NorthBay Healthcare 2017 Nursing

Annual Report

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2017 NURSING ANNUAL REPORTTable of Contents

3 LetterfromTraciDuncan,VicePresident,ChiefNursingOfficer

4 NorthBayHealthcareOrganizationalInformation 5 StrategicPlan

5 NorthBayHealthcareAccomplishments •GuardianofExcellenceAward •TraumaRe-verification •JointCommission 6 MagnetDesignation

7 ProfessionalPracticeModel 8 ExtraordinaryNurses •DAISYAwards 9 NursingEducationandClinicalPracticeDevelopment

10 ProfessionalPresentations

11 ManuscriptsAcceptedforPublication

12 Demographics •EducationofNorthBayNurses •PatientCareHours •AgencyStaffing 16 PerformanceImprovement •ReductioninHospitalAcquiredInfections •ReductioninCesareanDeliveries

19 RefurbishmentofNorthBayAcuteCareUnits

20 EmergencyDepartmentExpansion

21 Community&Beyond •NorthBayHealthcareNurseCamp •DisasterHelp 23 Acknowledgments

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Message from the Chief Nursing Officer

Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest accomplishment or the smallest actof caring, all of which have the potential to turn a life around. - Leo Buscaglia

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NorthBayHealthcare2017LicensedBeds

Inpatient AverageDaily Census

InpatientLengthof

Stay (ALOS)

ObservationPatients

Emergency Department

Visits

Deliveries

NorthBayMedical Center 132 29,214 79.8 4.3 3,953 45,481 1,210

NorthBay VacaValleyHospital 50 12,456 33.3 5.0 1,890 24,953 0

NorthBay Medical Center and NorthBay VacaValley Hospital provides the following Inpatient and Outpatient Services:

•EmergencyServices •PerioperativeServices •GastroenterologyServices •ChestPainCenter •PharmacyServices •STEMIReceivingFacility •LaboratoryServices•TraumaLevelIIVerifiedCenter•PulmonaryServices •CardiovascularServiceLine •EmergencyDepartment •PeripheralVascularServices •IntensiveCareServices•MedicalSurgicalServices •NeuroscienceServiceLineincludingPrimary •LimitedPediatricServices StrokeCertification •LaborandDeliveryServices(NBMConly) •CardiacRehabilitation •Mother-BabyServices(NBMConly) •DiagnosticImagingServices/InterventionalRadiology •NurseryServices(NBMConly) •CaseManagement/DischargePlanning •NeonatalIntensiveCareServices(NBMConly) •SocialServices •NutritionServices •PalliativeCareServices •RehabilitationServices

Thehospital-basedclinicslocatedontheVacaValleycampusaretheWoundCenterwhichhousestwoHyperbaricChambers,anAnticoagulationClinic,MedicalOncologywithapharmacy,RadiationOncology,andCardiopulmonaryRehabilitation.

HomeCareandHospiceProgramsprovidevaluableservicestooutpatientsoncetheyleaveourhospitalsandareintegraltothecontinuityofcareforourpatients.HomeCareandHospiceservicesarelocatedinFairfield.TheHealthatHomeprogrammaintainedanaveragedailycensusof129patientsand11,756visits.TheHomeHealthvisitsareprovidedbyRNs,HomeHealthAides,PhysicalTherapists,andSocialWorkers.TheHospiceProgramprovidesend-of-lifecareformanypatientsinourcommunity.

NorthBay Healthcare Organization NorthBayHealthcareisanindependent,community-based,notforprofithospitalsystemwithtwoacutecarehospitals:NorthBayMedicalCenterandNorthBayVacaValleyHospital.Theorganizationhasbeeninoperationsince1957basedinFairfield,California.

PressGaneyPresentstheGuardianofExcellenceawardtotheNICUstaff.

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Strategic Plan ThemissionofNorthBayHealthcareistoprovideCompassionateCare,AdvancedMedicine,Closeto Homewithadynamicstrategicplanbasedonatri-foldplatformofTRUST,SEAMLESSCAREand INDEPENDENCE.TheorganizationalvaluesareCaring,Collaboration,CommunicationandCompetency.

ThePatientCareServicesStrategicPlandirectlysupportstheorganization’splan.

