NURSING REPORT ACCOMPLISHMENTS FOR 2017 SHARP MESA VISTA HOSPITAL/SHARP MCDONALD CENTER - SHARP HEALTHCARE
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
Accomplishments for 2017 Sharp Mesa Vista Hospital/Sharp McDonald Center Nursing Report
Welcome Dear Colleagues: Welcome to Sharp Mesa Vista Hospital and Sharp McDonald Center’s annual Nursing Report. I am so proud of our nurses! I have seen their growth and expertise blossom over the years. Our Magnet journey provides nurses an opportunity to showcase their accomplishments in working with our vulnerable patient population. Their caring is at the heart of every story you will read here. I see their excellent care each and every day — I hope you see it also. Sincerely, Cheryl Odell, MSN, RN, NEA-BC Vice President and Chief Nursing Officer Sharp Mesa Vista Hospital & Sharp McDonald Center COVER PHOTO: Teresia Ngeno, RN, BSN, Lead RN, Senior Behavioral Unit
“I just wanted to let you know that I’ve been doing great lately with my
recovery, and I wanted to thank you for all your help last year. Thank
you for teaching me how to be in touch with my mental health, as I am
currently thriving in every way mentally. Thank you so much for helping
kids like me get out of the dark. Keep doing what you are doing.”
— A grateful teenage patient
Since the Inaugural Nursing Report…
This annual report recognizes the extraordinary accomplishments of SMV/SMC nurses. It is
again organized by the four components of the Magnet Model: Transformational Leadership,
Structural Empowerment, Exemplary Professional Practice and New Knowledge, Innovations
& Improvements.
Our Journey to Magnet
Caring is in Our Nature is our Magnet theme and we carried it forward this past year.
We submitted our application for Magnet designation in October 2017, and the American
Nurses Credentialing Center (ANCC) Magnet Office has targeted Feb. 1, 2020, as our
document submission date.
Ongoing Hospital Modernization
Several enhancements have been made to our healing environment this past year. New
finishes were added throughout the hospital. East Wing 2 was renovated to include several
safety features and CAP 3, our Child and Adolescent Inpatient Unit, was completely
remodeled. Enhancements to the healing environment included:
• Replaced patient room flooring in ICU; painted corridors and patient rooms; replaced
patient beds; installed wall protection, handrails, and new room signage.
• Replaced flooring in Medical Records/Health Information Management; Intake and exam
rooms; and Admitting and Business Office. As a result, we added two new exam rooms
as well as new furniture in three exam rooms, Admitting, Medical Records/HIM and
Utilization Review/Case Management.
• Refreshed CAP building lobby (new flooring installed and walls painted).
• Upgraded corridor flooring throughout main building.
• Installed new hand gel dispensers and signage directing people to hand dispensers.
• Painted corridors and meeting rooms at our Mid-City outpatient location.
• Updated paint, flooring and furnishings in Adult Intensive Outpatient Program.
• Updated Physician Lounge and staff lounges: paint, flooring and furniture; installed TV
in CAP staff lounge.
• Installed new flooring (corridors and patient room) and painted East Wing 2; replaced
old furniture, signage and artwork.
• Installed two pet relief stations.
• Installed improved room-identifying signage and wayfinding signage throughout facility.
WELCOME 2
Vision. Leadership. Exemplary Outcomes. Transformational Leadership
Transformational Leadership: Vision. Leadership. Exemplary Outcomes.
Transformational leadership starts with a vision and incorporates participative leadership
and management to achieve exemplary outcomes. Nursing leadership, informed by a shared
governance structure, provides an infrastructure for continuous improvement. Various
strategic initiatives build a foundation to support a culture of quality and safety, including
the Sharp HealthCare Center of Nursing Excellence (CONE), which sets the vision for the
nursing enterprise.
Six Sigma/Lean/Change Management Training
STRUCTURAL EMPOWERMENT
Continuously improving processes is a part of everyday life at SMV/SMC. Nursing staff are
trained in Sharp HealthCare’s continuous improvement methods: Lean Six Sigma, Change
Acceleration Process, and Work-Out. Lean Six Sigma is an important part of our ongoing
journey to make Sharp the best place to work, practice medicine and receive care.
White Belts learn Lean Six Sigma awareness, apply basic A3 problem-solving, assist in
the identification of waste, and are active participants in huddles, learning boards and
problem solving.
Yellow Belts provide local assistance for meeting facilitation, group problem solving, and
meeting effectiveness; help instill new tools and techniques across the organization; identify
and complete A3 problem-solving in the workplace; and assist in the identification and
mitigation of waste.
4
Green Belts oversee project analytics and are leaders in addition to their current job
responsibilities, participate in Six Sigma projects, facilitate rapid improvement events and
5S events, and coach A3 problem-solving.
Nursing staff who have achieved White, Yellow and Green Belts include:
Six Sigma Green Belt (3) Laurie Costa Vanessa Kurzon
Alisha Carpenter Laura Cunningham Jenna Kwaitkowski
Naia Gomez-Andrade Debra Downes Steve Molina
Loralie Woods Nancy Earl Teresia Ngeno
Six Sigma Yellow Belt (44) Edrienne “Drin” Fae Yap Cheryl Odell
Mary Abbott Erica Gemgnani Luc R. Pelletier
Helen Aguilar Stephanie Harrington Kirstin Poliska
Tricia Armfield Brooke Hartsock Corinne Powell
Stephanie Ballesta James Holt Jesselyn Quiapo
Stephanie Bautista Joy Ilao Fred Quinn
Marc Brunton Robin Inkel Amy Recker
Danielle Campbell Ana Liza Javier Kathleen Reinhardt
Rhodora “Odette” Campos Bozena Kik Gregory Robin
Cathryn Cooper Linda Kueltzo Tim Sanford
Photo: Nicole Raymundo, RN, BSN, Administrative Liaison, Nurse Residency Program Graduate
TRANSFORMATIONAL LEADERSHIP 4
Yellow Belts continued: Joshua Barder Ricardo Mera
Perry Schoulten Tonya Bell Jennifer Moreno
Gretchen Smith Patricia Burningham Andrea Munoz
James Sommerville Michelle Etherington Marichu Reed
Maria Sufan Lynda Goldberg Kathleen Rhea
Stephanie Velbis Sandra Gray Carole Ross
Chandra Vincent Susan Hlobik Carmen Sagaste
Esperanza “Maria” Zamora Rebecca Johnson Mary Kay Shibley
Lilah Joy Leon Guerrero Shadette Soriano
Six Sigma White Belt (30)
Lauren Levario Dulce Soto
Martha Acosta
Richard Loving Erica Tiscareno
Sarah Badilla
Sharon Maidment Michael Ulrich
Kimberly Bailey
Peter J. Meaden Keith Vargas
Breanah Bandrowsky
Improving Hand Hygiene Results in Lower Infection Rates
SMV/SMC leadership and frontline staff have utilized a multi-modal approach to foster
hand hygiene compliance for all employees for several years. Clinical processes are
standardized and hardwired to ensure best practices are being employed in an effort to
reduce health care-associated infections. Specific interventions implemented to foster hand
hygiene include:
• Utilized The Joint Commission Targeted Solutions Tool for Hand Hygiene
• Implemented hospital-wide training and monthly educational sessions
• Reviewed and clarified the definition of “wash in” and “wash out” for the inpatient
psychiatric setting
• Continued monitoring by observers; enhanced coaching provided; barriers to hand
hygiene solicited and addressed
• Created visual and verbal prompt for cross-monitoring (ID badge guards)
• Shared hand hygiene compliance data on learning boards
TRANSFORMATIONAL LEADERSHIP 5The graph below shows how increased hand hygiene compliance results in lower hospital-
acquired urinary tract infection (UTI) rates.
