C. diff Free 400+ Days and Counting
From 2021 to 2022, 8 North noted an increase in hospital acquired Clostridium difficile (C. diff) positive cases. In early 2023, a multidisciplinary group composed of the chief medical officer, unit medical director, Infection and Prevention Council staff, Quality and Patient Safety staff, and the nursing team developed and piloted an escalation pathway for potentially inappropriate C. diff specimens. The goal of the pilot was to encourage the rational use of C. diff testing to diagnose true C. diff infection and reduce inappropriate testing and false positive results. The pathway encouraged real-time decision support dialogue between nursing and providers.
Outcome
During the four-week pilot, ten C. diff testing requests were made. With decision support from nursing, five of the 10 were deemed appropriate to send for testing. The pathway was determined to be successful and effective, and the team moved forward to adopt it into policy. The 8 North unit proceeded to have 428 days without a positive C. diff case until December 2023 and that remains to date to be the last hospital acquired C. diff case on 8 North.
Responding to the Migrant Crisis
Over 150,000 people have come to New York City seeking asylum with several hundred arriving daily since April 2022. Adults and children arrive needing basic life essentials, such as housing, food, and health care. Migrants face difficulties navigating the oversaturated health system and delays receiving medical care. Tenesia Richards, EMPA, RNC-OB, C-ONQS, CCE, C-EFM, Nurse Outreach Coordinator, Community Outreach Program, Ambulatory Care Network, led an effort to support migrants needing immediate medical support by partnering with community-based organizations (CBOs) that have direct connections with incoming migrants to host pop-up medical clinics throughout New York City. The Community Outreach Program recruits nurses, doctors, and non-clinical staff from NewYork-Presbyterian, Columbia University Irving Medical Center, and Weill Cornell Medicine to perform triage, physicals, and screenings, and to provide vaccinations and education.
Outcome
To date, the outreach program has collaborated with eight CBOs to host six pop-up clinics in the Bronx, Washington Heights, and Brooklyn. More than 150 health screenings have been performed, 150 vaccinations were administered, and over 50 medications were prescribed and delivered at no cost. The team also hosted donation drives that led to van loads of donations delivered to the CBOs that included clothing, toys, over 1,700 diapers, 150+ feminine products, and 20 packs of baby wipes. The outreach program will continue to host recurring pop-up clinics to meet the ongoing crisis.
Enhancing the Patient Experience on a Transplant Unit
In 2023, 7 North, a 23-bed transplant unit, achieved a 5-Star rating from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). The focus of the transplant team has always been extraordinary patient- and family-centered care. Aligned with the Department of Nursing’s Professional Practice Model, 7 North nurses foster a culture of teamwork, collaboration, professional development, exemplary practice, and autonomy. Collaboration and mentorship are provided daily by senior nurses who share their knowledge and expertise. The team collaborates to conduct an annual transplant class that shares best practices. Nurses on 7 North are encouraged and empowered to pursue professional development, certifications, and advancement in the clinical ladder. New nurses are provided with an orientation packet that provides a timeline for opportunities and engagement.
Together, members of the 7 North team created a Transplant Miler T-shirt initiative to encourage post-transplant patients to ambulate for better recovery outcomes. The incentive to walk a mile decreases the risk of pneumonia and blood clots and has created quite the competition in the hallways. This evidence-based practice has been a tremendous success. We appreciate the hard work of each team member and show support in various ways throughout the year. Every team member matters, and we strive to de-LIVER 5-Star excellent care always!
Outcome
The transplant team distributed more than 75 Transplant Miler t-shirts. Four nurses earned transplant certification and one RN was promoted to senior staff nurse. Autonomy of the team was reflected in their creation of poster-sized transplant medication posters displayed at the bedside of all patients to improve their knowledge. This practice helped increase the unit’s “Communication on Medications” HCAHPS score by eight points.
Introducing a Compassion Collaborative on a Surgical Intensive Care Unit
Nurses caring for critically injured and ill patients often experience moral distress, potentially contributing to burnout, compassion fatigue, and compromised patient care. Collaborative care models promote shared decision models and facilitate communication. As part of a quality improvement project nurses and attending physicians in the Surgical Intensive Care Unit (SICU) were surveyed about the morale climate of the unit. The nurses’ perceptions of the experience of death and dying and the need for palliative care were statistically different from their attending physician counterparts. In response, a bi-weekly nurse-led rounding process was undertaken with representatives from the MD line, physical therapy and occupational therapy, social work, palliative care social work, chaplaincy, and wound, ostomy, and continence nursing.
Outcome
In the reviewed group there was an increase of 350 percent palliative care consultations, a 120 percent increase in chaplaincy consultations, and a 100 percent increase in ethics consultations – all statistically significant. Characteristics of all patients were captured in a retrospective review (IRB supported) and vulnerable patients were identified.
