UT Southwestern Committed to being Nurses...UT Southwestern Nursing Mission and Vision The Nursing...
Transcript of UT Southwestern Committed to being Nurses...UT Southwestern Nursing Mission and Vision The Nursing...
Executive Leadership1
UT Southwestern Nurses: Committed to being
a model of excellence in professional
nursing practice, education, and research.
Excellence is our starting point, not our finish line.
Nursing Report 2017
Executive Leadership 3
IntroductionHospital Executive Leadership Team
Message from the CNE
Nursing Philosophy, Mission, and Vision
Transformational LeadershipA Year of Nursing Excellence
Meritorious Service Award
D Magazine Excellence in Nursing
Dallas-Fort Worth Great 100 Nurses
DAISY Award
Strauss Award
Nurse Excellence Awards
Press Ganey Nurse of the Year
Other Honors and Recognition
Structural EmpowermentShared Governance
Clinical Ladder
APP Mentoring Program
Exemplary Professional Practice Certifications
Certified Registered Nurses
Clinical Education and Professional Practice
Nurse Satisfaction
Practice Enhancements
Community Involvement
New Knowledge, Innovation, and ResearchNursing-Led Research
Publications, Posters, Presentations, and Abstracts
Executive Leadership “As we continue to focus on the elevation of nursing at UT Southwestern Medical Center, the exceptional work
done by our nurses is gaining national attention, most recently demonstrated by Press Ganey’s selection of
one of our nurses, Dawn Brown, as the 2017 Nurse of the Year. This award recognizes the skill, collaboration,
and attention to patient experience of just one direct care nurse in the nation each year. We are very proud of
Dawn, who is an exemplar of her outstanding nursing colleagues at UT Southwestern. Their skill, commitment
to ongoing learning and development, and compassion allow us to provide safe, high-quality patient care to
a rapidly growing population, and we are grateful to our nurse colleagues for the important role they play in
our delivery of excellent patient care and innovative, advanced medical thinking.”
– John Warner, M.D., MBA
John Warner, M.D., MBA
Executive Vice President forHealth System Affairs
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On the cover: Ruqi Lai, RN
Managing Editor: Victoria England, MBA, B.S.N., RN, NE-BCAssistant Editor: Kelly Murphy, B.S.N., RN
Executive Leadership 5Executive Leadership4
Innovation
How do patients experience what we do? We’ve pushed our-
selves to try new things to serve the physical and the emotional
needs of our patients. One of our 2017 efforts was “Musicians
On Call,” in which our volunteers escort professional musicians
around the hospital so they can perform in patient rooms. At the
moment, the program is active on the 12th floor of Clements
University Hospital, and we intend to eventually expand into Zale
Lipshy University Hospital.
Nurses, you are truly an inspiration. You’ve poured your heart and
soul into helping move patient care forward at UT Southwestern.
Keep pushing those boundaries in 2018 and beyond.
I’ll see you around the corner.
Susan Hernandez, MBA, B.S.N., RN
Chief Nurse Executive
UT Southwestern Health System
Message from the Chief Nurse ExecutiveAs I walk the halls of our University Hospitals and clinics each day, it’s no wonder I smile. Around every corner,
I see reflections of what made 2017 such a remarkable year for nurses at UT Southwestern:
nIt’s often in the greeting of a grateful patient.
nIt’s in the familiar faces of nurses who boarded a bus for Houston in September in the aftermath
of Hurricane Harvey.
nIt’s even in the mammoth construction cranes looming outside the windows of William P. Clements
Jr. University Hospital, signifying growth.
All of these reminders are tied directly to the patient experience, which really drives us in our calling as nurses.
As I enter my fourth year at UT Southwestern, I marvel at how far we’ve come as a team. Throughout 2017,
our nurses have pushed, achieved, and inspired – and I could not be prouder. Nurses here are passionate
about patient care excellence. They make sure that the whole family unit feels cared for and like part of the
team. They are transformational leaders at every level.
Here are some highlights of 2017.
Accolades
nIn August 2017, our University Hospitals were ranked No. 1
in Dallas-Fort Worth by U.S. News & World Report.
Nurses played a key role in that achievement, by striving to
provide the best possible care to patients through team-
based medicine.
nUT Southwestern scored in the top 5 percent in the nation
by Press Ganey in patient experience in 2017.
nOur work in the field of pain management was recognized
when nurse manager Dawn Brown was named the country’s
Nurse of the Year by Press Ganey.
nWe also had four nurses inducted into the DFW Great
100 Nurses organization and 20 winners of D Magazine’s
Excellence in Nursing awards.
Resilience
We are in the midst of a $480 million construction project
that will expand Clements University Hospital to include a
new, 12-story tower to be complete in 2020. While the future is
thrilling, the ongoing construction is also disruptive and noisy.
Our staff knows how to manage expectations, so in spite of
the upheaval, our patients believe that they are getting a great
experience from us – and they are.
Giving spirit
In the days following the Hurricane Harvey devastation in
Houston, we got a call that our sister institution, MD Anderson,
needed help. When we put the query out to our nurses, more
than 100 nurses raised their hands to volunteer. In the end,
more than 40 UTSW nurses headed to Houston, changing their
lives for two weeks to work in unknown territory. This amazing
outpouring revealed not only the giving spirit of our nurses, but
demonstrated that UT Southwestern’s compassion and commit-
ment to patient care is indeed boundless.
Growth
In 2016, there were fewer than 100 people enrolled in our
Nurse Residency program. In 2017, that number expanded to
more than 130.
We’re also broadening our partnerships with neighboring
Schools of Nursing – collaborating more with Texas Woman’s
University and Texas Christian University and starting a new
initiative with Texas Tech University. In 2017, the deans of those
programs reached out to UT Southwestern and we reached
back. These partnerships benefit not only new graduate nurses
joining our staff, but because they’ll have the opportunity to
teach and serve on the faculty, the future of nursing, as well.
The message is getting out: UT Southwestern is a place where
nurses want to come to work.
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UT Southwestern Nursing Mission and Vision
The Nursing Division at UT Southwestern is committed to being a national leader among academic
health centers in providing high-quality, safe, and innovative patient care and to being a model of
excellence in professional nursing practice, education, and research.
Our Commitment to Our Patients and Each Other
nI will do my part to make the hospital environment a peaceful, quiet place dedicated to the healing
of the body and spirit.
nI will anticipate the needs of patients and their families rather than waiting to be asked for assistance.
nI will own and resolve every problem I can or personally hand over the problem to someone who
can resolve it.
nI will respect the confidentiality of patients, their families, and my colleagues through discrete
conversation and attention to privacy.
nI will be responsible for keeping our work environments clean and safe.
nI will dress professionally, and I will speak and conduct myself in a manner that always keeps the
focus on our patients.
Nursing Philosophy
nUT Southwestern is committed to providing quality nursing care through effective use of resources
and the development of innovative programs in clinical practice, education, and research.
nWe value the worth, dignity, and autonomy of our patients and their families. We believe that each
individual has unique physical, social, emotional, and spiritual needs that are served through
personalized, compassionate care.
nWe encourage each nurse to care for his or her body, mind, and spirit as a critical element in
achieving clinical excellence. Nurses at UT Southwestern are also encouraged to nurture and support
one another in an environment that fosters teamwork and interdisciplinary collaboration.
nWorking collaboratively affords us the opportunity for common goal-setting through trust,
mutual respect, and a commitment to open and honest communication in serving our patients.
From left: Annie Philip, B.S.N., RN, RNC; Erika Draper, B.S.N., RN; Sara Fay, B.S.N., RN
Transformational Leadership 9Transformational Leadership8
Katherine Walker, B.S.N., RN
Transformational Leadership: As health care continues on its path of rapid change, the
Division of Nursing is leading the charge with each step. Our journey supports the transformation
needed to fulfill our mission of excellence in patient- centered care. Every day, our world-class
nursing team delivers comprehensive, quality care. We bring compassion and understanding to
our patients and their families and loved ones, going beyond the routine to show genuine caring –
and making a real difference in the process.
Transformational Leadership 11Transformational Leadership10
A Year of Nursing ExcellenceEach nurse at UT Southwestern is a leader within his or her clinical areas. Across campus, from hospitals
to clinics, excellent nursing practice is seen in the best quality care for each patient. It involves the ability to
promote good health and well-being throughout each patient’s continuum of care. Nurses lead at every level
through direct patient care and beyond. Excellence is our starting point, not our finish line.
Nurse Executive Board
Seated (left to right) Mike Mayo, M.S.N., RN, CCRN; Sean Gilmore, M.H.A., CSSGB; Rudy Arispe, B.S.N., RN, CNOR; Todd Bailey, M.S., B.S.N., RN, NE-BC; Eldon Setterlund, MBA, B.S.N., RN;Standing (left to right) Shelley Brown-Cleere, M.S.N., RN; Trish Jackson, MBA, M.S.N., RN, NE-BC; Victoria England, MBA, B.S.N., RN, NE-BC; Lori Hodge, D.N.P., RN, OCN, NEA-BC; Tsedey Melaku, B.S.N., RN; Amanda Truelove, M.S.N., RNC-OB, NE-BC; Susan Hernandez, MBA, B.S.N., RN; Thea Vanderhill, M.S.N., RN, CNRN; Stephanie Huckaby, M.S.N., RN-BC; Deshonna Taylor, M.S.N., RN, CCRN; Stacey Clark, MBA, B.S.N., RN, CMPE; Rhonda Hough, D.N.P., RN, CPNP-AC; Sherri Medina, MBA, B.S.N., RN;Not pictured: Renee Bailey, M.S.-M.A.S., M.S., B.S.N., RN, CNOR; and Cheryl Kaplan, MBA, M.H.A., B.S.N., RN
Zile Ameh, A.D.N., RN – CUH Surgery
Houston Carr, B.S.N., RN, CPAN – Zale PACU
Sarah Clakley, B.S.N., RN – CUH Surgery
Melissa De Leon, B.S.N., RN – CUH Surgery
Erica Donckers, RN, CNOR – CUH Surgery
Shannon Dunleavy, B.S.N., RN, CCRN – Neuroscience ICU
Claudia Engle, B.S.N., RN, CWOCN – Wound Ostomy
Hannah Fischer, RN – 6 South
Emily Flahaven, M.S.N., RN, CAHIMS – Quality Project
Management & Informatics
Johnsly George, B.S.N., RN, CNOR – CUH Surgery
Rochelle Green, RN – Internal Medicine
Linda Greer, B.S.N., RN – Obstetrics and Gynecology
Cynthia Groce, A.D.N., RN – Psychiatry
Lauren Harper, B.S.N., RN – Emergency Department
Azubuike Ikwueme, RN – 12 South
Amy John, B.S.N., RN – 12 North
Mari Ann Lewis, B.S.N., RN-BC – Ambulatory Services
Administration
Cheryl Marks, RN, CDE – Obstetrics and Gynecology
Molly Mattay, B.S.N., RN, OCN, BMTCN – 11 South
Katelyn, Mitchell, B.S.N., RN – 5 South Delivery Room
Shelia Moss, B.S.N., RN – Center for Mineral Metabolism
Amber Narayanan, MBA, B.S.N., RN – Urology
Devishri Naveen, B.S.N., RN, PCCN – 10 North
Wai-Chung (Simon) Ng, B.S.N., RN – Rehabilitation
Cary Orrick, B.S.N., RN, CEN – Emergency Department
Anna Mary Park, RN – 6 North
Leah Parker, B.S.N., RN – 10 South
Nadia Pratt, B.S.N., RN – 7 South SICU
Bina Regi, B.S.N., RN – 9 North
Amanda Reitz, RN – 8 North
Aurora Relampagos, B.S.N., RN, OCN – Simmons Cancer Center
Richardson Clinic
Pamela Ridgeway, M.S.N., RN, CCRN – Resuscitation Team
Lynn Sawyer, M.S.N.-Ed., RN-BC – Ambulatory Float Pool
Allison Sunleaf, B.S.N., RN – Ambulatory Float Pool
Giovanni Torti, B.S.N., RN – Apheresis
Rebecca Tutt, B.S.N., RN-BC – Ambulatory Services
Administration
Emily Williams, B.S.N., RN – Plastic Surgery
Meritorious Service Award 2017
The Meritorious Service Award is bestowed annually to hospital and clinic employees who have provided extraordinary
service and care to our patients and demonstrated an excellent work ethic and performance. These UT Southwestern
employees exemplify PACT standards (Problem-Solving; Ability, Attitude, and Accountability; Communications and
Compassion; and Teamwork) and serve as role models to the campus. The PACT program was designed by the staff to
set expectations for interactions with each other and with patients. The 2017 recipients were:
Transformational Leadership 13Transformational Leadership12
1. Tomas Armendariz, B.S.N., RN, CMSRN
Nurse Manager, Apheresis
2. Christen Bennett, B.S.N., RN, OCN, BMTCN
Sr. Bone Marrow Transplant Coordinator
3. Dawn Brown, M.S.-M.A.S., B.S.N., RN, NE-BC
Nurse Manager, Clements University Hospital – 6 North
4. Denise Bulpitt, B.S.N., RN, IBCLC
Lactation Consultant, Clements University Hospital
– Women’s Resource Center
5. Linda Chan, B.S.N., RN, OCN
Registered Nurse, Clements University Hospital – 11 North
6. Candice Coker, B.S.N., RN
Assistant Nurse Manager,
Clements University Hospital – 8 South Medical ICU
7. Jeanette Coleman, RN
Assistant Nurse Manager,
Clements University Hospital – Neonatal ICU
8. Rebecca Dill, B.S.N., RN
Registered Nurse, Apheresis
9. Kim Donoghue, A.D.N., RN
Registered Nurse, Zale Lipshy University Hospital – Psychiatry
10. Victoria England, MBA, B.S.N., RN, NE-BC
Magnet Program Director, Office of Nurse Excellence
11. Kimberly Harrison, B.S.N., RN, CCRN
Registered Nurse, Zale Lipshy University Hospital
– Neuroscience ICU
12. Tracy Heineman, B.S.N., RN, CCRN
Registered Nurse, Resuscitation Team
13. Beth Hernandez, A.S., RN, PCE
Registered Nurse, Clements University Hospital
– Labor and Delivery
14. Cynthia Hill, B.S.N., RN
Nurse Manager, Zale Lipshy University Hospital
– Rehabilitation
15. Stephanie Huckaby, M.S.N., RN-BC, NEA-BC, CSSGB
Director of Nursing – Surgical Specialty
16. Abdulkadir Kamal, B.S.N., RN
Registered Nurse, Zale Lipshy University Hospital
– Neuroscience ICU
17. Micki Lacker, M.S.N., APRN, ANP-BC, CEPS
Nurse Practitioner, Cardiology
18. Sarah McCraw, B.S.N., RN
Registered Nurse, Outpatient Surgery Center
19. Kristen Montgomery, B.S.N., RN
Registered Nurse, Clements University Hospital
– Emergency Department
20. Rocky Sonemangkhara, B.S.N., RN, CCRN
Registered Nurse, Clements University Hospital
– 8 South Medical ICU
Dallas-Fort Worth Great 100 Nurses
Dallas-Fort Worth Great 100 recognizes 100 professional
registered nurses each year who have been nominat-
ed by their peers, practice sites, families, and patients
entrusted to their care. Each year, Great 100 honors
excellence in the art and science of nursing across all
practice areas, including acute care, sub-acute care,
school nursing, nurse leaders, academics, and many
more. UT Southwestern was honored to have four nurses
receive this award in 2017.
D Magazine Excellence in Nursing Awards
Each year, D Magazine honors excellence in nursing through an award recognizing nurses who have made a difference
in the lives of their patients and colleagues. These nurses are nominated by their peers, co-workers, and patients.
Through a selection committee, 20 winners were recognized in 20 categories. UT Southwestern is proud to salute
our 20 recipients of the 2017 D Magazine Excellence in Nursing Awards.
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16 17 18 19 20
DFW Great 100 recipients
Left to right: Candice Coker, B.S.N., RN; Denise Bulpitt, B.S.N., RN, IBLCL; Tomas Armendariz, B.S.N., RN, CMSRN; Michelle Blacketer, B.S.N., RN, ONC, BMTCN
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Transformational Leadership 15Transformational Leadership14
DAISY Award
To recognize our amazing nurses in direct patient care,
UTSW has partnered with the DAISY Foundation, which
established the DAISY (Diseases Attacking the Immune
System) Award in memory of J. Patrick Barnes, who died
at age 33 of idiopathic thrombocytopenic purpura (ITP),
an autoimmune disease. After witnessing the skilled,
caring, and compassionate nursing Patrick received, the
Barnes Family created this national award as a way to
say “thank you” to nurses everywhere. Any nurse can be
nominated for the DAISY Award. The award committee
selects one nurse each month from a hospital or hos-
pital-based clinic who exemplifies our mission. Each
month’s winner receives a nominee pin, a DAISY Award
recipient pin, a Healer’s Touch hand-carved statue, and
an award certificate. In addition, the selected nurse’s
unit receives a banner to post for the month and freshly
baked cinnamon rolls for everyone on the day the award
is presented. DAISY honorees from UT Southwestern for
2017 were:
1. William Algood, B.S.N., RN – 8 North CUH
2. Rebecca Dill, B.S.N., RN – Apheresis
3. Vickie Lamb, RN – Kidney, Liver & Pancreas Clinic
4. William Langford, A.D.N., RN – 7 South SICU CUH
5. Teofila Loza, B.S.N., RN – 6 North CUH
6. Rebecca Workman, RN, CCRN – 7 South SICU CUH
7. Abbie Money, B.S.N., RN – 10 North CUH
8. Jennifer Goodman, B.S.N., RN, OCN – Simmons Cancer
Center Infusion
9. Shannon Chalk, B.S.N., RN, CCRN-CMC – 7 South SICU CUH
10. Rebecca Tutt, B.S.N., RN-BC – DAISY Nurse Leader
Strauss Award
The quarterly Strauss Award recognizes employees who
exemplify excellent care and service in a professional
and positive manner, dedication to teamwork, and com-
passion for patients, guests, and co-workers. Employees
from Clements University Hospital, Zale Lipshy University
Hospital, and UT Southwestern clinics are recognized.