Figure 1:
SMV/SMC RN Hand Hygiene Compliance and UTI Rates
Hand Hygiene
1
0.86 0.85 0.80 0.87
0.9
0.80 0.79
0.77 0.94
0.8
0.7
0.6
RATE
0.5
0.4 0.33
0.3 0.26
0.18 0.18
0.2
0.08 0.08
0.1
0 0
0
FY2016 Q1 FY2016 Q2 FY2016 Q3 FY2016 Q4 FY2017 Q1 FY2017 Q2 FY2017 Q3 FY2017 Q4
QUARTER
INFECTION RATES RN HH COMPLIANCE LINEAR
TRANSFORMATIONAL LEADERSHIP 6Engagement. Lifelong learning. Community. Structural Empowerment
Structural Empowerment: Engagement. Lifelong Learning. Community.
Structural empowerment requires nurse engagement at every level, with a commitment to
lifelong learning. We emphasize the principle of lifelong learning for all nursing staff. Nurses
have an opportunity to lead change efforts and enhance the services we provide — each and
every day.
Nurse Residency Program — A Path to Professional Nursing
Since its inception in 2011, 60 nurses have participated in the Nurse Residency Program
(NRP). The primary goal of the NRP is the recruitment and retention of nurses into the
psychiatric-mental health and addiction nursing specialties. Only 28.7 percent of California
hospitals offer an NRP. 1(p7) An NRP can serve as a recruitment and retention strategy that
lowers overall turnover rates as demonstrated in a study completed this past year. Within
the study period (2010 — 2016), there was a turnover rate of 11.7 percent in year one
(88.3 percent retention) and 2.9 percent in year two (97.1 percent retention), which are lower
than reported turnover rates in the literature (17.5 percent and 33.5 percent, respectively).
Significant correlations were revealed in the workplace domains of knowledge and skills,
social support, organizational citizenship behavior, civility, coping self-efficacy, organizational
and occupational commitment, person-organizational fit, and burnout.
Components of the program include didactic instruction, clinical immersion and competency
validation, looping, mentoring, and debriefing. Respondents to the survey have listed the
greatest source of job satisfaction as:
• “Knowing that you are helping patients get through a difficult time in their lives.”
• “Being part of a patient’s recovery. Working as part of a great team and knowing I
make an important contribution.”
• “Positive, measurable patient outcomes.”
• “Patient improvements in condition; coworkers create a pleasant environment;
teamwork.”
This past year’s graduates of the NRP were Kailyn Anderson (CAP 3), David Lindley (ICU),
and Edrienne “Drin” Fae Yap (EW1).
Over the life of the program, 13 NRP graduates have assumed nursing leadership roles
(Advanced Clinician, Lead, Administrative Liaison).
Photo: Rhodora “Odette” Campos, MSN, RN-BC, Lead RN, Senior Behavioral Unit,
2017 Nurse of the Year
STRUCTURAL EMPOWERMENT 8Raising the Bar: Baccalaureate Preparation
SMV/SMC leadership continues to foster a well-prepared nursing workforce, aligned with
The Future of Nursing: Leading Change, Advancing Health, 2 which has identified a goal of
80 percent of the nursing workforce having a BSN or higher degree by 2020. Leadership
has consistently hired more nurses with a baccalaureate degree and have identified a goal
of increasing BSN or higher-prepared nurses by 2 percent annually. Additionally, there are
a significant number of clinical nurses practicing with master’s degrees. All nurse managers
have a baccalaureate degree in nursing.
Currently, 63 percent of the RN workforce at SMV/SMC has a BSN degree or higher. In
2017, only 24.8 percent of hospitals that participated in the 2017 Survey of Nurse Employers
reported having between 51 percent and 75 percent of BSN-prepared RNs on staff. 3
In California, 57 percent of nurses are BSN-prepared compared to 51 percent nationally.4
Our number of BSN-prepared RNs is above the state and national rates, and we have
exceeded our goal of increasing the rate by 2 percent annually.
Figure 2:
SMV/SMC RNs with a Bachelor’s or Higher Degree in Nursing
Organization RNs with Nursing Degrees
100
90
80
70
61
60
PERCENT
50
40
30
20
10
59 63
0
Year — Baseline (2016) Year — 1 (2017)
YEAR
GOAL: 2% ANNUAL INCREASE
STRUCTURAL EMPOWERMENT 9Several of our Mental Health Associates and LVNs are pursuing RN degrees. Currently nine
nursing staff are pursing BSNs and eight clinical RNs are in master’s programs; two are
pursuing doctorates in nursing. SMV/SMC nursing leadership is a founding member of Sharp
HealthCare’s Center of Nursing Excellence (CONE). Established in 2009, CONE provides
structures and processes to address nursing workforce challenges, along with a common
infrastructure for nursing professionals to share best practices and enhance collaboration
across the system. CONE unites Sharp’s contributions to the future of the nursing profession
through a strategic vision — shaping best practices, driving research and grant opportunities,
and influencing legislative efforts to support nursing at a national level — with the ultimate
goal of improving patient care. In 2017, CONE provided three scholarships to SMV/SMC
nursing staff totaling $12,000 to defray the costs of their nursing education.
Recognition of Nursing Excellence
SMV/SMC recognizes the contribution of its exceptional nursing staff through various award
programs. These include Employee of the Month and Year, Nurse and LVN/LPT of the Year,
Great Catch Awards, Nursing Support Staff of the Year, and the Sharp HealthCare Center of
Recognized Excellence (C.O.R.E.) and Pillar Awards.