Accomplishments
Publications
Nakame, M., Staley, A. (2023). ToT Training for Rural Health Workers to Raise Their Voices for Vaccine Equity. The People’s Vaccine Alliance, African Alliance, and REMI East Africa; A collaboration with Africa CDC.
Raso, R., O’Neil, S. (2023). Nurturing Leadership Growth in a Millennial Clinical Nurse: A Blueprint Through Mentoring. In: Rollins Gantz, N., Hafsteinsdóttir, T.B. (eds) Mentoring in Nursing through Narrative Stories Across the World. Springer, Cham, p 599-603.
Awards and Recognitions
External Honors
Amy Staley, MSN, RN, MEDSURG-BC
Recognition for World Health Worker Week
Johnson & Johnson
March 2023
Recognition from People Power Health
Affiliated with Harvard University for Nurse Advocacy
February 2023
Co-Chair, Nursing Now Challengers Committee
May 2023
Jaclynn Chen, CNM, MPH, BSN, RNC-OB, C-EFM
First Place Winner
NewYork-Presbyterian Nurses Week Evidence-Based Poster Symposium
May 2023
Third Place Poster Winner
Weill Department of Medicine
Annual Quality Improvement/
Patient Safety (QIPS) Symposium
June 2023
Mary A. Gallagher, DNP, RN, PED-BC
2023 Region Leadership Award New York Organization for Nursing Leadership
September 2023
Sam Martinez, BSN, RN, CNN
Robee Ravago, BSN, RN, CNN
Marifel Axalan, BSN, RN, CNN
People’s Choice Poster Abstract Award
American Society for Apheresis April 2023
Presentations
Podium Presentations
Nusrat J. Qadir Chaudhry, MSN, BSN, BS, RN, CBC. Healthcare for the Millennials: What does it look like? July 2023: Medicine, Science, Learning and Innovation (MSLM23) Ahmadiyya Muslim Medical Association (AMMA), Ahmadi Women Scientists Association (AWSA), and Association of Ahmadi Muslim Scientists (AAMS), Orlando, FL.
Jaclynn Chen, CNM, MPH, BSN, RNC-OB, C-EFM. Evaluating Maternity Nurses’ Perception of Implicit Bias and its Influence on Maternal Outcomes. May 2023: American College of Nurse-Midwives (ACNM)National Conference, Orlando, FL.
Maria Deda, BSN, RN, MEDSURG-BC; Theresa Raczko, AGCN, BSN, RN CPAN. Improving Efficiency and Environmental Sustainability of Nasal Cannula Oxygen Delivery. Shark Tank. April 2023: American Society of PeriAnesthesia Nurses (ASPAN) National Conference, Denver, CO.
Sharon Llerena, DNP, RN-BC, CCTN, CPAN; Maria del Mar Rodriguez, MSHI, AGCNS, RN, CNOR, CPAN. Assessing the Language Proficiency of Our Bilingual Perioperative Staff. April 2023: American Society of Perianesthesia Nurses (ASPAN) Conference, Denver, CO.
Tammy McNinney, BSN, RN, OCN; Danica Dorlette, MPH, BSN, RN, OCN. Raising Hazardous Drug Precaution Awareness Among Non-Oncology Nurses. April 2023: Oncology Nursing Society (ONS) Congress, San Antonio, TX.
Stephanie O’Neil, MSN, RN, MEDSURG-BC, CCTN; Reynaldo R. Rivera, DNP, RN, NEA-BC, FAAN, FAONL. STOP Technology Overload: Nurses Perceptions of Alerts. November 2023: 13th Annual NewYork-Presbyterian Nursing Research, Evidence-Based Practice, and Innovation Symposium, New York, NY.
Alanna Perlstein, MSN, RN-BC; Katherine O’Hara, MPA, BSN, RN, CPAN. Improving FCOTS Using a Multidisciplinary, Multifactorial Approach: A Quality Initiative Project. April 2023: American Society of Perianesthesia Nurses (ASPAN) Conference, Denver, CO.
Shanna Sapienza, DNP, RNC-OB, C-EFM, C-ONQS. Trauma Informed Care - Back to Basics. December 2023: Association of Women’s Health, Obstetric and Neonatal Nurses – New York Section, New York, NY.
Joann Wong, BSN, RN. Cannabis Use as a Fall Risk Factor for Older Adults. September 2023: Falls Prevention Symposium, New York, NY.
