Houston Methodist Nurse February 2014

FEBRUARY 2014 | A Magazine for Nurses

METHODIST NURSELeaders in Nursing

HOUSTON

Page 8

BROTHERS Share

LIVES

for theirFight

Two CHRISTUS Hospitals

JOINHouston Methodist

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AAs winter begins to disappear and the first signs of spring arrive, our nursing

organization also continues to unfold and evolve. All years present unique

challenges, and it is our ability to master change that makes us successful. I

continually witness the unfolding of our nursing environment as one that empowers

our nurses to become leaders in the quality and patient safety arenas. Each of you

has played an integral part in the development and implementation of significant

patient care standards: protocols that address hourly rounding, bedside report,

preventing of BSIs and UTIs, VAPs, glucose control and delirium and sepsis.

This year you have managed to markedly increase the numbers of patients along

with increased acuity and have managed their care successfully. We have published

in nursing journals, participated in evidence-based practice activities, attended and

presented at national and international conferences: all speaking to our evolution

into an academic nursing environment. We have successfully implemented

care coordination rounds, and our leaders, along with each of you, have led this

interdisciplinary initiative.

Our patients always remain our singular focus. Your energy, enthusiasm and

commitment confirm my great belief and optimism in each of you and your

individual and collective contributions. Our journey continues to unfold…

Our Journey in 2014

Ann Scanlon McGinityA Message from

Senior Vice President and Chief Nurse Executive

2014 EDITORIAL BOARD MEMBERSRosario AlvaradoShuntá Fletcher Donna EspositoElizabeth Gigliotti Elizabeth Himes

Beverley Lamoth Robert MoreheadCarlette PattersonJoy ShillerRobyn Washington

MAGAZINE EDITORKelli Gifford

GRAPHIC DESIGNER/PHOTOGRAPHERPhyllis Gillentine

Do you have a

STORYthat you would like to post in the

METHODIST NURSE MAGAZINE?Please submit your articles or ideas to Kelli Gifford [email protected]

NURSING CAREER FAIR DRAWS HUNDREDS

THE NURSING CAREER FAIR held on Feb. 13 was a resounding success. Approximately 300 GNs and experienced Registered Nurses attended; there have been approximately 60 offers made so far.

“The collaboration and partnership between nursing leaders and HR really made a difference,” said Sheila Coggins, MA, SPHR, Director of Human Resources, Houston Methodist Hospital. “We had a great turnout of both applicants and nursing management. I really appreciate the time commitment nursing leadership made to spend the day with us and interview the applicants as they came in. This timely and personal experience was appreciated by the candidates.”

RN recruitment has been a great opportunity for Houston Methodist, said Coggins. “The job market has opened up and become highly competitive for top talent, not only here in Houston but across the country. The advantage Houston Methodist has is the excellent quality of care we provide to our patients — nurses want to work here.”

During the career fair, nursing directors and leaders spent time with the candidates to tell them about the job and about their units, and also had someone take them to tour the units. “Providing candidates with the opportunity to see where they could be working and talking to some of their potential coworkers leaves a positive impression on them,” said Coggins.

Houston Methodist is planning a systemwide career fair in May, and dates are being finalized. Each entity will host its own fair with a joint advertising campaign.

RN REFERRAL BONUSHouston Methodist Hospital is offering a $2,000 BONUS for successful referrals of experienced RNs.

Current employees are eligible when a referred candidate is hired. Referral bonuses are dispersed in 2 payments – 1st payment at 90 days of employment/2nd payment at 12 months of employment.

Both employees must be employed on both pay out dates to receive both payouts. The applicant must list the current employee’sname on the application under referral information.

For questions, email [email protected].

Jane DeStefanoVice President and Chief Nursing Officer

Houston Methodist San Jacinto News

4 HOUSTON METHODIST NURSE

HOUSTON METHODIST SAN JACINTO HOSPITAL is happy to announce

two newcomers this month! Charyl Bell-Gordon, DNP, RN, CEN, FNP-C,

will be joining the management team of Houston Methodist San Jacinto

Hospital as Director of Emergency Services. Along with diverse nursing

experience in emergency nursing, leadership, and as a Family Nurse

Practitioner, Charyl has recent experience as a Director of the Nurse

Practitioner Program at Houston Methodist Hospital. She also is adjunct

faculty for Graduate studies at Vanderbilt University.

Angelica G. Hermosillo will be joining the HOUSTON METHODIST SAN

JACINTO nursing staff as the manager of 2 South. Angelica is joining us

from El Paso where she was a Medical-Surgical unit Director. She has

extensive experience as a nursing director, manager, clinical coordinator,

charge nurse and critical care nurse.