Employee of the Month
The Employee of the Month program honors employees for service excellence. Nursing staff
who received this award in 2017:
Marichu Reed (CAP 3 1), Roland Guy (CAP 3), Ryan Harina (ICU), Robert Bayaca (EW1) ,
Helen Rees (EW2)
Employee of the Year
The Employee of the Year is chosen from the Employee of the Month pool. The recipient of
Employee of the Year for 2017 was Roland Guy, MHA (CAP 3).
Exemplary Professional Practice — Clinical Nurse of the Year/LVN-LPT of the Year
Frontline nurses are central to The Sharp Experience and contribute to SMV/SMC’s
innovations and accomplishments. Each year, SMV/SMC honors nurses who demonstrate
outstanding qualities in their chosen area of practice and who show a commitment to the
nursing profession. While all the nurses at Sharp are truly exceptional, a select few exemplify
an above-and-beyond standard of excellence that deserves special recognition. The Nursing
Excellence Awards provide the opportunity to recognize and reward registered nurses for
the special contribution they make to SMV/SMC. Rhodora “Odette” Campos, MSN, RN-BC
(EW1), was recognized as Clinical Nurse of the Year in 2017.
1
CAP3 = Child & Adolescent Program; ICU = Intensive Care Unit; EW1 = East Wing 1; EW2 = East Wing 2;
SMC = Sharp McDonald Center; NR = North Rotunda; AL = Administrative Liaison; SBU = Senior Behavioral Unit;
SR = South Rotunda; NA = Nursing Administration
STRUCTURAL EMPOWERMENT 10The Licensed Vocational Nurse (LVN)-Licensed Psychiatric Technician (LPT) Award provides
the opportunity to recognize and reward an outstanding LVN or LPT in a clinical setting
for the special contribution they make to SMV/SMC. The goal is to honor individuals who
demonstrate outstanding qualities in their area of practice and contributions to patient care.
The recipient of the 2017 LVN-LPT award was Megan Pehl, LVN (ICU).
Great Catch Awards
The Great Catch Award recognizes staff who have intervened to prevent a potentially
harmful event from reaching a patient. Why is this program important? Increased reporting
of Great Catches will help us learn of risks and issues and make improvements to provide
safer care. For example, while preparing to administer medications, an RN questioned why
a patient who had never taken opiates had Suboxone ordered for pain. He continued with a
questioning attitude, reviewed the patient’s history and physical, and called the physician to
clarify the order. The physician confirmed that the order was not intended for this patient.
The lesson learned is to have a questioning attitude when conducting medication rights of
administration, and closed-loop communication for order clarification in order to help catch
errors before they happen. Recipients of Great Catch Awards include:
• Marina Buhle, RN (SR; 2013)
• Brooke Hartsock, BSN, RN (SR; 2013)
• Gretchen Smith, RN-BC (EW2; 2015)
• Christopher Marrazzo, BSN, RN (EW1; 2017)
Nursing Support Staff of the Year
The Nursing Support Staff of the Year Award seeks to recognize nursing support staff who
reflect a positive, professional image by his/her commitment to leadership, collaborative
practice, support of professional growth and excellence in patient care. SMV/SMC award
recipients for 2017 include:
Patient Care — Direct
SMV/EW1 Veronica Silver, MHA
Patient Care — Indirect
SMV/Quality Jennifer Thomas, Data Quality Analyst
Sharp HealthCare C.O.R.E. and Pillar Awards
C.O.R.E. and Pillars of Excellence Awards recognize team members and partners who
exemplify the spirit of The Sharp Experience and produce extraordinary results under one
of Sharp’s seven Pillars of Excellence. Each year, SMV/SMC presents C.O.R.E. Awards to
recognize exemplary team members. All C.O.R.E. Award winners are then considered for
Sharp’s system-wide Pillars of Excellence Awards, which are honored at the annual All-Staff
Assembly. The following is a list of SMV/SMC C.O.R.E. and Pillar Award recipients (RN and
other nursing staff names are italicized). Awards with an asterisk also won the Pillar award.
STRUCTURAL EMPOWERMENT 112017 C.O.R.E. and Pillar Awards
Adolescent Partial Hospitalization Program (Safety — Team)
Jennifer Wojciechowski, Alison Wilbanks, Alisha Carpenter, Roland Guy, Jennifer McWaters,
Kimberly Thornton, Stephanie Lord, William Wright, Garrett Work, Dianna Fischer
Amanda Gastelum Munoz* (People — Individual)
Denials and Appeals Team (Finance — Team)
Kari Cornicelli, Christiana Paul, Scott Carruthers, Jennifer Ward, Angela McKinney, Stacie
Elamparo, Penny Peterson, Jodi Carlton, Martha Acosta, Aileen Carr, Mildred York, Suzanne
Sorrells, Chanon Chenowth, Julia Monell, Allen Lee, Elaine Coney
COG/DBT Intensive Outpatient Programs (Community — Team)
Christina Huang, Rafael Reyes, Joseph Gannon, Jacqueline Noonan, Safa Rashid, Kristin
Whitaker, Abby Griesbach, Alexandra Mazzulo, Amber Salvador, Romi Mouhibian, Angelica
Waring, Colleen Auth, Suhair Erikat, Anna Morgan, Laura Thackray, Julie Braatz, Jonna
Ferma, Suzanne Whittemore, Terra Schmookler, Karl Pongyingpis, Raymond Fideleo
San Diego Evidence-Based Practice Institute (EBPI)
Sharp HealthCare participates in the San Diego Evidence-Based Practice Institute (EBPI),
which prepares teams of staff fellows (interprofessional staff) and mentors to change and
improve clinical practice and patient care. This evolution in practice and care occurs through
identifying a care problem, developing a plan to solve it and then incorporating this new
knowledge into practice. EBPI is part of the Consortium for Nursing Excellence, San Diego,
which promotes evidence-based practice in the nursing community. The consortium is a
partnership between Sharp HealthCare; Scripps Health; Palomar Health; Rady Children’s
Hospital-San Diego; University of California, San Diego Health System; U.S. Department of
Veterans Affairs (VA) San Diego Healthcare System; Elizabeth Hospice; Point Loma Nazarene
University; San Diego State University; Azusa Pacific University; and the University of San
Diego Hahn School of Nursing and Health Science.
Sharp HealthCare actively supports the EBPI by providing instructors and mentors as well as
administrative coordination. The San Diego EBPI includes six full-day class sessions featuring
group activities, self-directed learning programs outside of the classroom and structured
mentorship throughout the program. The EBPI fellows partner with their mentors and
participate in a variety of learning strategies. Mentors facilitate the process of conducting an
evidence-based practice change and navigating the hospital system to support the fellows
through the process of evidence-based practice. Mentors also assist the fellows in working
collaboratively with other key hospital leadership personnel.
