providence holy cross 2011 nursing annual report

Our Magnet efforts are rooted in knowledge, Cultivated with a passion for excellence, And nurtured to sustain continued growth.

2011 nursing annual report

When a seed is planted, the ‘seed’

does not decide to grow…it is the

gardener who makes this happen.

Core Values RespectAll people have been created in the image of God. Genesis 1:27 We welcome the uniqueness and honor the dignity of every person. We communicate openly and we act with integrity. We develop the talents and abilities of one another.

compassion Jesus taught and healed with compassion for all. Matthew 4:24 We reach out to people in need and give comfort as Jesus did. We nurture the spiritual, physical and emotional well-being of one another and those we serve. We embrace those who are suffering.

Justice This is what the Lord requires of you: act with justice, love with kindness and walk humbly with your God. Micah 6:8 We believe everyone has a right to the basic goods of the earth. We strive to remove the causes of oppression. We join with others to work for the common good and to advocate for social justice.

excellence Much will be expected of those who are entrusted with much. Luke 12:48 We set the highest standards for ourselves and for our ministry. We strive to transform conditions for a better tomorrow while serving the needs of today. We celebrate and encourage the contributions of one another.

stewaRdship The earth is the Lord’s and all that is in it. Psalm 24:1 We believe that everything entrusted to us is for the common good. We strive to care wisely for our people, our resources and our earth. We seek simplicity in our lives and in our work.

the Providence commitment

MissionAs People of Providence, we reveal God’s love for all, especially the poor and vulnerable, through our compassionate service.


The start of our hospital in Mission Hills, California

in the mid-1950’s, an airplane crash in Pacoima dramatically emphasized the lack of acute-medical care in the northeast section of the San Fernando valley. the people of Mission hills

turned to the Sisters of the holy cross (from notre dame, in) to build the much needed hospital which opened in 1961.

disaster struck the San Fernando valley in 1971 in the form of a 6.6 earthquake, then again in 1994 when the northridge earthquake severely damaged holy cross. each time the hospital came back to serve the acute and trauma needs of the valley.

in 1996, Providence health System took ownership of the Medical center. Strategically located near the intersections of the 405, 5, 118 and 210 freeways, the Medical center serves both the San Fernando and Santa clarity valleys. An $180 million Leed Silver certified patient care wing expands Providence holy cross Medical center to 377-beds making it one of the largest hospitals in the San Fernando valley. it is also one of the very few Medical centers within the greater Los Angeles area which has achieved the prestigious Ancc Magnet® designation for excellence for nursing services and is one of only two hospitals in the San Fernando valley with Level ll trauma center designation, verified by the American college of Surgeons.

Services Include:cancerheart & vascularWomen’s ServicesorthopedicsneurosciencerehabilitationSubacuteSurgerydigestive disorderstrauma & emergency

Statistics of Interestemployees: 1,900 +Medical Staff: 600+Licensed beds: 377

annual (2011 data):Births: 2,647inpatient Admissions: 19,898outpatient visits: 49,464emergency room visits: 75,679trauma cases: 1,153inpatient Surgeries: 4,313outpatient Surgeries: 1,849

the Providence commitment

4 2011 nursing annual report

Message from cno .................................................................................... 5

transformational Leadership ....................................................................... 6

Structural empowerment .......................................................................... 12

exemplary Professional Practice ................................................................. 22

new Knowledge, innovations & improvements ......................................... 37

Awards & recognition .............................................................................. 43

in Memoriam ............................................................................................ 43

tABLe oF contents


Letter FroM the chief nuRsing officeR

I was so honored and pleased to be accepted as the chief nursing officer (cno) for Providence holy cross Medical center (PhcMc), in early december 2011.

For years i have admired the excellence in nursing practice and the supportive practice environment that earned PhcMc the prestigious Magnet designation. A special thank you goes to my colleague Betty newsom, the previous cno, for leading the way.

When i arrived here in early december 2011, i was not disappointed with what i found. i saw how the nursing staff assessed each patient or situation, synthesized the data and made the best professional decisions; i heard from our physicians about our nursing excellence; i saw the compassion of all who touched our patients; i heard about the caring and empathy from patients and families; and i observed how all departments within the hospital supported the clinical processes.

2011 was a challenging year for our nursing staff as the hospital added 138 new beds, which included additional step-down, telemetry and medical surgical beds, as well as, expansion of Women’s Services and a brand new 12 bed nicU. throughout the expansion our nurses always focused on and achieved excellence in patient care and compassion for all who entered our doors.

We are proud of our nurses and their amazing accomplishments, which are explicated in our 2011 Annual report. our theme is all about growth and change. PhcMc rns continue to lead change with their physician partners and the interdisciplinary team. You will read stories about how our nursing staff has improved the structures and processes, which affect staff, physicians, patients and families. i am most proud of the “can do” attitude that permeates everything our nurses achieved at PhcMc.

our vision as we move into 2012 and beyond is to retain the small hospital feel of collaborative teamwork, respect and compassion while expanding the services we offer. We will work together to maintain the best of who we are and to become even better as we enhance our structures and processes to support our increased volume and size. i have always believed the role of the cno is to establish an excellent practice environment, which attracts and retains high-level professionals. Being at PhcMc is a dream come true and i am committed to continue the dream.

Ann Dechairo-Marino, PhD, NEA-BCChief Nursing OfficerProvidence holy cross Medical center

trAnSForMAtionAL leadeRship


2011 Nursing Leadership:ann dechairo-marino, phd, Rn, nea-Bc, Chief Nursing Officer (december 2011 to present)

Betty newsom, Rn, ma, cnaa, Chief Nursing Officer (January 2011 to october 2011)

Ken archulet, Rn, cfn, Manager Epidemiology and Infection Prevention

deborah Bergida, Rn; msn/mha, ocn, cmsRn, Director Medical Surgical

missy Blackstock, Rn, Bsn, Director Emergency Department

Jerilyn Brown, Rn, ocn, Director Patient Care Support Services

tricia Burkholder, Rn, Bsn, Director Maternal Child Health

Ronald carpio, Rn-Bc, msn, ne-Bc, Manager Medical Surgical

laura castro, Rn, Bsn, Manager Medical Surgical

Kate connolly, Rn, Bsn, Director Post Acute

annette cordero Britton, Rn, Bsn, phn, Director Occupation Health and Safety

Jane flaherty, Rn, msn, cns, pccn, ccRn, Director Clinical Education

sherri friedrich, Rn, msn, fnp-Bc, Coordinator Stroke Program

Yvonne gaffney, Rn, Bsn, mBa, cnoR, Director Perioperative Services

heinrich huerto, Rn, msn, onc, cmsRn, Manager Orthopaedics

Kathy Kirby, Rn, Bsn, Manager Telemetry

Ronda mcphail, Rn, Bsn, Manager Labor and Delivery

patricia mayberry, Rn, Director Clinical Project Implementation

sherri mendelson, phd, Rnc, cns, iBclc, Director of Nursing Research and Magnet Program

Kimberly murphy, Rn, acnp-Bc, Manager Trauma Program

Victor oden, Rn, msn, Manager Telemetry

lisa pettinelli, Rn, RRt, cen, Manager Respiratory Care Services

sandra pieschel, Rn, cde, Manager of Diabetes Education

pam Rick, Rn, Bsn, Director Critical Care Services/Interim Chief Nursing Officer

Barbara Rozewicz, Rn, msn, ccRn, cmc, np-c, Manager Cardiology

cathy Yee, Rn, msn, ccRn-csc, Clinical Nurse Leader Surgery

nuRsing At Providence hoLY croSS



Nursing Statistics:Rn turnover 5.2%

Rn Vacancy 7.8% (affected by new wing additional positions)

direct care nurses• BSN or higher among direct care nurses 47.4%• Certifications among direct care nurses 45.3%

patient care managers/directors • BSN or higher among nurse leaders 100%• Certifications among nurse leaders 72%

2011-2013 Nursing Strategic Plan Vision measuRes of success

• Innovative, safe, reliable, outcome oriented and patient centered care across the continuum of health services

• Outreach to poor and vulnerable in global community

• Competent and abundant nursing workforce

coRe stRategY: one Ministry committed to excellence: inspired by our heritage, we work together to deliver excellent health care in the communities we serve. We realize the value of being a system through our common strategic directions, systems & structures, tools & resources, knowledge transfer and operational execution and results.

• Effective Communication: Deliver effective communication that is accountable, clear, timely, consistent and fosters a cohesive organizational culture.

• Quality and Excellence: Advance a culture committed to excellence, patient safety and satisfaction

– Workforce Planning & development: recruit & retain a competent, healthy and satisfied workforce

– nursing Magnet: implement business plan for achieving Magnet re-designation.

