Each year, Children’s Hospital Central California recognizes nurses who exemplify nursing excellence. These individuals are nominated by their peers and colleagues for their contributions to the practice of nursing. These nurses represent excellence in nursing and exemplify the Forces of Management. The accomplishments of these individuals are exceptional. It is our honor to recognize the following individuals in 2010:
Nurse of the Year – Clinical Practice 2010
Brittany Meyer, RN, BA, CPN
Perioperative Services, Medical Imaging/Perianesthesia Care
Brittany has consistently shown herself to be a leader in clinical practice and has solidified that role in the last three years by assuming the position of charge nurse for nursing in the Medical Imaging Department at Children’s Hospital. In this role Brittany has dedicated herself to clear communication, leading by example, exemplary customer service, and building a true team environment both interdisciplinary and interdepartmental in nature. Her efforts and leadership in promoting a culture of excellence supported the achievement of re-designation of Magnet for the organization. Brittany served as an escort for the Magnet re-designation survey. Brittany supports the governance of nursing at Children’s Hospital through her involvement in Nursing Governance Committees. She has served as the co-chair of the Magnet Nursing Steering Committee and as a member of the highest level nursing governance committee, the Executive Nursing Council.
She has developed new processes which have moved the department forward into a highly functioning, very efficient team:
- Pre-procedure phone calls: She collaborated with the Day Surgery Educator and Health Information Services (HIS) in the development of a hospital approved script for pre-procedure phone calls, providing families with the information they need to be prepared for their scheduled procedures.
- Pre-procedure brochure: Brittany collaborated with Day Surgery, HIS and Communications and Marketing to create an educational brochure for families preparing to have radiological procedures.
Imaging/Anesthesia Orientation Program: Brittany led the development and implementation of an orientation program for Imaging patients and their families. The orientation enables the patient and family to visit the department and actually see the process they will experience when they come for their procedure.
- She initiated the Imaging Operations Committee which brought together the disciplines of radiologists, anesthesiologists and nursing in collaboration with radiology administration to discuss the operations of the department. This created an open forum, which previously didn’t exist, to discuss opportunities for improvement which has led to an enhanced, efficient collaboration of the Peri-op and Imaging Departments.
- Brittany maximized the role of radiology technicians: As the anesthesia program in Imaging continued to grow and it was noted that many of the other nursing functions her staff had been providing were becoming more difficult to achieve, Brittany worked with the Imaging Department to expand the role of the CT and MRI technicians to fully utilize their scope of practice. Brittany and the nurses facilitated the instruction and competency validation for the technicians on venous access and the insertion of urinary catheters, thereby improving patient care and timeliness of studies.
Committed to Central Valley children, Brittany has focused on efforts to enhance patient care through efficient and effective processes, serving the community through board involvement with group homes serving troubled youths, and volunteering at the Central California Blood Bank.
Brittany supports the professional practice of nursing as a role model for clinical practice and provides leadership in the governance of nursing practice. She is involved in several nursing professional organizations and is nationally certified in pediatrics. Her efforts have supported a “magnetic” culture, promoting nursing excellence and quality patient care.
Nurse of the Year – Advanced Practice 2010
Jennifer Le, MSN, NP-C, CDE
Endocrinology Practice and Pediatric Diabetes Care Center
A nurse practitioner in the Endocrinology Practice at Children’s Hospital, Jennifer Le has a specialized focus in the care of high risk adolescents with Type 1 diabetes. She has successfully provided specialized, personalized care utilizing innovative strategies to achieve notable outcomes for adolescents with Type 1 diabetes. Jennifer has developed an innovative specialized plan of care for these adolescents based on key principles: 1) adolescence is a unique period in the growth and development of the individual with the struggle for independence being a major factor; 2) no one volunteers for diabetes; 3) no one has diabetes alone; 4) care of the diabetic is a team effort; and 5) immediate feedback contributes to behavior change. Using these principles, Jennifer devised a plan that included frequent visits with her and a negotiated teamwork plan with parents and the adolescent to manage the diabetes. Jennifer praises the progress no matter how minimal and assists the entire team in the identification of improvements in health and feelings of wellness. The parent/patient/NP team is focused on the success of the person behind the disease.
Reflective of the Magnet culture at Children's, Jennifer was innovative in her development of the critical communication process for the patient care model. Jennifer obtains feedback from her adolescent patients and their parents as well as communicates with them very quickly, using the texting process. After reviewing the requirements for HIPAA compliance, she garnered approval from the physicians and parents and partnered with her patients. Jennifer has the parents initially provide her with their children’s blood sugars. As parents and patients negotiate their responsibilities, the parent and adolescent work together in texting daily glucose levels. Finally, it is the adolescent who has the texting power. Her recognition of the interest and dependence on social networking with today’s youth made this a key element in the success of the plan of care. Jennifer responds with encouragement, appropriate comments and information.
