CaringCaringMay 27, 2004

H E A D L I N E S

Inside:Special IssueSpecial IssueSpecial IssueSpecial IssueSpecial Issue

Dedication of Nursing

Sundial Sculpture ................ 22222

Jeanette Ives Erickson Nurse

Week Presentation .............. 44444

Strategies for Publishing ......... 77777

Scientific Sessions and Yvonne

Munn Research Lecture ...... 88888

Disparities in Health Care .... 1010101010

Professional Achievements .. 1313131313

Educational Offerings ........... 1919191919

Nurse Week 2004Nurse Week 2004

MGHWorking together to shape the future

Patient Care ServicesPatient Care Services

Chantalle AlcanteChantalle AlcanteBigelow 11 staff nurse, Chantalle Alcante, RN,

with patient, Marie Tosi

May 27, 2004

Page 2

he MGHNurses Alum-nae Associa-tion helped

kick off NurseWeek this year with aninspired gift honoringboth the nursing profes-sion and the nurses ofMGH. The gift, alarge, bronze sun-dial depictingthe past,

present, and future ofnursing, was presented ata special dedication cere-mony on Monday, May3, 2004. Questionableweather necessitated the

Nurses Alumnae Associationpresents MGH nurses with nursing

sundial sculptureevent be held under theBulfinch tent, but thespirits of those in attend-ance were undampened.

Senior vice presidentfor Patient Care, Jeanette

Ives Erickson, RN, pre-sided over the festivities,which included commentsfrom MGH president,Peter Slavin, MD; USCongressman, MichaelCapuano; Massachusettssenator and Health CareCommittee chair, Rich-ard Moore; and DianeSmith, RN, president-elect of the MGH NursesAlumnae Association.

Ives Erickson beganby wishing all the nurses

in the audience a hap-py Nurse Week and

thanking theNurses

Alum-

nae Association for theirgenerous gift. She ac-knowledged members ofthe Board of Trustees,the MGH and MGPOexecutive teams, hospi-tal leadership, and mem-bers of Ruth Sleeper’sfamily who were alsopresent. Before turningthe podium over to thefirst speaker, Ives Erick-son introduced sculp-tress, Nancy Schön, theartist commissioned bythe Nurses AlumnaeAssociation to designand create the nursingsundial sculpture. Schön,an internationally ac-claimed artist, is bestknown for her rendering

of the “Make Way forDucklings” sta-

A Special Dedication

T

continuedon next

page

nursing sundial sculpture

May 27, 2004

Page 3

tues that welcome visit-ors to the Boston PublicGardens. Said Erickson,“Nancy feels that thenursing sundial sculptureis her most serious workto date. She wanted thispiece to acknowledge theimportant contributionsand critical thinking ofnurses, and inspire futuregenerations of nurses aswell.”

Dr. Slavin expressedgreat pride in the nursesof MGH, reminding aud-ience members that MGHwas the first hospital inMassachusetts to receiveMagnet designation thispast September. SaidSlavin, “Today’s dedica-tion of the sundial sculp-ture is a great tribute toour nurses. Its prominentplacement on the groundsof our campus reflectsthe central place nurseshold in the heart of theMGH family.”

Congressman Capu-ano opened his re-

marks by sharingthat many mem-

bers of hisfamily

had

benefited from the skilland compassion of nursesover the years. “I wantedto come here today to saythank-you on a personalas well as a government-al level. For most Amer-icans, nurses are the faceof health care. Nurses arethe ones who hold ourhands when we’re suf-fering or afraid. It wasimportant for me to comehere today to thank you.”

Senator Moore quot-ed Emily Dickinson’sfamous poem:

If I can stop one heartfrom breakingI shall not live in vain;If I can ease one Lifethe AchingOr cool one PainOr help one faintingRobinUnto his Nest again,I shall not live in Vain.

Said Moore, “To me, thisverse sums up the spiritof nursing—not just forone life, but for thous-ands of lives.We need tolet nursesknow howcriticallyimportantthey are toevery aspectof healthcare. On be-half of all mycolleagues instate govern-ment, I amproud to jointhe nation insaluting theinvaluablecontributionsof nurses.”

Nurses Alumnae As-sociation president, Di-ane Smith, told of howthe idea to create a sun-dial came to be a reality.She spoke of her closecollaboration with sculp-tress Nancy Schön andtheir journey to achievethe right balance of beau-ty, functionality, andinspiration. The sundialdepicts three figures inlong robes, each carryinga symbol relevant to anera in nursing. One car-ries a lantern (a tribute toFlorence Nightingale);one carries a book (indi-cating the importance ofcontinuing education);and one carries a globe(representing the univer-sal and multi-culturalaspects of the nursingprofession). A replica ofan MGH nurses’ capfrom the 1800s sits at thebase of the sundial as atribute to the hospital’sformer nursing school.

Said Smith, “Nancythought of it as puttingnurses on a pedestal likeGreek goddesses. I thinkof it as a quiet, elegant,

Diane Smith, RN, president-elect of the MGH NursesAlumnae Association, addresses standing-room-only

crowd at dedication of nursing sundial sculpture.

charismatic work of art.Just like nurses.”

