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Affiliated with The University of TexasHealth Science Center at Houston
(UTHealth) Medical School
PROUD TO BE NURSE FRIENDLY!The mission of nursing at the Memorial Hermann-Texas Medical Center Campus is to drive quality outcomes by protecting, promoting and optimizing the health and wellbeing of patients we treat.
October 15, 2012
a publication for nurses and allied healthcare professionals
Magnet® Component Highlight: Structural Empowerment
The Nursing Shared Governance Structure, whose members are pictured above, is just oneexample of Structural Empowerment at the Memorial Hermann-Texas Medical Center Campus.
Read on to learn more about how you can make a difference in your profession!
What Is Structural Empowerment?
Special Message from the CNOs
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We would first like to thank everyone fortaking the time to attend the specialTown Hall meeting dedicated toMagnet® late last month. We had animpressive turnout and truly enjoyedsharing our thoughts with you.
Many people offered great ideas andconstructive feedback, which isincredibly valuable to nursingoperations. For example, one nurse saidit would be helpful if the CNOs roundedduring the night shift – which is exactlywhat we are going to do. Don’t besurprised to see us on the unit around1:30 a.m.!
Most importantly, the Town Hallmeetings gave us an opportunity toshare the exciting news of our Campus’
intent to apply for Magnet in early 2013.During our presentation, we brieflyexplained the application process andwhy becoming a Magnet-designatedfacility is such an important goal.
Magnet isn’t just a trophy or one-time award – it’s an organization’spromise to serve as a source ofknowledge and expertise for the deliveryof nursing care. It’s a promise toconstantly advance nursing standardsand practice by providing a roadmap fornursing excellence and serving as aframework for a hospital nursingdelivery system that elevatesperformance all around.
Because of your commitment anddedication, the Campus now has theopportunity to achieve Magnet status.Similar to the Joint Commission visit,the Magnet visit will comprise of highly-trained professionals who will ask staffmultiple questions about the nursingoperations and structure on thisCampus.
To help better prepare us for the sitevisit, we have dedicated the next feweditions of Clinical Notes to focus on
different Magnet components. It’simportant for everyone to be well-versedin the Magnet language and understandwhat all has been done to improvenursing.
This month’s edition highlightsStructural Empowerment. Please readbelow for a quick explanation of thiscomponent. The following articlesprovide detailed information on theMemorial Hermann-TMC Campus’initiatives and programs supportingStructural Empowerment. We hope youenjoy the issue and we look forward tohearing your feedback.
Sincerely,
Victoria King, M.H.A., M.S.N., R.N.,C.N.O.R., N.E.A.-B.C.Chief Nursing OfficerMemorial Hermann-TMC
Cheryl Olson, M.S., R.N., N.E.A.-B.C.Chief Nursing OfficerChildren’s Memorial Hermann Hospital
Solid structures and processes provide an innovative environmentwhere strong professional practice flourishes and wherethe mission, vision and values come to life to achieve theoutcomes believed to be important for the organization.
The key components of Structural Empowerment are:• Collaborative relationships with community
organizations;• Professional engagement in organizational
structure; • Commitment to professional development;• Teaching and role development;• Recognition of nursing locally, statewide and
nationally.
– American Nurses Credentialing Center
Global Issues in Nursing & Health CareStructural
Empowerment
TransformationalLeadership
ExemplayProfessional
Practice
NewKnowledge,
Innovations &Improvments
EmpiricalOutcomes
Victoria King Cheryl Olson
Establishing Structure through the Nursing Shared Governance Councils
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A key component of StructuralEmpowerment is professionalengagement, which includes nursinginvolvement in self-governance andshared decision-making. At theMemorial Hermann-Texas MedicalCenter Campus, nurses supportprofessional engagement by participatingin multiple committees, councils andtask forces.
For example, the Nursing SharedGovernance Structure is an operationalmodel composed of multiple councilsthat provide nurses the opportunity tohave an active voice in shaping theirpractice environment and influencingpatient outcomes.
Established in 2011, the Structureincludes the following nursing councils,each of which comprises at least 50percent bedside nursing members:• The Professional Nursing
Practice, Quality and PatientSafety Council develops, reviewsand updates standards of nursingpractice and care delivery to beconsistent with local, regional, stateand national standards, as well aswith the Texas State Nurse PracticeAct.
