained through enculturation of the central line blood transfusion policy vital sign parameters. maintenance bundle, continuous extensive staff education, and staff compliance with central line protocols. Interventions to improve peripherally inserted central catheters with the use of sapiens tip confirmation technology Number of CABSI Marsha Conklin, RN 6 5.69 The purpose of this evidence-based practice project was to implement BARD’s sapiens technology to confirm tip 5 placement when inserting peripherally inserted central catheter (PICC) lines. This technology would eliminate 4 the need for a chest X-ray following PICC placement. Equipment was purchased, education conducted and 3 competencies validated. Patients can now begin using their 2 PICC line immediately, decreasing delays in care. Patients do not have to undergo an X-ray to confirm placement, 1 Infections per 1,000 patient days per 1,000 Infections 0.99 thus saving the hospital $152,670 in a six-month timeframe. 0.48 0 2011 2012 2013 36 • 2013 – 2014 nursing annual report

Professional presentations Julie Cooke, RN, RN-BC; and Dale Callicutt, MSN, RN, RN-BC, CCRN (2013, poster presentation). “COPD and Novant Health nurses are at the forefront of investigating readmission: What needs to be done?” North Carolina and developing evidence-based practices that improve Organization of Nursing Leaders Annual Research clinical quality and patient outcomes. In the last 18 months, Symposium, Winston-Salem, NC nurses at NHCMC, NHFMC, NHKMC, and NHMPH disseminated more than two dozen projects at state Julie Cooke, RN, RN-BC; Dale Callicutt, MSN, RN, CCRN, and national levels. RN-BC; and Jessica Lundquist, RN (2014, poster presentation). “Improving COPD readmission rates.” Robin Atkinson, RN, OCN (2013, poster presentation). American Association of Critical-Care Nurses’ National “Trial of a cervical/HPV Hispanic screening.” Fourth Teaching Institute (NTI) and Critical Care Exposition, Annual Meeting of the Academy of Oncology Nurse Denver, CO Navigators, Memphis, TN Brenda Elder, BSN, RN, CRRN (2013, podium Kathy Bowman, BS, RN; and Julie Pope, RN, BSN presentation). “Securing our future: managing RACs.” (2013, poster presentation). “Connecting with American Medical Providers Association’s 11th Annual gastrointestinal patients and families.” Fourth Annual Conference and Expo, Fernandina Beach, FL Meeting of the Academy of Oncology Nurse Navigators, Memphis, TN Maggie Fogg, BSN, RN, CRRN (2013, podium presentation). “Is it really team conference without the Dale Callicutt, MSN, RN, RN-BC, CCRN; Julie Cooke, RN, most important members of the team?” American Medical RN-BC; and Cristine Andrews, RN (2013, podium Providers Association’s 11th Annual Conference and Expo, presentation). “A retrospective study looking at Fernandina Beach, FL contributing factors affecting readmission rates in a progressive pulmonary unit.” North Carolina Organization Sharon Gentry, RN, MSN, AOCN, CBNC and Sellers, J. of Nursing Leaders Annual Research Symposium, (2014). “Navigation considerations when working with Winston-Salem, NC patients.” In K. D. Blaseg, P. Daugherty and K. A. Gamblin (Eds.), Oncology Nurse Navigation: Delivering Patient- Gladys Campbell, MSN, RN, CNRN (2013, podium Centered Care Across The Continuum. Pittsburgh: presentation). “Use of EEG in affecting neurological Oncology Nursing Society outcome post arrest.” American Association of Neuroscience Nurses 45th Annual Educational Meeting, Sharon Gentry, RN, MSN, AOCN, CBNC; Laurie Mathis, Charlotte, NC RN, OCN, CBCN; and Jamie Calcutt-Flaherty, RN, CBEC (2014, poster presentation). “Supporting evidence-based Gladys Campbell, MSN, RN, CNRN; and Jason Jenkins, practice in nurse navigation.” Fifth Annual Academy of MSN, RN (2013, podium presentation). “Depression Oncology Nurse and Patient Navigators conference, screening: The importance in the stroke patient.” Orlando, FL American Association of Neuroscience Nurses 45th Annual Educational Meeting, Charlotte, NC Cherie Hardy, DrPH, BSN, RN, NE-BC (2013, poster presentation). “Collaborating for improved outcomes: Gladys Campbell, MSN, RN, CNRN; Amanda Doub, MSN, Coordinating point of care testing, meal delivery and insulin RN, CMSRN; Becky Lasley, BSN, RN, ONC; and Grace administration.” NCONL Annual Research Symposium, Allen, BSN, RN, CMSRN (2013, poster presentation). Winston-Salem, NC “Using the domains of learning to impact performance in emergency management.” Southeastern Nurses Staff Education Symposium, Wrightsville, NC Making nursing remarkable • 37