The morning culmi-nated with the unveilingof the sundial, which istemporarily on display atthe bottom of the stairsleading to the TreadwellLibrary, soon to be re-located to its permanent

Nursing Sundial Sculpturecontinued from previous page

location several yardsaway on the Treadwelllawn.

Ives Erickson closed,saying, “I couldn’t be moreproud. I hope you all sharethe pride I feel when I lookat this beautiful sculptureand the extraordinary nurs-ing practice it represents.”

Senator Richard Moore, IvesErickson, and sculptress, Nancy

Schön, at the unveiling

Photo by Paul Batista

May 27, 2004

Page 4

Keeping patients safe: an originalbroadcast from ‘WMGH-TV Nursing’

Nurse Week Presentation

n keeping with the tradi-tion of blending educa-tion, innovation, and

entertainment during herNurse Week presentations,

senior vice president for PatientCare and chief nurse, Jeanette IvesErickson, RN, delivered an origi-nal speech/mock television newsbroadcast focusing on the impor-tant role nurses play in ensuringquality and safety in the hospitalsetting. With O’Keeffe Auditoriumtransformed to look like the set ofThe Today Show, and completewith her own team of ‘roving’ re-porters, Ives Erickson simulatedthe inaugural telecast of ‘WMGH-TV Nursing.’

Using both live, in-studio inter-views and taped, investigativereports, Ives Erickson made thecase that MGH nurses are meetingand exceeding the quality andsafety expectations put forth by theInstitute of Medicine’s (IOM’s)report, “Keeping Patients Safe:Transforming the Work Environ-ment of Nurses.” The report em-phasizes teamwork, group dyna-mics, and inter-disciplinary com-munication. It challenges health-care organizations to focus onprocess-improvement and adaptingsystems to reduce the potential forerrors. Quoting the IOM report,Ives Erickson said, “When we’rehospitalized, in a nursing home, ormanaging a chronic health condi-tion at home—when we’re at ourmost vulnerable—nurses are thehealthcare providers we are mostlikely to encounter, spend thegreatest amount of time with, andbe dependent upon for our recov-ery.”

Ives Erickson focused on fourmajor themes as she describedstrategies for creating a safe pa-tient-care environment:

I Management of the organiza-tion—adopting evidence-basedmanagement and leadershippracticesNurse staffing—maximizing thecapability of the nursing work-forceWork design—ensuring thatwork and work spaces are de-signed to reduce errorsOrganizational culture—creat-ing and sustaining a culture ofsafetyMoving from the podium to ‘the

set,’ Ives Erickson donned herKatie Couric hat to interview MGHpresident, Peter Slavin, MD, aboutthe role nurses play in keepingpatients safe. Said Slavin, “We’vedone much work over the years toimprove the systems and processesthat drive safe, high-quality care.We hear more and more from ourpatients that nurses have the big-gest impact on their lives duringhospitalization. When I think backto when I was a medical student atMGH, then a resident, a memberof the staff, and now in my currentrole, it’s clear to me the incrediblyimportant role nurses play. I’mextraordinarily grateful for thequality, capability, and spirit ofnurses at MGH.”

Following Slavin’s remarks,Ives Erickson introduced a na-tional leader on issues related todiversity, our own director of PCSDiversity, Deborah Washington,RN. When asked how culturallycompetent care impacts patientoutcomes, Washington said, “Wehave learned that health and illnesshave different cultural meaningsamong different patient popula-tions. If we don’t partner with ourpatients to discover those culturalmeanings, we are compromisingpatient outcomes.”

When Ives Erickson referred tothat morning’s Nurse Week pre-

sentation on racial and ethnic dis-parities in health care, Washingtonobserved, “What was interesting tome was hearing the gasps of sur-prise when the speakers shareddisturbing information about howAfrican Americans had been (mis)-treated in the healthcare systemthroughout history. I would ven-ture to say that none of thosegasps came from people of color.We need to bring that level ofunderstanding about how healthcare has served, or failed to serve,minorities to the larger popu-lation.”

The live ‘telecast’ of WMGH-TV Nursing was interspersedwith videotaped field reportsfrom news correspondents, Mari-anne Ditomassi, RN; Deb Colton,Steve Taranto, Georgia Peirce,and crack Caring Headlinesreporter, Susan ‘Scoop’ Sabia.

Ditomassi spoke with collab-orative governance committeeleaders (Taryn Pittman, RN; Ca-therine Griffith, RN; SharonBrackett, RN; andEdna Riley, RN)about the impactthat shared de-cision-making hason quality andpatient safety. Shespoke with precep-tor, Jennifer Al-bert, RN, and newcritical care nurse,Andrea Warner,RN, about theirexperience withthe New GraduateNurse CriticalCare Program.

Colton inter-viewed staff nurse,Meg Soriano, RN,about her recentvisit with StateRepresentative,

Peter Koutoujian, House Chair-man of the Joint Health Care Com-mittee. Soriano and other nurseshad an opportunity to share withKoutoujian the strategies we em-ploy at MGH to ensure adequatestaffing and patient safety.

