nursing excellence 2018 ...

“As nurses we never know how strong we are until being strong is the only choice we have.” ... nursing excellence 2018

3 2018 NURSING EXCELLENCE

Letter from the Chief Nursing Officer

Dear Nursing Colleagues, Table of Contents As I reflect on what we accomplished in 2018, it is nothing short of “simply amazing.” It was full of intense change with multiple projects. We started off recovering from the Thomas Transformational Fire and the January 9 disaster which affected each and Leadership every one of us either directly or indirectly here at Cottage Health. While the events of January 9 were extremely tragic, 8 the care our Nursing team provided to our community was professional and selfless, and brought out the overwhelming Structural compassion we all felt for the victims and their families. Empowerment Immediately following, we went through Joint Commission 22 surveys at each campus. We then stepped up transition planning for Phase 6 at SBCH, launched Cottage Compass/ Kronos, rolled out Omnicell machines system-wide, Exemplary Professional Practice completed a “double-upgrade” to EPIC, and finally moved into Phase 6 at SBCH in December. The Phase 6 move was extremely well done and almost 44 magical as our Cottage Children’s Medical Center came together physically all on one floor—connected once again to the Birth Center and Mother Infant units. New Knowledge, Innovations and Improvements Throughout the endless changes in 2018, Magnet efforts were alive and well. Nursing Excellence published its tenth edition, which was probably our best yet. Our Magnet Quality 50 Celebration was fabulous, and was very well attended. I would be remiss in not mentioning the tireless efforts of Jen Bower, our Magnet Program Coordinator. She keeps us moving forward on Magnet Component Committee’s work. With all this change, SBCH and GVCH Empirical Outcomes kept their 5 Star Rating with CMS, and SYVCH continues to be celebrated as one of the top 53 20 Critical Access hospitals in the country. We are doing amazing work, and as we celebrate Nurses Week and all the accomplishments of 2018, I hope you are as proud as I am of all you do for our patients and families. Thank you! Happy Nurses Week, THANK YOU TO Glenn Dubock and Monie de Wit for their invaluable photo contributions. REFERENCED American Nurses Credentialing Center (2017). 2019 Magnet Application Manual. Silver Spring, MD Magnet® and National Magnet Conference™ are trademarks of the American Nurses Credentialing Center

Herb Geary, MBA, BSN, RN, FACHE Cover quote: Nursing Excellence Publication Committee, adapted from VP Patient Care Services & Chief Nursing Officer Bob Marley

4 ... Letter from the Nursing Magnet “Forgive yourself, Program Coordinator you are not perfect. 2018 began in such a traumatic way that it is hard to grasp the full effects Show yourself grace; of starting a new year under such circumstances. The devastating debris flow followed on the heels of the Thomas Fire which left our community you are still learning. in raw vulnerability. Throughout the span of chaos, I witnessed true Show yourself patience; heroes in action. Nurses doing what nurses do, coming together to care for those in need. The care was for anyone and everyone, extending you are on a journey.” outside of hospital walls. Nurses opened their homes to coworkers who - Nursebuff.com, submitted by Jennifer Granger Brown, were unable to return to their own due Nursing Education to the Highway 101 closure, ongoing evacuations, and homes lost to the fire ... and debris flow. In these moments, nurses exemplified our core values of excellence, integrity, and compassion. As the Nurse Excellence (NE) committee works to tell the story of 2018, we have been reflecting on the resilience demonstrated. We know that resilience is a fluid process, and at times we are more resilient than others. With intention we can strengthen our resilience like a muscle. This was the kind of year that strengthened our resilience muscle, whether we liked it or not. For anyone who is struggling or continues to struggle, I encourage you to reach out to our Employee Assistance Program (EAP). As the year progressed, nurses continued to adapt to the ever-changing healthcare environment and create new and better ways to care for our patients. As you read through the pages of this Nursing Excellence Nursing Excellence publication, I hope that your resilience is strengthened and that you find Publication Committee a sense of pride in yourself and your nursing peers for all that has been Photo, left to right, back row: Jan Ingram (Parish Nursing), Katie accomplished in a year that started off in the most challenging of ways. Gorndt (Surgery), Shelley Algeo (Education), Linda Reimer As a reminder, the NE committee works hard to create an inclusive (Patient Care Services) publication, and we appreciate each of you who have taken time to tell Front row: Jennifer Bower (Education), Shawn Hodges (Materials your story. We encourage those who have stories to tell, please share Management), Kristen Walker (Marketing), Amy them so they too can be represented in this amazing work of art. Enjoy VandenHeuvel (Orthopedics/ the journey. Oncology/SBCH) Sincerely, Not pictured: Herb Geary (Vice President, Patient Care Services and Chief Nursing Officer), Dan Thomas (CRH), Jennifer Wobig (Nursing Administration) Jennifer Bower, MSN, RN-BC Nursing Magnet Program Coordinator

5 MAGNET QUALITY CELEBRATION

Professional Pride — Magnet Quality Celebration

The 5th Annual Magnet Quality Celebration was hosted by Herb Geary along with the Magnet Steering and Magnet Component Committees. The event featured 36 posters filling Burtness with a stunning display of outcomes. As CH continues to be a Magnet inspired organization, while not formally seeking designation, we continue to benchmark ourselves against the Magnet standards. The 5 Magnet Component Committees continue to meet monthly to ensure alignment with the Magnet Sources of Evidence since the committee’s inception in 2012. The Magnet Quality Celebration is a time to honor and celebrate the hard work of the nursing staff, sharing results related to patient care, nursing satisfaction, quality, organizational and community outcomes. This year over 400 people attended the adventure-themed event. The event was well attended from 0700 through its end at 0100. Each year the theme reflects the location of the Annual National Magnet Conference, this year held in Denver, Colorado. Awards are given to winning posters voted on by celebration attendees. The awards were for I Never Knew “Wow,” Most Creative, Most Informative and Most Research Oriented. The Most Research Oriented award was chosen by the Nursing Research Consortium. AWARD WINNING POSTERS The winners received a trophy and presented Never Knew “Wow”: NICU, Karen Rose, Candice Leary, Katie Dudley: their poster topics at the October C3 event. Benefits of Delayed Cord Clamping for the Neonate (this poster also Congratulations to this year’s winners. had the most votes overall) All posters can be viewed on the Employee Portal > Education and Training > Magnet Quality Most Creative: Peds, PICU, Peds Endocrine Clinic, Vicki Lekas, CNS: Celebration. There’s No Sugar Coating it: Education for the Families of Newly Diagnosed Diabetic Patients “As the Magnet Program Coordinator, I would like to say a special thank you to Herb Geary, Magnet Most Informative: 1RT, Kyndra Alspaugh, Christy Balster, Morgan Noe, Steering, and the Magnet Component Committees Alma Patino: Managing the Behaviorally Challenged Patient with a for supporting this celebratory event. Also, thank Neurological Disorder you to those who worked so hard to create the posters that brought this event to life.” Most Research Oriented: QI, Carolyn Gstettenbauer, Elizabeth Taylor-Linzey, Laurie Biscaro, Misty Fetko, CH Cardiovascular Institute – Jennifer Bower Management Group: Un-breaking a Heart: Preventing Heart Failure Readmission 6 7 TRANSFORMATIONAL LEADERSHIP

Transformational Leadership Characteristics: “ Identifies and Visionary, Courageous, Strategic Planner, Influential, Empowering Co-Chairs: Herb Geary, Linda Bacon/Penny Morgan Overgaard communicates Members: Amy VandenHeuvel, Andrew Gajardo, Christine Block, Denise McDonald, mission, vision, and Elyse DeMar, Jenifer McClure, Jennifer Bower, Lorie Loomis, Marc Dailey, Sabine values, and asks for Keller Accomplishments: the involvement of 1. Conducted a CH CNC leadership gap analysis utilizing literature review to the workgroup to identify areas that new nurse leaders experience the most challenges. Created and disseminated a survey asking CNC’s to identify the leadership areas they find to achieve the vision.” be most challenging. Summarized results and presented findings to the Clinical Operations team. 2. Participated in the Magnet Quality Celebration “Where can you find Transformational Leadership at CH?” Ongoing: 1. Ongoing leadership succession planning.

TL Magnet Component Committee Photo, left to right: Sabine Keller, Elyse DeMar, Lorie Loomis, Christy Block, Penny Morgan Overgaard, Herb Geary, Amy VandenHeuvel, Jennifer Bower Not Pictured: Amy Johnson, Marc Dailey, Linda Bacon, Denise McDonald, Andrew Gajardo, Jenifier McClure

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Nurse Leader News “Positivity and change has led to Bobbie Evans, foundation for resuscitation science. As fantastic growth BSN, RN, CCRN part of this role, Christy is a member of Critical Care the CPR Committee. and development Nurse Educator in nursing. We have Bobbie’s Cynthia Manigault, BSN, RN learned to support experience Nurse Educator for Psychiatry and includes working in the SICU for Chemical one another.” 13 years and as a Clinical Resource Dependency - Luis Monroy, MacDougall Eye Center Nurse for the last 11 years. She has her Services CCRN and is in process of completing Cynthia began ... her MSN with a focus in Education. her nursing career She has served as a preceptor, given working at the presentations on TAVR and open heart, Psychiatric Institute of New York and Erica Ashley, RN along with providing complex neuro New York University. She moved to training for Critical Care staff. Clinical Manager California in 1982 and took a position of Surgical Of note, Bobbie assisted with at UCLA Health System working in Intensive Care coordination of cardiac re-sternotomy psychiatry with children, adolescents simulations and was a guest speaker at and adults. Cynthia came to Cottage in Erica started the CH 2017 Trauma Symposium. 2000 and has worked on the inpatient her nursing psychiatry unit (5 East) for the past 18 career in the Surgical Intensive Care years. Unit at SBCH as a new grad in 2010. Carol Prager, She quickly moved up the clinical RN, CRRN She volunteers at the Mental Wellness ladder and was promoted to CNC in Clinical Manager center co-teaching the Mental Health 2015. Erica is able to create rapport, for Villa Riviera Matters five-day program that is and excels in training, leading, and Carol has been offered to 6th and 9th grade students in motivating people. She is on many with CRH since Santa Barbara County Schools. committees, leads various task teams, June 2003. In that time she has served and is committed to excellence. Erica in the Admissions Coordinator role, Donna Janega, inspires others to do their best. relief charge nurse and relief Nursing MBA, BSN, RN Care Coordinator. Prior to coming Service Director Kim Berry, BSN, to CRH Carol worked in a variety of of Critical Care RN, COHN-S roles including Director of Nursing for Services Supervisor, Beverly La Cumbre Nursing Home. Donna completed Employee Health her MBA degree from Webster & Safety Christine Block, University in St. Louis, Missouri, and Kim has a BSN MSN, RN, her BSN degree from Marian College from California State University, Long CNRN, SCRN in Fond du Lac, Wisconsin. Beach. She worked in Med/Surg units AHA Training She worked in the nursing profession at Saddleback Memorial and Hoag Center in Denver, Colorado, for 25 years prior Hospital before finding her way to Coordinator to joining Cottage Health in 2009. SBCH in June 2015 working with the Following AHA guidelines, Christy has Donna accepted the position of Clinical Nursing Resource Unit. provided instruction on BLS, ACLS Manager of SICU, until June 2018 when she was promoted to Director of Kim believes that when families are and ACLS for Experienced Providers. healthier, they do better at work. Her prior experience as Critical Care Critical Care Services. Educator and Facilitator for Crisis Resource Management supports her 9 TRANSFORMATIONAL LEADERSHIP

Frances John DeDonatis, in the medical surgical unit, operating Elizabeth (Libby) BSN, RN room circulating RN, charge RN in Smith, DNP, RN, SBCH Relief the surgical department, Hospital C-EFM Nursing Supervisor and lastly Director of Director, Women’s Supervisor Perioperative Services. Services John began his Libby comes to Santa Barbara Cottage nursing career working for St. Joseph Katie Welch, Hospital from the University of Medical Center in Stockton, California, MSHA, BSN, RN Louisville Hospital, Kentucky. She and then transferred to Pacific Medical Cardiology has her Doctorate in Nursing Practice Center. He came to the SBCH Nursing Manager from Regis University in Denver, with Resource Unit in 2016, working at the Katie Welch her MSN and BSN from Cal State bedside and in the role of Sedation RN. worked in the Fullerton. Libby is no stranger to John attained his BSN from Dominican ICU for three California and has worked at several University in San Rafael, California. years at Henry Ford Hospital in Detroit hospitals here on the West Coast. John’s grandmother was influential while going to school for her Master’s Libby’s passion in nursing is doing on his choosing a career in nursing. in Health Services and Administration from University of Detroit Mercy the right thing for people. She is a During the school years John worked and U of M. She then moved to strong advocate for patient, staff and as her caregiver learning to provide Chicago and worked peripheral and providers to provide the best patient one on one care. John and his mother neurointerventional radiology (IR), experience and work environment. attended the same nursing school at cardiac cath lab and electrophysiology She enjoys working with disparate Dominican University and graduated for eight years. Her next adventure led groups to regain balance after change. together. Libby supports advanced education her to San Diego Scripps where she for nurses, believing that education managed similar specialty areas as well never stops. She is currently pursuing Katie Gorndt, as an imaging admissions unit. a second Master’s Degree in Health MSIHM, BSN, Katie has experience in Epic Services Administration. RN conversions which has been helpful in Director of her new role at SBCH. Ambulatory She is currently working on Glenda Adams, Surgical Services BSN, RN Comprehensive Stroke Certification Director of Katie Gorndt started her healthcare and Intersocietal Accreditation Surgery career in 1999 at the age of 20 as a Commission Echocardiography CNA in the Surgical Department Accreditation. Glenda Adams in her hometown of Great Falls, started her Montana, at Benefis Health System. career in nursing over 35 years ago Lauren Fink, BSN, RN, CNRN, SCRN There she advanced her career to Stroke in her home state of North Carolina. surgical technician. Katie continued Coordinator After spending a brief period of time on to obtain her ADN from Antelope Lauren joined as a clinical nurse she transferred to Valley College and her BSN from SBCH in 2010 as surgery. Gaining a wealth of knowledge Western Governors University. Later a new graduate specifically in the Ortho/Neuro service Katie attained her Masters of Science nurse on the line, she joined SBCH in 2012 as a in Integrated Healthcare Management CRN focusing on Neurological Surgery. Neurology/ (MSIHM) at Western Governors Urology unit where her passion for Glenda advanced to CNC of Surgery University. Katie spent time as a critical where her focus was on the day-to-day neuroscience began. In 2014 she care RN at Antelope Valley Hospital transferred to the SICU, advancing functioning of the operating rooms. before moving to the Central Coast. her knowledge and expertise of Glenda has always considered the OR Spending nearly seven years at Lompoc neuroscience nursing as well as earning her home. The teamwork and family Valley Medical center, she worked in a promotion to CRN. Over the past atmosphere is what keeps her devoted many positions such as clinical nurse eight years Lauren has been involved to the Surgery department.