PatientCareServiceVision:Safe,Trusted,Competent,Compassionate

PatientCareServiceGoals:

TRUST: •Inallunits,achievescoresbetterthanthenationalaverageintheNDNQI nursesatisfactionandcultureofsafetyoutcomessurvey.SEAMLESSCARE: •Deliverseamlesscarethatresultsinpatientsatisfactionscoreswhere patientsrecommendourhospitals95%ofthetime. •Ourpatientshighlyrecommendourhospitalthemajorityofthetime inthemajorityofallunits. INDEPENDENCE: •Educate/traininLeanmanagement/toolsthroughoutpointofcaresystem fromdirectortobedsideclinician. •DevelopVacaValleycampusasacenterofexcellenceforCancerServices.

NorthBay Healthcare Accomplishments Guardian of Excellence Award TheNeonatalIntensiveCareUnit(NICU)wasrecognizedfor consistentlysustainingperformanceinthetop5percentofallPressGaneyclientsforeachreportingperiodduringthecourseofoneyear.TheGuardianofExcellenceAwardrecognizestop-performinghealthcareorganizationsthathaveconsistentlyachievedthe95thpercentileoraboveinperformanceinthecategoryofthepatientexperience. Trauma Re-Verification

NorthBayTraumaCenterwasreverifiedfor3yearsasalevelIItraumacenterfollowingatwo-dayreviewfromtheAmericanCollegeofSurgeons.Nodeficiencieswerefoundandhighmarkswerereceivedforperformanceimprove-mentefforts,communityeducationprogramsandcommitmenttohelpingtrainpre-hospitalemergencyresponseteamstoensurethebestpossibleoutcomeforcriticallyinjuredpatients.

Joint Commission

InSeptember,surveyorsarrivedforafour-daysurveyfolloweddayslaterbyathree-daylabsurvey.Theyreported22findings,noneofwhichwere“conditional.”Thesurveyincludedthehospitals,medicalofficesthatfunctionun-derthehospitallicense,andHealthatHome.Surveyorsspecificallycommendedtheknowledgeofournurses,thecollaborationbetweendepartmentsandaskediftheycouldsharemanybestpracticesthathavebeencreatedandsustainedbyNorthBay.

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Magnet Designation

MagnetdesignationisgrantedbytheAmericanNursesCredentialingCenter(ANCC)fornursingexcellence.NorthBaynursesembarkedonthejourneytowardMagnetinOctober2008andachievedMagnetdesignationinDecember2014.Thiswasnotanendpointhowever,simplyamarkeronthecontinualjourneytowardexcellenceinclinicalpracticeandpracticeenvironment.Asthefounderofmodernnursing,FlorenceNightingalenotedlongago,“prog-ressintheworkofnursingisessential.”

Oncedesignated,ourworkimmediatelybegantoprepareforMagnetredesignationwhichisdueinOctober2018.ExamplesofstructuresessentialforMagnetdesignationwhichhavebecomepartofournursingcultureatNorthBayincludebutarenotlimitedto: •Sharedgovernance •Evidence-basedpractice •Nursingresearch •Nursingstrategicplanalignedwiththeorganizationalstrategicplan •ProfessionalPracticeModel

TheANCCpublishesanewMagnetmanualeveryfouryears,consciouslyraisingthebarforMagnetdesignation.NorthBayispositionedfavorablyasweareinthelastcohorttowritetothecurrentmanual.Forourfirstdesignation,clinicaloutcomeswererequired,howeverforourredesignationtherigorofoutcomereportinghasincreased.TheANCCnowrequirestrendedimprovementinresponsetonursinginterventions.

In2017,NorthBay’svicepresident,chiefnursingofficer,TraciDuncan,DNP,RN,NEA-BC,submittedourapplicationstatingourintentiontosubmitredesignationdocumentsinOctober2018.TheredesignationdocumentwillconsistofhundredsofpagesofvalidateddocumentationoftheworkofnursingatNorthBay.

Magnetwritingbeganin2017asdatabecameavailablefromqualityimprovementactivities,evidencedbasedpracticeinitiatives,collaborativepatienteducation,shareddecisionmakingandanincreasedpercentageofnurseswithBSNorhigherdegrees.

WhilethewritingmayappeartobetheworkofMagnet,therealworkofMagnetoccurseveryshift,everydayasclinicalnursesandnursingleadersworktogethertoprovidesafequalitypatientcaretoourcommunity.Asthelogoabovesuggests,Magnetprovidesdirectiontotruenorth,thedirectiontoexcellence.

Wethankourseniorleaders,physiciancolleagues,professionalservicepartners,andboardsofdirectorsfor supportingthiswork.