– infrastructure reliability: Maximize patient outcomes and satisfaction by proactive of equipment acquisition & management


Recognized with the 2011 California Award for Performance Excellence providence holy cross medical center of mission hills was among nine statewide winners of the prestigious eureka awards bestowed by the california council for excellence. the eureka award for performance excellence is the top level award offered by cce, part of the organization’s california awards for performance excellence, known as cape.

the cAPe program guides california organizations in maintaining competitiveness by promoting continuous improvement. Applicants are evaluated through 50-page application and a weeklong site visit, based on the requirements of the Baldrige criteria for Performance excellence: leadership, strategic planning, customer and market focus, measurement, analysis and knowledge management, workforce focus, process management and results.

IBCLC Care Award, 2011, recognized by IBLCE and ILCA was awarded to PHCMC. the international Board of Lactation consultant examiners (iBLce) and the international Lactation consultant Association (iLcA) present the iBcLc cAre AWArd For hospitals, Birthing Facilities, and Birthing Services to recognize maternity facilities worldwide that hire international Board certified Lactation consultants (iBcLcs). this provides optimal education and support for our breastfeeding mothers.

nuRsing At Providence hoLY croSS



gRowing to Serve oUr coMMUnitY

Patricia Mayberry, RN, Director of Special Projects, was our internal lead as our new 138-bed South Wing was designed, constructed and opened. transformational leadership leads to positive changes in those who follow. these individuals are enthusiastic, passionate, and inspiring. not only are these leaders concerned and involved in the process; they are also focused on helping every member of the group succeed as well. Quality patient care is achieved by the contribution of all care providers and their expertise. design teams, representing diverse areas of our ministry, provided a forum to create ideal workflow processes, coordination of equipment, delivery, and storage, establishing room standards and usability, and care delivery model centered on a patient safe culture. this was a wonderful opportunity to hear from all interests as we created an efficient and sustainable work environment for moving into our new wing. Finally, each team carefully reviewed the current state process and integrated those processes when possible. the kick-off for the design teams was July 29, 2010.

each team lead received the charter and a tool Kit consisting of:

• Status Report Template

• WWW Template

• Member Selection and R&R Grid

• Education Plan Template

• Communication Plan Template

Nursing supervisors touring the construction site.

Care board design team


Missy Blackstock, RN, BSN, helped to develop our new Patient Placement Center the vision of the PPc all started because Providence holy cross Medical center was continuing to outgrow our bed capacity at a very fast rate. the house Supervisor was the main person trying to keep track of all the patient movement and transfers within the facility and also trying to coordinate patients that need to be admitted to Providence holy cross Medical center. this was a very overwhelming task especially when were holding many patients in the emergency room due to lack of room availability. We also had the opening of our new South tower with an increased capacity of 138 additional beds. therefore, we started developing a process to improve patient placement and manage our new growth.

the Patient Placement center (PPc) would ensure the successful management of new patient volumes and the restructure of patient throughput with efficient bed placement communication. A PPc coordinates inpatient placements from the emergency department and unit to unit transfers, while maximizing staffing. in addition, the PPc serves as a transfer center for all external transfers from hospitals and skilled nursing facilities into PhcMc.

We needed a registered nurse that had the knowledge-base to understand the clinical picture of every patient and also personnel that understood the legalities of transferring a patient into the hospital. We hired a house Supervisor and a case Manager to manage the Patient Placement center. they are highly qualified clinical staff capable of ensuring the appropriateness of patient placement into the correct care area and coordinating the admission and transfer of patients. the PPc is able to handle direct admissions from other hospitals, physician offices, higher level of care transfers, emergency room to emergency room transfers and of course, due to our trauma Level ii designation, transfer of trauma Patients into PhcMc. the benefit of the PPc for transfers is that one phone call will assist any transfer into the hospital. the PPc staff has direct access to the acute services within the hospital and is able to manage the patient placement with quick decision-making. Providence holy cross Medical center has 24/7 hospitalist care on-site to accept care for any type of patient, increasing the program effectiveness and efficiency.

What is making the Patient Placement center a success is that one number and one phone call allows the PPc staff to be in direct contact with someone qualified to assist in bedding, admitting and arranging for a transfer of the patient to our medical center.

deVeloping A neW PAtient PLAceMent center



Ron Carpio, RN-BC, MSN, NE-BC, was relatively new to PHCMC as a Nurse Manager for Medical Surgical. during our reorganization, due to the opening of our

South Wing, ron was requested to shift from Medical Surgical to our new neurology Unit and assume management of our Acute rehabilitation Unit. here are ron’s thoughts.

feaR: fear of the unknown

- Am i going to do well in this transition knowing i just developed rapport with one unit in a short period of time, and now, attempting to develop 2 other units?

- is staff going to respect me knowing they didn’t participate in providing input on who their manager was going to be?

- Am i going to be successful learning 2 totally different specialties?

- clinically, am i going to be able to assist the staff when needed because i’m out of my comfort zone?

- is this going to be challenging enough for me?

fear of losing control

- With the changes surrounding the organization i.e. voluntary separation, organizational structure changes, morale concerns, etc., what will happen to me if i say no to this new role?

- With 2 different specialties belonging to 2 different umbrellas, one in post-acute and the other in telemetry, am i going to be reporting to 2 different bosses?

i completely understand that change is inevitable in any organization. no matter how uncomfortable it feels and no matter what different scenarios i play in my head, at the end of the day, life goes on - the staff needs a leader, the organization needs a leader, and most importantly, patients need a leader.


Providence holy cross Medical center serves a diverse population of nearly $2 million residents in the San Fernando and Santa clarita valleys. As a not-for-profit facility, we offer a full continuum of health services, from outpatient to inpatient to home health care. As our communities continue to grow, we have expanded our hospital and its services to meet their ever-changing health care demands of our patients and families

oUr communitY

StrUctUrAL empoweRment

22.05%

17.65%

28.48%

58.36%

27.95%

22.74%

7.81%

1.26%

2.42% 3.64%

7.63%

Population by Age

Population by Race

0-13

14-24

25-44

45-64

65-84

85+

Asian

Black

hispanic

White

other


• Mental health services that are affordable and accessible, especially for children, older adults, homeless, veterans and undocumented.

• Affordable and portable health insurance and providing access for undocumented individuals.

• Permanent supportive and affordable housing including more Section 8 housing and emergency shelter beds.

• Chronic disease management and prevention with a focus on diabetes, hypertension, obesity and asthma.

• Dental health services that are affordable and accessible especially for adults, seniors, and low-income children.

pRioRitY healthcaRe issues in oUr coMMUnitY

39.71%

11.77%9.63%

11.8%

16.51%

8.40%

27.50%

30.14%

12.13%

7.88%

3.42%

3.66%

17.45%

Educational Attainment

Insurance Status of Community Residents

Still in School/too Young for School

out of School K-8th Grade

Some high School

high School Graduate

Some college - no degree

Associate’s degree

Bachelor’s degree

Graduate/Professional degree

total Uninsured

Medi-cal

Medicare

hMo

PPo


our nurses have ample opportunity for participation helping form the direction for the department of nursing and to collaborate with other departments through our Shared Governance Structures. the following list includes the nursing committees and chairs for 2011.

nUrSinG ShAred goVeRnance

Council/Committee ChairAcute rehabilitation collaborative Kate connolly, BSn, rn

Assistant nurse Manager council Lisa Fetterolf, rn

Brain trauma injury committee Kim Murphy, MSn, AcnP-Bc, cen

Breast Feeding task Force Maria Knoll, MSn, cnL-Bc, rn, iBcLc, rnc-oB, eFM, Mnn

chapter chair council Laurie Marx, RN, MPH, CPHQ

clinical education council Jane Flaherty, MSn, rn, cnS, Pccn, ccrn

Core Measures/Nursing Quality deborah Bergida, MSn, rn, ocn; cMSrn

clinical Ladder committee tanya haight, BSn, rn, ocn, cMSrn; onc

clinical Practice council Marirose Medina, BSn, rn

cPr committee chris consolo, BSn, rn, ccrn

critical Services/trauma clinical Practice Kristi Miura, rn, ccrn

cultural diversity council Barbara o’reilly, rn

disaster council connie Lackey, BSn, rn

documentation Management committee Jeri Brown, rn, ocn

donor council cathy cadden, MSn, rn, cnS, ccrn

emergency department Unit Based council carol carter, rn, cen

Falls committee ramona rojas, rn

interdisciplinary Palliative care team Karen roberson, MSW

interdisciplinary Patient and Family education Betsy Jansen, rn, chPn

Labor and delivery clinical Practice elaine Walker, rn, rnc-oB, eFM

Magnet council Karen Watson, BSn, rn, cMSrn; rn-Bc and Sherri Mendelson, Phd, rnc, cnS, rnc-oB, nic, c-eFM, iBcLc

Mother-Baby clinical Practice committee Yajaira Paredes, MSn, rn, cnS, rnc-oB; c-eFM

Med Surg/Post Acute divisional Practice Kathy christian, BSn, rn, ocn, cMSrn

Medication Management/Safety chapter chair tawny Bui, Pharm d.

