AACN News—January 2009—Association News

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Vol. 26, No. 1, JANUARY 2009


Beacon Award Recipients for Fall 2008 Announced

Pediatric and Progressive Care Units Honored for the First Time

Every year since 2003, AACN has recognized the top critical care units across the country with the Beacon Award for Critical Care Excellence. These units have demonstrated a greater use of best practices, stronger teamwork, higher morale, better patient care and improved patient outcomes. The Beacon Award recipients for Fall 2008 include 31 units from 27 hospitals in 17 states. This fall’s award cycle marks the first time the award has been available to pediatric critical care units and progressive care units. Previously, the award was only available to adult critical care units.

The AACN Beacon Award provides a mechanism for hospital units to measure their systems, outcomes and environment against evidence-based national criteria for excellence.
This fall’s recipients have demonstrated their commitment to patient safety by meeting standards in six categories:

• Recruitment and retention
• Education, training and mentoring
• Research and evidence-based practice
• Patient outcomes
• Leadership and organizational ethics
• Healing environment

“Working toward, and ultimately earning, a Beacon Award sends a clear message that these exceptional unit teams are committed to making continuous improvement in providing exceptional patient care fostered by a healthy work environment,” said Caryl Goodyear-Bruch, RN, PhD, CCRN, president, AACN. “We are especially proud to recognize the first recipients of the Beacon Award for pediatric and progressive care units. They are pioneers who have raised the bar for other hospital teams.”

The latest award recipients brings the total number of Beacon units to 152. More than 200 units are in the process of applying at any given time. The award is
presented twice a year.

The AACN Beacon Award for Critical Care Excellence recipients for Fall 2008 are:

PEDIATRIC CRITICAL CARE
California
Children’s Hospital of Orange County (CHOC), Orange
• PICU

PROGRESSIVE CARE

Massachusetts
Baystate Medical Center,
Springfield
• Daly 6-2 Surgical Intermediate Care-B

Pennsylvania
Hospital of the University of Pennsylvania, Philadelphia
• Silverstein 10

Virginia
Virginia Baptist Hospital,
Lynchburg
• Intermediate Care Unit

ADULT CRITICAL CARE
Colorado
Medical Center of the Rockies, Loveland
• Cardiac Intensive Care Unit
• Surgical Intensive Care Unit
(two units recognized)

Connecticut
Norwalk Hospital,
Norwalk
• ICU-2FCCU (Three-time
recipient)

Florida
Munroe Regional Health Care
System,
Ocala
• ICU (Three-time recipient)

Tampa General Hospital
Tampa
• CVSICU

Georgia
Saint Joseph’s Hospital of Atlanta,
Atlanta
• Medical/Surgical ICU

Idaho
Saint Alphonsus Regional
Medical Center,
Boise
• Cardiovascular ICU

Indiana
Methodist Hospital,
Indianapolis
• Cardiovascular Critical Care
Unit

Michigan
Spectrum Health Butterworth Campus,
Grand Rapids
• 5 Meijer Heart Center

New Jersey
Morristown Memorial Hospital,
Morristown
• Intensive Care Unit (Three-time recipient)

Cooper University Hospital,
Camden
• CCU
• ICU-CT CCU
(Two units recognized)

Valley Hospital,
Ridgewood
• Coronary Care Unit

New York
Highland Hospital of Rochester,
Rochester
• Intensive Care Unit (Two-time recipient)
North Carolina
University of North Carolina
Hospital,
Chapel Hill
• Cardiothoracic Intensive Care Unit-UNC

WakeMed New Bern Campus,
Raleigh
• CCU
• SICU
(Two units recognized)

Ohio
University Hospitals Case Medical Center,
Cleveland
• Medical ICU (Four-time
recipient)

Oregon
Oregon Health & Science
University,
Portland
• Cardiac & Surgical ICU

Pennsylvania
Hospital of the University of Pennsylvania,
Philadelphia
• Rhoads 5 Surgical Intensive Care Unit (Three-time
recipient)
Texas
JPS Health Network,
Fort Worth
• ICU
Virginia
Bon Secours Memorial Regional Medical Center,
Mechanicsville
• Critical Care Unit

Inova Fairfax Hospital,
Falls Church
• Cardiovascular ICU


University of Virginia Hospital,
Charlottesville
• Porter Medical Intensive Care Unit (Two-time recipient)

University of Virginia Medical Center,
Charlottesville
• Thoracic Cardiovascular Post Operative Unit (Two-time recipient)

Washington
Providence Everett Medical
Center,
Everett
• Critical Care Unit

Sacred Heart Medical Center,
Spokane
• 2 South-ICU

For more information on
the Beacon Award, visit www.aacn.org/beacon or call
(800) 899-2226.

