Nurses To Nurses Newsletter
Improving Work Environments
Winter 2008 Issue 6
Grant Update
Happy New Year!! As the busy Holiday season has come and gone, N2N grant activities didn’t skip a beat! In fact, the year ended in
a Big Bang with enough momentum to splash forward into 2009! On December 12, 2008, Abrazo nursing leaders came together for
the first “Nursing Leadership Day” to envision the Abrazo Culture of Caring. Kramer & Schmalenberg presented the evidence from
their research on healthy work environments and N2N Consultant, Sue Roe lead the group in creating a vision of the Abrazo environ-
ment. See page 2 for details and how patient-family centered care describes the values & expectations for this healthy work environ-
ment. This past fall, the PEP Program took a step forward when on Dec 1, 2008, 11 PEP I’s took the PEP II Mentor course which
prepared them to advance the PEP program and achieve N2N objectives (see page 3). And of course there was no stopping the N2N
Pilot Units from continuing their projects. There are projects going on all over Abrazo hospitals – read about them in Innovation Cor-
ner! The N2N also began offering Career Advising to Abrazo nurses (see page 3). No time to waste, the New Year is here, have no
fear, for we have lots of work to do!
Innovation Corner Local News/Events
Healthy Work Environment ASU: Innovations in Nursing & Healthcare
Roundtable Series
Pilot Projects January 7 & March 25, 2009
Phoenix, AZ
http://nursing.asu.edu
Many of you may be or have been involved in
N2N Pilot Projects. In the last N2N Newsletter, AORN - 56th Annual Congress
current Pilot Projects were listed; however a more “Embrace the Future”
detailed description will be highlighted here to PVH-W&I members: Chris McConaughy, Debbie March 14 – 19, 2009
Dargus, Hazel Hargrove (N2N) & Terri Pfaff Chicago, Ill
recognize the incredible work being done by www.aorn.org
Abrazo nurses. One of the four objectives of the policy and instilling greater staff accountability 30th Annual Conference on
N2N grant is to implement continuing education amongst nurses. The latter project has been well Pediatric Healthcare
programs focused on culturally responsive care recognized by Abrazo leadership locally and March 19 – 22, 2009
through skill development. While continuing edu- regionally and will be presented nationally at
Seattle, WA
cation programs are ongoing, a method of bring- http://napnap.org
the LEAD conference in Orlando, FLA in June
ing Healthy Work Environment standards to 2009! Check www.centerforamericannurses.org
How Hospitals Use Rapid Tests to Eliminate
Mother-Child HIV transmission (FREE)
nurses at the bedside was developed. This process for details and plan to join the presenting team. March 27, 2009
called the Staff Engagement Model partners N2N Poster presentations on other projects have Phoenix, AZ
Consultants with staff nurses to identify work been presented at various local professional www.azhha.org/educational_services/
processes on their units that need improvement. conferences to disseminate this outstanding AANA – The Arthroscopy Assoc. of North
During this process, nurses are educated on the work. America
2009 Annual Meeting
standards essential for a healthy work environ- Pilot projects continue at all five Abrazo April 30 – May 3, 2009
ment. hospitals. At PVH, there is a bustle of activity San Diego, CA
In earlier pilot projects presented in previous with pilot projects going on in five Depart- www.aana.com
newsletters, nurses at PBH Med/Surg brought the ments. The PVH Women’s & Infants Unit, led NTI – National Teaching Institute &
importance of needed patient equipment & sup- by Chris McConaughy, is consolidating multi- Critical Care Exposition
plies to administration’s attention where actions to May16 - 21, 2009
ple forms used to assess and document mom/ New Orleans, Louisiana
purchase and repair broken equipment were taken; baby care through the OB continuum. They are http://www.aacn.org/WD/NTI2009/Content/
nurses at AH Tele/PCU developed a process to also working on developing documentation to nti2009.htm
organize supplies which decreased time nurses provide more consistent patient teaching to improve “handoff” communication be-
spent looking for supplies; nurses at AH ICU/ moms upon discharge. Another need for the tween the nurses. A 4 page form, cumber-
CCU have applied for the coveted AACN Beacon unit is that of Spanish speaking individuals for some and rarely used properly has been
award as their project (still waiting for a re- translation – but the nurses want to learn Span- revised and is now being piloted. The
sponse); nurses at PBH PCU developed admis- ish as well! As a result, N2N is pursuing this nurses also wanted to relocate their staff
sion guidelines and Department standards for their opportunity for staff. lounge from the center of the unit to a
unit and lastly, nurses at MVH CMAC set out to In the ICU at PVH, champion nurses such larger more remote area of the ICU. After
reduce nurse call-offs and tardiness by revising as Melissa Smith, are designing a Kardex to working with Cont’d on next page
This project is supported in part by funds from the Division of Nursing (DN), Bureau of
In partnership with Health Professions (BHPr), Health resources and Services Administration (HRSA), De-
partment of Health and Human Services (DHHS) under HRSA grant # 1 D11HP07364-
A R I Z O N A S T A T E U N I V E R S I T Y
01-00, Nurses to Nurses: Improving RN Retention & Patient Care, for $1,346,240.