• The Professional NursingResearch and Evidence-Based Practice Council worksto strengthen the abilities of the clinical nurse to review,interpret and implement research to enhance professionalnursing practice across the hospital’s service lines.
• The Professional Nursing Education Council defines,implements and maintains educational standards thatpromote clinical competency for the professional nurse.
• The Professional Nursing Recruitment, Retentionand Recognition Council provides support in the areaof recognition and reward for the advancement ofprofessional nursing, and guides recruiting efforts to bealigned with the nursing strategic plan.
• The Professional Nursing Informatics Council worksto enhance patient outcomes through improvedtechnology and documentation processes.
• The Professional Nursing Night Council works toensure continuity of care across all shifts, and providesnight shift nurses a forum in which to contribute topatient care improvement initiatives.
• The Professional Nursing Magnet Council works tosupport and advance Campus efforts to achieve theesteemed Magnet® accreditation from the AmericanNurses Credentialing Center.
The councils have led numerous initiatives and programsaimed at improving the nursing profession and environment.The Professional Nursing Recruitment, Retention andRecognition Council collaborated with the nationallyrecognized DAISY Foundation to bring the DAISY Award tothe Memorial Hermann-TMC. The award is presented to onenurse each month for going above and beyond to deliver
(Continued on page 7)
NURSING SHARED GOVERNANCE
STRUCTURE
Professional Nursing Magnet Council
Chair: Marilyn Babich
Professional Nursing Adult Practice, Quality
and Patient Safety CouncilChairs: Stacy Wallace, Suja Shaji, Shelly Vargo
Professional Nursing Children’s Practice, Quality and Patient Safety Council
Chair: Open
Professional Nursing Research and Evidence-Based Practice Council
Chair: Candace Scheresky
Professional Nursing Education Council
Chair: Michelle Maixner
Professional Nursing Recruitment, Retention and Recognition Council
Chair: Elizabeth Maxon
Professional Nursing Informatics Council
Chair: Marco Ollervides
Professional Nursing Night Council
Chair: Jennifer Gonzales
New Children's Council Kick-Off The Professional Nursing Practice, Quality and Patient SafetyCouncil recently split into two separate councils so nurses canfocus on quality measures of the patient population to whichthey have received specialized education and practice. TheProfessional Nursing Children’s Practice, Quality and PatientSafety Council recently held an inaugural kick-off, whichincluded a day of training and orientation for members.
Did You Know?
Did you know that professional nursing certificationacross the Memorial Hermann-Texas Medical CenterCampus has increased from 4 to 28 percent in justtwo years?
One requirement for a Magnet® designated facilityis a certain percentage of the nursing staff must becertified. This is not only important for Magnet, butalso for the nursing profession and the care ofpatients.
Lifelong learning is the responsibility of the nurseand is essential to maintain and increase competencein nursing practice. A certification also assurespatients that the individual taking care of them iscommitted to a specialty and will bring best practicesinto their care.
Learn more about how you can become certifiedin your specialty by visiting a nursing certificationagency.
Nursing Certification Agencies:• American Nurses Credentialing Center (ANCC)
www.nursecredentialing.org• American Association of Critical-Care Nursing
(AACN) www.aacn.org• American Board of Neuroscience Nursing (ABNN)
www.aann.org• Association of Perioperative Registered Nurses
(AORN) www.aorn.org• The Wound, Ostomy and Continence Nursing
Certification Board (WOCNCB) www.wocncb.org
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The nursing profession developed theclinical ladder concept over 30 yearsago. The purpose of the program is to:• Foster professional development;• Strengthen the overall quality of
nursing practice;• Recognize nursing excellence in
patient care;• Recruit, retain and promote
competent experienced nurses;• Identify excellent nurses as role
models.The Campus’ clinical ladder programuses well-known nursing expert PatriciaBenner’s Novice to Expert Model thatdescribes the nurse’s experience andgrowth in the nursing profession. Theprogram is comprised of four levels –R.N. I, R.N. II, R.N. III and R.N. IV –and 13 criteria. As nurses advance tohigher levels, the number of criteria thatmust be met also increases.
R.N. I is the new professional withless than one year of experience. Theexpectation for this nurse is to learn hisor her role as a patient advocate as the
transition is made from student toprofessional nurse.
R.N. II is the nurse with one year ofexperience who satisfactorily meets thebehavior and performance expectationsof a competent nurse. Promotion to thislevel does not require an application.