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Bookstore Corner

Make a New Year’s resolution to invest in your career by becoming certified in 2009!

AACN will support you by offering for a limited time 20 percent off the cost of all certification review courses and packages on CD-ROM, audio CD and DVD available for purchase at www.aacn.org/getcertified. Resources support all AACN certifications — CCRN, PCCN, CCNS, ACNPC, CMC, CSC, CNML.

Excellence at the Bedside

Certification validates your clinical knowledge, skills and abilities beyond the scope of RN licensure. Certified meet standards of excellence in acute and critical care nursing, distinguishing themselves as leaders in bedside care. Cathie Manning, a medical-surgical ICU nurse at Baystate Medical Center, Springfield, Mass., earned her certification in 1991. She said, “The first time I added CCRN after RN, I felt a responsibility to be the best ICU nurse I could be. I was no longer just a good nurse,” she added.

Manning pointed out how, now that PCCN certification is available, certification reaches beyond the ICU. “With the many stepdown units in our hospital there is great opportunity for nurses to expand their knowledge to include information once limited to the ICU.”

According to a national study published in Critical Care Nurse in October 2006, certification improves patient care and satisfaction. Certified nurses generally intervene earlier, make fewer errors and demonstrate improved confidence, competence and control than their non-certified counterparts, it states.

“Simply put, the more a nurse knows about how to assess, monitor and treat a critically ill patient, the better that patient’s chances are for early intervention. Knowledge helps you anticipate adverse situations because you’re better informed,” Manning said.

Certified Nurses More Empowered

A study presented by Joyce Fitzpatrick, RN, PhD, FAAN, at last May’s National Teaching Institute & Critical Care Exposition in Chicago, found AACN-certified nurses to be more empowered and less likely to leave their current position than non-certified nurses. Nurses with specialty certifications, such as CCRN and PCCN, earn praise and recognition from peers and demonstrate improved productivity, engagement and job satisfaction.

“When I became certified, I became more aware of my role as an ICU nurse and the increased responsibility to stay current with practice standards. I became more involved with direct patient care and policies for care delivery,” Manning said.

Hospital Support

Nurses To meet the criteria for the AACN Beacon Award for Critical Care Excellence and/or the Magnet Recognition Program, institutions must maintain high numbers of certified nurses. Hospitals, especially Magnet-designated institutions, support certification to encourage professional staff development. Manning said ICU nurses at Baystate, a Magnet hospital, must be certified to be eligible for promotion.

To become AACN-certified, you must sit for a multiple choice exam. The computer-based exam can be taken at any of the more than 170 Applied Measurement Professional assessment centers five days a week year-round. Three times a year the AACN National Teaching Institute & Critical Care Exposition and Philadelphia-area TRENDS conferences offer paper and pencil versions of the test too. AACN also offers discounted exam application fees for groups to employers and the association’s local chapters.

Critical Care Nursing: Synergy for Optimal Outcomes

Designed for nurses new to the critical care environment, this book identifies and matches patient characteristics and nurse competencies based on the AACN Synergy Model, leading to optimal patient outcomes. Each chapter contains evidence-based online resources, case studies with critical thinking questions and action items designed to help students apply the Synergy Model to patient care in the clinical setting.

Regular Price: Member $80.70
Nonmember $84.95 (#100147)

Just Culture: Training for Healthcare Managers

This workbook/online training combination introduces healthcare managers to the principles of the Just Culture. This training guide covers the Three Duties of employees, the Three Manageable Behaviors, event investigation, systems design, and the use of the Just Culture Algorithm as a key decision- making tool. Managers will be educated in concepts that create a safety-supportive culture, supporting an open reporting environment while holding employees accountable for their choices. This workbook can also be used to supplement the one-day live training session.