Change is on the HORIZON!

LEADERS IN NURSING 5

When you think of the month of February, does the symbol of a heart or perhaps the thought of Valentine’s Day come to mind? If Valentine’s Day came to mind, did you think of flowers, candy, or those cute little cards that you may have exchanged as a child?

When thinking of the heart, most of us are interested in keeping our bodies healthy and search for words of wisdom to assist in this lifelong search for health. According to the Journal of the American Heart Association, there are seven simple steps to take to achieve ideal cardiovascular health for adults: never smoke or quit smoking; maintain physical health by exercising at least 150 minutes a week; maintain blood pressure below 120/80; keep fasting blood glucose at less than 100 milligrams/deciliter (ml/dl); maintain total cholesterol at less than 200 mg/dl; and of course eat a healthy diet. So, have you ever wondered about the health of your child’s heart? Are there additional steps to take for children or newborns?

What you might not know is that nearly 30 percent of all infant deaths are due to Critical Congenital Heart Disease (CCHD). Some defects of the newborn are immediately recognized after birth on the basis of assessment alone. However, the following seven conditions are not determined immediately: main CCHD, including hyperplastic left heart; pulmonary atresia with intact septum; Tetralogy of Fallot; total anomalous pulmonary venous return; transposition of the great arteries; tricuspid atresia and truncus arteriosus. If identified, these congenital heart diseases will require further medical and/or surgical intervention to prevent serious complication or even death.

In May 2013 at Houston Methodist Sugar Land Hospital, our nurses began to ask how they might help in identifying infants who are at risk for CCHD. Our nursing staff and other professionals reviewed

the literature regarding CCHD and searched for best practices in their quest to address these concerns. The interprofessional group identified studies that showed a newborn’s pulse oximetry screening consistently identifies the majority of these seven disorders and is a relative low-cost opportunity to identify structural heart defects. By providing neonatal echocardiograms and pediatric cardiac consultation, the nursing leaders submitted a request for the appropriate testing equipment for CCHDS, which included a pulse oximetry monitor and disposable probes. The multidisciplinary group developed policies and procedures for the routine screening of all newborns and educational information for the parents as well as a learning module for the nursing staff.

In July 2013, the nursing staff began to take steps to screen all newborns for CCHD with follow-up testing for positive screens. Since the initiation of the screening, two septal defects and one patent ductus arteriosus defect have been identified by a failed screen followed by further testing performed by the pediatric cardiologist. At the present time, no critical congenital heart defects have been identified.

Hippocrates is credited with saying, “A wise man should consider that health is the greatest of human blessings, and learn how by his own thought to derive benefit from his illnesses.”

The proactive approach of the nurses and staff of the Women’s Center at Houston Methodist Sugar Land Hospital should be congratulated for taking steps to identify early structural heart defects and provide excellent care through the loving hands and hearts of staff to the communities that we serve. Thank you for making a difference that supports health for the body and soundness for the mind.

Houston Methodist Sugar Land NewsJanet Leatherwood

RN, MSN, VP / Chief Nursing Officer


FEBRUARY–The Month for a Heart Check

Houston Methodist Willowbrook News

Sheila FataVice President & Chief Nursing Officer


This February marks the 50th year that our country has recognized American Heart Month! Since it was first observed in 1964, American Heart Month has

helped to raise awareness of heart disease and heart healthy living. According to the Centers for Disease Control and Prevention, heart disease is the leading cause of death for both men and women in the United States and has been described as a national health crisis, contributing to one of every four deaths. Given these facts, it’s great to know Houston Methodist Willowbrook Hospital is doing its part to save lives impacted by heart disease.

We care for patients affected by heart disease each day in many of our patient care departments —whether in ER, surgery, critical care, cardiac cath lab, surgical services, cardiac imaging or rehab, our patients are receiving high-quality cardiovascular care within the walls of our hospital. And since the beginning or our open heart surgical program in 2010, we have provided surgical and post-operative care to almost 300 heart patients in our community.

Our cardiovascular program continues to grow and improve. We have outstanding outcomes with our acute MI patients who come to the cath lab from ED: 100 percent of our STEMI patients received PCI in less than 90 minutes and our median door-to-balloon time was 54 minutes — outstanding! Our open heart program is outperforming STS National Adult Cardiac Surgery Database benchmarks for major complications and the NDNQI benchmarks for nurse sensitive indicators; we have achieved zero CAUTI, CLABSI or VAP for these patients. Sheelu Joseph, BSN, RN, CCRN, and manager of the CVCU, credits these outcomes to the team’s commitment to superior quality the multidisciplinary, patient-centered approach. The nursing staff in our cardiovascular care unit adopted improvement projects to ensure the best care to this patient population. For example, an early mobility initiative in critical care seeks to get post-operative patients out of bed and moving sooner, further reducing the risks of postsurgical complications.