Meditech User Group norma Arnau, BSn, rn/Stacey Williams, rPt

night Shift council Stacey Beatty, BSn, rn, Pccn

nurse Manager council Judy Pharris, BSn, rn

nursing research committee terri Gately, BSn, rn-Bc, crrn

Patient care Leadership Betty newsom, BSn, rn, cnAA/Ann dechairo-Marino, Phd, rn, neA-Bc

Patient Safety Jean Marie Kane, risk Manager

Performance review tim Gilmore, rn

Peri-operative/invasive Meeting Group ellen Webb, BSn, rn

Products and Standards Ken Archulet, rn, cFrn, cic

Provision of care council Jeri Brown, rn, ocn

recruitment and retention Workforce Planning Jeri Brown, rn, ocn

nursing director council Betty newsom, BSn, rn, cnAA/Ann dechairo-Marino, Phd, rn, neA-Bc

Safety committee connie Lackey, BSn, rn

tracer team Laurie Marx, RN, MPH, CPHQ

Wound/Skin committee Monica tweddell, rn, Wcc


night shift nUrSinG coUnciL

The Night Shift Nursing Council was created to assist the night shift nursing staff with problems and concerns that arises during the night shift.


an innovative and very successful new night shift council, with stacey Beatty, Rn, Bsn, pccn, staff nurse in the icu, was formed at the end of 2010 to address the concerns of our night shift nurses and ensure their active participation within our shared governance structure and processes.

the night Shift nursing council was created to assist the night shift nursing staff with problems and concerns that arise during the night shift. the night Shift nursing council is comprised of one primary night shift nurse representative and one secondary night shift nurse representative from each nursing department in the hospital. the night Shift nursing council meets on a monthly basis. With the assistance of the chair and co-chair, the night Shift nursing council discusses the issues and determines the next appropriate action to take. the night Shift nursing council has invited many representatives from other departments to join our meetings and assist with the concerns of the night shift nursing staff. the night Shift nursing council has also created a newsletter that is updated after each meeting on the hospital intranet. this newsletter allows the nursing staff in the hospital to view the minutes from each meeting.

the night Shift nursing council has made great progress since the council was created. the night Shift nursing council voiced a concern regarding patient transportation during the night shift. there was a concern that transportation was not available to the night shift staff to take patients to various tests such as Mri and ct scan. After inviting the representative for transportation to a night Shift nursing council meeting, the transportation department changed the hours and shifts of the transport employees to help with transporting patients at night. this has made transporting patient a much easier process. the night Shift nursing council also voiced a concern about the cafeteria being unavailable for the night shift staff. After working diligently with the Food and nutrition Services department, our new cafeteria opened and is now available to the night shift from 12:30 am to 3:30 am. discussions centered on hours of night operation and food choices. the employees have voiced satisfaction with the new cafeteria hours and with the fresh, hot food that is available to us. currently, the night Shift nursing council is working with the laboratory relating to handling of specimens. the night Shift nursing council has made great progress in helping with the issues that arise during the night shift. We are very pleased to have this council in place.


the clinical Ladder provides a vehicle to expand and advance the practice of professional nursing at PhcMc for the registered nurse.the clinical Ladder helps to demonstrate the forces of magnetism inherent in the structures and processes of the nursing organization at PhcMc. our clinical Ladder design is based on Benner’s novice to expert theory and recognizes the contribution of nursing excellence within our organization.

clinical laddeR committeetanya haight (chair)terri halverson (co-chair)

clinical laddeR leVel 3emergency departmentcarey FaulknerJennifer dodsonMary herrera

icuStacey BeattyJane Zema

labor and deliveryMarilyn herrickSusie catalano

nicuBarbara russoPensri choti

med/surgJohanna ongjocoWilliam Lim

telemetry/stepdownedeliza rosalescecile SalvadorSusana riveriosLourgelie de diosMelissa tell

girochelle nelsonJudy Albertdenise Willmarth

clinical laddeR leVel 4educationJennifer Lindskogtanya haightKathy christianKristi MuiraAurora tweddellYajaira ParedesKaren Watson

icucarole McKennanchristina consolo

labor and deliverytenesa reidKristina Shannon

med/surg/oncologyteodora tiongsoningrid BloseJenny Leonterrie BybeeBilma Pellissery

telemetry/stepdownWendell GarciaBeverly Gumodga

emergency departmentterri halversoncarol cartercathy carter

icuJessica horstSubacuteterri Gately

clinical laddeR leVel 5educationKimberly crabtree Loyd

icuKathy cadden

nUrSinG clinical laddeR


ouR tRaceR team ProceSS


Providence holy cross Medical center believes in consistently monitoring our readiness for any regulatory surveys. this promotes excellent care every day, for every patient as well as a safe and effective work environment for our staff. one of our methods is the use of monthly tracers. this is accomplished by nurses and ancillary staff at all levels who participate on our tracer team. there are 75 elements on the tracer focused on the most meaningful standards. the tracer tool is assessed at year end to identify areas regularly in compliance. Standards that are not problematic are dropped and areas with a higher risk for non-compliance are included. Standards for inclusion are selected from the top 10-15 that tJc has identified as generally problematic in the survey process and especially those having a direct impact on the patient. consideration is also made for those areas of highest importance for compliance with Medicare conditions of Participation. the database is also assessed to identify the top findings that fail to pass criteria and what needs to be done to improve compliance. the tracer team has helped clarify issues of documentation and policy for all nursing staff to improve patient care.

2011 Tracer Team Nursing ParticipantsBilma Pellissary, MSn, rn, cMSrn Medical SurgicalShan chin, BSn, rn telemetrySue rioveros, BSn, rn PAcUSherri Mendelson, Phd, rnc, cnS, iBcLc Magnet ProgramLorgelis vergel dedios, rn, Pccn telemetryAngel Soriano, BSn, rn telemetry Karen Watson, BSn, rn, cMSrn; rn-Bc educationcynthia Marsden, MSn rn, crn radiologydebbie dimeo Addison, rn Super Float PoolKathy dibene, BSn, rn, ccrn Short Stay Surgery/cardiac rehabterri Gately, BSn, rn, crrn, rn-Bc Sub Acute/Acute rehabrosie hanna, rn telemetryMargie McMenamin, BSn, rn, Pccn Perioperativehelen eichenhofer, rn Gi LabMarirose Medina, BSn, rn infection PreventionLois Kraznovsky, RN Quality ManagementKatie Walkowiak, rn Mother-BabyLaurie Marx, RN, MPH, CPHQ Quality Managementcynthia Loyd, rn orKaren Klein, BSN, RN, Quality Management


icu Kathy cadden, ccrn chris consolo, ccrnShirley ibarra, ccrn Melissa tell,Pccn carole McKennan, ccrnBrenda Mitchell, ccrnMelanie LaMadrid, ccrn crystal Akao, ccrn Amy rosengran, ccrn Jessica horst, Pccn Stacey Beatty, Pccn

medical-suRgical/oncologY Lois Agler, cMSrn Alvin Arceo, ocn Suzanne Bart, cMSrnPamela Baylon, cMSrningrid Blose, ocn, cMSrn Shiela Borelli, oncdeedee Bubalo, ocn, cMSrn terrie Bybee, cMSrn Sheila cardoniga, ocn Maricel delgado, cMSrncynthia dasaad, ocn eileen diaz, ocn Marisia duarte, onc riza estranero ocn; cMSrnBarbara Farrar, ocnGemma Francisco, onc Lori Galorneau, ocn Kathy Gilmore, cMSrn christian Gonzalez, cMSrn dary hult, rn, ocn