Honorees in 2017 were:
1. Angela Buchman, B.S.N., RN
Assistant Nurse Manager,
11 South Bone Marrow Transplant, CUH
2. Cindy Harper, M.A.-M.A.S., B.S.N., RN
Ambulatory Nursing Supervisor, Occupational Health
3. Nina Kwon, B.S.N., RN, RNC-NIC
Direct Patient Care, 5 North Neonatal ICU, CUH
4. Hlaing “Sue” Thu, B.S.N., RN, CRN
Direct Patient Care, Imaging Services, CUH
5. Martin Macias, B.S.N., RN, CMSRN
Direct Patient Care, Apheresis,
Zale Lipshy University Hospital
6. Mandy Winkler, B.S.N., RN
Ambulatory Nurse, Neurology and Neurotherapeutics
7. Kelly Moore, RN, OCN
Nursing Supervisor, Harold C. Simmons Comprehensive
Cancer Center – Fort Worth
8. Astrid Medrano, B.S.N., RN
Ambulatory Nurse, Aston Urology Clinic
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Transformational Leadership 17Transformational Leadership16
Press Ganey Nurse of the Year
Dawn Brown, M.S.-M.A.S., B.S.N., RN, NE-BC, Clinical Manager of the Surgical Specialty Unit at William P. Clements Jr.
University Hospital, was named the 2017 Nurse of the Year by Press Ganey, a national consulting firm specializing in
health care performance.
The national award recognizes the contributions of an outstanding direct care nurse who has gone above and beyond
in his or her role and demonstrated care innovation, transformation, and collaboration that support an exceptional
patient experience.
UTSW Nurse Excellence Awards
During Nurses Week in May 2017, UTSW bestowed its
second annual Nurse Excellence Awards. More than 65
potential recipients were nominated by their peers for
exemplifying what it is to be a role model, a leader, a
compassionate caregiver, and a significant contributor
who works to improve the community, organization, and
patient outcomes through effective listening, inspiring
others, actively participating in the community, and
devotion and compassion in caring for patients and their
families. The five winners of the 2017 Nurse Excellence
Awards were:
1. Keri Draganic, D.N.P., APRN, ACNP-BC
Heart, Lung, Vascular Services
2. Susan Neill, B.S.N., RN
Solid Organ Transplant Program
3. Julie Cox, B.S., B.S.N., RN
Clements University Hospital, 9 South CVICU
4. Kelli Holzwarth, B.S.N., RN
Clements University Hospital, 6 North
5. Rebecca Deisler, B.S.N., RN, PMHN-BC
Nurse Manager, Zale Lipshy University Hospital,
Psychiatry
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“She worked diligently with the staff to improve
our patients’ pain control,” Ms. Bailey wrote in
her nomination. “She took the crucial first step of
listening to feedback from patients, from which
she gleaned that a few nurses were very good at
managing pain.
“Dawn met with those nurses and asked them
what they were doing differently from the rest of
the staff,” Ms. Bailey continued. “She then intro-
duced strategies of these nurses to the unit-based
council and to the rest of the nursing staff. Chang-
es did not happen overnight, but with focus and
rounding for outcomes, the culture did change.”
Ms. Brown’s supervisor, Stephanie Huckaby,
M.S.N., RN-BC, NEA-BC, said Ms. Brown “has
worked really hard making the patient experience her priority, and
her efforts paid off. Dawn is a role model for her team and her peers.
We are lucky to have her on the team!”
Ms. Brown has been with UT Southwestern for 12 years and was
nominated for the award by fellow nurse Renee Bailey, M.S.-
M.A.S., M.S., B.S.N., RN, CNOR. Ms. Bailey specifically identified the
improvements and culture change resulting from Ms. Brown’s
leadership in the area of pain management for surgical patients
on her unit, 6 North.
UTSW’s Dawn Brown, M.S.-M.A.S., B.S.N., RN – the 2017 Press Ganey Nurse of the Year
2017 UT Southwestern Nurse Excellence nominees
Transformational Leadership 19Transformational Leadership18
Left to right: Robin Kochethu, B.S.N., RN; Kelli Holzwarth, B.S.N., RN, CMSRN
Other Honors and Recognition
Several UTSW nurses were named 2017-2018 Neuroscience
Nursing Research Center Fellowship recipients, including:
Kaylynn Armstrong, B.S.N., RN
Byron Carlisle, B.S.N., RN, CCRN
Elizabeth Dawson, B.S.N., RN, CNRN
Lakina Ferguson, RN
Zenebe Geneme, M.S.N., RN
Patricia Zulim, B.S.N., RN, PMHN-BC
In addition, Charlene Wilson, the CMOA for the Digestive
and Liver Diseases Clinic, was the winner of the Stand Up for
Patient Safety Pledge Raffle.
Winners of the Patient Safety Poster Contest:
1st place – Otolaryngology Clinic
2nd place – Urogynecology and Pelvic Disorders Clinic
Honorable Mentions – Mineral Metabolism Clinic
and Multispecialty Clinic
Daffodil Baez, Manager of Multidisciplinary and Vascular Surgery
Clinics, won the Ambulatory Patient Safety Advocate Award* for
the month of March.
*This award is presented monthly to an individual who promotes
patient safety through effective event reporting.
2017 Neuroscience Research Fellowship recipients
Transformational Leadership in Practice: CRNAs’ Role in Enhancing Recovery After Surgery
Patients at UT Southwestern undergoing a surgical procedure come in contact with many types of caregivers, including
Certified Registered Nurse Anesthetists (CRNAs) who work alongside anesthesiologists to provide necessary inter-
ventions to ensure comfort and safety. CRNAs at UTSW are visible in the operating rooms of Clements and Zale Lipshy
University Hospitals as well as the various surgical centers and procedural areas within UTSW Medical Center. They are
an important part of the patient’s surgical experience and participate in the Enhanced Recovery After Surgery, or ERAS,
pathway or protocol to optimize and hasten functional recovery after a procedure.
ERAS was pioneered by Danish surgeon Henrik Kehlet, M.D.,
Ph.D., who noted that when a patient was able to maintain
reasonable fluid intake, avoid introduction of tubes and cath-
eters, and have food intake up to several hours before surgery,
patients recovered more quickly with return of bowel function,
mobility, and early nutritional intake. In addition, maintaining
normotherapeutic parameters, reducing intravenous fluid
intake during surgery, and managing pain expectantly are
well-defined areas where the CRNA can make an impact on
patient recovery.
In an effort to introduce ERAS to the local community, includ-
ing UTSW employees, CRNAs at UTSW developed and held an
ERAS Symposium on February 10, 2018. At the helm of this
symposium were clinical educators Amanda Virginia D.N.P.-A.,
CRNA; Clay Freeman D.N.P.-A., CRNA,; and Chief CRNA of Clinical
Operations Tommy Sawyers D.N.A.P., CRNA. Goals of the ERAS
symposium included showcasing the concept behind ERAS,
supporting changes necessary in health care related to quality
care, decreasing costs, improving outcomes, and increasing
professional exposure to UTSW Medical Center.
ERAS is inherently designed to involve a multidisciplinary
approach to optimizing all areas of patient care for improved
outcomes. For this reason, leaders of the symposium designed
the offerings to include registered nurses, advanced practice
providers, physicians, and any others interested in participating in
or even developing an ERAS pathway in their own environment.
These members of the CRNA group have partnered with area
hospitals, clinical educators, and continuing medical education
(CME) staff to ensure provisions are in place for acquisition of
CME units based on the academic content of the conference.
Attendees were able to take back what they have acquired and
apply principles learned to surgical populations in their locations.
Kelli Holzwarth, B.S.N., R.N., celebrates Nurses Week, which highlights professional advancement opportunities for all nurses.
Transformational Leadership 21Transformational Leadership20
Members of the newly created Care Coordination Team at UT Southwestern work together to improve the patient experience and reduce readmissions.
Former State
At the beginning of 2017, nursing leadership assessed the state
of care coordination. The Care Coordinator (RN) role had been
embedded in every unit and was designed to not only drive but
champion collaboration within the interdisciplinary care team.
Social workers were also critical members of the care team,
primarily responsible for the psychosocial needs of the patients
and their post-acute care transitions.
Individual care coordinators reported directly to the Clinical
Nurse Managers of their respective units, and social workers
reported through a separate department altogether. The different
reporting channels contributed to variation in care coordination
practice across units and role confusion among the care team,
which included physicians, social workers, and the care coordi-
nators. Ultimately, leaders concluded that this confusion could
affect patients.
Current State
To address this confusion and other challenges, all care coordi-
nators and social workers were moved into a single department,
with a centralized leadership team. A Manager of Care Coordina-
tion, with the credentials of a social worker, now leads the team
of social workers and care coordinators, while a Director of Care
Coordination, with the credentials of an RN, directs the efforts
of the department. Having both a social worker and a registered
nurse as part of the leadership team was a department priority to
ensure an interdisciplinary approach for care coordination. The
entire department reports to the Chief Nurse Executive.
Collaboration Key to Creation of New Care Coordination Department
As part of the UT Southwestern mission to provide an excellent patient experience, we are continually looking for
opportunities to provide more collaborative, patient-focused care. A major initiative in 2017 to fulfill that mission was
the creation of the Care Coordination Department.
At pre-implementation and six months post-implementation,
care coordinators and social workers were asked for their
perceptions on the following two points: how supported they
felt from the organization as a whole, and how strong they felt
the level of collaboration was between the two disciplines.
While there is still opportunity for improvement, both domains
saw significant improvement over the first six months of the
department.
Future State
The Care Coordination Department continues to evolve to best
meet the needs of patients and families. For the coming year, the
department will be focusing on reducing LOS and unplanned
hospital-wide readmissions within 30 days. The focus on collabo-
rative work between members of the care team will also continue
as a foundation for the future.
The intended consequences of this change were:
nTo provide a more focused approach to care coordination that
will better align with the community population health
approach toward a transitions of care model
nTo improve financial strategies aimed at improving length
of stay (LOS) and reducing readmissions
nTo provide a more efficient use of staffing resources by
consolidating under a single departmental structure with
shared goals and measurements of success, and combined
leverage to overcome barriers
nTo improve employee satisfaction by providing a peer group
and common support system as a means to more effectively
identify opportunities for growth and development
Once the change was made, the new leadership team went to work to
promote a culture of collaboration. Department town hall forums were
held to receive staff feedback on the changes being implemented,
and team-building activities were conducted to help build a sense of
community and camaraderie.
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20
25Excellent Support
Solid Support
Somewhat Supported
Very Little Support
No Support
August 2017February 2017
How Supported do you feel in your role? (all staff)
Num
ber
of S
taff
0
5
10
15
20
25
Excellent Support
Solid Support
Somewhat Supported
Very Little Support
No Support
August 2017February 2017
How Supported do you feel in your role? (all staff)
Num
ber
of S
taff
0
5
10
15
20
25Excellent Support
Solid Support
Somewhat Supported
Very Little Support
No Support
August 2017February 2017
How Supported do you feel in your role? (all staff)
Num
ber
of S
taff
0
5
10
15
20
25
Excellent Support
Solid Support
Somewhat Supported
Very Little Support
No Support
August 2017February 2017
How Supported do you feel in your role? (all staff)
Num
ber
of S
taff
0
5
10
15
20
25Excellent Support
Solid Support
Somewhat Supported
Very Little Support
No Support
August 2017February 2017
How Supported do you feel in your role? (all staff)
Num
ber
of S
taff
0
5
10
15
20
25
Excellent Support
Solid Support
Somewhat Supported
Very Little Support
No Support
August 2017February 2017
How Supported do you feel in your role? (all staff)
How supported do you feel in your role? (all staff)
Num
ber
of S
taff
0
5
10
15
20
25
Excellent
Adequate
Inconsistent
Poor
Non-Existent
August 2017February 2017
How would you describe the teamwork between care coordinators and social workers (all staff)
Num
ber
of S
taff
0
5
10
15
20
25
Excellent
Adequate
Inconsistent
Poor
Non-Existent
August 2017February 2017
How would you describe the teamwork between care coordinators and social workers (all staff)
Num
ber
of S
taff
0
5
10
15
20
25
Excellent
Adequate
Inconsistent
Poor
Non-Existent
August 2017February 2017
How would you describe the teamwork between care coordinators and social workers (all staff)
Num
ber
of S
taff
0
5
10
15
20
25
Excellent
Adequate
Inconsistent
Poor
Non-Existent
August 2017February 2017
How would you describe the teamwork between care coordinators and social workers (all staff)
Num
ber
of S
taff
0
5
10
15
20
25
Excellent
Adequate
Inconsistent
Poor
Non-Existent
August 2017February 2017
How would you describe the teamwork between care coordinators and social workers (all staff)
Num
ber
of S
taff
0
5
10
15
20
25
Excellent
Adequate
Inconsistent
Poor
Non-Existent
August 2017February 2017
How would you describe the teamwork between care coordinators and social workers (all staff)
How would you describe the teamwork between care coordinators and social workers? (all staff)
Structural Empowerment 23Structural Empowerment22
Structural Empowerment: The shared
governance model at UT Southwestern Medical
Center is an organizational structure in which
clinical nurses have a voice in determining nursing
practice, standards, and quality of care.
Our Shared Governance Council structure is built on the foundation of teams coming together to create and
implement actions that result in quality patient outcomes. Nurses from all areas expand their awareness,
broaden their knowledge, and enhance their ability to make the best decisions for our patients and their families.
More than 685 direct care nurses and clinical staff participate in shared decision-making through unit-based
councils, committees, and the UT Southwestern Hospital and Hospital-Based Clinics Council structure.
This approach fosters an atmosphere of teamwork and professionalism and empowers every nurse to take
ownership and pride in their work and to have a voice in their nursing units.
UTSW has a strong shared governance structure
that includes all staff from all areas and disciplines,
as reflected in the examples on the following pages.
Unit-Based Council (UBC)
Research & Evidence-Based Practice Council
Nurse Executive Board
Practice Council
Quality & Safety Council
From left: Paula Jones, B.S.N., RN; Daniela Aguero, B.S.N., RN; Meena Punnoose, B.S.N., RN; Julie Greer, B.S.N., RN, Nurse Manager; Jessica Adams, M.S.N., RN, AGACNP-BC; Alyssa Johnson, B.S.N., RN
Structural Empowerment 25Structural Empowerment24
PACU Length of Stay
PACU N=34Mean time: 165 mins. Median time: 135 mins.
Minutes
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34
400
350
300
250
200
150
100
50
0375 240 255 240 240 240 55 240 155 135 150 100 112 283 95 149 110 116 79 183 114 116 150 91 308 123 321 84 141 130 194 84 104 108
lPts. 1-17 May 2, 2016 - Oct.17, 2016 lPts. 18-44 Oct.17, 2016 - June 12, 2017lLOS in PACU Mins
Improving Kidney Transplant Transition of CareHistorically, kidney transplant patients at UT Southwestern were admitted to the Surgical Intensive Care Unit
(SICU) immediately after their operation, without consideration of clinical necessity. Our transplant surgeons
thought there was a better, more efficient, and more patient-centered way. In a nutshell, their idea was to
send all qualifying patients to our Post-Anesthesia Care Unit (PACU) immediately following their surgery and
then, when ready, transfer them to our acute nursing unit at 7 North. Doing so, surgeons felt, would have a
positive impact on patient satisfaction and reduce direct patient costs while also improving throughput and
increasing SICU bed availability.
Successful implementation would require collaboration among
staff of the SICU, PACU, and 7 North and a significant amount of
education in a short time, along with making sure all equipment
and other logistics were in place.
Involved stakeholders met in February 2016 and established
goals and clinical criteria, along with key steps for the plan’s
implementation. In the weeks that followed, staff education
focused on the immediate post-procedure care of the kidney
transplant patient. The SICU team was the primary change
facilitator, providing resources, nurses, and pearls of wisdom
to the staffs of PACU and 7 North. In addition, there were also
physician-led educational sessions, all of which were recorded
for onboarding and continuing education. By March 2016, the
staff education phase was complete and staffing ratios for the
intervention group were identified and implemented.
On May 2, 2016, the new transition of care plan had its first
kidney transplant patient. Leadership within the PACU, 7 North,
SICU, and transplant clinic teams worked together closely to
ensure all went according to plan – which it did, seamlessly.
Over the next month, the teams held regular debriefing sessions,
and by the end of June 2016 they had identified and implement-
ed the following opportunities:
nDevelopment of a communication plan
nCreation of an escalation tree
nDevelopment of a standardized handoff from PACU to 7
North, including pre-op interventions such as a Criticore
monitor and a hospital bed for post-procedure care
nCreation of a transplant notification process
nDevelopment of phase-of-care orders that were
PACU-specific and now also used in 7 North
nTransitioning from limited hours to 24/7 capability in
the PACU using existing call coverage
With the successful implementation of this plan (see accompa-
nying graphs), it is now our practice at UT Southwestern that all
qualifying postoperative kidney transplant patients go to the
PACU for post-anesthesia care and recovery and then transition to
the inpatient unit at 7 North. Patient satisfaction is higher, patients’
lengths of stay in the hospital have decreased, and direct patient
costs are lower as a result.
