patient care services (pcs)

PATIENT CARE SERVICES (PCS) 2019 ANNUAL REPORT

N E M O U R S C H I L D R E N ’ S H O S P I T A L

Patient Care Services 2019 Annual Report 1

CONTENTS

03 A Letter From Helen Case, DNP, MA, RN, NEA-BC

Chief Nursing Officer and Operational Vice President (Retired)

04 Patient Care Services Professional

Practice Model, Mission and Vision

04 We Believe In...

04 Nemours Children’s Hospital Patient Care Services Mission

07 Transformational Leadership

07 Sixth Floor Now Open and Ready to Welcome Patients at NCH

08 Structural Empowerment

08 Versant Program Engages and Empowers Fourth Cohort of RNs

10 2019 DAISY Foundation Awards for Extraordinary Nurses

10 Celebrating Recognition: 2019 Nurses Week Award

12 Academic Advancement

12 Our Nurses Offer Expertise Outside the Hospital Walls

13 Unit Based Councils

14 Exemplary Professional Practice

14 Compassionate Care Sets the Stage to Help Child Thrive

14 Music Therapist Helps Foster Independence — and Happiness

14 Child Life Specialists Help Make Hospital a Home Away From Home

14 Pastoral Care Tends to Patient and Family Spiritual and Emotional Needs

15 Social Worker Offers Steadfast Support From Hospital to Home

15 New Knowledge, Innovation and Improvement

15 NCH Honored With Sixth Innovation Award

16 2019 by the Numbers

2 Nemours Children’s Hospital

BEST WISHES FOR A BRIGHT

AND MEANINGFUL FUTURE AHEAD.


A LETTER FROM

Helen Case, DNP, MA, RN, NEA-BC

Helen Case, DNP, MA, RN, NEA-BC Chief Nursing Officer and Operational Vice President (Retired)

As I embarked on the road to retirement, I looked back fondly at 2019 with immense pride and as another extraordinary year for Patient Care Services at Nemours Children’s Hospital (NCH).

We began the year with the much-anticipated launch of our High Reliability Organization (HRO) work toward Mission: Zero, which represents our collective journey to zero harm. Our team culminated 2019 with the relocation of our Cardiac Intensive Care Unit to our newly transformed, state-of-the-art space on the sixth floor. This move allowed NCH to provide even greater service, care and comfort to our patients and families, and will benefit many more families in the long term.

There are several other accomplishments and successfully tackled initiatives that enhanced patient care in between these two major events. Last year, 78 percent of our nurses held or successfully attained a Bachelor of Science in Nursing (BSN), Master of Science in Nursing (MSN) or Doctorate (PhD) degree, which ranked our Nemours nursing professionals above the national benchmark.

Our Journey to Magnet Excellence® continued with the submission of our Versant New Graduate Nurse Residency™ Program’s application for recognition as a Practice Transition Program (PTAP) from the American Nurses Credentialing Center (which we successfully received with distinction in January 2020).

Additionally, NCH was honored with its sixth consecutive Florida Hospital Association Innovation Award for Innovation of the Year in Patient Care for the ‘Path to Home’ discharge improvement process. Led by the Medical Surgical department, this significant triumph was made possible by the collective work of many skilled individuals collaborating seamlessly to improve the patient family experience.

Thank you for the opportunity to serve alongside this talented team of professionals who help, coach and encourage one another while also striving to reach new heights in the delivery of world-class care. I will forever remain in awe of the work, perseverance and commitment demonstrated by the Patient Care Services team during this past year and during my tenure at Nemours. Best wishes for an even brighter and meaningful future ahead.

With gratitude,


PATIENT CARE SERVICES VISION

Extraordinary Care.

Extraordinary Teams.

Extraordinary Results.

NURSING VISION

Extraordinary Care.

Extraordinary Nurses.

Extraordinary Results.

PATIENT CARE SERVICES PROFESSIONAL PRACTICE MODEL, MISSION AND VISION

Our Foundation: The Nemours Nurses’ Professional Practice ModelOur professional practice model (PPM) is the driving force behind nursing care at Nemours. It guides us in how we practice, collaborate, communicate and develop professionally to provide the highest quality of care to the patients and families we are privileged to serve. This extraordinary, compassionate care also contributes to successful treatment and optimal outcomes.

We Believe In:Our Promise: Caring for every child as if they were our own.

Our Inspiration: Communication and motivation to make a difference.

Our Excellence: Synergy and lifelong learning to deliver outstanding nursing care.