ChrisStevenson,BSN,RN,NE-BCInterimMagnetProgramDirector

KatieLydon,MSN,RN,NE-BCDirectorofWomen’sandChildren’sServicesMagnetAdvisor

KimWilliamson,MSN,RN,NE-BCDirectorofCardiacServices MagnetAdvisor “Unlesswearemakingprogressinournursingevery year,everymonth,everyweek,takemywordforit, wearegoingback.” -FlorenceNightingale,1914

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Professional Practice Model

TheNorthBayNursingProfessionalPracticeModelcreationwasinspiredbyourMagnetjourney.Thepatientandfamilyarethefocusofnursingpractice;theyaresurroundedintheinnerringwithprofessionalnursingpracticeconnectingthemtothehearts.ThisillustrationdepictshowNorthBaynursespractice,communicate,collaborateanddeveloppro-fessionally.ThespokesofthecirclearetheNorthBayorganizationalvalues.

In2017,theMagnetChampionsSharedGovernanceCommitteeconductedanevaluationofourProfessionalPracticeModel.ThroughfeedbackgatheredfromNorthBaynurses,adecisionwasmadetochangethe“Stewardship”spoketo“Trust.”

Extraordinary Nurses

DAISY Awards

2017wasthesecondyearthatNorthBaywasapartoftheDAISYFoundation.Nursesarenominatedbytheirpeers,families,patientsandothersfortheirextraordinarycompassionatecareforNorthBayHealthcare’spatientsandcommunity.TheprestigiousDAISYawardisdesignedtorecognizethenurseswhodeeplytouchthelivesof patientsandtheirfamilies.DAISYawardnursesreceiveasignedplaquefromthechiefnursingofficer,DAISYFoundationa“Healer’sTouch”sculpturecarvedbyartisansinZimbabwe,andtheirnamesareaddedtotheDAISYFoundationwebsite.

NorthBayHealthcarejoinedtheDAISYFoundationin2017andawardedthefollowingoutstandingnurseswiththeextraordinaryDAISYNurseAward:

KariCrain,AcuteCare1800

RoxySalmeron,AcuteCare1800

MirandaCariaga,AcuteCare1600/1700

KarenZeck,AcuteCare1West

EmilyTaylor,IntensiveCareUnit

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Nursing Education and Clinical Practice Development

Professional Presentations by NorthBay Nurses

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Professional Presentations

Presenter(s) Presentation Location

Shelley Johnson, MHA, BSN, RN, CENP,Director,CriticalCare Services

LeadershipPanelSpeaker HolyNames3rdAnnualNursingSymposiumMarch24,2017

Natalie Correll-Yoder, MN, RN, CCRN, CCNS,ClinicalPracticeMan-ager-ClinicalNurseSpecialist

Presentation:PanelSpeakerForgingaNewPath:TransformingMoralDistresstoMoralResilience

NationalTeachingInstituteandCriti-calCareExpositionMay,2017

Natalie Correll-Yoder, MN, RN, CCRN, CCNS,ClinicalPracticeMan-ager-ClinicalNurseSpecialist

FromMoralDistresstoMoral Resiliency:DealingwithEthicalIssuesattheBedside

NationalTeachingInstituteand CriticalCareExpositionMay,2017

Jennifer Tudor, MSN, RN, CNL, CCRN,ClinicalNurseIII,NorthBayMedicalCenterIntensiveCareUnitShelley Johnson, MHA, BSN, RN, CENP, Director,CriticalCareServices

Presentation:IntegratingtheCNLintothestaffingmodel

NorthBayHealthcareNursing Research&EBPSymposiumFairfield,CAAugust25,2017

Heather Theaux Venezio, MS, RN, CEN, TCRN,TraumaProgramDirector

Poster:DecreasingPostoperativeIleuswithGumChewing:AnRNDriven InterventionforPostoperativePatients

NorthBayHealthcareNursing Research&EBPSymposiumFairfield,CAAugust25,2017

Katie Lydon, MSN, RN , NE-BC CPXP, DirectorofWomen’s& Children’sServicesHeather Troutt, BSN, RN, RNC-OB, ClinicalManagerofWomen’sandChildren’sServices

Poster:CreatingaPatientSafetyCultureinOB

NorthBayHealthcareNursing Research&EBPSymposiumFairfield,CAAugust25,2017

Natalie Correll-Yoder, MN, RN, CCRN, CCNS,ClinicalPractice Manager-ClinicalNurseSpecialist

Presentation:LevelingtheEvidence NorthBayHealthcareNursing Research&EBPSymposiumFairfield,CAAugust25,2017

Natalie Correll-Yoder, MN, RN, CCRN, CCNS,ClinicalPracticeMan-ager-ClinicalNurseSpecialist

