Department of Nursing - NewYork-Presbyterian...

Department of NursingThe Center for Professional Nursing Practice

2010 Annual Outcomes Report

2 Department of Nursing - 2010 Annual Outcomes Report 3

WelcomeThe Department of Nursing at NewYork-Presbyterian is, above all, committed to providing the highest quality nursing care in a patient-centered environment.

We have a cohesive and dynamic team of nurse leaders who, in partnership with our nursing staff, is steadfastly working on advancing clinical practice and promoting professional and leadership development. Together, we are committed to improving patient care, safety and outcomes while also strengthening and empowering our staff to help us achieve our goals.

I’m immensely proud of our dedicated nursing leaders, our expert team of 4,695 RNs and our extraordinary partners across every discipline. Our department could not have achieved so much over the last year without the support, teamwork and collaboration across all areas of the organization.

Wilhelmina M. Manzano, MA, RN, NEA-BCSenior Vice President and Chief Nursing OfficerNewYork-Presbyterian Hospital

About NYPNewYork-Presbyterian Hospital, based in New York City, is the nation’s largest not-for-profit, non-sectarian hospital. NewYork-Presbyterian provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine at five sites: NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian Hospital/Columbia University Medical Center, NewYork-Presbyterian Morgan Stanley Children’s Hospital, NewYork-Presbyterian/The Allen Hospital and NewYork-Presbyterian Hospital/Westchester Division.

One of the most comprehensive healthcare institutions in the world, the hospital is committed to excellence in patient care, research, education and community service. NewYork-Presbyterian is the #1 hospital in the New York metropolitan area and is consistently ranked among the best academic medical institutions in the nation, according to U.S. News & World Report. The Hospital has academic affiliations with two of the nation’s leading medical colleges: Weill Cornell Medical College and Columbia University College of Physicians and Surgeons.

Table of ContentsWelcome 3

Department of Nursing – The Philosophy 4

The Face of NYP Nursing 5 Nursing Strategic Plan 8

Structural Empowerment 8 Transformational Leadership 10 Leading the Way 11 Exemplary Professional Practice 12 Quality Outcomes 18 Knowledge and Innovation 22

Center for Professional Nursing Practice 22

Recruitment and Retention 24

NYU Wagner Master of Science in Public Administration Program for Nurse Leaders 25

Nurses in the Community 25


The Face of NYP Nursing

Scope of Nursing ServiceWith 2,278 beds, NewYork-Presbyterian Hospital is the nation’s largest not- for-profit, non-sectarian hospital. This hospital has more than 1 million inpatient and outpatient visits in a year, including more than 195,294 visits to our emergency departments.

Nursing care at NYP is provided to patients of all ages through close collaboration with interdisciplinary teams—in inpatient, outpatient and emergency settings.

In addition, our Ambulatory Care Network provides community-focused and preventative care throughout the service areas of the NewYork-Presbyterian/Columbia and NewYork-Presbyterian/Weill Cornell sites.

With 4,695 RNs, our department is incredibly diverse. We span all culture, gender, lifestyle and age demographics. You’ll find NYP professional nurses in all areas of the hospital, in ORs and ICUs and in the community.

The Department’s nursing staff is 10.6% male compared to the national average of 5.8% (Health Resources and Services Administration, 2004). Currently, 2.4% of the workforce are Veterans (65-78 years old), 30.2% Boomers (48-64 years old), 51.2% Generation X (28-47 years old) and 15.2% Generation Y (20-27 years old).

Our RN workforce encompasses American Indian/Alaskan, Asian/Pacific Islander, African American, Hispanic, Caucasian and a number of other ethnic backgrounds.

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Wilhelmina M. Manzano MA, RN, NEA-BCSenior Vice President and Chief Nursing OfficerNewYork-Presbyterian Hospital

Lori Armstrong, MSN, RNVice President of Nursing and Patient Care ServicesNewYork-Presbyterian Morgan Stanley Children’s Hospital

Suzanne Boyle, DNSc, RNVice President of Nursing and Patient Care ServicesNewYork-Presbyterian Hospital/Weill Cornell Medical Center

Linda S. Espinosa, MS, RNVice President of Nursing and Patient Care ServicesNewYork-Presbyterian Hospital/Westchester Division and Behavioral Health-Cornell

Debra O’Hehir, MSN, MBA, RNVice President of Nursing and Patient Care ServicesNewYork-Presbyterian/The Allen Hospital

Georgia J. Persky, DNSc, RN, NEA-BCVice President of Nursing and Patient Care ServicesNewYork-Presbyterian Hospital/Columbia University Medical Center

Nursing Executive Team

Department of Nursing-The Philosophy The philosophy of the Department of Nursing is derived from the values of the nursing profession. We support the vision of NewYork-Presbyterian: to be among the very top academic medical centers in clinical and service excellence, patient safety, research and education.

Our department is unwavering in its adherence to the principles of nursing excellence:

• Transformational leadership• Empowerment of professional nurses• Exemplary professional practice• New knowledge, innovations and improvement• Quality outcomes

Our nursing team plays a central role in helping the hospital accomplish key goals. During the past year, the Department of Nursing has focused on implementing all components of our Strategic Plan, each of which influences our overarching mission: to transform care and practice.

“I spent over one month at this hospital, and it was as close to a perfect experience as is humanly possible. The nurses, in particular, could not have been more caring and professional.”

—NYP Patient

“When I traveled from South Carolina to NewYork-Presbyterian for a nine-hour pancreatic surgery, I had no idea what to expect. In a strange city, with a complex illness, I found a source of strength: my wonderful nursing team. Their knowledge, positivity and kindness were truly a gift to my family and me.” —NYP Patient


Educational Preparation Nursing research has demonstrated that improved patient outcomes are strongly attributed to nurses with higher educational preparation.

The 2010 consensus report by the Institute of Medicine (IOM) and the Robert Wood Johnson Foundation on the Future of Nursing supports increasing the number of BSN prepared nurses as an important patient safety initiative. The report recommends increasing the number of BSN prepared nurses from 50% to 80% by 2020. At NYP, 88% of our nurses have BSN degrees or higher.

National Certification We believe that professional specialty board certification and recognition empowers our nurses, while also contributing to better patient outcomes. Certification signifies a level of clinical competency in a specialty area and testifies to a nurse’s professional commitment.

We’ve seen an increase in the number of our nurses who have achieved certification in their specialty. Currently 28% of our nurses are certified and we are seeing a positive trend in our certification rates. The Department of Nursing continues to increase the number of specialty certification review courses available on site.

Service ExcellenceBuilding on the governing principles of Patient Centered Care, our nursing team continues to advance a multidisciplinary approach to hospital-wide excellence.

Our objective is to enhance quality outcomes, improve patient care and increase positive perceptions of care in the hospital. Annually, each unit identifies patient and employee opportunities for improvement and formulates a “Making it Better” plan. Each plan incorporates hard-wired best practices and identifies metrics to evaluate effectiveness.

