May 2016 - Ambulatory Action Newsletter 1

UW Health’s Ambulatory Nursing Council Newsletter

Vol. 2Issue 3May 2016

The Ambulatory Nursing Council

would like to take this time to thank and recognize all UW Health nurses for the expert care and compassion they provide to patients and families.

In celebration, this issue will put special focus toward UW Health’s ambulatory staff. Please enjoy this brief historical outline & photos courtesy of uwhealth.org, U-Connect and UW Health’s In Brief.

• 1920: In connection with the UW Medical School, Dr. Harold Cornelius Bradley and his wife, Mary Josephine Crane Bradley, raised nearly $100,000 to open the first children’s hospital in Madison. The building, now named the Bradley Memorial Building, remains on campus at 1225 Linden Drive.

• 1924: The first patients began receiving care at Wisconsin General Hospital, later known as University Hospital, in April. Further expansion ocurred in 1949.

• 1930: The Wisconsin Orthopedic Hospital was erected one block west of Bradley Hospital to combat the growing polio epidemic, and to provide medical, surgical and therapeutic treatment for children with special needs whose parents could not afford treatment on their own. This building still stands today as the Nutritional Sciences building at 1415 Linden Drive.

• 1973: The UW Clinical Cancer Center (renamed UW Carbone Cancer Cancer in 2006) was established.

• 1979: The Clinical Sciences Center opened on 3/31. There were 549 beds, spread among 70 clinics. The School of Nursing, Medical

School and WI Clinical Cancer Center were also housed there.

• 1985: Med Flight is launched.

• 1995: Research Park Clinic opens.

• 1996: UWHC began operating under a public authority on July 1st, allowing the freedom to purchase equipment and property.

• 2007: AFCH opened on 8/29.

• 2013: Digestive Health Center opened 4/8 at 750 University Row. In February 2016, the Women’s Pelvic Wellness Clinic moved to this location as well.

• 2014: Our midwifery team celebrated their 25th anniversary with UW Health. Today, certified Nurse Midwives are located at 20 S. Park, East & West Clinics.

• 2015: Ambulatory care began focus on complete & optimal health of populations using population health management programs, including a Pediatric Complex Care Program, Complex Case Management & RN Care Coordination.

• 6/5: The UW Board of Regents approved the proposal to integrate UWHC Authority & UWMF.

• 7/1: UWMF & UWHC Ingegration

• 8/17: The American Center opens.

• 2016: With more than 125 primary and specialty care clinics throughout Wisconsin & northern Illinois, the variety of UW Health practice environments & career possibilities for outpatient nurses are endless.

In Celebration of Nurses WeekMay 9-13, 2016

Ambulatory Nursing Excellence

Recognition should also be paid to the following ambulatory nurses, who were nominated for these high honors:

• Susan Benck (Urology)• Kelly Berg (Home Health Agency)• Mary Blum (Breast Center)• Erica Bouska (Organ Transplant)• Cheryl DeVault (Clinic Op Mgr)• Kelly Dunphy (Clinics-PED Specialties-AFCH)• Kelly Hibray (Coordinator-Heart Failure CSC)• Judith Hilgers (Pediatric Fitness Center)• Vicki Ingalls (MA-Heart Failure CSC)• Lisa Kaikuaana (SMPH/Surg/Vascular Surg)• Kristine Leahy-Gross (Nsg Program Specialist)• Sandra Ligon (Home Health Agency)• Catherine May (CL-Endocrinology-West)• Kayla McCarty (Organ Procurement Coordinator)• Holly Mucci (Medicine – Cardiology)• Jaime Myers (Manager, Liver Transplant) • Jill Triphan (Cardiology Coordinator -

Electrophysiology Lab)

2016 Ambulatory Nursing Excellence Award Recipients:

Clinical Nurse: ClinicsTeresa Wagner BS, RNPediatric Specialties Clinic

Clinical Nurse: Home Health & Coordinated CareLeigh Anne Lottridge BSN, RN, ONCNursing - Coordinated Care

Support StaffKalsang Youdon, NAPediatric Specialties Clinic

2 NURSING INFORMATICSSHOW US WHO YOU ARE

3 SHOW US WHO YOU ARE (CONTINUED)

4 CONGRATULATIONS, YOU’RE PUBLISHED

5 SPOTLIGHT NURSE COUNCIL MEMBERS WELCOME NEW MEMBERS

In this issue

May 2016 - Ambulatory Action Newsletter2

Below: Health Education Clinical staff refining their motivational interviewing skills during a hands-on learning session to help engage patients in diabetes self-management.

Below: OB/GYN Nurse Council © 2015 Nursing Practice and Progress Annual Report

Below: Clinical Staff Education

Show us who you are!join in celebration of all uw health ambulatory nurses & staff

We want to see ALL of our UW Health ambulatory staff. Please email your group photo(s) to epittsley@uwhealth.org and be featured in an upcoming issue of Ambulatory Action!