Taranto spoke with staff nurses,Immacula “Kiki” Benjamin, RN;Lin-Ti Chang, RN; and Ed New-bert, RN, about the nursing adcampaign and our efforts aroundretention and recruitment. He

Deborah WDeborah WDeborah WDeborah WDeborah Washingtonashingtonashingtonashingtonashington

Marianne DtioMarianne DtioMarianne DtioMarianne DtioMarianne Dtiomassi (left) andmassi (left) andmassi (left) andmassi (left) andmassi (left) andTherTherTherTherTheresa esa esa esa esa GallivanGallivanGallivanGallivanGallivan

spasteDv

May 27, 2004

Page 5

oke with Trish Gibbons, RN,sociate chief nurse for The Cen-r for Clinical & Professionalevelopment, and Michael Sulli-an, PT, director of Physical and

MGH president, Peter Slavin, MD,and senior vice president for Patient

Care, Jeanette Ives Erickson, RN,on the set of WMGH-TV Nursing

Occupational Therapy, about theLeadership Development Programand our work involving leadership-skills acquisition and ongoing pro-fessional development.

Associate chief nurse, DawnTenney, RN, spoke about the impactof new technology in ensuring pa-tient safety as we plan for the fu-ture. She demonstrated a new elec-tronic tracking device, the RFID,(radio frequency identification) tag,a new technology currently being

used in the peri-operative setting,but which will have application inother areas of the hospital as well.

Peirce spoke with co-director forthe Office of Quality & Safety, JoanFitzmaurice, RN. Fitzmaurice toldviewers what steps MGH is takingto create a ‘culture of safety,’ includ-ing how to talk to patients and fam-ilies about adverse events and a newadverse-event reporting system tohelp reduce and eliminate the risk oferrors occurring in clinical settings.

Back in the‘studio,’ live in-terviews with keyPCS leaders shedmore light onongoing efforts toensure patientsafety. Associatechief nurse, Ja-ckie Somerville,RN, shared in-formation on thework of the Elec-tronic MedicationAdministrationProcess Commit-tee. George Rear-

don, director of PCS Systems Im-provement, spoke about our effortsto improve communication bothamong clinicians and from unit tounit using an upgraded nurse-callsystem and new wireless techno-logy. Theresa Gallivan, RN, asso-ciate chief nurse, informed audi-ence members about the new Ra-pid Response Team and a new pro-gram to help optimize evening andweekend resources. And associatechief nurse, Debra Burke, RN, in-formed the audience that new bar-coded patient-identification wristbands will soon be introduced atMGH as an added measure of pa-tient safety.

In closing, Ives Erickson thankedLauren Holm, RN; Ed Coakley,RN; Jess Beaham, Ed Bonner, andPaul Bronk for their assistance inpreparing the first broadcast ofWMGH-TV Nursing. She extendeda special thanks to Marianne Dito-massi for her hard work in coordi-nating the many events and activi-ties of Nurse Week 2004.

Said Ives Erickson, “Ensuringappropriate staffing to care for our

patients will remaina priority. Advanc-ing best practiceswill remain ourpassion. Together,we will design workprocesses that sup-port clinical prac-tice, ensure suffi-cient resources,encourage contin-uing education andprofessional devel-opment, and contri-bute to a safe envi-ronment for ourpatients and ourstaff. Safe, high-quality patient careis my highest prio-rity.

“Thank-you fortuning in to WMGH-TV Nursing. Have avery happy NurseWeek.”

Debra Burke (left) andDebra Burke (left) andDebra Burke (left) andDebra Burke (left) andDebra Burke (left) andGeorgia PeirGeorgia PeirGeorgia PeirGeorgia PeirGeorgia Peircecececece

George RearGeorge RearGeorge RearGeorge RearGeorge Reardondondondondon

Ditomassi Ditomassi Ditomassi Ditomassi Ditomassi (left) and Jackie Somerville(left) and Jackie Somerville(left) and Jackie Somerville(left) and Jackie Somerville(left) and Jackie Somerville

May 27, 2004

Page 6

Diana SerinoRapid Response Team staff nurse,

Diana Serino, RN, with patient, BarbaraCummings, on Bigelow 7

May 27, 2004

Page 7

Behind the editor’s desk: strategiesfor becoming a published author

Publishing

uzanne Smith,RN, EdD,

editor of theJournal of Nurs-

ing Administration,in her presentation,

“Strategies for becominga published author,”offered an inside look atthe process and pitfallsof writing for publica-tion. “Remember thateditors of nursing jour-nals are your peers,” saidSmith. “It is a mutuallycollaborative process.Without you, I have nomessage to disseminate.Without me, you have noway to disseminate yourmessage.”

Smith’s presentationwas interrupted brieflyas Jeff Davis, senior vicepresident for HumanResources, escorted NewEngland Patriots widereceiver, Troy Brown,into the auditorium towish MGH nurses a hap-py Nurse Week. SaidBrown, “I just want totell you that the NewEngland Patriots loveMGH nurses.” His ap-pearance was met withsurprise and great enthu-siasm. Apparently, MGHnurses love Troy Brown,too!

