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.


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:


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


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


– Emergency Department

20. Rocky Sonemangkhara, B.S.N., RN, CCRN


– 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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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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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


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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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


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.


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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August 2017February 2017

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20

25Excellent Support

Solid Support

Somewhat Supported

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Num

ber

of S

taff

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25

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Solid Support

Somewhat Supported

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No Support



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ber

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25Excellent Support

Solid Support

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No Support



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ber

of S

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Somewhat Supported

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How supported do you feel in your role? (all staff)

Num

ber

of S

taff

0

5

10

15

20

25

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Adequate

Inconsistent

Poor

Non-Existent


How would you describe the teamwork between care coordinators and social workers (all staff)

Num

ber

of S

taff

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25

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Adequate

Inconsistent

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ber

of S

taff

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Poor

Non-Existent



Num

ber

of S

taff

0

5

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25

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Adequate

Inconsistent

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Non-Existent



Num

ber

of S

taff

0

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25

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ber

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taff

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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


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 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 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


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



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 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 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


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


0

1

2

Pts. 1-17 May 2, 2016-Oct. 17, 2016

Pts. 18-44 Oct. 30, 2016-June 12, 2017

Unplanned

1

0


0

1

2

Pts. 18-44 October 30, 2016-June 12, 2017

Pts. 1-17 May 2, 2016-October 17, 2016

Unplanned


0

1

2

Pts. 1-17 May 2, 2016-Oct. 17, 2016

Pts. 18-44 Oct. 30, 2016-June 12, 2017

Unplanned

1

0


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


% Excellent


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


% Excellent


Q3 17Q2 17Q1 17Q4 16Q3 16Q2 16Q1 16+

Staff’s Responsiveness to Requests**

Staff Easing Worries?Fears

0

20

40

60

80


% Excellent


Q3 17Q2 17Q1 17Q4 16Q3 16Q2 16Q1 16+

Staff Easing Worries/Fears**

Staff’s Courtesy and Helpfulness

0

20

40

60

80


% Excellent


Q3 17Q2 17Q1 17Q4 16Q3 16Q2 16Q1 16+

Staff’s Courtesy and Helpfulness**

Staff’s Courtesy and Helpfulness

0

20

40

60

80


% Excellent


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.


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


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


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.


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.


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


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


-48%

-51%

-37%

-16%

-38%

Total Alarms Per Bed/Per Day


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


-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


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


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%)


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


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.


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).


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.


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.


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.


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


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.


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.


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.


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.


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.


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


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.


Maria Grabowski, M.S.N., RN, OCN; DaiWai Olson, Ph.D., RN, CCRN,

FNCS. “Hi submit! Abstract writing bootcamp commits!” ANCC


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.


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.


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.


Stephanie Huckaby, M.S.N., RN, NEA-BC. “Reducing muda (waste)

in the discharge process.” ANCC National Magnet Conference.


Taylore Jansen, B.S.N., RN. CCRN; “Simulation game to improve

ETCO2 knowledge in critical care.” ANCC National Magnet Confer-



FNCS. “Pilot study of education gaming to improve adherence to

an ETCO2 monitoring protocol.” Mayo Clinic Neurocritical Care

Meeting. Orlando, Fla., May 4-6.


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

cognitive dysfunction.” ANCC National Magnet Conference.


DaiWai Olson, Ph.D., RN, CCRN, FNCS. “Associations between

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,

Mass., April 22-28.

DaiWai Olson, Ph.D., RN, CCRN, FNCS. “Incongruence in constriction

velocity and neurological pupil index.” Neurocritical Care Society

Annual Meeting. Waikaloa, Hawaii, Oct. 10-13.

DaiWai Olson, Ph.D., RN, CCRN, FNCS. “NNRC.” ANCC National Magnet

Conference. Houston, Texas, Oct. 11-13.

DaiWai Olson, Ph.D., RN, CCRN, FNCS. “Patient perceptions and knowl-

edge of Parkinson’s disease and its treatment.” American Neurological

Association Annual Meeting. San Diego, Calif., Oct. 15-17.

DaiWai Olson, Ph.D., RN, CCRN, FNCS. “Proxy servers and their poten-

tial of providing culturally sensitive information to patients.” Student

Creative Arts & Research Symposium. April.

DaiWai Olson, Ph.D., RN, CCRN, FNCS. “The language of data.” ANCC


DaiWai Olson, Ph.D., RN, CCRN, FNCS. “Verifying continuous data

acquisition for intracranial pressure.” ANCC National Magnet Confer-


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.

DaiWai Olson, Ph.D., RN, CCRN, FNCS; Byron Carlisle, B.S.N., RN, CCRN.

“Normative data of pupillary readings in neurocritical care patients.”

World Federation of Neuroscience Nurses. Opatija, Croatia, Sept. 17-19.

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.

Holly Ware, B.S.N., RN, CCRN. “Does BIS monitoring enhance nursing con-

fidence?” ANCC National Magnet Conference. Houston, Texas, Oct. 11-13.

Amy Weaver, M.H.A., B.S.N., RN, CEN; Carey Orrick, B.S.N., RN, CEN.

“A safety net for diabetic patients in the emergency department.” ANCC


Jennifer Wintz, B.S.N., RN, QIA. “Management of a perinatal patient

with sickle cell.” ANCC National Magnet Conference. Houston, Texas,

Oct. 11-13.

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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