News and Views from DMC Patient Care Services

Summer 2014

In this issue

Letter from Shawn Levitt

Shawn Levitt

Lately, I have been hearing many comments about the weather both during personal conversations, and from the media. Many ask, "Where are the long, lazy, hot days of Summer that I remember?" Well, the weather is different now as our planet continues to evolve and react to the environmental impact of human technology. There is no "normal" summer, or winter anymore. As our planet evolves, so must we adapt to the variations in the seasons and also learn to let go of the "way it used to be," in order to move forward.

Now more than ever, there is a need for us to be willing and open to new methods and processes related to our traditional work and mission of providing excellent clinical care to our patients and families.

This analogy is very similar to our health care industry. There are those who lament over the old processes claiming that they were better and that too much technology is changing the face of caring to our patients and their families. I would argue that we as humans have always adapted and evolved to ever higher levels of functioning. It is our nature to observe, question, try new things and evolve. Now more than ever, there is a need for us to be willing and open to new methods and processes related to our traditional work and mission of providing excellent clinical care to our patients and families.

We at the DMC have integrated the LEAN methodology and High Reliability practices throughout our organization, requesting innovation and leadership from employees at all levels to work with leadership to improve the way we provide care and do business. Through the brilliance of many we have identified improvements to workflows, financial opportunities or waste, enhanced patient safety and overall experience.

While we are challenged to respond and adapt to dynamic legislative and regulatory standards, we should not look upon this as "extra work", but as an opportunity to modify our existing practices, utilizing our nationally recognized foundation of technology to aspire to be the best hospital in both the state of Michigan and the Tenet Health system.

Mark Samuel in his book Creating the Accountable Organization states, "Typically, we assume that leadership is the exclusive domain of management. Yet successful organizations have leaders at all levels of the organization." In this ever changing environment, and as part of the Tenet family, we need strong leadership from everyone in order to keep the DMC in the national spotlight. We have the talent, technology and the desire to serve.

Each of us must choose to observe, question, be willing to try new things through innovation, and lead in order to achieve success.

Sincerely,

Shawn Levitt, BSN, MHSA, RN, FACHE, CPHQ, CMCN
Chief Nursing Officer
Detroit Medical Center

BACK TO TOP

Feature

Meet the DMC PNC

The mission of the DMC PNC is to represent professional nurses and promote shared decision-making in the pursuit of excellence in
nursing care.

Every month nurses from each DMC hospital come together in the RIM eighth floor conference room for an all day meeting. Together they form the DMC Professional Nurse Council (DMC PNC). The mission of the DMC PNC is to represent professional nurses and promote shared decision-making in the pursuit of excellence in nursing care. Our motto is "If it touches nursing practice at the DMC, it belongs to PNC."

Professional Nurse Council members discuss practice issues, develop and review policies, and collaborate in decision-making with leadership and other departments. Ongoing communication with the DMC nursing staff is available via the nursing website and through each hospital's council. The goal is to give staff nurses a voice in determining best nursing practice and standards of care.

The primary members are staff nurses who are also the site PNC chairs at each hospital. Of these, one member is elected by the group to serve as Chair and one as Chair-Elect. Other participants who support the group as advisors and mentors are Advanced Practice Nurses, Nurse Executives, Educators, Nurse Managers, and Directors. Representatives from Pharmacy, Clinical Transformation, R & R and MedVat also attend monthly.

We all work at different hospitals but together we work as one, representing the best nurses ever...DMC Nurses!