Key patient-centered strategies and performance improvement initiatives include:

• Leadership training and development• Rounding with intent• Discharge phone calls• Aligning actions and behaviors with goals• Shining Star competition• Service recovery• Employee retreats• Writing thank you notes to staff at home• Use of key words at key times• Admission-ready beds• Daily quiet times

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Nursing Presentations AlemAr, D. (2010, July). The Medical Home Model and Care Coordination-The Nurses’ Role. presented at New York-Presbyterian Hospital.

Bell, KAthy (2010, September). Substance Abuse and Diabetes. Presented at the Diabetes Resource Committee.

Brous, m.e., lAntz, s.D., (2010, October). Suicide Assessment and prevention in the Hospital Setting. Presented at Allen Hospital, New York, NY.

ByBel, B. (2010, January). The Second Chance Program: 10 Years of Successfully Treating the Severely Persistently Mentally Ill. Presented at the NewYork Presbyterian Hospital-Westchester Division, Nursing Grand Rounds, White Plains, NY.

ByBel, B., ClArKe, C., Criss, s., GrAy, C., (2010, May). Ethical Issues Around Restraint Use. Presented at the New York Presbyterian Hospital-Westchester Division, Nursing Grand Rounds, White Plains, NY.

ByBel, B., o’Connor, J., (2010, October). The Individualized Care Plan. Presented at the APNA Annual Conference, Louisville, KY.

CABello, C. (2010, April). Designated Liver Donor Nurse Program. Presented at the 18th Annual UNOS Transplant Management Forum, Orlando, FL.

Donnelly, C. (2010, March). Role of Nurse Manager in Innovation and Staff Development. Presented at St. Elizabeth Hospital, Singapore.

FinCK, A. (2010, March). NeuroScience Review: Seizures/Stokes Neuro ICU Management. Presented at Boston College, Boston, MA.

FrAnCois, D., Crissey, i., GABriele, m., (2010, January). Patient Morbidity and Mortality Report. Presented at the NewYork Presbyterian Hospital-Westchester Division, Nursing Grand Rounds, White Plains, NY.

GAllison, B. (2010 September/October). Nursing Fellowship Quality and Patient Safety. Presented at the Rockefeller University, New York, NY.

Glenn, s., Crissey, i., (2010, April). Effective Delegation. Presented at the NewYork Presbyterian Hospital-Westchester Division, Nursing Grand Rounds, White Plains, NY.

KluGmAn, D. (2010, May). Anticoagulation Clinic Transformation Past to Present a Team Approach. Presented at the ACN Clinic, New York, NY.

KluGmAn, D. (2010, February). Anticoagulation Referrals, Diet and Education. Presented at AIM Clinic, New York, NY.

KluGmAn, D. (2010, January). Applying the New ACOG Recommendation to the PAP Clinic. Presented at the AIM Clinic, New York, NY.

Nursing Presentations (cont.)lee, r. (2010, June). Mended a Broken Heart-Ventricular Assisted Devices. Presented at the American Association of Critical-Care Nurses’, New York, NY.

mAnzAno, W. (2010, April). Embedding Change in the Process of Care. CNO Summit, Marcus Evans Summits, Hollywood, Florida.

mAnzAno, W. (2010, April). Creating Strong Bonds and Improving Relationships: The Key to Solidifying the CNO Position as an Executive Member. Panel Speaker, CNO Summit, Marcus Evans Summits, Hollywood, Florida.

mAnzAno, W. (2010, June). From Vision to Reality: The Chief Nursing Officer Role. RN to BSN Program, Hunter College, New York.

mAnzAno, W. (2010, October). Succession Planning: Ensuring Effective Leadership Development and Continuity. CNO Summit, Marcus Evans Summits, Las Vegas, NV.

mAtuszeWsKi, r. (2010, July). Legislative Issues for Nurse Practitioners. Presented at Dominican College, Orangeburg, NY.

milAzzo, J. (2010, October). A Suicide Attempt in a Young Man with Major Depression and Social Phobia. Presented at Morbidity and Mortality Case Conference.

morAn, J., CAstelli, C., (2010, May). Nursing Exemplar: Night Advisory Council at WD. Presented at Nursing Board of Campus Exemplar.

PresCuitti, m. (2010, March). Microdialysis. Presented at AANN National Meeting.

rADostA, m., FArley, e., VeDoVino, K., (2010, July). Motivating through Delegation. Presented at NewYork Presbyterian Hospital-Westchester Division, Nursing Education Grand Rounds, White Plains, NY.

riVerA, r. (2010, January). Engaging the Global Workforce. Presented at International Conference, Manila, Phillippines.

riVerA, r. (2010, April). Closing the Engagement Gap: Presence of Drivers of Engagement and RNs Levels of Engagement. Presented at The Methodist Hospital, Houston, TX.

riVerA, r. (2010, October). Engage and Make a Difference. Presented at Crown Plaza Hotel, King of Prussia, PA.

sAVAGe, m. (2010, May). Ventilator Associated Pneumonia. Presented at 17th Annual Nursing NeuroScience Meeting at Penn State University, Hershey, PA.

sChuster, C. (2010, July). Pediatric Immunization Update 2010. Presented at NewYork Presbyterian Hospital, Nursing Education Grand Rounds ,

sulliVAn, r. (2010, April). Keynote address: Every Nurse is a Leader Presented at Sigma Theta Tau Induction Hunter College NYC NY.

“The learning opportunities here at NewYork-Presbyterian are vast and continuous. Every day, I’ve learned and grown as a leader at this institution.”

—Jasmine Pond, MSN, RN Patient Care Director, Medical Surgical


Nursing Strategic PlanThe Department of Nursing’s multi-year strategic plans have mobilized our nurses to support hospital-wide initiatives, while also realizing key goals for the nursing department.

2010 was a year of unparalleled opportunities for advancing the profession of nursing as we implemented Shared Governance and Primary Nursing across the nursing service.

Structural Empowerment Shared Governance In its simplest form, shared governance is shared decision-making based on the four principles of partnership, accountability, equity and ownership. This model empowers nurses to have a voice in decision-making on issues that impact their professional practice and patient care.

Benefits of Shared Governance include: better patient outcomes, improved patient and employee satisfaction, increased team work and collaboration and enhanced interdisciplinary communication (Hess, 2004; Anthony, 2004).

Shared Governance milestones for 2010:

• Authored Shared Governance charter, incorporating staff comments.• Finalized Shared Governance structure and educational curriculum.• Hosted celebrations at all five sites.• Invited all nurses to sign the updated charter.• Held two training seminars for approximately 250 nurses.

Primary NursingThe Department of Nursing care delivery model is Primary Nursing. In the practice of Primary Nursing, one nurse (the primary nurse) is responsible and accountable for establishing a therapeutic relationship with the patient. The nurse assesses and plans care and evaluates the progress of the patient throughout the hospital stay.

Primary Nursing revolves around the unique relationship between nurse and patient, while also facilitating the involvement of patients and families in the planning of care. Key goals and benefits include: improving care delivery and coordination and enhancing professional nursing practice (Creative Health Care Management, 2010).

NYP Nurses celebrate signing the Shared Governance Charter.