Our Team: Mutually beneficial partnerships to achieve optimal outcomes.

Nemours Children’s Hospital Patient Care Services Mission: Deliver quality, patient- and family-centered care through innovation, collaboration and a culture of excellence.


WE BELIEVE IN…

Mutually beneficial partnerships to achieve optimal outcomes.OUR TEAM

Communication and motivationto make a difference.OUR INSPIRATION

Synergy and lifelong learning todeliver outstanding nursing care.OUR EXCELLENCE

OUR PROMISE Caring for every child as ifthey were our own.

NURSING PROFESSIONAL PRACTICE MODEL


LISTEN, CHALLENGE, INFLUENCE,AFFIRM


TRANSFORMATIONAL LEADERSHIPThe American Nurses Credentialing Center (ANCC) defines transformational leaders as those who, “listen, challenge, influence, and affirm as the organization makes its way into the future.”

Throughout 2019, we worked to be transformational leaders, through multiple initiatives. One key focus area for the year was standardizing communication. The text below outlines the path we took to improve communication and handoffs — and, in the process, help lead Nemours Children’s Hospital into the future.

Sixth Floor Now Open and Ready to Welcome Patients at NCH In 2017, the Nemours Children’s Hospital team launched plans to expand services and embarked on an important master facility planning project. This was a part of our ongoing journey to establish NCH as a leader in pediatric health care, locally and beyond. In the fall of 2018, construction began on the sixth floor with the vision of enabling our teams to offer children with complex conditions highly specialized care and expertise.

Now, we are proud to report that we have achieved another significant milestone on our journey with the completion of our much-anticipated work. On December 3, 2019 the sixth floor became operational and ready to welcome patients and families in planned phases. Specifically, five patients were safely transferred from Pod 3C to 6C as a part of the milestone day and received seamless and quality care in our new space.

This 40,000 square-foot expansion includes a Pediatric Cardiac Center featuring a Cardiovascular Operating Room (CVOR) and hybrid catheterization lab, where traditional diagnostic functions of a cath lab are combined with the surgical functions of an operating room. These two new operating rooms will also alleviate the load on our current operating rooms and enable our surgical teams the opportunity to perform additional procedures, thereby serving more children in need. Also included are an additional 30 critical care capable beds, of which 20 are currently available, adjacent to the cath lab, providing for a safer and more seamless experience for all of our patients, and affording our specialists the opportunity to care for more cardiac, neonatal and other patients with complex conditions. The remaining 10 beds will become available in the first quarter of 2020. This work represents the final build-out of previous shell space at NCH, bringing the total number of inpatient beds to 130.

NCH has greatly evolved over the last seven years. With this new addition to our hospital, we will be better able to improve our patient and family experience, and the workflow for our associates, while creating efficiencies that reduce wait times and waste. Thank you to everyone who had a hand in bringing this new space to life. No matter how great or how small your contribution, your ongoing hard work and steadfast commitment to the families that entrust us with the care of their children are admirable and greatly appreciated.


STRUCTURAL EMPOWERMENTIn order for hospitals to earn Magnet recognition, the American Nurses Credentialing Center (ANCC) notes, “Staff need to be developed, directed and empowered to find the best way to accomplish the organizational goals and achieve desired outcomes.” In 2019, Nemours Children’s Hospital once again worked hard to empower staff and strengthen our infrastructure in order to help forward organizational goals and outcomes.

Versant Program Engages and Empowers Fourth Cohort of RNs The Versant New Graduate Nurse Residency Program™ is a one-year program designed to help newly graduated registered nurses transition from students to competent professionals who help improve the quality and safety of patient care. Nemours Children’s Hospital (NCH) began participating in the program in March 2017.

In Fall of 2019, the fourth cohort completed the program, which included eight RN residents. Six alumni also contributed to the fourth cohort by serving as preceptors, mentors and debriefers. To date, 38 Nemours RNs have completed the program.

In 2019 the program reached a milestone — accreditation with distinction as a Practice Transition Program from the American Nurses Credentialing Center (ANNC). This highly esteemed accreditation was only the 136th awarded nationally and followed an extensive evaluation conducted with the NCH Nursing Professional Excellence team. This recognition validates that the program is not only doing its due diligence, but is also going above standard to transition registered nurses into new practice settings that meet rigorous, evidence-based standards for quality and excellence.

The recognition also reflects the team’s collaboration to reliably help new RN residents safely transition to practice while delivering on the Nemours Promise to treat each child as if they were our own. ANCC standards also provide a powerful, global benchmark to continually self-assess and identify ways to strengthen our practice transition program.


