Magnet® Excellence

In line with NewYork-Presbyterian's mission to advance patient-centered care, Alexandra Taylor Berger, BSN, RN, PCCN; Tilu Chacko, BSN, RN, CCRN; Kayla Dunn, MSN, RN; and Michael Spicer, MS, AGNP, RN, CCRN-CSC; formed the Sternal Wound Action Team (SWAT) in June 2023 after participating in the Clinical Scene Investigator (CSI) Academy of the American Association of Critical-Care Nurses (AACN). The nurses leveraged their participation in the one-year national fellowship program to improve postoperative outcomes after cardiac surgery of patients on 5 Garden North (5GN) and in the Cardio Thoracic Intensive Care Unit (CTICU).

With guidance from Darshani Singh, MS, RN, AGCNS-BC, CEN, and Sarah Garza-Ohl, MSN, MPH, RN, CENP, PCCN, Patient Care Director, 5GS, they implemented the SWAT Nursing Bundle, a novel nurse-led initiative grounded in evidence-based practices found to be effective in reducing sternal wound infections. The patient-centered bundle included a preoperative education checklist, skin preparation instructions, and a postoperative sternal wound infection prevention checklist.

Outcome

Following the full adoption of the SWAT Nursing Bundle in October 2023, there have been zero superficial surgical wound infections, demonstrating excellence in patient-centered care.

In June 2023, the Neurosurgery Unit (8HS) noted an opportunity in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) "Communication with Nurses" domain to improve the "% always" response score of 74.3. During the Patient Experience Council meeting, nursing team members shared that a knowledge gap in bedside shift report was identified and contributed to this HCAHPS score. Bedside shift report is a standardized nurse hand-off process that supports accurate and timely communication between nurses and enhances patient satisfaction.

Claudia Charles, BSN, RN, collaborated with Lauren English, MSN, RN, APRN, SCRN, Patient Care Director, 8HS, to reeducate nurses on bedside shift report. Daniel Dicello, Director for Patient Experience, and Amanda Pallet, Patient Services Ambassador, conducted education sessions on bedside shift report using role-playing scenarios, while Ms. Charles; Kevin Schlegal, BSN, RN; Agnieszka Warenica, MSN, MPA, RN, CNRN; and Edna Romanos, BSN, RN, validated the practice using a performance checklist. Additionally, Ms. Charles, Mr. Schlegal, and Ms. Warenica educated new team members on bedside shift report during orientation, ensuring continuity of practice standards.

Outcome

Following education on bedside shift reporting, the 8HS "Communication with Nurses" domain "% always" response score increased.

As part of their commitment to excellence in care, the M9H nursing leadership team looked into strategies to improve patient experience. During a data review of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys, long wait times for bed placement was identified as an associated cause for patient dissatisfaction. Patient survey feedback from July, August, and November 2022 highlighted related issues, prompting Katie Melomedov, MS, RN, AGCNS-BC, CCTN, clinical nurse, and Kathleen Koenderman, MS, PA-C, to strategize process improvement efforts. Initiatives included a standardized discharge process, flow rounds, and a Transplant Discharge Workgroup.

Outcome

Ms. Melomedov and Ms. Koenderman's initiative to enhance discharge times on M9H significantly improved the patient experience regarding unit admission. By November 2023, there were no complaints regarding dissatisfaction with admission wait times, surpassing the unit's target patient experience star rating.

Natalie Voigt, PhD, MSN, RN, and Lindsey Stevens, BSN, RN, CWOCN, led a study aimed to improve nurses' understanding of pressure injury prevention interventions based on Braden Scale subscales. Ms. Stevens presented the study's findings at the NewYork-Presbyterian/Columbia Academic-Practice Research Fellowship Graduation Celebration and NewYork-Presbyterian/Columbia Nursing Research and Evidence-Based Practice Council meeting, highlighting the importance of enhancing nurses' knowledge of subscale-specific interventions to prevent pressure injuries effectively.

Outcome

Through an educational intervention, nurses' comprehension significantly improved, particularly in addressing moisture and friction/shear issues. However, challenges persisted, including overlooking the need for multiple interventions and relying solely on common practices such as applying moisture barrier cream.

