SACRED ENCOUNTERS

INSIDE

w Preparing for the Future by CNO Katie Skelton

w Meet The Center for Cancer Prevention and Treatment Navigators

w Care for the Poor through an RNrsquos Eyes

w In Step with Soudi Bogert New Magnet Project Coordinator

w Steps of the Magnet Journey

w Stand By for Flu Season

w IORT A Boost in World Class Cancer Care

wNursing Research Blog Poster to be Showcased at Magnet Conference

wFall 2009 Events

EDITORIAL BOARDPatti AubeacuteSoudi Bogert Carmen FerrellStacey FischerSheila HollidayCathy SemarJoanne StermerCarla Wilson

INSIDE THIS FALL 2009 ISSUE

A Nursing NarrativeBy Raena Hellgren RN CN III

AC is a 42-year-old pancreatic cancer patient who regularly comes to the outpatient Infusion Center for chemotherapy AC was diagnosed with pancreatic cancer in the same year that her sister was diagnosed with colon cancer and her father diagnosed with head and neck can-cer Her sister recently died from her disease From the first day that AC was seen in the Infusion Centercollaborative efforts were made with Social Services to try and assure that her needs were being met Extensive teaching about her chemotherapy and side effects was done Her laboratory values were closely monitored and her chemotherapy was administered safely andon-timeeachweekShehadbeenreferredtocounselorsforherselfherhusbandandher three children She was meeting regularly with the dietitian to maintain her nutritional intake The Cancer Center adopted her family for Christmas to help with presents for her children since she was not able to work due to her disease On a Tuesday afternoon I learned that what AC truly needed was something much simpler She came into the Infusion Center for her weekly chemotherapy and I could tell that she was not feeling her bestthatdayHavingseenherweeklyformorethanayearIcouldtellthatherspiritswere low without her even saying a word I decided to spend some extra time with her after I completed her assessment and startedherchemotherapyIdidnrsquotreallyhaveaplanonwhattosaybutIjustknewsheneeded someone to talk to I sat down and asked her how everything was going She immediately began to cry She started to talk about how angry she was and how ashamed she was that she was feeling angry She was mad at her sister for dying and even mad at God for allowing all of this to happen She felt as though her sister had given up because she stopped chemotherapy and stopped wanting to eat She didnrsquot know what to say to her15-year-oldsonwhenheaskedherifshewasgoingtodiejustlikehersisterhadShecouldnrsquottalktoherhusbandaboutanyofherfeelingsbecauseshedidnrsquotwanttoupsethimShefeltifsheventedtohermotheritwouldbeburdeninghersinceshehadjustlostadaughterShewastryingveryhardtobehopefulandoptimisticbutrealitysetinwithher sisterrsquos death IdidnrsquotknowquitewhattosaysoIsaidnothingIputmyhandonhersandletherventherfrustrationsangerandtearsIknewthatatthatmomentshedidnrsquotneedmetogiveheranswersbecausetherewerenoanswersShedidnrsquotneedsomeonetositthereandpityherandtrytofixhersituationShejustneededsomeonetobepresentbesideherandIamblessedtohavebeenthepersonAsnurseswearetaughttoofferresourcesprovidepatienteducationandmakereferralstosocialworkers Nursingisaverytask-orientedprofessionandnursespridethemselvesonclinicalskillstime management and teaching Sometimes the most effective nursing requires us to stop concentratingontaskssitdownbesideapatientandreallylistentowhattheyaresayingAsnurseswhenwebecometoofocusedontaskswelosethetrueessenceoftheprofession

Improvedtreatmentapproachesnewtechnologiesandagrowing body of expertise from multiple specialists have enhanced the accuracy of diagnoses and effectiveness of cancer therapy These strides have also made cancer care increasingly complex Having someone with a depth of experience in oncology care who can help the patient and family chart a course through the daunting maze of healthcare services helps those we treat in many ways bull Become better informed about the diseasebull Feel empowered to make healthcare decisionsbull Be more prepared for physician visitsbull Reduce anxiety and depressionbull Streamline referrals to specialists and community

resourcesbull Improvetheflowofinformationbetweencollabo-

rating physicians and cliniciansbull Reduce emergency room visits and hospital staysbull Improve treatment compliance and therefore treat-

ment effectiveness Navigators provide guidance for patients and their families from the time of diagnosis and throughout their cancer journey and to survivors and caregivers Theyensure that those we are privileged to serve experience ourvaluesDignityServiceExcellenceandJustice