Nursing Presentations (cont.)sulliVAn, r. (2010 May) Keynote address: Significance of the Nursing Pin , Presented at Long University School of Nursing Brooklyn, NY.

sulliVAn, r. (July 2010) Poster Presentation: Evidence-Based Dress Code National Health Care Leadership Forum, Washington DC.

torres, m. (2010, July). Growing Future Healthcare Leaders. Presented at National Association Hispanic Nurses 35th Annual Conference, Washington, DC.

torres, m. (2010, September). Community Health Update. Presented at NewYork Presbyterian Heart Hospital.

WAlKer, C., ABueDo, m., Allen, G., ColoPinto, K., Fox, V., GeorGes, m., Kertesz, l., tui, m., WAtts, B., (2010, March). Count Me In-Reliable Count Process. Presented at AORN 57th Congress, Denver, CO.

WArD-miller, s., huBert, J., WeinriB, B., PAriKh, s., (2010, August). Evidence Based Practice: Expressed Emotions in an Inpatient Setting. Presented at NewYork Presbyterian Hospital-Westchester Division, Nursing Education Grand Rounds, White Plains, NY.

lori ArmstronG, rn, ms. 4th Annual NNP and Neonatal Update. State of the Profession. Rockefeller University, June 2010.

lori ArmstronG, rn, ms. NANN 25th Annual Conference. Managing in a Unionized Environment. Austin, Texas, September 2009.

lori ArmstronG, rn, ms. Do Not Plan for US, Without Us. Involving Families in Parent Education Material Development: The Art and Science of Patient Education. NYP Patient Education Symposium, September 30, 2010.

lori ArmstronG, rn, ms. Involving Obstetrics in a Free Standing Children’s Hospital. Chief Nursing Officer Forum, CHCA. San Francisco, CA, May 2010.

CArolyn Kyne, rn. Challenges in Caring for a Pediatric Cardiac Patient, NYC Chapter AACN, June 2010.

lirA VillAr, rn AnD nAomi Bent, rn. Recent Advances in Perinatal and Neonatal Nursing. Dubai, August 2010.

DeBorAh ACeVeDo, rn AnD JuliA riVerA, rn Nasal CPAP Symposium. Italy, August 2010.

EuniCe ClArK, rn. The Use of Percutaneous VAD’s in the Pediatric Population—Case Reports. Northeast Pediatric Nurse Associates. October 2010.

sAnDrA mCGill, rn. The Levitronix Pediatrci Vas Devices as a Bridge to Transplantation Northeast Pediatric Cardiology Nurses Association, October 2010.


Transformational LeadershipToday’s healthcare environment is experiencing unprecedented, intense reformation. Effective and transformational leadership is critical to our ongoing success.

Leadership and Staff Development Professional growth is supported through educational programming and the promotion of innovation and research. Efforts include:

• Learning Needs Assessment - A comprehensive learning needs assessment was conducted in 2010, which will serve as our platform for educational programming in 2011. Unit-specific competencies were refined to reflect current practice.

• Live In-Services - In 2010, 16,692 participants attended live in-services and continuing education offerings. This is in addition to training that is done in the Division of Nursing Education through e-learning.

• Continuing Education - The NewYork-Presbyterian Hospital School of Continuing Education for Nurses offered a total of 200 programs awarding contact hours for nurses. 4,084 RNs from NYP and from other healthcare facilities inside and outside the United States attended.

• Hunter College RN to BSN program -In collaboration with Hunter College, NYP nurses attend classes toward their BSN degree on site.

Leadership DefinedIt is relatively easy to lead people where they already want to go; the transformational leader must lead people where they need to be in order to meet the demands of the future.

Transformational leaders must listen, challenge, influence and affirm as the organization makes its way into the future. Gradually, this transformational way of thinking takes root organizationally and becomes even stronger as other leaders adopt this way of thinking (Magnet Guide).

Leadership In PracticeAt NewYork-Presbyterian, we believe that transformational leadership requires vision, influence, clinical knowledge and strong expertise relating to professional nursing practice. We also recognize that transformation may create turbulence and involve unique approaches to solutions.

We value teamwork and collaboration. In addition, we promote an environment and culture where dialogue is open and new ways of thinking and problem-solving are expected.

Ongoing meetings are held by nurse leaders to review the department’s strategic plan and further align with the strategic plan of the hospital and the goals of the institution.

Leading the WayThe Department of Nursing at NewYork-Presbyterian is progressive and visionary, always striving to improve the nursing care we deliver to our patients.

Nursing is found in almost every area of NewYork-Presbyterian, representing the hospital’s largest clinical profession. Our organizational structure includes centralized and decentralized functions and initiatives—all supporting a culture of caring, compassion and safety for our patients.

Leadership StructureOur governance model adheres to the American Nurses Association’s scope and standards for Nurse Administrators. Our Chief Nursing Officer, Wilhelmina M. Manzano, MA, RN, NEA-BC, is ultimately responsible for the provision of nursing care across all of NewYork-Presbyterian.

Vice Presidents of Nursing and Patient Care Services provide leadership for nursing operations at our five sites. Nursing leadership staff at each site serve on the Nursing Board.

The Nursing Board is the Department of Nursing’s governing body. It is dedicated to providing leadership, guidance and education to nursing staff by setting standards that assures the delivery of the highest quality patient care.

Excellence in PracticeThe Center for Professional Nursing Practice and Office of the Chief Nursing Officer oversee all centralized functions for the Department of Nursing. These include:

• Professional nursing practice• Nursing informatics• Patient/family education• Research• Quality assurance/performance improvement

• Nursing education• Continuing education• Nursing school affiliations• Operations• Finance• Credentialing

Moving Forward

“Our successes were made possible through the outstanding efforts of each and every member of our department, from strategic leaders to those who deliver compassionate and competent care to our patients.

We are extremely proud of our nurses and will continue to count on our team to meet the challenges and opportunities facing our profession and the industry. We look forward to entering 2011 with an exciting and ambitious agenda for nursing.”

—Wilhelmina M. Manzano,

MA, RN, NEA-BC Senior Vice President

and Chief Nursing Officer NewYork-Presbyterian Hospital

Nursing Presentations (cont.)terri mCClusKey, rn. Culturally Effective Healthcare: In Pediatrics. 17th Annual Pediatric Nursing Conference: Diversity in Pediatric Nursing. Philadelphia, PA, July 2010 and Akron Children’s Hospital, Akron, Ohio, October 2010

AmAnDA BArille, rn, Cn3 AnD CAssAnDrA sVoroniC, rn. A Change of Shift Report. NYP/TMH Research Symposium, Houston, Texas, April 2010.

AnnA mArie CosGroVe, rnC,ms, nnP. Think Globally…Act Locally and Just Say No to Mechanical Ventilation! Bubble CPAP, IMV,CPAP and Other Strategies to Avoid Mechanical Ventilation. Washington, DC, February 2010.

AliCe CorBett, rn, ms. Radically Improving Radiology Outpatient Flow NACHRI. October 2009.

AliCe CorBett, rn, ms. Quality and Patient Safety-Optimizing Patient Access. NACHRI, March 2010.

mAureen liCursi, rn, PnP. Sickle Cell Disease Management for the Pediatric Nurse Practitioner. Columbia University School of Nursing. October 2009.