Despite education, some nurses still favored generic interventions, indicating a need for further training. This research underscores the significance of tailored education in improving patient outcomes and reducing the incidence of pressure injuries in healthcare settings.

Publications

Blagrove, C. (2023). Preventing hospital-acquired sacral pressure injuries with silicone foam dressing: An evidence-based practice quality improvement project. Journal of the New York State Nurses Association, (50)1.

Carter, E. J., Shang, J., George, M., DeForge, C., Mackson, G., Palace, Z. J., & Stone, P. (2023). Nursing home residents’ experiences and perceptions of antibiotic use: A qualitative descriptive study. American Journal of Infection Control, 51(2), 159-162.

Celona, C. A., Jackman, K., & Smaldone, A. (2023). Emergency Department Use by Young Adults with Chronic Illness Before and During the COVID-19 Pandemic. Journal of Emergency Nursing, 49(5), 755-764.

Enriquez, U. (2023). When life gives you lemons…a lesson on prosilience. Nurse Leader, December 28, 2023. Online ahead of print.

Hagerty, T. (2023). Cerebral Microdialysis, In Johnson, K.L. AACN Procedure Manual for Progressive and Critical Care, 8th Edition, pp827-833.

Kolb, K., Liu, J., & Jackman, K. (2023). Stigma towards patients with mental illness: An online survey of United States nurses. International Journal of Mental Health Nursing, 32(1), 323-36.

Navarro, S. P. (2023). Understanding the Relationship of Perceived Managerial Support and Practice Environment Among Staff Nurses. Journal of Nursing Practice Applications & Reviews of Research, 13(2), 28-38.

Navarro, S. P. (2023). An Immigrant’s Mentorship Experience Transitioning into Clinical Practice. Academic Medicine, Journal of the Association of American Medical Colleges, October 25, 2023. Online ahead of print.

Rojas, D. A., DeForge, C., Abukhadra, S. L., Farrell, L., George, M., & Agarwal, S. (2023). Family experiences and health outcomes following a loved one’s hospital discharge or death after cardiac arrest: A scoping review. Resuscitation Plus, 2023 Jun;14:100370.

South, K., DeForge, C., Celona, C. A., Smaldone, A., & George, M. (2023). Navigating liminal spaces together: A qualitative metasynthesis of youth and parent experiences of healthcare transition. Journal of Transition Medicine, 5(1), 1-17.

Stoffan, P., Hensler, K., Fitzpatrick, J., et al. (2023). A call for healthy role models. American Nurse, 18(8), 44-47.

Turkoglu, N. (2023). Plant Alkaloids. ONS/ONCC Chemotherapy Immunotherapy Certificate Course. Oncology Nursing Society. Online learning module.

Awards and Recognition

Clinical Excellence Recognition

External Honors
Beacon Silver Award for Excellence 
American Association of Critical Care Nursing 
Surgical Anesthesia Intensive Care Unit

Beacon Silver Award for Excellence 
American Association of Critical Care Nursing 
Perianesthesia Care Unit – First Beacon Award for a PACU in New York City

Beacon Bronze Award for Excellence 
American Association of Critical Care Nursing 
Neuro Intensive Care Unit

Clinical Excellence Recognition

Clinical Nurse Excellence Award
Roland Collins, MHA, BSN, RN, CCRN

Clinical Nurse III
CCU – Cardiac Care Unit

Nurse in Advanced Practice Role
Katie Melomedov, MSN, RN, AGCNS-BC, CCTN

Clinical Nurse Specialist
9 Hudson Transplant

Nurse Leader Award
Rebekah Wiley, MSN, MBA, RN

Patient Care Director
Cath Lab

Nurse Preceptor Award
Sarah Engelhardt, BSN, RN, CCRN

Clinical Nurse III
CCU – Cardiac Care Unit

Rising Star Award 
Shannon Forty, MSN, RN

Clinical Nurse I
6HN Medical Oncology

Nursing Support Partner Award
Anny Rosario

ICU Technician
7HS Surgical Oncology

Friend of Nursing Award
Linda S. Golding, MA, BCC
Coordinator
Pastoral Care and Education