10 with the stroke program as a unit nurse *Historical Note: 4N was a medical training and distribution of the new liaison and received two certifications: surgical unit serving a variety of Zoll Defibrillators throughout the Certified Neuroscience RN and Stroke diagnoses including cancer, infections, health system. Shelley played a vital Certified RN. (See stroke article on cardiovascular, GI bleeds, post op role in helping with the Simulation page 36.) patients and also had two four-bed Lab, various committees and special wards. Some patients were cared for by projects. the residents, but not all. Ellen Fenger Lisa Dugger, was the unit manager and eventually MSN, RN, CDE, Tammy Cain, RN she established the cardiac unit. Rickey BC-ADM, SBCH Farbman (later Anna Bissel) started ACNS-BC Administrative the oncology unit. Barb Stengel was the Diabetes Educator Nursing manager of the 4S orthopedic unit and Supervisor Lisa comes to 5S was managed by Sally Spence. CH with a wealth of knowledge and Tammy began significant experience in diabetes her nursing career in 1991 after education. Previously she worked at Rishelle Silva, receiving her ADN from the University Seton Family of Hospitals in Austin RN of Arkansas. She is currently enrolled and Cedars-Sinai Medical Center SBCH Relief in a BSN program through Aspen in LA. She is a Certified Diabetic Nursing University. Through the years, she has Educator, Clinical Nurse Specialist Supervisor had staff positions working in ICU and is Board Certified in Advanced Rishelle began step down unit, women’s health, high Diabetes Management. Lisa is currently her nursing career working for Kaweah risk OB, PICU, NICU, Pediatrics, High Risk Case Management, and as an evaluating our diabetes education Delta Health Care District in Visalia, Administrative Nursing Supervisor. process in collaboration with Dr. Mark California, transferring to SBCH in Wilson, our CH Endocrinologist. 2014. She attended College of the Tammy’s extensive experience both in Collectively they will make Sequoias, California, for her RN and is management and at the bedside gives recommendations to improve patient currently enrolled in the BSN program her the ability to see the dynamics of outcomes. at Western Governors University. the big picture, helping staff to live the core values of excellence, integrity and Her personal mission is to “improve Rishelle worked as a CNA and a nurse compassion in caring for our patients. the quality of life for people living intern prior to receiving her RN, with diabetes, and the healthcare they giving her a broad understanding of receive.” the importance of patient care and the Julie Hardin, value of education. BSN, RN, CRRN Educator Michele Murray, Julie transitioned BSN, RN, CNOR Shelley Algeo, into the Clinical Manager MSN, RN-BC Education of Surgery Director of Department as the Patient Family Education Michele Murray Educator. As part of her new role she is started her career Shelley started chair of the Patient/Family Education in nursing at Cottage Health over 21 at SBCH in Committee and coordinates childbirth years ago. She graduated with her ADN 1988. She has progressively advanced classes for the community. Prior to from Ventura College and later attained her education from ADN, to BSN, joining the Education Department, her BSN from Western Governors to MSN, and is certified in Nursing Julie worked at CRH, with a focus University. Michele spent a brief period Professional Development. Shelley on chart review, data collection, working on 4N* but after one year she has had multiple roles within the reimbursement, and staff education. transferred to the Operating Room. department; most notably she has been She is currently pursuing her MSN Advancing to CRN in 2002, Michelle the New Graduate Nurse Program through the University of Texas with focused on Neuro/Cardio as the Coordinator for 11 years. She was an emphasis in Nursing Education. services coordinator. She played a big the American Heart Association Julie’s past experience includes ICU/ part in implementing the iMRI rooms Training Center Coordinator and Telemetry and Mother/Infant Care, as the Hybrid coordinator. rolled out many projects over the as well as the Nursing Supervisor for years, most recently the system-wide Assisted Healthcare. 11 TRANSFORMATIONAL LEADERSHIP

Cottage Health tapping into RN Knowledge and Leadership Skills ALTERNATIVE ROLES SUPPORTING THE BEDSIDE NURSE

Injury Prevention Outreach Senior QI Specialist – Deborah Short Trauma Performance Improvement and Education Coordinator – Job title/purpose statement: Nurse Coordinator – Gena Topping Tammy McDevitt Supports and coordinates data Job title/purpose statement: Job title/purpose statement: collection Responsible for the overall planning, and reporting Provides coordination and facilitation development, and implementation to support of performance improvement data of the injury internal quality collection, prevention, monitoring and analysis, outreach and improvement trending and education initiatives and benchmarking programs. This public reporting. Actively participates of data and coordinator in identification of improvement outcomes. works to reduce opportunities, PI teams and report Collaborates the burden of injury and improve generation. with physicians, nurse practitioners, trauma care through injury prevention consultants and multidisciplinary “My role in Quality Improvement and public education as well as trauma team members to assure quality allows me to use my nursing continuing education to healthcare patient outcomes across the continuum background to support various providers. Promotes SBCH as a tertiary of care as well as collaborates closely multidisciplinary committees referral center by establishing and with Trauma Program leadership by providing data, identifying maintaining relationships with referring to assure compliance with trauma opportunities for improvement, creating agencies and community members standards and guidelines. performance improvement plans and throughout the region. ensuring we are following best practices “My position utilizes data analysis to “This position allows me to plan, for patient safety, reducing 30-day promote high standards of practice develop, and implement injury readmissions, orthopedic care and through the development of trauma prevention programs to reduce the cancer care.” policies, protocols and practice burden of injury to our patients and guidelines throughout the health the community, as well as continuing system. My nursing background education for the public and trauma allows for greater depth and vision healthcare providers through teaching when it comes to utilizing data for and coordinating ongoing trauma ... improvement monitoring and staff education. My extensive trauma care education that leads to the best experience and nursing background outcomes for ongoing development, allows for a deeper knowledge in “Our job as nurses growth and oversight of our patients…” overall standards of practice for quality trauma care. It also ensures an is to cushion the in-depth understanding of the impact sorrow and celebrate traumatic injury has on patients, families, and the community, thereby the joy, every day, enhancing the quality of strategic injury while we are just prevention and education programs.” doing our jobs.” - Christine Belle, RN, Author ...

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Cottage Health Nurse Mentor “Resilience is the ability to rebound and Leadership Students overcome difficulties Nurse Leaders mentored BSN and MSN Leadership students from a variety of schools while adapting and (including California State University Channel Islands) who participated in a number of learning from experience. projects and improvement initiatives. The mentor/mentee relationship is a core component Resilience develops of the BSN and MSN leadership class. These projects benefit the student, the mentor, and ultimately the patient. character when you value the professional role, MENTOR STUDENT PROJECT/OUTCOME Vicki McPhail, Mother Infant Julia Beccia Baby Friendly Ten Steps HealthStream maintain curiosity, do Educator, Women’s Services module for all new nurses hired to work in Women’s Services, and for NRU who inner work, and accept desire to cross train to Mother Infant Care personal limitations.” Shelley Algeo, Director Education Emily Bryant Preceptor program gap analysis - Elizabeth Ann Robinson Marsha Baselice, Cottage One/IT, Morgan Dalcerri CottageOne learning home dashboard (author of The Soul of the Nurse), EPIC Training Manager optimization Nursing Administration Marsha Baselice, Cottage One/IT, Ashley Rafael Engaging nurses for electronic health EPIC Training Manager record training ... Mari Mender, Behavioral Hilda Skvagerson Literature review for workplace violence Health Educator and the BEST program Steffanie Carty, Manager OR Keira Jacobs Enhancing communication and increasing efficiency in GVCH Surgical Services through the use of Vocera Maggie Wordell, Educator Amanda Garcia Evidence-based redesign and update of CRH competencies to meet the needs of today’s learner Christy Block, Critical Care Educator Danielle Rutz Symposium/conference planning Jackie Baker/Katie Loster, Jonathan Reynolds Revised “Ticket to Ride” to help meet Med-Surg Educators our goal of improving handoff communication Diane Barkas, Clinical Nurse Erin Serrano Clinical triggers for Palliative Care in Specialist/Critical Care Critical Care Ellie Melton, Palliative Care Angelica Benavides 144-hour clinical rotation for Frail and Program Manager Elderly Adult course Amy VandenHeuvel, Sharilyn Vasquez Acuity-Based Staffing Clinical Manager, Orthopedics and Oncology Chelsea Brown CLABSI Reduction Bundle Program Sue Fortier, Amanda Rogers Clinical Nurse Specialist Role Trauma Program Manager Performance I & II Danilyn McLaughlin, Kyndra Alspaugh Behaviorally Challenging Patients: Clinical Manager, Pulmonary A Change in Policy and Practice to Renal Infectious Disease Improve Outcomes Herb Geary, Chief Nursing Officer Laura Canfield Throughput Initiatives: Utilizing a Medical Surgical Overflow unit to increase throughput and improve patient outcomes Jackie Baker/Katie Loster, Molly Hawkins Observation of educator role Educators Med-Surg Lindsay Picotte, Educator Kim Jordan Nurse Educator Role Performance I & II

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HPI MENTORSHIP PROGRAM Health Professionals Institute (HPI) This year’s HPI cohorts were beneficiaries of a new HPI consists of a 15-course series of work-based skill training classes designed to enhance mentorship program facilitated by professional development and leadership over two years. Organizational Development and HPI looks to grow Cottage Health employees who meet the following criteria: Human Resources. Studies show •  Employed full-time at Cottage Health for a minimum of one year that new leaders benefit greatly •  Currently in a leadership role or growing into a leadership role from formal mentoring. • Demonstrates effective communication skills (verbal, written, and active listening) IN 2018… •  Able and willing to follow through on all assignments from beginning to end Nurses who joined HPI cohort: •  Excited and able to participate in 15 classes over a two-year period (classes are typically 8:30 Amber Fowler – GVCH am– 4:30 pm, Monday – Friday) Karen Cosio – CRH •  Able to complete assignments and view e-learning on Lynda.com •  Can apply new and/or reinforced learning between classes Kim Berry – Employee Health & Safety •  Demonstrates HPI learning in a final capstone presentation sharing impact of HPI in their job Noemi Macias – SICU HPI applications are due by January 15 each year. Speak to your manager if you are Tammy McDevitt – Trauma Services interested in the HPI program. Vicky McClain – NRU Wendy Gillespie – Endoscopy

Nurses who graduated from the HPI program: Andrew Gajardo – SICU Blake Henderson – SBCH ED Charlene DiGiulio – NRU Jorgene Gaunia – Telemetry Katie Loster – Education Meressa Parker – SICU Mimi Dent – Birth Center

Nurses current/alumni of HPI who expanded their role: Andrew Gajardo, CNC – SICU Amber Fowler, CNC – GVCH Erica Ashley, Manager – SICU Glenda Adams, Director – Surgery Jolee Farias, CNC – SBCH ED Kim Berry, Supervisor – Employee Health & Safety

20 Noemi Macias, CNC – SICU RNs in HPI program Promoted Attendees Sabine Keller, Manager – Behavioral 15 Health and Addiction Medicine Veli Nikolov, CRH Nursing Care 10 Coordinator

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0 2013 2014 2015 2016 2017 2018

14 Nurses current/alumni HPI who ‘led’ in a different way

COMPASS SUPERUSERS: Danilyn McLaughlin, Pulmonary, Renal, Infectious Disease Glenda Adams, Surgery Judy Corliss, Endoscopy

C3 PRESENTERS: Carola Pisani, Wound Care Karen Rose, NICU Kyndra Alspaugh, Neuro/Uro Morgan Cadena, Neuro/Uro

ADVANCED DEGREE: Blake Henderson, SBCH ED: MBA

Nurses who participated in HPI Mentoring Program

MENTORS: Angeli Mancuso Dan Thomas Danilyn McLaughlin Jenn Wobig Top photo, left to right: Vicki McPhail, Heather Harmon, Cindy Martienz, Heidi Steinhilber, Linda Bacon, Debbie Lorie Loomis Barnes, Dodi Gauthier Lynne Jessop Bottom photo, left to right: Mary Beth Del Mese, Sandra Jansen (retired), Sandra McGreevy, Roberta Bube, Serena Dorrance, Heather Harmon, Charity Lawton, Shawnelle Brophy Paula Gallucci Sarah Gray MENTEES: Celebrating Baby-Friendly Blake Henderson Hospital Designation Charlene DiGiulio Jorgene Gaunia The Baby-Friendly Hospital Initiative is a global program sponsored by the World Health Katie Loster Organization (WHO) and the United Nations Children’s Fund (UNICEF), created to recognize hospitals that offer an optimal level of support for breastfeeding mothers and their babies. This designation fulfills a longstanding SBCH Top Goal. SBCH is now one of only 511 Baby Friendly designated hospitals in the United States. The first and only other hospital in Santa Barbara County to have ever achieved this status is Goleta Valley Cottage Hospital. While having always offered compassionate and quality care for infants and mothers, the Birth Center now meets stringent requirements, including: • Implementing Ten Steps to Successful Breastfeeding with evidence-based practices to assist mothers and encourage breastfeeding. • Educating clinical staff on breastfeeding practices. • Promoting rooming in to allow mothers and infants to remain together 24 hours a day, and facilitating skin-to-skin care with parents and newborns. • Fostering support groups for continued breastfeeding support beyond the hospital stay. Congratulations to the SBCH Birth Center Baby Friendly task force led by Linda Bacon, Tina Collins, Jennifer Ferrick, Dodi Gauthier, Heather Harmon, Charity Lawton, Liz Lundquist, Vicki McPhail, and Heidi Steinhilber. 15 TRANSFORMATIONAL LEADERSHIP