JAmes h. GArVin, mD, Pl FAust, eileen stArK, rn PnP, r. AnDerson ,mD AnD n. FelDstein, mD. Preliminary Experience with Sirolimus for Dysplastic Cerebella Gangliocytoma. International Symposium for Pediatric Neuro Oncology. Vienna, June 2010.

miChelle Besmer, rn, CAtherine BArrrell, rn, PAiGe leiGh zAzzAli, rn, lAurA Kelly, rn AnD PAtriCiA mCClArD, rn Empowering New Nurses to Become Competent Caregivers and Active Team Members. National Pediatric Hematology Oncology Nursing Conference. October 2009.

toBy Bressler, rn, mPA. Leadership: A Choice, Not a Position. New York Organization of Nurse Executives. October 2009.

toBy Bressler, rn, mPA. Pediatric Oncology and Meaningful End of Life Care. Hunter University School of Nursing, New York. February 2010.

toBy Bressler, rn, mPA. Mesothelioma and the Family: Supporting the Children. International Symposium on Malignant Mesothelioma. Washington, DC, June 2010.

millie hePBurn, Cns-BC AnD toBy Bressler, rn, mPA. Professional Practice Integration and Leadership: Transforming Nursing Culture at the Bedside and Beyond. Sigma Theta Tau International Research Conference. Orlando, FL, July 2010.

“At NewYork-Presbyterian, they prepare you to be excellent. To thrive in diverse, multidisciplinary teams where Amazing Things are achieved every day.”

—Damon Davis, BSN, RN, Staff Nurse, Behavioral Health


Exemplary Professional PracticeThe foundation of professional nursing practice at NYP is our commitment to incorporating current research and best practices into clinical decision making. The competency of our nursing staff is evaluated regularly to ensure that practices are current, relevant and evidence-based to produce expected patient outcomes.

Practice Initiatives in the Spotlight:

CBT Training

On a 25-bed acute psychiatric inpatient unit devoted to the treatment of adults with affective disorders, nurses collaborated with their colleagues on the treatment team to develop a staff training program for the Cognitive Behavioral Therapy (CBT) treatment modality.

Prior to this training, patients were having a difficult time understanding their discharge medication instructions, which could lead to an adverse outcome after discharge and an almost certain increase in the recidivism rate amongst this population.

After CBT training, RNs on the unit formed a weekly CBT modality group to focus on medications. All medications are now reviewed with patients prior to discharge to alleviate concerns.

The Comfort Committee

Our Comfort Committee program is dedicated to providing a “pain free” patient experience in the Pediatric Emergency Department (PED). This initiative was borne from intensive multidisciplinary collaboration.

In July 2010, medical and nursing leadership initiated a new “Making it Better” committee. Their first initiative focused on reducing patient pain. Coined the “Comfort Committee,” this initiative began exploring and implementing evidence- based practice and best practice methodologies to decrease/eliminate children’s pain in the Emergency Department.

One successful new comfort measure was the utilization of an iPad for preparation, distraction and coping of pediatric and adult patients. This comfort measure has impacted patients in such a positive way that NACHRI invited our child life specialists to present at a poster session at the March 2011 conference.

Patient SatisfactionPatient Satisfaction is a priority focus for the Department of Nursing. We’re proud to report that our scores for Overall Patient Satisfaction with Nursing continue to trend in a positive direction.

Nursing care indicators for Patient Satisfaction (Press Ganey) include:

“I would tell an experienced nurse at the top of his or her game: come here, and see the difference. Nothing matches the magnitude of NewYork-Presbyterian.”

—Mary Halston, MPH, RN Patient Care Director Medicine/Geriatrics

• Overall patient satisfaction with nursing care• Friendliness of the Registered Nurse• Prompt response to call bell• Registered Nurses’ attitude towards requests

• Attention to special personal needs• Registered Nurse kept patient informed• Skill of Registered Nurse• Pain management

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Overall Patient Satisfaction with NYP Nursing — Press Ganey

“I will never forget the excellent care I received at this hospital. The nurses went beyond their responsibilities to show me care, concern and compassion.” —NYP Patient


Nursing Employee SatisfactionThe NYP Employee Opinion survey demonstrated a continued increase in Nursing Employee Satisfaction score across all sites. We’re proud to say that Overall Nursing Employee Satisfaction rates are at their highest levels ever—and, like Patient Satisfaction, continually trending in the right direction.

In 2010, the Nursing Employee Satisfaction score for overall job satisfaction increased three points to 83% from 80% in 2009. This is above the benchmark of 71% for academic medical centers.

Patient-Centered CareNewYork–Presbyterian is committed to ensuring that all patients and family members receive outstanding, compassionate care and excellent service from every member of our team.

The Nursing Department strives to continually provide care that is patient-centered: safe, effective, timely, efficient and equitable. Many of our nurses lead initiatives to improve the patient experience.

Care Initiatives in the Spotlight:

Hourly Rounding

The Department of Nursing rolled out hourly rounding on 150 patient units, with the goal of improving patient care outcomes and patients’ perceptions of care. Hourly rounding is a structured approach to interacting with the patient at regular intervals, incorporating eight basic nursing behaviors.

Hourly rounding helps patients and families feel safe and reassured that their healthcare needs are being addressed with urgency, proficiency and skill. Since hourly rounding has been implemented, there has been an improvement in Press Ganey and Hospital Consumer Assessment of Healthcare Providers & Systems (HCAHPS) indicators.

Congestive Heart Failure (CHF) Compliance

NYP nurses on Cardiac units recognized that compliance with medication and diet instructions is essential for patients with Congestive Heart Failure (CHF). Most notably, our Cardiac nurses found that compliance with these instructions can help reduce and prevent unnecessary patient readmissions.

The nursing staff initiated group classes for patients with CHF to review key elements for maintaining compliance with medication and diet instructions. The readmission rate for patients attending these group classes was 17%, as compared to an overall 29% for all patients with CHF.

Other Key Initiatives

Nurses in several areas of the hospital have initiated projects to improve efficiency and enhance the patient and family experience, such as decreasing wait time in procedure areas and removing barriers to patient throughput.

Other nursing-inspired initiatives to reduce patient length of stay and patient readmission include patient education on self-administration of insulin, the creation of an “all clear” discharge checklist and improved communication between healthcare providers and community pharmacists.

Annual Patient Centered Care Awards

Across the hospital, awards are presented to individuals and units that show sustained improvement in patient satisfaction scores, as measured by the Press Ganey Survey. In addition to patient satisfaction score awards, three award categories are determined through peer-based nominations. They are: Team, Leadership and Physician Champion Awards.

Nursing units have received team awards for innovations in practice that have resulted in improved patient outcomes. Nurse leaders have received leadership awards in recognition of their extraordinary efforts to support staff in providing quality care.

Care Awards in the Spotlight:

Nursing Team Award, Weill Cornell Medical Center

The Pediatric Unit for Procedures and Sedation (PUPS) at Weill Cornell was the recipient of a Team award for the initiation of “Comfort Rounds” for pediatric patients in the Ambulatory Surgery recovery room. The program has been notably effective for the unit, as indicated by a three-point increase from 2009 to 2010 in their Press Ganey patient satisfaction score.