Jenny Leon, cMSrn William Lim, cMSrnvener Lineses-diaz, cMSrn, onc veronica Lozano, cMSrn, oncMary Mahn, cMSrn, onc elizabeth Malaida, oncApril Mijares, cMSrn, ocncathy Millan, cMSrn, oncJohanna ongjoco, ocn, cMSrn Maelene owera, cMSrn, oncBilma Pellissery, cMSrnAmy revilla, onctristan robles, cMSrnMaria rodriguez, ocnLeticia Salvador, ocn Betsy Smith, cMSrn; ocn Jackie Sullivan, cMSrn Michelle tabar, cMSrnBarbara thomas, cMSrn dory tiongson, ocn; cMSrn catherine valbuena, cMSrn Lori West, rn, ocnMarietta Yuscon, rn, onc

supeR float poolSeta velasquez, cMSrn, onSMary ellen hazle, cMSrn; Wcc

nuRsing QualitY analYsts Karen Broggie, CPHQ Sheila Ritchie, CPHQ Cyndie Speen, CPHQ, RN-BC Marianne Plakas , ccrnLaurie Marx, CPHQ Faith community nursing

connie cruz, rnc-oBnurse PractitionersBrigitte condie, rn-Bc, Ancc-

AcnP deborah tsunoda, rn-Bc, Ancc-

AcnP

acute RehaB/suB acuteterri Gately, crrn, rn-Bc

education seRVices Yajaira Paredes, rnc-oB; c-eFMAdriana Basurco, rnc-nicKathy christian, ocn, cMSrnKim crabtree-Loyd, rn, cPAncynthia Funakoshi, Pccntanya haight, ocn, cMSrn; onc Jennifer Lindskog, rn, cenKristi Miura, ccrn Monica tweddell, Wcc Karen Watson, cMSrn; rn-Bc

case managementBetsy Jansen, chPn Kathy Menard, CPHQ, CPRM edna tiongco, ccM, crrn Jinky rivera, ccM, cPUM craig hollaway, cen, Micn

nuRsing management deborah Bergida, ocn; cMSrn Jerilyn Brown, ocn Ann dechairo-Marino, neA-BcYvonne Gaffney, cnor

ceRtified nuRses At PhcMc in 2011


nuRsing management cont’dJane Flaherty, Pccn, ccrn Betty newsom, cnAA carrie Sayeski-reid, rnc-oB Sherri Friedrich, Ancc-FnP Ken Archulet, cFrn, cicSherri Mendelson, rnc-oB, nic,

c-eFM, iBcLc Sandra Pieschel cde Lisa Pettinelli cen Barbara rozewicz, ccrn, cMc,

nP-Bc tina Moore-Yamron, rnc-nicron carpio, rn-Bc, ne-Bcheinrich huerto, cMSrn, onc

mateRnal child health Pamela Appleton, rnc-Mnn debbie Felkel, iBcLc, rnc-Mnn danielle Silvieri-Anthony, iBcLc Julie tannaci, rnc-Mnn nancy Mcclenaghan, rnc- nic nanette Moffet, rnc-Lrn Arvy Quizo, RNC-LRN; RNC-NIC Lilia nicholas, rnc-MnnLinda harrington, rnc-oB Jenni Kohl, rnc-oB claudia Preciado, rnc-c-eFM tenesa reid, rnc-oB delores relucio, rnc-oB; c-eFM Sally ritter, rnc-oB; c-eFM Kristina Shannon, rnc-oB Margaret Walker, rnc-oB, eFMtherese Gass, iBcLc cambria Stephens, iBcLchaley Barickman, rnc-nicSusan egami-iBcLccristina Gaor, rnc-nicMichela nueve, ccrnAnna Apalon, rnc-eFMMaria Knoll, iBcLc, cnL, rnc-oB,

eFM, MnnKristen Miller, rnc-oB, eFMLourdes Parseghian, rnc-oBdawn Schultz, rnFAcindy Fairchild, iBcLc, rnc-Lrn

emeRgencY depaRtmentMelissa Barnes, cencarol carter, cencathy carter, cen Jennifer dodson, centerri halverson, cenheidi Krause, cenAlexandria carey, cen Jacquie Siddens, cen Sue cassling, cenrosanna Macklin, cenMelissa Parsons, cenKim Murphy, cen cindy Sweem, cen

caRdiologYRadiologY hannah rhodes, Pccn Jackie richardson, ccrn cynthia Marsden, crn

peRiopeRatiVeFrankye Bauerle, cPAnKim crabtree-Loyd, FnP-Bc, cPAn ed Betker, cnorrenee dove, rnFA, cnorLisa eberhart, cnor Mike earnheart, cFrn Karen Kelsey, cnor nora Lucas, cPAn Mary Jane Pettee, cnor elizabeth Pleasant, cnor Marilyn Seckar, cPAn Louisa Singer, cnor, rnFA Melanie Ylagan, cnor Susan Zavala, ccrn, cPAn Gail Zerby-cook, cnor, rnFA Janine Montero, cMSrn denise Wilmarth, ocn, cMSrncathy Yee, ccrn-cSc Margaret McMenamin, PccnMaureen Jamgochian cheSKathy dibene ccrn

telemetRYBeverly Gumogda, Pccn Linda o’reilly, Pccntherese villanueva, Pccn

debbie Welch, Pccn Wendell Garcia, Pccn Audie Gonzalez, Pccn tracy Kwak, Pccn emmanuel Palad, Pccn danica Whisman, rn, Pccndevina Samonte, rn, PccnMyrene Martinez, rn, PccnLourgelie vergel de dios, rn,

Pccn


New Degrees in 2011ronda McPhail BSn

Yajaira Paredes MSn, cnS

rochelle nelson BSn

terri Gately BSn

Kate connolly BSn

Suzanne Weltig BSn

Jennifer habell BSn

ellen Lombardo BSn


oUr FAMiLY holidaY celeBRations

PhcMc is known for its family-like atmosphere. this permeates our entire Medical center, especially during the holidays! We become quite creative in our hoLidAY door decorAtinG conteSt!

categoRY winning depaRtmentcomic trauma ProgramSpiritual risk Managementcreative cardiac cath LabFestive clinical educationBest original design cafeteria

congratulations to the winning departments!

once again thank you all for your time, effort and your participation.


helping other coMMUnitieS


Mission to Tijuana25 leaders, mostly from Providence in Southern california, attended a five- day Ministry Leadership Formation trip to tijuana, Mexico, working through esperanza, international. they spent two days in “house building” work with families, seeing the immigration issues through the eyes of those recently deported from the United States and visited at a local clinic on the edge of the dump. the participants from PhcMc were:

lisa pettinelli, Rn, RRt, cen

pam Rick, Rn, Bsn, mBa


oUr nUrSinG pRofessional pRactice model

Our Providence Health & Services Vision Statement:Together, as People of Providence, we will answer the call of every

person we serve: KNOW ME, CARE FOR ME, EASE MY WAY

Our Providence Health & Services Nursing Vision Statement: Providence nurses embrace their heritage of compassion, courage,

and leading-edge care as a steadfast, sacred presence in protecting

and easing the way for those in need.

exeMPLArY pRofessional pRactice

the 4 c’s of phcmc nuRsing

patient and family

phcmc nursing philosophy

ph&s nursing Vision statement

achieving excellence in an evidence-Based practice environment

mission andcore Values

professionalpracticeenvironment

com

passion

competence

collaBoRation

caRi

ng


nuRsing inteRnal expeRts At PhcMc

internal experts are used at PhcMc to improve care in the practice setting. PhcMc seeks to attract, develop and retain the best people in each specialty area. this longstanding commitment has produced an environment that is rich with internal consultants. these individuals, each with specialized knowledge and expertise, are an important internal resource for nursing leaders and our direct care nurses. From our cFo and his staff assisting leaders with the budget process, ensuring adequate staff and equipment, to our risk Management team, ensuring that safe and legal patient care takes priority at PhcMc, there are supportive internal experts beginning at the top administrative levels at PhcMc. According to Boxer and taylor (2007), use of internal experts has a positive effect in disseminating evidence-based practice.

the following pages from a family member of one of our patients puts into words the effect of our Palliative care expert team that includes Leah Phillips, rn.


nuRsing inteRnal expeRts At PhcMc



thoUGhtS FroM oUr nuRsing expeRts

Sherri Freidrich, RN-BC, FNP stRoKe cooRdinatoR

As the Stroke coordinator at Providence holy cross Medical center (PhcMc), my role centers around four general areas; patient care, management, quality, and community education.

Patient care is my passion. As a nurse practitioner i work collaboratively with nurses and physicians as well as other members of the healthcare team. i take health histories, perform physical examinations, assess, treat and evaluate patients with stroke symptoms, order diagnostic tests and evaluate results, prescribe and manage medications, and educate to promote healthy behaviors.

