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Oct/Nov 2007

The preparation, time and care given to the Children’s Magnet documentation submission during the past 18 months have been extraordinary. The Magnet Champions, nursing leadership,
Magnet Steering Committee members and many of you worked with Madelyn Torakis, Magnet program coordinator, and me to meet very strict deadlines and criteria for submission. Although it is important to thank those most intimately involved in the documentation process, it is also important to thank those many of you who supported those efforts. As we prepare for the next phase of the journey, the site visit, it is nice to pause and reflect on how this process fostered
professional growth and a greater sense of inclusiveness and appreciation for one another.

I must give a “Shout Out” to the Professional Nurse Advisory Council (PNAC). I am extremely proud of the voice PNAC has had on behalf of nursing at Children’s Hospital and the DMC. What do I mean by voice? The concept of voice in this context refers to PNAC’s ability to bring attention to matters from a variety of staff perspectives and to use their authority to speak, articulate and frame issues in a manner that generates richer understanding and appreciation. Their efforts have resulted in modifications to the attendance policy and short term disability benefits,
equipment and supply prioritization, and the Promoting Excellence program.

PNAC and many of you participated in focus groups that were held several months ago. Results of the focus group and progress made on topics deemed most important to you will be shared in the next couple of months. The collective voice of those who participated in this process is making significant long-term changes that will have an enduring impact on the way we work and the way that health care is delivered at the Children’s Hospital of Michigan. You deserve our appreciation, respect and thanks.

Sincerely yours,
Rhonda Foster, Ed.D., MPH, MS, RN
Vice President of Patient Care Services

Interesting Nursing Facts
Nursing is a highly specialized field. When you major in Nursing, you can specialize in a number of different fields including:
• Geriatrics
• Pediatrics
• Neurology
• Recovery Room
• Operating Room
• Pulmonary
• Critical Care

Children’s Hospital congratulates its Nurses of the Month
Introducing our Nurses of the Month for May, June and July. Thank you for making Children’s Hospital a caring place for patients, families and each other!

Critical Care: Carrie Gelmini, RN, BSN, CPN; PICU and NICU; Carrie Gelmini
23 years. “Because I have been here so long, the people I work with have become like my family. We’ve grown up together. Working in the NICU and PICU offers a wide variety of nursing experiences and I am constantly learning.”

Alternative Practice: Denise Brisson, RN; recovery room;
36 years. “I wanted to be a nurse since the time I was a little girl. In the neighborhood, I was the one the kids came to for band-aids. I love it when I know that I made a difference in the outcomes
for my patients and their families. This award makes an already rewarding job even more rewarding.”

Acute Care: Bethany Page, RN; NICU, preceptor;Bethany Page
7 years. “I have watched the preceptor program grow and make an impact throughout the hospital. Precepting enables me to help someone else realize their potential. As I see my students apply what they have learned and go on to teach others, it makes me feel that I have something to offer in addition to patient care.”

Critical Care: Amy Bass, RN, CPN; ER preceptor;Amy Bass
5 years. Precepting is very satisfying because teaching is also a learning experience. When my students ask questions it makes me look deeper into what I think know. I always tell them, ‘Before you can learn anything, you need to know what it is you don’t know.’”
Alternative Practice: Ellen Dunn, BSN; care management and NICU; Ellen Dunn
27 years. “Working as a contingent in both the NICU and care management helps me understand how the clinical part of patient care is connected to the whole health care picture. I am so proud to be part of a team that takes their work so seriously and is always striving for excellence.”
Acute Care: Patte Sandstedt, RN; charge nurse on 6 East; Patte Sandstedt
16 years. “After my pediatric rotation I knew I wanted to work with kids because they seem to bring out the best in everyone. On 6 East, although we see sick kids, most of them are treated,
get better and go home. And that process is the most satisfying part of my job. I can’t imagine being anyplace else or doing anything else.”
Critical Care: Mary Lou Carey, RN; NICU; Mary Lou Carey,
34 years. “Working in the NICU is particularly rewarding because improvements in technology have enabled us to do so much more for our patients. These children are so very vulnerable and I often get very close to the parents. I particularly enjoy being able to visit the families at home when they need special help after their baby is released.”
Alternative Practice: Claudine Hoppen, RN, CRNA;Claudine Hoppen
10 years. “I love the one-on-one patient care that is possible in intensive care nursing. While
studying to be a nurse anesthetist, I found that my favorite subjects were cardiac thoracic and pediatrics. As an anesthetist, I can combine those practices with my dedication to caring for children.”
Acute Care: Wendi Tague, RN, CPN;
5 years. “I got into nursing because it just seemed like the right thing to do at the time. Now I can’t think of another profession I would rather be in. I love working with the kids and I love the challenge of always having something new to learn.”

November 1
Pharmacological Options for Diabetes Management
presented by Chad Schenavar & Rebecca Hunnicutt Farren • 11:30 a.m.-12:30 p.m.

December 6
Topic (To Be Announced)
presented by Laura Morasett from 5 West • 11:30 a.m. in Classroom 2

Children’s takes next step toward Magnet Status
After 18 months of hard work and planning, the Magnet Champions and nursing team of Children’s Hospital of Michigan were happy to submit the application to obtain Magnet status. It is the highest level of recognition a hospital can achieve for excellence in nursing granted by the American Nurses Credentialing Center (ANCC). Only two other hospitals in Michigan have attained Magnet level.