R.N. III is the nurse with aminimum of three years experience whohas demonstrated leadership in his orher practice environment either byleading a council, or by serving ascharge nurse or clinical coach. Theapplicant must meet six of the 13criteria to be eligible for this level.
R.N. IV is the nurse with aminimum of five years experience whodemonstrates expertise and is a leader inhis or her practice area. The applicantmust meet nine of the 13 criteria to beeligible for this level, hold a minimum ofa B.S.N. and have a nationallyrecognized certification in the specialtyarea.
The 13 criteria align with theMagnet® program’s component ofStructural Empowerment by depicting
how nurses practice and collaboratewith multiple disciplines to provide thehighest quality care and service topatients and the community.
“Overall, the clinical ladderprogram provides an opportunity forstaff to validate their practice, receiverecognition and monetary benefit, andachieve professional advancement,” saidAdrienne Watson, clinical director ofhospital education.
The clinical ladder committee iscomprised of R.N. IIIs and R.N. IVs whoprovide peer review and feedback,holding peers accountable for theirpractice and their own professionalgrowth and development.
Advancement can be accomplishedby participating and engaging ineducational offerings or continuingeducation, council participation,project work and activities thatcontribute to the strategic goals of theorganization.
For more information, please visitthe Career Ladder Sharepoint on theTMC Connections page of InSite.
An Update on the Career Ladder Program at the TMC Campus
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Our Campus is proud to announce Doris Jackson, R.N.,C.C.R.N., cardiac care unit, as September’s recipient of theDAISY Award, which recognizes one nurse each month forgoing above and beyond to deliver exceptional patient care.
“I was completely surprised when they presented me withthe award,” said Jackson. “Nursing is my passion and it’s veryrewarding to be recognized for working hard.”
Jackson was nominated by a patient’s family member. Thenomination said, “Doris is compassionate, caring and treatedmy mom with respect and dignity. She eased her fears and hasa very big, caring disposition. She was an excellent nurse –one of many great Memorial Hermann employees.”
The designation, presented in collaboration with TheAmerican Organization of Nurse Executives, is part of theDAISY Foundation’s national program to recognize nurseswho serve as role models to colleagues throughout theprofession.
To nominate a nurse for this prestigious honor, fill out anomination form located on various units throughout thehospital and available online at TMC Connections on InSite.Nominations are due by the 15th of each month, or they will becounted as a contender for the next month’s award.
September’s DAISY Award Goes to… Doris Jackson!
Continuing our journey toward Magnet®status, the Memorial Hermann-TexasMedical Center Campus exemplifies elementsof the Magnet program in the daily activities,behaviors, attitudes and professionalism ofthe nursing staff. To capture these elements,Magnet Moments provides caregiver storiesthat demonstrate the passion and driveevident in Magnet hospitals. This columnrecognizes our Campus caregivers’ knowledgeand technical skill with the artistic,immeasurable elements of caring, humanityand compassion.
Magnet® Moments at Memorial Hermann-Texas Medical Center
Community involvement is a key component ofMagnet’s Structural Empowerment. StructuralEmpowerment states that nurses should participatein and provide many community educationopportunities throughout the year. Communitypartnerships enable nurses to combine resources toimprove the health and wellbeing of the community.
Members of Children’s Memorial HermannHospital and Mischer Neuroscience Institute
recently exemplified community involvement byjoining forces to sponsor a team for the 2012Hydrocephalus Association Walk. The team wasable to raise $2,415 and register 41 people for thewalk. In addition, the Hydrocephalus Association isproviding Memorial Hermann with a grant to assistwith the upcoming Hydrocephalus Support Groupscheduled to kick off early next year.
MAGNET MOMENTS:A Successful Showing for the Hydrocephalus Walk
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Reminder: Complete the Nursing Satisfaction Survey by Oct. 21
In line with our Campus’ efforts to build the bestpossible nursing work environment, all registerednurses are asked to participate in the fourthannual nursing satisfaction survey, which is nowunder way and will last through Sunday, Oct. 21.To be eligible to take the survey, registered nursesmust be working on the unit for a minimum ofthree months, be employed by MemorialHermann and provide direct patient care at least50 percent of the time. Eligible nurses received a
letter and email with specific instructions on howto access the survey. It can be taken from anycomputer with an Internet connection, includingthose located within the nursing departmentsand in the computer lab on the 8th floor of JonesPavilion. For questions on the survey or how toaccess it, contact your supervisor or call VirginiaEarley, director of nursing quality integration, at713.704.5389.