09-02-02 J252_N2N_Newsletter.p1.pdf
“Abrazo Nursing Leadership Conference: Building our Legacy of Healthy Work
Environments and Excellent Patient Outcomes” - December 12, 2008
Over 80 Nursing Directors, Managers & Clinical Coordinators, 4 CNO’s and 2 CEO’s from across Abrazo Healthcare came
together at the Sheraton Crescent Hotel for the purpose of designing Abrazo’s Culture of Caring. Sponsored by the Nurses to
Nurses grant, the program was the first gathering of its kind to address nursing’s vision.
Abrazo’s President, Dan Ausman presented a global perspective of nursing’s role in a pa-
tient centered care environment and Abrazo’s commitment to supporting nursing leadership.
Participants had some fun, learning to master the “Option Finders”, a handheld device used
for polling. Participants were able to respond to questions unanimously, with instant tabula-
tion of results presented on large screens in front of the room.
In the morning session, Marlene Kramer & Claudia Schmalenberg presented the latest
evidence on healthy work environments (see “The Evidence”). From there, the afternoon
became a swarm of creative activity, where participants literally colored a picture of the ideal
Abrazo environment. Each diagram reflected a culture that embraces patient centered care,
working with others and supportive interdisciplinary relationships. Using the pictures as a
guide, participants were then asked to define the gaps between what currently exists and Marlene Kramer RN PhD speaks to partici-
the Culture of Caring they created. Gaps included accountability, expectations, team ap- pants about the HWE evidence.
proach to communication and problem-solving, walking the talk, managing “up”, hiring the
right people, sharing best practices and prioritizing the initiatives. Critical to process improvement, reflecting on areas for improve-
ment through self-evaluation assists leaders in determining the right course of action. And here, there was clearly some work to
be done!
“The Evidence – 8 Essentials for a
Healthy Work Environment”
♦ Clinically Competent Peers
♦ Collegial/collaborative RN MD relationships
♦ Autonomous Nursing Practice
♦ Supportive Nurse Manager
♦ Culture: Concern for the patient is paramount
♦ Control over Nursing Practice
♦ Perception that Staffing is Adequate
Erin Ocock RN, WVH— Med/Surg ♦ Support for Education Kay Brotman AH, Karen Jasinski PVH,
Bev Gibbon PVH, Evelyn Razon WVH
The day ended with a commitment to change. After identifying the work that needs to be
done, all participants were challenged to return to their perspective hospitals to start building this new culture. Congratulations
nursing leaders on taking a huge step in leaving your legacy!