Nursing Team Award, Columbia University Medical Center

The 6 Hudson South Unit at Columbia University Medical Center was the recipient of a Team award for the implementation of “Team Rounds,” which improved communication between all healthcare disciplines and the patient.

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Patient and Family EducationNYP nurses have active involvement in patient and family education. Better informed patients and families demonstrate not only higher levels of satisfaction but also improved outcomes and increased safety.

Our patient and family education committees have oversight for patient/family education across all departments and disciplines. A formalized review process for all patient education materials is governed by:

• Patient Education Nursing Council – Council members include Patient Care Directors, Clinical Nurse Supervisors and staff nurses; meetings are held monthly, with all five sites represented.

• Patient and Family Education Advisory Committee – Committee members include representation from all disciplines; meetings are held quarterly.

In 2010, our Patient and Family Education teams reviewed and approved 124 Health Matters, our written communication tool for patient/family education. In addition, we held a Patient Education Symposium to inspire our nurses with new ideas to educate the patient.

Interdisciplinary Collaboration

The Department of Nursing leads many interdisciplinary initiatives across the hospital, including efforts to improve patient safety in the areas of pressure ulcer reduction, infection reduction and medication administration.

Through close collaboration across disciplines, many comprehensive aspects of patient care are identified as opportunities to improve. Current practices are evaluated and best practices are adapted through a variety of communications, including engaging the hospital staff in daily huddles.

Length of Stay The Department of Nursing actively partners across disciplines with physicians, social workers, care coordinators, performance improvement groups and other clinicians to manage and reduce patient length of stay.

In 2010 at NYP, the average length of stay was 0.41 days lower than the expected length of stay.

Collaborations in the Spotlight:

Medication Safety-Zone of Silence

As part of NYP’s goal to Enhance Communication/Culture of Safety, the Department of Nursing partnered with physicians, allied health professionals and more to create a “Zone of Silence” pilot program in 2010.

Evidence supports that when a provider is interrupted during the process of medication administration, the opportunity for an error to occur increases. In response to these findings, a multidisciplinary team led by nursing members determined the need to have an interruption-free time and environment in which to perform these crucial tasks.

The group adopted the concept of a “Zone of Silence” when a provider is involved in any aspect of medication administration to improve patient safety.

Pain Management-PRN Program

In 2010, an interdisciplinary team led by the Department of Nursing was convened to address the topic of pain management. The team recognized that unrelieved pain prevents patients from healing and participating in their care.

This is a challenge in healthcare organizations due in part to a lack of knowledge about contemporary strategies for pain control. The team of nurses, pharmacists and physicians worked together to identify best practices, with the goal to solidify pain management strategies and improve the patient’s experience with pain.

The result was the creation of the Pain Resource Nurse (PRN) role. Prior to assuming the role, the PRN attends a two-day workshop to prepare the nurse to serve as a unit based consultant regarding pain management to other staff members.

Ventilator Associated Pneumonia (VAP)

The Department of Nursing coordinated an interdisciplinary initiative to reduce the occurrences of Ventilator Associated Pneumonia (VAP) throughout the hospital.

Nationally, VAP is the leading cause of death amongst hospital-acquired infections. VAP can prolong time spent on a ventilator, lengthen ICU stays and extend the total hospital stay after discharge from the ICU.

Our efforts to reduce VAP emphasize a highly organized approach, in addition to early recognition and consistent application of evidence–based practices.

Catheter Associated Urinary Tract Infection (CAUTI)

The NYP nursing team reached across disciplines to emphasize the reduction of Catheter Associated Urinary Tract Infection (CAUTI) rates throughout the hospital.

CAUTI is the most commonly acquired form of infection in a hospital setting. Catheters can cause discomfort for patients, impair recovery and decrease mobility, in addition to placing patients at risk for other complications and increasing the length of hospital stay.

Nurse-driven protocols—which include daily care, daily evaluation of the need for the catheter and discussions with members of the medical staff—were implemented with a resulting decrease in the CAUTI infection rates for 2010.

In October, NYP Nursing recognized the dedication and commitment of our more than 5,000 Nursing Ancillary and Support Services staff. Many of these individuals work in the Department of Nursing. They serve as the eyes and ears of our nurses, contributing in countless ways to the wellbeing of our patients and smooth operation of the patient care unit.


Quality OutcomesThe Department of Nursing maintains an integrated quality program in keeping with the hospital’s strategic goals and vision. As nurses, we aim to continually improve on our level of excellence. For us, nursing quality is about steadfast attention to the detailed elements of care—which add up to a more positive healing experience and better patient outcomes.

NYP Quality Initiatives at a Glance:• Reduction of patient falls/falls with injury• Reduction of hospital acquired pressure ulcers• Reduction in restraint use and compliance with restraint management • Core Measures - meeting or exceeding national benchmarks • Reduction of Catheter Associated Urinary Tract Infections (CAUTI)• Improve Hand-off Communication/SBAR• Improve Immunization Rates• Enhance Medication Safety/Zone of Silence• Improve Pain Management• Prevention of Ventilator Associated Pneumonia (VAP)

Quality and Patient SafetyIn 2010, the Department of Nursing achieved many accomplishments in quality and patient safety. As part of these efforts, staff nurses are leading or co-leading site Quality Councils to develop initiatives that target improvements in patient outcomes.

NYP Nurses have initiated such projects as:• Reducing noise on units.• Creating a contrast reaction pack for MRI and CT.• Exploring long-term 1:1 observation on Medical Surgical units.• Debriefing Behavioral Health patients after seclusion or restraint.• Improving peripheral intravenous management for inpatient organ transplant patients.

Quality Programs in the Spotlight:

Nursing Fellowships

The Department of Nursing established the Nursing Fellowship in Quality and Patient Safety. 38 staff nurses completed the Quality Fellowship program in 2010.

The goal of the fellowship is to provide high-performing nurses with an opportunity to advance quality and safety at the bedside. Nursing Quality Fellows work closely with Patient Care Directors on a Quality Improvement Project and deliver a presentation to the Campus Quality Council.

Great Catch Program

In 2010, NYP nursing launched the “Great Catch” program to not only prevent errors but also to provide an opportunity for staff to focus on positive opportunities to improve patient safety.

Quality Indicators and Benchmarks In an effort to continually improve the quality of patient care, the Department of Nursing stringently monitors key clinical indicators. Working together, nursing sensitive indicators are selected by nursing teams and nursing leadership.

Quality metrics are reported on an integrated scorecard across all inpatient sites. We benchmark performance against internal and external databases, such as the National Database of Nursing Quality Indicators (NDNQI) and the Maryland Indicator Project. Data is used for tracking outcomes, trending performance and monitoring results of implemented strategies.

National Database of Nursing Quality Indicators The Department of Nursing has participated in the National Database of Nursing Quality Indicators (NDNQI) since 2002. Participation gives NewYork-Presbyterian the means to compare patient outcomes and staffing patterns with other facilities of the same bed size.