Smith graciouslyrecovered from the inter-ruption and went on toshare a wealth of infor-mation about writingarticles, making revisions,selecting a topic, choos-ing a target publication,contacting potential jour-nals, and dealing withrejection. Some of the

salient points of Smith’spresentation include:

Know ahead of timethat it could be fromthree months to twoyears from the time anarticle is submitted towhen it is ultimatelypublishedMost papers acceptedfor publication willrequire some degree ofrevision (sometimesextensive; sometimesminor)Don’t look at rejectionas ‘failure.’ Rejectionis usually accompaniedby honest feedback;use that feedback toimprove your chancesof being accepted nexttimeThere are many reasonsarticles are rejected:

The topic may havebeen recently pub-lishedThe content is consi-dered unimportant orinappropriateThe writing may betoo technicalThe style may be tooformal, academic, orunprofessionalMaterial is poorlyorganized or poorlywritten

The best reasons topublish in professionaljournals are:

A passion for thetopicAn interest in a par-ticular fieldA desire to make acontribution to theliteratureTo give back to theprofession

Try to get honest feed-back from people be-fore you submit yourarticle for publication.Consult a content ex-pert, a style expert, andsomeone who is fami-liar with the format ofthe journal to whichyou will be submittingyour articleChoose the right jour-nal for your topicThere are hundreds ofspecialty publications;don’t focus exclusivelyon the ‘big five’Niche publicationsoften receive fewersubmissions and havea greater need for ma-terialSend a brief queryletter to the editor;use the letter as anopportunity tomarket yourideaWeather youend up submit-ting an article ornot, send a follow-up letter to the editorto keep the relation-ship ‘active’Understand that there’sa need for a variety oftypes of articles:

Conceptual, ‘how-to,’case studies, opinionpiecesClinical, administra-tive, staff-oriented,academicPractical, applied,theoretical

When choosing a jour-nal, consider the follow-ing:

What is their targetaudience?

SHow often is it pub-lished?What is their accept-ance rate?What is their circula-tion?Do they pay theirauthors?

Before you write any-thing, find out:

What lengtharticle are theylooking for?Do they re-quire you towrite anabstract?Do theywant a bio-graphy, andif so, howlong?

Do they want illus-trations or graph-ics?

In her handouts,Smith provided a num-ber of hard-copy andon-line resources re-lated to writing forpublication. To obtaina copy of these re-sources, call the Car-ing Headlines storydesk at 4-1746.

Suzanne SmithSuzanne SmithSuzanne SmithSuzanne SmithSuzanne Smith

May 27, 2004

Page 8

MGH nurses presentscientific findings

Prolonged Mechanical Ventilation and Weaning:a Patient Profile

usan Gavaghan, RN, clinical nurse specialist and 2001 YvonneMunn Nursing Research Award recipient, presented the results of a

research study conducted by her and co-investigator, Diane Carroll,RN, clinical nurse specialist, entitled, “Prolonged Mechanical Ventilation andWeaning: a Patient Profile.” The purpose of the study was to identify para-meters to assist patients to wean off of ventilators and predict successfulweaning candidates by describing patients admitted to the Respiratory AcuteCare Unit (RACU) with the goal of being weaned from a ventilator.

The study utilized an investigator-developeddata-collection form that incorporated aspects of the

Glasgow, Braden and Apache II scales, and theBurns Wean Assessment tool. Data was col-

lected upon admission to the unit andagain at discharge. To date, research

has not described successfully wean-able patients by examining the cri-

teria for admittance to the RACU.A sample group of 126

medical records was reviewedof which 85 subjects (76%)successfully weaned fromventilators and 27 (24%)subjects were unable towean successfully. It wasfound that a lack of COPD(chronic obstructive pul-monary disease), renaldisease, severe respiratoryco-morbidity conditions,and respiratory muscleweakness were positivelyassociated with success-ful ventilator weaning,and the amount of timethat passed between be-ing admitted to the hos-pital and being admittedto the RACU positivelyrelated to length of stay.

Gavaghan conclud-ed that the study beginsto describe non-vent-ilator-weanable pa-tients and assists inidentifying patientswho would be appro-priate for a ventilatorweaning program.

Research and Scientific SessionsCaring for Pregnant Women with HIV:Transforming Practice into Research

ynda Tyer-Viola, RN, clinical nurse specialistand 2002 Yvonne Munn Nursing Research Award

recipient, reported on her progress in studying,“The Care of Pregnant Women with HIV: TransformingPractice into Research.” Tyer-Viola shared a wealth offacts and information gleaned from her extensive ex-perience with, and study of, the care of pregnant wo-men with HIV. Some of the more salient points of herpresentation include:

Women of childbearing age are the fastest growingpopulationAIDS cases among women and adolescent girls are upfrom 7% in 1985 to 29% in 200242% of new cases of AIDS are attri-buted to heterosexual contact53% of 2,500 patients with AIDSwent without care because theyneeded money for food, clothing,and housing47% of 2,500 patients with AIDSwent without basic needs be-cause money was needed forhealth care91% of 9,074 children liv-ing with AIDS wereinfected through ‘ver-tical’ transmission60% of transmissionoccurs during the laborand delivery process27 studies exclusively withnurses (1984-2000) re-vealed that nurses:

were knowledgeable butunprepared to care forpregnant women withHIVfelt this population wasdeserving of care butwere unwilling to pro-vide that carefelt that patients wereresponsible for theirillnessfeared contracting AIDSthemselvesTyer-Viola’s study was

too extensive to be includedhere in its entirety. For moreinformation about her re-search findings, contactTyer-Viola directly at4-3608, or by e-mail.