*Awardee also won Pillar Award
STRUCTURAL EMPOWERMENT 12The nine-month program culminates with a community conference and graduation
ceremony in November, during which the project results of all EBPI fellows are shared.
In 2017, the following nursing staff participated in the program:
MENTEE MENTOR PROJECT
Wall Art in Psychiatric Intensive
Marta Michalowska, RN, ICU Mary Kay Shibley, MSN, RN
Care Unit
Improving Throughput by
Kathleen Reinhardt, RN, EW1 Loralie Woods, MSN, RN-BC
Implementing a Discharge RN
Providing a Learning Space and Service in the Community —
Adjunct Faculty
In FY2017, nearly 400 nursing students worked clinical rotations of six- to eight-hour
shifts in all inpatient units and several of the outpatient programs at SMV and SMC. SMV
offers two clinical rotations in one day, including morning and evening shifts, and nursing
students are on campus seven days a week. Including time spent with groups and individual
preceptors, nursing students served nearly 30,000 hours at SMV in FY2017. Academic
institution partners included, but were not limited to, Azusa Pacific University, California
State University San Marcos, National University, Point Loma Nazarene University, San Diego
City College, San Diego State University, Southwestern College, and University of San Diego
Hahn School of Nursing and Health Science. 5
Our professional nurses serve in the community as adjunct faculty at various health
professions schools. Their impact on future health care professionals is critical to ensuring a
vibrant workforce. A recent quote from a nursing student exemplifies these nurses’ influence
on the next generation of professional nurses:
Regardless of their status, the nurses demonstrated an unparalleled respect for
the patients; their rights, wishes and feelings; and all nurses were a credit to the
profession. Rarely have I seen these characteristics demonstrated to such a degree.
— Student Nurse, University of San Diego, May 2017
Adjunct Faculty: 13 nursing staff serve
as adjunct faculty at 10 colleges,
universities and professional schools
STRUCTURAL EMPOWERMENT 13Adjunct Faculty Appointments
Azusa Pacific University Suastha Yoga Academy
Nancy Earl, Lead RN Chris Marrazzo, Clinical RN
Living Works University of San Diego Hahn School of
Kris Lambert, Senior Specialist, Nursing Nursing and Health Science
Loma Linda University Nancy Earl, Lead RN
Janet Donnelly, Clinical RN Luc R. Pelletier, Senior Specialist, Nursing
Point Loma Nazarene University University of California, San Diego
Kris Lambert, Senior Specialist, Nursing Sharon B. De Peralta, Clinical RN
Kathleen Rhea, Clinical RN U.S. Navy Independent Duty Corps School
SDSU Joe Lacanienta, Administrative Liaison
Sharon B. De Peralta, Clinical RN Vinyasa Krama School of Yoga
Jay Villaflores, Clinical RN Chris Marrazzo, Clinical RN
Crisis Prevention Institute (CPI) Training and Crisis Management
SMV/SMC staff employ nonviolent crisis-intervention principles and practices that prioritize
care, welfare, safety and security. Staff are training initially upon employment and annually
by certified instructors. This training builds confidence and competence, and staff
demonstrate improved capabilities in preventing or reducing risks.6 Several nursing staff are
trainers for CPI, the crisis management program used at SMV/SMC. They include:
Jonathan Cartford, MHA (EW2)
Brian Donald, BSN, RN, CEN (ICU)
Naia Gomez-Andrade, MSN, RN (Outpatient, SMC)
Rene Gonzales, MHA (CAP3)
Kris Lambert, Ph.D., RN (NA)
Amanda Gastelum Munoz, MSN, RN-BC, CNL (NA)
Jacob Pfister, RN (Intake)
Chandra Vincent, MSN, RN (NA)
SMV/SMC Honors its Certified Nurses
SMV/SMC values professional board certification of nurses in specialty areas. The Sharp
HealthCare Center of Nursing Excellence partners with the ANCC to implement an efficient
pathway to certification, which reduces test-taking anxiety and eliminates financial barriers
through the Success Pays Program™. Each year, the Sharp Metropolitan Medical Campus
holds a celebration of our certified nurses. Nurses are recognized and receive a certification
coat to wear proudly.
STRUCTURAL EMPOWERMENT 14This past year, clinical nursing staff offered a board certification preparation course.
This program included evidence-based components and was taught by SMV/SMC nurses.
Several staff attended the course, covering the following topics: neuroanatomy/physiology,
high-risk behaviors, milieu therapy, crisis concepts and interventions, pharmacology and
integrative therapies, communication, and test-taking and practice questions. In 2017,
48 nurses held board certification in 14 nursing and health care specialties (several nurses
had more than one certification).
We congratulate our nurses for achieving and maintaining board certification. The following
list includes SMV/SMC nursing staff certified in various nursing, education and other health
care specialties.
Adult Clinical Nurse Specialist Certified Case Manager (CCMC)
(ANCC; ACNS-BC) Penny Peterson
Janet Donnelly Family Nurse Practitioner (AANP)
Adult Psychiatric-Mental Health Clinical Kelly Mullins
Nurse Specialist (ANCC; PMHCNS-BC) Nurse Executive (ANCC; NE-BC)
Keynan Hobbs Bozena Kik
Luc R. Pelletier
Nurse Executive — Advanced
Patricia Rodgers
(ANCC: NEA-BC)
Certified Addictions Registered Nurse Cheryl Odell
(IntNSA; CARN)
Nursing Professional Development
Sandra Gray
(ANCC; RN-BC)
Linda Kueltzo
Janet Donnelly
Lilah Joy Leon Guerrero
Amanda Gastelum Munoz
Matt Lockart
Loralie Woods
Certified Critical Care Nurse
Psychiatric-Mental Health Nursing
(AACN; CCRN)
(ANCC: RN-BC)
Mary Abbott
Helen Aguilar
Certified Emergency Nurse Sarah Badilla
(BCEN; CEN) Donis Baquirquir
Brian Donald Marc Brunton
Certified Medical-Surgical Registered Rhodora “Odette” Campos
Nurse (AMSN; CMRN) Carlos Cisneros
Bozena Kik Debra Downes
Certified Professional in Healthcare Nancy Earl
Quality (HQCC) Nicole Entenza
Sharon De Peralta Kenneth Fernandez
Luc R. Pelletier Rebecca Suzanne Johnson
Olivia Kearnes
Clinical Nurse Leader (AACN)
Amanda Gastelum Munoz
STRUCTURAL EMPOWERMENT 15Psychiatric-Mental Health Nursing Judy Reagan
(ANCC: RN-BC) Continued Amy Recker
Dawn Kochel Justin Sabol
Joe Lacanienta Gretchen Smith
Matt Lockart Shadette Soriano
Maria Dulce Mariano Carmen Sugaste
Ricardo Mera Tom Warmuth
Steven Molina Susan K. Williams
Cristin Peacock-Coleman Peggy Wilson
Corinne Powell Rachel Suh Yang
Fred Quinn Marie Zamora
Professional Certification: 48 nursing
staff are certified in 14 nursing and health
care specialties
Engagement in Professional Associations
Engagement in professional nursing organizations advances the profession. Many of our
nurses are active in their specialty nursing organizations and contribute to making health
care better for all Americans by influencing policy and practice standards. Some have even
held elected office in these prestigious groups. Belonging to a professional association is a
venue for professional practice and excellence, health care and public policy, knowledge and
research, unification, and workforce and workplace advocacy. 7 Below is a list of SMV/SMC
nurses and their professional organization affiliations.