Regular Price: Member $75.15
Nonmember $79 (#128282)

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AACN Member’s Volunteer Program Used in Hospitals Worldwide



Sandra Clarke, RN, AD, AAS, founded a volunteer program in 2001 called “No One Dies Alone,” at Sacred Heart Medical Center, Eugene, Ore. Her program and others based on it are now in use at hospitals around
the world.

Sometimes patients don’t have family members or close friends in the area who can be with them at the end of life. With the support of nursing staff, this program provides a “compassionate companion” (a hospital employee) to be with the patients so they won’t be alone. The companions talk to the patients, play music and sometimes listen or just sit with them.

Clarke was inspired to create the program after an experience at Sacred Heart. A terminally ill man had asked her to stay with him, but she needed to check on a few other patients first. When she returned, it was too late.

Now an administrative supervisor for nursing clinical support at Sacred Heart, Clarke also offers a guidebook for those who would like to start their own program. It is very inexpensive to start and run, and benefits all involved – patients, nursing staff, hospitals and volunteers.

One unexpected benefit is volunteers become invaluable resources for their friends and family when such events occur in their lives.

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Members on the Move

Professional



Christy Rose, RN, MSN, CNRN, CCRN, accepted a position as quality initiatives coordinator for nursing at Denver (Colo.) Health Medical Center (DHMC). She was previously the clinical nurse educator in the Surgical ICU at DHMC. Among many other projects, Rose participated in the redesign of the Step-down Unit, which she also managed, and the implementation of AACN’s Essentials of Critical Care Orientation program.

Karin Nevius, RN, CCRN, CPAN, co-wrote the CE article titled “Decrease Recovery Time With Proper Pain Management” for the November 2008 issue of Nursing Management. The authors noted that “standardized pain management can help bring patients quicker relief and discharge home from the outpatient surgical center.”

Honors

Sonya Hardin, RN, PhD, CCRN, associate professor and ICU staff nurse at the University of North Carolina at Charlotte, School of Nursing, received the 2008 Nursing Spectrum Teaching Excellence Award. She was one of six “National Nurses of the Year.” These awards recognize the extraordinary contributions nurses make to their patients, one another and the profession. Hardin is also the author of several books, including “Synergy for Clinical Excellence: The AACN Synergy Model for Patient Care.”

Holly Quinn, RN, received the Cameo of Caring Award from the University of Akron College of Nursing. This program works to “foster a positive image of nursing to the community.” As a recipient of the award, she will speak to various schools and community groups. Quinn teaches advanced and basic cardiac life support at Robinson Memorial Hospital, Ravenna, Ohio.

Nancy Davies-Hathen, RN, MSN, received the Nightingale Award of Pennsylvania in the Nursing Administration category. She is the cardiac administrator at Lehigh Valley Hospital, Allentown, Pa. The award in this category is in recognition of creating a healing environment, influencing quality patient care, utilizing professional standards and resources, and demonstrating positive recruitment and retention outcomes.

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AACN a ‘Lifesaver’ in Tough Times

When Patty Kelly, RN, BSN, CCRN, attended the Fall 2007 AACN Board meeting as community liaison, she was happily ensconced in a hospital where she’d worked for 29 years. Little did she know how AACN would help her through a professional upheaval in 2008. Here’s her story, then and now...

Fall 2007: My Community Board Liaison Experience
By Patty Kelly

Each year, the AACN Board of Directors offers an opportunity for two community liaisons from the AACN membership to attend the Fall and Spring Board meetings. The selection process begins with members submitting an application. In 2007, I was selected, along with Karen Wood, and had the opportunity to attend the Fall Board Meeting in Newport Beach, Calif.

At the time, I worked in a coronary care unit as a level 3 staff nurse at North Ridge Medical Center in Fort Lauderdale, Fla. Having been involved for many years with my local chapter, I wanted to get involved at the national level. I had applied for this position before and had not been selected. I was encouraged by Mary Stahl, RN, MSN, CNS-BC, CCNS, CMC, CCRN (a second-year board member) at AACN’s annual NTI meeting. She told me not to give up and keep applying. I am so thankful for this advice and encourage other members to do the same.

I received the news in late September 2007. I was so excited … a trip to California, and the chance to witness and be a part of the great AACN organization at the national level. My board buddy was Paula Lusardi, RN, PhD, CCRN, CCNS, third-year board member. Paula welcomed me and gave me an idea of my duties and responsibilities.