OR to ICU OR to ICUto staffing
OR to PACUto ICU
OR to PACUto 7 N
0
5
10
15
20
Pts. 18-44 October 30, 2016-June 12 2017
Pts. 1-17 May 2, 2016-October 17, 2016
OR to ICU OR to ICUto staffing
OR to PACUto ICU
OR to PACUto 7 N
0
5
10
15
20
Pts. 18-44 October 30, 2016-June 12 2017
Pts. 1-17 May 2, 2016-October 17, 2016
24 4
1 2 2
9
20
OR to ICU OR to ICUto staffing
OR to PACUto ICU
OR to PACUto 7 N
0
5
10
15
20
Pts. 1-17 May 2, 2016-Oct. 17, 2016
Pts. 18-44 Oct. 30, 2016-June 12, 2017
24 4
1 2 2
9
20Kidney Transplants by Postoperative Destination
Impact on Direct Cost and Length of Stay
32 cases 10 cases
$0
$20000
$40000
$60000
$80000
$100000
$120000
$140000
PACU = No (n=10)PACU = Yes (n=32)
4.00
$109,512
5.00
$116,456
Med
ian
LO
S (D
ays)
Med
ian
Dir
ect C
ost (
$)
10.00
9.00
8.00
7.00
5.00
6.00
4.00
3.00
2.00
1.00
Impact on Direct Cost and Length of Stay
32 cases 10 cases
$0
$20000
$40000
$60000
$80000
$100000
$120000
$140000
PACU = No (n=10)PACU = Yes (n=32)
4.00
$109,512
5.00
$116,456
Med
ian
LO
S (D
ays)
Med
ian
Dir
ect C
ost (
$)
10.00
9.00
8.00
7.00
6.00
5.00
4.00
3.00
2.00
1.00
Impact on Direct Cost and Length of Stay
OR to ICU OR to ICUto staffing
OR to PACUto ICU
OR to PACUto 7 N
0
5
10
15
20
Pts. 18-44 October 30, 2016-June 12 2017
Pts. 1-17 May 2, 2016-October 17, 2016
OR to ICU OR to ICUto staffing
OR to PACUto ICU
OR to PACUto 7 N
0
5
10
15
20
Pts. 18-44 October 30, 2016-June 12 2017
Pts. 1-17 May 2, 2016-October 17, 2016
24 4
1 2 2
9
20
OR to ICU OR to ICUto staffing
OR to PACUto ICU
OR to PACUto 7 N
0
5
10
15
20
Pts. 1-17 May 2, 2016-Oct. 17, 2016
Pts. 18-44 Oct. 30, 2016-June 12, 2017
24 4
1 2 2
9
20
Unplanned Postoperative Events within 24 hours post-op
0
1
2
Pts. 18-44 October 30, 2016-June 12, 2017
Pts. 1-17 May 2, 2016-October 17, 2016
Unplanned
Unplanned Postoperative Events within 24 hours post-op
0
1
2
Pts. 1-17 May 2, 2016-Oct. 17, 2016
Pts. 18-44 Oct. 30, 2016-June 12, 2017
Unplanned
1
0
Unplanned Postoperative Events within 24 Hours Post-op
Unplanned Postoperative Events within 24 hours post-op
0
1
2
Pts. 18-44 October 30, 2016-June 12, 2017
Pts. 1-17 May 2, 2016-October 17, 2016
Unplanned
Unplanned Postoperative Events within 24 hours post-op
0
1
2
Pts. 1-17 May 2, 2016-Oct. 17, 2016
Pts. 18-44 Oct. 30, 2016-June 12, 2017
Unplanned
1
0
Unplanned Postoperative Events within 24 hours post-op
0
1
2
Pts. 18-44 October 30, 2016-June 12, 2017
Pts. 1-17 May 2, 2016-October 17, 2016
Unplanned
Unplanned Postoperative Events within 24 hours post-op
0
1
2
Pts. 1-17 May 2, 2016-Oct. 17, 2016
Pts. 18-44 Oct. 30, 2016-June 12, 2017
Unplanned
1
0
Structural Empowerment 27Structural Empowerment26
Enhancing the Patient and Family Experience
At the beginning of 2016, patient satisfaction scores in the
Surgical Services department were not where we wanted them.
Based on data from independent health care consulting firm
Professional Research Consultants Inc. (PRC), we isolated areas
for improvement and took action.
After forming a committee with the express goal of scrutinizing
customer service skills within the department, we devised a
survey that included elements encompassing the entire time
patients and families were with us, from check-in to discharge,
each question related to what specifically defined excellent
care. Based on responses from more than 200 patients and their
families, we designed and implemented several initiatives that
had immediate effect.
Chief among our improvement measures was the creation of a
new position, which we dubbed our Patient Champion. In addition
to updating families regularly regarding the progress of their loved
one’s surgery, the Patient Champion was tasked with providing
general support and comfort to families while they waited,
whether that included serving snacks or answering questions that
might come up along the way via a direct phone line.
Other initiatives included:
nHaving a welcome card with the name the patient wishes to
be called waiting on the stretcher upon the patient’s arrival
for day surgery
nImplementing a post-op prescription process through
which patients can receive filled prescriptions prior to
their discharge
nIncreasing PACU visitation from less than 50 percent to
100 percent
By the start of 2017, as the accompanying graphs show, the
department’s data in all PRC areas drastically improved, resulting
in an enriched experience for our patients and their families and
satisfaction scores that were, in most cases, literally off the charts.
Program Emphasizes Teamwork Strategies
for End-of-Life Care
More than 45 staff nurses from UT Southwestern’s William
P. Clements Jr. University Hospital attended the End-of-Life
Nursing Education Consortium (ELNEC) held in October 2017 at
the Harold C. Simmons Comprehensive Cancer Center on the
UTSW campus. ELNEC has an evidence-based curriculum that
is sponsored by the City of Hope and the American Associa-
tion of Colleges of Nursing (AACN). Topics covered within the
curriculum include: Introduction to Palliative Care; Pain and
Symptom Management; Communication; Ethics/Culture; Final
Hours; Loss, Grief, and Bereavement; and Self-Care.
To date, more than 670,000 nurses and other health care providers
across the U.S. have received ELNEC training. Portions of the ELNEC
curriculum are developed to support nurses caring for critical care
patients, veterans, and pediatric patients; additional portions are
designed to serve academic faculty and undergraduate nurses.
The benefits of ELNEC training expand beyond bedside care into
the support of self-care and teamwork strategies for nurses. The
goal is to provide ELNEC conferences at least two to three times
per year, which includes continuing education credits for any nurse
wanting to attend the conference.
Women’s Resource Center Expands Services
With Online Classes, Other Initiatives
The 5 South Labor & Delivery unit at William P. Clements Jr.
University Hospital is a 16-bed LDR with five prep and recovery
rooms and three operating suites; the unit is designed to care for
women throughout all stages of their pregnancy and delivery.
The experienced nurses on 5 South provide care to a wide range
of patients, including high-risk obstetrics patients and women
desiring a natural childbirth experience, and are supported by
a uniquely skilled team of seven certified nurse midwives, four
maternal-fetal medicine physicians, and 15 staff OB physicians.
Of the 63 staff members providing patient care on 5 South, 75
percent hold a B.S.N. and 45 percent are certified in their specialty
area. Most notably, Beth Hernandez, RN, a 5 South nurse with 23
years of experience, received D Magazine’s Excellence in Nursing
Award for her numerous positive contributions to the unit. Among
those contributions was her involvement in spearheading an
online staff self-scheduling initiative. The environment on 5 South
is enriched by the involvement in ongoing collaboration with the
UT Southwestern High Reliability Team to integrate technologically
advanced real-life maternal simulations into its annual educational
offerings to enhance patient safety and improve communication
between providers and frontline staff. These simulations encour-
age participation in all facets of the multidisciplinary team, which
includes physicians and anesthesia staff.
The 6 South Mother-Baby Care team and the Women’s Resource
Center aim to provide the best patient experience in a family-cen-
tered environment while providing individualized attention and
education, reassurance, and quality care in each stage of pregnancy
and beyond. In October, online prenatal classes and breastfeeding
classes started for UT Southwestern patients. These classes are
offered in addition to traditional classroom sessions for childbirth,
baby care, and breastfeeding.
Other accomplishments of this nursing team in 2017 included:
nIn March, Women’s Services outsourced the hearing screens
for our babies. This was a significant cost savings for the
organization and offers more accurate technology for early
identification of hearing deficits.
nThe 5N Neonatal Intensive Care Unit completed its first
American Academy of Pediatrics level of care survey with
zero deficiencies.
Nurses’ Understand and Caring
0
20
40
60
80
100 Out Surg 90th percentile
% Excellent
Out of Surg % Excellent Rank*
Q3 17Q2 17Q1 17Q4 16Q3 16Q2 16Q1 16+
Nurses’ Understanding and Caring**
0
20
40
60
80
100 Out Surg 90th percentile
% Excellent
Out of Surg % Excellent Rank*
Q3 17Q2 17Q1 17Q4 16Q3 16Q2 16Q1 16+
Overall Qualty of Nursing CareOverall Quality of Nursing Care**
Staff’s Responsiveness to Requests
0
20
40
60
80
100 Out Surg 90th percentile
% Excellent
Out of Surg % Excellent Rank*
Q3 17Q2 17Q1 17Q4 16Q3 16Q2 16Q1 16+
Staff’s Responsiveness to Requests**
Staff Easing Worries?Fears
0
20
40
60
80
100 Out Surg 90th percentile
% Excellent
Out of Surg % Excellent Rank*
Q3 17Q2 17Q1 17Q4 16Q3 16Q2 16Q1 16+
Staff Easing Worries/Fears**
Staff’s Courtesy and Helpfulness
0
20
40
60
80
100 Out Surg 90th percentile
% Excellent
Out of Surg % Excellent Rank*
Q3 17Q2 17Q1 17Q4 16Q3 16Q2 16Q1 16+
Staff’s Courtesy and Helpfulness**
Staff’s Courtesy and Helpfulness
0
20
40
60
80
100 Out Surg 90th percentile
% Excellent
Out of Surg % Excellent Rank*
Q3 17Q2 17Q1 17Q4 16Q3 16Q2 16Q1 16+
*Rankings are based on PRC Norm data. **The data in this chart has been filtered. +Marked bars are statistically significant.
Nursing care is essential for creating a peaceful end-of-life experience.
Structural Empowerment 29Structural Empowerment28
Timely, Focused Nursing Contributes to Reduced
Acute Care Readmissions
Going into 2016, the percentage of patients being returned
from our Inpatient Rehabilitation Unit to acute care settings
was not where we wanted it and was, in fact, greater than the
percentage at like regional/national inpatient facilities. After
identifying and addressing all causes of patients needing to
return to the acute care environment, we set a goal of lowering
our readmission rate to the regionally adjusted benchmark
of 10.3 percent (or less) by Dec. 31, 2017. As the chart below
shows, our commitment to timely, focused care in the inpatient
unit along with other concentrated efforts resulted in our
surpassing that goal significantly.
Taking Charge: Nurses Use Electronic Medical
Records to Streamline Handoff Process
Background for why the project took place:
Charge nurses in our Surgical Intensive Care Unit (ICU) were still
handwriting charge nurse reports with pencil and paper – a
labor-intensive task that not only took a great deal of time but
added risk for errors in transcription and caused nurses to stay over
their shift to complete tasks. Voicing concerns that this process was
inefficient and inaccurate, the team proposed using the electronic
medical record (EMR) as a tool to improve handoff procedures. The
team’s initial goal was to streamline the process and measure the
project’s success by gauging any increase in nurse satisfaction and
decrease in charge nurse incremental overtime by May 2017.
Working with UT Southwestern EMR analysts, the team created a
“charge nurse note” column in the EMR for the nurses to use. This
is a free text column for charge nurses to type information related to
patient handoffs; data from patients’ charts could simply be “cut and
pasted” into this column, for example (see Image 1). Each charge nurse
was educated on how to add this column to the EMR list and how to
use predesigned smart text phrases to further simplify the process.
After initiation of this project, the incremental overtime for our charge
nurses decreased from 8.5 percent to 3.6 percent. The initiating team
followed up with the charge nurses in real time during the trial period
to ascertain if using the electronic report was an improvement from the
paper report, and the responses were overwhelming that the electronic
was the preferred method of conducting handoff. The Surgical ICU
team has since provided education to other nursing inpatient units,
which have also adopted this method of handoff.
The Surgical ICU team focuses on creative best practices aimed at improving the quality of patient care.
Clinical Ladder Promotes Professional Development,
Increased Proficiency
UTSW’s Clinical Ladder process promotes clinical growth and
development, addresses recruitment and retention, and encour-
ages and rewards nurses in direct patient care and non-adminis-
trative roles.
“Recognition, reward, and retention of the experienced nurse in
positions of direct clinical practice – along with the documentation
and adequate description of their practice – are the first steps in
improving the quality of patient care.” (Patricia Benner, M.S., RN,
“From Novice to Expert,” The American Journal of Nursing, 82(3),
1982, p. 407.)
The UTSW Clinical Ladder is open to all clinical nurses involved in
direct patient care.
The Advanced Practice Providers (APPs) who primarily function
in a clinical role must demonstrate fundamental competency in
their day-to-day practice. Professional development that supports
increased proficiency and expertise is essential for UT Southwestern
APPs to reach top of license and optimized scope of practice.
Recognition of the efforts and accomplishments put forth by
clinically focused APPs is available annually with the Advanced
Practice Provider Clinical Ladder (APPCL). Entrance into any tier
of the APPCL is acknowledgment of the intent to acquire new
and enhance existing clinical skills essential to consistent delivery
of high-quality, evidence-based care concurrent with ongoing
0%
5%
10%
15%
20%
1618
8 7
3
Q3TD 2017Q2 2017Q1 201720152015n=168 n=180 n=36 n=39 n=1/27
0%
5%
10%
15%
20%
1618
8 7.7
3.7
Q3TD 2017Q2 2017Q1 201720162015
All STROKE Readmission to aAcutre (RTA) {Goal ≤10%}
All STROKE Readmission to aAcutre (RTA) {Goal ≤10%}
PM&R residents RTA presentations
Nurse-led rapid response debrie�ngs and sepsis education
Nurse management-facilitated interdisciplinary case review
PM&R Residents RTA Presentations
PM&R Residents RTA Presentations
Nurse Management facilitated interdisciplinary case review
n=168 n=180 n=36 n=39 n=1/27
All Stroke Readmissions to Acute (RTA) {Goal ≤10%}
0
50
100
150
200
250
Tota
l Cha
rge
Nur
se H
ours
Wor
ked
% o
f Ave
rage
Incr
emen
tal O
vert
ime
20%
18%
16%
14%
12%
10%
8%
6%
4%
2%
0%
300
350
400
Dec-25Ja
n-8Ja
n-22Feb-5
Feb-19
Mar-5
Mar-19
Apr-2Apr-1
6
Apr-30
May-14
May-28
Jun-11
Jun-25
July-9
July-23
Aug-6
Aug-20Sep-3
Total # Charge HRs worked % of Average Incremental OvertimeBudgeted # Charge HRs
Pay Period Intervals
Give charge RN handoff to oncoming charge RN
Use updated charge RN report sheet for charge
RN handoff
Wait
Manually transcribe all information from RN onto charge RN report sheet
Round on each RN to get current patient information
and plan of care
Wait
Manually transcribe newly admitted patient
information onto charge RN handoff report, including
demographics
Wait
Manually erase all patients no longer on unit
from charge RN report sheet
Access EMR to compare previous patient list to current patient list
Get charge RN report sheet with handwritten patient data/updates from previous shift
Prepare for Charge Nurse (RN) Handoff report
OLD
Give charge RN handoff to oncoming charge RN
Use updated charge RN report sheet for charge
RN handoff
Type updates from RN into charge RN notes column
in EMR
Round on each RN with mobile computer to edit and update patient information
and plan of care
Insert smartphrase into charge nurse notes for
newly admitted patients
Access EMR to view current patient list
Prepare for Charge Nurse (RN) Handoff report
NEW
SICU Charge RN Trend of Incremental Overtime
[ ] Service: Vascular
[ ] Date of admit: 9/22/17
[ ] PMH: HTN, HLD, CKD with baseline Cr 1.35, RCC s/p R nephrectomy 1995, prior open aortic repair for AAA 9 years ago
[ ] Admit Diagnosis: OSH transfer - abdominal pain - found
[ ] Procedure: TEVAR on 9/22
[ ] Plan: Two stage repair - FEVAR tomorrow (9/25)
[ ] Neuro: A/O X 3
[ ] CV: SR, BP Goal <140
[ ] Resp: RA
[ ] GI: Reg; Reflux issues
[ ] GU: voids
[ ] Skin: Bilateral groin incision
[ ] Access: PIV X 3, A Line
[ ] Drips: None
[ ] Restraints:
Charge Nurse Notes
Image 1
Structural Empowerment 31Structural Empowerment30
professional development. Advancement within the APPCL is
recognition that an individual is adding to his/her clinical skill
set and utilizing these skills effectively as well as contributing
to the educational and research missions of UT Southwestern
Medical Center.
Clinnical Ladder participation rate increased 79 percent
from 2016.
*The Advanced Practice Provider Clinical Ladder (APPCL)
underwent a series of process improvements in 2017, which
resulted in 59 percent of the overall gain, as well as:
nStreamlined data management
nSimpler application process
nUtilization of mail merge and DocuSign
nSample applications
nQ&A sessions
nFewer errors
nImproved communication of program requirements
nRecognized customer service to the APPs
nEfficiencies in the review process
nProjected succession plan for awardees
Ambulatory’s newest clinical ladder, the Medical Office Assistant
Clinical Ladder, was enthusiastically received. Within two and a
half weeks of the announcement of the ladder’s creation, admin-
istrators received 29 letters of intent.
APP Mentoring Program Designed to Promote
Professionalism and Enhance Job Satisfaction
The lifespan of a clinician can be cut short when there is some
combination of work overload, professional practice hurdles,
and/or lack of opportunity and support. Mentorships are one
way of bridging the gap between perceptions of instability and
defeat versus strength and purpose. Nationally, formal men-
toring programs have arisen over the past several decades to
combat issues such as high turnover rates and to boost profes-
sional satisfaction. At UTSW, through the querying of advanced
practice providers, a formal matched mentoring program was
developed with a specific purpose: to promote professional
satisfaction in the role of the provider.
APP Mentoring Program 2015-Present
Planning for UTSW’s Advanced Practice Provider Mentoring
Program began in the summer of 2015, when interested APPs
formed a work group to discuss what mentoring meant to
them and compared that to similar programs underway else-
where in the UTSW community. Through frequent meetings,
brainstorming sessions, and a desire to create a product wor-
thy of production, the vision was solidified and the program
was subsequently launched in 2016 with five matched pairs of
mentors and mentees.
Throughout its second year (2017), the APP Mentoring Pro-
gram continued to focus on providing tools to the matching
mentors and mentees to promote achievement of self-devel-
oped S.M.A.R.T. goals over the course of the 12-month long
program. Examples of S.M.A.R.T. goals during the first cohort
included improving knowledge and gaining mastery of the
comprehensive neurologic exam through the development of
a lecture on neuroanatomy; performing as a podium speaker
at a regional level during the course of the year; becoming an
active educator at UTSW through precepting APP students and
giving lectures; and writing a scholarly paper for submission to
a professional journal.
APPs who are interested in participating in the program complete
an application used to match them with a mentor by the commit-
tee. What the mentee achieves is predicated on goal-setting. The
mentor’s role is to provide resources, support, and guidance aimed
at helping the mentee remain on target to goal achievement. At
the completion of the one-year mentorship, mentees present
their work and lessons learned to an audience of their peer cohort,
family, leadership, and invited guests.
Left to right: Abdulkadir Kamal, B.S.N., RN; Shannon Dunleavy, B.S.N., RN, CCRN; Heather Hasan, B.S.N., RN, CNRN
level Four
level Three
level Two
level One
3%
22%
62%
13%
level Four
level Three
level Two
level One
Ambulatory Clinical Ladder Recipients 2016
Ambulatory Clinical Ladder Recipients 2016
22%
3%13%
62%
UTSW Overall Clinical Ladder 2017
level Four
level Three
level Two
level One
20%
16%
44%
20%
Clinical Ladder Recipients 2016? 2017?
level Four
level Three
level Two
level One
Clinical Ladder Recipients 2016? 2017?