Poster Presentations
Dianna Assalone, DNP, RN, OCN, BMTCN, NE-BC; Dan Cernivani, MSN, RN, OCN, BMTCN. Tackling CLABSI through Weekly Central Line Device Rounds and Huddle Messages: A Team Focused Approach. April 2023: Oncology Nursing Society (ONS) Congress, San Antonio, TX.
Toni Correggio, BSN, RN, CPAN; Katherine O’Hara, MPA, BSN, RN, CPAN; Maria del Mar Rodriguez, MSHI, AGCNS, RN, CNOR, CPAN. Fostering a Culture of Recognition in the PACU. April 2023: American Society of Perianesthesia Nurses (ASPAN) Conference, Denver, CO.
Mary A. Gallagher, DNP, RN, PED-BC. Analysis of Gratitude Documents of Nurses who Received COVID-19 Emergency Grants. July 2023: International Council of Nurses (ICN) Congress, Montreal, CA.
Mary A. Gallagher, DNP, RN, PED-BC. Creation of Financial SafetyNets: Policy Priorities for Nurses Responding to a Pandemic or Crisis. July 2023: International Council of Nurses (ICN) Congress, Montreal, CA.
Mary A. Gallagher, DNP, RN, PED-BC. Financial Impact of COVID-19 on Frontline US Nurses. July 2023: International Council of Nurses (ICN) Congress, Montreal, CA.
Mary A. Gallagher, DNP, RN, PED-BC; Cosme Taipe, MPA, BSN, RN, CCRN-K; Tzipora Schwartz, MSN, RN, CPHQ. RID Project: Removing Indwelling Urinary Devices to Decrease Female Hospital Acquired Pressure Injuries (HAPI) and Catheter Associated Urinary Tract Infections (CAUTI). July 2023. International Council of Nurses (ICN) Congress, Montreal, CA.
Sam Martinez, BSN, RN, CNN; Robee Ravago, BSN, RN, CNN; 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) Annual Meeting, Minneapolis, MN.
Sam Martinez, BSN, RN, CNN; Robee Ravago, BSN, RN, CNN. A Quality Improvement Project on Mentorship and Training in Plasmapheresis and Red Blood Cell Exchange. November 2023: 13th Annual NewYork-Presbyterian Nursing Research, Evidence-Based Practice, and Innovation Symposium, New York, NY.
Stephanie O’Neil, MSN, RN, MEDSURG-BC, CCTN; Patricia Prufeta, DNP, RN, NEA-BC. Self-care is Not Selfish: A Quality Improvement Project Focused on Nurse Leader (NL) Well-Being Using Creative Scheduling. January 2023: Columbia University School of Nursing Annual Poster Presentations, New York, NY.
Angela Patruno, BSN, RN, CPAN; Maria del Mar Rodriguez, MSHI, AGCNS, RN, CNOR, CPAN. “Tell Us How We’re Doing”: Putting Patient Satisfaction in the Patient’s Hands. April 2023: American Society of Peri-anesthesia Nurses (ASPAN) Conference, Denver, CO.
Urszula Pawka, RN, BSN; Samantha Mayhew, RN, BSN; lanna Perlstein, MSN, RN-BC; Katherine O’Hara, MPA, BSN, RN, CPAN. Improving FCOTS Using a Multidisciplinary, Multifactorial Approach: A Quality Initiative Project. April 2023: American Society of Perianesthesia Nurses (ASPAN) Conference, Denver, CO.
Maria del Mar Rodriguez, MSHI, AGCNS, RN, CNOR, CPAN; Sharon Llerena, DNP, RN-BC, CCTN, CPAN. Assessing the Language Proficiency of Our Bilingual Perioperative Staff. April 2023: American Society of Perianesthesia Nurses (ASPAN) Conference, Denver, CO.
Therese Roselli, BSN, RN, OCN; Paige Ahearn, BSN, RN, BMTCN. Upskilling Oncology Nurses to CAR-T Infusion & Management. April 2023: Oncology Nursing Society (ONS) Congress, San Antonio, TX.
May Saulan, DNP, MSN, MPA, CNOR, AOCNS; Megan Belknap, BSN, RN, CPAN. Augmenting the 5 Rights: Improving Compliance with Barcode Medication Administration. April 2023: American Society of Perianesthesia Nurses (ASPAN) Conference, Denver, CO.
Grace Song, BSN, RN, CCRN, CPAN. PACU. Fitness Challenge: Promoting Health and Well-Being Post-Covid-19 Surge. April 2023: American Society of Perianesthesia Nurses (ASPAN) Conference, Denver, CO.
Amy Staley, MSN, RN, MEDSURG-BC. Beyond the Patient Experience: Influencing Patient Satisfaction Through Family-based Comfort Rounds. December 2023: Columbia University School of Nursing Annual Poster Presentations, New York, NY.