Heart disease and open heart procedures are physically (and sometimes emotionally) difficult for the patient and their families as they recover after their hospital stay. The cardiac rehab unit supports their physical recovery and has grown 14 percent year over year. And in 2013, Adrienne Joseph, RN, helped relaunch the Mended Hearts support group, a community initiative that offers heart disease survivors both peer support and education from Houston Methodist caregivers and our physician partners. We plan to expand this program in 2014 to include home visits by a Mended Hearts volunteer during recovery. Mended Hearts is an important part of helping our surgical patients establish heart healthy lifestyles and sustained recovery of their health.

Speaking of heart healthy lifestyles, I would be remiss if I did not mention that Houston Methodist is committed to supporting heart health not only in patients, but employees as well! Heart disease and related death is largely preventable through healthy lifestyle choices. We’re fortunate that Houston Methodist offers several benefits and incentives to support heart health, such as our tobacco cessation incentive, BMI weight loss challenge and on-campus fitness facilities. This Heart Month, let’s all be reminded to make choices that will ensure a heart healthy life for ourselves and our loved ones!

Celebrating Hearts

Houston Methodist West News

Vicki Brownewell Vice President & Chief Nursing Officer

What Does a Cath Lab Nurse Do?

When I was asked to write an article about Heart Awareness for February, I did not know what to

write about. Then it hit me, I will write about what I am best at doing. I am a Cath Lab nurse, and I

am blessed with the opportunity to care for cardiac patients in the Cath Lab. However, I am having a

difficult time describing what a Cath Lab nurse is, much less what a Cath Lab nurse does.

So I decided to look toward the Internet for some answers. I read blogs, Wikipedia and even asked a

friend to post a question about Cath Lab RNs on a chat. The answers where quite humorous and made

me laugh, most responses consisted of a RN who deals with insertion or maintenance of a foley catheter

(ha, ha). I can see why you would describe Cath Lab nurses with these characterizations, but it is

furthest from what a Cath Lab nurse does.

A Cath Lab nurse is a highly skilled technical nurse who is held to same standards as an ICU nurse,

ER nurse and OR nurse. The Cath Lab nurse is responsible for the patient care during all Cath Lab

procedures. The nurses have to prioritize and triage the patient’s care much like an ER nurse does

when caring for a trauma patient. The Cath Lab nurse provides the same level of critical caring as a

cardiogenic shock patient in the ICU. The orchestration of circulating in a procedure much like an OR

nurse does in a surgery. These standards suggest only a few of the responsibilities a Cath Lab nurse

executes in every Cath Lab procedure. The Cath Lab nurse must display a high level of critical thinking,

even during emergency procedures at 2 a.m.

I hope that illustrating some of the similarities a Cath Lab nurse has with better-known specialized

nurses provides some clarity as to what we do. However, the most important part of what a Cath Lab

nurse does is creating a calm, peaceful environment for a patient experiencing a heart attack. It is being

there to hold their hand and wipe away the tears as they realize what is now happening. The nurse is

there to educate the family and help them understandd what to expect next with the illness. We give

hugs of happiness and hugs of sorrow to family and loved ones, and yes, we insert and maintain foley

catheters, too.

All humor aside, we are nurses like any other nurse here at Houston Methodist West, providing the best

environment of caring for every patient and family — but in a unique role. Because we are small in

number and work in a rather isolated area, we can go unnoticed. However, we are here every day (and

many nights) wearing many hats and providing excellent, vital care to cardiac patients. Thank you for

taking the time to read about Cath Lab nurses and letting me share my passion about the role we play

on the cardiac team.

Joe Ray, RN, BSN



But what is unusual is that Tyler Wertz, 18, and his 16-year-old brother, Austin Tucker, both have a debilitating disease that requires heart assist devices to keep them alive.

As young boys, Tyler and Austin were diagnosed with Becker muscular dystrophy, a disease that slowly weakens the arms and legs and damages the heart.

“Sometimes I’ll be walking and I’ll fall down for no reason,” Tyler said. “It can be scary and embarrassing, but it’s just something I have to deal with.”

In 2010, Tyler’s heart condition became so grave that doctors at the Methodist DeBakey Heart & Vascular Center implanted a left ventricular assist device (LVAD), a battery-run device that assists the pumping of the heart, in an attempt to improve his quality of life. Austin received one in 2012.

While most teenagers carry a backpack with books and other items, Tyler and Austin carry a small computer-controlled device powered by two batteries that always have to be charged.