16%
20% 20%
44%
Hospital Nursing Clinical Ladder 2017
level Four
level Three
level Two
level One
20%
16%
44%
20%
Inpatient Ladder Recipients 2017
level Four
level Three
level Two
level One
Inpatient Ladder Recipients 2017
18%
9% 21%
11%
*Advanced Practice Provider Clinical Ladder 2017
0 1 2 3 4 5 6 7 8
Summer 2016Summer 2016
0 1 2 3 4 5 6 7 8
Summer 2017Summer 2016
APP Mentoring Program
APP Mentoring ProgramAPP Mentoring Program
Tota
l Num
ber o
f Mat
ched
Pai
rs
Exemplary Professional Practice 33Exemplary Professional Practice32
Exemplary Professional Practice
Exemplary Professional Practice: Encourages, values, and recognizes continuing education
and certification as integral to the professional development of our nurses. Our road map for
the future of nursing includes strategic goals and provides nurses with an environment that
fosters excellence through continual learning and the development of transformational leaders.
Jonathan Philipose, B.S.N., RN
Exemplary Professional Practice 35Exemplary Professional Practice34
Certified Registered Nurses
Nationally certified and state licensed, Advanced Practice
Providers (APPs) at UT Southwestern include Clinical Nurse
Specialists (CNSs), Nurse Practitioners (NPs), Physician Assistants
(PAs), Certified Nurse Midwives (CNMs), and Certified Registered
Nurse Anesthetists (CRNAs).
AAACN Certification
UT Southwestern offers an on-site opportunity every quarter
for ambulatory nurses who are interested in becoming board
certified in the discipline to take part in an American Academy
of Ambulatory Care Nursing (AAACN) certification review course
and leadership training. The two-day course includes eight
hours of certification review material along with leadership ses-
sions delivered by the UTSW Department of Clinical Education
and Professional Development. Since the program’s inception,
35 UT Southwestern RNs have completed the course; the pass
rate for the examination is 100 percent. In 2017, nine UT South-
western RNs participated in the course.
CertificationsUT Southwestern nurses validate their mastery of skills, knowledge, and abilities through certification and
meet ongoing learning and practice requirements through recertification. Patients and families benefit
from certification because it assures them that the nurse caring for them has demonstrated experience,
knowledge, and skill in the complex specialty of their care. Nurse certification and the continuing educa-
tion required to maintain certification contribute to the creation of an environment of professionalism and a
culture of retention. Certification also differentiates UT Southwestern from other health care organizations,
demonstrating to consumers that we have attracted the most skilled and experienced nursing professionals.
Simmons Cancer Center nurses observe Certified Nurses Day, recognizing nurses across the campus in a variety of specialties.
Department of Clinical Education & Professional
Practice (CEPP) Outcomes for 2017
The Department of Clinical Education & Professional Practice
(CEPP) provides support for nurses by offering education, training,
and professional development activities. This includes clinical
orientation, clinical placement, and education on standards of care
and quality improvement. CEPP is committed to achieving and
maintaining excellence and advancing the practice of clinical staff.
Clinical Education Team
CEPP serves as UTSW’s American Heart Association (AHA) Training
Center, providing leadership and vision for AHA programs in terms
of operations and services that are consistent with evidence-based
practice. We also provide oversight to the AHA’s Resuscitation Qual-
ity Improvement (RQI) program, with more than 4,000 clinical staff
taking advantage of Advanced Cardiovascular Life Support (ACLS),
Basic Life Support (BLS), and Pediatric Advanced Life Support (PALS)
renewal in a non-traditional manner.
Clinical Educators/ Professional Development Specialists
Alfonzo Mendoza III, B.S.N., RN, CCRN-CMC, CNRN
Barbara Crim, MBA, RN, CNOR
Carrol Buckner, B.S.N., RN,
Deborah Spitzer, M.S.N., RN, OCN
Delanea Parr, B.S.N., RN-BC
Elsa John, B.S.N., RN
Hazzel Gomez, M.S.N., RN
Liffy Cherian, M.S.N., RN, OCN
Kathie Waldron, M.S.N., RNC-NIC
Karen Relle, B.S., CLS (ASPC)
Pamela Ridgeway, M.S.N., RN, CCRN
Shannon Bowling, D.P.T., PT
Sheena Mathew, M.S.N., RN, CPN
Suzan New, M.S., B.S.N., RN, CNOR
Tarin Prince, B.S.N., RN
Leadership Team
Trish Jackson, M.S.N., MBA, RN, NE-BC
Allen Kirby, MBA, B.S.N., RN
Sue Ruffner, B.S.N., RN
Tracy McGaw, M.S.N., RN, CCRN-K, CNRN
Support Team
Jean Hoyt-Sehnert, M.S., B.S.N., RN, NEA-BC
Jessica McNeil, M.S.N., RNC-OB
Education/Assistant Coordinators
Arlanda Redman, B.S.B.A.
Mia Murphy
Naudia Moore, MBA, B.A.A.S., CMA
Paula Dunn
Tasha Grismore
Certified nurses are recognized each year on March 19th, which is designated as Certified Nurses Day. UT Southwestern has more than 660 certified nurses.
Exemplary Professional Practice 37Exemplary Professional Practice36
UT Southwestern University Hospitals is an approved provider
of continuing nursing education by the Texas Nurses Association
– Approver, an accredited approver with distinction by the Amer-
ican Nurses Credentialing Center’s Commission on Accreditation.
Our Approved Provider Unit is housed within the Department of
Clinical Education and Professional Practice (CEPP) and comprises
a Primary Nurse Planner, Nurse Planners, and an Education
Assistant. The unit provides continuing nursing education (CNE)
as defined by the Texas Nursing Association and the American
Nurses Association, achieving and maintaining excellence and
advancing the practice of clinical staff.
Educational Levels
In October 2010, the Institute of Medicine released its land-
mark report on “The Future of Nursing,” initiated by the Robert
Wood Johnson Foundation, which called for an increase in
the number of baccalaureate-prepared nurses in the workforce
to 80 percent by 2020. The expert committee charged with
preparing the evidence-based recommendations in this report
stated that in order to respond “to the demands of an evolving
health care system and meet the changing needs of patients,
nurses must achieve higher levels of education.”
The UTSW Nursing Executive Board is ultimately responsible for
attaining this 80 percent B.S.N. goal, which we achieved in 2017.
Review Course
The UTSW Solid Organ Transplant program hosted the North
American Transplant Coordinators Organization (NATCO) for
its 2nd annual Regional Certified Clinical Transplant Coordinator
(CCTC) Review Course on March 13-14, 2017. Forty transplant
coordinators from 13 different states and one attendee from
Ontario, Canada, participated in the event. The course is designed
to provide the information and confidence that potential candi-
dates need to pass the examination the first time.
Ambulatory Stats
n80% B.S.N. rate as of 12/31/17
nClinical Orientation: 244 staff as of September 2017
nClinical Placements:
I Started hosting traditional RN students in the ambu-
latory setting as part of their community health course
rotation (6 students, Fall 2017)
II 61 High School Students (HACS)
III 7 MOA externs
nEmergency Management Certifications
I ACLS staff certifications – 210
II ACLS physician certifications – 104
III BLS certifications – 386
IV HeartSaver certifications – 143
nLeadership: Calli Davis, M.S.N.-Ed., RN
nClinical Educators: Mari Ann Lewis, B.S.N., RN-BC; Cara
Hough, B.S.N., RN-BC; Monica Patton, M.S.N.-Ed., RN; Mandi
Longoria, B.S.N., RNC-OB, IBCLC
40%
45%
50%
55%
60%
65%
70%
75%
80%
85%
90%
2017201620152014
Percentage of Direct Care RNs BSN and Above
% o
f RN
s B
.S.N
. pre
par
ed
66.2%
77.5% 78% 79% 80%
Percentage of Direct Care RNs B.S.N. and AboveContinuing Nursing Education
0
500
1000
1500
2000
ParticipantsCNE Hours OfferedPrograms
Continuing Nursing Education
0
500
1000
1500
2000
ParticipantsCNE Hours OfferedPrograms
91
439
1949
Continuing Nursing Education
91 439
1949
UT Southwestern nurses work collaboratively to provide the best possible care and experience for patients.
Exemplary Professional Practice 39Exemplary Professional Practice38
Using Best Practices to Manage Educational Initiatives: Implementation of CHANGE Week
The goal was to create a standardized and uniform approach to
managing initiatives and projects across the organization. When
an educational need is identified, a request form is completed
and placed on a calendar. Nurse executives then review the
requests to ensure initiatives and projects are aligned with
organizational priorities. Upon approval, staff and unit leaders are
made aware of upcoming educational initiatives for the month.
Using an Evidence-Based Model to Assist Staff With High-Risk/Low-Frequency Skills
SQIM: Skill, Quality, Improvement & Maintenance – We imple-
mented an evidence-based model to assist staff with high-risk/
low-frequency skills. This model provides an opportunity for
staff to demonstrate competency of psychomotor skills that
could be problematic or a serious safety risk to our patients if
not performed correctly.
Nurse Satisfaction Survey
Each year, UT Southwestern participates in a nationally bench-
marked nurse satisfaction survey. Literature shows that when
nurses enjoy their jobs and intend to stay in their positions long
term, it translates to improved patient outcomes. Due in part to
the many programs in place at UTSW to support clinical nurses as
they provide quality patient care, the UTSW Division of Nursing
outperforms other academic medical centers in nearly all areas of
nurse satisfaction, as the graph below shows.
Sponsored by:
Live In-Services
Vial 2 Bag—Roving inservices Mid October (All RNs excluding NICU, L&D, anesthesia and CRNAs); Dates TBA
Wound Vac Troubleshooting—Oct 23, 26 and 27th—dates and times to be confirmed via email soon
Zflex offloading boot—Roving inservices Oct 3rd, 4th, 7th
Classes
Transfer Mobility Coach Initial Training—For new TMCs
Oct 3, 10, 17—Register in Taleo
Conferences 2 Day, End of Life Nursing Education Consortium Conference —
Oct 16/17th, 2017; Regis-ter in Taleo
OC
T
23 2017
2017
Elsevier MODULES
Zflex offloading boots– Elsevier AND Live roving in-services - Equipment available October change week– RNs, PCTs, PTs, OTs, Therapy Techs—training; HUCs to receive ordering information; Due 10.23.17
Restraint Policy Update—Elsevier lesson; Due 10.23.17
MEWS/RRT— Elsevier Module—Re-educate nursing staff in MEWS score/response—All nursing staff us-ing Rapid Response Team—Due Date 10.31.2017
Exemplary Professional Practice in Action
APRNs Fill Critical Role in New Epilepsy
Monitoring Unit
The UT Southwestern Epilepsy Program, part of the Peter
O’Donnell Jr. Brain Institute, houses a new Epilepsy Monitoring
Unit (EMU) and with it a new way to provide team care across
the care continuum. The unit leverages the role of Advanced
Practice Registered Nurses (APRNs) in both the acute and ambu-
latory settings, where they not only serve as essential providers
of care but also ensure the coordination and transition of care
for the program’s often complex patients.
“There are thousands of patients with epilepsy in North
Texas, including many with seizures that have not
responded to medications,” explains EMU Medical Director
Ryan Hays, M.D. With the addition of the EMU, “we’re now
able to offer more comprehensive care on the UT South-
western campus and treat more patients.”
The EMU provides a safe inpatient setting where a team
of specialized nurses, including Nurse Practitioner Jessica
Adams M.S.N., APRN, AGACNP-BC, along with technicians
and physicians, can monitor patients using continuous
video and scalp electroencephalogram (EEG) recordings.
Prior to the spring of 2017, patients who needed 24-hour
EEG monitoring in order to locate the source of their sei-
zures required admission to the monitoring unit through
an established partnership at Parkland. While APRNs have been
providing care to these patients in the ambulatory setting for
many years, the addition of APRNs to the new inpatient EMU
was a new and exciting role.
Ms. Adams, for example, provides direct clinical management for
patients admitted to the unit and ensures quality, patient-centric
care. By working in tandem with physician providers and the
care team, she is able to coordinate care starting with admis-
sion, manage epilepsy medications throughout the stay, ensure
proper imaging is obtained, provide patients and families with
necessary education, and transition care to her colleagues in the
ambulatory setting after discharge. The need for patient educa-
tion, shared decision-making, and keeping families informed is
essential to the patients’ diagnostic work-up during their stay.
Families are often frightened, concerned, or confused about the
future. As a key contact for patients and families going through
this process, Ms. Adams serves to keep them informed, allay fears,
and make sure the patient’s needs are met during the EMU stay.
Ms. Adams notes that providing such patient-centered care is a
collaborative effort at the EMU. She and her nurse practitioner
colleagues Mona Cheung, M.S.N., APRN, FNP-C, and Lilian Omburo,
M.S.N., APRN, FNP-C, are part of a large, multidisciplinary team
made up of 35 specialty providers, including neurologists, neuro-
surgeons, neuroradiologists, epileptologists, neuropsychologists,
and other advanced practice providers.
“It is a team sport in that I couldn’t do it alone,” Ms. Adams says.
“It requires the knowledge of the epileptologists to read the EEG;
myself to manage the day-to-day tasks, lab follow up, and plan
of care; EEG techs to hook up and set up the EEG machines; and
the nurses to help deliver the care and test the patients during
seizures. I build a rapport with the patients and the families and
try to make the hospital stay better by helping to alleviate concern
and anxiety in an unfamiliar environment. We give patients and
families answers to questions, not only about their disease process
but also on how to proceed and what the next steps are.”
Left to right: EMU Manager Jennifer Griffin, EMU Medical Director Dr. Ryan Hayes, and APRN Jessica Adams monitor patients using continuous video and scalp EEG recordings.
UT Southwestern 2017 RN Satisfaction vs. NDNQI Academic Medical Centers
0
1.00
2.00
3.00
4.00
5.00
6.00
UTSW
Mea
n RN
Sat
isfa
ctio
n
AutonomyProfessional
DevelopmentOpportunity
ManagerLeadership
RN-RNInteractions
Interprofes-sional
Relationships
Nursing Foundationsfor Quality
of Care
Sta�ng andResourceAdequacy
NDNQI Mean
4.58
4.43
4.81
4.50
3.18
3.07
5.10
5.14
4.03
3.95
3.21
3.10
2.96
2.74
Exemplary Professional Practice 41Exemplary Professional Practice40
Starting the Day in the OR Off Right – and On Time
Especially in the OR, it is so important to have the first case start
on time. Delays are not accurately documented in EPIC, which
leads to an inability to identify trends and develop action plans
for increasing the daily percentage. A multidisciplinary group
at UT Southwestern comprising OR nurses, managers, and SSEC
committee members came together expressly to identify the
root causes hindering patient arrival in the surgery suite and to
increase UTSW’s daily first case on-time percentages from an
average of 60 percent to greater than 85 percent.
The group conducted two pilots. In the first, team members used
a time study observation tool to avoid bias between service lines,
which were limited to general surgery, urology, ENT, neurology,
and ophthalmology. The monitoring was conducted for five weeks.
In the second pilot, team members used both the time study tool
and an electronic scanning time stamp for all disciplines to badge
in for each surgery; service lines this time were limited to cardio-
vascular and thoracic surgery, surgical oncology, and plastic and
reconstructive surgery.
The group not only exceeded its initial 85 percent goal, but the
studies resulted in overall better use of the ORs on campus.
Establishing a New Standard for Alarm Management
In 2016, the adult critical care areas at Clements University
Hospital were experiencing high numbers of physiologic alarms
daily, resulting in potential alarm fatigue for clinicians and pos-
ing a potential safety risk for patients. In order to avoid either
of those potentialities, an alarm safety committee was formed
comprising physicians, technicians, and a dozen nurses. After
monitoring the issue, the committee began a pilot program in
accordance with the requirements of The Joint Commission’s
National Patient Safety Goal 06.01.01 to reduce the harm asso-
ciated with clinical alarms. The pilot, which was conducted from
late October 2016 through late January 2017, was limited to the
hospital’s cardiovascular intensive care unit (CVICU), medical
intensive care unit (MICU), surgical intensive care unit (SICU),
Emergency Department (ED), and neuroscience intensive care
unit (NSICU) with a goal of reducing nuisance alarms and alarm
fatigue by 25 percent in these areas while allowing no adverse
events or near misses related to the piloted changes.
Committee members oversaw the development of a list of critical
alarms by device (e.g., ventilators, infusion pumps, anesthesia ma-
chines, ECMO machines, bed alarms, etc.) and identified those con-
tributing to alarm fatigue by tracking the total number of alarms
per bed per day. During the pilot, those in the CVICU focused on
reducing arrhythmia alarms through default setting changes; those
in the MICU focused on reducing alarm parameters through de-
fault setting changes; and those in the NSICU focused on reducing
alarms through manual customization. All changes were focused
on improving response times to allow earlier intervention to critical
alarms and guiding clinical decision-making.
By the end of the pilot, the committee’s success was clear. The total
alarms in the CVICU alone post-implementation decreased by
51 percent. Due to the pilot’s success, in April 2017 alarm default
setting changes were made in all critical care areas, resulting in a
further decrease in nuisance alarms and a new standard for alarm
management at UTSW.
APRN Boosts Weight Wellness Clinic’s Capabilities
Obesity has become an increasingly more common and serious
condition and is a major driver of health care resource utiliza-
tion and cost. Approximately 36.5 percent of adults in the U.S.
have been categorized as being obese, defined as a body mass
index of ≥ 30. That percentage is slightly less in Texas – 33.7
percent, according to the Centers for Disease Control and Pre-
vention’s 2017 report, “Nutrition, Physical Activity, and Obesity:
Data, Trends, and Maps.”
Obesity results from a combination of genetic, physiological,
behavioral, environmental, and sociocultural factors that lead to
an imbalance between energy intake and expenditure over an
extended period of time. At UTSW, the Weight Wellness Clinic,
within the Division of Endocrinology, provides overweight and
obese patients with a multidisciplinary approach to support
weight loss management and post-bariatric care.