Current indicators include:

• Nursing Hours per Patient Day• Fall and Fall-Injury Rates (adults)• Nosocomial Pressure Ulcers (adults)• RN Education• Peripheral Intravenous (PIV) Infiltrations (pediatrics)• Pediatric Pain Assessment/Intervention/Reassessment Cycle (Pain AIR Cycle)

Fall and Fall-Injury Rates Reduction of falls is an on-going challenge and remains a strong focus for nursing at the unit level. The reduction of falls and falls with injury is another way we strive to keep our patients safe. In 2010, we standardized falls documentation and reporting. It enabled us to provide consistent data to analyze and trend fall occurrences and identify root causes.

In addition, the Department of Nursing participates in a multi-hospital initiative to reduce patient falls. Within this forum, hospitals share strategies that have been successful in falls reduction. Unit based “Falls Champions” are identified to oversee efforts. Their role is to review unit-specific falls data, discuss risk factors with unit staff and generate ideas on how to prevent fall occurrences.

All units continue to emphasize hourly rounding, focusing on how assistance can be offered to patients for toileting and/or other activities. In addition, units are reinforcing hand-off communication between charge nurses on patients at high risk for falls to ensure correct signage and interventions.

“Working here, you have a voice in the quality of patient care. You learn to be a patient advocate. Every hour, every minute.” —Clarissa Barbon, BSN, RN

Clinical Nurse Pediatric Cardiac ICU

NYP Total Falls. NYP Total Falls with Major Injury.

Nursing Awards and RecognitionsNursing Spectrum National Award in the Mentoring Category: JosePhine, mArCAntonio, msn, rn, CPn

Regional finalists:Advancing and Leading the Profession: suzAnne Boyle, DnsC, rn

Clinical Care: thomAs GooDsell, rn, CCrn

Clinical Care: mAry PresCuitti, Bsn, rn, CCrn, Cnrn

Mentoring: Janette O’Connor, BS, BSN, RN-BC

New York Times Tribute to Nurses:Winner Innovation: JAne JeFFrie seley, mPh, msn, rn, GnP, BC-ADm, CDe

Honorable Mention:lisette DorFmAn, ms, rn, APrn

melAney GorDon, rn

elizABeth PolAnCo, msn, rn, PnP

lee reDstone, msn, rn, Cns

FernAnDo roDriquez, Bsn, rn, WCC

Sigma Theta Tau Alpha Phi Chapter Hunter College of Nursing

Excellence in Nursing Leadership: rosemAry sulliVAn, mA, rn

Excellence in Nursing Practice: linDA sAAl, mA, rn-BC

NYP Clinical Excellence Awards

merlitA AGuilAr, Bsn, rn, CGrn

omAyrA CAstillo, Bsn, rn-BC

JenniFer mAynArD, Bsn, rn, - Rookie of the Yearleslie Felsen, mA, eDs, rn, PmhCns-BC, lmFt, - Advanced Practice

melAney GorDon, AAs, rn, - Community Service

JAsmine PonD, msn, rn, - Nursing Leadership

PAt mCmAster, ms, rn, Cnm, - Advanced Practice

FernAnDo roDriquez, Bsn, rn, WCC

lynn sPeer, Bsn, rn - Community ServicesVetlAnA KhAimoVA, Bsn, rn

mArthA mArsCiAno, rn

lAuren PierCe, Bsn, rn, oCn

m.mArGAret Pilon, Bsn, rnC-BC

JoyCe PhilliP, Bsn, rn, CCrn

yesseniA VAlentin sAlGADo, rn, Cnor

lisA Ann GAlluP, Bsn, rn,- Rookie of the YearJAne JeFFrie seley, mPh, DnP(C), msn, rn, GnP, BC-ADm, CDe - Advanced Practice


Pressure Ulcer Prevalence The Department of Nursing continues to monitor pressure ulcer prevalence.

Pressure ulcers can cause considerable harm to patients, hinder functional recovery, cause pain and serve as vehicles for infections. They are also associated with extended length of stay and increased mortality.

Multiple nursing strategies have assisted in the successful and continuing reduction of the pressure ulcer prevalence rate across all sites in 2010. These include:• Unit based skin care champions.• The utilization of Wound Ostomy and Continence Nurses (WOCN). • Ongoing staff education.

Restraint ManagementPatients deserve to feel safe and to be treated with dignity. It has been demonstrated that, in some cases, the use of restraints can cause more harm than was intended to prevent. Recognizing the need to preserve the patient’s right to have safe and compassionate care, our nursing staff has made reduction in restraint use a priority.

Restraint use is limited to situations where other alternatives have been explored and were not successful. On occasion, some patients may need to be restrained for their own safety or the safety of the staff. In all instances, the least restrictive method is used for the shortest amount of time.

Nursing Hours per Patient Day Nursing hours per patient day at NewYork-Presbyterian Hospital are reviewed on a regular basis by nursing leadership and compared to statewide and national benchmarks. Efforts continue to assess the changing needs of patients and assure that appropriate recommendations and considerations for nurse staffing are made.

Core Measures The Core Measures are evidence-based quality metrics that have been agreed upon by expert clinicians, the Joint Commission and Centers for Medicare Services (CMS). Core Measures help promote higher quality and more efficient care for our patients.

Nursing plays an important role in improving patient outcomes by following specific Core Measures associated with acute MI, heart failure, pneumonia and child asthma care. Nurses offer smoking cessation counseling, promote flu and pneumonia vaccination and assure children with asthma have a written home management plan.

PneumoniaMeasures

Pneumococcal Vaccine

Smoking Cessation Counseling

Influenza Vaccine

Q42009

Q12010

Q22010

Q32010

Hospital CompareBenchmark

87%

100%

87%

95%

90%

n/a

95%

96%

n/a

95%

93%

96%

92%

97%

91%

Acute MIMeasure


Q42009

Q12010

Q22010

Q32010


95% 100%100%100% 99%

Heart FailureMeasures

Discharge Instruction


Q42009

Q12010

Q22010

Q32010


60%

100%

96%

100%

94%

96%

61%

100%

87%

98%

90% or above AND above benchmark

Below benchmark; OR above benchmark but below 90%

Below both 90% and benchmark

Percent Compliance with Core Measures – Nursing Processes

Nursing Awards and Recognitions (cont.)BArry GAllison, ms, msn, rn, APrn-BC- Nursing Leadership

Anthony DeDonAtis, BA, Bsn, rn, - Advanced Beginner

AnDreA FAiellA, Bsn, rn-BC

lissette DorFmAn, ms, APrn, - Leadership

AmAnDA BArile, Bsn, rn, CPn

elizABeth KAtz, Bsn, rn - Rookie of the Year

JosePhine mArCAntonio, msn, rn, CPn - Advanced Practice

elizABeth PolAnCo, msn, rn, PnP - Leadership

reBeCCA GiBBons, Bsn, rn, Cen - Rookie of the Year

lee reDstone, msn, rn, Cns - Advanced Practice

Doreen tAliAFerro, rn

DAISY Awards

AGnes CinDriCh, rn

eileen zieGler, rn

roBin VelluCCi, rn

Winsome oVerstreet, rn

tom PAlumBo, rn

mAry BurKe, rn

eDeliA DeVerCiA-menDozA, rn

JoAnne iAnnuzzi, rn

JAne PArK, rn

mAry smith, rn

nAnCy Cimitile, rn

hillAry hAlter rn

GinA DinAPoli, rn

nirmAlA KothA, rn

reGAn Collins, rn

moniKA mAtheW, rn

KAtelin PhelAn, rn

mArGAret mCGreGor, rn

helen s tAnnenBAum AWArD

JoAnnA iAnnuzzi, Bsn, rn

NYU College of Nursing

WilhelminA mAnzAno, mA, rn neA-BC - Distinguished Clinician Award

mArGAret silBerGer, msn, rn, CCrn - Preceptor of the Year

Other Awards

WilhelminA mAnzAno, mA, rn, neA-BC - Honoree, “Woman of Excellence and Achievement,” Women United in Philanthropy, United Way of New York City, 2010.