DELIVERING ON THE NEMOURS PROMISE TO TREAT EVERY CHILD

AS IF THEY WERE OUR OWN.


2019 DAISY Foundation Awards for Extraordinary NursesThe DAISY Award for Extraordinary Nurses has long been a prestigious honor for its recipients. Each month a Nemours Children’s Hospital nurse is recognized with a DAISY award. There is no better testament to the caliber of our nurses than the DAISY nominations they receive from their teammates and the patients and families under their care.

Congratulations to Nemours Children’s Hospital nurses who are the 2019 recipients of the DAISY Award, a nationwide program that rewards excellence in nursing.

Celebrating Recognition: 2019 Nurses Week AwardsNurse of the Year: Ashley ChickPreceptor of the Year: Karen JohnsDAISY Nurse Leader of the Year: Janice JeuneDAISY Team of the Year: Breast Milk Team

Jacob McCabe, MSN, RN – PICUJanuary 2019 DAISY Award Recipient

Tertusha Dessources, ASN, RN, CPN – PICU

February 2019 DAISY Award Recipient

Stephanie Chase, ASN, RN – PICUMarch 2019 DAISY Award Recipient


Ashley Chick, BSN, RN – Emergency Services

April 2019 DAISY Award Recipient

Rebekah Vallejo, BSN, RN – Critical Care Transport

May 2019 DAISY Award Recipient

Christine Porter, MSN, RN, CCRN – NICU

June 2019 DAISY Award Recipient

Ashley Kelly, BSN, RN – Medical Surgical

July 2019 DAISY Award Recipient

Megan Little, ASN, RN – Medical Surgical

August 2019 DAISY Award Recipient

Abigail Marquez, MSN, RN – Medical Surgical

September 2019 DAISY Award Recipient

Safiya Bogle-Williamson, ASN, RN – Inpatient Rehabilitation

October 2019 DAISY Award Recipient

Beverly Brown, MSN, RN – Hematology/Oncology

November 2019 DAISY Award Recipient

Kaitlyn Brown, BSN, RN – Medical Surgical

December 2019 DAISY Award Recipient


Our Nurses Offer Expertise Outside the Hospital WallsNemours Children’s Hospital patient care services personnel contribute their skills, talent and expertise to a wide variety of professional organizations and academic institutions.

Professional organization representation and leadership includes:Lori Brittingham, MSN, RN, CNS, ACCNS-N, Immediate Past President of the National Association of Neonatal Nurses (NANN), NANN Nominations Committee Chair, Neonatal Clinical Nurse Specialist Competencies and Education Standards Lead, NANN Certification Review Course Co-Lead

Toni Christopherson, EdD, MSN, RN, CPN, serves as a reviewer for three nursing journals and is a member of the Society of Pediatric Nurses Clinical Practice Guidelines for Immunizations Task Force

Kelly Eberbach, DNP, MBA, RN, CPN, CPEN, serves as a Certified Pediatric Nurse (CPN) champion for the Society of Pediatric Nursing & UCF Alumni Board, Mentorship Program Chair

Barb Lennon, MSN, APRN, ACCNS-P, CCRN, is the Chair-Elect for the Florida Association of Clinical Nurse Specialists (FAOCNS) and Board Member and Education Chair for Central Florida Advanced Practice Council

Academic appointments include:Lori Brittingham, MSN, RN, CNS, ACCNS-N, Adjunct Faculty, University of Pennsylvania School of Nursing Science

Kelly Eberbach, DNP, MBA, RN, CPN, CPEN, Adjunct Nursing Faculty, University of Central Florida and ECPI University

Marva Grootfaam-Phillips, MSN, RN, CPN, Adjunct Nursing Faculty, Keiser University — Orlando Campus

Barb Lennon, MSN, APRN, ACCNS-P, CCRN, Adjunct Nursing Faculty, ECPI University

Timothy McCormick, BSN, RN, Adjunct Nursing Faculty, Polk College

Academic Advancement

58

77

Q4 2017 Q3 2018 Q4 2019 All Pediatric Hospitals Benchmark

% BSN and Higher

58 71 78 77

% Clinical Nurse BSN and Higher

7871

24.5

34.8

40

34.5

Q4 2017 Q4 2018 Q4 2019 All Pediatric Hospitals Benchmark

% Certified

24.5 34.8 40 34.5

% Clinical Nurses with Specialty Certifications


Unit Based Councils (UBC)