On Saturday we arrived at the beautiful Balboa Bay Club and Resort, the site for the 2007 Fall Board Meeting. At dinner, Paula introduced me to the board members and AACN staff. Sunday morning we began our work. Guests were introduced, and I gave the board members and AACN staff “Reclaiming Our Priorities” pins, which I brought from the Broward County Chapter. Dave Hanson, RN, MSN, CCRN, CNS, immediate past AACN president, called the meeting to order and reported on the places he had visited around the country on behalf of AACN. The interactions were positive, and members were excited to begin “Reclaiming their Priorities.” During lunch we talked with AACN staff and learned some of what they do at the national office.

Monday discussions revolved around strategic planning. Interestingly, the board sets the vision with the AACN staff who develop and implement actions to accomplish it. Each member had the opportunity to give his/her viewpoint and explain how each had come to this conclusion. I felt like a valued team member, because I was given the chance to provide input throughout the meeting. A few times we split into small groups. This activity was so energizing, bouncing ideas around and sharing with the whole group. I talked with all of the board members and found them very approachable, receptive, interesting and fun loving.

Tuesday, the meeting concluded after a morning session, and the first-year board members, Karen Wood and I toured the national office in the afternoon. We saw staff whom we had “met” by e-mail or phone, and each person explained his/her role at the national office. What a delight to meet these individuals who keep our organization operating efficiently on a daily basis.

In conclusion, I came home with a greater appreciation for the AACN staff and Board of Directors. I will always cherish this experience and look forward to more volunteer opportunities.

Fall 2008: An Interview With Patty Kelly

AACN News: When you reread the feature you wrote recounting your community board liaison experience in 2007, what came to mind?

Kelly: I still recall how board and staff members spoke to each other—with utmost respect, caring and concern. We often forget to treat our co-workers with the same level of esteem. Each person brings something important to the table. I had a wonderful relationship with my colleagues at North Ridge Community Hospital, where I’d worked for 29 years. My North Ridge coworkers were -my family; we were looking forward to retiring together in a few years. That all disappeared when the hospital was bought—and then closed—by Holy Cross Hospital. With that decision, 400 of us lost our jobs. Our careers were turned upside down.

What a difficult time! How did you manage it?

I was one of the lucky ones who transferred to Holy Cross. But it was definitely a culture shock. North Ridge was relatively small; Holy Cross much larger and very different in its policies and procedures. At this point in my career, I found myself learning a whole new way of working. It was traumatic, to say the least.

The bright spot during that time was my affiliation with AACN. After a personally challenging orientation at Holy Cross, I went to NTI 2008 in Chicago, where I had support and guidance from those I’d met at the 2007 board meeting. I returned to my new job refreshed and determined to bring what I’d learned from AACN into the workplace.

It’s been more than six months since your job change. How’s everything going?

In a word, awesome. The transition, though tough, actually worked out very well for me. I have additional responsibilities and plenty of opportunities to mentor. And I enjoy spreading the word about the advantages of belonging to AACN through good times and bad. I just can’t say enough about the organization, especially during the past year. For me, AACN is a lifesaver.

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Scene and Heard

Our Voice at the Table

Maria Shirey, RN, PhD, MS, MBA, CNAA, BC, FACHE, chair-elect, AACN Certification Corporation, represented AACN Certification Corporation at Health Professional Oversight Boards and Quality of Care, the 21st annual meeting of the Citizen Advocacy Center (CAC), in Asheville, N.C. The conference focused on health professional oversight boards and quality of care for patients. More than 100 representatives of many credentialing organizations, including AACN, were in attendance.

CAC’s president and CEO, David Swankin, Esq., consumer representative on the AACN Certification Corporation board, moderated a roundtable discussion titled “How Can Licensing Boards Promote Quality of Care?” and a panel discussion on “Promoting Quality and Access via Evidence-Based Scope of Practice.” The CAC’s consumer protection mission is to increase the accountability and effectiveness of healthcare regulatory, credentialing, oversight and governing boards.

Our Experts Share Their Knowledge

Kathy Stephens Williams, RN, MSN, CCRN, AACN board member, presented a breakout session titled “Creating a Healthy Work Environment” at the Sister Noreen McGowan Pediatric Conference, When Crisis Comes to Call, in Creve Coeur, Mo. The audience was a mix of pediatric, ED and trauma nurses and physicians. This year’s conference focused on the challenges that healthcare workers face in foreign and war-torn countries, during natural disasters, in hospital clinical settings and in the community.

