Nursing Spectrum will honor the 30 finalists in its 2010 Nursing Excellence Awards and choose a winner in each category June 8 at Martins Crosswinds in Greenbelt, Md.
The finalists in Clinical Care are as follows:
Ellen Merrill, RN, CCRN
Staff Nurse, Clinical Nurse IV
Howard County General Hospital, Columbia, Md.
Nominated by: Catherine Miller
Ellen Merrill, RN, CCRN, works with medical and surgical patients full time on the nightshift. She is calm in the face of emergencies and staff crises, funny when everyone needs a chuckle and compassionate to all she cares for (family, friends, patients and fellow healthcare team members). Merrill is not afraid to address issues head on, and she provides the spark of ideas for new ways to provide care or handle a difficult situation. A prime example was when Merrill conceptualized a clinical informatics initiative. She had been auditing charts for months and noticed patterns in the restraints documentation compliance. Merrill collaborated with the clinical informatics department to design a change specific to the nursing care plan and shift assessment for the ICU staff, resulting in compliance on restraint documentation of nearly 100%. The ICUs catheter-related bloodstream infections project had her mark of excellence. Through Merrills relentless chart audits, feedback to staff, reinforcement of use of bundle and checklist, the units CRBSI rate for the past 12 months is zero. Merrill has strong critical thinking skills, and when faced with an unknown problem she immediately seeks out resources to get what she needs to be the ultimate patient advocate. When a woman came into the hospital a year ago in full cardiac arrest, Merrill found out the patients husband had started CPR at home and activated EMS. Merrill saw the potential to save the patient using the newer approach of post cardiac arrest induced hypothermia. The hospital did not yet have such a policy in place, but that did not slow Merrill from getting an approved evidence-based protocol from a local affiliate organization. Within a few hours, the protocol was implemented, and Merrill has since authored the policy for Howard County General Hospital, which was approved for use this fall. The patient returned to the ICU at Christmas to bring the staff cookies in appreciation for the innovative care they provided.
Kelly Kingsbury-Simonton, RN, BSN, CCRN
ICU Staff Nurse and Education Specialist
Franklin Square Hospital Center, Rosedale, Md.
Nominated by: Angela Amig, RN, MA, NE-BC
After only six years in the profession, Kelly Kingsbury-Simonton, RN, BSN, CCRN, has established that she is a lifelong learner. She graduated with a BSN to enter the profession, honed her skills in the telemetry unit and transferred to the ICU while pursuing a masters degree in nursing education. She is an active member of several professional organizations. Kingsbury-Simonton is the consummate professional. She is an exceptional critical care clinician who readily shares her knowledge through a variety of initiatives throughout the hospital and community. While providing excellent care to critical care patients, she reaches out to make a difference for the broader population of hospital patients with her presence on multiple councils and task forces and by suggesting ways to improve clinical care. In the ICU, Kingsbury-Simonton is an excellent, knowledgeable and compassionate critical care nurse. She is a proficient charge nurse and preceptor. Kingsbury-Simonton generally runs charge when on duty and is able to ensure that clinical outcomes, as well as patient flow goals, are met. She participates in unit activities and leads several unit-based initiatives, including an interdisciplinary quality improvement process choreography of the team during a unit emergency. Kingsbury-Simonton is a skilled critical analyst of patient satisfaction data and can utilize that information to make significant changes at the bedside. She also is working on several efforts to improve the efficiency and effectiveness of the non-licensed team members and improving overall morale in the unit.