“Sometimes I’ll be in public and people will stare and ask me about it,” Tyler said. “It’s overwhelming at times, but I know that it gave me a second chance at life and for that I am grateful.”

“Tyler and Austin are the first people in the world with this condition who have received this type of treatment to stop the

By: George Kovacik

BROTHERS SHARE UNCERTAIN FUTUREBoth diagnosed with Becker muscular dystrophy and live with heart pumps

“We are always there for each other and stay strong for each other,” Austin said. “When I’m feeling bad he encourages me, and vice versa. That’s what brothers do. We are going through this together and trying to make the best of it.”

It is not unusual for brothers to fight, tease, love and support each other.


progression of heart disease and improve the quality of their lives,” said Dr. Jerry Estep, a cardiologist with the Methodist DeBakey Heart & Vascular Center. “We are using this as a ‘bridge to transplant’ in the hopes that somewhere down the road they will be able to receive a heart transplant. It all depends on how the underlying disease progresses.”

Becker muscular dystrophy is a genetic and milder form of muscular dystrophy that affects mainly males. The boy’s mother, Jennifer Banks, has had to deal with the heartache of this disease most of her life.

“Two of my brothers had it,” Banks said. “One of them died a decade after receiving a heart transplant and the other never lived long enough to receive a new organ. It’s heartbreaking to watch my boys go through the same thing.”

“Before they received the heart pump, the boys did not have the energy to do any kind of physical activity and it was making their muscular dystrophy worse,” said Dr. Matthias Loebe, chief of division of thoracic transplant and assist device at the Methodist DeBakey Heart & Vascular Center and director of thoracic transplantation at the Methodist J.C. Walter Jr. Transplant Center. “The pump gives them the ability to perform every day activities and move around because they are no longer in heart failure.”

For now, Tyler and Austin go to school and play video games and continue to fight the disease that threatens them. They know the pump will not stop the progression of their muscular dystrophy, but it has given their family hope.

“We are always there for each other and stay strong for each other,” Austin said. “When I’m feeling bad he encourages me, and vice versa. That’s what brothers do. We are going through this together and trying to make the best of it.”

“I love them more than life itself, and without the LVADs I know they probably wouldn’t be here,” Banks said. “It’s a blessing to have doctors who will find the proper technology to save lives. I’m just happy they have been given a chance to enjoy their lives.”

Left Ventricular Assist Device (LVAD)

WHAT IS AN LVAD?The left ventricular assist device, or LVAD, is a mechanical

pump that is implanted inside a person’s chest to help a

weakened heart ventricle pump blood throughout t

he body.

Unlike a total artificial heart, the LVAD doesn’t replace

the heart. It just helps it do its job. This can mean the

difference between life and death for a person whose

heart needs a rest after open-heart surgery, or for some

patients waiting for a heart transplant.

LVADs may also be used as destination therapy, which is an

alternative to transplant. Destination therapy is used for

long-term support in some terminally ill patients whose

condition makes them ineligible for heart transplantation.

HOW DOES AN LVAD WORK?Like the heart, the LVAD is a pump. The LVAD is surgically

implanted just below the heart. One end is attached to the

left ventricle — that’s the chamber of the heart that pumps

blood out of the lungs and into the body. The other end is

attached to the aorta, the body’s main artery. Blood flows

from the ventricles into the pump which passively fills up.

When the sensors indicate it is full, the blood is ejected out

of the device to the aorta.

A tube passes from the device through the skin. This tube,

called the driveline, connects the pump to the external

controller and power source.

The pump and its connections are implanted during

open-heart surgery. A computer controller, a power pack,

and a reserve power pack remain outside the body. Some

models let a person wear these external units on a belt or

harness outside.

The power pack has to be recharged at night.

Source: Medicinenet.com


The Iowa Model [1] is a “cookbook” approach to conducting an evidence-based practice (EBP) project. It utilizes the problem-solving steps in

the scientific process to provide a logical framework for conducting an EBP project.

Widely utilized in multiple clinical settings and interprofessional teams, the Iowa Model is intuitive and easy to follow. Application of the model maximizes the clinician’s time and resources and prevents incomplete implementation of the practice change[2]. In summary, by integrating the Iowa Model into all EBP projects, new evidence is readily adopted into practice and ultimately embedded into the foundation of our nursing organization and culture[3]. (See Appendix A)

The Iowa Model begins by encouraging clinicians to identify a question that is a priority for the organization. Problem-focused (e.g., financial data, clinical problem, process improvement data) or knowledge-focused (e.g., new research data, new guidelines, philosophies of care) are used as catalysts to encourage clinicians to critically think about the efficiency and effectiveness of their clinical and operational work environment and seek a scientific basis for decision-making[1]. Considering then how a topic fits within the organizational priorities will facilitate garnering support both from leadership and other disciplines in order to complete the project. Higher priority topics to consider may address: 1) high-volume, high-risk or high-cost procedures; 2) topics that align with the organization’s strategic plan, and; 3) topics driven by other institutional or market forces (e.g., changing reimbursement)[4].