Prior to November 2016, Weight Wellness Clinic Medical Director
Jaime Almandoz, M.D., was the sole provider for these patients and
was faced with growing wait times for both new and follow-up
patients. However, that all changed when Lanese Ogunkua, M.S.N.,
APRN, ANP-C, joined the clinic, allowing Dr. Almandoz to continue to
see new patients and know that established patients were being
seen in a timely manner and cared for by a knowledgeable provider.
Providing access to short-term follow-up in this particular patient
population sustains engagement and motivation through the chal-
lenging journey of chronic weight management.
Ms. Ogunkua joined the Weight Wellness Clinic as a result of her
strong interest in health promotion and wellness. After obtaining
her master’s degree from Temple University, she moved to Texas
and initially worked with diabetic patients, which offered her a
foundational understanding of conditions that adversely alter the
endocrine system, often progressing to comorbid conditions and
negative outcomes. In joining the UTSW Weight Wellness Clinic,
she continues to focus on health and wellness and has enabled the
clinic to care for more patients than ever.
From left: Lauren Cooper, registered dietitian; Lanese Ogunkua, M.S.N., APRN, ANP-C; Medical Director Jaime Almandoz, M.D.; and Alison Jordan, RN, help motivate patients through the challenging journey of chronic weight management at UT Southwestern’s Weight Wellness Clinic.
MICU
CVICU
NSICU
SICU
ED
Total Alarms
(Pre/Post Full Implementation)
118,576/ 56,422
152,043/ 77,933
68,526/ 43,462
54,433/ 45,843
79,710/ 49,331
% Change in Total Alarms
(Pre/Post Full Implementation)
-48%
-51%
-37%
-16%
-38%
Total Alarms Per Bed/Per Day
(Pre/Post Full Implementation)
173/79
216/116
120/74
81/68
71/44
Implementation
Four weeks pre-intervention – Jan 2017Four weeks post-intervention – May/June 2017
% Change in Total Alarms
Per Bed/Per Day
(Pre/Post Full Implementation)
-46%
-46%
-38%
-16%
-38%
0
50
100
150
200
250
NP Test % Total Est
NP Contribution to Patient Access: Weight Wellness
Tota
l En
coun
ters
% o
f Tot
al E
st V
isit
s fo
r Pra
ctic
e
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Nov-16
Dec-16
Jan-1
7
Feb-17
Mar-1
7
Apr-17
May-1
7
Jun-1
7
Jul-1
7
Aug-17
Sep-17
Oct-17
NP Contribution to Patient Access: Weight Wellness
Exemplary Professional Practice 43Exemplary Professional Practice42
Accelerating Wound Therapy With Better Coordination of Care
In 2016, UT Southwestern nurses noticed a spike in the average
number of wound therapy days patients were experiencing, due
primarily to the then-current process for ordering negative-pres-
sure wound therapy systems (also known as vacuum-assisted
closure systems, or VACs) for use by wound ostomy patients
discharging from the acute hospital setting to home. The process
was complex and confusing and often resulted in needless delays,
leading ultimately to patient and staff dissatisfaction. A group of
nurses and administrators decided to do something about it; their
goal was to decrease the average number of days to at least the
national average for such therapy.
Working with UTSW’s Six Sigma Quality Department, the group
analyzed the problem, ranked the top five areas of concern, and
identified key suppliers, inputs, outputs, and process boundaries.
Together, they developed a process map outlining the then-cur-
rent state and future state for wound VAC ordering, giving priority
in the future state to securing physician orders for all eligible
OR patients and using EPIC order groups and alarms to facilitate
timely communication.
The planning, put in place throughout 2017, worked. By the end
of the year, the measures had not only decreased the average
number of wound therapy days by more than 50 percent but
had, as a result, well surpassed the national average of 17.9 days,
ending the year at 7.9 days.
Controlling Diabetes in Low-Income Populations
UT Southwestern has a partnership with North Dallas Shared
Ministries, a charity clinic serving the low-income and uninsured
populations. UTSW physicians and nurses provide care at the
clinic, performing mammograms, pneumonia and flu vaccines,
lab work, and additional work as needed. At the end of 2015, the
percentage of the clinic’s diabetic patients whose blood glucose
(A1C) was uncontrolled (defined as >9 percent) was a shocking 83
percent; at the end of 2016, that figure was down to 46 percent
but still much higher than our Delivery System Reform Incentive
Payment (DSRIP) goal of 33 percent. We were determined to make
2017 a year of change for these patients.
We formed a committee of physicians, nurses, advanced practice
providers, and health care administrators and developed a planned
team focus centered around educating patients about their disease
and how to best manage it. In both one-on-one and group settings,
we emphasized at every contact the importance of committing to
routine follow-up, medication management, nutrition, and exercise.
To help manage the follow-up, we also began running routine regis-
tries for the patients and changed prescribing patterns to incentivize
their regular return to the clinic. In addition, we provided diabetic
testing equipment and supplies for patients who were unable to
afford the out-of-pocket expenses to better monitor their disease.
These efforts made a difference.
As the chart below shows, by March 2017 the percentage of the
clinic’s diabetic patients (ages 18 to 85 years old) with uncontrolled
high blood glucose was already down to 19.23 percent, and the
post-intervention numbers have continued to improve.
Leaders in the Community
One of the most rewarding ways UT Southwestern nurses
share their experience with the community is by lending
their skills, knowledge, and time as volunteers. From formal
volunteer programs to impromptu acts of service, our nurses
make a difference in the health and well-being of their local
communities while also bettering themselves as nurses by
offering their services and lending a hand. UT Southwestern
encourages the nursing staff to participate in many ways
and through many local entities, sharing their expertise and
developing professionally through community involvement.
Highlights from 2017 included:
nUT Southwestern nurses participated in career fairs at
Baylor University, Northwest University, Texas Tech
University, University of Texas at Arlington, and West
Coast University.
nIn May, UT Southwestern held an event called Higher
Opportunities for Professional Excellence, focusing on
connecting UTSW nurses with schools of nursing.
Approximately 110 nurses from across the UTSW campus
attended, and the following schools of nursing
participated in the event: Baylor University, Chamberlain
University, Grand Canyon University, University of Phoenix,
University of Texas at Arlington, Walden University, and
West Coast University.
nIn June, UTSW began a new nurse externship program,
increasing the number of positions from two to 10 across
service lines. Nurse externs are provided a unique
opportunity to observe and learn the professional role
and responsibilities of the RN while working alongside an
assigned preceptor.
nIn FY ’17, total encounters included 407 undergraduate
students with 13,683 hours and 168 graduate students
with 29,189 hours.
nUTSW also hosted its annual High School and College
Student Symposium. This program launched in 2016 and
has already grown significantly.
UTSW hosts a High School and College Student Symposium. This program was launched in 2016 and has grown significantly over this past year.
High School & College Student Symposium
0
20
40
60
80
100
120
140
Attendance Total
10/31/20178/9/20174/1/20172/1/2016
High School & College Students Symposium
6573
97
133
0
20
40
60
80
100
120
140
Attendance Total
2/1/20162/1/20162/1/20162/1/2016
High School & College Students Symposium
6573
97
133
Annual Average Length of Therapy
ALO
T
0
5
10
15
20
25
30
35
40
45
Q3-17Q2-17Q1-17Q4-16Q3-16Q2-16Q1-16
Quarterly Average Length of Therapy
Annual Average Length of Therapy
Pre-Intervention Intervention Post-Intervention
10%
20%
30%
40%
50%
60%
% of Diabetic Patients with A1C>9%
Mar-17Feb-17Jan-17Dec-16Nov-16
50%
50%
26.09%
20.33%
19.23%
North Dallas Shared Ministries – Percent of Patients with Uncontrolled Diabetes (A1C>9%)
Annual Average Length of Therapy
Pre-Intervention Intervention Post-Intervention
10%
20%
30%
40%
50%
60%
% of Diabetic Patients with A1C>9%
Mar-17Feb-17Jan-17Dec-16Nov-16
50%
50%
26.09%
20.33%
19.23%
3.54.8
43.1
8.8
6.1
11.3
5.5
New Knowledge, Innovation, and Research 45New Knowledge, Innovation, and Research44
New Knowledge, Innovation, and Research: UT Southwestern Medical Center’s Nursing
Research Program has two strong components
supporting nursing research within the UTSW
hospitals and hospital-based clinics. Structures
and processes have been developed and imple-
mented to involve more nurses at all levels in the
research process and in disseminating new nursing
knowledge gained through research efforts.
The Nursing Research and Evidence-Based Practice Council works diligently with its members and nurses
across the organization to stimulate research ideas and create an environment of scientific inquiry. The
Neuroscience Nursing Research Center is dedicated to ensuring that nurses at all levels are able to provide
vital research contributions to the science of caring for patients with neurological illness.
Left to right: Anu Mathew, M.S.-HCI, B.S.N., RN, CNN; Carina Letargo, B.S.N., RN
New Knowledge, Innovation, and Research 47New Knowledge, Innovation, and Research46
Using Technology to Improve the Patient ExperienceIn large health care systems, clinic response times to patient calls, messages, and prescription refills have
historically been a problem and a source of patient complaints. At UT Southwestern, each clinic across the
health system averages more than 1,250 telephone messages and 700 MyChart messages every month;
prior to 2017, the average time for personnel to open a MyChart message exceeded 10 business hours.
An interprofessional team comprising nurses, administrators, and
analysts from UT Southwestern’s Ambulatory Services identi-
fied opportunities for changing that history. The group devised
technology-based measures designed to improve responsive-
ness across all UTSW ambulatory clinics. Specifically, they:
nImplemented in all clinics a software program that
automates the prescription refill process to save time
while increasing accuracy. Called Swoop, the
software reduces inconsistent refill orders by applying
evidence-based protocols as the request is entered
into the electronic medical record.
nImplemented a nursing decision support tool, which uses
evidence-based practices to triage symptom-based calls.
nDeveloped health system standards for responding to
patient messages based on guidelines for division of work
that allow nurses and clinical staff to work to the top of
their license, certification, training, and skill set.
The measures had an almost immediate effect, resulting in a
better patient experience and far fewer complaints about not
getting questions answered in a timely manner. By the end of
2017, all ambulatory clinics had achieved:
n90 percent completion of patient messages within one
business day for acute, symptom-based patient questions
and problems
n85 percent completion of patient messages within two
business days for clinical administrative questions,
including FMLA, prior authorizations, etc.
n85 percent completion of patient messages within one
business day for medication refills
Upgrading Transplantation Through Innovation, Efficiency
The Collaborative Innovation and Improvement Network (COIIN)
is a three-year study conducted by the United Network for Organ
Sharing (UNOS) exploring an innovative approach to transplant
performance monitoring. The overall aim of the project is to
increase transplantation, with a particular focus on the utilization
of deceased donor kidneys with a Kidney Donor Profile Index
(KDPI) score of 50-100 percent. The KDPI is a numerical measure
that combines 10 donor factors, including clinical parameters and
demographics, to summarize into a single number the quality of
the deceased donor kidney relative to other recovered kidneys.
The current national average for acceptance of 50-100 percent
KDPI kidneys is 11 percent, and the national average for utilization
is 45 percent. The successful outcome of the pilot project depends
on active transplant center participation in a structured and closely
monitored quality improvement process. UT Southwestern was
one of only 36 transplant centers across the United States chosen
to participate in the second cohort of the COIIN project, which
began in September 2017.
From left: Debby Miller, B.A., B.S.N., RN, CCRN; Crystal Riddle, B.S.N., RN, CCRN; Caitlin Clark, B.S.N., RN, B.S.B. Patient care at UT Southwestern frequently involves nurses' expert use of state-of-the-art technology.
New Knowledge, Innovation, and Research 49New Knowledge, Innovation, and Research48
Nursing-Led Research in 2017
Throughout 2017, UT Southwestern nurses were involved in
nursing research and evidence-based practice initiatives in
specific areas. Many either published their research or presented
their findings in poster and/or podium presentations at profes-
sional gatherings locally and across the country. Some of this
nursing-led research is noted below and on the following pages.
Evidence-Based Practice and Research 2017
Abdulkadir Kamal, B.S.N., RN; DaiWai Olson, Ph.D., RN, CCRN,
FNCS. Enhancing communication for handovers from the oper-
ating room to the ICU (ECHO-ICU).
Susan Alex, D.N.P., APRN, ANP-BC. Quality improvement project:
Exploring barriers among nurses for implementing a depression
screening in stroke patients.
Tomas Armendariz, B.S.N., RN, CMSRN; Shelli Chernesky, M.S.N.,
MBA, RN, CCRN; Julie Earnest, MBA, B.S.N., RN; Dara Mariani,
B.S.N., RN, CCRN; Jim West, B.S.N., RN. Rapid response . . . using
MEWS in apheresis-EBP.
Emelita Bennett, B.S.N., RN, CCRN; DaiWai Olson, Ph.D., RN,
CCRN, FNCS. Exploring the influence of cultural competence
care for patients and providers in an apheresis unit (C3PO).
Angela Carlton, M.S.A., B.S.N., CPTC, CTP; Rhonda Armour,
M.S.N., RN; Kay Jones, RN, CCRN; Sarah Wright, Pharm.D., BCPS.
Infective (bacterial) endocarditis prophylactic guidelines for
heart, lung, liver, kidney, LVAD, CHF, PHTN programs.
Linda Chan, B.S.N., RN, OCN; Chelsea LaFond, B.S.N., RN, OCN;
Donna Matheou, A.D.N., RN, OCN; Sarah Storie, A.D.N., RN, CMSRN,
OCN; Sharon LeRoux, B.S.N., RN, CMSRN, OCN; Linda Ahrens, RN,
OCN. Making appropriate and equitable nurse-patient assign-
ments: Adapting a medical-surgical acuity tool for a surgical-
oncology unit.
Linda Chan, B.S.N., RN, OCN; Sharon LeRoux, B.S.N., RN, CMSRN,
OCN; Melissa Trevino, B.B.S., A.D.N., RN, OCN. Gum chewing as a
clinical intervention study (GUCCI).
Rebecca Dill, B.S.N., RN, QIA; DaiWai Olson, Ph.D., RN, CCRN,
FNCS. The impact of motivational interviewing of self-perceived
burden in chronic neurological patients (MI-Patients).
Amanda Dirickson, M.S.N., APRN, ANP-C, SCRN; Maddy Stewart,
RN; DaiWai Olson, Ph.D., RN, CCRN, FNCS. Helping to educate
women about the risk of stroke (HER stroke).
Linda Dobson, B.S.N., RN; DaiWai Olson, Ph.D., RN, CCRN, FNCS.
Interventions to promote sleep hygiene for patients hospitalized
with cystic fibrosis or pulmonary hypertension (The SHHH Study).
Keri Draganic, D.N.P., APRN, ACNP-BC; DaiWai Olson, Ph.D., RN,
CCRN, FNCS. A retrospective review of preoperative PT value to
postoperative Coumadin levels in mechanical valve replacement
patients (POT-C).
Tobi Duncan, B.S.N., RN, OCN; DaiWai Olson, Ph.D., RN, CCRN,
FNCS. A personalized tracking and education packet for patients
with cancer: A pilot study (TEC Study).
Maria Grabowski, M.S.N., RN, OCN; Deb Spitzer, M.S.N., B.S.N.,
RN, OCN; Shaghayegh Rezaie, M.S., B.S.N., RN, OCN. Educational
needs may add barriers to patient discussion on fertility preserva-
tion for cancer patients.
Kimberly Harrison, B.S.N., RN, CCRN; DaiWai Olson, Ph.D., RN,
CCRN, FNCS. Optimizing how nurses record and monitor cerebral
perfusion pressure (ON RAMP).
Meredith Heath, B.S.N., RN; Kavitha Nair, M.S.N., RN, OCN, NEA-BC;
Liffy Cherian, M.S.N., APRN, AGCNS-BC, OCN. Heparin flushes in the
BMT unit.
Meghan Hoffman, B.S.N., RN; DaiWai Olson, Ph.D., RN, CCRN,
FNCS. Exploring the reliability and correlation of noninvasive
(oscillometric) blood pressure and invasive intra-arterial blood
pressure monitoring in patients receiving a vasoactive medica-
tion: A prospective observational study (ABP/NBP Study).
Max Holder, B.S.N., RN; DaiWai Olson, Ph.D., RN, CCRN, FNCS. The
impact of ultrasound IV placement on DVT risk.
Kelli Hulsman, M.S., B.S.N., RN, IBCLC, LCCE. Maternity practices
associated with infant feeding following hospital discharge: A
multi-site study.
Taylore Jansen, B.S.N., RN, CCRN; DaiWai Olson, Ph.D., RN, CCRN,
FNCS. Use of simulation game to improve ETCO2 monitoring
policies in the ICU setting (SO LONG 2 PONG).
Maureen LeDanseur, M.S.N., APRN, ACNS-BC, CCRN, CCM; DaiWai
Olson, Ph.D., RN, CCRN, FNCS. Can patient anxiety be alleviated
with music therapy (The CALM Study)?
Maureen LeDanseur, M.S.N., APRN, ACNS-BC, CCRN, CCM; Dai-
Wai Olson, Ph.D., RN, CCRN, FNCS. Is the CABIC clean intermit-
tent catheterization patient education effective (ICPEE)?
Michael Levy, M.S.N., APRN, ACNP-BC, CNRN; DaiWai Olson,
Ph.D., RN, CCRN, FNCS. Incidence of local PIN site inflammation
following Gamma Knife procedure (iPIN Study).
Karen Martin, M.S.N., RN, ACNS, CWOCN; DaiWai Olson, Ph.D.,
RN, CCRN, FNCS. Language of data II.
Karen Martin, M.S.N., RN, ACNS, CWOCN; DaiWai Olson, Ph.D.,
RN, CCRN, FNCS. Language of data III.
Natalie Martinez, M.S.N., APRN, FNP-BC; DaiWai Olson, Ph.D., RN,
CCRN, FNCS. Interventions that may instill a sense of self-worth
for patients with mild or early-onset dementia (I’m Still Me).
Morgan Mattay, B.S.N., RN; Linda Chan, B.S.N., RN, OCN; Victoria
England, MBA, B.S.N., RN, NE-BC; Susan Hernandez, MBA, B.S.N.,
RN. Replication study: EBP readiness.
Linda Merritt, M.S.N., RN; Stephanie Huckaby, M.S.N., RN, NEA-
BC. Determining the needs of fathers of premature neonates.
Kelly Moore, RN, OCN; DaiWai Olson, Ph.D., RN, CCRN, FNCS.
Investigating onset of chemobrain in chemotherapy patients:
A comparison of early versus late onset (Chemobrain).