Alpha Tau Delta American Holistic Nurses Association
Stephanie V. Ballesta Kris Lambert
Academy of Integrative Health & Medicine American Nurses Association
Jennifer Francis Sarah H. Badilla
American Academy of Nursing Odette Campos
Luc R. Pelletier Naia Gomez-Andrade
Erin Hansen
American Association of Critical Care
Olivia Kearnes
Nurses
Petra Klee
Janet Donnelly
Vanessa Kurzon
American Association of Nurse Kris Lambert
Practitioners Jacqueline Linehan
Kelly Mullins Abby Nauman
STRUCTURAL EMPOWERMENT 16Luc R. Pelletier International Nurses Association
Jesselyn Quiapo Hannah Biernacki
Kathleen Reinhardt Kripalu School of Ayurveda
Leila Riches Chris Marrazzo
Shadette Soriano
National Alliance on Mental Illness
Joyce Wei
Justin Sabol
Loralie Woods
National Association of Clinical Nurse
American Psychiatric Nurses Association
Specialists
Marc Brunton
Janet Donnelly
Patricia L. Burningham
Odette Campos National Association for Healthcare Quality
Daniel M. Casale Sharon B. De Peralta
Laurie Costa Luc R. Pelletier
Sharon B. De Peralta National Black Nurses Association
Debi Downes Donny Brown
Nancy Earl National Coalition Against Domestic
Erica Gemgnani Violence
Naia Gomez-Andrade Kris Lambert
Bozena Kik
Philippine Nurses Association
Vanessa Kurzon
Theresa Dacuycuy
Kris Lambert
Sigma Theta Tau International
Richard Loving
Laurie Costa
Luc R. Pelletier
Sharon B. De Peralta
Cheryl Odell
Cristina Diocson
Cristin Peacock-Coleman
Nancy Earl
Kathleen Reinhardt
Bozena Kik
Leila Riches
Joe Lacanienta
Madeleine Thompson
Kris Lambert
Loralie Woods
Jacqueline Linehan
Esperanza “Maria” Zamora
Cheryl Odell
Association of California Nurse Leaders
Shadette Soriano
Debi Downes
Loralie Woods
Bozena Kik
Rachel Yang
Cheryl Odell
University of Santo Tomas Nurses
Naia Gomez-Andrade
Association International
Kathleen Reinhardt
Evelyn B. Cuevas
Mary Kay Shibley
Loralie Woods Western Institute of Nursing Research
Kris Lambert
International Association of Forensic Nurses
Steve Molina Yoga Alliance
Chris Marrazzo
STRUCTURAL EMPOWERMENT 17Engagement in Professional Associations:
73 nursing staff are involved with
22 professional associations
Community Volunteer Service
Community service is an important part of the professional nursing role. In FY2017,
SMV/SMC contributed more than $18 million in programs and services to improve the health
and well-being of the San Diego community. This included $16.8 million in unreimbursed
medical care services through the dedication of SMV and SMC team members to community
service activities, examples of which are listed below.
USO 4th Tuesday Dinner Roll for Puerto Rico
Kris Lambert Naia Gomez-Andrade
Penny Peterson Sharp Lends a Hand (Coastal Habitat
Alzheimer’s San Diego Memory Screenings Restoration, Doors of Change, Feeding San
Tonya Bell Diego, Habitat for Humanity, I Love a Clean
American Foundation for Suicide San Diego, Life Rolls On, San Diego Food
Prevention Bank, Special Olympics, Ssubi Foundation
Kris Lambert Greening for Good, Stand Down, Veterans
Village of San Diego, and Wreaths Across
California State University, San Marcos
America, etc.)
Free Clinic
Martha Acosta
Cynthia Chesy
Maria A-Spears
Check Your Mood Depression Screening Tonya Bell
Esperanza “Maria” Zamora Marc Brunton
Date with a Cure Cynthia Chesy
Tonya Bell Carlos Cisneros
Linda Vista Cultural Fair Sandy Gray
Kris Lambert Naia Gomez-Andrade
Carole Hayworth
Miracle Babies Gala
Petra Klee
Mary Kay Shibley
Jenna Kwaitkowski
National Alliance on Mental Illness (NAMI)
Penny Peterson
Debi Downes
Esperanza “Maria” Zamora
Kris Lambert
Survivors of Suicide Loss
Operation Amped
Kris Lambert
Keynan Hobbs
STRUCTURAL EMPOWERMENT 18Philanthropy — Giving at Sharp HealthCare
Thousands of Sharp employees support foundations and initiatives at Sharp HealthCare
through charitable gifts, and together, employees system-wide donate more than $1 million
a year. Employees choose from over 30 funds to help build facilities, fund innovative
programs and equip expert caregivers with technology that saves lives. We are grateful to
the following staff members for their generous financial support in 2017 on our journey to
transform the health care experience:
Sara A. Ackerman Keynan Hobbs
Helen Aguilar Rebecca S. Johnson
Naia Andrade-Gomez Vanessa Kurzon
Francisco Calinisan Richard Loving
Debra Columb Cheryl Odell
JohnPaul Conly Luc R. Pelletier
Benjamin Contreras Jessalyn N. Quiapo
Susana S. Corpuz Irais S. Stricklin
Shirley Felicien Catherine Trager-Dobbs
Bernita Florentino Loralie Woods
Gerald Heath
STRUCTURAL EMPOWERMENT 19Collaboration. Accountability. Autonomy. Exemplary Professional Practice
Exemplary Professional Practice: Collaboration. Accountability.
Autonomy.
Our Professional Practice Model (PPM), developed by frontline nurses, is the framework
used to envision and provide nursing care. The SMV/SMC PPM serves as a framework for all
nursing activities and forms the basis of our pursuits of innovation in nursing science. Sharp
HealthCare’s nursing vision is “Transforming lives through caring, innovation and leadership.”