S

L

Susan GavaghanSusan GavaghanSusan GavaghanSusan GavaghanSusan Gavaghan LLLLLynda Tynda Tynda Tynda Tynda Tyeryeryeryeryer-V-V-V-V-Violaiolaiolaiolaiola

May 27, 2004

Page 9

The annual Yvonne L. MunnNursing Research Lecture

and awardsCare of the Elderly: Making a Difference

through Research

orraine C. Mion,RN, is the directorof Nursing Services

for Geriatrics atMetroHealth Medical

Center in Cleveland,Ohio. She has been anurse for more than 25years practicing as a staffnurse, clinical nurse spe-cialist, faculty member,researcher, and seniornurse administrator inacute and long-term carefacilities. Mion is theauthor (or co-author) ofmore than 100 articles,chapters, and abstractson nursing care of hospi-talized elders that dealwith, among other things,sleep protocols, physicalrestraints, falls, and deli-rium. MGH was fortu-nate to have Mion asguest lecturer for the2004 Yvonne L. MunnNursing Research Lec-ture.

Mion’s presentation,“Care of the Elderly:Making a Differencethrough Research,” fo-cused primarily on theuse of physical restraintsamong geriatric patientsand on caregivers’ atti-tudes toward the use ofphysical restraints. Mionshared a quote from aformer colleague, whichshe said helped ‘trigger’her research. A physicianat a healthcare facility inEngland made the follow-ing comment during pa-tient rounds: “Americannurses have strange prac-

Ltices... they tether theirpatients.” Mion’s studybegan as an effort torefute this doctor’s seem-ingly rash generalization.

Mion set out to dis-cover the extent of phy-sical-restraint use. Sheused four 28-bed medi-cal units at her homehospital (MetroHealthMedical Center in Cleve-land), a 750-bed, countyteaching hospital. Datawas collected on all pa-tients in the study units,Monday through Fridaybetween the hours of7:00am and 5:00pm,over a 15-week period.The study revealed thatthe rate of restraint useincreased by age. 3.2%of patients under 40 yearsold were physically re-strained; while 20.3% ofpatients 70 and olderwere restrained. Types ofrestraints varied, thegender of restrained pa-tients varied, and the rateof restraint use variedamong units. Eleven of24 deaths that occurredduring the course of thestudy were patients whowere being restrained atthe time.

In an effort to under-stand the clinical deci-sion-making that led tothe use of restraints,Mion discovered that:

nurses are the clini-cians primarily respon-

sible for requestingrestraintsnurses and physiciansvary widely in the theirreasons for using phy-sical restraints for thesame patientthe two major reasonsfor using restraints areto prevent falls and toprevent the disruptionof therapies such as IVtherapy or intubationMion’s research show-

ed that positive out-comes associatedwith the use of re-straints are unsubstan-tiated; and there is evi-dence to suggest that theimmobility that resultsfrom being restrainedcontributes to increasedweakness and falls, pres-sure ulcers, the onset ofincontinence, the onsetof delirium, and jointcontractures. In addition,many adverse events,such as strangulation,nerve injury, encepha-lopathy (brain dysfunc-tion), and psychologicaldistress could be directlyattributed to restraint use.

In a separate study,Mion sought to deter-mine if strategies thathad been effective inreducing restraint use inlong-term care facilitiescould be successfullyapplied in acute-caresettings. Interventionsincluded:

continued onpage 17

daily staff nurse andCNS consultationsbi-weekly inter-disci-plinary roundsone-on-one and unit-based feedback ses-sionsgroup and individu-alized educationstrong admini-strative sup-port

Lorraine MionLorraine MionLorraine MionLorraine MionLorraine Mion

The study, conductedon 7 general care units,six ICUs, and one step-down unit, showed fourof the seven general careunits had a decrease infall rates; three of theseven general care unitshad a decrease in thera-py-disruption rates (twohad no change); and fourICUs and the step-downunit had a decrease in

May 27, 2004

Page 10

DiversityRacial and ethnic disparities in health:

past, present, and futureacial and eth-nic disparities

in health: past,present, and

future,” wasco-presented by W. Mi-chael Byrd, MD, of theHarvard School of Pub-lic Health, and MarthaHill, RN, dean of theJohns Hopkins Univer-sity School of Nursing.Byrd focused on the his-tory and contributingfactors that have led toour current reality whereinequities and disparitiesin health care (and otherrealms) continue to exist.He showed how science,economics, health policy,racial and ethnic rela-tions, anthropology, anda number of other factorshelped shape the im-perfect system that hascarried over into pre-sent-day healthcarepractices andpolicies. Fromthe beginning,said Byrd, raceand wealthhave been

“R

MarMarMarMarMartha Hilltha Hilltha Hilltha Hilltha Hill

WWWWW. Michael Byr. Michael Byr. Michael Byr. Michael Byr. Michael Byrddddd

the defining elements ofthe healthcare deliverysystem. He pointed to atime in American historywhen low-income popu-lations were divided intogroups that were labeled,“worthy poor” and “un-worthy poor.”

Still today, said Byrd,“the separation of groupsbased on race, ethnicity,class, and other demo-graphic factors is theway we do business inhealth care.” Think of‘clinic’ patients versus‘private’ patients. Weknow the origins andevolution of health dis-parities, but we continueto perpetuate these in-equities.