Healthy Work Environment Pilot Projects cont’d. SCO online resources and is currently training nurses on how to navigate
administration and education, the newly located staff lounge will be the website to find the appropriate patient teaching material. Plans for a
away from the “catch all” area in the middle of the unit. Poster session to describe the new patient education materials are under-
Lastly, ICU nurses were constantly challenged by patients who way.
were admitted with abusive drug problems. Staff arranged for Lynn The PVH Emergency Dept has determined that care of the mental
Brown-Wagner RN from the AZ Poison Control Center to give a health patient will be its area of focus for their pilot project. Staff are
2.5hr in-service on Jan 14, 2009. Twenty nine attended and all thor- challenged by these very complex patients who often remain in the ED
oughly enjoyed Lynn’s presentation. (See next issue of the N2N for long lengths of stay. The team is attempting to narrow the scope of
Newsletter for details). their project in order to explore means to improve patient care and nurse
The Med/Surg Unit at PVH is going great guns according to satisfaction.
Carol Ann Cavouras, N2N Consultant. The group is led by Judy At Maryvale Hospital, the Med/Surg Unit led by Steve Aston, is
Rurup and Bradley Slate and meetings are well-attended by staff. busy with a project that will strengthen RN-PCA teams. Talk about an
Their project has just completed piloting a revised Kardex report engaged group! Steve who actively participates in the meetings is work-
form. This form will be used for nurse to nurse report and is key to ing with the staff to clarify roles and responsibilities and to identify op-
avoiding errors in patient care due to breakdown in communication. portunities for improving RN-PCA staffing protocols. They are also de-
A post intervention survey will inform us of improvement in patient signing an RN-PCA report form to enhance communications among staff
care. to better ensure consistent quality patient care. As the project moves
Patient teaching materials were severely lacking in the Tele/PCU forward, measurements will be determined to see how these changes
Unit at PVH. Cheryl Sheriff has championed the staff in acquiring make a difference.
an extensive collection of patient teaching materials for diabetic and In a unique and exciting project, nurses are taking control of their
cardiac patients. Audits showed that nurses were teaching patients Communication Boards! WVH’s Med/Surg/Tele Units are working
about their disease process but retention of information was limited together to develop creative ways for communicating important patient
by the lack of written information available for patients to read, share related items such as identifying a patient who is NPO, off the unit for a
with family and take home. The staff has also created access to EB- procedure, admission coming from the ED, etc. Cont’d on next page
09-02-02 J252_N2N_Newsletter.p2.pdf
Recognition Corner
Congratulations PEP II’s!!
On December 3rd and 10th, Rita Anderson RN (AH-ED), Karen Guy RN (AH-OB), Laura
Campbell (AH-ED), Ginger Martinez (MVH-Med/Surg) and Ginny Orcutt RN (AH-ED) completed
their training to become Abrazo PEP II’s. The addition of these PEP II’s are critical to sustaining
the PEP program for Abrazo after the N2N grant is completed. PEP II’s will be responsible for
ongoing instruction and evaluation of the PEP program. Six other nurses completed the course.
They are Julie Edgar (MVH-OB), Lilia Harvey (MVH), Stefanie Brown (PVH-Educ), Carol Bush
(PVH-ED), Diane Neville (PBH-Prof Practice) and Deb Campbell (PVH-ED). When these nurses
complete their teaching practicum, they will also be certified as PEP II Mentors! Karen, Laura, Ginger, Ginny and Rita
Abrazo has put 295 nurses through the PEP I program. Data shows that nurses who have
completed PEP training have 14% higher rates of retention than those nurses who do not go through the program. This is just one
way Abrazo and N2N partner together to improve the work environment through better nurse retention!
Career Advisement
Get Ready, Start, Go ……. Back to School !!! As part of the N2N grant, Career Advising for nurses is
being offered at each Abrazo hospital. ASU’s Academic Specialist, Patti Crocker MEd, has been making her
way around the Abrazo Healthcare system, talking to nurses about career advancement through formal edu-
cation. ASU offers many programs for nurses including: RN to BSN, Masters in Healthcare Innovation, Nurse
Educator, Community Health and Clinical Research Management, many graduate certificate programs and
the PhD or DNP. In addition, ASU’s Nursing Alliance program provides an easy transition for all Maricopa
AD graduates wanting to get their BSN! Abrazo’s Gift of Learning provides financial assistance for nurses
interested in furthering their education at ASU College of Nursing & Healthcare Innovation. If you were not
able to meet with Patti, you may contact her at pcrocker@asu.edu or 480-727-9469
Patti Crocker & Judy Rurup
Healthy Work Environment Pilot Projects cont’d.