Utilizing Transformational Leadership Planning for a patient move is a complex task that requires attention to detail and a visionary approach. Multiply this concept by five departments moving patients and two departments providing patient care, and it becomes a multidisciplinary task that spans over 33 months. Throughout the planning and move, Anne Whiteside, Dialysis RNs played an integral role in the “Change is always difficult, but with such great prep work and ample training, we felt less apprehensive and more enthusiastic. We savored the opportunity to clean out the process, providing feedback and closets and have a fresh start in a beautiful new unit!” expertise. Highlights:

5 Planning Committees, 72 Committee meetings supported by RNs

Stand and Deliver: August 28

Vendor Training: September 18 and 19

29 Day in the Life prep/follow-up sessions

Day in the Life #1: September 28

Day in the Life #2: October 12

Mock Move: October 17 Jared Grode, 2 Compton/Telemetry Jennifer Taylor, 1 Compton/Oncology 12 CDPH prep/survey sessions “Great teamwork and a very smooth “What an awesome team coming together transition to our new unit.” CDPH survey: October 22 – 24 and working as one.”

Soft opening of new ED: November 14

4 Patient Move sequence sessions

Dialysis department move: December 8

Patient Move: December 9 (60 patients in 3 hours)

16 Karen Rose, NICU Liz Lundquist, Children’s Services “I had confidence that patient safety was the number one priority. “It finally happened! All of Children’s Services on the same, At one point our team asked for a pause and it was quickly honored brand new floor! We are just thrilled to be here. without hesitation. Bravo to the entire team!” Thanks to all of our teams for making the move so successful!”

Ann Jenkins-Diebold, NICU Maria-Gabriella Salsbury, NICU “The best thing about the move for the NICU is the proximity of the NICU with Mother Infant and Birth Center. The parents no longer have to “The secret to change is to focus all of your energy, walk a distance to see their baby.” not on fighting the old but on building the new.” —Socrates

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Disaster Response

THOMAS FIRE:

STARTED: December 4, 2017 at 6:28 p.m. FULLY CONTAINED: January 12, 2018

ACRES BURNED: 281,893 (or 440 square miles)

LARGEST WILDFIRE TO DATE IN CALIFORNIA HISTORY

Santa Ana and Sundowner winds major contributor (60+ mph winds, extremely low humidity)

Traveled 42 miles north 42 to Santa Barbara County

1,063 structures destroyed

8,500 Firefighters

18 MONTECITO DEBRIS FLOW:

STARTED: January 9, 2018

Heavy rain caused rapid erosion of Thomas Fire burn scar, causing catastrophic mud and debris flow of soil, downed trees, and boulders down Montecito and San Ysidro Creeks

inches of rain fell 0.54 in 5 minutes

129 residences destroyed

FATALITIES 23

28 patients seen in ED / Trauma Center at GVCH and SBCH

Cottage Health Incident Command Center opened at 6:15 am by Steve Fellows, Executive VP & COO

nights of overnight housing arranged + for employees at 900 local hotels & GVCH

19 TRANSFORMATIONAL LEADERSHIP

20 ...

Katherine Reece - A Nurse’s Reflection “The amount Following the devastating Thomas Fire, the first week of January had been tension- of support filled for our community. Staff had been overwhelmed by evacuation warnings over Cottage Health the last month, and many developed what we now call “evacuation fatigue.” The night gives to nursing staff crew in the SBCH ED on January 8 consisted of six nurses and three ED techs. This team was led by an experienced charge nurse, Shelley Sanchez. When Shelley got on a regular basis word there had been an explosion with injuries, she immediately notified the ED is impressive.” MD and Nursing Supervisor, and rallied the ED staff while reaching out for off-duty - Danielle Hammack, reinforcement. The ED Medical Director, Dr. Brett Wilson, and ED Director, Denise MacDougall Eye Center McDonald, were also notified. A CAMS alert was sent out and a disaster code was called. At this point CH employees from across the organization became engaged in ... the collective effort to care for our community. I was one of the off-duty RNs responding that morning. When I arrived, patients were covered in mud in different stages of drying, making it difficult to see the extent of their injuries. Debris Flow– Horrific information came in as the morning progressed. The team was made aware Staffing on of a 20 foot high debris flow traveling at 40 mph from the mountains to the ocean, Another Level destroying everything in its track. Following the January 9 debris flow Dr. Brett Wilson and Denise McDonald arrived shortly after being notified. Dr. critical staffing of the hospitals Wilson’s guidance and composure were invaluable, as he had firsthand knowledge became an added challenge due to of how and what to do during a disaster, after surviving Hurricane Katrina. Denise the closure of the 101 Freeway. Nurse and Dr. Wilson worked together with the command center to ensure the ED had the Managers across the system accessed resources needed. The ED had drilled and practiced disaster training in the past, which the Cottage “travel service” designed provided the foundation to ensure timely and diligent care for our community. by Organizational Development to In addition to the patients arriving from the debris flow, the ED had a number of request transportation and lodging other patients awaiting care. Challenges encountered included: competing priorities, accommodations for staff living on multiple simultaneous conversations, need to coordinate staffing/assignments/breaks, the other side of the freeway closure. and managing supplies and equipment. Everyone knew their roles and did them The managers organized pick up without question or complaint. and drop off times, continuously As the morning continued to unfold, the command center dispatched Spiritual Care analyzed staffing needs, available and Psychiatric teams along with hospital Psychologists to help family members. personnel, and lodging needs based They were also checking in with the staff, most of whom had never dealt with this on employee’s physical address so kind of devastation. For their own physical and mental wellbeing, staff had to be “reservations” could be entered into encouraged to take breaks or even leave the hospital to go home and rest. The team the various spreadsheets used for was determined to be there until the crisis was over. tracking. The massive system-wide For me, it was one of the most powerful and moving experiences to see everyone effort displayed strategic planning working together, not just the ED staff, but all of the hospital coming together for these and collaboration between Nursing, patients. There was so much support it was overwhelming—in a good way. Facilities, Security, Hospitality, Human Resources and the During the ED staff debriefing, one thing was repeated by all who worked that day: we Organizational Development teams. either broke down in tears on our way home and/or when we got home, hugging our Systems were created for travel and loved ones and holding them close. Many of us still have a hard time talking about it lodging in coordination with local without breaking into tears. emergency management personnel, Employees needing/wanting to speak with a trained professional can access Employee hotels and Goleta Valley Cottage Assistance Program (EAP) for free support. Hospital.

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Structural Empowerment

Characteristics: Life-Long Learner/Teacher, Professionally Engaged, Commitment to Community, Nurse Role Model “The conditions Co-Chairs: Carol Henderson Nelson/Shelley Algeo, Caroline Rosen under which care is Members: Tia Caldwell, Daniel DeAlba, Diane Barkas, Gina Randall, Jennifer Bower, Judy Corliss, Mari Mender, Paula Gallucci, Ramona Pursel, Rhonda Bernstein, Selveda provided, including Ertas, Shawn Hodges, HR Liaison Henry Ventura material resources, Accomplishments: 1. Reviewed and updated portal references for specialty nursing certification. human resources, 2. Hosted the Nursing Back to School Day—a gathering of various nursing and organizational undergraduate and graduate schools from across the country, including online programs. characteristics that 3. Promoted the celebration of certified nurses during certified RN day March 19. allows nurses the This included a celebratory photo that was placed in local newspapers (photo taken at each campus), distributed green ribbons and created a list of suggestions for capacity to mobilize managers to create fun events on their units. people and resources 4. Established new goals around mentorship/coaching program, experienced nurse clinical pathways, and improving nurses’ involvement in professional specialty to get things done.” organizations. 5. Participated in the Magnet Quality Celebration with the poster “Give me an E-M-P-O-W-E-R-M-E-N-T.” Ongoing: 1. Establishing a clinical pathway for experienced RNs. 2. Certification policy review and update. 3. Professional Nursing Organizations Promotional Video staring CH Nurses.

Magnet Component Committee Photo, left to right: Caroline Rosen, Diane Barkas, Gina Randall, Shawn Hodges, Shelley Algeo, Jennifer ... Bower, Daniel DeAlba, Selveda Ertas Not pictured: Tia Caldwell, Judy Corliss, Mari Mender, Paula Gallucci, Ramona Pursel, Rhonda Bernstein, “Live life when you Henry Ventura have it. Life is a splendid gift—there is nothing small about it.” - Florence Nightingale ...

22 CH Specialty Nursing Certifications Acute Care Transition Nurse Program 130 Cottage welcomed seven Acute Care New Certifications 120 Transition Nurses to Cottage Health in Recertification 110 2018—the fourth consecutive year of the program. Since 2015 Cottage Health 100 has welcomed 32 Acute Care Transition 90 Nurses to various departments and hospitals including Santa Barbara Cottage 80 Hospital, Goleta Valley Cottage Hospital 70 and Cottage Rehabilitation Hospital. This 60 year’s participants joined the following departments: GVCH-ED, Telemetry, Surgical- 50 Trauma, Oncology, NRU and CRH. 40 The team celebrated with a Nursing Poster, 30 “ACT Now: Implementation of an Acute Care Transition Nurse Training Program,” 20 at the 2018 Magnet Celebration. The poster 10 has also been presented by Lindsay Picotte at 0 the 2019 Association of Nursing Professional 2010 2011 2012 2013 2014 2015 2016 2017 2018 Development (ANPD) national conference.

CH Loan Program for Nursing Degrees

35 BSN 30 MSN 25 Photo: Front row, left to right: Shannon Paxton (NRU), Melody Mata (NRU), Sandra Jaramillo (CRH) 20 Back row: Elizabeth Densmore (GVCH-ED), Amy Benesh 15 (Telemetry), Elaine Henderson (Surg/Trauma), Yolanda 10 Martinez (Oncology) 5 0 2012 2013 2014 2015 2016 2017 2018

Data reflects employees who have utilized the Cottage Heathcare Education Loan

The “ACT Now: Implementation of an Acute Care Transition Nurse Training Program” poster highlights the innovative program and nurse retention.

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New Certifications, Degrees and Promotions*

Nursing, like health care in general, has become increasingly complex. The knowledge-intensive requirements of modern nursing require extensive education, as well as a strong personal commitment to excellence. Board certification of nursing plays an increasingly important role in the assurance of high standards of patient care.