As a manager, i oversee and coordinate care for each patient admitted with a possible stroke diagnosis to ensure that each receives evidence-based care. i keep the department’s policies and procedures up to date and make sure that they are implemented by the healthcare team. Additionally, i provide the necessary education for nursing as well as other members of the interdisciplinary team and make sure they have the appropriate tools to care for the population of patients with stroke related diagnoses.

the quality segment of my role includes ensuring that performance is measured and tracked. Stroke care is held accountable for eight specific core measures. i gather and report data for all of these core measures, evaluate results with members of the collaborative team, and then if necessary, implement a performance improvement plan to enhance compliance with established clinical guidelines.

community education focuses on primary and secondary prevention of stroke. PhcMc provides ongoing community lectures, health screenings, and monthly stroke support groups for stroke survivors and their family members. PhcMc is an Advanced Primary designated Stroke center.


thoUGhtS FroM oUr nuRsing expeRts

Deborah M Tsunoda, MS, RN, ACNP-BCinteRVentional caRdiologY nuRse pRactitioneR

the first thing i do when arriving at the hospital is check to see how many stress tests are ordered. i coordinate with the team and nuclear medicine to complete them in a timely manner. Most of these tests require the patients to be nPo so we don’t want to keep them waiting all day and if they are receiving a nuclear isotope, they will be going to nuclear medicine twice. these tests are usually 2 parts and can take several hours to complete. All of the stress tests require me to be present with the patients to observe their ecG and vital signs. our hospital is growing and becoming busier every day which means there are more stress tests ordered so patients can be discharged. i juggle supervising these and discharging patients in a timely manner.

i manage the care of the myocardial infarction (Mi), and post interventional cardiac catheterization patients during their hospitalization. We are a SteMi receiving center which means holy cross specializes in providing state of the art care to patients having an St elevation Mi. the paramedics will bypass another hospital to bring a patient to holy cross if the ecG shows St elevation on it. this is a nation-wide program and the goal is to open the artery in 90 min from the time of medical contact in the field and ed door. Statistics are kept and entered into a data base which is sent to Los Angeles county. We are compared to other Los Angeles county participating hospitals. our overall door-to-balloon times have been very good. it is a team effort including the staff of the emergency department and cardiac catheterization Laboratory as well as the physicians.

i work in collaboration with the cardiologists, hospitalists and Primary care physicians to provide the most comprehensive and complete care to each one of our patients. there is usually more than one medical issue that requires attention. diabetes mellitus, hypertension and hypercholesterolemia are the main issues i deal with in most of my patients. education is the key to keeping the patients from returning to us. i provide education to each patient prior to discharge. Many new diabetics are discovered when they come in with their Mi. our diabetes department provides a meter and instructs them on how to do a finger stick. i always make sure that the patients have had diet instruction also prior to discharge. this is for both cardiac and diabetes diets. there are a lot of different elements that go into discharging a patient and i also make sure the patients have proper follow up instructions. if a patient cannot afford his/her mediations, i provide appropriate resources.

there are several committees i attend, such as, interdisciplinary committee, cardiovascular conference, cardiology division, cardio/cvS conference, cardiac oversight, Stemi receiving center work group, Stemi receiving center Quarterly Meeting, Critical Care Committee and Medicine Department Meeting. Continuing medical education credits are required to remain credentialed so i attend our tuesday and Friday cMe lectures offered at the hospital.

during the orientation of new nursing staff, i will give a brief overview of my position and also review treatment for the cardiac catheterization patient. i am called with questions during the day about my patients and our nurses contact me with any problems. My days are unpredictable because a code acute myocardial infarction (AMi) can come in at any time. i usually write orders and follow the AMi patient through to discharge. the cardiologists rely on me to make sure the patient is discharged home with all the correct prescriptions. Aspirin and other medications are essential for the stent patients because of the high potential for thrombosis. i also do all of the AMi core measure documentation which helps keep PhcMc in the 100% rating.

there are many elements that make up my day to keep it interesting and exciting to work at Providence holy cross Medical center as a nurse Practitioner in cardiology. i value the relationships i have with the staff and have made some very good friends.



Kimberly Murphy, RN, ACNP, CEN, MICN tRauma pRogRam manageR

the Providence holy cross Medical center, Level ii trauma Services saw 1153 patients in 2011. the trauma Program Manager role is a unique leadership role that spans multiple disciplines over the entire continuum of the trauma patient’s care from injury to rehabilitation. it involves interfacing with the Los Angeles county eMS Agency, Pre-hospital care coordinator, nurses, nurse leaders, hospital administration, physicians, and multi-disciplinary teams. An understanding of optimal trauma outcomes and evidence-based practice is vital as performance improvement / patient safety measures are key to successful trauma programs. My experience in trauma nursing has made me an internal expert here at Providence holy cross Medical center. My career began with nine years in the emergency department. in this time, i earned my certification as a certified emergency nurse (cen) and became a regularly assigned charge nurse. i also obtained my Micn certification to be able to provide medical direction to pre-hospital providers. the exposure to, and quickly acquired passion for, critically injured trauma patients drove my training encounters in my AcnP program (vascular, wound care, er, neurosurgery, and surgical critical care). thus, upon completion of my degree and board certification, i developed a position as a nurse practitioner in trauma/critical care. during the four years in this role i was an important part of the continuity of care in er resuscitation, or surgical intervention, icU stabilization, rehabilitation, and post-discharge follow up. i had a strong relationship with my supervising surgeons and was able to improve patient satisfaction, access to care, and length of stay. in the trauma Program manager role, as an internal expert, i draw upon my trauma nursing experience to be a resource in maintaining quality, evidence-based practice, and collaborative relationships with the multi-disciplinary team.

Cathy Yee, RN, MSN, CCRN-CSCclinical nuRse leadeR-peRiopeRatiVe

As clinical nurse Leader i serve as a clinical resource that coordinates and guides care for the cardiothoracic surgery patient population. i work closely with all team members including the patient, family, nurses and physicians along with other members of the healthcare team. Prior to surgery i review all preoperative studies for completeness and abnormalities. this is critical to patient care excellence and preventing post-operative complications. Pertinent patient information is provided to the icU staff and the anesthesiologist prior to surgery.

excellent communication skills with staff, physicians, patients and family members produce an open, caring environment in even the most difficult and stressful situations.

during the surgery i keep the family informed as to the progress in surgery and or complications during or after. i establish a communication path that patients and their family members can utilize during the hospitalization and also after discharge. With extensive experience in the care of the cardiac surgical patient this role provides both education and support essential for positive outcomes.

My education includes a Master of Science in nursing (MSn) along with ccrn-cSc certifications.


Cambria Stephens, RN, BSN, IBCLClactation consultant

As a Lactation consultant at PhcMc, i provide breastfeeding education to in-patients, staff and the community, on an outpatient basis, to promote breast milk as optimal nutrition and support women in making informed decisions about how they choose to feed their babies. My role is to educate and contribute to the healthcare team as an advocate for breastfeeding and evidence based best practice for our patients and their families in accordance with Baby Friendly hospital guidelines. For our inpatient population, this includes hands-on assistance to patients at the bedside, support of pumping and expressing milk for our patients who are unable to directly breastfeed, providing plans of care for breastfeeding dyads that have specific medical conditions or complications that may put them at risk for breastfeeding issues. For our outpatient population, this includes weekly breastfeeding support groups, telephone support via the breastfeeding helpline, and outpatient one-to-one consults for management of ongoing issues. For our staff, this includes providing input to the healthcare team, participating in nicU discharge planning rounds, participation in Breastfeeding task Force meetings, facilitating breastfeeding competencies for all staff and providing one-on-one breastfeeding specific training to all new staff as well as contributing to PhcMc policy development.

From: Beatty, Stacey L

Sent: Tuesday, November 15, 2011 2:32 AM

To: Bowe, Larry S

Cc: Mendelson, Sherri G

Subject: A thank you letter

Dear Larry Bowe,I am writing you this letter to let you know about my recent admission here at

Providence Holy Cross. My daughter was born at Providence Holy Cross on

September 9, 2011. My experience was amazing from the minute I walked into the

door until discharge. When I walked into the emergency room I was helped

immediately and within minutes an ER nurse took me in a wheelchair to labor and

delivery. The nurses in L&D were very caring and warm. They explained every detail

to me and my husband. They treated me like a patient, not a nurse, and made me

feel very comfortable. Dr. Cooper, the L&D nurses and the respiratory therapist were

amazing and I had a great birthing experience. When I was transferred to post-

partum the great care continued. The nurses took time to assist me with breast-

feeding and answered all of our questions and concerns. We felt like we were at

home. The new tower suites were beautiful and very comfortable as well. The food

was very good as well. The post-partum nurses made our transition from the hospital

to home an easy one. It is not often that we, healthcare workers, are on the receiving

end of care. Now that I have been a patient here at Holy Cross I can see why patients

and family members hold our hospital in such high regards. My family and I will

never forget the amazing hospital staff that we encountered during our stay here. I

am truly proud to be a nurse here and lucky to work with such amazing people.