Through enhanced communication (e.g. “texting”) and a structured approach to accountability and empowerment, Jennifer and her patients have seen significant improvements in the patient’s glycemic control. Her evaluation research of the patients, using a random sample of 34 patients found that the mean Hgb A1C (a long term measure of average blood sugar) decreased by 3.9 percent (range of 1.4 percent to 8.1 percent). The highest number accurately measured for A1C is 14 percent, placing the diabetic at very high risk of complications. A decrease of 3.9 percent translates into a decrease of 136.5 mg/dl of average blood sugar. This not only decreases risk, it also leads to the adolescent feeling better physically and mentally. In addition to these physical measures of success, Jennifer and the other members of the Endocrinology Practice have noted: 1) an increased diligence in reporting blood sugar results; 2) enhanced cooperation with the physical plan of care; and 3) a decrease in the no show rate. She closely evaluates her practice through research and is able to demonstrate positive measurable outcomes of success.
She has delivered numerous educational presentations at events to enhance the awareness and knowledge of patients, healthcare providers and the community related to childhood obesity and diabetes. She is engaged in professional practice through these presentations and participation in professional organizations and research.
Patients identify her as their partner in their journey along the diabetes road. Jennifer is passionate about her commitment to her patients and their parents.
Nurse of the Year – Clinical Education 2010
Mary-Ann Robson, BSN, RN, CCRN
Clinical Education and Informatics
A Clinical Educator in the Pediatric Intensive Care Unit (PICU) at Children’s, Mary-Ann is a highly experienced and dedicated pediatric nurse with extensive knowledge and skills which are applied to the development of staff resulting in improved patient outcomes. Her efforts have been integral in the achievement of improved patient outcomes including 205 days between Central Line Associated Bloodstream Infections (CLABSI) for the PICU. In addition, a significant reduction in CLABSI rates have been achieved and maintained. She promotes a culture of excellence which contributed to the achievement of Magnet re-designation for Children’s.
Mary-Ann has a great willingness to share her knowledge and expertise with an enthusiasm that exemplifies nursing excellence. She has served as an instructor for a range of nursing courses including: basic general nursing, pediatric nursing and specialized and advanced level care. Mary-Ann coordinates the Pediatric Nurse Extern and Senior Focus Leadership student experiences within the PICU. She is dedicated to creating a learning environment that matches student/preceptor learning styles and is tenacious about tracking the experiences of the student to build upon his/her knowledge base. She meets minimally every two weeks with the student/preceptor and documents and shares findings with the leadership group to facilitate the best experiences and update their teaching plans. She offers support and encouragement to nurses and healthcare professionals in order to facilitate their development and practice.
She helped develop and oversees Mock Codes for the PICU and has worked to involve residents and intensivists in this process supporting an interdisciplinary approach. This work has led her to an interest in Rapid Response activities and what could be done to increase the number of these efforts while reducing the number of Code Blue calls.
As a PALS instructor, she was able to develop nurses, RCPs and physicians in the care of the critically ill child. This has impacted healthcare professionals in the wider community around Children's. Mary-Ann is sought out as an expert whenever there is an identified gap in education. She goes above and beyond in her presentation of data, always having clear facts, current research and supportive data for best practice no matter what the topic is at hand.
Mary-Ann remains a “go to” person by both students and staff and always leads by professional example. She recently completed a Bachelor’s of Science in Nursing and has since enrolled in a master’s degree program in education.
She contributes to the governance of nursing practice at Children’s Hospital through participation in the Practice Council, Professional Development Council and organizational and unit-based initiatives. Mary-Ann has served as a leader in the PICU Unit-Based Professional Development Council, contributing to the Beacon Award application. The PICU was awarded the Beacon Award in 2010. Her contributions to the writing of the document and keeping others looking forward have been priceless.
She contributes to the profession through involvement in professional organizations, professional presentations and contributions to nursing research resulting in enhanced patient care. She is the principle investigator for research study entitled: “Retrospective Case Matched Study to Evaluate the Predictability of the Toronto Children’s Hospital Paediatric Early Warning (PEW) Tool and Bristol Children’s PEW Tool in Identifying Acute Care Patients at Risk of Developing Critical Illness.”
Mary-Ann contributes to the community as a volunteer in the Drowning Prevention Program, providing education to over 50 preschools and schools in the region teaching parents and children about water safety as part of the Drowning Prevention Program. In addition, Mary-Ann provided education during healthcare fairs within the community.
