Contact:
svmhsnurse@svmh.com


In This Issue:

Patient Care Champions

Increasing comfort improves patient outcomes

And they were even smiling

Nurses saddle up for the
California Rodeo Salinas


Nurse Q & A








Video:

Watch our interview with
Maria O'Rourke








Nurse Volunteer Opportunities:

BMW Ultimate Drive
June 6
Seaside Auto Mall

Relay for Life
June 20, 4:00 pm through
June 21 noon
Hartnell College track

Taylor Farms Health Fair
June 24
1:00–5:00 p.m.
Taylor Farms parking lot

California Rodeo Salinas
July 17-20
Rodeo Grounds

Labor of Love
September 4
3:30-7:30 p.m.
Sherwood Hall

Legs for Life
September 17 & 18
4:00-8:00 p.m.
SVMHS

CSUMB Health Fair
September 17
11:00 a.m.-2:00 p.m.
CSUMB University Center

California International Airshow
September 27 & 28
Salinas Airport

City of Salinas Health Fair
October 1
3:00-6:00 p.m.
Sherwood Hall

Walk to Cure Juvenile Diabetes
October 12
10:00 a.m.-1:00 p.m.
Lovers Point, Pacific Grove

City of Seaside Health Fair
November 2
1:00-4:00 p.m.
Seaside City Hall

Monterey Chamber of
Commerce Showcase
November 6
4:00-7:00 p.m.

Hyatt Regency Hotel
Health Fair
November 12
10:00 a.m.-2:00 p.m.
Hyatt Regency Grand Ballroom
Monterey

The Californian Showcase
November 23
4:30-7:00 p.m.
Sherwood Hall


For more information on
these volunteer opportunities, contact Health Promotion at
759-1890.


SVMHS Nurses—Champions for Patient Care

Vanessa Irwin, RN, BSN, CLC, PediatricsEvery SVMHS nurse is a champion for patients. And since February 2008, we have an innovative education program that takes that role to a whole new level—Patient Care Champions (PCC). Coordinated by Vanessa Irwin, RN, BSN, CLC, Pediatrics, currently assigned to the Education Department, the PCC program centers on nurse-to-nurse education. All PCCs are nurses who provide direct patient care. “Because they work on the unit, they have great credibility and rapport with other staff nurses,” says Vanessa. “They’re also sensitive to the special demands of the unit so they can tailor education messages and timing to be most effective.”

A team that includes representatives from Nursing Administration, Education, Informatics and other departments meets bi-monthly to discuss the most pressing education needs and plan topics. Education topics range from mock surveys and medication reconciliation to policy changes and new programs such as Speak Up.

“Nurses have been very receptive,” says Vanessa. “Everyone is focused on quality patient care and this is an excellent way to ensure ongoing improvements.”

For more information on Patient Care Champions, contact Vanessa Irwin at ext. 2857 or virwin@svmh.com.

Patient Care Champions

Olga Breboneria, RN, BSN, Ortho/Spine, PCC for Ortho/Spine
Connie Brick, RN, Heart Center Holding Area, PCC for HCHA, Heart Center, Cath Lab, DI
Melanie Cancio, RN, BSN, CCC, PCC for CCC
Rebecca Chow, RN, BSN, PACU, PCC for PACU, OR, SSOP, ENDO
Jovita Dominguez, RN, BSN, ED, PCC for ED/CDU
Tonia Fales, RN, 4/5 Towers, PCC for 4/5 Towers
Kelly Flower, RN, BSN, ICU, PCC for ICU/CCU
Marcia McDonald, RN, MSCV, PCC for MSCV
Kim Mendoza, CRT, DI, PCC for DI Techs
Heidi Olguin, RN, Peds, PCC for Peds
Michelle Roberts-Reyes, RN, Level II, PCC for Level II
Berni Safi, RN,  L&D, PCC for Mother Baby/L&D
Clarita Salviejo, RN, BSN, MSCV, PCC for night shift CCC, Ortho/Spine, MSCV, Peds
Deborah Thorpe, RN, NICU, PCC for NICU