Meet your DMC PNC

    Joshua Alexander, RN
DSG Representative
 
  Molly Duane, BSN, RN, CCRN
DMC PNC Chair-Elect
Graduate of Wayne State University
Staff Nurse in MICU at HUH for 29 years
Chair of HUH/HWH PNC and CC PNC
 
  Sheri Frank, BSN, RN, CCRN
2014 DMC PNC secretary
DRH's associate DMC PNC member
Graduate of Madonna University
Chair of DRH's Practice Review/Safety and Quality Council
Staff Nurse in Neuro ICU at DRH for 15 years
 
  Laura Kovie, RN
DMC PNC Chair
3rd floor RIM
Gradate of Baker College – Clinton Township
Staff Nurse for 6 ½ years
 
  Kevin LeForge, RN
RIM PNC Chair
6th floor RIM
Gradate of Schoolcraft College
Staff Nurse for 5 years
 
  Pam Loszewski, RN, CCRN
Staff Nurse in the ICU at HVSH for 20 years
HVSH PNC Chair
 
  Patty Reaume, BSN, RN
CHM PACU for 20 years
CHM PNC Chair elect
 
    Angel Schultz, RN
Chair of Sinai-Grace PNC
Staff Nurse NICU at Sinai-Grace since 2007
"I feel very strongly about the importance of nurses' input in their everyday evidence-based practice."
 
  Charlene Staddon, BSN, RN
Staff Nurse at DRH for 21 years
(Spinal cord unit, neuro-trauma ICU, recovery room and pre-op holding)
Chair of DRH Coordinating Council
"I love being a nurse and being a part of the councils. We are the voice for all nurses at the DMC."

BACK TO TOP

Feature

Celebrating the DMC’s PCAs:
Compassion In Action

PCA Day was celebrated with the theme "Compassion in Action", a perfect tribute to recognize all PCAs, ED Technicians, Medical Assistants and Mental Health Technicians, for all of the hard work and dedication provided by each of them, for the sake of excellent patient care.

The Recognition Ceremony was held at DMC Children's Hospital of Michigan on June 10th, to honor our Hospital Winners. The guest speaker was William Randall Brown, Regional Director Service Excellence. The DMC PCA Council, Patient Care Service Division and The Department of Nurse Recruitment sponsored the event.

From left: Kim Howell, Kevin Lundberg, Kimberly Pritchard, Tamika Tarver and Gigel Peti Bota.

Congratulations to our hospitals’ PCAs of the year!

CardioVascular Institute
Kevin Lundberg, CPCT
Began his PCA position at CVI in February of 2012

DMC Children's Hospital of Michigan
Mary Hampton
Started with the DMC in 2008

DMC Detroit Receiving Hospital
Kim Howell, CPCT
Began working at the DMC in 1990

DMC Harper University Hospital
Tamika Tarver, CPCT
Began her PCA position at HUH in November 2011

DMC Huron Valley-Sinai Hospital
Gigel Peti Bota, CPCT
With the DMC since 2004

DMC Hutzel Women's Hospital
Karima Samad-Davis
Has been at HWH as a PCA since 1999

DMC Rehabilitation Institute of Michigan
Kimberly Pritchard, CPCT
Has been working at the DMC since 1995

DMC Sinai-Grace Hospital
Patricia Kardosh
Began her career at the DMC in 1972

On June 12th, the PCAs enjoyed a Rock n' Bowl Party held at Majestic-Garden Bowl. Bowling, food and fun! Click here to view more PCA Celebration pictures.

BACK TO TOP

Feature

DMC 2014 Research and
Evidence-Based Practice Day

Research and Evidence-Based Practice Day is a way for the DMC's academic partners and nurses to share the impact of their research, while hearing new perspectives and forging collaborative partnerships.

Nursing research is the foundation of advancing health care. As a champion of impactful nursing research, the DMC Nursing Research Council organized an initiative in 2010, bringing together the nursing community to highlight just that subject The goal was not only to provide a forum for advance practice nurses and DMC Scholars to present their evidence-based practice and research projects, but also to expose staff nurses to these insights, igniting and fueling their own research ambitions. Three lectures were offered on a rotating schedule along with continous oppurtunities to preview posters and talk with authors about their research. Podium presentations were: Mooving Sacred Cows Out of Nursing Practice (presenter: Maria Bobo, DNP, RN, WHNP-BC); Distinguishing Research from QI or Evidence-Based Practice (presenter: Margaret L. Campbell, PhD, RN, FPCN); and Finish the Job (presenter: Mary Sieggreen, MSN, APRN, BC, CVN).