JosePhine, mArCAntonio, msn, rn, CPn2010 Nursing Spectrum National Award in the Mentoring Category. A Clinical Nurse Specialist in pediatric cardiology and neurology at MSCHONY.

0 30% 60% 90% 100%

CU

WC

AH

Order present and complete

Alternatives assessed, tried, and documented

Flowsheet doumentation completePrevalence

Restraint Prevalence and Compliance, Adult ICU Units; Average Results, Jan 2010 – Dec 2010


Knowledge and Innovation

Center for Professional Nursing PracticeThe Center for Professional Nursing Practice (CPNP) includes the areas of professional nursing practice, nursing informatics, patient/family education, research, quality assurance/performance improvement, nursing education, continuing education, nursing school affiliations, operations, finance and credentialing.

Each area supports Nursing practice across the 5 sites.

Office of Professional Nursing Practice This office oversees Clinical Practice Standards, Nursing Administrative Standards, the Patient Education Program, Hospital Policy & Procedures and Corporate Nursing Communication.

The Office of Professional Nursing Practice reviewed 349 clinical nursing standards in 2010.

Division of Nursing Education and School of Continuing Education

The Division of Nursing Education’s primary objective is to provide education and support ongoing clinical competency for all registered nurses at NYP. The intent of the educational programming is to orient new staff, facilitate ongoing competency development and support programmatic changes.

The School of Continuing Education supports continuing professional development and education of nurses from NYP system hospitals for programmatic changes at their respective facilities.

Nursing School Affiliations

The Department of Nursing is committed to assuring that the next generation of nurses is fully prepared to meet the challenges of patient care when they transition from the role of student to professional nurse. Each year, there has been an incremental increase in the number of student nurses who request NYP as their preferred environment in which to learn.

Nursing Operations and Credentialing

The Office of Operations and Credentialing ensures nursing operational challenges are uniformly addressed across all sites. In collaboration with the Director of Finance/Nursing, budget variances across all sites are reviewed regularly to ensure staffing levels are maintained within budget.

Nursing Credentialing Services (NCS) facilitated the appointment and reappointment of Advanced Practice Nurses Activities for 2010, including:• 103 initial appointments

• 258 Advanced Practice Nurses reappointed for the 2010-2012 period

The NCS also monitors nursing staff compliance with RN registration and resuscitation requirements. To date, 45 Delineation of Clinical Privileges have been developed and approved by the Credentials Committee.

Nursing ResearchWe are committed to promoting nursing research, utilizing case studies and innovations that drive improvements in practice. The Department of Nursing holds a Nursing Research Symposium every year. In 2010, we initiated 10 nursing research projects and continued efforts in nursing grant acquisition.

Our Nursing Research Governing Council, as well as site-specific Nursing Research Councils, facilitates the final approval and implementation of all nursing research. As part of the Department of Nursing’s shared governance model, nursing research is also promoted at the unit level.

Active Research• Bufe, G. (2006). “NYP Nursing Residency Program.”

• Bufe, G., & Fisher, M. (2007). “Measuring Nurses’ Individual Perceptions of Workload by using the Individual Workload Perception Scale.”

• Bufe, G., Halliday, C., Pettijohn, D., Rabbani, L., Reyes, D., & Tahan, H. (2007). “Evaluation of an Automated Approach to Quality Metrics in Telemetry”.

• Currie, L., Brous, M.E., Bufe, G., Lecorps, M., Muth, J., Saddul, R., St John, A., & Espinosa, L. (2007). “Automated Fall and Injury Prevention for Behavioral Health (AFIP-BH).

• Persky, G., Kaiser, J., & Valentino, L. (2011). “Time & Motion Observational Study Utilizing Omnicell Mobile Carts”.

• Rizzo, J., Graham-Ogilvie, A., Kaiser, J., Valentino, L. (2011). “Transforming Nursing Stress At The Bedside Utilizing HeartMath”.

• Manzano, W. & Bufe, G. (2007). “Practice Environment Scale-Nurses’ Work Index; PES-NWI”

• Rivera, R. & Bufe, G. (2006). [Site Investigators]. Post-Baccalaureate Nurse Residency Program Demonstration Project Evaluation Study. (Multi-Site Principal Investigator: Krugman, M. PhD, RN, University of Colorado Hospital).

• Rivera, R., Boyle, S., Bufe, G., & Fitzpatrick, J. (2008). “Presence of Drivers of Engagement and Registered Nurse Engagement.”

Funded Research• Evaluation of an Automated Approach to Quality Metrics in Telemetry—$150,000 grant from General Electric

• Automated Fall and Injury Prevention for Behavioral Health—$100,000 grant from the National Institute of Mental Health

• Nursing Residency Program—$300,000 funded over three years by the Jonas Center for Nursing Excellence (currently in year three)

• Implementation of Being Warm is “Cool”: Increasing Patient Comfort and Autonomy Through Perioperative Warming—$5,000 from the DAISY Foundation

Completed Research Projects• Attitudes to Patient Education Documentation. Bufe, G, Garnica, P., and Mellino, L. • Staff Nurse Perception on Shared Governance. Bufe, G., Mellino, L., and Moreno, J. • Endoscopy Nurses Knowledge of Informed Consent. Bufe, G., Cabello, C., and Boland, T.

Adelphi University

College of Mt. St. Vincent

College of New Rochelle

Columbia University

Concordia College

DeSales University

Dominican College

Graceland University

Fairleigh Dickinson University

Hartwick College

Johns Hopkins

Hunter College

LaSalle University

Lehman College

Long Island College Hospital

Mercy College

Molloy College

Mount Saint Mary College

New York University

Pace University

University of Rochester

Stony Brook University

Thomas Jefferson University

UMDNJ

University of Pennsylvania

University of Wisconsin

Wagner College

Walden University

Yale University

Nursing PublicationsBussel, J., BerKoWitz, r., hunG, C., KolB, e., Wiset, m., PrimiAni, A., tsAur, F., mCFArlAnD, J. (2010). “Intracranial Hemorrage in Alloinmune Thrombocytopenia: Stratified Management to Prevent Recurrence in the Subsequent Affected Fetus”. American Journal of Obstetrics and Gynecology, 135, 1-14.