Below: Access Center Staff, 2012

Below: Ophthalmology Surg. Sched. RNs

Below: Ophthalmology Triage RNs

Below: Healthline RN

Nursing Informatics The Nursing Informatics Team participated in Nurse’s Week activities by hosting a booth at the Nursing Skills Fair. Nursing Informatics provided Health Link Tips and the opportunity for

staff to get hands on practice with these tips. The “Quick Health Link Tips” handout contains tips that are useful for both Ambulatory and Inpatient staff. A copy of the handout is available under the “Resources” tab in the Nursing Informatics page on U-Connect.

It is important to keep LDAs

up to date for patient safe-

ty, clinician workflow effi-

ciency, and for accurate

reporting.

LDAs can be removed from

a flowsheet by entering the

date, time and removal

reason. Clicking the blue

summary sentence will take

you there.

From a navigator use the

following procedure. In the

navigator section titled, (1)

LDA Removal, (2) click on

the properties of the LDA

you wish to remove. The

properties is the blue sum-

mary sentence; a hyperlink

that takes you to the (3)

LDA properties window

where you can document

date, time and removal

reason. (4) Click Accept

to save your changes.

You might ask “What if the

dates and details of remov-

al are unknown?” Docu-

ment the removal by using

the Date and Time Re-

moved as the date and

time you are documenting.

Choose Not Present on

Arrival as the Removal

Reason, since you probably

don’t know the exact rea-

son but it is obvious the

LDA is not present.

To complete the LDA, go to

the Flowsheet activity and

locate the LDA. (1) Right-

click the LDA’s title row in

the flowsheet. (2) Select

Complete.

Documenting the Removal and Completion of

LDA(s) for Current and Previous En

counters

View the Chart While Writing Your Note!

Want to review the record

while writing your note, and

not have to worry about

losing or pending it?

Health Link has a feature

that allows you to “pin”

your note to the sidebar.*

When writing a note, look in

the top-right corner of the

note box for the icon seen

below. Click it, and your

note will stick to the right

sidebar, allowing you to

review the record while

displaying your note!

Quick Health Link Tips

Quick Tips On:

Removing LDAs

Building SmartPhrases

How to pin your note

to the sidebar

How to write Flow-

sheet notes

Using Filters to find

information fast

Sign In/Sign Out

Tap In/Tap Out

Single Sign-On (SSO)

COMING THIS SUMMER to a work-

station near you!

Not a new dance routine but a

technology solution that allows

you to quickly and securely access

clinical applications while saving

time. Opening Health Link and other

applications is done by tapping

your employee badge on the

badge reader located on the com-

puter. Reducing the number of

times each day you need to enter

your username and password. *If your workstation has a low screen resolution, this feature

may not work.

Coming This

Summer!

May 2016 - Ambulatory Action Newsletter 3

Below: Ambulatory Float Staff

Below: AFCH Pediatric Specialties Clinics RNs Below: Immunology (HIV) Clinic RNs

Below: Internal Medicine Staff - 2016 Quality Excellence Award winners

show us who you are!

May 2016 - Ambulatory Action Newsletter4

Congratulations You’re Published

Ventrogluteal Injections:

It’s Hip! by Deanna Blanchard,

MSN, RN-BC & Kimberly S. Payette, BSN, RN-BC, was published in the March/April 2016

issue of AAACN’s Viewpoint

Read it here:www.aaacn.org/publications/

currentissue.pdf

Blood pressure (B/P) measurements can provide essential information about a per-

son’s health. The findings can determine what treatment and health care interventions will

be required to adequately treat the patient and help to control B/P. This intervention will

only be useful if nurses are competent in taking B/P. Tracking a person’s B/P can provide

an early warning about potential problems and allow steps to be taken to deal with a sus-

tained increase prior to it becoming worse and, in some instances, life-threatening (Peate

& Wild, 2012).Measuring B/P is one of the most important, commonly performed procedures by

nurses. However, even as it is so essential to methodically carry out the steps, it is “one of

the most inaccurately performed measurements in clinical medicine” (Smith, 2005, p.

1391). Assessing a person’s B/P is an activity that requires skill, competence, and a com-

mitment to perform it safely and accurately (Peate & Wild, 2012). It is important for nurs-

es to know the many factors that might impact a patient’s B/P while taking a measure-

ment. An inaccurate reading will frequently lead to errors in making clinical management

decisions (Peate & Wild, 2012; Wallymahmed, 2008).

When a single improper technique is performed, it can result in an inaccurate B/P of

at least 5 mm Hg or more. When several steps are performed improperly, it compounds

the inaccuracy of the reading even more (Handler, 2009). The false measurements fre-

quently lead to inappropriate treatment for patients.

The Official Publication and Voice of the American Academy of Ambulatory Care Nursing

Page 3AAACN Partners with

LippincottNew Ambulatory Care Nursing

Procedures Available

Page 4Ventrogluteal Injections:

It’s Hip! Free Education Activity for

AAACN Members

Page 10AAACN News

Page 12Health Policy Update

Advocating for the Aging in

Ambulatory Care

Page 14Telehealth Trials &

TriumphsDuty to Terrify: Taking

Appropriate Action in Telephone

Triage

Volume 38, Number 2

MARCH/APRIL 2016

Patricia Watts-Davison

continued on page 9

Happy Nurses Week!