Co-Presentation;Whereisthe Evidence?UnmaskingtheSacredCow

NorthBayHealthcareNursing Research&EBPSymposiumFairfield,CAAugust25,2017

Professional Presentations (Continued)

Presenters(s) Presentation Location

Jennifer Leone, MS, RN, CNS, CEN, Emergency-Trauma CNS/ClinicalPracticeManager

Co-Presentation;Whereisthe Evidence?UnmaskingtheSacredCow

NorthBayHealthcareNursing Research&EBPSymposiumFairfield,CAAugust25,2017

Katie Lydon, MSN, RN , NE-BC, CPXP,DirectorofWomen’sandChildren’sServicesHeather Troutt, BSN, RN, RNC-OB, ClinicalManagerofWomen’sandChildren’sServices

Poster:CreatingaPatientSafetyCultureinOB

ANCCAnnualMagnetConferenceHouston,TXOctober11-13,2017

J. Trask, MS, RN, CCRN, Barbara Rickabaugh, MSN, RN, NE-BC, T. Pak, MSN, RN, NE-BC, B. Raingruber, Ph.D., RN, NE-BC, M. Wilson, Ph.D.

Poster:ResearchStudyAlleviatingMoralDistressAmongNursesinaMedicalSurgicalICU

UCDavisMedicalCenterProfessionalGovernance CelebrationSacramento,CAOctober31-November1,2017

Manuscripts Accepted for Publication 2017

Laura Oiler, MS, BSN, RN, CCRNClinicalInformaticsEducationNurse

LauraOilerisfirstauthoronthispublication

Title:Multi-PatientSimulation:StudentPerceptionsofConfidenceandReadinesstoCareforMultiplePatients

AcceptedbyJournal of Informatics Nursing andpublishedinMarch2018

Shelley Johnson, MHA, BSN, RN, CENP,Director,CriticalCareServices

ShelleyJohnsonisauthorofthispublication

Title:CombatingHospitalAcquiredClostridiumdifficile:ASuccessfulCollaborationBetweenClinicalNurseLeadersandClinicalNurseSpecialist

Acceptedby Nursing Management andpublishedinMarch2018

Shelley Johnson, MHA, BSN, RN, CENP,Director,CriticalCareSer-vices

ShelleyJohnsonisauthorofthispublication

OrganizationRiskofHospitalAc-quiredInfections

AcceptedbyNursing Economics andpublishedinJuly2018

Elisa Jang, MS, RN, CNS,ClinicalNurseSpecialist,TranslationalResearch

Evidence-BasedPracticeExemplar AcceptedbyFoundations of Clinical Nurse Specialist Practice, 3rd Edition andpublishedinSpring2018

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2017 Nursing Research Proposals

Date ProposalTitle IRBApprovalNumberor Exempt/Expedited PIName

7/19/17 SurgicalSiteInfectionPreventionin PatientsUndergoingColonSurgeryUsinganSSIBundle

17-06EBP RosaTorres-Westphal,RN

7/19/17 SatisfactionwithPatient-CenteredVisitationPolicy

17-07EBP TeriChamberlain,RN

8/16/17 FamilyInvolvementinPatientCare 17-16EBP ShawneeLaiwa-McKay,RN

Research in Progress

DEMOGRAPHICS (ALL NURSES OF NORTHBAY HEALTHCARE)

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

100%

Female Male

RN Gender

2016NorthBayHealthcare2017NorthBayHealthcare

AllRegisteredNurses(includingNursingLeadership)(includingNursingLeadership)

RNEmployees 940Education AA 181

BSN 617Diploma 1

MSN 138DNP 1PhD 2

AverageAge 43yearsAverageYearsof

Service7.36years

2017NursingLeadership

Employees 37Education BSN 13

Diploma 0MSN 23DNP 1

AverageYearsofService

14.5years

Education of NorthBay Nurses

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WorkForce and Agency Usage 2017Nurseretentionisstronginmaintainingasignificantlybelowbenchmarkturnoverstatisticfor2017.NurseturnoverratesthroughoutCaliforniasawanincreasefrom2016to2017.NorthBayHealthcarealsosawaslightincreaseinnurseturnover,althoughnotattheleveloftheincreaseseenthroughoutthestate.TheNorthBayHealthcarenurseturnoverremainssignificantlybelowthestatelevels.Vacancyratesimprovedfrom2016to2017astheincreasehiringinitiativeof2017toimprovestaffinglevelswassuccessful.TheNorthBayHealthcarenursevacancyrateremainsbelowthestatelevels.