Acute Care Unit Based CouncilPenelope (Penny) Davis, BSN, RN, RN-CMichelle George, BSN, RN, CPNAshley Gilmore, BSN, RN, CPNJessica Grebey, ASN, RNVivian Alvarez, BSN, RNAmy Latner, BSN, RN, CPNDeborah Rosa, MSN, RNAshley Kelley, BSN, RNTina Burton, BSN, RN, CCRN

Family-Centered Care Unit Based CouncilShalese Bennett, MS, CCLSSummer GottJoelle Just-DelOrbeJerry JasminSarah Mullinax, LCSW, MSWAmy Fernandez, RNTracie HermanDanny CabreraBecca Grysko

Pharmacy Unit Based CouncilAugustine Gabriel, PharmDNilam Gandhi, PharmD, MBAGuy Penna, RPTSusanna Ho, CPhT, RPTMonique A. Thompson, CPhT, RPTMatthew (Matt) Wiggins, PharmD, BCPS

Ancillary Unit Based Council David Conomon, AS, RRT-NPSAlyse Cunningham, AS, RRT-NPSApril Hamoui, AS, RRT-NPSBeverly Mainville, AS, RRTLeslie Mawa, AS,RRT-NPSJamie Myers, AS, RRT-NPSAmy Post, AS, RRTDonald Sagarino, BS, RRT-AE-CHelen Cano, R. EEG. T

Lisa Deguzman, AS, RRT-NPS, RPSGT, CCHSCarol Mellen, MS, RD

CCCU Based CouncilHeather Butcher, BSN, RNStephanie Klein, BSN, RNPauline Weir, ASN, RN, CCRNErin Taylor, BSN, RN, EMT-PNicole Rozier, RNAngela Padres, BSN, RN, CCRNRachel Hunt, RNJanice Jeune, MSNBridget Nims, BSN

Clinical Logistics and Transport Unit Based Council Chantale Blanchet-Berggren, MSN, RN, CCRNPeggy Markovic, BSN, RN, CPNKate Wilson, BSN, RNKelly Bradley, BSN, RN, CPNLiz Bass, ASN, RNColleen Maceyak, MHA, RRT, NPSMissy Jasiorkawski, PMDRaul Rivera, EMTCarly Campbell, MSNBarbara Lennon, MSN, RN

ED Unit Based CouncilJoanie Haycook, BSN, RN, CPENKaren Johns, MBA, BSN, RN, CPNEdy Juarbe, BSN, RNMandy Collins, BSN, RN, CPNKimberly Bogers, BSN, RN, CPNAmanda Smith, BSN, RNMartin King, BS, RN, CPENKelly Eberbach, DNP, MBA, MSN, RN, CPEN, CPN

NICU Unit Based CouncilTammy Horvath, BSN, RN, NCCAndrea Tyson, RNJill Ferebee, RNAlicia Jagprashad, BSN, RNCarol Ann Moccio, RNLisa Nichols, RN, MSNLori Brittingham, MSN, RN, CNS, ACCNS-N

Perioperative Services Unit Based Council Yvonne Allan, BSN, RNLauren Cavette, BSN, RNLauren Wheately, BSN, RN, CPNTiffany Dahlin, BSN, RN, CPNJanet King, BN, RN, CNORJacqueline Gilbert, BSN, RNSophia Lacayo, BSN, RNMark Woodard, ASN, RNKourtni Lewis, MSN, RN, CPNSarah Gerard, BSN, RNTerri Fry, MSN, RN, CNOR

PICU Unit Based CouncilMike McCuen, RNKat Errico, BSN, RNLarissa Moon, BSN, RN, CCRNCaitlyn Stevens, BSN, RNLynette Oliphant, RNJae Jensen, BSN, RN, CCRNJamie Harrison, BSN, RNKaren Pierce, MSN, RNTertusha Dessources, RN


Compassionate Care Sets the Stage to Help a Child ThriveIn 2019, staff at NCH came together to care for a teenage girl. This young girl had been involved in a traumatic accident earlier in the year and, as a result, no longer had the use of her arms or legs. She came to Nemours Children Hospital and spent three months in the rehab unit. Further complicating her care was the fact that it was difficult for her family to be with her in the hospital, so she had few visitors.

At Nemours, we believe in putting the patient and family at the center of our care. During her time here, a team of compassionate staff members not only gave her Nemours quality clinical care, but allowed her to express herself, connect with others and find ways to cope with her lengthy hospitalization.