And how they are doing this is through the use of bright colored magnets placed on the Communication Boards in the patient care areas and the
nurses’ station. As staff are having a fun and adventurous time determining what magnets they will use, this is one project to be following! Shari
Kretzschmer and Amy Yarborough are the pied pipers of this energetic group of staff nurses.
At AH ICU/CCU the journey to Beacon continues, with Cindy Fishel and Kay Brotman busy working with N2N on collaborative issues that
will support and sustain Beacon criteria. Plans are under way for a “Bullying in the Work-
Congratulations to PEP I Graduates!
place” CE program which focuses on staff development.
December 3rd & 30th 2008
With all of this unit based activity, it seems certain that nurses at Abrazo hospitals are find-
ing opportunities to improve their work environments and impact patient outcomes. Nursing Lauren Bohacik, WVH Tricia Otstot, PVH
research informs us that work environments are one of the major factors affecting nurse satis- Dawna Cato, ARS Tracy Pearlman, AH
Valerie Chalup, MVH Diane Neville, PBH
faction and nurse retention. What we are finding through the N2N Pilot projects is that the Jolly Devasia, MVH Amanda Ramirez, MVH
more the staff is involved, the more fun and creative the project, the greater the nurse engage- Dolcy D’Mello, PBH Michelle Robinson, AH
ment which leads to impressive patient outcomes! Congratulations to all of you on your pro- Victor Diaz, PVH Heidi Ross, WVH
jects! Look for updates on pilot projects in future N2N Newsletters…. Amy Driscoll, PVH Linda Schaefer, AH
Jennifer Farrell, PBH Lisa Salway, PBH
Leslee Geer, AH Alana Sanchez, PBH
Marci Hageman, AH Imelda Verdugo, PBH
Word Scramble– Cardiovascular System Shirley Lesure, MVH Barbara Zafiris, AH
Tara Melvin, PVH Maria Pearl Anzures, PBH
Shirly Miole, PBH Stephanie Betancourt,
1. OLTSYSE : Contraction of the Heart is called? Gudi Munck, AH PBH
Sheena Oakley, PVH Alwilda Bryant-Churchill,
2. GANNIA : Chest pain is also called? Erin Ocock, WVH AH
3. EDSTIALO : Relaxation of the heart is called? Congratulations to PEP I Graduates!
4. PCUSTDIIR : Which valve is between the right atrium and the right ventricle? January 9th & 16th 2009
Verna Barnett, WVH Rebecca Prouty, PV
5. AEPERKACM : The sinoatrial node is better known as the __ of the heart.
Regina Clute, WVH Ashley Rosas, PBH
6. MORIMYACUD : What is the name of the muscle of the heart? Carmen Ortiz, WVH Sharon Schneider, MVH
Kelli Pew, MVH Claire Stevens, MVH
7. OALRYPUNM : what is the name of the artery that carries deoxygenated Trischella Moore,
Rex Thomas, PV
blood? WVH Theresa Bates, PBH
N2N Project Staff Contact Information
David Hrabe PhD, RN Project Director Phone: 480-965-0735
Carol Stevens, RN MS, Project Coordinator Fax: 480:965-0619
Silpa Kode, Graduate Assistant Email: N2N@asu.edu
Lorena Everhart, Secretary Administrative Website: http://nursing.asu.edu/n2n/index.htm
* Check the N2N website for answers to the word scramble
09-02-02 J252_N2N_Newsletter.p3.pdf
09-02-02 J252_N2N_Newsletter.p4.pdf
Tempe, AZ 85287
P.O. Box 873008
A R I Z O N A S T A T E U N I V E R S I T Y
In This Issue…
♦ Nurses to Nurses Project Grant Update
♦ Innovation Corner
Nurses to Nurses Healthy Work Environment Pilot Projects
♦ Upcoming Events
♦ Abrazo Nursing Leadership Conference
♦ Recognition Corner
PEP II’s Graduates
PEP I’s Graduates
♦ Career Advisement
♦ Nursing Word Scramble