Byrd presented anera-by-era account of

disparities in healthcare

dating back to 500BC, through theRenaissance, American coloniza-tion, the Civil War, the civil rightsmovement of the 60s, the failedClinton healthcare-reformattempt, and up to thepresent. Based on a longand sustained history ofinequitable healthcare in this country,Byrd recommendedthe following actionsto help overcomethe stalemate:

initiate a philoso-phical and ideolo-gical shiftimplement multi-cultural, culturalcompetence, andanti-bias curriculumenact health policychangesconduct race, class,and ethnicity researchrelevant to healthcaredisparities.develop interventionstargeting populationswith less-than-accept-able outcomesMartha Hill reportedon a study commis-sioned by the blackcaucus of the USCongress askingthe Institute ofMedicine to lookat this, “stunning-ly complicated andimportant topic.”Faced with hardevidence that dis-parities exist consist-ently across a widerange of clinical set-tings, said Hill, we

wanted to know,“How could well-meaning, highlyeducated health-

care professionals createa pattern of care thatappears to be discrimin-atory?” The study found,among other things, thatthere is an ‘unconscious’bias among caregivers;that many caregivers areuncertain about culturaland linguistic variations;and that stereotyping isused in many situationsas a ‘cognitive shortcut’to care.

Hill offered a numberof recommendations forovercoming inequitiesthrough improved health-care interventions, edu-cation, data-collectionand research. She sug-gested:

promoting consistencyand equity of carethrough the use of evi-dence-based guidelineslimiting provider in-centives that promotedisparitiesproviding financialincentives for practices

that reduce barriers andencourage evidence-based practiceintegrating cross-cul-tural education intotraining of all healthprofessionalspromoting the use ofinterpreter servicescollecting and report-ing data on healthcareaccess by race, ethni-city, socio-economicstatus, and languageincluding measures ofracial and ethnic dis-parities in performancemeasurementmonitoring progresstoward the eliminationof healthcare dispar-itiesconducting furtherresearch to identifysources of racial andethnic disparitiesconducting research onethical issues and otherbarriers to help elimi-nate disparities

May 27, 2004

Page 11

Hazel AudetHazel AudetPhillips House 21 staff nurse, Hazel Audet, RN,

with patient, Rosemarie Cortese

May 27, 2004

Page 12

Mary O’BrienEmergency Department nurse, Mary O’Brien, RN,cares for patient, Abhas Gupta, in the triage area

May 27, 2004

Page 13

Professional AchievementsEdwards publishes

Annabel Edwards, RN, co-authoredthe article, “Anti-neuropathic effects of

the antibiotic derivative spicamycinKRN5500,” in the March, 2004,

journal, Pain Medicine, along withDavid Borsook, MD.

Kaiser, Waithe, appointedto BORN

Sheila Kaiser, RN, chief nurseanesthetist, and Philip Waithe, RN, clinicaleducator, have been appointed to positions

on the Massachusetts Board ofRegistration in Nursing.

Looper, Martin, and Savageinducted into Sigma Theta Tau

Ann Martin, RN, clinical nurse specialist,White 7 and Ellison 7; Amanda Savage,

RN, nurse leader, Surgical Clinic; and RuthAnn Looper, RN, staff nurse, EmergencyDepartment, were inducted into the AlphaChi Chapter (Boston College) of Sigma

Theta Tau International on Sunday,April 18, 2004.

Perry presents, publishes

Donna Perry, RN, professionaldevelopment coordinator for The Center

for Clinical & Professional Development,published, “Self-transcendence: Lonergan’s

key to integration of nursing theory,research and practice,” in

Nursing Philosophy.Perry presented the poster, “Cultivating

America the Beautiful: A LegislativePartnership for Environmental Justice in

Massachusetts at the March, 2004,Eastern Nursing Research

Society meeting.

Bouvier, Capasso, Carter, andCodner receive Best Poster Award

Best Poster Award was presented toco-authors, Diane Carter, RN;

Cheryl Codner, RN; Sharon Bouvier, RN;and Virginia Capasso, RN, for their posterpresentation, “Peripheral Arterial Sheath

Removal Team,” at the Society for VascularNursing’s National Symposium in

Albuquerque, New Mexico,in April, 2004.

IMSuRT nurses honored byAdvance for Nurses

Advance for Nurses named membersof the IMSuRT team as one of the Best

Nursing Teams for 2004. The award wasgiven in recognition of their teamwork,

adaptability, and their extraordinaryability to function effectively in

an emergency situation in aforeign country.

Cierpial, Haldemanpresent poster

Chelby Cierpial, RN, and SiobanHaldeman, RN, presented their poster, “Discharge Guidelines after Coronary

Procedures,” at the National Association ofClinical Nurse Specialists’ 2004

conference, Renaissance in CNS Practice:Transforming Nursing in the 21st

Century, in March.

Capasso presents

Virginia Capasso, RN, presented,“Reducing the Bio-Burden in Vascular

Ulcers” at the national meeting ofthe Society for Vascular Nursing,

in Albuquerque, New Mexico,April, 16, 2004.