Now an annual event at the DMC, Research and Evidence-Based Practice Day remains a way for the DMC's academic partners and nurses to share the impact of their research, while hearing new perspectives and forging collaborative partnerships.

Wayne State University and Drexel University were onsite to assist those with additional education decisions. Congratulations to Nicoli Novak (DMC RIM), Drexel University's iPad winner!

Thanks to everyone who made Research Day 2014 a wonderful success! Click here to view posters.

BACK TO TOP

Feature

Targeting Toileting to
Reduce Patient Falls

Successful fall prevention programs use the critical thinking of nurses to link research-based risk factors with specific nursing interventions to reduce the risk of falling.

The causes of falls are complex, and assessing each patient for their risk of falling is required to determine what the patient needs in order to keep them safe. Comprehensive fall prevention programs combine environmental risks with key strategies to reduce the risk of patient falls and fall rates. Ann Hendrich (2006) found that there is a direct safety benefit from targeting individual patient risk factors so they can be reduced or eliminated. It is a known fact that more than 50% of all falls occur while patients are trying to get to the toilet, return from the toilet, and while trying to exit the bed to get to the toilet. It is a universal phenomenon, and it is the one most often overlooked (Hendrich, 2006).

Alert patients who have fallen while trying to meet elimination needs often report they felt concerned about asking for nursing help given how "busy" they perceive nursing staff to be. Regularly scheduled toileting of high-risk patients with impaired gait and mobility due to functional deficits or drug side effects will reduce falls in most acute care hospitals between 50% and 70%, yet this intervention is inconsistently applied (American Nurse, 2011)

Successful fall prevention programs use the critical thinking of nurses to link research-based risk factors with specific nursing interventions to reduce the risk of falling. Since lack of assistance while toileting accounts for the majority of falls, a variety of interventions need to be in place. It will take contributions from the entire care team to meet the goal of keeping patients safe.

Speaking directly and clearly about fall risk to patients and their families can help reduce personal risk taking that contributes to falls.

Interviews with patients who have fallen often show that they did not understand their own personal risk, and staff failed to involve the family. Speaking directly and clearly about fall risk to patients and their families can help reduce personal risk taking that contributes to falls. Letting patients know they may suffer a minor injury, a permanent injury, or even a fracture as a result of a fall should be considered as a possible element of effective patient education. Patients with symptoms of confusion, depression, or dementia will benefit from continuous monitoring (chair and bed alarms and visual or remote monitoring) to assure they do not attempt to get up without assistance.

Environmental factors that may impact the risk of falls include:

The goal is to reduce the likelihood of falls while maintaining dignity and independence. So what can the healthcare team do?

American Nurse Today (2011). Meeting the challenge of falls reduction. American Nurse Today Vol. 6 No. 3.

Hendrich, A. (May/June 2006). Inpatient Falls: Lessons from the Field. Patient Safety & Quality Healthcare. Retrieved via this link.

Institute for Healthcare Improvement (2009). Leadership for Safety: Supplement 1 Patient Safety WalkRounds. Retrieved via this link.

BACK TO TOP

Detroit Fire Department: Engine 40 Fire House

Back to School Community Project

Once again, the Detroit Receiving Hospital Professional Nurse Council & the Education Department are partnering with Detroit Fire Department, Engine 40 for their Back to School event. Last year with help of donors like you, the council provided almost 100 backpacks filled with school supplies! We are hoping you will join us in this community effort again. We are collecting supplies at DRH in Education Suite 3N-2 until August 22nd. So, if you see those sales for 10 for $1 spiral notebooks or 1ยข pocket folders, grab a couple and drop them off. Attached is a list of things the kids can use. Any help is appreciated.

If you would like to come by and bring your family for the event, it is a great time. If you want to help the firefighters stuff the backpacks, it's always fun working with them. This year the DRH Educators will have a table with demos of AED and a CPR game. We won't turn away help with that either. So grab some supplies, bring the family and join us at Engine 40.