Nancy Neal, B.S.N., RN; Valerie Doublas, B.S.N., RN; Kavitha Nair,
M.S.N., RN, OCN, NEA-BC; Amy Flores, B.S.N., RN; Ruben Castillo,
M.S.N., RN, CCRN. Meaningful patient communication.
DaiWai Olson, Ph.D., RN, CCRN, FNCS. A retrospective study of
the hospital course and outcomes of patients with brain contu-
sion (The SHOC Study).
DaiWai Olson, Ph.D., RN, CCRN, FNCS. Acute stroke or transient
ischemic attack treatment with aspirin or ticagrelor and patient
outcomes (Socrates).
DaiWai Olson, Ph.D., RN, CCRN, FNCS. Dynamic interaction
among multimodal physiologic measures in neurocritical care:
A feasibility study using the Component Neuromonitoring
System (Dimisuns).
DaiWai Olson, Ph.D., RN, CCRN, FNCS. Interrater reliability of
pupillary assessments.
DaiWai Olson, Ph.D., RN, CCRN, FNCS. Patient perceptions of
knowledge of Parkinson’s disease and treatment (Know PD).
DaiWai Olson, Ph.D., RN, CCRN, FNCS. Patient-centered transfer of
care (PC-Care).
DaiWai Olson, Ph.D., RN, CCRN, FNCS; Byron Carlisle, B.S.N., RN,
CCRN. Establishing normative data for pupillometer assessments
in neurointensive care (The END-PANIC-Pupil Study).
DaiWai Olson, Ph.D., RN, CCRN, FNCS; Shelli Chernesky, M.S.N.,
MBA, RN, CCRN; Michelle Proveschner, B.S.N., RN. Stroke readiness.
DaiWai Olson, Ph.D., RN, CCRN, FNCS; Alexa Collins, B.S.N., RN.
Optimum external ventricular drain wean strategy in subarach-
noid hemorrhage.
DaiWai Olson, Ph.D., RN, CCRN, FNCS; Margaret Dupre, M.S., RN,
CNL; Amy Weaver, M.S.H.A., B.S.N., RN, CEN. Management of
acute stroke patients on treatment with new oral anticoagulants:
Addressing real-world anticoagulation management issues in
stroke (ARAMIS Study).
DaiWai Olson, Ph.D., RN, CCRN, FNCS; Margaret Dupre, M.S., RN,
CNL; Meg Wilson, B.S.N., RN, CCRN. PROSPER: Patient-centered
research into outcomes stroke patients prefer and effectiveness
research.
DaiWai Olson, Ph.D., RN, CCRN, FNCS; Joann El-Aya, B.S.N., RN,
CCRN, FNCS. A novel approach to exploring the impact of various
nursing interventions in critical care (NATIVe).
DaiWai Olson, Ph.D., RN, CCRN, FNCS; Elizabeth Gunter, B.S.N., RN;
Melissa Lesack, B.S.N., RN. Aneurysmal subarachnoid hemor-
rhage trial randomizing heparin: Continuous low-dose intrave-
nous heparin therapy in coiled low-grade aneurysmal subarach-
noid hemorrhage patients (ASTROH).
DaiWai Olson, Ph.D., RN, CCRN, FNCS; Taylore Jansen, B.S.N., RN,
CCRN; Sarah Jannusch, B.S.N., RN. Postoperative management of
systemic hypertension in the neurosurgical intensive care unit
after craniotomy: A prospective observational study.
DaiWai Olson, Ph.D., RN, CCRN, FNCS; Michael Rogers, B.S., RN,
CCRN. EMR validation: Exploring the reliability of intracranial
pressure data abstracted from the electronic medical record –
pilot (VERDAD-P).
DaiWai Olson, Ph.D., RN, CCRN, FNCS; Audra Wagner, RN. Sound
in neuroscience intensive care (SONIC).
New Knowledge, Innovation, and Research 51New Knowledge, Innovation, and Research50
Lilian Omburo, M.S.N., APRN, FNP-C; Mica Choate, B.S.N., RN;
DaiWai Olson, Ph.D., RN, CCRN, FNCS. PENlight: Variance in
pupillary exam findings among PACU nurses.
Melissa Panter, B.S.N., RN; DaiWai Olson, Ph.D., RN, CCRN, FNCS.
Is an algorithm for deciding PICC vs. midline access superior to
medical experience (ADVISE ME)?
Marco Pataray, B.S.N., RN. C diff 11N.
Michelle Roberson, B.S.N., RN. Ambulation outcomes in patients
>65 years.
Michael Rogers, B.S.N., RN, CCRN; DaiWai Olson, Ph.D., RN,
CCRN, FNCS. When is an ICP transducer providing a values
reflecting true ICP? (Wait a tic.)
Andres Rozo, B.S.N., RN, CCRN; Hlaing Thu, B.S.N., RN; DaiWai
Olson, Ph.D., RN, CCRN, FNCS. Situational factors associated with
caregiver burnout in the emergency department (FACES).
Renee Schlueter, B.S.N., RN, OCN; Ruben Castillo, M.S.N., RN,
CCRN. Reducing delirium in the ICU patient population.
Rocky Sonemangkhara, B.S.N., RN, CCRN; DaiWai Olson, Ph.D.,
RN, CCRN, FNCS. A qualitative study to understand the lived
experiences of the spiritual care triad (QUEST Study).
Deb Spitzer, M.S.N., B.S.N., RN, OCN; Suzy Lockwood, Ph.D., M.S.N.,
RN, OCN, FAAN; Elaine Demery, M.S.N., RN, AOCN. A pilot study
on the impact of nurse mentorship on nurse speaker anxiety.
Annamma Stephen, B.S.N., RN, CCRN; DaiWai Olson, Ph.D., RN,
CCRN, FNCS. Creating healing uniform periods of minimum
assessment time (CHUP).
Hlaing Thu, B.S.N., RN; DaiWai Olson, Ph.D., RN, CCRN, FNCS. Is
MRI waiting room time associated with increased anxiety?
Holly Ware, B.S.N., RN, CCRN; DaiWai Olson, Ph.D., RN, CCRN,
FNCS. Confidence and comfort of nurses caring for patients who
have sedation (BETCHA).
Amy Weaver, M.S.H.A., B.S.N., RN, CEN. TCU fellowship: NGT air
insufflation.
Amy Weaver, M.S.H.A., B.S.N., RN, CEN; DaiWai Olson, Ph.D., RN,
CCRN, FNCS. Effects of nurses’ sleep deprivation and fatigue on
perceived medical error rates when caring for patients in the
emergency department (NAP).
Amy Weaver, M.S.H.A., B.S.N., RN, CEN; DaiWai Olson, Ph.D., RN,
CCRN, FNCS; Cary Orrick, B.S.N., RN, CEN. CATCH – diabetes in ER
management.
Jim West, M.S., B.S.N., RN; DaiWai Olson, Ph.D., RN, CCRN, FNCS.
Formatting an experiential learning education module to encour-
age dysphagia assessment in apheresis patients (FEED ME).
Publications in 2017
Abdulkadir Kamal, B.S.N., RN; DaiWai Olson, Ph.D., RN, CCRN,
FNCS. “PC-care.” AORN Journal Jan. 2017, 105(2): 193-202.
Amit Banga, M.D.; Manish Mohanka, M.D.; Luke Mahan, M.S.N.,
FNP; Srinivas Bollineni, M.D.; Jessica Mullins, M.D.; Vaidehi Kaza,
M.D.; Fernando Torres, M.D. “Need of dialysis during index hospi-
talization after lung transplant surgery: Independent predictors
and association with early and late survival.” American Journal of
Respiratory and Critical Care Medicine May 2017.
Amit Banga, M.D.; Melissa Tran, M.S.N., RN, CCRN. “Predictors of out-
come among patients on extracorporeal membrane oxygenation as
a bridge to lung transplantation.” Clinical Transplantation. In press.
Byron Carlisle, B.S.N., RN, CCRN; DaiWai Olson, Ph.D., RN, CCRN,
FNCS. “Establishing normative data for pupillometer assessment
in the neuroscience intensive care: The END-PANIC registry.” Jour-
nal of Neuroscience Nursing 2017, 49(4): 251-254.
Linda Chan, B.S.N., RN, OCN. “Gum chewing helps prevent intes-
tinal blockages in oncology patients after abdominal surgery.”
Oncology Nursing News May 2017.
April Crow, B.S.N., RN; Maureen LeDanseur, M.S.N., APRN, ACNS-
BC, CCRN; DaiWai Olson, Ph.D., RN, CCRN, FNCS. “Music therapy to
alleviate anxiety during inpatient rehabilitation of stroke.” Rehabil-
itation Nursing Journal [epub] Sept. 2017.
Tamara Dickinson, M.S.N., APRN, AGPCNP-BC, CURN, CCCN. “An
International Continence Society report on the terminology for
adult neurogenic lower urinary tract dysfunction.” Neurourology
and Urodynamics Aug. 2017.
Amanda Dirickson, M.S., ANP-C, APRN, SCRN-C; DaiWai Olson,
Ph.D., RN, CCRN, FNCS. “Piloting a gender-specific, technology-en-
hanced, active learning intervention for stroke prevention in
women.” Journal of Neuroscience Nursing 2017, 49(6): 349-354.
Amanda Dirickson, M.S., ANP-C, APRN, SCRN-C; Laura Riise,
M.S.N., RN, CCRN, SCRN; Donald Jones, RN, CEN; DaiWai Olson,
Ph.D., RN, CCRN, FNCS. “Feasibility and efficacy of nurse-driven
acute stroke care (NASCAR).” Journal of Stroke and Cerebrovascu-
lar Disease Jan. 2017.
Keri Draganic, D.N.P., APRN, ACNP-BC; Haley Legg, B.S.N., RN;
Kristina Duxbury, B.S.N., RN; DaiWai Olson, Ph.D., RN, CCRN,
FNCS. “Preoperative prothrombin: Length of stay and valve
replacement.” Worldviews on Evidence-Based Nursing (submitted).
Maria Grabowski, M.S.N., RN, OCN; Deborah Spitzer, M.S.N.,
RN, OCN; DaiWai Olson, Ph.D., RN, CCRN, FNCS. “Development
of an instrument to examine nursing attitudes toward fertility
preservation in oncology.” Oncology Nursing Forum July 2017,
44(4): 497-502. DOI: 10.1188/17.ONF.497-502.
Paula Hardeman, M.P.A.S., PA-C; Rhonda Hough, D.N.P., APRN,
CPNP-AC. “Integration of advanced practice clinicians in neurol-
ogy practices.” JAMA Neurology Aug. 2017.
Kimberly Harrison, B.S.N., RN, CCRN; DaiWai Olson, Ph.D., RN,
CCRN, FNCS. “A national trial on differences in cerebral perfusion
pressure values by measurement location.” Neurocritical Care
[epub] Oct. 27, 2017: 1-8. DOI: 10.1007/s12028-017-0467-7.
Christy Hicks, M.S., APRN, WHNP-BC. “Fulranumab vs. placebo
for treatment of IC/PBS.” Interstitial Cystitis Association [online
review] March 2017.
Christy Hicks, M.S., APRN, WHNP-BC. “Human relations.” Interstitial
Cystitis Association Update June 2017.
Christy Hicks, M.S., APRN, WHNP-BC. “Mindfulness over matter.”
Interstitial Cystitis Association Update Sept. 2017.
Christy Hicks, M.S., APRN, WHNP-BC. “Recent trial fails to effec-
tively compare DMSO and chondroitin sulphate 2% bladder
instillations for IC/PBS.” Interstitial Cystitis Association [online
review] March 2017.
Max Holder, B.S.N., RN; Sonja Stutzman, Ph.D.; DaiWai Olson,
Ph.D., RN, CCRN, FNCS. “Impact of ultrasound on short periph-
eral intravenous catheter placement on vein thrombosis risk.”
Journal of Infusion Nursing May/June 2017, 40(3): 176-182. DOI:
10.1097/NAN.
Stephanie Huckaby, M.S.N., RN-BC, et al. “Chapter 3: Research
evidence in nursing practice.” Foundations of Nursing Research,
7th edition [co-author] May 2017.
Taylore Jansen, B.S.N., RN, CCRN; DaiWai Olson, Ph.D., RN, CCRN,
FNCS. “Pilot study of educational gaming to improve adherence
to an ETCO2 monitoring protocol.” Journal of Continuing Educa-
tion in Nursing (submitted).
Martha Kingman, D.N.P., APRN, FNP-BC. “Management of pros-
tacyclin side effects in adult patients with pulmonary arterial
hypertension.” Pulmonary Circulation 2017.
Martha Kingman, D.N.P., APRN, FNP-BC. “Riociguat in PAH and
CTEPH: Strategies for patient management.” Pulmonary Therapy
Feb. 2017.
Anitha Litty, D.N.P., APRN, FNP-C, CDE; Susan Chaney, Ed.D., RN,
FNP-C, FAANP. “Glucocorticoid-induced hyperglycemia.” The Nurse
Practitioner Aug. 2017.
Molly McNett, RN, CNS, CNRN; Shelly Amato, RN, CNS, CNRN;
DaiWai Olson, Ph.D., RN, CCRN, FNCS. “Sensitivity, specificity, and
receiver operating characteristics: A primer for neuroscience nurs-
es.” Journal of Neuroscience Nursing April 2017, 49(2): 99-101.
Kavitha Nair, M.S.N., RN, OCN, NEA-BC. “Improving nurse compe-
tencies for using evidence in practice.” American Journal of Nursing
(submitted).
DaiWai Olson, Ph.D., RN, CCRN, FNCS. “A novel approach to
explore how nursing care affects intracranial pressure.” American
Journal of Critical Care March 2017, 26(2): 136-139.
DaiWai Olson, Ph.D., RN, CCRN, FNCS. “Association between
preceding antithrombotic treatment and acute ischemic stroke
outcomes among patients with atrial fibrillation.” JAMA March 14,
2017, 317(10): 1057-1067.
DaiWai Olson, Ph.D., RN, CCRN, FNCS. “Depression status is
associated with functional decline over one year following acute
stroke.” Journal of Stroke and Cerebrovascular Diseases 2017, 26(7):
1393-1399.
DaiWai Olson, Ph.D., RN, CCRN, FNCS. “Future trends: Guideline.”
Journal of Neuroscience Nursing Feb. 2017, 49(1): 1.
DaiWai Olson, Ph.D., RN, CCRN, FNCS. The AANN Core Curriculum,
6th edition. 2017.
New Knowledge, Innovation, and Research 53New Knowledge, Innovation, and Research52
DaiWai Olson, Ph.D., RN, CCRN, FNCS. “The Adam Williams
Foundation educational program is associated with increased
adherence to Brain Trauma Foundation guidelines for hospital
care of traumatic brain injury (TBI) patients.” Critical Care Nurse.
In press.
DaiWai Olson, Ph.D., RN, CCRN, FNCS. “The language of data
program: Use of gaming to promote critical appraisal skills.”
Worldviews on Evidence-Based Nursing [epub] Aug. 29, 2017. DOI:
10.1111/wvn.12252.
DaiWai Olson, Ph.D., RN, CCRN, FNCS. “Why Five Years?” Journal
of Neuroscience Nursing April 2017, 49(2): 64.
DaiWai Olson, Ph.D., RN, CCRN, FNCS; Abdulkadir Kamal, B.S.N.,
RN. “The patient and family perioperative experience during
transfer of care: A qualitative inquiry.” AORN Journal Feb. 2017,
105(2): 193-202.
DaiWai Olson, Ph.D., RN, CCRN, FNCS; John Bazil, B.S.N., RN,
CCRN. “Chapter 98: AACN procedure manual.” AACN Procedure
Manual for High Acuity, Progressive, and Critical Care, 7th edition
[co-authors] Jan. 2017.
DaiWai Olson, Ph.D., RN, CCRN, FNCS; Monica Keller, B.S.N., RN,
CCRN. “An approach to cerebral perfusion pressure manage-
ment.” Journal of Neuroscience Nursing 2017. 49(6): 372-376.
Michael Rogers, B.S.N., RN, CCRN; DaiWai Olson, Ph.D., RN,
CCRN, FNCS. “Intracranial pressure values are highly variable
after cerebral spinal fluid drainage.” Journal of Neuroscience Nurs-
ing April 2017, 49(2): 85-89.
Jose Andres Rozo, B.S.N., RN, CCRN; DaiWai Olson, Ph.D., RN,
CCRN, FNCS; Hlaing (Sue) Thu, B.S.N., RN; Sonja Stutzman, Ph.D.
“Situational factors associated with burnout among emergency
department nurses.” Workplace Health & Safety June 2017, 65(6):
262-265.
Annamma Stephen, B.S.N., RN, CCRN; DaiWai Olson, Ph.D., RN,
CCRN, FNCS. “Nurses’ perceptions of a novel protocol address-
ing uniform period of minimum assessment times.” Journal of
Neuroscience Nursing July 2017.
Holly Ware, B.S.N., RN; Lori McGarry, M.S.N., B.S.N., RN; Jenna Bland,
M.S.N., B.S.N., RN; DaiWai Olson, Ph.D., RN, CCRN, FNCS. “Does neuro-
function monitoring enhance nursing confidence and comfort?” Pain
Management Nursing Nov. 2017. DOI: 10.1016/j.pmn.2017.08.005
Amy Weaver, M.S.H.A., B.S.N., RN, CEN; Susan Hernandez, MBA, B.S.N.,
RN; DaiWai Olson, Ph.D., RN, CCRN, FNCS. “Clinician perceptions of
teamwork in the emergency department: Does nurse and medical
provider workspace placement make a difference?” Journal of Nurs-
ing Administration Jan. 2017, 47(1): 50-55.
James West, M.S., B.S.N., RN; DaiWai Olson, Ph.D., RN, CCRN, FNCS.
“Formatting and experiential learning education module to encourage
dysphagia assessment in apheresis patients.” Journal of Clinical Apheresis
Aug. 2017. DOI: 10.1002/jca.21572.
Mary West, RN, et al. “Oxidized regenerated cellulose (fibrillar) reduces
risk of postoperative corporal bleeding following inflatable penile
prosthesis surgery.” Urology Oct. 2017, 108: 190-194.
Nurse Presentations, Posters, and Abstracts
As evidence of our organizational commitment to professional devel-
opment, UT Southwestern supports attendance at local, regional, and
national conferences. Financial support for continuing education is
aligned with organizational priorities and initiatives. Full or partial
funding is awarded based on the nurse presenting a poster or deliv-
ering a presentation at the podium. Over the past four years, we have
taken an increasingly forward-looking approach to supporting our
nurses in participating in key conferences through poster and podium
presentations. This approach supports our leadership’s strategic goal
of positively impacting the nursing profession at UT Southwestern
and beyond.