We are guided by the Sharp HealthCare seven Pillars of Excellence: Quality, Safety, Service,
People, Finance, Growth and Community. SMV/SMC’s PPM includes five components:
Professional Nursing Values, Professional Relationships, Leadership Approach, Care Delivery
System, and Reward and Recognition. Our care delivery system (circle in graphic below)
envisions patient- and family-centered care that is relationship-based, trauma-informed and
recovery-focused.
The foundation of our nursing practice at SMV/SMC includes the Magnet Recognition
Program components of Transformational Leadership, Structural Empowerment, Exemplary
Professional Practice, and New Knowledge, Innovations & Improvement; a shared
governance structure; core values of The Sharp Experience: Integrity, Caring, Innovation,
Safety and Excellence; and our professional nursing scope of standards and practice. The
PPM is depicted below.
Vision
Transforming Lives Through
Caring, Innovation and Leadership
Quality Safety Service People Finance Growth Community
amily-Cen
nd F ter
-a
ent ed
ti C
Pa
ar
Relationship-
e
Based Care
Co
mmu s
nit rse
y Nu
Patient
& Family
Trauma- Recovery-
Healthcare
Informed Focused
Team
Magnet Recognition Program:
Transformational Leadership, Structural Empowerment, Exemplary Professional Practice, New Knowledge, Innovations & Improvement
Shared Governance
The Sharp Experience: Integrity, Caring, Innovation, Safety, Excellence
Professional Nursing Scope and Standards of Practice
Professional Practice Model — Sharp Mesa Vista Hospital — Sharp McDonald Center
Photo: Laura Thill, BSN, RN, Advanced Clinician, ICU
EXEMPLARY PROFESSIONAL PRACTICE 21RN Engagement Survey
In 2017, RN engagement was measured through the annual employee engagement survey
administered by Press Ganey. SMV/SMC nursing leadership believes that engaged nurses
are central to effective, efficient, caregiving teams. By capturing the voice of nurses, our
organization can better understand the unique concerns of nurses, build a patient-centered
culture that reduces stress for caregivers, and support strategies to attract and retain valued
nurses. 8 The survey is a multi-dimensional view of nurse engagement and provides nursing
leadership with data on strengths and opportunities for improvement. Six out of seven scores
were above the national mean compared to other comparable hospitals (national benchmark;
see below).
Figure 3:
SMV/SMC 2017 RN Engagement Survey Results
RN Engagement
6
5
4.21 4.37 4.37
4.09 4.08
4.02
3.75
4
4.07 4.08
3.96
3.86 3.69 3.85
MEAN
3
3.41
2
1
0
y y ls r- p l
ac s m ta ty te l hi na t RN
q u r ce
o
e n a li re In ona s rs and s io en o - nd
on e s s
es m -t k a ion
de ou ut m
a Q Ca u si ip ad ss ne N
R o r rat
A es A es sh L e c c e i ve of o p
R n d of n g of i o n P r ve l w o
of Fu si r
p la t A ns e a m lla b
ur o D e
T o
N Re sp C
Re
SURVEY DOMAINS
SMV/SMC MEAN NATIONAL BENCHMARK MEAN
EXEMPLARY PROFESSIONAL PRACTICE 22External Recognition for Exemplary Professional Practice
SMV/SMC has received recognition from external organizations acknowledging various
aspects of our care and services
2017 Association of California Nurse Leaders — San Diego Chapter Poster Award
SMV’s poster entry,“Increasing Board Certification Using Frontline Nurse-Driven Review
Courses,” won the 2017 ACNL Innovations Conference: Professional Advancement of the
Frontline Caregiver Poster Award. Congratulations to Odette Campos, MSN, RN-BC; Amanda
Gastelum Munoz, MSN, RN-BC, CNL; Gretchen Mansch, BSN, MEd, RN; Kathleen Reinhardt,
RN; and Peggy Wilson, BSN, MEA, RN-BC.
American Psychiatric Nurses Association 31st Annual Conference Poster Award
SMV won first prize in the Education category for “Increasing Board Certification Using
Frontline Nurse-Driven Review Courses.” Congratulations to Odette Campos, MSN, RN-BC;
Amanda Gastelum Munoz, MSN, RN-BC, CNL; Gretchen Mansch, BSN, MEd, RN; Kathleen
Reinhardt, RN; and Peggy Wilson, BSN, MEA, RN-BC.
2017 Sharp HealthCare Interprofessional Research & Innovations Conference Poster Award
SMV received a Professional Advancement of the Frontline Caregiver Poster Award
for “Increasing Board Certification Using Frontline Nurse-Driven Review Courses.”
Congratulations again to Odette Campos, MSN, RN-BC; Amanda Gastelum Munoz, MSN,
RN-BC, CNL; Gretchen Mansch, BSN, MEd, RN; Kathleen Reinhardt, RN; and Peggy Wilson,
BSN, MEA, RN-BC.
Seclusion and Restraint Reduction
SMV/SMC continues to implement strategic interventions to reduce the use of physical and
mechanical restraint and seclusion. These interventions include:
• Ongoing training in crisis prevention and management
• Monitoring and trending of restraint and seclusion data
• Implementation of an assault risk assessment (Brøset Violence Checklist) into the clinical
nursing workflow
• Patient and staff debriefing
• Sharing seclusion and restraint rates on learning boards
• Updated CPI instruction to include a new decision-making matrix to assist staff in
selecting the type of intervention to be used
EXEMPLARY PROFESSIONAL PRACTICE 23The following graph shows comparisons between SMV and California and national rates for
available reporting years.
Figure 4:
SMV Restraint Rates Compared to CA and National Rates
SMV Restraint Rates
0.8
0.66 0.68
0.7
RATE PER 1,000 PATIENTS
0.58
0.6 0.55
0.5
0.42 0.44
0.38
0.4
0.3
0.2
0.09
0.1
0.03 0.03 0.03
0
CY 2013 CY 2014 CY 2015 CY 2016
CALENDAR YEAR
SMV CA NATIONAL
EXEMPLARY PROFESSIONAL PRACTICE 24Satisfaction with Nursing Services Remains High
Patients rate their satisfaction with nursing services as measured regularly through the Press
Ganey survey. These surveys are reviewed by managers and frontline staff, and the results
inform the enhancement and continuous improvement of our programs. When compared to
other freestanding psychiatric hospitals, SMV rates higher in all nursing-sensitive items.