Melissa C. Custer, RN, BSN
Senior Clinical Nurse I
University of Maryland Medical Center, Baltimore
Nominated by: Greg Raymond
Melissa C. Custer, RN, BSN, is a positive force that can be felt throughout the organization and, especially, in the SICU. She has taken considerable ownership in providing a healthy and positive work environment for her peers and colleagues. Custer has championed educating patients and families regarding important information about common medications given in the SICU. She developed a document that explains, in easy-to-understand terms, the purpose, side effects and expectations for 11 common groups of medications. The framework for this document has been adopted and implemented in several other care areas of the institution. Custer also has been instrumental in educating physician and nursing staff members about the dangers of hypoglycemia, especially for patients receiving insulin infusion therapy. She developed a data collection tool to document incidences of hypoglycemia on a monthly basis, which has helped guide glycemic management strategies. Custer has taken on the responsibility of championing best practices in the prevention of central line-associated blood stream infections. She has identified practice changes in central line dressing management, which were recognized in a regional patient safety conference call for solutions. Clinicians throughout the organization and outside it have sought her counsel in efforts to implement best practices to achieve similar outcomes in their areas. In recognition of Custers passion for improved patient safety at the bedside, she was selected as a member of an organizational multidisciplinary team focused on CLABSI prevention. Custer is a clinical beacon on the night shift and has developed a keen proficiency in coaching and mentoring others in the care of clinically complex patients. She does all this and continues to provide direct patient care in the SICU.
Kimberly Krakowski, RN, MSN
Inova Mount Vernon Hospital, Alexandria, Va.
Nominated by: Patricia J. Mook
Kimberly Krakowski, RN, MSN, thinks you must believe in order to lead, and thinking outside the box is not good enough. It is time to design the box. In the past eight months, Krakowski immediately took the lead with hospitalwide efforts to be stroke certified and created a handoff tool which replaces multiple forms. Soon, that tool will be implemented systemwide. Krakowski coordinated the efforts to outline a stroke packet in order to better guide physicians and nurses in their stroke care. She conducted a housewide stroke education initiative that was far more successful than any previous efforts in this regard. Among other efforts, Krakowski provided a standardized poster for all nursing units. The results of her work have brought all outcome indicators for Get With The Guidelines-Stroke to 100% compliant for the third consecutive month. Krakowskis energy and clinical expertise have truly pointed the staff in a positive direction. As co-chair of the operating units sepsis team, Krakowski has helped lead the development of a sepsis screen algorithm and creation of a multiday form aimed at improving usability. Krakowskis creativity does not stop with clinical nursing. She personally wrote, directed, produced and filmed an educational sepsis video to roll out the sepsis screening tool. The result was a major decrease in sepsis mortality in the past quarter.
Pamela B. Wagner-Cox, RNBC, BSN, CWOCN
Wound Ostomy Continence Nurse
Inova Alexandria (Va.) Hospital
Nominated by: Joanne Gucciardo
Pamela B. Wagner-Cox, RNBC, BSN, CWOCN, is a highly skilled, compassionate, sound critical thinker who serves as the ultimate patient advocate around any issues related to wounds and the skin. She is steadfast in educating staff about prevention of ulcers and skin breakdown and is relentless in following up with staff when she initiates a new protocol. She will call a physician to change an order when she sees that a type of wound calls for a different protocol. Wagner-Cox continually works with value analysis to get the most effective products ordered and in stock. She advocates for patients when she believes they need further or alternative wound healing treatments. Wagner-Coxs passion and dedication to keep patients free from pressure ulcers and other wounds has had a positive impact on pressure ulcer rates in the second and third quarters of 2009, with all but two units achieving zero hospital-acquired pressure ulcers. Wagner-Coxs attention to detail is always evident. When she was called to look at the sacral wound of an ICU patient, she did a full skin assessment and noticed a small area where the nasal canula was touching the back part of the patients ear. She pulled it away and saw some redness. Because of her diligence, she was able to prevent an ulcer from starting. Wagner-Cox developed a program to train nurses to be skin resource champions, and she developed a comprehensive skin resource manual that is placed on all the units to provide nurses with added resources. Wagner-Cox conducts multidisciplinary rounds on various units weekly and has developed and produced a half-day seminar open to all nurses in the health system. When Wagner-Cox saw the need for the entire healthcare system to have the same evidenced-based procedures, policies and protocols, she brought together all the WOCNs and led the charge to develop numerous policies and procedures around every aspect of skin care from pressure ulcers to nonhealing postsurgical wounds.