Hour

s per

uni

t

Performance Improvement

16

0

10

20

30

40

50

60

CAUTI CLASBI C.Diff

2016

2017

Num

berofcases

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Performance Improvement Continued

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Refurbishment of NorthBay Acute Care UnitsBeginninginJuneof2017,NorthBayMedicalCenterAcuteCareUnitsunderwentrefurbishment.Taking advantageofatypicalsummerslowdownincensus,eachunitwasshutdowninphases,allowingforpatientcaretobeconsolidatedinotherareas.

On1700,fournewbedswereaddedandopenedneartheendofJuly.Phase2includedarefreshto1600unit,withthefinalphasebeing1800unit.

Unit1800NorthopenedseveraldaysearlierthanplannedwhenconcernsaboutwildfiresinNorthernCaliforniapromptedorganizerstoexpediteandready15bedsaheadofschedule.TheareawasopentopatientsonOctober9th.Amultidisciplinaryteamworkedtogethertoprepareroomsasdeliveryofequipmentandnewbedswereaccelerated.

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Emergency Department Expansion

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Community & BeyondDisaster Help

InOctober2017,theAtlasFiredestroyednumeroushomesandresultedinNorthBayHealthcareactivatingacommandcenterasthefirespreadintoSolanoCounty.Thegoalwastokeeppatientssafe,servicesavailableandlookoutforco-workers.

AshospitalsinnearbySonomacountyhadtoevacuateduetothefire,theyputoutacallforhelpincoveringshifts,asmanyoftheirstafflosthomes.NorthBaystaffsteppedupandmadethemselvesavailabletocoverthoseshiftsatotherfacilities.

AsNorthBayemployeesalsowereforcedtoevacuate,theyfoundshelterinhomesoftheirco-workers.RebeccaMiller,RN,learnedthatmanyofherfriendsandcolleagueswereevacuatedtakingshelterinvariousspotsaroundFairfield.Shewentintodeliverymode,providingnotonlysnacksbutlunchanddinnerforthosewhoweredis-placed.

NorthBayalsosupportedSonomaDevelopmentalCenterpatientsdisplacedinthefire.

NorthBay Healthcare Nurse Camp

Thirty-sixteensrepresentingeveryhighschoolinSolanoCountyattendedthe13thAnnualNorthBayNurseCampfromJune20-23,2017.Selectedfromafieldofmorethan75applica-tions,thestudentsspenttwodaysonthe VacaValleyHospitalcampusandtwodaysatNorthBayMedicalCenter,learningwhatittakestobeanurse.

NorthBaynursesfoundedtheannualcamp14yearsagoandthecurriculumisfocusedoninspiringyoungadultstoseriouslyconsid-eracareerinnursing.Duringthe4-daycamp,nursesfromallareasofthehospitalmentorstudentsandeducatethemaboutavarietyofaspectsofthenursingprofession.

Onthefirstday,thestudentsjumpedrightintohands-on-experiencesastheylearnedtosuturewounds,giveinjections(tooranges),startIVs(onsimula-tionmodels)andpracticeCPR.Onthesecondday,spentintheVacaValleyHospitalEmergencyDepartment,theteenslearnedaboutcastingandsplint-ingbyapplyingsoftcaststoeachothers’armsandtheywitnessedamocktrauma.Laterthatday,theygotalookatemergencymedicineinthefield,thankstoREACHmedicalhelicopterandtheVacavilleFireDepartment.

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OneofthemostpopulareventswasavisittoNorthBayMedicalCenter’sSurgeryDepartment,wheretheteensdonnedsterilegarbtoenterasurgicalsuite,examineditemsunderamicroscopeandpracticedlaparoscopicsurgeryonamelon.

Othereventsincludedavisittotheintensivecareunit,wheretheylearnedaboutstrokepatientsandpracticedusingtheliftequipment.ThefinaldaywasallaboutbabiesinNorthBayMedicalCenter’sWomen’sandChildren’sServicesdepartment.

TheNorthBayNurseAcademybeganin2003asawaytoreachouttohighschoolstudentsandexposethemtocareersinnurs-ing.NursesvolunteerasNurseAmbassadorsandhostnursingclubsinseverallocalschools.ManyteenswhoattendNurseCampalsoparticipateintheirschool’snursingclub.

Notonlyhastheprogrambeensuccessful,theextremelypositiveimpactthestudentshavehadonthenursesinvolvedintheprogramwasunexpected.Morethan50nurseshavetaughtthroughtheyears,andcomeawayfromNurseCampwitha

renewedsenseofworth,loveoftheir profession,andcollaborationwiththeir peers.

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Acknowledgments

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