Figure 5:
FY2017 SMV Patient Satisfaction Compared to National Benchmark
Patient Satisfaction
96
94 93 93
92 91 91
90 90 90
89 89
90
88 87
MEAN
86 86
86 85
84
84
82
80
78
ll s/ s’ s’ s’ s’ s
ra g es sy se n se t se x se e: es s
ve s i n l i n r te u r tio it ur mp se u r e: t m ur o r n ln e
O r d N c n N ro n N r a N f io p fu urs
nu n u
i e co
u u p po fo gr in at el n
o d to i n ro ic H the
Fr tr re
s
p ed f
in m o
SATISFACTION SURVEY ITEM
SMV MEAN PSYCHIATRIC FREESTANDING HOSPITAL MEAN
High Rankings in Hospital-Based Behavioral Inpatient Psychiatric
Services Core Measures
SMV/SMC continues to report Hospital-Based Behavioral Inpatient Psychiatric Services
(HBIPS) core measures. HBIPS is a major leadership effort to improve quality, safety and
performance. Management staff have worked collaboratively with frontline staff to ensure
that systems and infrastructure support compliance with these evidence-based core quality
measures. Nurse-sensitive core measures include seclusion and restraint (HBIPS-2 and
HBIPS-3) and tobacco cessation. Our restraint reduction performance was described above.
EXEMPLARY PROFESSIONAL PRACTICE 25In regards to the tobacco cessation measures, although smoking in general has decreased
in the past few years, smoking rates among patients with mental health issues continues to
be high. For those with phobias and fears, 34.3 percent smoke; 88 percent of patients with
schizophrenia smoke. This is compared to 18.3 percent of people without a mental illness
who smoke. At SMV, the percent of patients admitted who smoke remained about the
same from 2016 to 2017 (18.0 percent and 17.9 percent, respectively). At SMC, there was a
significant decrease in smoking rate; 16.8 percent in 2016 compared to 9.1 percent in 2017.
Table 2:
SMV/SMC total admits, current everyday or same-day smoker numbers and rates
CY 2016 CY 2017
SMV SMC SMV SMC
Total Admits 9,912 333 9,015 330
Current Everyday or
1,780 56 1,618 30
Same-Day Smoker
Current Everyday or 18.0 16.8 17.9 9.1
Same-Day Smoker Rate percent percent percent percent
Tobacco cessation measures include TOB-1: Tobacco Use Screening, and TOB-2: Tobacco
Use Treatment Provided and Offered, and TOB-2a: Tobacco Use Treatment. SMV is above
the state and benchmark targets on these measures. Frontline staff and managers continue
to ensure that structures and processes are in place to provide evidence-based care to
persons who smoke.
Figure 6:
HBIPS Tobacco Cessation Measures Compared to State and Benchmark — CY2017
HBIPS Tobacco Cessation Measures
100
99.7
88.9
99.3 98.1
90
82.2
80 86.3
70
70
60
PERCENT
50
41
40
30
20
27.1
10
0
TOB-1 TOB-2 TOB-2a
HBIPS TOBACCO MEASURES
SMV CA NATIONAL
EXEMPLARY PROFESSIONAL PRACTICE 26Innovation. Evidence. Teamwork.
New Knowledge, Innovations
& ImprovementsNew Knowledge, Innovations and Improvements: Innovation.
Evidence. Teamwork.
To date, SMV/SMC has completed two Institutional Review Board-approved research
studies and initiated a new study to advance nursing science in psychiatric-mental health
and addictions nursing. In addition, clinical and administrative nurses have managed and
participated in various evidence-based and performance-improvement projects.
The Effectiveness of a Psychiatric-Mental Health Nurse Residency Program on
Retention (Completed)
This study asked the question: What is the effectiveness of a Nurse Residency Program
(NRP) in retaining new graduate nurses in a psychiatric-mental health setting? The Nurse
Residency Program provides new graduate nurses with social support and experiential
activities as a formal transition to clinical practice.
The researchers conducted a quantitative time-sequenced comparative study of multiple
cohorts of nurses hired into an NRP. The study yielded a turnover rate of 11.7 percent in
year one (88.3 percent retention) and 2.9 percent in year two (97.1 percent retention rate),
which are lower than turnover rates reported in the literature (17.5 percent and 33.5 percent,
respectively). Significant correlations were described in the workplace domains of knowledge
and skills, social support, organizational citizenship behavior, civility, coping self-efficacy,
organizational and occupational commitment, person-organizational fit, and burnout.
The researchers concluded that NRPs are effective in attracting and retaining competent,
confident new graduate nurses in psychiatric-mental health nursing. All of the respondents
were satisfied with their job and believed that the NRP offered a welcoming environment. A
research article based on this study has been accepted for publication in a future issue of the
Journal of the American Psychiatric Nurses Association.
Psychometric Testing of a Survey to Measure Patient Engagement in Hospitalized
Patients (Ongoing)
This study, initiated in 2017, is a collaboration between SMV and Sharp Memorial Hospital
nurse researchers. The study is being conducted to determine the psychometric properties
of a patient engagement survey for hospitalized patients. There are a limited number
of surveys in the public domain for measuring patient empowerment, engagement and
activation. In 2017, a survey was developed and tested at all seven Sharp HealthCare system
hospitals. Data from these surveys were analyzed and an updated survey will be tested in
early 2018.
Photo: Amanda Gastelum Munoz, MSN, RN-BC, CNL, Senior Specialist, Nursing
NEW KNOWLEDGE, INNOVATIONS & IMPROVEMENTS 28An Exploratory, Descriptive Study of Nurse Leaders’ Personal and Work Experiences During
Union Negotiations and Strike Events (Completed)
This study was a collaboration between SMV and Sharp Memorial Hospital nurse
researchers. There is little in nursing literature about nursing unions and their impact on
patient outcomes, nursing leadership, Magnet designation, overall job satisfaction and
retention, or other such variables. In a review of the literature, fewer than five articles were
published in peer-reviewed nursing or health care journals.
Other than anecdotal stories shared during union negotiations and strike preparations, we
know very little about how such events affect the personal and professional experiences
of nurse leaders. This research was significant because of the dearth of evidence-based
information in the nursing literature. The findings indicated that nurse leaders experience
a range of emotional states in response to union activities, with perceptions of increased
workload, job stress and constrained and deliberate communications with their staff. This
study adds to the body of knowledge about nurse leader experiences and feelings during
union activities.
Findings will help executive leaders in anticipating nurse leaders’ professional and personal
responses to union activities and in planning organizational strategies for future union
negations and strike preparations to neutralize the effect on providers, patients and families,
and the organization as a whole. The study has been accepted for publication in a 2019 issue
of the Journal of Nursing Administration.
New Knowledge and Innovation Council
To support research and evidence-based practice through research projects and activities
at SMV/SMC, a New Knowledge and Innovation Council was initiated in 2017. Participants
learn how to translate research, improve clinical research, facilitate podium and poster
presentations, develop evidence-based procedures and provide feedback on proposed
projects. The group meets monthly and is led by Richard Loving, DNS.