Please give our thanks to the staff here. Thank you.

Stacey Lynn Beatty RN, BSN, PHN, PCCN

Critical Care

Page 1 of 1

7/9/2012

file://C:\Documents and Settings\nadeimy\Local Settings\Temporary Internet Files\Content....



oUtcoMeS & excellence

4

3.5

3

2.5

2

1.5

1

0.5

0

8

7

6

5

4

3

2

1

0

Q1 2011 Q2 2011 Q3 2011 Q4 2011

PhcMc Falls/1000 Pt days 3.22 2.59 2.24 2.32

NDNQI Non-Teaching Hosp. Mean

3.78 3.48 3.48 3.3

Jan feb mar apr may Jun Jul aug sep oct nov dec

PhcMc cLA-BSi/1000 central Line days

0 0 0 0 0 7.46 6.54 0 0 0 7.46 0

nhSn cLe-BSi Median 0 0 0 0 0 0 0 0 0 0 0 0

phcmc 2011 falls/1000 patient daysBenchmark: ndnQi non-teaching facilities

phcmc 2011 central line associated Blood stream infections-trauma icu

Benchmark: nhsn trauma icu pooled median

Providence Holy Cross Medical Center is proud of our Nurse Sensitive Quality Outcomes. A sample of these outcomes is provided below.


2.00

1.50

1.00

0.50

0.00J ‘11 f m a m

% LWBS 0.10 0.80 0.90 0.80 0.90

nhAMcS Benchmark 1.70 1.70 1.70 1.70 1.70

phcmc percent of patients left without Being seen (lwBs)Benchmark - national hospital ambulatory

medical care survey (nhamcs)1998-2006

specialty service: emergency department 2011



PAtient satisfaction

100%90%80%70%60%50%40%30%20%10%0%

100%90%80%70%60%50%40%30%20%10%0%

phcmc 2011 patient satisfactionunit: post-partum

phcmc 2011 patient satisfactionunit: 3an

At PhcMc we utilize hcAhPS scores via Press Ganey to compare our patient satisfaction by inpatient unit to a large national database. examples of our excellent scores are demonstrated below.

nurses treat with courtesy and respect

call button help soon as

wanted it

staff do everything to help with pain

tell you what new medicine was for

hcAhPd via Press Ganey top Box Score PhcMc PP

81% 74% 86% 80%

% rank all PG dB 48% 90% 71% 16%



wanted it



hcAhPd via Press Ganey top Box Score PhcMc 3An

86% 68% 73% 63%

% rank all PG dB 48% 90% 71% 16%


100%90%80%70%60%50%40%30%20%10%0%

100%90%80%70%60%50%40%30%20%10%0%

phcmc 2011 patient satisfactionunit: 2cn

phcmc 2011 patient satisfactionunit: 2Bn



wanted it



hcAhPd via Press Ganey top Box Score PhcMc 2Bn

87% 72% 79% 65%

% rank all PG dB 48% 90% 71% 16%



wanted it



hcAhPd via Press Ganey top Box Score PhcMc 2cn

87% 67% 72% 66%

% rank all PG dB 48% 90% 71% 16%



nUrSinG satisfaction

4.54

3.53

2.52

1.51

0.50

4.54

3.53

2.52

1.51

0.50

ndnQi nurse satisfaction pes 2011 medical-surgical orthopedics 2dn

ndnQi nurse satisfaction pes 2011 perioperative

Providence Holy Cross Medical Center uses two survey methods annually, Kenexa and NDNQI with Practice environment Scale, to measure nurse satisfaction. examples of our excellent 2011 results are provided.

nursing participation in hospital

affairs

nursing foundations for Quality

of care

nurse manager ability,

leadership and support

of nurses

staffing and

Resource adequacy

collegial nurse-

physician Relations

PhcMc MS Mean 2dn 3.15 3.23 3.29 2.92 3.09

NDNQI National non-teaching hospitals MS Mean

2.84 3.09 2.96 2.56 2.92


affairs


of care



of nurses

staffing and

Resource adequacy

collegial nurse-

physician Relations

PhcMc PAcU Mean 2.92 3.2 3.03 3.27 3.38

NDNQI National non-teaching hospitals Periop Mean

2.79 3.09 2.84 2.83 3.09


4.54

3.53

2.52

1.51

0.50

4.54

3.53

2.52

1.51

0.50

ndnQi nurse satisfaction pes 2011 Rehabilitation

ndnQi nurse satisfaction pes 2011 emergency department


affairs


of care



of nurses

staffing and

Resource adequacy

collegial nurse-

physician Relations

PhcMc rehab 3dn Mean 3.26 3.32 3.33 3.17 3.22

NDNQI National non-teaching hospitals rehab Mean

2.84 3.11 2.93 2.72 3.01


affairs


of care



of nurses

staffing and

Resource adequacy

collegial nurse-

physician Relations

PhcMc ed Mean 2.76 3.15 3.09 2.67 3.46

NDNQI National non-teaching hospitals ed Mean

2.76 2.97 2.84 2.57 3.23



nUrSinG satisfaction

4.54

3.53

2.52

1.51

0.50

4.54

3.53

2.52

1.51

0.50

ndnQi nurse satisfaction pes 2011 adult icu

ndnQi nurse satisfaction pes 2011 cardiac cath lab


affairs


of care



of nurses

staffing and

Resource adequacy

collegial nurse-

physician Relations

PhcMc icU Mean 2.92 3.21 3.11 2.99 3.03

NDNQI National non-teaching hospitals icU Mean

2.79 3.04 2.96 2.73 3.09


affairs


of care



of nurses

staffing and

Resource adequacy

collegial nurse-

physician Relations

PhcMc cardiac cath Lab Mean

3.64 3.74 3.88 3.85 3.87

NDNQI National non-teaching hospitals interventional Mean

2.90 3.16 3.07 3.03 3.12



The Joint Commission Strategic Surveillance System (S3) scores for Q’1, 2011 are provided below. Providence holy cross received a score of 6 (lower is better), which puts us in the top 25% for all hospitals in the country. the S3 score takes into account compliance with core measures (orYx), past survey findings, complaints, and hcAhPS scores and indicates an overall level of compliance with performance expectations.

Overall PFP Point Totalsnote: higher point totals may indicate risk as the data that assign points are primarily negative and outlier data.

100

80

60

40

20

0

Preliminary d

enial of Accreditation (n=

11)

conditional/c

ontingent Accreditation (n=

119)

For-cause Survey (n=

479)

University h

ealth System c

onsortium Full M

embers (n=

104)

US n

ews A

merica’s Best h

ospitals (n=140)

2010 thomson reuters 100 top h

ospitals® (n=

80)

Magnet h

ospitals (n=3610)

top 25% h

ospitals (n=688)

top 10% h

ospitals (n=279)

region ix (A

S, AZ, c

A, G

U, h

i, nv

) (n=465)

california (n=

253)

national (n=

2685)

provid

ence h

ealth system

s-sou

thern

califo

rnia (n

=1)

6

3542

34

59

39

29

4149

56

4854

compaRison gRoups

pfp

poin

t to

tal


neW KnoWLedGe, innovAtionS and impRoVement

3rd PHCMC Annual Nursing Research Conferenceour 3rd PhcMc Annual nursing research conference in May highlighted our own internal research activities. We also were privileged to have presentations by our Ph&S chief nursing officer, deborah Burton, Phd, rn and our Ph&S Southern california chief nursing officer, Katherine Bullard, MSn, rn. our keynote speaker, roxane cohen-Silver, BA, Phd, Professor, department of Psychology and Social Behavior, Uc irvine; Professor, department of Medicine, School of Medicine, Uc irvine, gave an exciting presentation on her research with victims of disaster. dr. Silver is an internationally recognized expert on homeland security and serves on multiple national and international governmental committees for homeland security and disaster preparation and management.