Meet The Center for Cancer Prevention and Treatment Navigators SACRED ENCOUNTERS

Lorilee Amlie RN MSN PHN

Melanoma Program

Alice Rodiguez RN BSN

Breast Program

Kathleen Close RN MS MBA

Colorectal Program

Kimberlee Moses RN BSN OCNUrologic Oncol-

ogy Program

Stacey Fischer RN BSN OCNBreast Program

Heather Stern RN MS CNOR OCN

Head and Neck Program

Pam Matten RN BSN OCN

Thoracic Oncology

Dave Sanders PA-C

Liver Tumor Program

As Washington con-tinues to buzz with healthcare reform con-troversy one thing isvery very clear The

role of the Registered Nurse will be key in improving quality and safety eliminatingbarriers to care reducing costs providingvalue and advocating on behalf of patients and families We know more resources wonrsquot be coming our way The reality is that we will havetodeterminehowtodomorewithlessto do it more efficiently and effectivelyAnd to provide carewith the full contin-uum of care in mind In addition to helping thepatienthealweneedtofocusonkeep-ingthispersonhealthyactiveknowledge-able and engaged in self care There is no role in healthcare better positioned to make a positive lasting contri-bution to the health and welfare of patients and families than the role of the RN As financialmodelschangetheroleoftheRNin coordinating care integrating informa-

tion educating advocating and empower-ing patients and families will become even more vital than it is today There are some questions that each of us need to be asking ourselves in order to make sure we are pre-pared for this challenge bull How will I ensure I have the skill

sets required to help my patients and families access the continuum of care they need

bull Whatistheevidencetellingmetodohere Do I know how to access it

bull HowdoIadvocateformypatients

and families in thishighlycomplexoften fractured system of healthcare

bull Who aremy partners in care in thecommunity that I can utilize

As we move forward together through this period of uncertainty letrsquos eachcommit to preparing ourselves well for the future That may mean enroll in that school programorgainthatknowledgepracticethat technique or commit to a healthierlivingstylethancurrentlyWhateveritisjustdoitWehavealottogetreadyfor

Preparing for the FutureKatie Skelton RN CNAA BC Vice President Patient Care Services Chief Nursing Officer

Magnet Forces ConsolidatedTo provide greater clarity and direction as well as eliminate redundancy this new Magnet model reconfigures the 14 Forces of Magnetism into 5 components The new model reflects a greater focus on measuring outcomes and allows for more streamlined documentation The 14 Forces remain as foundational elements of the program

HEALTHIEST COMMUNITIES

Healthiest Communities via Disneyreg Half Marathon - St Joseph Hospital dispatched nearly 170 volunteers to provide first aid for the 13500 runners at Disneyrsquos Half-Marathon on September 6 There were four medical tents along the 13-mile route At the finish line these Main Medical Tent nurses served with James Pierog MD (back row center) Medical Director of the event

JanetHildebrandRNFNP(atright)wasborn in Ecuador and raised by working poor parents in South Central Los Angeles She still recalls how as a child she took the bus with her mom from South Central to West-wood to be seen by medical students at UCLAtranslatingforhermom Janetrsquosbackgroundledhertobecomeapublichealthnursevisitingmothersandnewborns within the indigent population of Orange County Five years later she became a nurse with PuenteA La Salud MobileCommunityClinicsaStJosephHospitalprogram providing medical dental andvision care for the medically underserved As a part-time nursing instructor at CSU Dominguez Hills she makes sure her students are well aware of the needs of the community as well as resources available to them She recently spoke to Foundation members and community leaders at a ldquoDollars forDiabetesrdquo Care for the Poorevent ldquoMy parents always stressed helpingthosewhohavelessrdquostatesJanetldquoServingmedically unfundedunderfunded people in our community is my way of giving back for what Irsquove been able to personally achieverdquo Twice a week Janet travels withthe medical van to community centers in theStJosephHospitalserviceareaSheprovides comprehensive care to her patients including well woman exams physicalexams counseling support and educationBecause of the high incidence of diabetes intheLatinopopulationallthepatientsare