Leading New Knowledge — Presentations and Publications
SMV/SMC nurses disseminated new knowledge and innovations through presentations and
publications to internal and external audiences. Author names in bolded type are nurses at
SMV/SMC.
Internal presentations — Poster
Campos, O., Mansch, G., Gastelum Munoz, A., Reinhardt, K., & Wilson, P. Increasing board
certification using frontline nurse-driven review courses. 3rd Annual Sharp HealthCare
Interprofessional Research & Innovations Conference, June 2017.
Donnelly, J. and Geany, K. Greening for good: A collaborative community-based project.
NEW KNOWLEDGE, INNOVATIONS & IMPROVEMENTS 29Sharp HealthCare Research and Innovation Conference, June 2017.
Internal presentations — Podium
Donnelly, J. and Geany, K. Greening for good: A collaborative community-based project.
Sharp HealthCare Research and Innovation Conference, June 2017.
External presentations — Poster
Campos, O., Mansch, G., Gastelum Munoz, A., Reinhardt, K., & Wilson, P. Increasing board
certification using frontline nurse-driven review courses. Association of California Nurse
Leaders-San Diego Chapter, 2017 Innovations Conference, March 2017.
Campos, O., Mansch, G., Gastelum Munoz, A., Reinhardt, K., & Wilson, P. Increasing board
certification using frontline nurse-driven courses. American Psychiatric Nurses Association
31st Annual Conference, Phoenix, AZ, October 2017.
Reinhardt, K. Improving throughput by implementing a discharge RN. San Diego EBPI Annual
Conference, Point Loma Nazarene University, Nov. 7, 2017.
Zamora, E. Health literacy: Development of inpatient education packet utilizing readability
statistics and materials-assessment tools to increase usability. APNA 31st Annual National
Conference, Phoenix, AZ, Oct. 20, 2017.
External presentations — Podium
Lambert, K. Coming alongside: Crisis prevention in the acute care setting. Professional
Development Workshop for Sharp Mary Birch Hospital for Women & Newborns,
September 2017.
Woods, L. and Kurzon, V. What is the secret? Open the medical record. American Psychiatric
Nurses Association 31st Annual Conference, Phoenix, AZ, October 2017.
Publications
Pelletier, L.R. (2017). Quality and safety. In D. Huber, Leadership and nursing care
management. Atlanta, GA: Elsevier.
Pelletier, L.R., and Beaudin, C.L. (Eds). (2017). HQ Solutions: Resource for the healthcare
quality professional. Alphen aan den Rijn, The Netherlands: Wolters-Kluwer.
2017 Knowledge Sharing: 7 Poster
Presentations, 3 Podium Presentations,
2 Publications
NEW KNOWLEDGE, INNOVATIONS & IMPROVEMENTS 30Innovations in Health Information Technology and their Benefits
Health information technology (IT) has an important role in helping nurses work more
efficiently and safer. Over the past few years, SMV/SMC has implemented various hospital-
wide initiatives that serve to enhance the quality of care and safety through the use of IT.
These included:
• Barcoding and VitalsLink: These technologies were implemented at Sharp McDonald
Center in 2017. In an effort to minimize medication errors, barcoding was implemented.
In January 2018, 99 percent of medications were scanned at SMC. VitalsLink was
implemented to reduce the process steps in taking and recording vital signs.
• SurgiNet: This Cerner application was implemented in the SMV Electroconvulsive
Therapy (ECT) Department. The application ensures increased patient safety by allowing
allergies, infection prevention information and medical history to be easily accessible
throughout the ECT procedure. It also provides automated methods of capturing vital
signs and touch screens that allow for easier data capture and conformation.
Photo (from left): Christina Devoe, RN (Intake), Jonathan Brininger, RN (EW 1), and Jennifer Jones, RN (EW 2)
31 NEW KNOWLEDGE, INNOVATIONS & IMPROVEMENTSAcknowledgements
Our sincere thanks to all who contributed to this report.
Angela Behnke Ameen Koucheki Mary Kay Shibley
Jennifer Chapman Richard Loving Thomas Snyder
Jessica Crawford Emilia Macias Tyrone Thomas
Connie Duquette Luc R. Pelletier Chris Tomac
Karen Flowers Tiana Powell Chandra Vincent
Steven George Beth Redman Marisol Vizcarra
Rachel Gold Stacey Robinson Kristine White
1
Chu, L., Spetz, J., & Bates, T. (2018). Survey of nurse employers in California, Fall 2017. San Francisco: Philip R. Lee
Institute for Health Policy Studies & Healthforce Center at UCSF. Online at https://rnworkforce.ucsf.edu/sites/
rnworkforce.ucsf.edu/files/2017_Moore_Report_Final.pdf
2
Institute of Medicine (IOM). (2011). The future of nursing: Leading change, advancing health. Washington, DC:
The National Academies Press.
3
Chu, L., Spetz, J., & Bates, T. (2018). Survey of nurse employers in California, Fall 2017. San Francisco: Philip R. Lee
Institute for Health Policy Studies & Healthforce Center at UCSF. Online at https://rnworkforce.ucsf.edu/sites/
rnworkforce.ucsf.edu/files/2017_Moore_Report_Final.pdf
4
Berg, J. (2018). Personal communication (HealthImpact). April 9, 2018.
5
Sharp HealthCare. (2018). Sharp HealthCare community benefit plan and report, fiscal year 2017. Retrieved from
https://www.sharp.com/about/community/community-benefits/upload/Community-Benefits-Report-2017.pdf
6
CPI. (2015). Instructor guide: Nonviolent crisis intervention foundation course. Milwaukee, WI: Author.
7
American Nurses Association. (n.d.). The importance of belonging to your professional nursing
associations. Retrieved from http://www.nursingworld.org/EspeciallyForYou/Educators/Educator-Tools/
TheImportanceofBelonging.ppt
8
Press Ganey. (2016). Nurse engagement. Retrieved from http://www.pressganey.com/solutions/engagement/
nursing
Indiana Prevention Resource Center. (n.d.). Tobacco dependence and treatment for smokers with co-occurring
9
mental illness. Retrieved from http://desalledesigns.com/cdesalle/Tobacco1/development/index.html
NEW KNOWLEDGE, INNOVATIONS & IMPROVEMENTS 327850 Vista Hill Avenue
San Diego, CA 92123
858-836-8434
sharp.com/mesa-vista
7989 Linda Vista Road
San Diego, CA 92111
858-637-6920
sharp.com/mcdonald
MV00567.11.18 ©2018 SHCYou can also read