Structural Empowerment Unit Award
5 Hudson North Interventional Cardiology

Quality Cup

February 2023
9 Hudson Transplant

March 2023
6 Garden North 
Medicine

April 2023
7 Hudson North 
Surgical Stepdown

May 2023
6 Garden South 
Medical Infectious Disease

June 2023
CCU

July 2023
6 Garden North 
Medicine

August 2023
9 Garden South 
Hospitalist/Ortho/Surgical

September 2023
Surgical Anesthesia ICU

October 2023
8 Hudson South 
Neuro Surgery

November 2023
CCU

December 2023 
9 Hudson
Transplant

Podium Presentations

Lovie Marie D. Amolo, MSN, RN, ACCNS-AG, CCRN, SCRN, CEN, NYSAFE; Jennifer Arrieta, RN, CCRN.Set The Stage and Dress the Wound: The CNS and Skin Team in Action. March 2023: National Association of Clinical Nurse Specialists Annual Conference, Portland, OR.

Tjwana Dennis, MSN, RN, CWOCN. Addressing Disparities in Diabetic Foot Ulcers Prevention and Treatment. August 2023: National Black Nurses Association (NBNA) 51st Annual Institute and Conference, Atlanta, GA.

Bernadette Khan, DNP, RN, NEA-BC. Panelist, Leading the Five: From Veterans to Gen Zers and Everyone in Between. September 2023: National Healthcare CNO Summit, San Diego, CA.

Erin Testerman Mitra, MSN, RN, CWOCN. Speaker, Hands-On Workshop: Integrating the Use of Negative Pressure Wound Therapy and Dermal Regeneration Template. November 2023: Symposium on Advanced Wound Care, Las Vegas, NV.

Erin Testerman Mitra, MSN, RN, CWOCN. Speaker, The Benefit of Prehabilitation (Prehab/ERAS) for Ostomy Surgery. July 2023: WoundCon, Virtual.

Erin Testerman Mitra, MSN, RN, CWOCN. Podcast Guest Speaker, EP97 Continent Ileostomy and the WOC Nurse Role. March 2023: Wound, Ostomy and Continence Nurses Society (WOCN) WOCTalk, Podcast.

Erin Testerman Mitra, MSN, RN, CWOCN. Speaker, Hands-On Pre-Conference Workshop: Advanced Wound Care and So, Your Patient Has an Ostomy: Caring for the Stoma and the Patient! April 2023: Symposium on Advanced Wound Care, National Harbor, MD.

Erin Testerman Mitra, MSN, RN, CWOCN; Vanessa Marra, BSN, RN, CWOCN. 
K-Pouch: The WOCN Role in Continent Ileostomy Care. December 2023: Northeast Region Wound, Ostomy and Continence Nurses (WOCN) Society 2023 Annual Conference, Pocono Manor, PA.

Simon Paul Navarro, MA, RN, CCRN, TCRN. Managerial Support and Practice Environment Among Registered Nurses Employed in a Tertiary Hospital in Quezon City, Philippines. June 2023: International Research Forum, Padjadjaran, Indonesia, Virtual.

Poster Presentations

Carol Blagrove, DNP, MSN/NEd, RN, CCRN, MEDSURG-BC. Preventing Hospital-Acquired Sacral Pressure Injuries with Silicone Foam Dressing. May 2023: American Association of Critical-Care Nurses (AACN) National Teaching Institute and Critical Care Exposition, Philadelphia, PA.

Carol Anne Celona, DNP, FNP-C, ENP-BC; Kasey Jackman, PhD, RN, PMHNP-BC, FAAN; Arlene Smaldone, PhD, CPNP, CDCES, FAAN. Emergency Department Use by Young Adults with Chronic Illness Before and During the COVID-19 Pandemic. March 2023: Eastern Nursing Research Society Conference, Philadelphia, PA.

Jennifer Hussain, BSN, RN, CCTN; Katie Melomedov, MS, RN, AGCNS-BC, CCTN; Mo Satar, BSN, RN, CCTN. Creation of a Nursing Mentorship Program for a Solid Organ Transplant Unit: Optimizing Orientation and Retention Strategies During a Pandemic. October 2023: International Transplant Nursing Society Annual Symposium, Dallas, TX.