NEW DEGREES PROMOTIONS Cece Jackson [SBCH SICU] Gail Yoney [SBCH SICU] BACHELORS OF SCIENCE IN CLINICAL NURSE Brandon Mack [SBCH SICU] NURSING [BSN] COORDINATOR [CNC] Alma Lee [SBCH Surgery] Jolee Farias [SBCH ED] Lia Hebert [SBCH Birth Center] Tamara Teitelbaum [SBCH Transfer Andrew Gajardo [SBCH SICU] Sofia Segerstrom [CRH] Center] Lorin Blaver [SBCH SICU] Lorenzo Vasquez [SBCH 3WC] Corinne (Cori) Stritzel [SBCH 3WC] Noemi Macias [SBCH SICU] Taryn Miller [SBCH EDHU] Kim Kekoanui Blair [SBCH Psychiatry Deanna Meyers [SBCH PPSU] Luis Monroy [SBCH Eye Center] and Addiction Medicine] Amanda Rogers [SBCH MICU] Bianca Bell [OPS] Tami Perez [SBCH NRU] Robert Kerr [SBCH MICU] Juliet Maroni [SBCH PPSU] Celina Hunt [CRH] Raquel Tinio [SBCH Surgery] Ana Landeros [GVCH Surgery] Anne Belot [SBCH MICU] Amber Fowler [GVCH ED] Cori Ramirez [GVCH Surgery] Victoria Brown [SBCH 3RT] Christine Pimentel [SYVCH ED] Michael Coombs [GVCH ED] Christina Valdivia [SBCH 3RT] MANAGEMENT/LEADERSHIP Susan San Marco [SWOT] CLINICAL RESOURCE NURSE [CRN] Shelley Algeo – Gayle Mercado [SYVCH M/S] Amber Veazey [SBCH MIC] SBCH, Director, Education MASTER OF SCIENCE IN Heather Harmon [SBCH Lactation] Donna Janega – NURSING [MSN] Sharon Partee [SBCH Pediatrics] SBCH, Service Director, Kyndra Alspaugh [SBCH 1RT] Critical Care Services Gen King [SBCH ED] Kimberly Jordan [SBCH NRU] Erica Ashley – Kelly Ferguson [SBCH ED] Patti Wicklund [Education] SBCH, Clinical Manager, SICU Melanie Kramer [SBCH MICU] Glenda Adams – DOCTOR OF PHILOSOPHY IN Kim Runhaar [SBCH MICU] SBCH, Director, Surgery NURSING [Ph.D.] Caroline Karakashian [SBCH MICU] Roya Nassirpour – Penny Morgan Overgaard [Grotenhuis Catherine Uhl [SBCH MICU] SBCH, Director, Clinical Quality Pediatric Clinic] Kathleen Meza [SBCH MICU] Sandi Marotto – Lisa Berrett [SBCH MICU] SBCH, Manager, PACU Rebecca Love [SBCH MICU] Michelle Murray – SBCH, Manager, Surgery Amanda Rogers [SBCH MICU] Carol Prager – Amber Veazey [SBCH MICU] SBCH, Manager, Villa Riviera Kimberly Jordan [SBCH NRU] Tammy Cain – Tami Perez [SBCH NRU] SBCH, Nursing Supervisor Nicole De Oliveira [SBCH Psychiatry John DeDonatis – and Addiction Medicine] SBCH, Day Relief Nursing Supervisor Kerry O’Rourke [SBCH Psychiatry and Rishelle Silva – Addiction Medicine] SBCH, Night Relief Nursing Supervisor Clayton Davidson [SBCH SICU] 24 The Sky’s the Limit! Cynthia Manigault – INPATIENT OBSTETRICS NURSE PROFESSIONAL NURSING SBCH, Educator, Psychiatry and [RNC-OB] CERTIFICATION Addiction Medicine Rebecca Licha [SBCH Birth Center] Goal: Increase number of Bobbie Evans – SBCH, Educator Lia Hebert [SBCH Birth Center] specialty nursing certification Julie Hardin – SBCH, Educator Caitlin Natale [SBCH Birth Center] to 50% of eligible staff in each department Lauren Fink – Chelsea Grattan [SBCH Birth Center] SBCH, Stroke Coordinator Nicole Dennis [SBCH Birth Center] Stephanie Guzman – Edelweiss Borras [SBCH Birth Center] SBCH, Access Case Manager Meredith Wroblewski [SBCH Birth Barbara Bliss – Center] SBCH, Quality Assurance RN-ED Celebrating Hannah Ferrer [SBCH Birth Center] Suzanne Edick – Certified Nurses SBCH, Quality Assurance RN-ED INTERNATIONAL BOARD Cottage Health is proud to recognize Velislava Nikolov – CERTIFIED LACTATION and honor certified RNs at SBCH, CRH, Nursing Care Coordinator CONSULTANT [IBCLC] GVCH and SYVCH. Nursing Xochitl Ortiz – Maria Gabriella Salsbury certifications play an increasingly Employee Health & Safety [SBCH NICU] important role in the assurance of Hannah Tegan – high standards of care for Cottage MATERNAL NEWBORN Health patients and their loved ones. Beacon/ClinDoc/Stroke Lead NURSING CERTIFICATION Cottage nurses hold over 415 Board [RNC-MNN] Certifications. NEW CERTIFICATIONS Edelweiss Borras [SBCH MIU] Hannah Ferrer [SBCH MIC] BOARD CERTIFIED EMERGENCY NURSE [BCEN] Meredith Wroblewski [SBCH MIC] Vincent Russo [GVCH ED] NEONATAL INTENSIVE CARE Penelope Odom [GVCH ED] NURSING [RNC-NIC] Elizabeth Mutus [SBCH NICU CERTIFIED MEDICAL SURGICAL REGISTERED NURSE [CMSRN] ONCOLOGY CERTIFIED NURSE Conef Bardinas [SBCH 3WC] [OCN] Lorenzo Vasquez [SBCH 3WC] Christy Calder Baeza [SBCH 1C] Ember Bartch [SBCH NRU] Stephanie Askins [SBCH 1C] John DeDonatis [SBCH NRU] PROGRESSIVE CARE CERTIFIED Jenny Ashby [SBCH 1RT] NURSE [PCCN] Carina Celio [SBCH 1RT] Katherine Gray [SBCH 2C] Veronica Rios [SBCH 1RT] STROKE CERTIFIED Jessica Scott [SBCH 1RT] REGISTERED NURSE [SCRN] Katie Lopez [SBCH 2C] Chelsea Brooks [SBCH 1RT] Christina Valdivia [SBCH 3RT] Martha Montanez [SBCH 1RT] Cari Voth [SBCH 3RT] Jessica Scott [SBCH 1RT] Amie Fowler [GVCH ED]

CRITICAL CARE REGISTERED *New degrees, promotions and NURSE [CCRN] certifications include those submitted Melissa Aldecoa [SBCH MICU] to the Nursing Excellence Publication Heather Johnson [SBCH MICU] Committee.

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Awards RECOGNITION OF NURSING EXCELLENCE IN THEIR SPECIALTY.

Santa Ynez Valley Cottage Hospital (SYVCH) is “Stroke Ready” Through the launch of its Tele-Stroke program, SYVCH provides remote neurological evaluations to patients who arrive at the Emergency Department with stroke or neurological symptoms. The Joint Commission and Santa Barbara County Emergency Medical Services certified the hospital as a “Stroke Ready” facility. This official designation allows patients who are at risk of stroke to begin Photo: NRAW honorees, presenters and special guests receiving treatment immediately at SYVCH. Cottage Rehabilitation Emergency Department RNs participated in Hospital Awards Team stroke specific education Member of the Year and training to meet Photo: Janis Hutchison, SYVCH ED the requirements set Each year CRH celebrates National forth by this designation. Rehabilitation Awareness Week (NRAW) by These RNs are instrumental in ensuring timely patient handoff, neurological paying tribute to the medical rehabilitation evaluation and execution of key interventions. In specific instances, stroke process and the team by honoring individuals patients can receive tPA within the vital 45-minute window to reduce brain in several different categories through a variety damage. Prior to initiating this program, all patients with stroke symptoms of events. Many awards are given, including were sent to Santa Barbara Cottage Hospital for diagnosis, resulting in a delay the “Team Member of the Year” and “Service in treatment. of the Year.” The award for “Team Member of the Year” was given to Erin Nordholm at the “With the Tele-Stroke program and Stroke Ready certification, Santa Ynez annual awards ceremony held at CRH. Erin Valley Cottage Hospital is saving lives and improving outcomes for patients received the award based on team member suffering from a stroke,” said Wende Cappetta, Vice President of Santa Ynez votes for excellence in her role as CNC and Valley Cottage Hospital. her daily support for the entire CRH team. “Service of the Year” was awarded to the Research Award Ridley-Tree Center for Wound Management Judy Corliss was the recipient of the Society of Gastroenterology Nurses team. Other events during the week included and Associates (SGNA) Nurse Fellowship program GNJ Novice Writers’ a movie night and Empowerment Series. This Award. Her article “Effect of Low-Volume Split– year’s Empowerment Series was held at the Dose Purgative on the Quality of Bowel Prep for Lobero Theatre and Colonoscopy on the Hospitalized Patient” was featured a special acknowledged from the podium at the 45th Annual presentation of Conference in Orlando. “Storm Reading,” a theatrical In her 41 years of nursing, Judy, a lifelong learner, representation of life uses the opportunities that come her way to grow with disability. and influence and inspire others. As the recipient of Photo: Erin Nordholm this Nursing Fellowship, Judy expressed that at first “it was a foreign word; now I’m recognized in our organization as the Nurse Fellow.” Photo: Judy Corliss 26 Gastroenterology Award New Graduates

Santa Barbara Cottage Hospital received the In 2018 Cottage Health welcomed 42 New Graduate Nurses. The New 2018 Excellence in Professionalism Award Graduate Nurses were hired into various departments of Santa Barbara Cottage from the American Board of Certification for Hospital, Goleta Valley Cottage Hospital and Cottage Rehabilitation Hospital. Gastroenterology Nurses (ABCGN). Units included MICU, SICU, Telemetry, Neurology/Urology, Oncology,

Photo, left to right: Accepting the award on behalf of Surgical Trauma, Pulmonary/Renal/Infectious Disease, Psychiatry, Emergency, the unit are Jennifer McDonnell, Josefina Cardiel (GI Surgical Services and NICU. Cottage Health supports and facilitates their Tech), and Alma Espinoza (GI Tech). transition into practice by offering the New Graduate Nurses the opportunity to build relationships and learn in a safe and fun environment. These nurses bring smiles, joy and compassion to their departments and patients, and they are excited about starting their nursing journey at Cottage Health.

Photo, left to right: Linda Akutagawa, Kim Lemon, Laura Rodriguez, Judy Corliss (Clinical Manager), and Andrea Powditch. Not present are Sally Jordan and Debra Lee.

SPRING NEW GRADUATE NURSE PROGRAM Front row, left to right: Katherine Jimenez (Neuro/Uro), Nicole Ridgell (Psych), Erika Loya (Neuro/ Uro), Chelsea Perahia (PRID), Karina Meza (Surg/Trauma), Kelhia Castillo (PRID), Sarah Ruiz (Surg/ Trauma). Back row, left to right: Yuritzi Gonzalez Villicana (PRID), Amber Altavilla (PRID), Madison Carter (Oncology), Nicole Paden (Neuro/Uro), Stacey Gannon (MICU), Ariana Ornelas (Telemetry), William “Billy” Spencer (MICU), Shanna Jowers (Oncology), Erica Guzman (Telemetry), Leyla Abass Ali (SBCH-ED), Rozelle Nebran (CRH), Yosemite Olivo (CRH).

FALL NEW GRADUATE NURSE PROGRAM Front row, left to right: Oscar Corona (SICU), Jennifer Wang (PRID), Ruby Miranda (Surg/Trauma), Kimberly “Kimmy” Domingos (PRID), Alisha Kiner (PRID), Hollie-Ann McKiel (SICU), Brandie Harris NICU NEW GRADS (SBCH-ED), David Scott (Telemetry). Brigette Kiesewetter and Sabrina Livne- Back row, left to right: Brigette Kiesewetter (NICU), Andrianne Crawford (CRH), Mayra Vazquez- Kennedy (NICU) work with Newborn Hal Ortega (PRID), Jasmine Montes De Oca (SBCH-ED), Sarintha Bell (SICU), Ashley Contreras (Neuro/ Manikin during clinical practice sessions. Uro), Danielle Rutz (CRH), Jenna Escobedo (CRH), Anna Troung (Telemetry), Lisa Nordella (SBCH-ED), Emily Bryant (SICU), Kira Fernandez (Neuro/Uro), Jessica Ostrowski (GVCH-ED), Sabrina Livne-Kennedy (NICU), Elizabeth Jordan (OR). 27 STRUCTURAL EMPOWERMENT

Community Events and Health Fairs

CH nurses extend their expertise and passion for helping others out into the community. Aligning with our professional practice model, nurses are committed to wellness and prevention in the community. CH nurses help to organize, promote and staff local health fairs that fill health and health education needs in our community to make a lasting impact on community wellness.

Striving for a Summer on Catalina Island Healthier Community – Paralee Schmechel participated in the Catalina Community Flu Clinics Island Summer Camp program. Two nurses and one doctor Parish Nursing provided over 750 are available to flu vaccines free of charge to our assist children vulnerable community members, with management including: of medication • Garden Court senior housing and basic needs. These healthcare • St. Vincent’s –Villa Caridad senior providers also housing triage medical and • Presidio Springs senior housing trauma needs. • Pilgrim Terrace senior housing Top Photo: Paralee Schmechel with • Villa Santa Fe senior housing camper • Casa Serena residential treatment Bottom Photo: Boo, center Therapy Dog • PathPoint behavioral health program • PATH Santa Barbara • Transition House • Westside Health Collaborative Food Bank Cottage Concussion Clinic Rebecca Pifer and Penny Morgan Overgaard • Isla Vista and Carpentaria Food oversee the Cottage Concussion Program, Banks which provides a community education • Homeless outreach at Pershing program and an individualized approach to and Alameda parks patients who have experienced a concussion. • Catholic Charities Evaluation, diagnosis, Top photo: Sharon Head • St. Joseph’s Church management and Middle photo: Cathy • Our Lady of Guadalupe Parish monitoring of Mollkoy at the St. Vincent’s flu clinic • Trinity Lutheran Church progress allows athletes to safely Bottom left photo: Sandy • Trinity Episcopal Church Gullet at PathPoint return to school and • First Presbyterian Church Bottom right photo: sports. This grant- Claudia Wood at PathPoint • Goleta Presbyterian Church funded clinic is provided throughout the Tri-County area. • Senior Expo

28 Cottage Center for Orthopedics – Arthritis Walk Cottage Center for Orthopedics sponsored a booth at the Arthritis Walk. Two hundred Aware and Prepare – walkers Fiesta First Aid Photo: HOPE image created by artist participated During Fiesta, Elly Walters-Bible Bridget Hochman, this year’s featured artist in the event led a team of volunteers from Our and support Lady of Guadalupe Church in Commitment was received providing a First Aid booth for over to Community by many a thousand people who attended Involvement – Mental more. Karin this popular annual event. de Witte and Amy VandenHeuvel Health Arts Festival managed the booth, providing The 24th Annual Mental Health community education on Arts Festival was held in De optimizing health for total joint Senior Health and La Guerra Plaza in July. Darcy replacement surgery and other Wellness Keep, Administrative Director of related orthopedic topics. The Senior Wellness Lunch Psychiatry & Addiction Medicine and Learn was a three-hour at Santa Barbara Cottage Hospital, educational offering for 44 has been the chairperson for this attending local seniors. There were event for many years and she Parish Nurse presentations by multiple health organized and sponsored the event Supports “Every professionals on topics of senior again this year. Woman Counts” health, wellness, and safety with a The Mental Health Arts Festival focus on fall prevention. Elly Walters-Bible led a team of is a much anticipated event by volunteers at the “Every Woman artists living with mental illness Counts” event at St. Joseph’s in the Santa Barbara community. Church in Carpinteria. This state- The event features the talent of funded wellness program provides approximately 70 local artists. many services including free breast The festival showcases paintings, and cervical cancer screenings drawings, sculpture, jewelry, and follow-up services for eligible Photo: Gena Topping speaks to seniors poetry, arts and crafts and much woman. attending event more. Educational materials on Photo: Elly Walters-Bible, Romi Alavardo mental illness, treatment options, (collaborator) and Patty Robles-Morris and community resources are (volunteer) available with staff to answer questions. Photo: Featured artist Bridget Hochman Photo: attendees doing exercises for strength and balance Photo: event snapshot

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Trauma Services

Stop the Bleed Every 15 Minutes Program In recognition of National Stop the Bleed Day, Trauma “Every 15 Minutes” is a two-day program for high school Services held a community training event at Paseo Nuevo juniors and seniors. The content challenges them to think mall to teach community members how to recognize life- about the consequences threatening bleeding. Uncontrolled bleeding is the number of drinking and driving one cause of preventable death from trauma. The aim of and personal safety, along the project is to provide training for the community to with the responsibility of obtain valuable skills and save lives in emergency situations. making mature decisions. Attendees learned how to control bleeding through direct Participants reflect on the pressure, wound packing, and use of a tourniquet. impact their decisions have Photo, left to right: Rohit Sharma, MD, Tammy McDevitt, Gena Topping, on family, friends, loved Sue Fortier, and Melessa Dillingham (Trauma Registrar) ones, and many others. A broad coalition of local agencies participates in the goal of reducing alcohol- Photo: Staged crash scene as DP High School students watch the related incidents among event. our youth. Trauma Services coordinates in the filming of hospital scenes at GVCH and provides all makeup and moulage for the program.