The More to Life WeekendTraining: Nov. 9 – 11 All nurses and employees are invited toattend a three-day workshop to learnhow to access creativity in the face of anever more demanding career field. Inthis powerfully transformational course,attendees will learn how to reduce stressand replace self-defeating behaviorswith more effective habits. The eventwill take place at the Houston Marriot –North from 7 a.m. to 11:15 p.m., Fridaythrough Sunday. Nurses can receive upto 25 contact hours and an applicationfee of $15 must be submitted at
registration. Please [email protected] for moreinformation.
Advance Burn Life Support(ABLS) Provider Course: Oct. 26Memorial Hermann Life Flight®
Education will host an ABLS ProviderCourse in the Life Flight Classroom(Robertson Pavilion, rm. 175) from 7:30 a.m. to 5 p.m. on Friday, Oct. 26. A registration form has been posted toTMC Connections. For moreinformation, contact Life FlightEducation at 713.704.6151.
Facilitating Excellence in ClinicalTrial Management: Oct. 24 -26The University of Texas Health ScienceCenter at Houston (UTHealth) MedicalSchool will host a basic clinical researcheducation seminar Wednesday, Oct. 24through Friday, Oct. 26 on the 5th floorof 6431 Fannin. A registration form hasbeen posted to TMC Connections. Formore information, please contact LindaGilbert at 713.500.3621.
Recognizing nurses for their achievements in patient care andin our community is an integral part of the culture of nursingexcellence at Memorial Hermann, both at the Texas MedicalCenter Campus and across the System. It is also an importantcomponent of Structural Empowerment to reward andrecognize staff, many of whom have gone above and beyondtheir day-to-day responsibilities to make achievements in theirfields. Congratulations to the following employees!
PromotionsEmergency Center• Miguel Garcia has been promoted to R.N. IV. Pediatric Intensive Care Unit• Ashley Hazelwood has been promoted to R.N. III.
Achievements• Tracey Stanzel, R.N., MICU, received her bachelor’s in
nursing.• Linda Winegeart, R.N., MICU, received her bachelor’s in
nursing.
• Vanessa Rae Banks-Gonzales, R.N., M.S.N., A.C.N.P. –B.C., CVICU acute care nurse practitioner, had her articlepublished, which is titled Thrombophilia andHypercoagulation: Risk Assessment and Screening.
Certifications• Nick Escobedo, R.N., 4 West Cullen, received his
professional certification from O.C.N. • Maureen Waweru, R.N., B.S.N., clinical coordinator in 4
West Cullen, received her professional certification fromO.C.N.
• Joe Gajdusek, R.N., MICU, received his professionalcertification from C.C.R.N.
New Leadership• Melanie Cockrell, R.N., B.S.N., M.B.A.,C.E.N., has been
named the clinical director for the Emergency departmentand clinical observation unit (COU).
Recognizing Our Employees
OctoberOct. 15, 8 a.m. – 12:30 p.m. *Class Full
CPR HeartSaver (Non-Licensed Staff Only)Oct. 16, 8 a.m. – 5:30 p.m. *Class Full
Advanced Cardiac Life Support – Recertification
Oct. 18, 8 a.m. – 4:30 p.m. EKG Interpretation: Beyond the Basics
Oct. 22 & 23, 8 a.m. – 4:30 p.m. *Class FullPediatric Advanced Life Support
Oct. 24, 8 a.m. – 5 p.m.Pediatric Advanced Life Support – Recertification
Oct. 25 & 26, 8 a.m. – 3 p.m. *Class FullRespiratory – Adult Emergency Airway Management Course
Oct. 26 & 27, 8 a.m. – 3 p.m. Respiratory – Adult Emergency Airway Management Course
Oct. 26, 10 a.m. – Noon *Class FullHealthQuest – Nursing ADT
NovemberNov. 1, 8 a.m. – Noon
EKG Interpretation: Beyond the Basics
Nov. 2, 8 a.m. – 4:30 p.m. Transplant Symposium
Nov. 5, 8 a.m. – 12:30 p.m. CPR for Healthcare Providers (Licensed Staff Only)
Nov. 6 & 7, 7:30 a.m. – 4:30 p.m. *Class FullTrauma Nursing Core Course
Nov. 6, 8 – 11 a.m. Advanced Continuous Renal Replacement Therapy
Nov. 12, 9 a.m. – Noon *Class FullImplanted Vascular Ports
Nov. 13 & 14, 8 a.m. – 4:30 p.m. *Class FullPediatric Advanced Life Support
Nov. 15 & 16, 8 a.m. – 4:30 p.m. *Class Full Advanced Cardiac Life Support – Recertification
Nov. 19, 8 a.m. – 12:30 p.m. CPR HeartSaver (Non-Licensed Staff Only)
Nov. 19, 8 a.m. – Noon *Class FullPhlebotomy Class
Nov. 27, 8 a.m. – 4:30 p.m. *Class Full Advanced Cardiac Life Support – Recertification
Nov. 29, 8 a.m. – 4:30 p.m. EKG Interpretation: Beyond the Basics
Nov. 30, 10 a.m. – Noon *Class FullHealthQuest – Nursing ADT
Continuing Education Opportunities
To register or get more information on any class, visit the Partners in Learning section of InSite.