ANNUAL REVIEW:

Iowa Model of Evidence- Based Practice

As a lifeline in our quest to bring evidence to the bedside, the Iowa Model of Evidence-Based Practice is an anchor in the mist of uncertainty.


There are three decision points within the Iowa Model delineated by a diamond. The first decision point asks the question, “Is this topic a priority for the organization?” If the answer is “no,” then the model prompts the clinician to consider other triggers and returns them back to the problem — and knowledge-focused triggers for consideration of a different topic (feedback loop).

The second decision point on the model asks, “Is there a sufficient research base?” Determining if there is enough research to guide clinical practice is a critical step in the EBP process; implementing a practice change on limited or poorly conducted studies will not produce the intended outcome and can be potentially dangerous. When evaluating the evidence the following criteria are useful to consider: (a) consistency of findings across research studies; (b) the level and quality of the research; (c) clinical relevance of the findings to practice; (d) similarity of sample characteristics; (e) feasibility of implementing the findings; and (f) the risk-to-benefit ratio[1]. If after a thorough literature review and synthesis, high-quality research evidence is not available, the project team may either recommend use of lower level evidence (e.g., case reports, expert opinion) or conducting a research study in order to generate the knowledge needed to base practice decisions[4].

When evidence is deemed sufficient, the practice change is piloted to determine feasibility and effectiveness of the change in the actual clinical setting. Pre- and post-pilot data will determine the appropriateness of adopting the change into practice. If the desired outcomes are not achieved in the pilot study, adopting the change is not appropriate (third decision point) and the EBP team should refocus on ongoing quality monitoring and consider a new problem- or knowledge-focused trigger (feedback loop). If the pilot data show positive outcomes the practice change is implemented into practice. Integrating a practice change is facilitated by leadership support, staff education and continuous monitoring of outcomes[4].

Implementing a practice change can be a challenge. Effective, sustained implementation requires multiple reinforcing and interactive strategies.

The final stage of the Iowa Model that is likely the most significant entails disseminating the EBP change results internal and external to the organization through presentations and publications. Results dissemination is important for professional learning and ensures the growth of an EBP culture, expands our knowledge, precludes duplication of work and encourages positive EBP changes in other organizations[4].

The Iowa Model outlines a pragmatic approach to changing practice by melding quality improvement with timely translational science. The ultimate goal is always improvement in patient outcomes. Through the use of the Iowa Model, clinicians can effectively manage EBP projects and gain confidence in the fact that the best available evidence has been translated into practice at the bedside.

For further assistance please contact:Houston Methodist Hospital: Shannan Hamlin Houston Methodist San Jacinto: Kathy ArthursHouston Methodist Sugar Land: Betty Gonzales or Tricia Lewis Houston Methodist West: Kahla LaPlante or Laura EspinosaHouston Methodist Willowbrook: Robin Howe

References

1. Titler MG, Kleiber C, Steelman VJ, Rakel BA, Budreau G, Everett LQ, Buckwalter KC, Tripp-Reimer T, Goode CJ: The Iowa Model of Evidence-Based Practice to promote quality care. Critical care nursing clinics of North America 2001, 13(4):497-509.

2. Gawlinski A, Rutledge D: Selecting a model for evidence-based practice changes: A practical approach. AACN advanced critical care 2008, 19(3):291-300.

3. Dearholt SL: The johns hopkins nursing evidence-based practice model and process overview. In: Johns Hpkins Nursing Evidence-Based Practice: Model and Guidelines. Edited by Dearholt SL, Dang D, 2nd edn. Indianapolis: Sigma Theta Tau International; 2012: 33-53.

4. Ciliska D, DiCenso A, Melnyk BM, Fineout-Overholt E, Stetler CB, Cullen L, Larrabee JH, Schultz AA, Rycroft-Malone J, Newhouse RP et al: Models to guide implementation of evidence-based practice. In: Evidence-Based Practice in Nursing & Healthcare a Guide to Best Practice. Edited by Melnyk BM, Fineout-Overholt E, 2nd edn. Philadelphia: Wolters Kluwer/ Lippincott Williams & Wilkins; 2011: 241-275.