Photo, left to right: Chelsea Schmid, Sue Fortier, Gena Topping, two moulaged Dos Pueblos High School students, Tammy McDevitt, two moulaged Dos Pueblos High School students, and Christy Philip pose before the start of the event. Top photo: Stop the Bleed location Photo at right: Ashten O’Malley and Tammy McDevitt at training table

30 Supporting Safety in Children Trauma Services, as the lead department agency for Safe Kids Santa Barbara County, provided numerous helmet distributions this year in Santa Barbara County at no or low cost to families in need. Helmet distributions provide children and adults with proper helmet fitting instructions while encouraging riders to wear helmets properly every time they ride, thereby reducing risk of head injuries. Distributions included a Touch a Truck Event, Carpinteria Children’s Project, victims 1 of Thomas Fire, Franklin School, and SYVCH Health Fair. Photo 1: Jessica Aten fitting a child’s helmet at Franklin Neighborhood Center

A Day Dedicated to Safety Cottage Trauma Services hosted their first ever Safe Kids Day. Many Cottage Departments along with 13 other local organizations participated in providing education, awareness, and safety tips to kids and families to support the mission of keeping all children safe from preventable injuries. At this event: • Many risk areas were addressed 2 3 • 61 car seats were inspected • 45 helmets were distributed • Approximately 300 individuals were in attendance

Photo 2: Sharon Partee assists a family with their car seat Photo 3: A participant tries out the concussion simulation goggles Photo 4: Gena Topping and daughter, Adelyn, after being fitted properly for a new helmet 4 5 Photo 5, left to right: Sue Fortier, Tammy McDevitt, Diana Martinez, Jessica Aten, Melessa Dillingham, and Gena Topping

Safe Cars Save Lives Trauma Services, in conjunction with other community partners, organized a car safety event for families at Franklin Neighborhood Center. Trauma Services provided drive-up car seat inspection, proper installation of car seats, demonstrations to ensure safety when backing up, and a thermometer display to show dangerous temperatures in cars. Utilizing the Graco Car Seat Grant, 66 new car seats were given away at no cost to families in need. In the United States, up to 80% of car seats are installed incorrectly. By providing new seats, installation assistance, and education to families, Trauma Services helps to decrease preventable injuries. 6 Photo 6, left to right: Jessica Aten, Tammy McDevitt, Gena Topping, Christy Philip, 7 Diana Martinez Photo 7: New Graco replacement car seats were given away and installed for families in need

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Parish Nursing The Parish Nursing Community Outreach Program provides nursing service free of charge to those most in need in our community. They work with seniors in five senior housing complexes, five churches, three homeless shelters, two food banks, Catholic Charities, and with PathPoint Behavioral Health program clients. The focus this year for the Magnet Quality Celebration poster highlighted the seniors that they serve.

SENIOR OUTREACH PILGRIM TERRACE Cathy Mollkoy providing blood pressure Jan Ingram provides blood pressure checks and free flu shots to seniors at screenings and individual health coaching Garden Court. with seniors monthly at Pilgrim Terrace senior housing community.

...

“As parish nurses HANDWASHING FOR INFECTION we are blessed to CONTROL support families and Sharon Head provided a health education and disease prevention program at First individuals with Presbyterian Church. Her presentation included proper handwashing to prevent concerns from the the spread of infection during the flu cradle to the grave. season. With just over 40 percent of people demonstrating effective technique before Love is the language training, the Cottage light box was used to show how well they performed this crucial that everyone step in preventing infection. understands.” - Elly Walters-Bible, Parish Nursing ...

VILLA SANTA FE Jan Ingram teaches fall prevention and “Strength and Balance” classes to seniors 2-3 times a month at the Housing Authority’s Villa Santa Fe community room.

32 Health Fairs

Senior Fair The 30th annual Senior Expo at Earl Warren Showgrounds was a success with more than 1,000 seniors in attendance. Cottage Nurses provided flu vaccines, Photo top row, left to right: Dana Espina, Russ Chaffin, Kim Kekoanui Blair, Nicole DeOliveira, stress management education, fall Darcy Keep, Sabine Keller, Cynthia Manigault prevention and caregiver support. Front kneeling, left to right: Leesbeth Lagendyk, Top photo: Jan Ingram with attendee Kerry O’Rourke 36th Annual Santa Ynez Valley Cottage Mental Health Fair Hospital Free Health The 13th annual Mental Health Fair Fair was held in Burtness Auditorium, as a collaborative project with the Shared Over a thousand community Governance Council on Psychiatry members from the Central Coast & Addiction Medicine (5 East) attended the Health Fair at the with various community agencies. Santa Ynez Valley Marriot Hotel Represented at the fair were over 20 in Buellton. The Health Fair different agencies that provide services featured 40 exhibitors and display to those living with mental illness. booths. Over 300 free flu vaccines were administered by SYVCH RNs. Additionally, 112 free total cholesterol and glucose finger stick screenings were provided. Hands only CPR was taught by CH Basic Life Support instructors and the SBCH Trauma Services team fitted 35 safety helmets for children and adults for a reduced rate. Photo: Gena Topping and Tammy McDevitt with SYVCH Auxillary

... Photo: Endoscopy team Colon Cancer Awareness “Sometimes During Colon Cancer Awareness I inspire my patients, month the Endoscopy team took the most often they opportunity to work with Marketing to send out postcards containing inspire me.” screening information and resources to - Unknown community members. ...

33 STRUCTURAL EMPOWERMENT

On-Site & Off-Site Presentations Nurse-Physician Annual Collaborative Practice Luncheon Cottage Health nurses are committed to professional development The Santa Barbara County Chapter of the American as demonstrated by exceptional participation in off-site and on-site Association of Critical Care Nurses sponsored its classes. They collaborate to enhance the patient care experience 27th Nurse-Physician Annual Collaborative Practice while elevating their knowledge and confidence. Luncheon. David Linzey spoke on “HERT” or Hospital Emergency Response Teams and Dr. Rohit Sharma did Association of Nursing Professional a case study and spoke on “Stop the Bleed.” The topics were fascinating and timely. After their presentation, a Development (ANDP) National Conference team of instructors from the Emergency Department, Poster Presentation including our two speakers, signed off the participants In July, Jen Bower presented in “Stop the Bleed.” Attendees learned how to apply her poster titled “Research tourniquets and pack deep wounds in emergent out- and the Clinical Nurse: of-the-hospital situations to stop the bleeding and save You’ve got Questions? lives. Research has Answers!” at the national ANPD conference in Orlando. The poster focused on Jen’s work to create a program that supports the clinical nurse in conducting nursing research. The poster was also the culmination to her fellowship program conducted through the ANPD association. Jen stated, “It felt great to have the opportunity to share the successes of my yearlong fellowship with my education peers from across the country at our national convention.” Photo, left to right: SBCC AACN Board and Speakers: Rhonda Alvarado, Rohit Sharma, MD, Vicky McClain, Sharon Morley, Janet O’Connor and David Linzey Poster Presentation at Annual Bay Area Medical Surgical Nursing Conference Cherie Mignone attended and presented a poster session at the 28th Annual Bay Area Medical Surgical Nursing Conference in San Francisco, California. The poster titled “Our Founding Mothers” was inspired by the 125th anniversary of Santa Barbara Cottage Hospital. Cherie and Elizabeth Robinson’s poster outlined the history of the Cottage Founding Mothers, Photo, left to right: Stop the Bleed Instructors Tammy McDevitt, the founding mothers of Gena Topping and Sue Fortier the nursing profession, and Photo: Stop the Bleed participants a little personal history of what inspired them to go into the nursing profession. Previously they presented at Nursing Grand Rounds and C3. They believe everyone’s story matters and hope to inspire others.

34 Magnet Combined Committee Meeting Special Magnet Guests Upon returning from the ANCC National Magnet Maricarmen Luhrsen from Torrance Memorial and Rosalyn Conference in Denver, the five CH attendees hosted the Phan from Keck Hospital of USC, both Magnet Program Magnet Combined Committee meeting in Burtness. Directors, presented their Magnet Journey to the CH Magnet Members from each of the four Magnet Component Component Committees. Together they outlined the highs Committees were invited to share in the interactive learning and lows experienced as they led their respective hospitals to session. Herb Geary kicked off the agenda sharing CH updates a successful Magnet Designation. Attendees were able to ask and reflecting on the Magnet program accomplishments. questions and hear firsthand the experience of the process. Areas covered in the session included Happiness: The Highest Form of Health, Empowering Nursing with and Online Roadmap for EBP, 2019 Magnet Application updates, Reducing Unrecognized Clinical Deterioration: A Watcher Program, and finished with an Escape Room exercise.

35 STRUCTURAL EMPOWERMENT

Professional Nursing Grand Rounds Electronic Nurse role models share their knowledge and experience Poster resulting in collaboration, support and learning together. Making These Grand Rounds facilitated by the CH Clinical Nurse Workshop Specialists (CNS) covered a variety of patient care themes. In an effort to promote NURSING GRAND ROUNDS professionalism, Jen March 21 Bower organized a Bariatric Barriers class to support nurses Diane Grill, BSN, RN, CCRN, Allyson Toscher, BSN, RN, CCRN, in creating electronic Isaac Hainley, BSN, RN posters. Participants received assistance to April 18 From Lying in to Life Support: navigate the electronic Challenging Obstetrical poster template Cases website and templates Dodi Gauthier, M.Ed, BSN, in PowerPoint. They RNC-OB, C-EFM were also provided recommendations for June 20 NGR: Managing the content placement and Behaviorally Challenging instruction on the elements of a Patient with a Neurological professional poster. The CH Research Disorder Institute and nursing PhD consultant, Kyndra Alspach, MSNc, RN, Karen Jensen, provided additional CNRN, SCRN, course support. Morgan Noe, BSN, RN, CNRN, Alma Patino, MSN, RN, CNRN, SCRN, Christy Balster, BSN, RN

October 17 Supporting A New Approach to Managing Patients with Diabetes Certifications – During Hospitalization SCRN Lisa Dugger, MSN, RN, ACNS-BC, CDE, BC-ADM, Mark Wilson, MD In order to review American Stroke PAIN GRAND ROUNDS Association best practices May 16 in caring for stroke Management of a Patient with Complex Pain patients and prepare (Multidisciplinary Panel) for the Comprehensive Ellie Melton, NP, Moderator, Michael Kearney, MD, Medical Stroke Certification Director, Catherine Nelson, LCSW, Lynn Rapp, RN Survey, Christy Block, Lauren Fink and Kyndra Alspaugh adapted and June 7 taught the Stroke Certification Pain Resource Nurse Training Program Review Course for Cottage Health Susan White, MSN, Michael Neuroscience RNs. The class Kearney, MD, Ellie Melton, NP offered an in-depth review of neuro August 15 anatomy and stroke physiology Topical Opioids across the continuum of care. Of Ellie Melton, NP, Jodie the 35 attendees, five staff have now Woodall, RN achieved their SCRN Certification. Photo, left to right: Kyndra Alspaugh, Lauren Fink and Christy Block

36 ...

Conferences “Perseverance was CH nurses engage in professional development in a variety of ways including attending widely demonstrated local, national, and international conferences. The knowledge acquired during these in 2018 in nursing at events is then brought back to CH and translated into practice. Cottage Health.” - Paralee Schmechel, AORN Global Hospital Quality Institute Pediatric Clinic/OPS Surgical Conference (HQI) ... & Expo HUNTINGTON BEACH, CALIFORNIA NEW ORLEANS, LOUISIANA A group of Cottage leaders attended Association of Perioperative the Hospital Quality Institute (HQI) Registered Nurses (AORN) Conference. HQI builds reliable held their Global Surgical and sustainable measures to gauge Conference & Expo. They California hospitals’ performance Southern California provided 700 live educational and identifies opportunities for Chapter of the sessions designed to generate improvement and innovation. Association of Pediatric ideas and provoke new Attendance at this conference gave Hematology Oncology thinking along with the latest the group the ability to see that— comparably—CH is doing everything Nurses (APHON) technology and trends. There SAN DIEGO, CALIFORNIA were also fabulous events and to provide high quality care to our Cottage Health Pediatric networking opportunities with patients. The team observed that Hematology Oncology RNs more than 5,800 colleagues in most areas CH is ahead of the attended the APHON conference from around the world. curve, while knowing there is always opportunity to grow. in May. Topics included new This conference is often ATTENDEES: molecular findings that refine anticipated as it is a great Sharon Lutz, VP Quality Services, Wende risk stratification in children and opportunity to gain necessary Cappetta, Nicole Huff, Ryan Skrupky, MD, prognostic factors in childhood Edward Bentley, MD, Julie Enslow, Zed Reagan, CE credits specific to the leukemia. These nurses also MD, and Colleen Wheeler surgical department. Josephine enjoyed learning from adolescent Kelly, perioperative educator, cancer survivors about their attended this 2018 conference. experience during treatment and The information provided at Digestive Disease Week how patient care can be enhanced the “Foundation of Professional WASHINGTON, DC at Cottage. Development” four-part Judy Corliss and Wendy Gillespie education session was exactly attended the Digestive Disease Week what she was hoping to see. (DDW) conference. This event is the Josephine gained insight into world’s largest gathering of physicians, the development of education researchers and industry leaders programs and creative in the fields of gastroenterology, thinking strategies that she hepatology, endoscopy, and is excited to implement at gastrointestinal surgery. Cottage. Josephine stated that “the conference left me feeling inspired and connected.”