The research presentations given by our staff included:0800-0815 welcome

Betty newsom, rn, BSn, MS, cnAA, cno PhcMc

0815-0845 setting the stage – whY nuRsing ReseaRch?Katherine Bullard, rn, BSn, MS, neA-Bc, cno Ph&S california region

0845-0915 glucose, the missing coRe measuReSandra Pieschel, MPA, BSW, rn, cde, Manager diabetes department

0915-0945 fim and falls foR acute RehaBilitation patientsterri Gately, rn, BS, MS, crrn, rn-Bc, dSd, educator Post Acute, PhcMc

0945-1000 BReaK

1000-1030 expanding the Rapid Response teamchris consolo, rn, BSn, ccrn, Assistant Manager icU, PhcMc


1030-1100 do we need to hold continuous g-tuBe feeding duRing patient Repositioning

Sylvia Pacis, rn, BSn, Subacute nurse, PhcMc; terri Gately, rn, BS, MS, crrn, rn-Bc, dSd, educator Post Acute, PhcMc

1100-1200 coping with tRaumatic life eVentsdr. roxane cohen Silver, BA, Phd-- Professor, department of Psychology and Social Behavior, Uc irvine; Professor, department of Medicine, School of Medicine, Uc irvine

1200-1245 lunch

1245-1315 BReaKing out of ouR silosYajaira Angulo, rnc, BSn, Phn, Bc-oB; eFM, educator, Mch, PhcMc and Adriana Basurco, rnc, BSn, Phn, Bc-nic, educator nicU, PhcMc

1315-1400 using eVidence to eliminate unnecessaRY VaRiationdeborah Burton, Phd, rn, chief nursing officer, Providence health & Services

1400-1415 BReaK

1415-1445 compassion fatigueingrid Blose, rn, ocn, cMSrn, oncology nurse, PhcMc; terrie Bybee, rn, cMSrn, oncology charge nurse, PhcMc; dory tiongson, rn, ocn, cMSrn, oncology nurse, PhcMc

1445-1515 nuRsing peeR ReViewCarol Rozner, RN, BSN, PHN, Quality Management Specialist, PHCMC; Cynthia Marsden, RN, MSN, CRN, radiology nurse, PhcMc; Sherri Friedrich, rn, MSn, FnP-Bc, Stroke coordinator, PhcMc

1515-1545 clinical laddeR pRogRam deVelopmentcynthia Funakoshi, rn, BSn, Pccn, clinical educator, telemetry, PhcMc; tanya haight, rn, BSn, ocn, cMSrn, onc, clinical educator Medical Surgical, PhcMc

1545-1615 pRoJect hope: communitY Based nuRsing ReseaRchronda McPhail, rn, BSn, Manager Labor and delivery, PhcMc; Sherri Mendelson, rnc, Phd, cnS, Bc-oB; eFM; nic, iBcLc, director nursing research and Magnet Program.

This year we also had poster presentations with diverse and interesting topics:

• Do We Need To Check Residuals In SubAcute?• Perinatal Documentation• Save Our Heels• 4A Admission/Discharge Process• Ortho• Reducing Falls on Oncology• Breaking Out of Our Silos• SLE• Thermoregulation in the PACU• ICU PUP Pressure Ulcer Prevention in the ICU



PublicationsYee, cathy A. rn, MSn, crn-cSc. (2011). Aortic dissection: the tear that kills. Nursing 2011; 37; 1-6.

Sherri Mendelson rnc, Phd, cnS, iBcLc. (2011). Maternal Grand Mal Seizure Leads to a Surprising diagnosis of dandy-Walker variant. JOGNN, 40(4), 458-462.

Sherri Mendelson rnc, Phd, cnS, iBcLc. (2011). When the Grandma is An oB nurse. Nursing for Women’s Health, 15(5), 454-456.

Jane Zema, rn (2011). Make room for Success in Your Plan of care. Nursing 2011, 41(8), 61.

Presentations/LecturesYajaira Angulo, rnc, MSn, cnS, and Adriana Basurco, rnc, BSn, Phn, Bc-nic, Providence holy cross Medical center nursing research day, Mission hills, cA; May, 2011; Podium presentation: Breaking out of our Silos.

Yajaira Angulo, rnc, MSn, cnS, AWhonn national conference, denver, nv; June, 2011; Poster presentation: A Multidisciplinary Approach to hysterectomy: A case Study.

Yajaira Angulo, rnc, MSn, cnS, Sherri Mendelson, Phd, rnc, cnS, iBcLc, and Adriana Basurco, rnc, BSn, Phn, Bc-nic, Providence holy cross Medical center nursing research day, Mission hills, cA; May, 2011; Poster presentation: Breaking out of our Silos.

ingrid Blose, rn, ocn, cMSrn; terrie Bybee, rn, BSn, cMSrn; dory tiongson, rn, BSn, ocn, cMSrn, deborah Bergida, rn, MSn, MhA, ocn; and tanya haight, rn, ocn, cMSrn, onc; Providence holy cross Medical center nursing research day, Mission hills, cA; May, 2011; Podium presentation: compassion Fatigue and Spiritual caring.

ingrid Blose, rn, ocn, cMSrn; terrie Bybee, rn, BSn, cMSrn; dory tiongson, rn, BSn, ocn, cMSrn, deborah Bergida, rn, MSn, MhA, ocn; and tanya haight, rn, ocn, cMSrn, onc; AcnL Boston, MA; April, 2011; Poster presentation: compassion Fatigue and Spiritual caring.

ingrid Blose, rn, ocn, cMSrn; terrie Bybee, rn, BSn, cMSrn; dory tiongson, rn, BSn, ocn, cMSrn, deborah Bergida, rn, MSn, MhA, ocn; and tanya haight, rn, ocn, cMSrn, onc; AcnL Sacramento cA; February, 2011; Moderated Poster presentation: compassion Fatigue and Spiritual caring.

Kathy cadden, rn, MSn, cnS, ccrn, Providence holy cross Medical center nursing research day, Mission hills, cA; May, 2011; Poster presentation: PUP Pressure Ulcer Prevention in the icU.

chris consolo, rn, BSn, ccrn; Providence holy cross Medical center nursing research day, Mission hills, cA; May, 2011; Podium presentation: expanding the rapid response team.

Kim-crabtree-Loyd, rn, MSn, nP, Providence holy cross Medical center nursing research day, Mission hills, cA; May, 2011; Poster presentation: thermoregulation in the PAcU.

cynthia Funakoshi, rn, BSn, Pccn and tanya haight rn, ocn, cMSrn, onc, Ancc Magnet conference, Baltimore, Md; october, 2011; virtual poster presentation: Promoting clinical Ladder for clinical excellence.

cynthia Funakoshi, rn, BSn, Pccn and tanya haight rn, ocn, cMSrn, onc; Providence holy cross Medical center nursing research day, Mission hills, cA; May, 2011; Podium presentation: Promoting clinical Ladder for clinical excellence.

terri Gately, BSn, rn-Bc BS, MS, crrn, dSd and Sylvia Pacis, rn, BSn; AcnL, Sacramento cA; February, 2011; Poster presentation: do We need to check Gastric residuals for the Sub Acute Patient?

puBlications, pResentations And gRants


terri Gately, BSn, rn-Bc BS, MS, crrn, dSd and Sylvia Pacis, rn, BSn; Providence holy cross Medical center nursing research day, Mission hills, cA; May, 2011; Poster presentation: do We need to check Gastric residuals for the Sub Acute Patient?

terri Gately BSn, rn-Bc BS, MS, crrn, dSd, virtual poster presentation: eliminating the Practice of holding continuous G-tube Feeding during reposition of Patient.

terri Gately BSn, rn-Bc BS, MS, crrn, dSd, Providence holy cross Medical center nursing research day, Mission hills, cA; May, 2011; Podium presentation: FiM and Falls.

tanya haight, rn, BSn, ocn, cMSrn, onc; nAon conference; May, 2011, Baltimore, Md; orthopedic nursing: Advancing Practice and Promoting certification.

tanya haight rn, BSn, ocn, cMSrn, onc ; international Association for human caring conference; June, 2011; San Antonio, tx; Poster presentation: compassion Fatigue and Spiritual caring.

Karen Klein, RN, BSN and Cyndie Speen, RN-BC, CPHQ, Southern california Patient Safety collaborative; May 2011, industry hills, cA; podium presentation the road to improvement: core Measures.

ronda McPhail, BSn, rn, Sherri Mendelson, rnc, Phd, cnS, iBcLc; Ancc Magnet conference, Baltimore, Md; october, 2011; Podium presentation: Project hope: A collaborative case Management Project to improve Aspects of a health Promoting Lifestyle.

ronda McPhail, BSn, rn, Sherri Mendelson, rnc, Phd, cnS, iBcLc; Providence holy cross Medical center nursing research day, Mission hills, cA; May, 2011; Podium presentation: Project hope: A collaborative case Management Project to improve Aspects of a health Promoting Lifestyle.

ronda McPhail, BSn, rn, and Sherri Mendelson, rnc, Phd, cnS, iBcLc; Ancc Magnet conference, Baltimore, Md; october, 2011; virtual poster presentation: it takes a village: implementing a Multidisciplinary Perinatal collaborative.

ronda McPhail, BSn, rn, Sherri Mendelson, rnc, Phd, cnS, iBcLc Premier Breakthroughs conference, nashville, tn; March, 2011; Podium presentation: A Wide-Area network Perinatal documentation System.

ronda McPhail, BSn, rn, Sherri Mendelson, rnc, Phd, cnS, iBcLc; AWhonn national conference, denver, nv; June, 2011; Poster presentation: it takes a village: implementing a Multidisciplinary Perinatal collaborative.