Podium Presentations by UT Southwestern
Nurses in 2017
Rose Bagh, M.S.N., APRN, AGACNP-BC, FNP-BC, CCRN, RNFA. “Manage-
ment of arrhythmia syndromes during pregnancy.” UT Southwestern
William P. Clements Jr. University Hospital. Dallas, Texas, September.
Peggy Bartholomew, M.H.S.M., RN, PMP, et al. “The journey to reducing
alarm fatigue: Tips on what not to do.” Association for the Advance-
ment of Medical Instrumentation (AAMI) Foundation Annual Forum.
San Diego, Calif., Nov. 18-19.
Byron Carlisle, B.S.N., RN, CCRN. “Education matters: 3-minute
micro-SIMS solve an education time crunch.” ANCC National
Magnet Conference. Houston, Texas, Oct. 11-13.
Linda Chan, B.S.N., RN, OCN; Sharon Leroux, B.S.N., RN, OCN;
Melissa Trevino, B.S., RN, OCN. “Gum chewing intervention to
prevent prolonged postoperative ileus in the abdominal surgical
oncology patient population: An evidence-based practice
change.” 42nd Annual Oncology Nursing Society Congress.
Denver, Colo., May 4-7.
Linda Chan, B.S.N., RN, OCN; Sharon Leroux, B.S.N., RN, OCN;
Melissa Trevino, B.S., RN, OCN. “Using a gum chew teaching packet
to prevent prolonged postoperative ileus: An evidence-based
practice change.” Helene Fuld Health Trust National Summit: Trans-
forming Health Care Through Evidence-Based Practice. Columbus,
Ohio, Oct. 18-20.
Shelli Chernesky, M.S.N., MBA, RN, CCRN. “Implementing
MEWS scoring in the apheresis/transfusion clinic.” 24th
National Evidence-Based Practice Conference: Personal-
ized Health Care: Shades of Gray in Evidence-Based Care.
Coralville, Iowa, April 27-28.
Shelli Chernesky, M.S.N., MBA, RN, CCRN. “Use of single needle
access in therapeutic plasma exchange: A single institution
experience.” American Society of Apheresis Annual Meeting. Fort
Lauderdale, Fla., May 3-6.
Kate Conklin; Luann Culbreth; Marcia Schneider; Susan Her-
nandez, MBA, B.S.N., RN. “Panel discussion.” American College
of Healthcare Executives Annual Women’s Breakfast. North
Texas, Oct. 3.
Amanda Dirickson, M.S., APRN, ANP-C , SCRN. “HER stroke.”
American Association of Neuroscience Nursing 49th Annual
Educational Meeting. Boston, Mass., March 21-24.
Betty Doggett, AT (ASCP); Nellie Session, AT (ASCP); Shelli
Chernesky, M.S.N., MBA, RN, CCRN; Matthew Strunk, PA-C;
Shiney Valiyaparambil, PA-C; Nicole DeSimone, M.D.; Ravi
Sarode, M.D. “Use of single needle access in therapeutic plasma
exchange: A single institution’s experience.” American Society of
Aphereis Annual Meeting. Fort Lauderdale, Fla., May 3-6.
Nancy Drobycki, M.S.N., RN, CDE. “Transitions in diabetes care:
Pediatric to adults.” Texas AADE Annual Diabetes Conference.
Round Rock, Texas, March 31-April 1.
Susan Hernandez, MBA, B.S.N., RN. “Developing nurse leaders
through a research fellowship.” ANCC National Magnet Conference.
Houston, Texas, Oct. 11-13.
Christy Hicks, M.S., APRN, WHNP-BC. “Electrical stimulation for
urinary & fecal incontinence, pelvic pain, and sexual dysfunction.”
UT Southwestern Medical Center. Dallas, Texas, March.
Christy Hicks, M.S., APRN, WHNP-BC. “Pelvic organ prolapse and
mesh complications.” UT Southwestern William P. Clements Jr.
University Hospital. Dallas, Texas, July.
Lori Hodge, D.N.P., RN, OCN, NEA-BC; Shelley Brown-Cleere, M.S.N.,
RN; Michael Rubin, M.D., M.A.; Susan Hernandez, MBA, B.S.N., RN.
“NoMMAD: A unique approach to a healthy work environment
by minimizing the harmful effects of moral distress.” 4th National
Nursing Ethics Conference. UCLA, Los Angeles, Calif., March 23-24.
Rhonda Hough, D.N.P., APRN, CPNP-AC. “2016 year in review:
Nursing research.” Critical Care Medicine Annual Congress.
Honolulu, Hawaii, Jan. 22.
Kelli Hulsman, B.S.N., RN. “Breastfeeding workshop.” Association of
Women’s Health, Obstetric, Neonatal Nurses (AWHONN) Confer-
ence. New Orleans, La., June 24-28.
Kelli Hulsman, B.S.N., RN; Linda Catterton, B.S.N., RN, IBCLC.
“Current lactation breastfeeding standards and support methods.”
AWHONN Conference. San Marcos, Texas, June 24-28.
Celeste Johnson, D.N.P., APRN, PMH CNS; Rebecca Deisler, B.S.N.,
RN, PMHN-BC. “Spreading recovery oriented care across the state:
Everything’s bigger in Texas.” APNA Annual Conference. Phoenix,
Ariz., Oct. 18-21, 2017.
Chidimma Nguma, M.S.N., GNP, ANP-BC, ACHPN. “Delivering bad
news: The art of role playing.” UT Southwestern William P. Clements
Jr. University Hospital. Dallas, Texas, July.
Kimberly Oas, M.S.N., APRN, FNP-BC. “Legislative agenda priorities for
current session.” Texas Brain Injury Advisory Board. Austin, Texas, April.
DaiWai Olson, Ph.D., RN, CCRN, FNCS. “Ask the expert.” American
Association of Neuroscience Nurses Advances in Stroke Care
Conference. Rosemont, Ill., Aug. 10-12.
DaiWai Olson, Ph.D., RN, CCRN, FNCS. “Back to the future of nursing”
[plenary speaker]. World Federation of Neuroscience Nurses. Opatija,
Croatia, Sept. 17-21.
New Knowledge, Innovation, and Research 55New Knowledge, Innovation, and Research54
DaiWai Olson, Ph.D., RN, CCRN, FNCS. “Developing nurse leaders
through a research fellowship.” ANCC Magnet Conference. Hous-
ton, Texas, Oct. 11-13.
DaiWai Olson, Ph.D., RN, CCRN, FNCS. “Disney stroke cases.”
Advancing Regional Healthcare in Rural West Texas Symposium.
Odessa, Texas, June 23.
DaiWai Olson, Ph.D., RN, CCRN, FNCS. “Education matters: 3-min-
ute micro-SIMS solve an education time crunch.” ANCC National
Magnet Conference. Houston, Texas, Oct. 11-13.
DaiWai Olson, Ph.D., RN, CCRN, FNCS. “In-hospital stroke delay.”
International Stroke Conference. Houston, Texas, Feb. 22-24.
DaiWai Olson, Ph.D., RN, CCRN, FNCS. “Making connections”
[keynote speaker]. UT Tyler School of Nursing. Tyler, Texas, June.
DaiWai Olson, Ph.D., RN, CCRN, FNCS. “Snow White had a stroke.”
AACN National Teaching Institute & Critical Care Exposition.
Houston, Texas, May 22-25.
DaiWai Olson, Ph.D., RN, CCRN, FNCS. “Stroke presentation in
animated movies.” North Central Texas Regional Advisory Council.
Grand Prairie, Texas, July.
DaiWai Olson, Ph.D., RN, CCRN, FNCS. “Stroke trends, care, and
controversy.” Professional Issues Conference. Manhattan, N.Y.,
November.
DaiWai Olson, Ph.D., RN, CCRN, FNCS. “Successful strategies for
writing for publication.” World Federation of Neuroscience Nurses
12th Quadrennial Congress. Opatija, Crotia, Sept. 17-21.
DaiWai Olson, Ph.D., RN, CCRN, FNCS. “Unusual stroke presenta-
tions and symptoms.” Meridian Stroke Conference. April 2017.
DaiWai Olson, Ph.D., RN, CCRN, FNCS. [Keynote speaker:] “Un-
usual strokes in unusual folks.” AANN Advances in Stroke Care
Conference. Rosemont, Ill., Aug. 10-12.
DaiWai Olson, Ph.D., RN, CCRN, FNCS. “What’s wrong with my
patient? Deciphering the assessment dilemma through interac-
tive anatomy and case studies.” AANN 49th Annual Educational
Meeting. Boston, Mass., March 21-24.
James West, B.S.N., RN. “Magnet journey.” ANCC Magnet Work-
shop. Dallas, Texas, Dec. 11-12.
Susan Hernandez, MBA, B.S.N., RN. “Learn how to contribute to the
future of nursing and culture of health work of North Texas!” Texas Team
North Region General Meeting. April 26.
Poster Presentations in 2017
Tomas Armendariz, B.S.N., RN, CMSRN; Shelli Chernesky, M.S.N., MBA,
RN, CCRN; Christina Lin, B.S., EMR; Nicole Simone, M.D.; Ravi Sarode,
M.D. “Synopsis in the electronic medical record: Recapturing the
apheresis story.” American Society of Apheresis Annual Meeting. Fort
Lauderdale, Fla., May 3-6.
Tomas Armendariz, B.S.N., RN, CMSRN; Roberto Contretas, CT, R, ARRT;
Patrice Griffith, MBA, CMQ/OE; Shelli Chernesky, M.S.N., MBA, RN,
CCRN. “Making a difference with SBAR.” Texas Christian University EBP
Fellowship Graduation. Fort Worth, Texas, Sept. 20.
James Burner, M.D.; Shannon Davis, B.S.N., RN; Suzan New, M.S., B.S.N.,
RN, CNOR; Vaishali Patel, MT, ASCP; Oren Guttman, M.D. “Develop-
ment of a standardized response team for massive hemorrhage events
outside of an operating room.” AABB Annual Meeting. San Diego, Calif.,
Oct. 7-10.
Linda Chan, B.S.N., RN, OCN; Marco Pataray, B.S.N., RN, OCN, CMSRN.
“If a picture is worth a thousand words then a video is worth ten thou-
sand words: Using a unit-based video blog to increase bedside staff
communication and engagement.” 42nd Annual Oncology Nursing
Society Congress. Denver, Colo., May 4-7.
Shelli Chernesky, M.S.N., MBA, RN, CCRN; Tomas Armendariz, B.S.N.,
RN, CMSRN; Dara Mariani, B.S.N., RN, CCRN; Pam Ridgway, M.S.N., RN,
CCRN; Ravi Sarode, M.D.; Nicole DeSimone, M.D., M.P.H. “Use of MEWS
scoring in an apheresis clinic reduces sentinel events.” American Soci-
ety of Apheresis Annual Meeting. Fort Lauderdale, Fla., May 3-6.
Shelli Chernesky, M.S.N., MBA, RN, CCRN; Julie Earnest, MBA, B.S.N.,
RN; Pam Ridgway, M.S.N., RN, CCRN; Jim West, B.S.N., RN; Dara Mariani,
B.S.N., RN, CCRN; Tomas Armendariz, B.S.N., RN, CMSRN. “Implementing
MEWS scoring in a transfusion medicine clinic reduces sentinel events
for cancer patients.” [Winning poster for advancing clinical practice.]
Sigma Theta Tau International Research Symposium, Arlington, Texas,
April 22.
Stacey Clark, MBA, B.S.N., RN, CMPE. “Nursing workload to assess staff-
ing matrix.” American Academy of Ambulatory Care Nursing Webinar.
October 2017.
Amanda Dirickson, M.S., APRN, ANP-C, SCRN. “Changing women’s
stroke education through a quality improvement study.” Ameri-
can Association of Neuroscience Nurses Annual Meeting. Boston,
Mass., March 1.
Betty Doggett, AT, ASCP; Shelli Chernesky, M.S.A., MBA, RN,
CCRN; Nicole DeSimone, M.D., M.P.H. “Cardiovascular disease and
extracorporeal photopheresis.” Sigma Theta Tau International
Research Symposium. Arlington, Texas, April 22.
Betty Doggett, AT, ASCP; Nellie Session-Augustine, AT, ASCP;
Tomas Armendariz, B.S.N., RN, CMSRN; Shelli Chernesky, M.S.N.,
MBA, RN, CCRN; Matt Strunk, PA; Shiney Valiyaparambil, PA;
Nicole DeSimone, M.D., M.P.H.; Ravi Sarode, M.D. “Decreasing
fluid balance during extracorporeal by altering flow rates during
purging air cycle.” American Society of Apheresis Annual Meet-
ing. Fort Lauderdale, Fla., May 3-6.
Keri Draganic, D.N.P., APRN, ACNP-BC. “Assessing preoperative
prothrombin times to postoperative therapeutic Coumadin
levels in mechanical valve replacement patients.” Neuroscience
Nursing Research Center Symposium. Dallas, Texas, August.
Keri Draganic, D.N.P., APRN, ACNP-BC. “Comparing fluid rates in
septic patients with heart failure.” US-Sino University of Pitts-
burgh. Pittsburgh, Pa., June 4-6.
Shannon Dunleavy, B.S.N., RN, CCRN. “Pilot study to examine
methods of data capture for examining temperature manage-
ment practice in neurocritical care.” 15th Annual Neurocritical
Care Society Conference. Kona, Hawaii, Oct. 10-13.
Karen Elmore, D.N.P., RN, NE-BC. “Evaluation of interpreter use.”
AMSN Annual Conference. Palm Spring, Calif., Oct. 12-15.
Maria Grabowski, M.S.N., RN, OCN. “Tele-nicotine.” International
Cancer Education Conference. Cleveland, Ohio, Sept. 13-15.
Carol Hall, B.S.N., RN, CWOCN, CFCN; Tomas Armendariz, B.S.N.,
RN, CMSRN; Shelli Chernesky, M.S.N., MBA, RN, CCRN; Jennifer
Wintz, B.S.N., RN, QIA. “Pictures worth 1,000 words.” WOCN 49th
Annual Conference. Salt lake City, Utah, May 19-23.
Carol Hall, B.S.N., RN, CWOCN, CFCN; Claudia Engle, B.S.N., RN,
CWOCN; Emily Flahaven, B.S.N., RN. “What do PUPPs and skin
have in common? A multidisciplinary approach to documenta-
tion improvements.” WOCN Annual Conference. Salt Lake City,
Utah, May 19-23.
Tracy Heineman, B.S.N., RN, CCRN; Shannon Chalk, B.S.N., RN,
CCRN-CMC; Chris Davis, M.S.N., RN, CCRN. “Making it matter: Add-
ing SPO2 and oxygen requirement monitoring to modified early
warning score.” AACN National Teaching Institute & Critical Care
Exposition. Houston, Texas, May 22-25.
Lori Hodge, D.N.P., RN, OCN, NEA-BC. “NoMMaD: A unique ap-
proach to a healthy work environment by minimizing the harmful
effects of moral distress.” National Ethics Conference. Los Angeles,
Calif., March 23-24.
Stephanie Huckaby, M.S.N., RN-BC, NEA-BC, CSSGB. “Reduce the
muda in the discharge process.” ANCC National Magnet Conference.
Houston, Texas, Oct. 11-13.
Martin Macias, B.S.N., RN, CMSRN; Tomas Armendariz, B.S.N, RN,
CMSRN; Shelli Chernesky, M.S.N., MBA, RN, CCRN; Christina Lin,
B.S., EMR; Amena Usmani, M.D.; Nicole DeSimone, M.D.; Ravi
Sarode, M.D. “A method of calculating net red blood cell mass gain
to monitor sick cell patients undergoing red blood cell exchange.”
American Society of Apheresis Annual Meeting. Fort Lauderdale,
Fla., May 3-6.
Katherine Mancini, B.S.N., RNC; Sheila Woodwarn-Morgan, B.S.N.,
RN, CCE. “Increase percentage of NICU/CMC moms who initiate
breast pumping with 6 hours of delivery.” AWHONN Texas State
Conference. San Marcos, Texas, May 4-6.
Sheila Morgan, B.S.N., RN. “Increasing the number of NICU moms
pumping in the first 6 hours after birth.” Association of Women’s
Health, Obstetric, Neonatal Nurses Convention. New Orleans, La.,
June 24-28.
Kavitha Nair, M.S.N., RN, OCN, NEA-BC. “Impact of a nurse-driven
acuity tool in nurse satisfaction and financial efficiency of an acute
patient care unit.” National Association of Indian Nurses of America
3rd Annual Leadership Conference. Norcross, Ga., Sept. 16.
Kathy Pratt, B.S.N., RN, OCN, CBCN; Jillian Huang, M.S., M.P.H., CGC.
“Surveillance compliance among underserved and insured heredity
cancer mutations.” 7th Annual Cowtown Oncology Nursing Sympo-
sium. Fort Worth, Texas, March 10-11.
Kathy Pratt, B.S.N., RN, OCN, CBCN; Jillian Huang, M.S., M.P.H., CGC.
“Surveillance compliance among underserved and insured heredity
cancer mutations.” Oncology Nurse Advisor Navigation Summit.
Austin, Texas, June 15-17.
New Knowledge, Innovation, and Research 57New Knowledge, Innovation, and Research56
Michelle Roberson, M.S.N., RN, CMSRN. “These non-skid socks
are made for walking: Increasing ambulation in an ACE unit.”
Nurses Improving Care for Healthsystem Elders Annual Confer-
ence. Austin, Texas, April 19-22.
Suzanne Stone, B.S.N., RN. “What goes around comes around: The
impact of adding the stroke coordinator to daily rounds.” Interna-
tional Stroke Conference. Houston, Texas, Feb. 22-24.
Carolyn Swann, MBA, RN; Rudy Arispe, B.S.N., RN; Keely Correa,
B.S.; Priya Dandekar, MBA, M.H.A.; Cortney Hockett, M.S.N.,
RN; Cheryl Kaplan, MBA, M.H.A., RN; Sarah McCoy, B.F.A.; Laura
Restall, B.S.N., RN; Linnea Tolbert, B.S.N., RN. “ABO verification
policy changes: Mapping the complex requirements in an easy-
to-follow flowchart.” UNOS Transplant Management Forum.
Orlando, Fla., April 25-27.