Photo, left to right: Debra Launius, Pam Rodriguez, Isabel Diaz, Paralee Schmechel, Kirsten Olsen

37 STRUCTURAL EMPOWERMENT

American Nurses California Society for Advanced Trauma Credentialing Center Cardiac Rehabilitation Care for Nurses (ANCC) Annual Conference (ATCN) DENVER, COLORADO SAN DIEGO, CALIFORNIA SANTA BARBARA, CALIFORNIA Five attendees represented CH and Karen Bradbury, Lynn Tabor Victoria Brown is the Course soaked up the Magnet experience and Marsha Griggs attended the Director for the ATCN course in Denver. Together with 10,000 California Society for Cardiac provided at Cottage Health other nurses, the CH team was Rehabilitation 33rd Annual State annually. Attendees included introduced to the 2019 Magnet Conference. New knowledge was RNs from the International manual, explored innovations in obtained on the latest research Committee of the Red Cross and nursing, and attended concurrent and best practices and shared from a Trauma hospital in South sessions focused on best practices. with cardiac rehabilitation staff Korea. This provided CH RNs the Each attendee came to the and patients. The team networked opportunity to learn about trauma conference with the intention to with nursing professionals and care in other parts of the world. focus on their Magnet component state leaders to plan for a future and bring back essential conference in Santa Barbara.

Photo, left to right: Jessica Barbosa, Marcel Wangraoua, and Victoria Brown Photo, left to right: South Korea attendee Seoyoung Song, Victoria Brown, ATCN information to share at the annual Course Director combined Magnet committee meetings. Not only did the team network with nurses across the country, but they also got to know Photo, left to right: Karen Bradbury, Lynn their CH peers better. Tabor and Marsha Griggs Photo, left to right: Marla Dan-Rambaran, Penny Morgan Overgaard, Jackie Baker, Daniel DeAlba, Jennifer Bower

National Teaching Institute (NTI) for Critical Care Nurses BOSTON, MASSACHUSETTS Cottage Health was represented by nurses from PICU, PACU, Critical Care and the Education Department. They joined 10,000 attendees from around the world. Photo: Rhonda Alvarado, Lesley Gardia, Melissa Aldecoa, Diane Barkas, Meressa Parker, Paula Gallucci, Julie Bair, Amanda Rogers, Becky Love, Bob Kerr, Vanaja Selvaraj, Donna Janega, Janet Sheppard, Tarra Van Wingerden

38 ...

“In my support of our clients in times of crisis, I always share the thought that was shared with me by a hospice patient, ‘Don’t deny the diagnosis, defy the verdict.’” -Jan Ingram, Parish Nursing

Photo: Safe Kids California coalition coordinators pose on the State Capitol steps after the Safe Kids meeting and advocacy day. ...

Advocacy for the Kids SACRAMENTO, CALIFORNIA The annual Safe Kids California meeting and Advocacy Day took place at the Capitol building. This event provides an opportunity for all California Safe Kids Coalitions to come together to discuss collaborative strategic planning, upcoming events, and to raise awareness of lawmakers on upcoming safety bills and community safety issues. Oncology Nursing Society – Safe Kids Santa Barbara One Nurse, One Moment, County Coordinators, One Action Gena Topping and Jessica WASHINGTON, DC Aten (Pediatric Injury Photo: Gena Topping and Jessica Aten Prevention Specialist), had Bethany Wood, Julius Manlulu, Kylie-Jean (Pediatric Injury Prevention Specialist) at “Kahea” Kahui Warrecker and Renata Singulani the State Capitol in front of Governor’s the opportunity to discuss office for Safe Kids California meeting. safety in Santa Barbara with attended the Oncology Nursing Society (ONS) Legislative Director Israel Congress and explored new information and Landa on behalf of the cutting-edge oncology treatments. Conference Assembly Member of our takeaways: district, Monique Limon. • One Nurse—To make an impact, educate and reassure. • One Moment—To connect with a patient and show compassion. • One Action—To transform Oncology Nursing by new oncology treatments, fostering leadership skills and improving patient outcomes. • Discover new information in your specialty. Photo: Gena Topping, Israel Landa and Jessica Meet and discuss ideas with presenters and Aten meet in Assembly Member Limon’s office to discuss community safety and injury fellow nurses. prevention initiatives. • Why go to a conference? See the larger world view of our profession and decide how you want to shape your future.

39 STRUCTURAL EMPOWERMENT

Pediatric Nursing: Care of the Hospitalized Child

SEATTLE, WA National Advanced Practice Neonatal Nurses

PORTLAND, OR

Advance Fetal Monitoring Annual Antepartum/Postpartum Management Safe Kids California Annual Meeting and Advocacy Event Inpatient OB Review American for SK California Coalitions PCQN - Palliative Care Association of Nurse Quality Network Practitioners SACRAMENTO, CA Pediatric Sedation Outside of the Magnet Conference Operating Room DENVER, CO SAN FRANCISCO, CA

Debriefing Workshop - California Simulation Alliance KronosWorks - VISALIA, CA Workforce Innovation That Works Pediatric Acute, Critical and Emergency Care

LAS VEGAS, NV

Trauma and Critical Care Symposium Hospital Quality Institute Leadership Intensive: Architects of the Future (HQI) Vizient West Coast The Healthcare Roundtable CNO, CQO, CMO Networks Network Fall Conference Debriefing Workshop - California Simulation Meeting Vizient West Coast CNO Alliance SANTA BARBARA, CA and CQO Networks SCOTTSDALE, AZ Meeting TQIP - Trauma Quality California Regional Improvement Program California Society for Cardiac Networking - Press Ganey Rehabilitation Annual Conference Regional Meeting International Injury Prevention Symposium Southern California Association of PASADENA, CA PCCN - Palliative Care Hematology/Oncology Nurses Certified Nurse Exam Southern California Chapter of the Review Association of Pediatric Hematology CHA Agents of Change - Behavioral Oncology Nurses (APHON) Health Care Symposium Trauma Registrar Course Diabetes Educator Course Behavioral Health Care Symposium LOS ANGELES, CA and Emergency Services Forum Annual Cancer Care Symposium

RIVERSIDE, CA AANN - American Association of Neuroscience Nurses

40 SAN DIEGO, CA ...

“The best way to 2018 Conference Locations find yourself is to CH nurses seek and share evidence-based practices at home lose yourself in the and across the United States. service of others.” - Mahatma Gandhi ...

NTI - National Teaching Institute & Critical Care Exposition International Transplant Nurses Society Symposium BOSTON, MA

CHICAGO, IL

AADE - American Association of Diabetes Educators

BALTIMORE, MD

American Association Oncology Nursing Society of Cardiovascular and - One Nurse, One Moment, Pulmonary Rehabilitation One Action Coming Full Circle - WASHINGTON, DC Conference of International Childbirth Educators Association

LOUISVILLE, KY

Association of Peri-Operative Registered Nurses (AORN) NACNS - National Global Surgical Conference Association of & Expo Clinical Nurse ANPD - Association for Specialists NEW ORLEANS, LA Nursing Professional Development AUSTIN, TX LAKE BUENA VISTA, FL AWHONN - Association of Women’s Health, Obstetric Association of and Neonatal Nurses Rehabilitation Nurses (ARN) TAMPA, FL Reach WEST PALM BEACH, FL

41 STRUCTURAL EMPOWERMENT

Service Abroad Trauma and Critical Care Symposium SANTA BARBARA, CALIFORNIA CH nurses give back to our community through volunteering both locally and globally. Offering Trauma Services’ annual Trauma and Critical Care Symposium their time, their knowledge and getting to know our educates attendees in the latest evidence-based practices in the local and global communities speaks to the core management of diverse trauma-related issues. The most powerful values of CH excellence, integrity and compassion. take home this year was the understanding of a patient’s need for Commitment to community is also recognized as an emotional support throughout the recovery process. Keynote essential component of our professional practice model speaker Ed Gavagan, a stabbing victim who had been left for and philosophy of nursing. dead, shared his firsthand account and story of recovery, which deeply impacted the standing Island Impact Ministries to the room only group of nurses, Dominican Republic physicians, and other providers. Debra Launius participated in her fifth medical Top photo, left to right: Paula mission, providing general care and outreach Gallucci, Sherrie Grimes (retired), to outlying Haitian and Dominican villages. Patti Wicklund Approximately 200 patients per day were evaluated, Bottom photo, left to right: Diana patients who otherwise would have no access to Martinez (Trauma Registrar), medical treatment. Debra also joined in the fundraising Jessica Aten (Pediatric Injury Prevention Specialist), Sue effort to support monthly follow-up visits at a local Fortier, Gena Topping, Lily Haitian village clinic. Her next trip will include a Limon (Trauma Registrar), medical group from National Children’s Medical Tammy McDevitt, Kathy Williams Center in Washington, DC. (Administrative Assistant), Melessa Dillingham (Trauma Registrar), Rohit Sharma, MD

Association of Rehabilitation Nurses (ARN) PALM BEACH, FLORIDA Maggie Wordell attended ARN Reach, the annual education conference for Rehabilitation Nurses. The conference promotes excellence in rehabilitation nursing care and provides nurses the opportunity to maintain certification and licensure requirements. Topics included state-of-the-art approaches to improving patient care, reducing fall risk and improving functional outcomes, caring for LGBT patients, and using animal therapy and technologies to assist people with disabilities. Information learned at the conference was shared with the intent to improve outcomes in the rehabilitation of patients with a variety of diagnoses.

42 Notable News

45th Anniversary Critical Care Outpatient Surgery Educational Strategic Cottage Outpatient Surgery (OPS) Planning Retreat opened on November 17, 1973. It was The Critical Care Education the first Committee met off campus to freestanding, engage in their annual education hospital- retreat. 2019 competencies were based discussed and determined based surgery center in California. The on the identified needs assessment. facility was modeled after an outpatient surgery center that opened in 1970 in Arizona. The original OPS was located approximately where the power plant is currently located. In 1986, OPS moved for nine months to the basement of Pinecrest Hospital (now CRH), while the original facility was remodeled. After the remodel was Community completed, two ORs at each site were Partnership utilized for a while. Cathy Mollkoy participated in In December 1990, the current OPS a new community partnership between Parish Nursing facility (on the corner of Castillo and Dates for skills days were planned and the Westside Health Junipero) was completed and opened and sub-teams organized to ensure Collaborative. Each month with four ORs. all staff will be competent in their at the food bank at Harding OPS provides personalized care to 2019 skills. School, Cathy provides health patients of all ages. Preoperative/ Photo, left to right: Donna Janega, Vanaja screenings, flu vaccines and PACU nurses are both ACLS and PALS Selvaraj, Bobbie Evans, Patti Wicklund, certified, as this is a critical care area. health education for our Melanie Kramer, Paula Gallucci, Vivian underserved community Elbert, Sharon Morley, Lesley Gardia, Sarah Types of surgeries performed include: members. Gray and Diane Barkas • Pediatrics - orthopedic, ENT, chemotherapy, gastroenterology • Orthopedic - podiatry, knee and shoulder arthroscopies • GYN, ENT, dental procedures, plastic Partnering with Population Health surgery and general surgery Parish Nurses Jan Ingram and Jan Fadden partnered with Population Health Over the past 45 years, nurses have to support the new “Recuperative Care continued to work diligently to maintain Program” at PATH Santa Barbara. A the highest quality of patient care. four-bed pilot program was launched in October and will expand to ten beds. Jan The OPS staff continues to have a Fadden works directly with chronically genuine desire to treat the whole patient ill homeless clients who are discharged from beginning to the end of their stay. from Cottage Health and supports them They look forward to the opportunity to during their recovery as they wait for continue to care for our community. permanent housing.

43 EXEMPLARY PROFESSIONAL PRACTICE

Exemplary Professional Practice

Characteristics: Professional Practice Model Passion, Value Nurse/Patient Satisfaction, Nurse Sensitive Indicators, Interdisciplinary Influence, Peer Review, Quality “ Nurses functioning Improvement, Autonomy Co-Chairs: Laura Canfield, Darcy Keep, Liz Lundquist in the highest Members: Karin De Witte, Christina Hubbard, Danilyn McLaughlin, Donna Janega, capacity of Jennifer Dunn, Jennifer Ferrick, Jennifer Granger Brown, Jim Ouellette, Karen Rose, Katie Gorndt, Lindsay Picotte, Marla Dan-Rambaran, Sharilyn Vasquez, Tammy accountability, McDevitt competence, and Accomplishments: 1. Conducted a peer evaluation survey with a 43% response rate (340 responses). The autonomy.” survey provided insight into the peer evaluation process and also included questions about moving toward face-to-face evaluations. 2. Conducted a gap analysis of EP sources of evidence utilizing the new Magnet manual. 3. To address EP14- Security Issue Resolved with a Clinical Nurse’s or Clinical Nurses’ Contributions to an Interprofessional Group, the committee invited guest speakers to present. Guests included Kevin Nelson, Melody O’Shock and committee co-chair Darcy Keep. 4. Participated in the Magnet Quality Celebration with the poster “NDNQI Nursing Satisfaction Survey.” Ongoing: 1. Supporting the best practice of nursing peer evaluation.