Sherri Mendelson, Phd, rnc, cnS, iBcLc, Providence holy cross Medical center nursing research day, Mission hills, cA; May, 2011; Poster presentation: SLe: A 36 Year case Study.

Sandra Pieschel, MPA, BSW, rn, cde, Providence holy cross Medical center nursing research day, Mission hills, cA; May, 2011; Podium presentation: Glucose, the Missing core Measure.

Sandra Pieschel, MPA, BSW, rn, cde, AAde 38th Annual Meeting, Las vegas, nv August, 2011; Poster presentation: Glucose, the Missing core Measure.

Sandra Pieschel, MPA, BSW, rn, cde, Providence holy cross Medical center nursing research day, Mission hills, cA; May, 2011; Podium presentation: Glucose, the Missing core Measure.

Sandra Pieschel, MPA, BSW, rn, cde, AAde 38th Annual Meeting, Las vegas, nv August, 2011; Poster presentation: Glucose, the Missing core Measure.

carol rozner, rn, BSn, Phn; cynthia Marsden, rn, MSn, crn; and Sherri Friedrich, rn, MSn, FnP-Bc, Providence holy cross Medical center nursing research day, Mission hills, cA; May, 2011; Podium presentation: nursing Peer review.


Innovationsour new 12-bed nicU opened in July. We quickly filled the beds. Learning new technology and routines has been interesting and challenging for these excellent nurses, caring for our most vulnerable new lives. the design of the nicU allows for parental involvement and privacy for our moms to provide the best nutrition for their babies.

during this transition to our nicU and the new South Wing, one of our nurses had the following thoughts on transition. Little did she know that a few months later she would make the decision to retire after spending more than 35 years as a cherished nurse in Labor and delivery at PhcMc.


increasing smoking cessation for patients and staff at a community hospital

terri Gately, rn, BS, MS, crrn, dSd /Sherri Mendelson, rnc, cnS, Phd;

in-patient nursing education home Blood pressure monitoring to manage hypertension

Susie Parker, Lvn, Sherri Mendelson, rnc, cnS, Phd, debbie tsunoda, AcnP-Bc

project hope: health promotion for a healthy pregnancy and family

Sherri Mendelson, rnc, cnS, Phd

calnoc interdisciplinary nursing Quality Research initiative study

tim Gilmore, rn

Site Pi

high protein diet for weight loss Sherri Mendelson- Phd, rnc, cnS PhcMc Site Pi

Lorraine evangelista, Phd, rn-UcLA

fim scores and falls in the acute Rehab unit terri Gately, BSn, rn, BS, MS, crrn, dSd

sacral pressure ulcer prevention in the icu Kathy cadden, rn, MSn

national children’s study Yajaira Angulo, rn, MSn

Site Pi

the effect of mentoring for new graduate nurse Retention and satisfaction

Bilma Pellissery, rn, MSn; William Lim, rn, BSn

use of cranberry extract capsules to decrease the incidence of utis in women in labor and delivery

Sherri Mendelson, Phd, rnc, cnS

the financial implications of a nursing Research committee

Sherri Mendelson, Phd, rnc, cnS

the effectiveness of a nursing Research committee Sherri Mendelson, Phd, rnc, cnS

unavoidable pressure ulcer study Monica tweddell, rn, Wcc

Site Pi

c-difficile correlations Jane Boylan, rd

cms Breastfeeding support study cSUn Merav efrat, Phd

Sherri Mendelson Phd, rnc, cnS -Site Pi

gi lab-over 65 bowel prep completion Lisa Fetterolf rn and rochelle nelson, rn, BSn

iRB appRoVed nUrSinG reSeArch StUdieS Active in 2011


Finally, it’s moving day!enthusiastically, i prepare for this much anticipated event. i can’t wait to leave this small and inadequate space.Archaic equipment and broken beds will not be missed.our new wing will be so much nicer; bring me some empty

boxes; let’s get packing!

Like a dog searching for a hidden bone, i start digging through the cabinets in the nurses’ station.

Why am i finding flashlights in 4 different places? how did all these outdated packs get missed?

What in the world is this cable for? do we even still have this piece of equipment?

nurses never throw things away; several overstuffed drawers are a testament to that.i expect this will be a long day…..

i keep working. i find old procedure manuals and magazines from 1998: i toss them.the bookcase is filled with a collection of antiquated instruction manuals for equipment long gone: i toss them. Stacks of obsolete forms are uncovered in a remote corner of a crowded office: i toss them. it is amazing how progress produces so much trash; it seems i haven’t found anything worth packing yet.

i shake my head in disapproval; thank goodness for this opportunity to clean house.i continue on my mission; i move on to the nurse’s lounge.this should be a snap; everyone was told to remove their belongings by today.the locker doors are open; empty lockers smile at me; very nice…..exhausted, i sit on the floor and take a much needed break.

closing my eyes i imagine the large, bright, well equipped rooms we will have next week.the latest technology will be at our fingertips.i smile and think how lucky we are: how lucky our patients will be.i want to linger in this state of calm eagerness, but there is work to be done.opening my eyes, i notice i had missed a locker, the door is locked.

Using the master key, i open the door and look inside.A dust covered plastic bag protects a white nurse’s cap; the black velvet ribbon is slightly crushed.White clinic nurse shoes are stowed on the bottom shelf; a white sweater hangs on the hook.i keep probing: a clipboard, a red pen, 2 pencils, white bobby pins, and a dime. Whose locker was this? how long has this stuff been in here?

An uncomfortable sense of intrusion washes over me.

one by one i remove the items; these dusty relics suggest the passage of a good deal of time. Staring at the abandoned articles i try to imagine a colleague i never knew. i am certain things were quite different ‘back then’. i wonder if we could relate to each other if we met today. i contemplate the question.

our eras may have been different, but our goal to help others was not.We have both experienced progress and have risen to the challenges of change.nursing’s constant state of evolution requires energy and vision to create the future.We share similar strengths; we are on the same journey; we are just traveling at different times.intuitively, each generation knows what to toss and what to save as they move forward……. …..our compassion and a commitment to care are always the first things that we pack.

touching the mementos i feel a kinship to my invisible peer.

Startled by a colleague’s offer to help, i return to the task at hand.i look at the trash can……i reach for a box instead…..carefully i place the inherited treasures inside.turns out i found something worth packing after all. camouflaged as nursing paraphernalia, my sense of heritage and sisterhood were hiding in that locker.i feel honored to have found them.

Walking out of the building i grin.i expected this to be a long day.i did not expect to discover a legacy …… …….i never expected to make a new friend.

the locKeR By Linda Harrington RNC


awaRds And recoGnition

In Memoriam to the Nurses We Grieved For In 2011When a calming, quiet presence was all that was needed, a nurse was there.

in the excitement and miracle of birth or in the mystery of loss and life, a nurse was there.

When a silent glance could uplift a patient, family member or friend, a nurse was there.

At those times when the unexplainable needed to be explained, a nurse was there.

When the situation demanded a swift foot and sharp mind, a nurse was there.

When a gentle touch, a firm push, or an encouraging word was needed, a nurse was there.

to witness humanity—its beauty, in good times and bad, without judgment, a nurse was there.

to embrace the woes of the world, willingly and offer hope, a nurse was there.

And now, that it’s time to be at the Great One’s side, a nurse is there.

PHCMC Nurse’s Week Awards for Nursing Excellence

Patty Mayberry

leo carandang, rn-Acute rehabilitationLeo was with our PHCMC nursing family since 2001.

Sherri Mendelson Norma Arnau

providence holy cross medical center15031 rinaldi Street

Mission hills, california 91346(818) 365-8051

1-888-healingwww.providence.org/holycross

2012 promises to bring changes and challenges.We continue our journey towards Magnet Program recognition re-certification. We have faced the

challenges this year of a large nursing turnover due to delays in opening our new South Wing and significant

leadership reorganization. We continue to provide the high level of excellent nursing care that we have been

known for over 50 years.

Thank you to all of our nursing colleagues for making Holy Cross a great place to work and a great place for our friends, families and neighbors to receive excellent health care!

providence holy cross 2011 nursing annual report

Documents

san fernando valley

medical care

medical centers

people of mission hills

nursing services

damaged holy cross

providence health system

nursing annual reportthe