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Increasing comfort improves patient outcomes

Laura Welch, RN, OR Information SpecialistRecognizing the need for a more consistent and effective patient warming system, Laura Welch, RN, OR Information Specialist in the Surgery Department, through the Perioperative Clinical Practice Council, initiated a survey. Patient body temperature upon arrival in the OR as well as during surgery and in post-op was recorded. Following a two-week study, it was clear that the existing warming measures in the OR were not effective. This meant potentially much longer stays in the PACU recovery unit.

With the support of department Senior Administrative Director, Candace Samudio, RN, Laura’s survey led to a trial of the Bair Hugger and Bair Paws warming system. The Bair Hugger unit connects to a variety of types of blankets including those for OB and pediatric patients that can be used under or over the patient before, during and after surgery. The Bair Paws unit connects to a specialized soft paper gown that provides full coverage and has a bellowing system that disperses warm air that can be controlled by the patient. Bair Paws is applied and started in the Outpatient Surgery Department and follows the patient to the OR and then to PACU. The gown can be used with either the Bair Paws or the Bair Hugger unit.

“Patients, physicians, anesthesiologists and nurses just love the new system,” says Laura. Put into use about two months ago, we have seen a dramatic change in patient temperatures when they reach PACU. The OR staff is now more aware of the patient’s body temperature, and have changed some of their routines. For example, the OR room temperature is increased while the patient is awake and then lowered after induction of anesthesia.  

A second, identical survey was conducted after a few weeks of using the new system and the results were outstanding. The average patient is now coming out of the OR with a normal thermic body temperature. Maintaining this healthy body temperature speeds up the recovery process and greatly increases patient comfort and improves outcomes. In fact, the PACU has not kept a single patient longer due to a low body temperature.

Other departments including OB and the Cath Lab for starters, are going to be looking at the new Bair warming system. More information will be coming from the Education Department as we progress throughout the hospital.

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And they were even smiling…

Emergency DepartmentDuring Magnet Moments at a recent Magnet Steering Committee meeting one of the members mentioned how well the Emergency Department did during a tracer that she and the in-house tracer team had completed. She ended her comments saying that, staff members were actually smiling and were eager to demonstrate their department’s knowledge and preparedness to the “surveyors.”

When we asked one of our members who works in ED how they had achieved their success, she said it had a lot to do with attitude, practice, support and a skill that is developed working in ED—how to ask questions and get information.

One thing that made a big difference for ED staff was realizing that The Joint Commission (TJC) surveyors were coming not to find fault, but rather to affirm how well we are doing. When the perception changed from “test-taking and fault-finding” to “let me show you how we do it,” staff did much better during the interview process.

Repetition and practice also played a big role. The staff reviewed the “job cards” almost daily and did practice interview sessions with their PCC Jovita Dominguez, so they were familiar with best practices and TJC terminology.

Practice sessions were brief and impromptu—brief since nurses naturally didn’t want to spend much time away from patient care; impromptu because that is how tracers and surveys are conducted. ED nurses are learning that they can take that time to do a tracer and trust turning over patient care to their Director, AHN or DCN as needed. In an ideal world, tracers and TJC surveys take place during downtime, but in reality they don’t, so nurses need to be prepared to handle it—with a smile rather than a frown.

Finally, a skill honed from experience in the ED came into play—the ability to ask questions and get key information. Evidently, it can be challenging to get a patient to explain what the problem is, so ED nurses become especially adept at asking questions.  This skill came in handy when nurses weren’t sure what the in-house tracer team “surveyors” were asking. By applying their skills at asking questions, they were able to understand what the surveyor really wanted to know.

All in all, the ED staff’s practice, repetition and great attitude definitely paid off—especially since at the end of the tracer, even the surveyors were smiling.  