EP Magnet Component Committee Photo, left to right: Katie Gorndt, Sharilyn Vasquez, Karen Rose, Jennifer Bower, Jennifer Dunn, Jennifer Ferrick, Jennifer Granger Brown, Karin De Witte, Liz Lundquist, Laura Canfield Not pictured: Darcy Keep, Christina Hubbard, Danilyn McLaughlin, Donna Janega, Jim Ouellette, Lindsay Picotte, Marla Dan-Rambaran, Tammy McDevitt ...

“Communicate through actions; stay positive, support the change and lead by example.” - Nicole Huff, Santa Ynez Valley Cottage Hospital, Emergency Department ...

44 ...

“May you never doubt BEST the gifts you bring; Rather, learn from these frontiers The sense of relief the psychiatry nurses feel when the rapid response Wisdom for your own heart. team arrives to support them during a medical emergency is tremendous. This sparked the idea for the Behavioral Emergency May you come to inherit Support Team (BEST). Darcy Keep, Administrative Director of The blessings of your kindness Psychiatry & Addiction Medicine, And never be without care and love decided that they could perhaps give back in a similar way. BEST When winter enters your own life.” was launched in September. The - Excerpt from Blessings: For A Nurse goal of BEST is to provide early and by John O’Donohue, submitted by rapid intervention for patients in Elizabeth Robinson, Nursing Administration non-psychiatric settings who are developing psychiatric symptoms ... or behaviors that may pose a risk to themselves or others. When a BEST activation is initiated, two to three psychiatric-trained professionals will respond to the patient care unit to assess and provide consult on a patient who has been identified as having behavioral issues or psychiatric symptoms. BEST aims to promote better outcomes Diabetic Action Plan such as: improved care of psychiatric symptoms, reduced agitation Kristen Jennings and the Pediatric Endocrinology level of patients, and decreased incidence of threats, assaults and Team participated in the development of the Patient workplace violence toward employees. In addition to being a new Diabetes Action Plan. quality initiative, an IRB approved research project is underway to This tool was created determine the efficacy of the BEST program. to assist their patients to improve glycemic control. It offers a clear and concise way Recognizing Greatness at to discuss blood sugar management with Cottage Health the patient and family Dodi Gauthier, Perinatal Educator/Direct Care, has been a part of while in the clinic and during remote support in the Association of Women’s Health Obstetric and Neonatal Nurses home. (AWHONN) for 40 years. She began her journey in 1978 making her a well-respected lifetime member. During her AWHONN affiliation she was a section leader, one of Palliative Care: Going the Extra the original AWHONN fetal heart Mile for Our Patients monitoring instructor-trainers, and Board of Directors member, Lori Mendez, Christopher “Shea” Edwards and LCSW along with being the Distinguished Catherine Nelson joined teams to support a young Professional Service Award man in his twenties newly diagnosed with cancer. recipient. This patient was scheduled to begin chemotherapy treatment that could have left him unable to have “My career has really evolved children in the future. The patient wished to bank his around AWHONN, and being an sperm and delay the start of his treatment to achieve active member has afforded me this goal. The team worked quickly to navigate the opportunities I never would have otherwise had,” says Dodi. She is process. The case served as inspiration for Palliative constantly striving to promote and improve the health of women and Care to initiate a quality improvement project to infants to strengthen the nursing profession. Dodi credits all that she develop a protocol for addressing the fertility concerns has accomplished in her career to AWHONN. of oncology patients.

45 EXEMPLARY PROFESSIONAL PRACTICE

Sedation Nurses Maintaining Continuity of Care Beyond Our Walls The Ridley-Tree Cancer Center (RTCC) moved two blocks away from its original location within Santa Barbara Cottage Hospital (SBCH). This created a new patient flow for inpatients who would continue their radiation therapy treatments at the RTCC.

Association of Nursing Professional Development (ANPD) Leadership Academy As a member of the ANPD association, Jennifer Bower (front row, third from right) was alerted to an opportunity to participate in the organization’s inaugural Leadership Academy. After receiving support from then Director of Education Carol Henderson Nelson and CNO Herb Geary, Jen completed a lengthy application and was selected to participate in the program. The organization stated, “The purpose of the Nursing Professional Development (NPD) Leadership Lynne Jessop, Manager of Patient Support Academy is to prepare NPD practitioners to assume leadership of an NPD Services, Dan Thomas, Director of Nursing department in a variety of settings.” Jen worked with an assigned mentor and for Cottage Rehabilitation Hospital (CRH), collaborated with a cohort of nurse educators from across the country. Her Julissa Valerjev, Sedation RN, and Herb project focused on engaging the clinical nurse in conducting nursing research. The Geary, Vice President of Patient Care program both started and one year later concluded at the organization’s national Services and CNO, met with leadership conference. at RTCC to create a viable workflow. The team developed a new MD order set in CottageOne as well as new policies and protocols that would ensure inpatients could The Role of the Professional Pediatric Nurse start or continue radiation therapy while in the Outpatient Setting maintaining an acute care level of support and services in an outpatient setting. The pediatric RN in the outpatient setting helps facilitate patient care, provides patient and family education, coordinates services across the continuum and helps The Sedation RNs at SBCH expanded their the patient and family navigate the complexities of the healthcare system. program to include the transport of patients for their radiation therapy. The Transport The outpatient RN has a complicated and meaningful role in enhancing the lives of Sedation RNs work closely with CRH pediatric patients and families. The caring relationship often spans the childhood Drivers to transport SBCH inpatients via the experience and helps each child reach CRH vans to and from both facilities. From their developmental potential. March to December, the team completed Our outpatient pediatric nurses 800 transports. are Lauren Hardy, Kristin Jennings, The successful implementation of this Debra Launius, Pamela Rodriguez, new program is another example of how Paralee Schmechel, Katie Unzueta, staff works together with our community Tera Yamasaki, Jenny Bell-Berch and healthcare partners to help ensure that our Penny Morgan Overgaard. patients’ needs are met.

46 Retirements

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

Yvonne Molinari Carol Henderson State Dominguez Hills. Her clinical 45 years, OPS, Nelson experience included Med-Surg and Santa Barbara 39 Years, Birth Center nursing. Cottage Hospital Education, Cottage Tina ultimately transitioned into the role Health Yvonne worked of Educator and fulfilled this role for Med-Surg for Carol earned her almost 30 years. Her focus was Maternal nearly seven years and participated in BSN through Health Patient Education, teaching the first OR training class offered at Mount St. Mary’s College, where she childbirth classes and providing Birth SBCH. She transferred to OPS in 1981 was among the first class to learn Center tours to thousands of expectant the Roy Adaptation Model taught by parents. Tina was also responsible for and stayed until her retirement. Yvonne nursing theorist Sister Callista Roy. In supporting SYVCH staff education, loved working in the main OR, but also 1978, Carol began her career at Cottage BLS instruction and new employee loved being able to wear multiple hats as a Med-Surg clinical nurse before orientation. As co-chair of the Patient/ at OPS (admit patients, circulate in transitioning into the role of Educator. Family Education Committee for over the OR, recovery room and scrub) and Upon becoming a certified Diabetes 20 years, Tina had oversight of such enjoyed patient contact. On top of being Educator, Carol became one of the first projects as the interactive patient a talented RN who could work in any specialty certified nurses at Cottage and education videos on the TV and area of OPS, she also played a huge role the American Diabetes Association has Krames/Staywell handouts. in the department’s infection control recognized her inpatient and outpatient Tina will always be remembered for efforts. diabetes education programs. her expertise in data analytics and In the last phase of her career, Carol her mentorship of nurses returning Beverly was promoted to the role of Director of to school in the CH-CSULA onsite Fernandes Education. She was involved with the BSN and MSN programs. In her 43 years, OPS, Nursing Excellence Publication, was a retirement, Tina is looking forward to Santa Barbara Charter Member of the Magnet Steering spending more time with her beautiful Cottage Hospital Committee, and was instrumental in grandchildren, as well as hiking, skiing, spearheading the Specialty Certification reading, quilting, and sleeping in! Beverly started her Plaques. Under Carol’s leadership, the nursing career on the East Coast in 1968 Simulation Center was created, and the Mary Ellen and came to Santa Barbara in 1973. She Acute Care Nurse Transition Program Strong worked in the OR at St. Francis Hospital as well as the Nurse Intern programs 30 years, OPS, until coming to SBCH OPS in 1975. were implemented. Carol was well Santa Barbara Bev served in a variety of roles in the respected and was identified by her Cottage Hospital team of educators as “the best educator OR including scrub, circulating, and Mary Ellen started ever.” In her retirement, Carol looks charge nurse until she became the her nursing career forward to spending time with her director of OPS in the 1990s, until in Los Angeles. Having grown up in husband, children, and grandchildren Santa Barbara, she chose to come back her retirement. Toward the end of Caysen and Calli. her career she also oversaw the SBCH and work at SBCH OPS. She worked Endoscopy Department and Eye Center. from 1976 to 1977, returning in 1989. Tina Collins Mary Ellen was part of the original OPS Bev was very well respected by her 36 years, Education, Cottage Health (located where the power plant is now) staff and the physicians she worked Tina began her and the second OPS location (basement with. Her no-nonsense approach has career at Cottage of Pinecrest Hospital), and for a time yielded remarkable results including as an Associate worked in both locations. She took part year-over-year top-quartile (and higher!) Degree Nurse in the move to the current OPS location. patient satisfaction, consistently high- from SBCC. She She circulated in the OR, scrubbed, quality patient care, and perhaps most returned to school and was the OR CNC nurse as well. importantly, an incredibly cohesive team to obtain a BSN Mary Ellen’s methodical and organized of professionals who love what they do. from the Statewide Nursing Program leadership will be missed. and then received her MSN from Cal

47 EXEMPLARY PROFESSIONAL PRACTICE

Wanda Johnson Tokie Shynk Member. She was also a member of 36 years, Nursing 31 years, the California Maternal Quality Care Supervisor, Santa Director Critical Collaborative, bringing “best practice” Barbara Cottage Care, Santa to Women’s Services. She currently Hospital Barbara Cottage can be found at her Wisconsin North Wanda started Hospital Woods cabin reading, playing cribbage working in health care as a nursing Tokie worked passionately as a on the deck or cheering on the assistant in 1970 while attending Critical Care nurse, Cardiac Care Packers. Dodi’s expertise and smile will college. She graduated from the Unit manager and as the Director be missed by many. University of New Mexico in of Critical Care Services. Tokie was Albuquerque in 1973 with a Bachelor a role model in appreciative inquiry Elizabeth Link of Science in Nursing and a Bachelor in her interactions with her peers. 27 years, of Arts in Psychology. She then went She was an advocate for patient- MacDougall Eye on to obtain her Masters of Science in centered care through her work in Center, Santa Nursing from UCSF. opening the doors to the Intensive Barbara Cottage Wanda found her way to Cottage Care Units for visitation of family and Hospital Hospital in 1980 and worked in the loved ones by eliminating restrictive Elizabeth Link Float Pool for a year prior to accepting visiting hours. Tokie was instrumental started working at SBCH in 1991 a position as an Administrative in disaster preparedness, Palliative and was one of the original staff Nursing Supervisor on the night shift. Care in Critical Care and Emergency members of the Eye Center. She She has been an inspiration to the Departments, infection control was a scrub nurse during the first night shift nursing staff, the NRU, her prevention with hand gel dispensers surgery at the Eye Center. While at fellow Nursing Supervisors and other outside of patient rooms and leading Cottage she initiated the development colleagues throughout the hospital. staff in nursing research at the of the Recycling Committee (now She has been a calm and wise leader bedside. She was also a supporter of the Environmental Sustainability during many crises over the years. the Magnet program and co-chaired Committee). Elizabeth served on the Her wisdom, her sage advice, and her the New Knowledge, Innovations, Design Team for Shared Governance leadership will be greatly missed by all. and Improvements Committee. and three years on the Resource When asked what she most looked Tokie received national recognition Committee. While working full time forward to in her retirement, she said with her research titled “Compassion she volunteered with SEE International “having a normal circadian rhythm, Doesn’t End When the Heart Stops: and performed cataract surgeries on being able to sleep at night, and Nurses’ Perceptions of Honoring 25 mission trips to Mexico. In 2018, freedom from demands” topped the Ceremony at End-of-Life.” Tokie she received a Lifetime Achievement list. She is also looking forward to loved all things from Massachusetts— Award from the California Retina chasing after her five grandchildren and Boston University, the Red Sox, Consultants for her role in the traveling, and she hopes to volunteer at Dunkin Donuts and the Patriots, and development of the Retina program at a couple of National Parks. of course her Labrador Retrievers. SBCH Eye Center. Most of all Tokie loved being a nurse Elizabeth is a devoted mom and and continues to be proud of her Carol Bury grandmother, and dedicated her profession. Her legacy will continue on 35 years, OPS, professional life to the Eye Center, the through her amazing contributions. Santa Barbara doctors, staff and patients. Cottage Hospital Dodi Gauthier Carol started her 29 years, Julie Smedley nursing career Women’s 24 years, OPS, at OPS in 1977 Services, Santa Santa Barbara and worked until 1979. She returned Barbara Cottage Cottage Hospital to OPS in 1985 and stayed until her Hospital Julie began her retirement. Carol circulated and career at OPS in scrubbed in the OR until she became A dedicated 1995, working the CNC. She helped the OR schedule labor and delivery nurse and educator, run smoothly, all while keeping Dodi worked as an RN for 41 years. part time covering the late shift in the surgeons, anesthesiologists Known to her colleagues as “Ms. the recovery room. Additionally she and patients happy. Carol is very AWHONN,” Dodi was a lifetime, worked in the triage call center for thoughtful, always ready to lend a active member of this professional pediatrics at Sansum Clinic. In 1996, helping hand. Her bright smile and nursing organization serving in many Julie started working a full-time caring personality will be missed. capacities including a national Board position in the PACU at OPS. Her 48 ...