Devaney presents

Lynn Devaney, RN, research nursefor the Department of Surgery, spoke at theNational Nurses Conference on NationalSurgical Quality Improvement Program

(NSQIP): The Leader in Improving SurgicalOutcomes, on March 24, 2004, in SanAntonio, Texas. Devaney presented,

“The Use of NSQIP Data forPerformance Improvement

at MGH.”

Carroll accepted to ResearchScholar Program

Diane L. Carroll, RN, clinical nursespecialist, has been accepted to the

Hartford Foundation/American Journalof Nursing Geriatric Nursing Research

Scholars Program at New YorkUniversity for the Summer

2004 program.

Cox presents

Erin Cox, RN, access nurse inthe Emergency Department, presented,“Synergy in Practice: The CNS Role inCaring for Victims of Intimate PartnerViolence,” at the National Association

of Clinical Nurse Specialistsin March.

Carroll, Elliott, Fitzgerald,Gonzalez, and Vallent publish

Diane L. Carroll, RN, clinical nursespecialist; Jeanne S. Elliott, RN, staff

nurse; Patricia A. Fitzgerald, RN, clinicalnurse specialist; Colleen E. Gonzalez, RN,

clinical nurse specialist; and Heather J.Vallent, RN, staff nurse, published,

“The visiting preferences of patientsin the intensive care unit and

on a complex-care medical unit,”in the American Journal

of Critical Care.

Carroll and Hamilton publish

Diane L. Carroll, RN, clinical nursespecialist, and Glenys Hamilton, RN,

nurse researcher, published, “The effectsof age on quality of life in implantablecardioverter defibrillator recipients,”

in the Journal of ClinicalNursing.

Tyrrell presents

Rosalie Tyrrell, RN, professionaldevelopment coordinator for The Center

for Clinical & Professional Development,presented “Understanding and Leading a

Multigenerational Workforce” at:The Boston Collaborative Learning Group

on November 3, 2003;The Bay State Medical Center, in

Springfield, Massachusetts,on December 3, 2003;

The Celebration of Leadership in PracticeConference sponsored by Children’s

Hospital Medical Center, on January 26,and February 2, 2004;

Spaulding Rehabilitation Hospitalon March 17, 2004;

Massachusetts Organization of NurseExecutives on April 28, 2004;

and Mt. Auburn Hospital, Nurse WeekCelebration in May, 2004.

May 27, 2004

Page 14

MGHnursesMGHnurses

Simplythe Best!

May 27, 2004

Page 15

setting the barfor excellencein patient care

setting the barfor excellencein patient care

Page 16

May 27, 2004

Linda KimballLinda KimballEllison 18 staff nurse and ‘Jill-of-all-trades,’

Linda Kimball, RN, spends some quality timewith 12-year-old, Samantha Caban

Page 17

May 27, 2004

Next Publication Date:June 17, 2004

Published by:Caring Headlines is published twice eachmonth by the department of Patient Care

Services at Massachusetts General Hospital.

PublisherJeanette Ives Erickson RN, MS,

senior vice president for Patient Careand chief nurse

Managing EditorSusan Sabia

Editorial Advisory BoardChaplaincy

Mary Martha Thiel

Development & Public Affairs LiaisonGeorgia Peirce

Editorial SupportMarianne Ditomassi, RN, MSN, MBAMary Ellin Smith, RN, MS

Materials ManagementEdward Raeke

Nutrition & Food ServicesPatrick BaldassaroMartha Lynch, MS, RD, CNSD

Office of Patient AdvocacySally Millar, RN, MBA

Orthotics & ProstheticsEileen Mullen

Patient Care Services, DiversityDeborah Washington, RN, MSN

Physical TherapyOccupational Therapy

Michael G. Sullivan, PT, MBA

Police & SecurityJoe Crowley

Reading Language DisordersCarolyn Horn, MEd

Respiratory CareEd Burns, RRT

Social ServicesEllen Forman, LICSW

Speech-Language PathologyCarmen Vega-Barachowitz, MS, SLP

Volunteer, Medical Interpreter, Ambassadorand LVC Retail Services

Pat Rowell

DistributionPlease contact Ursula Hoehl at 726-9057 for

all issues related to distribution

Submission of ArticlesWritten contributions should be

submitted directly to Susan Sabiaas far in advance as possible.

Caring Headlines cannot guarantee theinclusion of any article.

Articles/ideas should be submittedin writing by fax: 617-726-8594or e-mail: ssabia@partners.org

For more information, call: 617-724-1746.

Yvonne Munn Nursing ResearchLecture and Awardscontinued from page 9

therapy-disruption rates.Mion concluded that long-

term-care strategies for restraint-reduction proved to be safe andeffective for most general careunits, but not ICUs. Thoughthere was no increase in falls ortherapy disruption, further stud-ies are warranted to examinerestraint-reduction strategies incritical care areas.

But Mion still has questionsshe wants answered: What is thenational benchmark for restraintuse? What environmental, or-ganizatinal, and administrativevariables influence the rate ofphysical restraint? What are thecontexts and consequences ofpatient-initiated therapy disrup-tion? For the answers to thesequestions, we’ll have to wait forthe results of Mion’s next re-search study.

