About us

The NewYork-Presbyterian Hudson Valley Department of Nursing is under the leadership of Vice President of Patient Care Services and Chief Nursing Officer (CNO), Ophelia. M. Byers, DNP, WHNP-BC, RNC, NEA-BC. Applying elements of the authentic and transformational leadership styles, Dr. Byers provides strategic vision and direction for the Department of Nursing and interfacing clinical areas. As CNO, she is accountable for the provision of around-the-clock nursing services; and her responsibilities include, but are not limited to, fiscal planning, resource allocation, employee relations and generally promoting a diverse, inclusive, and safe work environment.

In addition to the CNO, the nursing leadership team consists of Directors of Nursing who have oversight of clinical service lines, Patient Care Directors (PCDs) who manage the daily operations of units and Clinical Nurse Managers who assist the PCDs. There are also non-supervisory nurse leaders, such as Nurse Educators and the Magnet Program Director. All of these nurse leaders coordinate to support the practice, professional development and engagement of nursing teammates whom directly care for patients and families: clinical nurses, advanced practice nurses, care coordinators, nurse navigators and myriad support team members.

Since joining the NewYorkPresbyterian Hudson Valley Hospital team in September 2019, Dr. Byers has focused on promoting greater autonomy and empowerment in nursing while fostering stronger inter-professional/cross-departmental collaboration. She enhanced the nursing professional governance structure by adding the Staff Advisory Forum — a meeting wherein registered nurses and other team members directly interface with the CNO to learn what is occurring in the NewYork-Presbyterian enterprise and to share their feedback and ideas. Then, using that feedback, nurse leaders coordinate with partners across units, disciplines and departments enhance the team experience and patient-family care at NewYorkPresbyterian Hudson Valley.

Throughput Committee member Donna Rosenberg, MSN, RN, nursing director, 4South, 3South, ED and Care Management, working with committee members, proposed a daily discharge target that would help reduce the NYP-HVH inpatient average length of stay (ALOS). The Throughput Committee agreed and after examining the throughput data and daily census reports, the committee set an organizational goal of 20 inpatient discharges per day. In order to meet this target Donna worked with multiple stakeholders and developed strategies to decrease the ALOS, these included:

• Arranging for care managers to meet each morning with the hospitalists and discuss which patients could possibly be discharged that day
• An end-of-the-day patient review, where nursing, care managers and hospitalists would examine the in-house patient list and identify potential discharges for the next day
• Scheduling two care managers on site for each weekend day
• Setting up the structure for patient rounding on the weekend by the unit charge nurses, care manager, and hospitalist to discuss possible discharges and obstacles to discharge
• Improving communication on bed availability by having ambulance attendants sign in and out within the ED

A nurse director’s membership in an organization-level, decision-making group, resulted in a reduced ALOS and improved throughput.

According to the United States Department of Health and Human Services, more than 42,000 deaths were attributed to opioid overdose in 2016, prompting the agency to declare a public health emergency the following year. In 2018, in tandem with the national opioid crisis, NewYork-Presbyterian Hudson Valley Hospital’s Emergency Department (ED) noted a marked increase in drug overdoses among its younger patient population, as well as an increase in the number of patients seeking pain medication for various ailments. The ED practitioners attempted to refer such patients for substance use counseling, but many refused. These disturbing trends inspired Donna Selwa-Selig, BSN, RN, CEN, CMSRN, clinical nurse, ED, to learn more about existing treatment options, obstacles to seeking treatment, and how to connect patients struggling with opioid dependency to the services they needed.

Donna partnered with a nearby community health center which had an established medication-assisted treatment (MAT) program for persons withdrawing from opioids — to form the Opioid Dependence Disorder team. Together, they worked with NewYork-Presbyterian Hudson Valley Hospital’s ED nurses and practitioners to help identify ED patients who could benefit from the MAT program and developed other strategies for connecting more of the community’s residents with appropriate services. Donna spoke to other local drug rehabilitation centers and created a resource list with information about each facility for ED patients and their families. In March 2018, Donna began conducting in-services for all NewYork-Presbyterian Hudson Valley ED registered nurses and practitioners, to educate them on the signs and symptoms of opioid dependence, withdrawal, and criteria for referral to local community center’s MAT program. By the end of 2018, using the strategies implemented by Donna and her team, the NewYork-Presbyterian Hudson Valley ED team identified numerous patients appropriate for substance use disorder treatment, many of whom agreed to enter a program. Donna’s efforts were recognized by the organization and she was nominated by NewYork-Presbyterian Hudson Valley for Hudson Valley Magazine’s 2019 Excellence in Nursing Award.

In 2017, the Intensive Care Unit (ICU) at NewYork-Presbyterian Hudson Valley Hospital experienced an upward trend in hospital-acquired pressure injuries (HAPI). In reviewing the results, the ICU clinical nurses questioned if there were other approaches to pressure injury prevention that would reduce HAPI incidence.