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Nurses saddle up for the California Rodeo Salinas

California Rodeo Salinas

Vanessa Lockard, RN III, BSN, Emergency Department is already busy rounding up nurses to volunteer at the 2008 California Rodeo Salinas, July 17-20. A member of the Rodeo committee for six years, Vanessa has recruited and scheduled RNs since 2005. Also a volunteer, Vanessa spends an average of 12 hours a day at the four-day event. “It’s amazing to have so many SVMHS nurses who participate year after year and to see a growing number of nurses joining in,” says Vanessa. “Together, we provide about 300 nurse hours caring for competitors, attendees and vendors.”

SVMHS nurses staff the Chutes Hospital where they assist physicians in providing first aid, adding or removing casts and stitches and other care to Rodeo competitors. They also cover the first aid booth where fans and vendors alike come for everything from extra sunscreen and shade to care for bumps and bruises. Salinas Fire Department and Westmed paramedics are on hand to transport people with more serious injuries to the hospital.

If you’d like to saddle up as a volunteer, contact Vanessa at ext. 1180 or vlockard@svmh.com.

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Nurse Q & A

Q: How are you incorporating SBAR into your clinical practice, and do you find it an effective method of communication?

Mary Nuki, RN, Comprehensive Cancer Center
A: I started incorporating SBAR into my shift reports because I experienced how challenging it was when this important information wasn’t passed on to me. On day shift, many patient procedures are performed and many doctors’ orders are written. When I give a shift report to the oncoming RN, I always start by giving the situation...patient’s name, age, diagnosis, and also admitting MD as well as other MDs who have seen the patient that day. As part of the report I include the patient’s pertinent medical history and what has occurred during my shift (procedures, symptoms, my interventions and any critical changes in his or her condition). At the end of my report, I recap the plan of care for the patient and record any calls that I have out to MDs regarding this patient. I’ve found that sticking to the SBAR format is effective in sharing information with the next caregiver.
—Mary Nuki, RN, Comprehensive Cancer Center



Stephanie Knappe, RN, BSN, PACUA: “Yes, I use SBAR in my practice. We actually talked about it in PACU and pretty much decided we were using SBAR even before we heard of (the acronym) SBAR. We do baseline, interim and exit assessments on all of our patients. And we talk with doctors frequently—as they’re often preparing for or are in surgery, it’s important that we state the problem and our assessment clearly and efficiently. Typically, we also include our recommendations for medications, monitoring level and other aspects of the patient’s care.
—Stephanie Knappe, RN, BSN,  PACU


Kathleen Finnigan, RN, AHN, Float PoolA: SBAR is a good framework for communications—both verbal and written. It provides a formula that helps me organize my thoughts and prepare recommendations, especially before communicating with a physician about a change in a patient’s status. For many nurses, making recommendations can be the most difficult part, so being clear and confident by using SBAR can really help. In clinical practice, SBAR is invaluable for the patient profile and verbal shift reports when receiving or transferring a patient to another caregiver. As an AHN, I no longer provide direct patient care, but I use SBAR to communicate important information particularly when there’s been a problem or issue that needs to be addressed. It’s easy to follow and really helps facilitate critical communications and keep everyone on the same page.
—Kathleen Finnigan, RN, AHN, Float Pool

Kathy Finnigan, RN, AHN, Float Pool was honored with the 2007 Outstanding Spring Undergraduate Student Award from the CSU Dominguez Hills School of Nursing. The award was presented by Dr. Carole Shea, Director of the School of Nursing, at the Sigma Theta Tau–Xi Theta Chapter’s Annual Induction Ceremony on May 22 in Carson, California. Congratulations Kathy on being recognized for your exemplary efforts in earning your BSN!

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Question for the next SVMHS Nurse e-newsletter:
"What was the most important message you got from the Maria O'Rourke classes and how do you see what you learned in the classes affecting your practice?" Send us an email.

Have a question or comment about SVMHS Nurse Send us an email.

Illustration © Peggy Clancy, RN
Illustration © Peggy Clancy, RN

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