Julie Miller, RN, BSN, CCRN, AACN board member, spoke at the Greater Milwaukee Area Chapter’s Critical Care Update on the “Latest in Vasospasm Treatment” and presented the closing keynote, “Life’s Daily Challenges - Lifting Ourselves Above.” Chapter President Diane Dressler, RN, CCRN, GMAC chapter officers and members, and Beth Hammer, RN, MSN, APRN-BC, AACN president-elect, were in attendance.

Caryl Goodyear-Bruch, RN, PhD, CCRN, AACN president, gave the Opening Keynote, “With Confidence, Live Your Power of One.” After the two-day conference, she summarized her speech. “We all want to work with people who have positive, can-do attitudes, are great team players and are fun! These are characteristics of people with confidence … Finding confidence in our power of one requires building know-how, including how to have a crucial conversation, practicing this new skill and imagining your success by painting the successful, confident action in your mind … Confident nurses feel empowered to act and believe in the power of one … Confident units are teams that create their own ideal workplace.”

The conference is designed to update acute and critical care nurses on the latest evidence-based practices, motivate them to use the power of one and embrace their practice with confidence.
Hammer was the featured speaker at the South Central Connecticut Chapter’s annual dinner meeting. Her topic, “Assuring Patient Safety and Healthy Work Environments With Confidence,” included a discussion on how attendees could implement Healthy Work Environment standards to meet patient safety goals.

Linda Bucher, RN, DNSc, AACN board member, spoke at TRENDS in Critical Care Nursing in Valley Forge, Pa., a conference co-sponsored by AACN and the Southeastern Pennsylvania Chapter (SePA). Her topic was “Designing the Ideal Nursing Research Study: Forewarned Is Forearmed.” In her presentation, Bucher shared her experiences with the barriers she has encountered while conducting nursing research. She advised that identifying and dealing with these common barriers beforehand contributes to the successful completion of most studies. For example, there should generally be at least one or two eligible subjects per day who can be invited to participate in the study, to assure the target sample size is achievable within a reasonable period of time.

John Whitcomb, RN, PhD, CCRN, AACN and AACN Certification Corporation board member, spoke on “Healthy Work Environments” at the Dinner Lecture in Chesapeake, Va. sponsored by AACN’s Tidewater Chapter.

Whitcomb spoke on “Healthy Work Environment, Crucial Conversations and Lateral Violence” during Grand Rounds at the Naval Medical Center, Portsmouth, Va. He also presented the topic to Navy Medicine East, Directors of Nursing, via teleconference.

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AJCC Article Among Medscape’s Top Critical Care Articles of 2008

The article “Outcomes of Tube Thoracostomies Performed by Advanced Practice Providers vs. Trauma Surgeons,” published in the July 2008 issue of the American Journal of Critical Care (AJCC), ranked sixth on Medscape’s list of “Top 10 Critical Care Articles of 2008.” The article received this ranking based on the total number of unique and per-page visits to the Medscape Web site during a four-month period starting in July, the month of the article’s publication, and ending in October 2008.

Medscape, part of the WebMD Health Professional Network in New York, provides registered users with free Internet-based access to clinical and continuing medical education information. Journal articles that appear on www.medscape.com enjoy enhanced public exposure to a medical readership beyond that afforded by their specialty niche, explained Medscape’s Stefanie Parsons, who noted that the site boasts 1 million visits by physicians in 33 specialty areas per month.

The AJCC article, written by Laura C. Bevis and colleagues of the Wesley Medical Center in Wichita, Kan., compares tube thoracostomies performed by advanced practice providers (APPs) to those performed by trauma surgeons to determine differences in complication rates. The authors concluded that APPs (including advanced registered nurse practitioners and physician assistants) provide quality tube thoracostomies and “a safe and reasonable solution” to meet the needs of trauma and emergency departments.

“The quality of tube thoracostomies performed by APPs is neither statistically nor clinically inferior to those performed by attending trauma surgeons. These findings add to the evidence that well-educated and supervised APPs may safely and competently enhance and expand the trauma/emergency center staffing model and care to patients,” the authors concluded.
To read the full article on the AJCC Web site, visit http://ajcc.aacnjournals.org/cgi/content/full/17/4/357.

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