In October 2017, Amy Garrabrant, BSN, RN, PCCN, clinical nurse, ICU, and Mary McGuinness, ASN, RN, clinical nurse, ICU, offered to review the literature on best practices for HAPIs and bring back recommendations to the ICU team. The clinical nurses reported on a promising intervention to prevent skin breakdown, using foam wound dressings as a prophylactic intervention on areas of the body at high risk for skin breakdown.

A trial of foam dressings for prophylactic use was initiated by the ICU clinical nurses. The trial was successful and a change in practice occurred. The prophylactic use of foam wound dressings led to significant improvement in the development of HAPI’s in ICU. Amy and Mary shared their knowledge and findings via poster at the American Nurses Credentialing Center Magnet Conference in Orlando, Florida, October 10-12, 2019.

Postanesthesia Care Unit (PACU) clinical nurse Eve Holderman BSN, RN, CAPA, wanted to establish a step by step coordinated response to a malignant hyperthermia (MH) crisis that nurses could easily follow. To better distinguish roles and responsibilities during a MH event, Eve and Pam Germinaro, BSN, RN, CAPA, patient care director ASU/PACU, in February, 2018, designed color–coded cards with a designated job printed on each card. The cards served as visual cues for those participating in the event. The team leader would be responsible for distributing a different color-coded card to each member of the team. The card would be attached to the outside of their clothing. This reduced job confusion and improved communication and productivity during a MH event.

To assist the clinical nurses preparing the required medication during an MH emergency and reduce the risk of error, in March 2018, Eve elicited the assistance of Anthony Maddalena RPh, pharmacy, in creating a dosing conversion chart. The medication chart provided a quick reference for accurately preparing the appropriate dose of medication for the patient, based on the patient’s weight.

Eve and Antonio Petruzzo, MD, Chair of Anesthesiology, provided didactic education sessions on MH, followed by mock drills, for nurses, physicians, and other personnel in the Surgical Services Department. Education was delivered to both the outpatient and the inpatient areas. Eve shared her evidence-based work as a podium presenter at the New York State Conference for Surgical Technicians, on September 21, 2019.

Publications

• Fitzpatrick, J.J., Rivera, R., Walsh, L., Byers, O. (2019). Narrative nursing: Inspiring a shared vision among clinical nurses. Nurse Leader, 17(2), p. 131-134. doi: https://doi.org/10.1016/j.mnl.2018.12.002
• Zia, M.T.K., Golombek, S., Lemon L., Nitkowski-Keever, S., Paudel, U. (2019). The influence of time of birth and seasonal variations on weight loss in breastfeeding neonates. Journal Neonatal Perinatal Medicine, 12(2): 189-194. doi: 10.3233/NPM-17137.

2019 Awards & Recognition

• NICHE (Nurses Improving Care for Healthsystem Elders) facility, redesignation with “Exemplar” status.
• Baby-Friendly USA Designation Award, a joint initiative of the World Health Organization and the United Nations Children’s Fund.
• Commission on Cancer, a program of the American College of Surgeons, three-year accreditation with commendation.
• National Accreditation Program for Breast Centers by The NewYork-Presbyterian Hudson Valley Hospital Ashikari Breast Center, three-year accreditation.
• Comprehensive Center under MBSAQIP a joint program of the American College of Surgeons and the American Society of Metabolic and Bariatric Surgery, reaccredited.
• Get With the Guidelines (GWTG)-Stroke Gold Plus & Target: Stroke Honor Elite Award, American Heart Association.
• Kay McNamara Quality Cup Award, Progressive Care Unit.

Transformational Leadership Awards:

• Clinical Nursing Excellence-Jean Smith-Rakotz, RN, CEN, clinical nurse, Emergency Department
• Nurse Preceptor-Amy Garrabrant, RN, PCCN, clinical nurse, Intensive Care Unit
• Rising Star-Marissa Offenbacher, RN, clinical nurse, Maternal Child Health
• Nursing Support Partner-Regina Caputo, patient care technician, Ambulatory Surgical Unit
• Friend of Nursing-Claudia Rivas, CSW
• Nurse Leader-Casey Forde, RN, NE-BC, patient care director, Maternal Child Health
• Nurse in and Advanced Practice Role-Margaret Adler, MSN, RN-BC, NEA-BC
• Structural Empowerment Unit Award-Maternal Child Health

Podium Presentations

Eve Holderman, RN, CAPA. Malignant hyperthermia drills. 2019 New York State Conference for Surgical Technicians, September 9, 2019: Albany, NY.

Poster Presentations

Amy Garrabrant, BSN, RN, PCC , Mary McGuinness, ASN, RN, Theresa Ryan, MSN, RN-BC. Reducing pressure injuries in ICU. 2019 ANCC Magnet Conference. October 2019: Orlando, FL.