At this time of year, we honor

our members and colleagues for the

care, kindness, guidance, and sup-

port they give to every patient.

Nursing continues to be one of the

most trusted professions and there is

a reason for that – YOU! Be sure to

do something special for yourself

during the week of May 6-12.

Submit your stories and photos of

how you celebrated by sending an

email to aaacn@ajj.com.

May 2016 - Ambulatory Action Newsletter 5

Gail is part of a group that is valuable to the health care system –

nurse practitioners. Originally from North Dakota, Gail completed her BSN from the University of Mary in 1981 with minors in theology, art, and philosophy. Subsequently,

she completed her MSN at the University of Wisconsin – Madison in 1988 and post-graduate NP studies at the University of Wisconsin – Madison in 1995.

Outside of the walls of UW Health, she enjoys spending time with her family, including their dog. Many of her hobbies include leisure biking, swimming, and traveling. At the height of the NHL Stanley Cup Playoffs, she enjoys watching her nephew play for the Nashville Predators.

What is your role at UW Health? I’ve been happily employed at UW since 1998 as a Geriatric Nurse Practitioner. My current role as Clinical Supervisor of our expanded model was recently created as our program broadens.

Describe the Nursing Home Program the NPs are involved in: Our nursing model of care is based on collaboration with the PCP, patient, families, and SNF staff. Our program has evolved from one NP 30 years ago, Nancy Nelson, to our current model of 10 APPs. We work very closely with the PCP and patient to ensure that transition from hospital to SNF is seamless. We attempt to see the patient within 72 hours of admission to the SNF, reconcile records and medications, and ensure that appropriate follow-up is addressed based on clinical needs and assessment. Acute issues are also addressed for both the rehab patients and our long-term care elders within the SNF setting via onsite visits and/or phone management of assessment, plan, and follow-up. Discharge planning and coordination is also central to our role, ensuring that the patient is clinically ready for discharge from the SNF, securing appropriate DME and home services for the transition home, medication management, and follow-up. Finally, our long term care elders are those who permanently reside in the SNF, although this population is

shrinking, we are often the point for them in the healthcare system, ensuring that their healthcare needs are addressed based on Medicare guidelines.

How has this program affected your view of nursing? This model has definitely strengthened my view of nursing as an instrumental role in the long term care delivery system. I was told once by a patient’s daughter during her mother’s final journey, “It takes a village of caring, loving people to walk the final passage with an elder and their family.” It’s an honor to be part of this “Village.” In addition, it’s a professional distinction to be part of the UW Health “Village” where nurses continue to be recognized for their contributions/creativity to the “Healthcare Village” across all disciplines.

What are some of the challenges: Primarily facilitating changes in a system of this size can be daunting. It’s important to remember patience and “eye on the goal” mentality. With amazing colleagues, administrative and physician support, we have moved forward and are looking to our goals for the near future of how we can expand into other long term care settings.

What advice for nurses interested in following this path: The rewards are too many to mention. I often inquire new nursing grads who aspire for rich clinical hospital experience and/or who are landing their first job in the SNF, what attracted them to the nursing profession. The more common response is “I want to care for others and make a difference.” For me and my colleagues, it’s all about caring and making a difference for our elders, whether it’s the delicate transition from the hospital to SNF, puzzle of assessing, planning and evaluation of acute changes, the intricate discharge coordination or the intimate last voyage with an elder and family. Geriatric nursing care is an amazing journey that I would encourage all to experience.

Interviewed by Jaeca Malacara, BSN, RN

SPOTLIGHT ON: Gail Gaustad, NP2015-2016

Ambulatory Nursing Council Members

COUNCIL CHAIRSLINDSEY BERGESON, BSN, RN-BC

BRUCE HENDERSON, MS, RN>>

COUNCIL MEMBERSSARI ARCHER, BSN, RN

DEANNA BLANCHARD, MSN, RN-BCSUSAN HOPKINS, BSN, RN-BC

KRISTINE LEAHY-GROSS, MSN, RN, CPHQJAECA MALACARA, BSN, RN

CATHY MAY, BSN, RN-BCROSEMARY MONACO, MN, BSN, RN-BC

VICKI PARKS, BSN, RNEMILY PITTSLEY, RN

MARY PLESH, BSN, RN-BCSHAWN REISDORF, RN-BC

KATHLEEN SCOTT, RNKIMBERLY ZIELKE, MSN, RN

>>ADMINISTRATIVE LIAISON

AND SUPPORTDEB BRAUSEN, VP SPECIALTY CARE

CLINICS UW HEALTH>>

TERI KUNTZSCH, MSN, RN ADMINISTRATIVE LIAISON, DIRECTOR

OUTPATIENT HEALTH LINK OPS, CLINICS ADMINISTRATION

>>WENDY NEWBURG, SR. ADMIN CLINICS

ADMINISTRATION

WELCOME 2016-2017 NEW MEMBERS

STEPHANIE BANDLKARRON CONGERCARA OMERNIKHEATHER REED

ANDREA STUMPF GUERREROAMANDA WIECICHOWSKI

SHELLY WHITE