She is a mentor, resource and role model for professional, role-based nursing. Mary-Ann always “leads,” yet exhibits a humble, joyful spirit both personally and professionally.
Nurse of the Year – Administration 2010
Amy Slater, BSN, RN
Neonatal Intensive Care Unit (NICU)
A dynamic Charge Nurse in the NICU at Children's Hospital Central California, Amy Slater has dedicated her career to improving the outcomes for neonates. This includes participating in a national level collaborative and serving as the champion for performance improvement activities. Amy is the Vermont Oxford Network (VON) Collaborative charge representative. She ensures that all activities of the collaborative are communicated to her charge peers while championing many of the performance initiatives with staff. She is dedicated to improving the care of the neonate by implementation of best practices in the unit. Amy worked collaboratively with leadership and staff to develop strategies which ensures that NICU infants’ oxygen status is appropriately monitored.
Amy is a dedicated champion for providing compassionate family-centered care. Her direct efforts have improved the integration of families, in addition to parents, to spend time with the neonate and partner in care while in the NICU. Her innovative implementation of toddler packs to entertain young visitors has improved staff and family satisfaction. Amy has a true passion for the care of babies in the NICU. It is not uncommon for the neonate to require nursing care for long periods of time and to have infants who require true infant care rather than neonatal interaction. Amy finds these “older” babies endearing. Recently there was an infant who was in the NICU for over five months. The baby was literally “growing up” in front of the staff. Amy’s individualized approach to care was demonstrated when she bought a special developmental toy and interactive mobile for this long-term infant. Amy has been known to utilize boppy’s to assist in positioning these “older” NICU infants in positions for which they can then interact with the world. They sit up in their boppy and smile at the room. This interaction with the environment is as important to the infant’s development as the ventilator was to their respiratory status during the first several days of their admission.
During times of change, Amy serves as a change agent, promoting best practices in clinical excellence, leadership and family-centered care. She serves as a preceptor for charge nurses and relief charge nurses, providing mentorship and training in the NICU.
Amy acts as a resource throughout the organization related to neonatal care. She is extremely giving and leads by example. She makes every effort to be responsible for all things charged to her, and is accountable for the resources she is utilizing related to personnel and supplies. Amy is in constant communication with management and staff to ensure there is a clear understanding of the needs of the unit.
Active in the community, Amy is also a member of several nursing professional organizations. She volunteers annually at the NICU Graduate Reunion Picnic which brings hundreds of past patients from Children’s NICU back together to celebrate. For two consecutive years Amy has taken part in mission trips to Mexico, as nurse for the mission team members. She provides first aid and collects and stocks medical supplies.
Amy has influenced the profession, enhanced outcomes, mentored staff and future leaders, and engaged families as partners-in-care.
Friend of Nursing
Children’s annually recognizes a Friend of Nursing. The Friend of Nursing is a non-nurse who has contributed and supported nurses in the provision of patient care and/or the development of processes to enhance the professional work environment for nursing. It is our honor to recognize Christina “Tina” Costello as the Friend of Nursing for 2010:
Friend of Nursing
Christina Costello, M.Ed.
Regulatory Compliance and Accreditation
Tina was hired in 2008, hit the floor running and hasn’t stopped since! She quickly took charge of the tracer process, creating a collaborative partnership with clinical leaders throughout the organization. She developed reporting systems and forms to support the patient care division. Her ability to take complex things and present them in simplified terms helped the end user to be more successful. Tina has a detailed, thorough understanding of The Joint Commission Standards, Periodic Performance Review requirements, and CDPH Title 22 regulations. She has translated this knowledge into user friendly tools for data capture that are meaningful. She has developed and provided guidance on roadmaps for data collection for both the Morrisey System and Meditech to further support regulatory compliance of patient care standards.
Her incredible friendship to nurses through not only the regulatory and accreditation processes but through her professional and respectful collaboration is felt throughout the organization. She has been instrumental in developing nursing medical record review, fall risk medical review, restraints medical review, and sedation and anesthesia review roadmaps to monitor the quality of our documentation. Streamlining medical review processes has resulted in new medical review roadmaps for data collection and evidence of care.
She was instrumental in our outstanding success with The Joint Commission survey this past fall and the confidence she helped instill in our patient care teams. She is a role model of a true professional as she skillfully supports the professional practice of nursing.
Tina is a “can do” person who enjoys a challenge and is a cheerleader for the team in any circumstance. We often have great ideas in our organization and Tina brings life to those ideas, making them a reality in the most effective ways. She is highly respected amongst her peers and appreciated for the talents she has shared with us.