Music Therapist Helps Foster Independence — and HappinessFor most of her life, this young girl loved to rap. With the help of our music therapist, she was able to rap and record music throughout her hospital stay. This allowed her to express her emotions through her lyrics and stay connected. She also bonded with friends by asking them to recommend rap backbeats and recorded their voices over the phone. She gained a sense of independence and control while making choices and even learned how to use the voice commands on her phone so she could create songs on her phone. By the end of her admission, she had created and recorded over 30 songs. The music therapist created a special award just for this patient to celebrate her hard work and success — the Nemours Platinum Album.

Child Life Specialists Help Make Hospital a Home Away From HomeOur Child Life specialists supported this teen patient during her lengthy admission by arranging peer interaction with volunteers. Volunteers played video games with her, listened to music and engaged in conversation. The Child Life specialists also helped normalize the hospital environment, had meaningful conversations about what had happened to her, and helped her feel like a kid, even though she was in a hospital. At the end of her admission, she received a card signed by nurses, social workers, technicians and other members of her care team, expressing how proud they were of her and the progress she had made.

Pastoral Care Tends to Patient and Family’s Spiritual and Emotional NeedsOur pastoral care team helped ensure that the teen patient and her family were supported spiritually and emotionally. They listened to their concerns and hopes and when the family asked for prayers, the pastoral care team responded, letting them know they would keep the family and the patient in their thoughts and prayers.

EXEMPLARY PROFESSIONAL PRACTICELeaders in healthcare demonstrate an unwavering commitment to developing the very best practices and continually improving upon them. Governed by their focus on patients and their team-oriented approach to care, Nemours Children’s Hospital reaffirmed their commitment to exemplary professional practice throughout 2019.


Social Worker Offers Steadfast Support From Hospital to HomeOur social worker provided support during the young girl’s admission and communicated with her family when they could not physically be at the hospital. When the time came for the patient to go home, our social worker helped the family prepare so they could help her reintegrate into school, as well as get ongoing mental health support. The social worker also provided the patient and family with information to help them continue to stay in touch with the care team and ensure they had the tools and resources needed at home.

In addition to receiving the necessary clinical care, our teen patient and her family received the education, support and tools our patient needed once she was back home, giving her the potential to thrive and become be as independent as possible. She is now back at home exploring her favorite music, rapping and making backbeats with friends.

UNWAVERING COMMITMENT

New Knowledge, Innovation and Improvement Evidence-based practice and research enhance the ability to provide safe care to pa-tients and families. By establishing and maintaining best practices, the achievement of high-quality, effective and innovative care is empowered to grow.

NCH Honored With Sixth Innovation AwardOn October 24, 2019 Nemours Children’s Hospital was honored with its sixth consecutive Florida Hospital Association Innovation Award. This acknowledgement came as a welcomed surprise on the heels of the hospital’s seventh birthday on October 22.

In 2019, NCH was recognized for Innovation of the Year in Patient Care for the ‘Path to Home’ patient discharge improvement process. In summer 2017, a cross-functional process improvement team partnered with the Continuous Improvement team and investigated the hospital’s overstay days.

The team then identified several barriers to discharge, such as understanding the patient’s medical equipment at home, transportation options and access to home-health nurses. By addressing these questions at the start of a patient’s stay, the team was much more likely to have everything in place when discharge orders were signed, and facilitate the ‘Path to Home’ for patients and their families.

This esteemed FHA Innovation Award is another shining example of how Nemours is continuing to make the delivery of quality care, and the overall patient experience, top priorities — well-done, everyone! Congratulations to all who participated in this important event and poured their time, ideas and efforts into this work!


BY THE NUMBERS OUR HOSPITAL

120 ACTIVE

PATIENT-CARE

BEDS

75 CE COURSE OFFERINGS

57 INTENSIVE CARE BEDS

AVERAGE DAILY CENSUS:70

39,429VISITORS TO EMERGENCY DEPARTMENT

38,844 TREATED585 CHOSE TO LEAVE PRIOR TO SEEING A PROVIDER

OUR NURSES

243NURSING STUDENTS TAUGHT

NURSING CONTINUING EDUCATION

313ALLIED DISCIPLINE ACADEMIC TRAINING EXPERIENCES

8 RN RESIDENTS

CE CERTIFICATES ISSUED (NURSING):1,134

CE COURSE ATTENDEES (TOTAL PARTICIPANTS)1,419


Your child. Our promise.

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® Nemours is a registered trademark of The Nemours Foundation. J5742 (12/20)

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