Cheryl Ann Thaxton, M.N., APRN, FNP-BC, CPNP, CHPPN. “State of
the science for pediatric palliative care (PPC).” National Palliative
Care Conference. Phoenix, Ariz., Feb. 25.
Jennifer Thibodeau, M.D.; Peggy Bartholomew, M.H.S.M., B.S.,
RN; Debra Boswell, M.S.N., MBA, RN; Janet Burkhard, MBA; Sarah
Gualano, M.D.; Christina Hartley, B.S.N., RN; Cheryl Kaplan, MBA,
M.H.A., RN; Seana Mathew, Pharm.D.; Anne McCormack, B.S.N., RN;
Sarah McCoy, B.F.A.; Chadell Rayford, M.P.H.; Pamela Scott, B.S.N.,
RN; Carolyn Swann, MBA, RN; Deshonna Taylor, M.S.N., RN; William
Tharpe, Pharm.D.; Amber Ulate, M.S.N., M.H.A., RN. “Identification of
high-risk patients and implementation of risk-specific interventions
to decrease readmission rates for heart failure and acute myocardi-
al infarction: Experience from the ACC Patient Navigator Program.”
National Cardiovascular Data Registry 17th Annual Conference.
Washington, D.C., March 13-15.
Jennifer Wintz, B.S.N., RN, QIA; Shelli Chernesky, M.S.N., MBA, RN,
CCRN. “Management of extracorporeal photopheresis in a patient
receiving total parenteral nutrition: Interdisciplinary collaboration
and coordination of care.” American Society of Apheresis Annual
Meeting. Fort Lauderdale, Fla., May 3-6.
Jennifer Wintz, B.S.N., RN, QIA; Shelli Chernesky, M.S.N., MBA, RN,
CCRN. “The challenges of a pregnant patient with sickle cell dis-
ease receiving red cell exchange.” American Society of Apheresis
Annual Meeting. Fort Lauderdale, Fla., May 3-6.
Jennifer Wintz, B.S.N., RN, QIA; Shelli Chernesky, M.S.N., MBA, RN,
CCRN. “Therapeutic plasma exchange to assist with acute antibody
medicated heart rejection.” Sigma Theta Tau International Research
Symposium. Arlington, Texas, April 22.
Jennifer Wintz, B.S.N., RN, QIA; Raquel Martin, B.S.N., RN, OCN; Shelli
Chernesky, M.S.N., MBA, RN, CCRN. “Clinical challenges with a patient
receiving total parenteral nutrition in need of extracorporeal pho-
topheresis.” 7th Annual Cowtown Oncology Nursing Symposium. Fort
Worth, Texas, March 10-11.
Fatemeh Youssefi, Ph.D., RN, OCN; Kim Marchard, RN, OCN; Kristen
Vaught, B.S.N., RN, OCN. “Increase awareness and promote ‘health
literacy’ in a clinical setting.” ONS 43rd Annual Congress. Denver,
Colo., May 4-7.
Abstracts in 2017
Abdul Abdulkadir, B.S.N., RN. “Enhancing communication during
hand-over: The ECHO study.” ANCC National Magnet Conference.
Houston, Texas, Oct. 11-13.
Dawn Brown, M.S.-M.A.S., B.S.N., RN, NE-BC. “Call light response.” ANCC
National Magnet Conference. Houston, Texas, Oct. 11-13.
Dawn Brown, M.S.-M.A.S., B.S.N., RN, NE-BC; Stephanie Huckaby,
M.S.N., RN, NEA-BC. “Stop the surgical pain!” ANCC National Magnet
Conference. Houston, Texas, Oct. 11-13.
Byron Carlisle, B.S.N., RN, CCRN. “Micro-SIMS solve an education time
crunch.” ANCC National Magnet Conference. Houston, Texas, Oct. 11-13.
Byron Carlisle, B.S.N., RN, CCRN. “New evidence and innovations: Pup-
illometers in acute care.” ANCC National Magnet Conference. Houston,
Texas, Oct. 11-13.
Byron Carlisle, B.S.N., RN, CCRN; DaiWai Olson, Ph.D., RN, CCRN, FNCS.
“Describing central tendency data for pupillary assessment in stroke
patients using automated pupillometry.” International Stroke Confer-
ence. Houston, Texas, Feb. 21-24.
Ruben Castillo, M.S.N., RN, CCRN; Candice Coker, B.S.N., RN; Emily
Coleman, B.S.N., RN, CCRN; Kelsey Wright, B.S.N., RN. “The butterfly initia-
tive.” ANCC National Magnet Conference. Houston, Texas, Oct. 11-13.
Linda Chan, B.S.N., RN, OCN. “Making it stick: Fusing practice model and
evidence-based care.” ANCC National Magnet Conference. Houston,
Texas, Oct. 11-13.
Linda Chan, B.S.N., RN, OCN; Marco Pataray, B.S.N., RN, OCN.
“Using a unit-based blog site to enhance bedside communica-
tion and engagement.” 42nd Annual Oncology Nursing Society
Congress. Denver, Colo., May 4-7.
Linda Chan, B.S.N., RN, OCN; Melissa Trevino, B.B.A., A.D.N., RN,
OCN; Sharon LeRoux, B.S.N., RN, CMSRN. “A pilot evidence-based
practice change project: Gum chewing to prevent prolonged
postoperative ileus in oncology patients undergoing abdominal
surgery.” 7th Annual Cowtown Oncology Nursing Symposium.
Fort Worth, Texas, March 10-11.
Shelli Chernesky, M.S.N., MBA, RN, CCRN. “MEWS scoring in
apheresis reduces sentinel events.” ANCC National Magnet Con-
ference. Houston, Texas, Oct. 11-13.
Joy Cox, B.S.N., RN. “The snap: A novel way to decrease informa-
tion fatigue.” ANCC National Magnet Conference. Houston, Texas,
Oct. 11-13.
Rebecca Dill, B.S.N., RN; Dara Mariani, B.S.N., RN. “The impact of
motivational interviewing on self-perceived burden in chronic
neurological patients.” UTSW Neuroscience Nursing Research
Center Symposium. Dallas, Texas, Aug. 12.
Rebecca Dill, B.S.N., RN; Dara Mariani, B.S.N., RN; DaiWai Olson,
Ph.D., RN, CCRN, FNCS. “A vision of the future: The impact of mo-
tivational interviewing with chronically ill neurological patients.”
AANN National Conference. Boston, Mass., March 21-24.
Rebecca Dill, B.S.N., RN; Dara Mariani, B.S.N., RN; DaiWai Olson,
Ph.D., RN, CCRN, FNCS. “The impact of motivational interviewing
on self-perceived burden in chronic neurological patients.” AACN
National Teaching Institute & Critical Care Exposition. Houston,
Texas, May 22-25.
Amanda Dirickson, M.S., ANP-C, APRN, SCRN; DaiWai Olson, Ph.D.,
RN, CCRN, FNCS. “Helping to educate women about the risk of
stroke (HER Stroke): Initial results from a teaching intervention.”
International Stroke Conference. Houston, Texas, Feb. 21-24.
Keri Draganic, D.N.P., APRN, ACNP-BC. “Comparing fluid rates in
septic patients with heart failure.” ANCC National Magnet Confer-
ence. Houston, Texas, Oct. 11-13.
Keri Draganic, D.N.P., APRN, ACNP-BC. “Preoperative prothrom-
bin levels in mechanical valve replacement.” ANCC National
Magnet Conference. Houston, Texas, Oct. 11-13.
Shannon Dunleavey, B.S.N., RN, CCRN; DaiWai Olson, Ph.D., RN,
CCRN, FNCS. “Pilot study to examine methods of data capture for
examining temperature practice in neurocritical care.” Neurocritical
Care Society Annual Meeting. Waikaloa, Hawaii, Oct. 10-13.
Laura Duran, M.S.N., RN-BC; Maria Flores, B.S.N., RN; Maria Darauay,
B.S.N., RN-BC. “Engaging leadership in proposed changes to staffing
model.” ANCC National Magnet Conference. Houston, Texas,
Oct. 11-13.
Victoria England, MBA, B.S.N., NE. “Leadership 3.0 – You’re a great
catch!” ANCC National Magnet Conference. Houston, Texas, Oct. 11-13.
Deleatha Foster, B.S.N., RN, CCTC. “Multidisciplinary team collab-
orates to improve outcomes.” ANCC National Magnet Conference.
Houston, Texas, Oct. 11-13.
Maria Grabowski, M.S.N., RN, OCN; DaiWai Olson, Ph.D., RN, CCRN,
FNCS. “Hi submit! Abstract writing bootcamp commits!” ANCC
National Magnet Conference. Houston, Texas, Oct. 11-13.
Maria Grabowski, M.S.N., RN, OCN; Deb Spitzer, M.S.N., B.S.N., RN,
OCN; DaiWai Olson, Ph.D., RN, CCRN, FNCS. “Cancer fertility pres-
ervation: What will it take?” ANCC National Magnet Conference.
Houston, Texas, Oct. 11-13.
Sarah Gray, B.S.N., RN, CCRN. “Exploring consistency of intracranial
pressure in research.” ANCC National Magnet Conference. Houston,
Texas, Oct. 11-13.
Sarah Gray, B.S.N., RN, CCRN; DaiWai Olson, Ph.D., RN, CCRN,
FNCS. “Exploring the variability and reliability of ICP reporting
in literature.” World Federation of Neuroscience Nurses. Opatija,
Croatia, Sept. 17-19.
Sarah Gray, B.S.N., RN, CCRN; DaiWai Olson, Ph.D., RN, CCRN, FNCS.
“Inconsistency in reporting variables related to intracranial pres-
sure measurement in scientific literature.” Congress of Neurological
Surgeons. Boston, Mass., Oct. 7-11.
Carol Hall, B.S.N., RN, CWOCN; Tomas Armendariz, B.S.N., RN, CMSRN;
Shelli Chernesky, M.S.N., MBA, RN; Jennifer Wintz, B.S.N., RN, QIA.
“Pictures worth 1,000 words.” WOCN Annual Conference. Salt Lake
City, Utah, May 19-23.
Carol Hall, B.S.N., RN, CWOCN; Claudia Engle, B.S.N., RN, CWOCN;
Emily Flahaven, B.S.N., RN, CWOCN. “What do PUPPs and skin
have in common?” WOCN Annual Conference. Salt Lake City,
Utah, May 19-23.
New Knowledge, Innovation, and Research 59New Knowledge, Innovation, and Research58
Tracy Heineman, B.S.N., RN, CCRN; Shannon Chalk, B.S.N.,
RN, CCRN-CMC. “Making it matter: Adding SpO2 and oxygen
requirement monitoring to modified early warning score.” AACN
National Teaching Institute & Critical Care Exposition. Houston,
Texas, May 22-25.
Tracy Heineman, B.S.N., RN, CCRN; Cindy Nixon, B.S.N., RN, CCRN;
Mike Mayo, M.S.N., B.S., RN, CCRN. “Diversity in practice: It’s not
just critical care anymore.” ANCC National Magnet Conference.
Houston, Texas, Oct. 11-13.
Stephanie Huckaby, M.S.N., RN, NEA-BC. “Reducing muda (waste)
in the discharge process.” ANCC National Magnet Conference.
Houston, Texas, Oct. 11-13.
Taylore Jansen, B.S.N., RN. CCRN; “Simulation game to improve
ETCO2 knowledge in critical care.” ANCC National Magnet Confer-
ence. Houston, Texas, Oct. 11-13.
Taylore Jansen, B.S.N., RN, CCRN; DaiWai Olson, Ph.D., RN, CCRN,
FNCS. “Pilot study of education gaming to improve adherence to
an ETCO2 monitoring protocol.” Mayo Clinic Neurocritical Care
Meeting. Orlando, Fla., May 4-6.
Taylore Jansen, B.S.N., RN, CCRN; DaiWai Olson, Ph.D., RN, CCRN,
FNCS. “The use of simulation gaming to improve ETCO2 mon-
itoring policies in the ICU setting.” AANN National Conference.
Boston, Mass., March 21-24.
Kelly Moore, RN, OCN. “Chemobrain: Early versus late onset of
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Houston, Texas, Oct. 11-13.
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invasive and noninvasive BP monitoring in patients receiving
vasoactive medications.” Neurocritical Care Society Annual
Meeting. Waikaloa, Hawaii, Oct. 10-13.
DaiWai Olson, Ph.D., RN, CCRN, FNCS. “Dynamic interaction
between EEG and ICP: A pilot study on wavelet coherence.”
American Academy of Neurology Annual Meeting. Boston,
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DaiWai Olson, Ph.D., RN, CCRN, FNCS. “Incongruence in constriction
velocity and neurological pupil index.” Neurocritical Care Society
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edge of Parkinson’s disease and its treatment.” American Neurological
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tial of providing culturally sensitive information to patients.” Student
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National Magnet Conference. Houston, Texas, Oct. 11-13.
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acquisition for intracranial pressure.” ANCC National Magnet Confer-
ence. Houston, Texas, Oct. 11-13.
DaiWai Olson, Ph.D., RN, CCRN, FNCS; Byron Carlisle, B.S.N., RN, CCRN.
“Eye color does not alter automated pupillometer readings.” Mayo
Clinic Neurocritical Care Meeting. Orlando, Fla., May 4-6.
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Julie Petitta-Greer, B.S.N., RN. “Changing practice in headache popula-
tion.” ANCC National Magnet Conference. Houston, Texas, Oct. 11-13.
Guilla Santos, B.S.N., RN. “Engaging nursing students to participate in
research experiences.” ANCC National Magnet Conference. Houston,
Texas, Oct. 11-13.
Carolyn Swann, MBA, RN; Rudy Arispe, B.S.N., RN; Keely Correa, B.S.;
Priya Dandekar, M.H.A., MBA; Cortney Hockett, M.S.N., RN; Cheryl
Kaplan, MBA, M.H.A., RN; Sarah McCoy, B.F.A.; Lara Restall, B.S.N., RN;
Linnea Tolbert, B.S.N., RN. “ABO verification policy changes” [see story
on page 59]. 25th Annual UNOS Transplant Management Forum.
Orlando, Fla., April 25-27.
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fidence?” ANCC National Magnet Conference. Houston, Texas, Oct. 11-13.
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National Magnet Conference. Houston, Texas, Oct. 11-13.
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ABO Abstract Presented at UNOS Transplant
Management Forum, April 2017
To illustrate the complex requirements of ABO verification
policy changes, we created an easy-to-follow flowchart. ABO
verification was already a complicated process involving the
coordination of multiple team members to ensure critical data
points are documented. The changes to the verification pro-
cess added an additional layer of complexity, prompting our
team to reassess our entire verification process. Our goal was
not only to meet the new requirements but also to drill down
on our current workflow, addressing any areas of potential
risks and developing a simplified, concise process that all team
members could consistently follow. Team members included:
Carolyn Swann, MBA, RN; Rudy Arispe, B.S.N., RN; Keely Correa,
B.S.; Priya Dandekar, MBA, M.H.A.; Cortney Hockett, M.S.N.,
RN; Cheryl Kaplan, MBA, M.H.A., RN; Sarah McCoy, B.F.A.; Laura
Restall, B.S.N., RN; and Linnea Tolbert, B.S.N., RN.
From left: Sharon LeRoux, B.S.N., RN, CMSRN; Melissa Trevino, B.B.A., A.D.N., RN, OCN; and Linda Chan, B.S.N., RN, OCN, conducted a pilot evidence-based practice change project, "Gum chewing to prevent prolonged postoperative ileus in oncology patients undergoing abdominal surgery," and shared their findings at mutliple venues across the country throughout 2017.
Background
Methods
Results Findings/Solutions
References
Conclusion
ABO verification is a complicated process involving the coordination of multiple team members to ensure critical data points are verified. The accuracy of the verification is a priority in ensuring that the correct organ is transplanted into the correct recipient. The event of an incompatible transplant is rare, but the outcome can be devastating. In an effort to eliminate safety gaps and risks, the OPTN implemented changes to the ABO policy on June 23, 2016. In 2015, our team began preparing for ABO Determination, Reporting and Verification Policy changes. The changes to the verification process added an additional layer of complexity, prompting our team to reassess our entire verification process. Our goal was not only to meet the new requirements, but to drilldown on our current workflow, address any area(s) of potential risk, and develop a simplified, concise process that all team members could consistently follow.
Utilizing a multidisciplinary approach, we involved representation from all departments/teams critical to the process: Donor Net Coordinators, Transplant Coordinators, OR, Anesthesia, HLA, Transplant Administration, Quality and Compliance, Transplant Surgery, HIM and our Electronic Medical Record team. The first step was a comprehensive review of all policy changes. Once a clear understanding of the changes in policy was established, we cross walked the policy against our current workflow, closely examining each team member’s role and each specific process, from time of organ offer to transplant completion.
Using the ABO flowchart, team member understanding of process changes, and the impact of their role on patient safety, has improved significantly as evidenced by feedback and work performance. Effective July 1 we are at 100 percent compliance with OPTN policy changes. Ongoing, focused education and retraining, supplemented with tools, such as the flowchart, continues.
1. OPTN Policy 5.5 – Receiving and Accepting Organ Offers
2. OPTN Policy 5.6 – Blood Type Verification upon Receipt 3. OPTN Policy 5.7 – Release Organs 4. OPTN Policy 16.4 – Packaging and Labeling
Disclosures and Contact Authors do not have any disclosures Carolyn Swann, MBA, RN: [email protected] Cheryl Kaplan MBA/MHA, RN: [email protected]
VERIFICATION POLICY CHANGES – WE MAPPED THE COMPLEX REQUIREMENTS IN AN EASY-TO-FOLLOW FLOWCHART
Carolyn Swann, MBA, RN; Rudy Arispe, BSN, RN; Keely Correa, BS; Priya Dandekar, MBA/MHA; Cortney Hockett, MSN, RN; Cheryl Kaplan, MBA/MHA, RN; Sarah McCoy, BFA; Laura Restall, BSN, RN; Linnea Tolbert, BSN, RN
The University of Texas Southwestern Medical Center
Areas of opportunity were identified and targeted for change. Certain tasks were segregated and reallocated or modified to ensure redundant safety checks throughout. A critical component of the project was gathering the source documents containing key elements required for verification into an electronic packet, accessible to only members of the team. The attached flowchart was created to incorporate the ABO policy requirements and reflect our journey of a reworked roadmap, from offer to transplant. This flowchart serves as a great training tool for all team members, as well as a quick reference guide.
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