screened accordingly ldquoMany patients arepleasantly surprised that all our staff speak Spanish There is a difference between translating and speaking directly to the patientrdquo notesJanet adding ldquoIlike to think that Puente has a familyatmosphere I tell everyone that not only is thepatient our concern itrsquos thewholefamily When a father is diagnosed with diabetes for example the whole familyis affected His wife is taught to make healthychangesintheirnutritionbecausethe children are also at risk for diabetes ldquoOnaverage twooutoffivepatientswe see have a diagnosis of diabetes Two morearepre-diabetichavinginsulinresis-tance with elevated blood sugars and other diabetic risk factors such as high choles-terol and obesity Of those who have good weightandlabresultstheyalmostalwayshave a family history of diabetes Addition-allywearediagnosingpatientsatanearlieragendashsomeintheir20sand30sndashwhilejusta few years ago most of those diagnosed with diabetes were much olderrdquo The clinics emphasize prevention and education And through a grant-fundedCareforthePoorprogramcalledElClubcommunity educators provide biculturalbilingual education in nutrition exerciseand diabetes management

ldquoTheir conditions arenrsquot cured but they canlearntocontrolthemrdquoexplainsJanetldquoI have seen patients with uncontrolled symptoms who make lifestyle changes and are now off their medications They learn this will be a battle for the rest of their lives We protect them and help as-sure a healthy future by keeping track of their health We check their blood sugars everysixmonthsorsoandiftheirnum-bershavecreptupwestartthembackonmedications I tell them what wersquore doing isnotfortodayitrsquosfor10yearsfromnowto prevent blindness kidney and heartdisease Wersquore not telling them what to doorscoldingthembutinsteadshowingthemwhatrsquos possible and providing lotsof positive reinforcement Itrsquos an amazing programandthereissuchaneedforitinthis communityrdquo

Care for the Poor through an RNrsquos Eyes

E-news a Wellness MuseFeelinGreat Today St Joseph HospitalrsquosmonthlyE-newsletterarrivedinmorethan100000inboxesthissummerThenewE-newsletterisagreattooltohelpStJosephHospital stay in touch with the community and build health awareness -- without the cost of printed materials and postage Along with viewing a variety of timely andinformativehealtharticlesreaderscanemail health-related questions to ldquoAsk an Expertrdquo to be addressed in coming monthsrsquo newsletters In the latest issue HowardHewlett DPM explains how to protectonersquos feet when beginning a running pro-gram A quiz to test readersrsquo knowledge of stroke information on reducing prostatecancer risk and an invitation to hip and knee lectures appear Ifyoursquodliketosubscribepleasevisithttpwwwsjoorgsubscribe

Improvedtreatmentapproachesnewtechnologiesandagrowing body of expertise from multiple specialists have enhanced the accuracy of diagnoses and effectiveness of cancer therapy These strides have also made cancer care increasingly complex Having someone with a depth of experience in oncology care who can help the patient and family chart a course through the daunting maze of healthcare services helps those we treat in many ways bull Become better informed about the diseasebull Feel empowered to make healthcare decisionsbull Be more prepared for physician visitsbull Reduce anxiety and depressionbull Streamline referrals to specialists and community

resourcesbull Improvetheflowofinformationbetweencollabo-

rating physicians and cliniciansbull Reduce emergency room visits and hospital staysbull Improve treatment compliance and therefore treat-

ment effectiveness Navigators provide guidance for patients and their families from the time of diagnosis and throughout their cancer journey and to survivors and caregivers Theyensure that those we are privileged to serve experience ourvaluesDignityServiceExcellenceandJustice

