Memorial Medical Center
Two 2G nurses perform a bedside report with a patient.
Standing is Katie Mehlick, RN, BSN; sitting is Kristyn Yocius, RN, BSN.
Great Patient Experience Champions
24 The number of nursing staff who have taken on the
new role of Great Patient Experience (GPE) Champions.
GPE Champions are nursing staff who function as resources
and change agents for their units/departments and serve as
role models for patient-centered care and the GPE initiatives
adopted by MMC. They disseminate information to
coworkers and collaborate with their nurse managers and
Unit-Based Councils (UBCs) to drive action plans for
improving patient experiences.
Champions must demonstrate
an attitude of service to patients that exceeds expectations,
an interest in sharing knowledge with colleagues, and a
communication style that fosters collaboration. They commit
to their own professional development through regular
attendance at the GPE Inpatient Team monthly meetings;
serve as role models for colleagues by demonstrating patientand
family-centered care, and share updates about GPE
outcomes in UBC and staff meetings. Their nurse managers
collaborate with them to implement action plans to create
great patient experiences and support the Champions in
their monthly meeting attendance and operationalization
of the Champion role.
The Inpatient GPE Team is co-chaired
by Deidra Glisson, RN, MSN, MBA, director of Nursing
Operations, and Paula Fyans, RN, MSN, 2G nurse manager.
Through the efforts of the team, the GPE Champions and the
many evidence-based patient experience initiatives we have
implemented, including nurse manager rounding and bedside
shift report, we achieved top-quartile performance for overall
patient satisfaction as measured by the Press Ganey survey
for 10 of the 12 months of 2012.
56 The number of staff nurses who
advanced on the Clinical Ladder
The Clinical Ladder Program
recognizes nurses’ contributions to
Memorial and to the nursing profession,
supports individual professional nursing
development, and reflects the full scope
of professional nursing practice.
Benner’s “novice to expert” model
of professional development is the
theoretical framework used by the
program. As nurses advance in
experience, their ability to contribute to
Memorial and to the nursing profession
expands. Clinical Ladder advancement
recognizes that development. Nurses
earn credits in four areas: clinical
excellence, nursing contributions,
professional ccomplishments, and
education/certification. The Clinical
Ladder is also a strong example of
nursing peer review. Nurses applying for
advancement on the Ladder prepare
their evidence as described in the
Definitions and Guidelines for Behaviors
Contributing to Professional Recognition.
Their evidence is reviewed and approved
by their Unit-Based Council colleagues
and their nurse managers.
goes on to the Clinical Ladder Review
Committee, a group of staff nurses
and nurse managers who review
each applicant’s evidence and
approve advancement on the ladder if
they determines the evidence is sufficient.
This is a critical step, ensuring that the
Clinical Ladder requirements are
consistently met by all advancement
applicants. The MMC Clinical Ladder
Program has been in existence for nearly
20 years but has been revised several
times based on staff feedback,
changing nursing practice expectations
and opportunities, and regular review
of best practices in other Magnet
Critical Care Collaborative
Jennifer Bond, RN, MSN, (left) nursing outcomes improvement facilitator, facilitates a Critical Care
10 The number of units or departments represented on the
Critical Care Collaborative (CCC).
This group meets monthly
to focus on performance improvement in our critical care and
intermediate care areas.
Case reviews are conducted for falls,
pressure ulcers and hospital-acquired infections to identify care
defects and opportunities for improvement. The CCC has
implemented the catheter-associated urinary tract infection (CAUTI)
bundle, pressure ulcer prevention (PUP) bundle, and the central
line-associated bloodstream infection (CLABSI) bundle.
The group is
expanding its focus from ventilator-associated pneumonia (VAP) to
ventilator-associated events (VAE), the most recent terminology and
criteria used by the Centers for Disease Control and Prevention.
This enables staff to intervene earlier with prevention and treatment,
including scheduled tooth brushing to decrease oral bioburden. The
group has worked aggressively on pressure ulcer prevention and seen
a 30-percent decrease in pressure ulcer prevalence. Interventions
adopted by the group include wedges to facilitate turning and
capillary closure pressure relief, the SkinIQ to manage excessive
moisture, and waffle-type boots to facilitate heel suspension. Jennifer
Bond, RN, MSN, nursing outcomes improvement facilitator, serves as
facilitator for the group.
Bedside Scientist Intensive
Cecilia Wendler, PhD, RN (left center), with three Bedside Scientist participants:
Paula Harwood, RN, BSN, Carrie Cantrall, RN, BSN, and Natalie Huebner, RN, BSN.
12 The number of nurses who completed the Bedside
Scientist Intensive (BSI) in 2012.
This program is offered in
May and October each year in 3½-hour sessions over four weeks and
is co-taught by Cecilia Wendler, PhD, RN, director, Nursing Research
and Academic Partnerships, and Sheryl Samuelson, PhD, RN, Millikin
The Intensive was developed from the Bedside
Scientist Institute, a 30-hour course initiated in 2007. The BSI is
designed to introduce staff nurses to the research process via
development of “burning clinical questions” based on participants’
areas of interest and practice. The course includes a literature review,
formulation of PICO questions (population, impact, control and
outcomes) and the fundamentals of the research process. Each
participant produces a research proposal that many choose to
Topics in 2012 included implementation of the EWSS Score
for bariatric patients receiving general anesthesia, family visitation in
PACU, personal care preferences for patients of size, comfort room
therapy for patients with dementia in a psychiatric unit, skin
preparation prior to cardiac monitor electrodes, diabetes education
in cardiac rehabilitation, critical incident debriefing effects on nurse
satisfaction, and therapeutic massage. Two of these were supported
with grants from the Memorial Medical Center Foundation. Ninety-one
nurses have completed one of the Bedside Scientist courses since
2007: 31 in the Institute and 60 in the Intensive.
Unit-Based Council Retreats
24 The number of nursing units that held their annual Unit-Based Council Retreats over a 45-day
period in 2012.
By standardizing the content and structure of the UBC retreats, as well as their monthly
meeting formats, our shared governance structure and processes were strengthened in 2012.
monthly meeting, UBC members review the previous meeting minutes for follow-up on action items from the
previous month, analyze their nursing-sensitive indicator data for patient falls, pressure ulcers and hospitalacquired
infections (VAP, CLABSI, CAUTI), and discuss practice-related issues and opportunities to improve
patient care on their units. Each UBC conducts individual case reviews of falls, pressure ulcers and infections
to determine ways to prevent further occurrences. Based on these analyses, the group develops action
plans to strengthen the use of evidence-based practices to prevent these adverse events and spread these
expectations to their nursing staff colleagues in 1:1 interactions.
The annual UBC retreats in the fall are
generally four hours in length and allow time for all UBC members to come together to review the UBC
charter, their membership and the unit’s performance toward achievement of the previous year’s goals.
Members set unit-specific goals in alignment with the Nursing Division goals for the coming year. Additionally,
the UBC Chairs Collaborative meets for an hour every other month to share learning across the UBCs.
This is an important network of support for the UBC chairs, including coaching new chairs, sharing
accomplishments, interacting on issues related to all nursing units and nursing quality indicators, and
spreading evidence-based practice across nursing units.