Allison Hooker, BSN, RN; and Christina Roels, RPH, Josh Nitsche, MD; and Dana Morris, BSN, RN, RNC-OB, PharmD (2014, poster presentation). “Improved detection C-EFM (2014, poster presentation). “The impact of vaginal and treatment of post-stroke depression utilizing Patient delivery simulation on medical student education.” 2014 Health Questionaire-9 (PHQ-9) screening over standard Annual Clinical Meeting of the American College of methods.” International Stroke Conference 2014, Obstetricians and Gynecologists, Chicago, IL San Diego, CA Karen Norman, MSN, RN, CCRN, RN-BC; and Heather Amy Jones, RN, BSN, CRRN; and Gladys Campbell, MSN, Norman, MHA, BSN, RN (2014, podium presentation). RN, CNRN (2014, poster presentation). “Effectiveness of “Recognizing and honoring donation.” WakeMed’s Organ National Institutes of Health stroke scale training.” Donation Conference, Raleigh, NC International Stroke Conference 2014, San Diego, CA Nancy Pearson, MSN, RN, NE-BC (2013, poster Daria Kring, PhD, RN, NE-BC (2014, podium presentation). presentation). “Nursing peer review: A non-punitive “More than a cornerstone: Building a strong nursing approach to professional accountability.” 106th North research foundation.” ANCC National Magnet Conference, Carolina Nurses’ Association Annual Convention, Dallas, TX Greensboro, NC

Tinisha Lambeth, DNP, NNP-BC (2013, poster Carrie Rogers, MSN, RN, CMSRN (2014, poster presentation). “Babies with neonatal abstinence presentation). “Tailored from the start: The orientation syndrome.” Vermont Oxford Network Learning Fair during pathway.” ANCC National Magnet Conference, Dallas, TX the Annual Meeting and Quality Congress, Chicago, IL Carrie Rogers, MSN, RN, CMSRN; and Elizabeth Rebo Tinisha Lambeth, DNP, RN, (2013, poster presentation). “Medication reconciliation: NNP-BC (2014, podium In the right hands.” 22nd Annual Academy of Medical- presentation). “Standardization Surgical Nurses (AMSN) Convention, Nashville, TN of care for very low birth weight infants during the first Stephanie Starling, MHA, BSN, RN, NE-BC, RN-BC; and (2014, podium presentation). hour of life.” 2014 Pediatric Linda Hogan, MSN, RN “Cath lab outcomes at Novant Health Forsyth Medical Academic Societies and Asian Center.” Fourth Annual VHA Pacific NW Variability Society for Pediatric Research Conference: Accelerate Models for Affordable Care, Tinisha Lambeth, DNP, RN, Joint Meeting, Vancouver, Seattle, WA NNP-BC British Columbia, Canada Kelly Swauger, BSN, MHSA, MAOL, RN, NE-BC (2014, Laurie Mathis, RN, OCN (2013, podium presentation). poster presentation). “Asking the right questions: “Role of the navigator and tumor conferences.” Fourth Appreciative inquiry around fall prevention.” 2014 Annual Annual Meeting of the Academy of Oncology Nurse NICHE (Nurses Improving Care for Healthsystem Elders) Navigators, Memphis, TN Conference, San Diego, CA Sheri McVay, MSN, RN, CPAN (2014, publication). “The effect of different types of navigators on patient Chasity Wagoner, BSN, RN; Dale Callicutt, MSN, RN, outcomes.” Journal of Oncology Navigation and Survivorship, RN-BC, CCRN; and Christina DeHart, BSN, RN, CMSRN (2013, poster presentation). “Team nursing: Does it work?” 5(2), 17-24. Sigma Theta Tau International’s Healthy Workplace Kelly Miles, BSN, RN, CRRN; and Sheila Swortzel, RN Conference, Indianapolis, IN (2013, podium presentation). “Knowledge is power.” (2013, podium Association of Rehabilitation Nurses’ Annual Education Andrea Underwood, DNP, FNP-BC presentation). “Social media and health information Conference, Charlotte, NC technology: An innovative way to interact with patients and healthcare providers.” American Nursing Informatics Association annual conference, San Antonio, TX 38 • 2013 – 2014 nursing annual report Making nursing remarkable • 39

Moving forward

To continue to grow, we must continue to change. That’s why our journey to remarkable nursing doesn’t end in 2014. We are continuing to move forward with our journey.

There will undoubtedly be new challenges to face along the way, new barriers to remove and new ideas to create and adopt. And we are ready to take them on. We’ll learn to work even more effectively and efficiently across the healthcare continuum. As a result we will continue to build and strengthen the professional practice of nursing.

We are planning our fourth Magnet designation for 2018, which will include Clemmons Medical Center. Each Magnet designation gets more exciting as we exceed our previous performance. We will continue to demonstrate excellent patient, community and nursing outcomes. We will show that we deserve continued recognition, and that we belong in this elite group of hospitals.

All the while, we will make sure we accomplish what we’ve set out to do: Deliver the most remarkable patient experience, in every dimension, every time. Making nursing remarkable • 40

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