Following Mion’s presenta-

Nurses take a moment to read researchposters, which were on display throughout

the hospital during Nurse Week

tion, Jeanette Ives Erickson,RN, senior vice president forPatient Care, presented theYvonne Munn Research awardsto this year’s recipients. Thefirst award went to the researchteam of:

Barbara Guire, RNMonique Mitchell, RNJennie Repper-DeLisi, RNSue Kilroy, RNLaura Sumner, RNMary Lussier-Cushing, RNConnie Cruz, RNLeslie, Wlodyka, RNErin Kelleher, RNJoan Fitzmaurice, RN, mentor

The award will fund their study,“Recognition and Prevalence ofDelerium in Patients who FallWhile Hospitalized in the Acute-Care Setting.”

The next award went to theresearch team of:

Laura Sumner, RNGail Alexander, RNMary McAdams, RNDorothy Jones, RN, mentor.

Their study will focus on, “Eval-uating the Drug Dosage Calcu-lation Guide on the RegisterredNurses’ Achievement Scoresand Multi-Step Calculations onan Orientation Medication As-sessment.”

The third Munn researchaward went to:

MaryLou Kelleher, RNEllen Robinson, RN, mentor

This study asks the question,“Family-Centered Care at Mass-General Hospital for Children:How are We Doing and JustHow Important is It?”

In closing, Ives Ericksonthanked all the award recipients,past and present, for advancingthe nursing research agenda atMGH. Yvonne Munn was un-able to attend the event thisyear, but, said Ives Erickson, “Ithink she’d agree—nursing re-search is alive and well at MGH.”

Please recycle

Page 18

May 27, 2004

Peg HickeyOperating room scrub nurse,

Margaret (Peg) Hickey, RN, assistsin neuro-surgical procedure

Page 19

2004

2004

May 27, 2004Educational OfferingsEducational Offerings

For detailed information about educational offerings, visit our web calendar at http://pcs.mgh.harvard.edu. To register, call (617)726-3111.For information about Risk Management Foundation programs, check the Internet at http://www.hrm.harvard.edu.

Contact HoursDescriptionWhen/WhereNew Graduate Nurse Development Seminar ITraining Department, Charles River Plaza

6.0(for mentors only)

June 98:00am–2:30pm

OA/PCA/USA Connections“Emergency Preparedness.” Bigelow 4 Amphitheater

- - -June 91:30–2:30pm

Intermediate ArrhythmiasHaber Conference Room

3.9June 98:00–11:30am

Pacing: Advanced ConceptsHaber Conference Room

4.5June 912:15–4:30pm

Nursing Grand Rounds“Child Abuse.” Sweet Conference Room GRB 432

1.2June 911:00am–12:00pm

Building Relationships in the Diverse Hospital Community:Understanding Our Patients, Ourselves, and Each OtherTraining Department, Charles River Plaza

7.2June 108:00am–4:30pm

The Surgical Patient: The Challenge of the First 24 HoursO’Keeffe Auditorium

TBAJune 148:00am–4:30pm

Advanced Practice Nurse Series“Type II Diabetes: the Growing Epidemic.”O’Keeffe Auditorium

1.2June 165:30–6:00pm networking6:00–7:00pm presentation

Pediatric Advanced Life Support (PALS) Certification ProgramDay 1: Holiday Inn Day 2: Wellman Conference Room

- - -June 16 and 237:30am–4:30pm

CPR—American Heart Association BLS Re-CertificationVBK 401

- - -June 177:30–11:00am/12:00–3:30pm

Preceptor Development ProgramTraining Department, Charles River Plaza

7June 188:00am–4:30pm

BLS Certification for Healthcare ProvidersVBK601

- - -June 228:00am–2:00pm

New Graduate Nurse Development Seminar IITraining Department, Charles River Plaza

5.4 (for mentors only)June 238:00am–2:30pm

Nursing Grand Rounds“Patient Safety.” O’Keeffe Auditorium

1.2June 241:30–2:30pm

CPR—American Heart Association BLS Re-CertificationVBK 401

- - -July 17:30–11:00am/12:00–3:30pm

Greater Boston ICU Consortium CORE ProgramNewton Wellesley Hospital

44.8for completing all six days

July 1, 2, 6, 7, 12, 137:30am–4:30pm

16.8for completing both days

Advanced Cardiac Life Support (ACLS)—Provider CourseDay 1: O’Keeffe Auditorium. Day 2: Wellman Conference Room

July 9 adn 128:00am–5:00pm

CPR—Age-Specific Mannequin Demonstration of BLS SkillsVBK 401 (No BLS card given)

- - -July 138:00am and 12:00pm (Adult)10:00am and 2:00pm (Pediatric)

New Graduate Nurse Development Seminar ITraining Department, Charles River Plaza

6.0(for mentors only)

July 148:00am–2:30pm

OA/PCA/USA ConnectionsBigelow 4 Amphitheater

- - -July 141:30–2:30pm

More Than Just a Journal ClubWalcott Conference Room

- - -July 144:00–5:00pm

May 27, 2004

Page 20

CaringCaringH E A D L I N E S

Send returns only to Bigelow 10Nursing Office, MGH

55 Fruit StreetBoston, MA 02114-2696

First ClassUS Postage PaidPermit #57416

Boston MA

Nancy DesjardinsNancy DesjardinsAmbulatory care nurse, Nancy Desjardins, RN,

of the Bulfinch Medical Group, performs earlavage for patient, Florence Stanley