Suggested School Supplies List

BACK TO TOP

AWARD

RIM Receives Tenet
Clinical Innovation Award

There have been hundreds of “good catches” at RIM, in which patients have been prevented from falling and the patients and families have experienced a high sense of security through the use of video monitoring.

DMC Rehabilitation Institute of Michigan was the proud recipient of a Tenet Innovation Award at the April National Tenet Leadership Conference in Dallas, Texas. One of ten recipients across the country, RIM was recognized for commitment to patient safety through the use of video monitoring technology on its new neuroscience unit.

Patient falls are a significant risk to all patients and especially those in an acute inpatient rehabilitation environment. Patients recovering from a neurological condition such as a traumatic brain injury or stroke are at an even greater risk to fall due to impaired judgment, decreased mobility and balance. Even as patients increase their mobility, their confidence often exceeds their capability thus increasing their risk for falling. The Neuroscience Unit had the highest incidence of falls and highest fall rate at RIM. This unit also had the highest sitter usage.

As one part of the redesign of the new unit, which opened in November 2012, the nursing team launched the use of video monitoring technology 24 hours a day, 7 days per week. Their goal was to reduce falls below the NDNQI mean of 5.72 for Rehabilitation Facilities and to reduce their reliance on sitters. Through the use of this creative technology and the outstanding commitment of the nursing team, the neuroscience unit had excellent results in 2013! The number of falls decreased from 67 to 21 (69%) and the fall rate per 1000 patient days decreased from 9.29 to 3.3 (a 68% reduction). The number of sitters used also decreased 28%. There have also been hundreds of "good catches" in which patients have been prevented from falling and the patients and families have experienced a high sense of security through the use of video monitoring.

RIM was presented with a beautiful crystal trophy at the conference and received a check for $10,000 to use towards continued efforts to innovate and build a culture of safety.

BACK TO TOP

Education Beat

DMC PCA Preceptor Workshop
October 1, 2014 • 8:00am – 5:00pm
Huron Valley–Sinai Hospital, Nursing Education Classroom 3C-348
No cost to the employee
Register in NetLearning
You may also email nursing education: Diana Bowman (dbowman@dmc.org) or Michelle Compton (mcompton2@dmc.org)

Save the date!
DMC Pain conference
September 19, 2014
Kresge Auditorium at the Kresge campus (Old Hutzel Hospital)
Watch for more information

9th Annual Children's Hospital of Michigan Nursing Conference: Excellence in Nursing: Research/Practice/Innovation
September 26, 2014
Registration is now open; click here for more.
Click here for a conference brochure.

BACK TO TOP

Kudos Corner

Congratulations to the following for their outstanding accomplishments!

DMC Children’s Hospital of Michigan

Degree Advancement

Awards

Promotions

Congratulations

DMC Harper University
and Hutzel Women’s Hospitals

Certifications

PCA Certifications

Professional Development Ladder Recipients for June 2014

Degree Advancement

Daisy Award Recipients

Presentations

Special Recognition
Circle of Excellence Award Recipient

The Circle of Excellence Awards recognize up to 25 individuals who exemplify excellence and innovation in the care of acutely and critically ill patients and their families. Award recipients must be an active AACN member.

DMC Detroit Receiving Hospital

Certifications

Degree Advancement

Special Recognition

Cathy June pictured with Dr. Knicker, the father of CPR, and his lovely wife. Dr. Knicker discovered CPR and published the first research on its use in 1960. He is also credited with the invention of defibrillation.

DMC Rehabilitation Institute of Michigan

2014 Tenet Clinical Innovation Award

DAISY Award

TULIP Award

LILY Award

ROSE Award

Degree

Certifications

Promotions

DMC Sinai Grace Hospital

Degree Advancement

Congratulations to the following nurses certified as Lactation Counselors

DMC Huron Valley-Sinai Hospital

Degree Advancement

New Certification

BACK TO TOP