The transfer of majority ownership of CHRISTUS St. John Hospital and CHRISTUS St. Catherine Hospital to Houston Methodist is now complete,

with the two hospitals officially joining Houston Methodist. Under this new agreement, CHRISTUS St. John Hospital in Clear Lake will now be called Houston Methodist St. John Hospital, and CHRISTUS St. Catherine Hospital will now be Houston Methodist St. Catherine Hospital.

Houston Methodist St. John Hospital will continue providing comprehensive care to the greater Clear Lake area. Houston Methodist St. Catherine Hospital soon will be repurposed to a long-term acute care hospital to complement the services Houston Methodist already offers the West Houston/Katy community. Under this agreement, Houston Methodist has retained CHRISTUS Continuing Care, a division of CHRISTUS Health, to manage St. Catherine.

“I cannot emphasize enough what a good fit the two organizations are for each other,” said Marc Boom, MD,

president and CEO of Houston Methodist. “This brings together two faith-based organizations that share common missions and values. We are especially excited about the opportunity to expand our services to the Clear Lake area, and to work with CHRISTUS to open our first continuing care facility.”

Houston Methodist has 15,000 employees caring for patients in seven hospitals, stand-alone emergency departments, imaging centers, physical therapy clinics and a top-ranked research institute.

“We are delighted that St. Catherine and St. John will continue providing high-quality, compassionate care to the Katy and Clear Lake communities as part of a faith-based system,” said Ernie Sadau, president and CEO of CHRISTUS Health. “This completed transition creates a new, innovative partnership, and ensures that Gulf Coast residents will have access to a full continuum of care right in their own backyard.”

The partners will work together to find new opportunities to serve, innovate and enhance the health care provided throughout the Gulf Coast area. In addition, the CHRISTUS Foundation for Healthcare will continue serving the Houston community through its clinics, school-based centers and services for the poor and underserved, which are not part of the transition.

“We welcome the CHRISTUS employees to the Houston Methodist family,” Boom said. “Through this business process it became very clear: CHRISTUS employees are wholeheartedly dedicated to their patients and their care. This partnership will be a benefit to the entire community.”

Welcome Aboard TWO HOUSTON CHRISTUS HOSPITALS BECOME PART OF HOUSTON METHODIST

Ernie Sadau, left, president and CEO of CHRISTUS Health, and Dr. Marc Boom, president and CEO of Houston Methodist, shake hands after signing final documents completing the transfer of majority ownership of CHRISTUS St. John Hospital and CHRISTUS St. Catherine Hospital to Houston Methodist. Looking on is Sr. Lillian Anne Healy, CCVI, congregational leader of Sisters of Charity of the Incarnate Word of Houston. (Photo courtesy of Houston Methodist)

INFECTION CONTROL SPOTLIGHT


What is an ICP (or IP)?ICP stands for “Infection Control Practitioner.” Another title is IP, for “Infection Preventionist” or “Infection Prevention Specialist.”

Do ICPs have a professional organization?There are several professional organizations that ICPs can join. One is APIC, The Association For Professionals in Infection Control and Epidemiology. The APIC website is www.apic.org, and you don’t have to belong to check it out. You’ll find lots of great infection prevention information there for you and your family.

What do ICPs do?APIC describes its members as nurses, physicians, public health professionals, epidemiologists, microbiologists or medical technologists who:

Collect, analyze and interpret health data in order to track infection trends, plan appropriate interventions, measure success and report relevant data to public health agencies. (Determine HAIs, Healthcare Associated Infections)

Establish scientifically based infection prevention practices and collaborate with the health care team to assure implementation. (Infection Prevention Bundles/Daily Care Checklists for Central Line and Foley Catheters)

Work to prevent health care-associated infections (HAIs) in health care facilities by isolating sources of infections and limiting their transmission. (Isolation)

Educate health care personnel and the public about infectious diseases and how to limit their spread. (Hand Hygiene, Disinfection of Rooms and Equipment, Isolation)

Further, ICPs plan facility construction, repair and remodeling projects. Construction barriers, airflow, and traffic patterns are determined before projects begin to protect patients, staff, and visitors from dust, germs, and mold that may be dislodged or introduced during construction.

ICPs perform environmental rounds and unit inspections, looking for unsafe conditions and practices that could pose a risk to patients and healthcare workers. Some ICPs, especially in community hospitals, may serve in employee health and quality (Core Measure) roles.

How do ICPs help you?Again, APIC tells it best: Many ICPs are employed within health care institutions and also serves as educators, researchers, consultants and clinical scientists (outbreak investigations). [Most] are affiliated with acute care settings, [but also] practice in ambulatory and outpatient services, [long-term care, and home health] where they direct programs that protect patients and personnel from HAIs.

All Methodist hospitals have ICPs. Outpatient facilities have access to ICPs through their affiliated hospitals.