“When someone is background in outpatient surgery and Pam Nelson pediatrics was invaluable. She always 21 years, Emergency Department, going through a storm, brought fun with her smile and easy Santa Ynez Valley Cottage Hospital your silent presence is laugh which will be missed from OPS. Pam was a hardworking emergency more powerful than nurse for 40 years. She spent the first a million empty words.” Sharon nine years of her nursing career in the —Mahatma Gandhi Baumert-Kysely Air Force and from there experienced 21 years, NRU many nursing opportunities before she ... and Endoscopy, came to the Santa Ynez Valley Hospital Santa Barbara Emergency Department in 1997. Pam Cottage Hospital had a wealth of knowledge to share Sharon received her BA in with her coworkers and throughout Anthropology from UCSB in 1997, her time at Santa Ynez supported the Association of Critical Care Nurses’ obtained her ADN from Santa Barbara growth of young professionals hospital Beacon Awards. She was instrumental City College, and then came to work wide. Pam’s dedication to her job, her in the planning and transition to at Santa Barbara Cottage Hospital. coworkers and her patients will be the Phase 4 MICU, creation of the She worked on the 5 South/Surgical missed. vacation/scheduling tracking tool, Trauma Legacy Unit for three years, and development of the Charge and then transferred to the Nursing Linda Bacon Nurse Council. She also served as Resource Unit in 2001. That same 19 years, Director a nurse preceptor. She co-authored year she became a per-diem nurse in of Women’s the winning poster “Charge and Endoscopy. Sharon was cross-trained Services, Santa Resource Nurse Council Supports to the role of Sedation RN in 2008 Barbara Cottage Growth of Direct Care Nurses as where she enhanced service excellence Hospital Transformational Leaders” at the 2013 AONE conference. Marilyn was and provided compassionate care. Linda began her an amazing leader, a highly reliable Sharon was a positive, hardworking 46 year career and accountable team player. Her nurse who was a pleasure to work as an RN when she received her BSN presence will be missed but her legacy with. Sharon is looking forward from Indiana University and later carries on. to having time to read, travel and obtained her MBA from California volunteer at the Therapeutic Riding Lutheran University. She obtained Center. her Inpatient Obstetrics certification Gretchen and encouraged her staff to do the Ostergren Cynthia Coccia same. Linda led the opening of the 9 years, 20 years, Central new Phase 4 Birth Center and Mother MacDougall Eye Coast Perinatal Infant Care Units at Santa Barbara Center, Santa Center, Cottage Cottage Hospital. She participated Barbara Cottage Health on multiple committees including Hospital In her role as co-chair of the Transformation Gretchen began working at Cottage Director of Leadership Magnet Component Health in April 2009. She was a Perinatology, Cindy ensured that Committee. Linda led staff to circulator in the main OR and at the all patients received individualized achieve the top goal: Baby-Friendly Eye Center. She was known for her care. She worked with her staff to Designation. Linda is looking forward upbeat and positive attitude. Gretchen create a cohesive team approach to to spending time with her family and also spent time working for Employee enhance the patient care experience. friends. The team will greatly miss her Health giving “painless” flu shots! Cindy partnered with providers to and her fabulous baking skills! Gretchen was a friend to many. She is expand coverage of Perinatal Services, now enjoying her retirement playing increasing the patient census both in Marilyn Lang golf, traveling and volunteering at the the clinic and at the hospital. 16 years, MICU, SB County Animal Shelter. Cindy worked collaboratively with Santa Barbara the Director of Women’s Services and Cottage Hospital created an independent and smooth Marilyn led the running department. MICU to be recognized with multiple American

49 NEW KNOWLEDGE, INNOVATIONS AND IMPROVEMENTS

New Knowledge, Innovations and Improvements (NK) “Blending research, Characteristics: Innovator, Adventuresome, Tolerant of Uncertainty, Confident, Risk Taker, Forward Thinking, Tech Savvy evidence-based Co-Chairs: Libby Smith, Dan Thomas practice, and Members: Deborah Short, Jackie Baker, Jared Grode, Jennifer Bower, Patti Wicklund, innovation to Susan San Marco, Vicki Lekas, Vicky McClain improve outcomes.” Accomplishments: 1. Identified the need to update and promote the CH Journal Club tool kit. The committee worked with Marketing to update the outdated documents and have presented the tool kit to a variety of workgroups. 2. Participated in the Magnet Quality Celebration with the poster “Clinical Inquiry, The More the Merrier! Updating the Journal Club Toolkit.” Ongoing: 1. The NK team continues to conduct careboard audits and review HCAHPS scores to ensure an upward trend. 2. Review and update CH external website nursing pages.

Magnet Component Committee Photo, left to right: Jared Grode, Patti Wicklund, Susan San Marco, Vicki Lekas, Dan Thomas, Libby Smith, Deb Short, Jackie Baker, Jennifer Bower Not pictured: Vicky McClain

50 Disaster Preparedness at GVCH Innovative New Nursing Projects – A Collaborative Effort Nurses at Cottage Health participate in and lead a variety of projects, including evidence-based practice, quality This year’s Disaster Drill was an extensive collaboration improvement and research. between all three Cottage Health Emergency Departments, MICU and SB County Fire’s Hazmat team. Everyone involved RN TITLE/SUBJECT OF PROJECT participated in multi casualty incident scenarios which Cherie Mignone Turn Teams and Patient Falls Phase 2 required coordination between hospital and fire disaster teams to set up, triage and treat victims. Jointly the teams Penny Morgan Concussion Database had great dialogue on how to improve, increase collaboration Overgaard, and continue to prepare for potential emergencies in our Jenn Wobig community. Linda Bacon How Does Nursing Care During Labor Influence Top photo, left to right: Catherine Uhl, Christina Roth Outcomes? (LaborRNs Study) Middle photo, left to right: Christina Roth, Catherine Uhl, Emma Aitken Mari Mender Exploring Workplace Violence and Employee Bottom photo: Emma Aitken Safety on Non-Behavioral Health units

Diane Barkas Decubitus in Intensive Care Units, A Multicenter International One-Day Prevalence Study (DeCubICUs)

Vicki Lekas, Study in Twins to Identify a Potential Link between Angela Hsu, MD Blood Group Antigens and Susceptibility to Infant Botulism

Rebecca Love, Death and Donuts Kimberly Runhaar, Lesley Gardia

Darcy Keep The BEST Approach: Working Together for Patient and Staff Safety at Santa Barbara Cottage Hospital

Kahea Warrecker Chemotherapy Competency Assessment in the Simulation Lab

Nurses Speak at Research Symposium The annual Collaborative Research Symposium hosted by Cottage Health Research Institute (CHRI) was another event where nurses shined. Two nursing stars, Penny Morgan Overgaard and Judy Corliss, spoke on research topics in their areas of expertise. Penny’s presentation titled “Current State of Concussion Health Promotion and Risk Reduction in Youth Sports” highlighted where we are and focused on the needs for the future. “Esophageal Food Bolus Impactions” was the talk given by Judy which explored the alternative treatments for food bolus. Photo, left to right: Judy Corliss and Catelynn Kenner (Cottage Health Research Institute)

51 NEW KNOWLEDGE, INNOVATIONS AND IMPROVEMENTS

Simulation for Registration Staff Simulation Facilitation and Debriefing Workshop The Simulation Coordinator, Jennifer Granger Brown, and the Patient Access Trainer, Gilda Branuelas, provided simulation This workshop provided training to nine nurses that currently education to all Patient Access employees that focused on use simulation or plan to incorporate simulation into their registering patients. Jennifer collaborated with other Cottage unit’s education. Participants were given the tools needed to departments to create scenarios including one pertaining to run a simulation that meets the standards required by the the new nondiscrimination provision of ACA 1557 legislation. International Nursing Association for Clinical Simulation and Participants stated enhanced confidence in addressing health Learning. Jennifer Granger Brown facilitated these sessions. information after training. Participants were: Karen Rose, Laura Danhauer, Mimi Dent, Photo, left to right: Gilda Branuelas (trainer) and Jennifer Granger Brown Deborah Barnett, Josephine Kelly, Bobbie Evans, Vicki Lekas, Kelly Park, and Jennifer Gamez-Sparrow.

Top photo, left to right: Mimi Dent, Bobbie Evans, Jennifer Granger Brown, Josephine Kelly Middle photo, left to right: Bobbie Evans, Vicki Lekas, Jennifer Granger Brown Bottom photo, left to right: Deborah Barnett, Jennifer Granger Brown

EPIC User Group Meeting This year a team of Cottage employees, including two nurses, were fortunate to experience EPIC’s User Group Meeting (UGM) in Madison, Wisconsin. This annual meeting provides opportunities to network and discuss industry trends, accomplishments, and strategies for success. The interdisciplinary team of EPIC users from CH were able to learn and connect at this fun “Great Outdoors” themed event.

Photo, left to right: Griff Sahlin, Bridget Crooks, Caroline Rosen, and Bryan Yagodzinski standing with one of the 85 “Bucky on Parade” Badgers. Not pictured: C. Alan Brown, MD.

52 EMPIRICAL OUTCOMES

Heart Failure Readmission Reduction

Quality Measure: Percentage of patients with a primary discharge diagnosis of congestive heart failure (CHF) readmitted for any unplanned cause within 30 days as an acute care inpatient. “ Identifying and Goal: measuring the • Remain at or below the 50th percentile (14.7% or less) for heart failure readmission nursing contribution rates within our comparative database. to patients, Outcome: nursing workforce, • A substantial decrease in readmission rates to 13.4% for 2018. organizational, and Nurse-Related Improvement Strategies: To meet the goal, Community Case Management (CCM) Nursing, Telemetry consumer outcomes.” Nursing, QI Nursing and the Cardiovascular Institute Management Group Quality Team employed the following improvement strategies: • Coordinated education of inpatients with heart failure utilizing the targeted education materials. Twice weekly inpatient rounds with MD, RN, and CCM staff to identify patients within the population and strategize treatment/education goals. • CCM nursing follow-up on all Medicare patients after discharge – assist with appointment scheduling, medication management and diet. • Retroactive review of all CHF readmissions by QI nursing with appropriate follow-up.

Congestive heart failure – % Readmit within 30 days

25%

20% 20.7 15% 16.7 13.4 10%

5%

0 2016 2017 2018

53 EMPIRICAL OUTCOMES

Advanced Hip and Knee Post-op Phone Calls

Discharge Phone Calls – Goal 80%

40 Patients Reached 35 Total Attempted

30 30 27 29 20 27 22 22 23 22 22 21 20 19 15

10

5

0 JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER 90% 95% 96% 93% 100% 95%

Quality Measure: Discharge phone calls are conducted to ensure the total joint population fully understands their discharge instructions, to identify potential early complications and to ensure that patients have filled their prescriptions and have set their next MD appointment. All total joint patients receive a post-operative phone call. Numerator: Number of patients reached by phone for discharge phone call Denominator: Total number of patients who received total joint surgery discharge phone call Percentage: Percentage of all patients reached Target: Increase percentage of total joint patients with discharge phone call attempted and reached Nurse-Related Improvement Strategies:

• Designated orthopedic RN (Joint Replacement Program Coordinator) places a call to the patient within one week post discharge. • The RN calling makes a total of 3 attempts to contact the patient after discharge. • The RN may leave a message for callback with the designated callback number. An interpreter is used for non-English speaking patients from the Interpreter Services Line.

Outcome: Third and fourth quarter 90% or greater discharge phone calls attempted and reached.

54 ...

Santa Barbara “Nursing is a blend of heart and science.” Cottage Hospital - Lindsay Picotte, Education ... Stroke Door-to- CT Result

Quality Measure: Code Stroke Door- to-CT Result in 45 minutes or less with Average Door to CT Results, in minutes Goal: 45 minutes or less greater than 80% compliance. 50 Numerator: Number of Code Stroke 45 CT results in less than 45 minutes from 40 arrival 35 Denominator: Total number of Code 30 Stroke CT orders 25 Target: To improve timeliness of Code 20 Stroke Door-to-CT results to under 45 15 minutes in greater than 80% of cases 10 Nurse Related Improvement Strategies: 5 • ED Charge Nurse or Triage Nurse 0 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec will order Code Stroke CT orders 18 18 13 13 29 19 27 21 30 28 37 26 prior to ED MD assessment • Nurses ensure patient is sent to CT via EMS Gurney for EMS Stroke Activation • Attended CT Department Meetings Timeliness of Door to CT Results – Goal 80% • Updated ED & Inpatient Stroke Policies 100% Outcome: 80%

• Steady improvement in compliance 60% since implementation of process. 40% • 2018 – Improvement of compliance with new Direct to CT process 20% implementation achieved 83% for 0% 45 minutes or less Code Stroke Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Door-to-CT. % under 45 minutes | % under 30 minutes | Goal (80%)

55 HEALING ARTS

Phase 6 Artwork

56 ...

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

57 PROFESSIONAL PRACTICE MODEL FOR NURSING

Professional Practice Model for Nursing

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

We stand for teamwork and collaboration

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

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

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

OUTCOME STATEMENT: Nursing is a blend of art and science

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