Richelle Anne Lobite, BSN, RN-BC CCRN; Jihee Yun, BSN, RN, CCRN-CMC; Darshani Singh, MS, RN, AGCNS-BC, CEN; Lisa Cullinan, BSN, RN-BC, CWOCN.HAPI Rounding to Reduce Pressure Injury in a Cardiac Care Unit. May 2023: American Association of Critical-Care Nurses (AACN) National Teaching Institute and Critical Care Exposition, Philadelphia, PA.

Erin Testerman Mitra, MSN, RN, CWOCN; Vanessa Marra, BSN, RN, CWOCN. The Value of the WOC Nurse Role in Outpatient K-Pouch Complication Management. December 2023: Northeast Region Wound, Ostomy and Continence Nurses (WOCN) Society 2023 Annual Conference, Pocono Manor, PA.

Robee Ravago, BSN, RN, CNN; Sam Martinez, BSN, RN, CNN; Uvannie Enriquez, MPA, BSN, RN, NEA-BC; Marifel Axalan, BSN, RN, CNN. A Performance Improvement Project on Use of Single-Needle Option in Optimizing Therapeutic Plasma and Red Blood Cell Exchange. April 2023: American Society for Apheresis (ASFA) 2023 Annual Meeting, Minneapolis, MN. Received People’s Choice Poster Abstract Award.

Karilin Salcedo, BSN, RN; Maxy Escalante, DNP, RN, CCRN. Bridging the Multigenerational Gap in Nursing Using Effective Communication. May 2023: American Association of Critical-Care Nurses (AACN) National Teaching Institute and Critical Care Exposition, Philadelphia, PA.

Darshani Singh, MS, RN, AGCNS-BC, CEN; Jihee Yun, BSN, RN, CCRN-CMC; Richelle Anne Lobite, BSN, RN, CCRN.Virtual Reality of Nursing. May 2023: American Association of Critical-Care Nurses (AACN) National Teaching Institute and Critical Care Exposition, Philadelphia, PA.

Darshani Singh, MS, RN, AGCNS-BC, CEN; Jihee Yun, BSN, RN, CCRN-CMC. ECMO Training Pathway for RNs in Cardiac Care Unit. November 2023: 6th Asia-Pacific Extracorporeal Life Support Organization (APELSO) Conference, Seoul, South Korea.

Nicole M. Turkoglu, MSN, RN, OCN; Jingjing Shang, PhD, RN, OCN, FAAN. Falls and Fall Risk Factors in Hospitalized Blood and Marrow Transplant Patients. April 2023: 48th Annual Oncology Nursing Society Congress, San Antonio, TX.

Nicole M. Turkoglu, MSN, RN, OCN; Nadeen Robinson, MSN, RN, OCN; Juliet Hernandez Henriquez, BSN, RN; Archana Shenoy, DNP, RN, OCN. An Innovative Method to Decrease Burnout on a Medical Oncology Unit Through Staff Led EBP Interventions. April 2023: 48th Annual Oncology Nursing Society (ONS) Congress, 
San Antonio, TX.

Eunice Eunyoung Yang, MSN, AGACNP-BC, CNN, CDCES; Danica Dorlette, MPH, BSN, RN, OCN; Uvannie Enriquez, MPA, BSN, RN, NEA-BC; Arlene Smaldone, PhD, CPNP, CDCES, FAAN. How Much Should Insulin Be Reduced on Dialysis Days for Adults with Diabetes Receiving Hemodialysis? A Systematic Review. December 2023: International Diabetes Federation Virtual Congress 2023, ePoster Presentation.

Jihee Yun, BSN, RN, CCRN-CMC; Darshani Singh, MS, RN, AGCNS-BC, CEN; Roland Collins, MHA, RN, CCRN; Richelle Anne Lobite, BSN, RN-BC CCRN.Tailored Orientation to Meet the Needs of the New Generation of Nurses. May 2023: American Association of Critical-Care Nurses (AACN) National Teaching Institute and Critical Care Exposition, Philadelphia, PA.