PersKy, G., romAnA, m., FelGen, J., nelson, J. (2011). “Primary Nursing, A Strategy to Enhance Caring” in “Measure Caring: A Computation of International Research on Caritas as a Healing Intervention”. ed. Jean Watson & John Nelson.

PersKy G., nelson, J., WAtson, J., Bent, K. (2011). “Profile of a Nurse Effective in Caring: A Computation of International Research on Caritas as a Healing Interventation”. ed. Jean Watson & John Nelson.

PersKy, G., FelGen, J., nelson, J., shermAn-JustiCe, D., rye, J., esPinozA, m., olshAnsKy, e. (2011). “Measurement of Caring in a Relationship Based Model of Nursing” in “Measuring Caring: A Computation of International Research on Caritas as a Healing Intervention”. ed. Jean Watson & John Nelson.

PersKy, G. (2010). “The Relationship of Environmental Turbulence to Patient Satisfaction in Acute Patient Care Units”. Doctoral Dissertations, Department of Nursing, Columbia University Proquest Dissertations and Thesis.

hAWKs, r. Complimentary and Alternative Therapies in Pediatric Oncology Palliative Care and End-of-Life Care Resource, Eds Ethier, A, Rollins, J & Steward, J. Cure Search Children’s Oncology Group & Association of Pediatric Hematology/Oncology Nurses. 2010 (4) Melissa Parsons, RN Cytokine Storm in the Pediatric Oncology Patient – Journal of Pediatric Oncology – Vol 27, No5, Sept/Oct 2010, pp 253-258

Bressler, t. “Professional Boundaries; A Legal, Ethical and Administrative Perspective,” APHON Counts, Volume 24, Issue 3. 2010 pp 4-5

Besmer, m, toBy Bressler, CAtherine BArrell “Using Incident Reports as Teaching Tools; Promoting a Culture of Quality and Safety,” Nursing Management. July 2010, pp 16-18

miChelle Besmer, rn, toBy Bressler, rn “Promoting Safety and Quality; Using Reporting as Teaching Tools.” NYP System Quality Review Journal. October 2009

toBy Bressler “A Peaceful Spirit. Extraordinary Healers: Honoring Oncology Nurses Vol. 3,” Cure Media Group. December 2009, pp 15-19


Nursing Informatics

The Director of Nursing Informatics facilitates the implementation of technology to improve nursing workflow efficiency and patient safety. In 2010, great strides were made in the use of electronic nursing documentation and technology.

• The Office of Nursing Informatics is responsible for ensuring that Electronic Medical Records (EMR) are used optimally by NYP nursing. Overall, 159 requests were approved and released into the Electronic Medical Record (EMR). • Nursing Informatics worked in collaboration with interdisciplinary teams to support the implementation of the Electronic Medical Record Module in all four Emergency Departments.• Automatic Dispensing Cabinets have been rolled out throughout the Organization and will complete installation in 2011.• Initiated a project to develop the Nurse Executive Dashboard, to provide nurse leaders with pertinent data.• A Patient Acuity tool that leverages data pulled from the patient’s Electronic Medical Record to calculate acuity is being researched and a feasibility pilot has begun.

Recruitment and RetentionThe hospital’s nursing leadership works closely with Human Resources to strategically plan and address recruitment and retention. The Department of Nursing is proud of its low vacancy and turnover rates, both of which are below the national average.

In 2010, our vacancy rate was 4.84%, compared to a national rate of 8.80% and a New York State rate of 3.60%. Our turnover rate in 2010 was 6.55%, compared to a national rate of 16.2% and a New York State rate of 7.10%.

Low vacancy and turnover rates speak to NewYork-Presbyterian Hospital’s continued standing as an employer of choice among qualified nursing candidates. In 2010, 610 nurses were hired; 190 (33%) were new graduates.

Though there is a waiting list for new graduate positions, recruitment and retention of experienced and specialty nurses continues to be a challenge. Each site has developed a recruitment, retention and recognition council to address this need.

Additional initiatives include:• UHC Nurse Residency Program - In collaboration with UHC, a Nurse Residency Program supports new graduates in their transition into practice. Nurses who have participated in the Nurse Residency Programs had a greater than 93% retention rate after the first year and an 88% retention rate after three years.

• Leadership Development Programs - Leadership progression programs, such as our collaboration between the Department of Nursing and NYU Wagner’s Executive MPA for Nurse Leaders program, and leadership competency and development courses through the Center for Organization Leadership Effective- ness prepare frontline nurse managers to drive outcomes in a fast-changing healthcare environment.

The following initiatives also continued in 2010 as part of our focused effort:• Enhanced Recruitment and Retention Councils at each site • Staff awards and recognition• Nurse Residency/Intern Programs• Summer Nurse Extern Program• Strengthened school affiliations and relationships• Redesigned NYP.org Careers & Nursing website

NYU Wagner Master of Science in Public Administration Program for Nurse Leaders

In 2006, the Department of Nursing partnered with the NYU Wagner Graduate School of Public Service to develop a Master of Science in Public Administration Program for Nurse leaders. Over the history of our partnership, over 39 NYP nurses have graduated. An additional 43 NYP nurses are currently enrolled.

The program addresses the educational needs of nurses who seek to advance to leadership positions. It’s designed to offer current and potential leaders the skills necessary to assume administrative roles in complex organizations.

Nurses in the CommunityThe Ambulatory Care Network supports many community partnership events. In alignment with our strategic goal to have an increased community presence, nurses have volunteered and provided education in areas such as:

In the Spotlight:

Tanzania Take-Two

The New Nurses Forum at NYP/Westchester Division completed their second annual fundraising event for Maasai nursing students in the East African nation of Tanzania.

These nurses (who are in their first and second year of NYP employment) raised funds that were donated to Operation Bootstrap, an organization that assists with nursing student tuition at Haydom Hospital in the Manyara area of Tanzania.

Over fifty employees participated in Tanzania Take-Two. As fellow nurses, we are grateful for everyone’s contribution as responsible global citizens and support in educating our fellow nurses throughout the world.

Fundraising for Operation Bootstrap.

• Hand-hygiene • Hypertension identification • Diabetes awareness• Healthy eating• Shaken baby syndrome

• Stroke awareness• Organ donation• Pediatric hospital stay education (through such programs as the Teddy Bear Clinic)

Nursing Turnover Rates by Campus (Data Source: NYPH HRIS, NDNQI)

Nursing Vacancy Rates by Campus (Data Source: NYPH HRIS, NDNQI)

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2%

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8%

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2009 2010

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SH

HR

A) N

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ng

6%

Nursing Turnover Rates (Data Source: NYPH HRIS, NDNQI)

Nursing Turnover Rates by Campus (Data Source: NYPH HRIS, NDNQI)

Nursing Vacancy Rates by Campus (Data Source: NYPH HRIS, NDNQI)

NY

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2008

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Nursing Vacancy Rates (Data Source: NYPH HRIS, NDNQI)

28 Department of Nursing - 2010 Annual Outcomes Report

2010 Day of Hope

May 10, 2010 Cosmetology Health Fair

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