The team submitted thousands of pages on a high quality CD, as opposed to a hard copy. The documents included real life stories to demonstrate excellence in care provided by nurses. It will be evaluated against 14-Forces of Magnetism which cover everything from patient care to staff job satisfaction and inclusiveness of leadership and organizational decision making.

Three Magnet appraisers assigned review the document, which takes about two to three months. The next step is a site visit, which if granted, would take place in late 2007 or early 2008.

Nurse appointed to prestigious national task force
Children’s Hospital of Michigan congratulates Linda Komisak, RN, who was recently selected to join a national task force for Management Engineering and Process Improvement for the Health Information and Management Systems Society (HIMSS). The sub-committee is also part of the Enterprise IS Steering Committee for HIMSS, of which Linda is currently a member.

As a result of her involvement in the task force, Linda will participate in bi-weekly teleconferences. “This opportunity will allow me to learn and share new ways of implementation/change management,” she says.

HIMSS is the health care industry’s membership organization exclusively focused on providing global leadership for the optimal use of health care information technology (IT) and management
systems to increase the effectiveness, safety and quality of patient care.

Team of nurses working to improve preceptor program
Preceptor nurses must have two to three years of experience, demonstrate the ability and willingness to teach other nurses, and understand the resources that are available. The preceptor program is essential to patient care at Children’s. According to Bethany Page, RN, “We rely on preceptors to teach other nurses how best to take care of sick kids.” Page, along with Lynne Hillman, RN, Dayle Ciurysek, RN, BSN; Natalie Fisher, RN, BSN, Lisa Francis, RN, BSN; Mary Kosek, RN, BSN; Michelle Sepenek, RN; and Mary Wagner, RN, are members of a sub-committee who are committed to improving the preceptor program from a nurse’s perspective.

“We saw the need to provide better, more structured support for preceptors,” says Page. “It is important for nurses who are teaching others to know that they can rely on the support of others. It helps current preceptors and encourages others to apply.”

After researching preceptor programs at other hospitals and gaining input from current and new preceptors, the sub-committee adopted the following goals to enhance the program:
• Establish a lead preceptor on every unit to serve as a liaison to improve communication with the preceptor development committee.
• Support current preceptors and encourage new preceptors by maintaining a reliable support system.
• Establish a system of consistent preceptor/orientee pairing.
• Establish unit-based preceptor councils.
• Build employee awareness about the preceptor program.

According to Page, feedback regarding the additional support provided to preceptors has been excellent. Surveys were sent to staff in June and will be redistributed in December.

EMR Update
Medication Scanning Reports
(As of September 19, 2007)
Scanning reports from Auguest 5 to 11 and August 19 to 25 have been received. Patient ID scanning reached 75 percent and 77 percent. Medication scanning was 68 percent and 72 percent. A review of reports submitted indicates that we are at 71 percent for patient ID scanning and 65 percent for medication scanning. As you may know, the Electronic Medical Records (EMR) and Pharmacy teams have a dedicated group that reviews Children’s medication scanning issues. Please continue to encourage staff to fill out the Medication Scanning Audit and place them in the Meds that don’t scan bin located on your units.

The EMR team continues to address hospital enhancement requests. A spreadsheet of all enhancements will be developed so that staff may view those requests that have been submitted, in progress or in production.

The RHO flip is currently on hold. As soon as a date and time is confirmed staff will be notified.

Care Mobile is on hold until more information is obtained about the RHO flip. A total of 13 handhelds have been delivered to the EMR office and the Care Mobile manual is in its final stages of development. The training plan on pilot units, 5W, 6W, PICU and ED, will begin once a date is
determined for Care Mobile.

For issues, questions or concerns, please contact the EMR office at (313) 745-5918.

What’s new with EMR?
Enhancement updates currently in production:
• Under the Plan of Care – we now have the options Hyperthermia, Hypothermia, Knowledge Deficit, Hypertension, PC Neurologic/Sensory, Ineffective Airway, Clearance, and Ineffective Breathing Patterns.
• We have consolidated the various places to document phone numbers and contact names onto one screen on the Admission Database so it’s not repetitive for the nurses.
• CR monitor and Pulse Ox alarm limits have been added at the bottom of the Pediatric Visual Observation form.
• When you chart on the Pediatric Visual Observation form – the data will not pull forward to the next form.
• On the I/O tab, you are now able to add # of Times Emesis as a column. This is found under the “Other Output” folder.
• On the Pain Assessment (Primary Site) screen – there is now a place to chart “Alleviating Factors.”
• You are now able to chart “Awake” or “Asleep” under the Activity Status on the Pediatric Visual Observation form.
• A capillary refill grid has been added to the Neurovascular Assessment forms so the nurse can
chart <3 seconds.
• There has been a reference text added to the Humpty Dumpty Fall Risk Tool that states “Refer to Patient Falls Safety Protocol and 3 PED 455 Attachment 1.”

The Children’s Hospital of Michigan Evidence-Based Practice (EBP) Nursing Conference was held on September 20 at the Grosse Pointe War Memorial. The turnout exceeded our expectations with 182 attendees. The keynote speaker was Marilyn Hockenberry, PhD, RN-CS, PNP, FAAN, director/nurse scientist, Center for Clinical Research and Evidence-Based Practice, Texas Children’s Hospital.

What kind of appointment would you like?