Last month you met an

ICP at Houston Methodist

Hospital. This month, let’s

find out what ICPs do for you.

By Robert Morehead, RN, ICPInfection Prevention and ControlHouston Methodist Hospital

OPERATION


“FOLLOW YOUR HEART” І Career Coach’s CornerBy ShuntÁ Fletcher, MSN, RN, NE-BC, CVRN-BC

CARE

ER C

OAC

H’S

CO

RNER

With a lifelong interest in sports and helping people, Joshua Davis knew before he graduated high school that he wanted to pursue sports medicine. But it was while taking a class on “Ethics in Healthcare” his freshman year of college that he was inspired to look in another direction.

That class was being taught by a nurse, and after class one day he asked her about nursing. He saw nursing as a way to have a more personal impact with the patient and soon changed his major to nursing. While in school he heard about the Houston Methodist Advancement into Professional Practice (MAPP) program and decided to apply. First was his phone interview and initial encounter with a career coach. He was pleased and hoped he would be selected.

And he was. After the one-year MAPP program in CVICU, Joshua fell in love with the unit and its staff and wanted to stay after graduation. He applied, and before the interview he became stressed because it was the only job he had applied for. Once again he turned to his career coach for assistance. She

provided guidance and support to help relieve his stress as well as provide clear direction for all possibilities. He got the job and is currently working in CVICU.

He really wanted to stay at Houston Methodist because “The Methodist Experience is real here.” He plans to continue with career coaching when he gets ready for his future education endeavors but “for now I will focus on being the best ICU nurse I can be.”

If you would like greater career success or need help in solidifying your vision for the future coaching appointments are flexible and are conducted by face-face interview or telephone. For more information please contact The Center for Professional Excellence at 713.441.4546 or via email at [email protected].

“The Methodist Experience is real here....For now I will focus on being the best ICU nurse I can be.” Joshua Davis

DID YOU KNOW?February is National Cancer Prevention Month?

We know that each month has at least one type of cancer

awareness that it signifies, but prevention is likely the most

integral part of the fight against this disease. According to

the American Institute of Cancer Research (AICR), many

Americans are still unaware that simple health practices,

such as 30 minutes of exercise each day, a healthy diet and

maintaining proper body weight, can lower their risk of

developing cancer (AICR, 2014). This particular organization

funds cancer research and works to dispel myths that

many Americans still hold about cancer. At Houston

Methodist, the entire health care team plays a vital role

in patient care for their fight against cancer, but half of

that battle is educating our patients about steps they can

take to prevent it For more information, including nursing

resources and evidence, check out the AICR website at

aicr.org and worldcancerday.org.

Chelsea Davang, BSN, RN, CNOR

Gift Basket GiveawayKatina Smith, representative in the BMT Outpatient Infusion Center, got into the Valentine’s Day spirit and wanted to spread it to coworkers and patients. Katina decorated the front desk and put together two gift baskets – one for a patient to win and the other for a coworker to win. She placed a vase full of Starburst candy next to the baskets and whoever guessed the closest won. Chasity Norris won the employee basket, and out of 282 patients who guessed, Mr. Richard Klein, 78, got the number exactly right. He was elated to be the winner and said the gesture made him feel very special. When told they were going to post his picture in the department, he said, “Send it to Hollywood!”

A Call to

Duty

Katina Smith Richard Klein

READYBATTLEOPERATION


At the heart of exemplary professional practice is the role of the nurse in patient care and the quality and service outcomes associated with the patient’s experience. A professional practice model is a visual description of nursing practice and provides a framework to define the role and impact of nursing. In 2013, members of the systemwide Houston Methodist (HM) Clinical Practice Council, led by Jane DeStefano CNO, Houston Methodist San Jacinto Hospital (HMSJ), collaborated with HM nurses throughout the system to review, evaluate and provide input into the continued development of HM’s Professional Practice Model (PPM) and RN Standards of Nursing Practice.

HM Shared Governance Councils at each hospital provided input into the refinement of the model and helped to identify generic RN Standards of Nursing Practice that support implementation of the PPM by all HM nurses. During the HM Shared Governance Conference in November, nurse colleagues participated in an activity to provide examples of RN behaviors that demonstrate the RN Standards in action. In December, DeStefano gathered a group of Magnet Coordinators and Magnet Champions to align the RN behaviors with the RN Standards and prepare next steps for developing an education plan for all nurses at HM. In 2014, nurses will have many opportunities to apply the RN Standards of Nursing that underpin HM’s Professional Practice Model.

