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Mercy Medical Center awarded Pathway to Excellence for RNs' dedication

Monday April 9, 2012
From left, are Margaret Glier, RN, director, critical care and oncology; Claire DeSetto, RN, nurse manager, PACU and endoscopy; Pamela Stengel, RN, nurse manager, behavioral health; Denise Sullivan, RN, nurse manager, ambulatory services; and Barbra Kahn, RN, nurse manager, maternal child.
From left, are Margaret Glier, RN, director, critical care and oncology; Claire DeSetto, RN, nurse manager, PACU and endoscopy; Pamela Stengel, RN, nurse manager, behavioral health; Denise Sullivan, RN, nurse manager, ambulatory services; and Barbra Kahn, RN, nurse manager, maternal child.
(Photos by Joseph Lanzetta)
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Shared governance council members, from left, include Humilidad Umali, RN, assistant head nurse, rehab; Regina Shelley, RN, staff nurse, endoscopy unit; Nancy Mylett, RN, staff nurse, OR; Barbara Simms, RN, staff nurse, telemetry; Michelle O'Reilly, RN, staff nurse, behavioral health; and Denise Calvi, RN, staff nurse, ED.
In recognition of excellence in nursing practice, Mercy Medical Center in Rockville Centre, N.Y., was awarded the Pathway to Excellence designation by the American Nurses Credentialing Center on Feb. 14. Mercy is the only hospital in the region, and one of only two in New York state, to receive the designation.

"During our journey we formed a successful clinical ladder program, adopted a strong shared governance model where we have seen a new level of staff engagement and excitement and continue to celebrate our nursing accomplishments," said Renee Mauriello, RN, MSN, CNO and vice president of patient care services. "Intended for smaller facilities like ours, the designation also can serve as a bridge to Magnet."

A new organizational credential, the ANCC program includes 12 practice standards that define and measure the essential elements of an optimal nursing practice environment and qualities critical to high-quality nursing practice, professional development and job satisfaction. For an organization to earn the distinction, it must undergo a review process that documents quality initiatives resulting in a positive work environment as defined by nurses and supported by research. After two years of preparing for and implementing the standards, RNs at Mercy completed and submitted a 1,200-page document to the ANCC.

Using evidence-based practice and investigating the latest research, RNs in acute rehab developed a safety risk protocol for patients with right-sided cerebral vascular accidents. "Using safety measures, such as hourly rounding, mattress alarms, different colored socks and visual alerts on the patients’ doors and wrist bands, we’ve achieved a steady decrease in our falls in rehab, from a rate of 9 in January 2011 to 3.2 in December 2011," said Kathleen McCaffrey, RN, MSN, NE-BC, senior director of nursing. In February, nurses from the unit presented their results at the International Stroke Conference in New Orleans.


Standing in front of the quilt created by each unit at Mercy Medical Center is Renee Mauriello, RN, CNO and vice president of patient care services. "All of the pieces came together into a beautiful quilt, which represents our unified staff and our unity in providing quality patient care," Mauriello said.
RNs adopted a nurse-driven protocol for removing indwelling urinary catheters, resulting in a decrease in catheter-associated urinary tract infections. Now a hospitalwide program, nurses use bladder scanners to support this protocol and independently make the decision to remove or keep in the catheter. "Nurses no longer need a physician’s order to remove the catheter because they are making decisions based on sound physical assessments," said Michele Kunz, RN-BC, MSN, ANP, director of nursing education and research. The facility purchased additional scanners to implement the program, and UTI rates have fallen below the national benchmark.

With the goal of decreasing central line-associated bloodstream infections, the ICU staff created a central line-associated bacteremia bundle of care, which includes the introduction of a chlorhexidine bath protocol, additional dressings specific to the jugular site and a standardized cart brought to the bedside. "We’ve decreased our CLABIs by 50%, with no incidences in 2011 and none in 2012 to date," said Margaret Glier, RN, BSN, director of critical care and oncology.


Educating the staff on Pathway standards and leading the clinical practice and research committee, Michele Kunz, RN, director, nursing education and research, left, worked with Kelly Zappolo, RN, critical care nurse educator, and other committee members to decide on theorists that reflect and promote nursing practice at Mercy and to review and revise policies and procedures.
Mercy has established a hotline number staff, patients and families may use to acknowledge excellence in nursing practice. Unit-based "walls of fame" honor nurses for certifications and other professional accomplishments, and RNs are recognized in peer-nominated programs. Mercy has seen a drop in the RN vacancy rate, which now is less than 3%, and a drop in its turnover rate, which went from 25% to 5%, said Beth Vlahavas, RN, MSN, director of the ED and behavioral health.

Mauriello and staff are presenting a "Journey to Pathway Success" poster at the ANCC Pathway to Excellence national conference in May in Arlington, Va.


Janice Petrella Lynch, RN, MSN, is a regional reporter. Send letters to editorNY@nurse.com or post a comment below.
12 Pathway to Excellence practice standards

• Nurses control nursing practice.

• The work environment is safe and healthy.

• Systems address patient care and practice concerns.

• Orientation prepares new nurses.

• CNO is qualified and participates in all facility levels.

• Professional development is provided and used.

• Competitive wages/salaries are in place.

• Nurses are recognized for their achievements.

• Balanced lifestyle is encouraged.

• Collaborative interdisciplinary relationships are supported.

• Nurse managers are competent and accountable.

• Quality program and evidence-based practices are used.