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exceptional patient care and for serving as role models tocolleagues throughout the profession. Another nursing-ledinitiative, the Spirit of Inquiry Campaign, was started by theProfessional Nursing Research and Evidence-Based PracticeCouncil. The Campaign encourages nurses to review currentprotocols for opportunities to implement evidence-basedpractices. Nurses who identify a practice that might be
outdated or not evidence-based, are asked to submit their ideato the council.
“These councils are a great way for nurses to share ideasand improve their profession,” said Virginia Early, R.N.,director of nursing quality integration, who oversees theStructure along with CNOs Victoria King and Cheryl Olson.“By acting as positive change agents, nurses not only improvetheir environment, but also the outcomes of the patients wetreat.”
6411 Fannin | Houston, TX 77030 | 713.704.4000 | www.memorialhermann.org
CLINICAL NOTES EDITORIAL TEAM
Alejandra RodriguezDirector, Communications and Volunteer Services
Lauren AllenMarketing and Communication Rep. II
Victoria King, M.H.A, M.S.N., R.N., C.N.O.R., N.E.A.-B.C.Chief Nursing OfficerMemorial Hermann-TMC
Cheryl Olson, M.S., R.N., N.E.A.-B.C.Chief Nursing OfficerChildren’s Memorial Hermann Hospital
Clinical Notes is a publication of MemorialHermann-TMC internal communications. We welcome your suggestions and comments.
713.704.1222
Free CE Dinner and Open House – Oct. 24On Wednesday, Oct. 24, Children’s Memorial HermannHospital will host a free CE dinner and open house from5:30 to 8:30 p.m. Caregivers are encouraged to attendand invite fellow R.N.s who might be interested in careeropportunities on our Campus. Attendees will receive a freedinner and a guided tour of the hospital. To register or getmore information, please [email protected].
6th Annual Yatsu Day Symposium: Innovations in StrokePrevention – Oct. 26Join neuroscience physician leaders on Friday, Oct. 26, from7:30 a.m. to 5 p.m. for the 6th Annual Yatsu DaySymposium: Innovations in Stroke Prevention. Held in theHermann Conference Center, the symposium offers 7 AMAPRA Category 1 Credits™. To register or for moreinformation, please visit www.utcme.net.
Start! Houston Heart Walk – Nov. 3On Saturday, Nov. 3, Memorial Hermann will once againsponsor the annual Start! Houston Heart Walk, benefittingthe American Heart Association. The 5K (3-mile) event willtake place at Reliant Stadium starting at 8:30 a.m. To signup for an existing Memorial Hermann team or create yourown, you may register online at www.houstonheartwalk.orgor sign up at the gift basket and drawing tables. For moreinformation or assistance registering for a team, contactKaitlin Cantell at 713.704.5203.
CNO Luncheon – Nov. 19 Don’t miss the chance to speak with Chief Nursing Officerof Memorial Hermann-TMC Victoria King over lunch onMonday, Nov. 19. Located in the Hermann ConferenceCenter, the luncheon will be held in two separate sessions:11:30 a.m. to 12:15 p.m. and 12:30 to 1:15 p.m. Lunchwill be served and participants receive one contact hour. Toregister, visit the Partners in Learning section of InSite.
Upcoming Events