Collaboration Among Houston Methodist NursesBy Kathy Arthurs MSN, RN-BC, RNC-OB,

HMSJ Magnet Coordinator

EDUCATION BOOT CAMP:

Houston Methodist Center for Professional Excellence hosted its first Nursing Education Boot Camp, themed “Call to Duty,” for two weeks at the end of January. The boot camp was mandatory for all nurses, and each had to visit stations targeting five nursing priorities: patient satisfaction; staff satisfaction; HAI-CLABSI & CAUTI; patient throughput; and core measures. The boot camp was made possible by a grant from the Texas Workforce Commission.

“We got so many positive comments from directors/managers and staff stating it was the best education event they had ever attended,” said Alicia Hernandez, director of the Center for Professional Excellence.

Of those who attended, 1,074 filled out evaluations for a chance to win an iPad. Maribel Castillo on Dunn 9 was the lucky winner!

Some feedback:

“It was a great experience. It gave me a lot of updates on what we need to focus on.”

“This was a great way to reinforce our clinical knowledge and give us an opportunity to ask questions.”

“Very creative decoration, great enthusiasm, very informative and great participation activities.”

A Call to

Duty

Tiffany Street, R.N., M.S.N., ACNP-BC, with the Houston

Methodist DeBakey Cardiovascular Surgery Associates, was recently elected to a two-year term on the board of directors of the Society for Vascular Nursing. The SVN is a not-for-profit international association dedicated to promoting excellence in the compassionate and comprehensive management of persons with vascular disease.

Please join us in congratulating the nurses listed below, who have successfully met the criteria and demonstrated during an interview the traits and abilities needed to successfully fulfill role responsibilities for promotion to R.N. III. These nurses put together an application packet that included various documents, evidence of six contribution points and a written clinical narrative. The nurses were also required to pass a clinical simulation. They are Jeremy Aganon, OPC AOD, Lisa Castro, OPC OR, Tracee Kennon, CVICU, Jennifer Daniels, Jones 9, Diana Garcia Prats, Jones 11, Christie Aguirre, Main 3 AOD, Theresa Vu, Dunn 3 OR, Bernice Onyenezi, Alkek 7, Felicia Akingbola, Jones 11, and Haley Hoskinson, MICU.

Congratulations to Jannah Mitchell, R.N., B.S.N., MEd, on Jones 8, for becoming Medical/Surgical certified!

Congratulations to Mary Silas, R.N., M.S.N., in CPE, on passing her Nursing Professional Development certification!

Kudos to Erica Mouton, R.N., on Jones 9 for becoming a Certified Progressive Care Nurse (PCCN)!

Joy Shiller , R.N., B.S.N., M.S., CAPA, from Main 3 Pre-Op, was selected to serve on the Exam Review Committee for the Certified Perianesthesia Nursing Exam in San Antonio.

AccoladesNursing

NewsHouston Methodist Hospital is proud to have nurses who are dedicated to the nursing profession, driven to achieve growth in their professional development, and creative and always compassionate in their care for patients.

The accolades page is an opportunity for the nursing staff to showcase a few of the many exciting tributes our nurses receive. Please submit kudos to: [email protected].

Congratulations to My Ton, R.N., and Shannon White, R.N., from NICU, for obtaining their Master of Science in Nursing degrees in December! My graduated from University of Phoenix and Shannon graduated from University of Texas Health Science Center.

Congratulations to Sadaf Abbas, R.N., in Neurosensory 7 AOD/PACU for getting her M.S.N and MBA degrees! Great job!

Congratulations to Becky Cox, R.N., at Kirby ECC, for earning her Emergency Nurse Certification!

Suzanne Cearley, Lauren Girardi, Audrey Thomas and Shelby Wileym in Case Management completed training and are InterQual Certified Trainers (IQCT). Great job!

Congratulations to Jessica W. Daniel, RN III, CNOR, Charge Nurse/Surgery Coordinator at Houston Methodist Willowbrook Hospital, for receiving a 2014 Stryker Educational Grant by the AORN Foundation to attend the AORN Surgical Conference & Expo 2014 in Chicago.

Congratulations to Casey McAndrew, RN, on SICU for earning her Critical Care Certification (CCRN). Great job, Casey!

Mavis Quarcoo-Asimenu, team RN, achieved her CVRN-BC certificate. What a great accomplishment!

The director and manager of the Inpatient Dialysis Unit presented two posters at the ANNA Texas Annual Collaborative meeting in Houston. Sana Haj-Khalil, MHA, RN, CNN. Poster presentation “Educational Illustration For ED Nurses: Best Practice—How to Collect Peritoneal Dialysis Fluid Cultures” and Gail Messner, MSN, APN, CNN, Poster presentation “Palliative Care for the Renal Dialysis Patient—An Educational Tool for Nephrology Nurses.”

Documents

Houston Methodist Nurse February 2014