Meet The Center for Cancer Prevention and Treatment Navigators SACRED ENCOUNTERS

Lorilee Amlie RN MSN PHN

Melanoma Program

Alice Rodiguez RN BSN

Breast Program

Kathleen Close RN MS MBA

Colorectal Program

Kimberlee Moses RN BSN OCNUrologic Oncol-

ogy Program

Stacey Fischer RN BSN OCNBreast Program

Heather Stern RN MS CNOR OCN

Head and Neck Program

Pam Matten RN BSN OCN

Thoracic Oncology

Dave Sanders PA-C

Liver Tumor Program

As Washington con-tinues to buzz with healthcare reform con-troversy one thing isvery very clear The

role of the Registered Nurse will be key in improving quality and safety eliminatingbarriers to care reducing costs providingvalue and advocating on behalf of patients and families We know more resources wonrsquot be coming our way The reality is that we will havetodeterminehowtodomorewithlessto do it more efficiently and effectivelyAnd to provide carewith the full contin-uum of care in mind In addition to helping thepatienthealweneedtofocusonkeep-ingthispersonhealthyactiveknowledge-able and engaged in self care There is no role in healthcare better positioned to make a positive lasting contri-bution to the health and welfare of patients and families than the role of the RN As financialmodelschangetheroleoftheRNin coordinating care integrating informa-

tion educating advocating and empower-ing patients and families will become even more vital than it is today There are some questions that each of us need to be asking ourselves in order to make sure we are pre-pared for this challenge bull How will I ensure I have the skill

sets required to help my patients and families access the continuum of care they need

bull Whatistheevidencetellingmetodohere Do I know how to access it

bull HowdoIadvocateformypatients

and families in thishighlycomplexoften fractured system of healthcare

bull Who aremy partners in care in thecommunity that I can utilize

As we move forward together through this period of uncertainty letrsquos eachcommit to preparing ourselves well for the future That may mean enroll in that school programorgainthatknowledgepracticethat technique or commit to a healthierlivingstylethancurrentlyWhateveritisjustdoitWehavealottogetreadyfor

Preparing for the FutureKatie Skelton RN CNAA BC Vice President Patient Care Services Chief Nursing Officer

Magnet Forces ConsolidatedTo provide greater clarity and direction as well as eliminate redundancy this new Magnet model reconfigures the 14 Forces of Magnetism into 5 components The new model reflects a greater focus on measuring outcomes and allows for more streamlined documentation The 14 Forces remain as foundational elements of the program

HEALTHIEST COMMUNITIES

Healthiest Communities via Disneyreg Half Marathon - St Joseph Hospital dispatched nearly 170 volunteers to provide first aid for the 13500 runners at Disneyrsquos Half-Marathon on September 6 There were four medical tents along the 13-mile route At the finish line these Main Medical Tent nurses served with James Pierog MD (back row center) Medical Director of the event

JanetHildebrandRNFNP(atright)wasborn in Ecuador and raised by working poor parents in South Central Los Angeles She still recalls how as a child she took the bus with her mom from South Central to West-wood to be seen by medical students at UCLAtranslatingforhermom Janetrsquosbackgroundledhertobecomeapublichealthnursevisitingmothersandnewborns within the indigent population of Orange County Five years later she became a nurse with PuenteA La Salud MobileCommunityClinicsaStJosephHospitalprogram providing medical dental andvision care for the medically underserved As a part-time nursing instructor at CSU Dominguez Hills she makes sure her students are well aware of the needs of the community as well as resources available to them She recently spoke to Foundation members and community leaders at a ldquoDollars forDiabetesrdquo Care for the Poorevent ldquoMy parents always stressed helpingthosewhohavelessrdquostatesJanetldquoServingmedically unfundedunderfunded people in our community is my way of giving back for what Irsquove been able to personally achieverdquo Twice a week Janet travels withthe medical van to community centers in theStJosephHospitalserviceareaSheprovides comprehensive care to her patients including well woman exams physicalexams counseling support and educationBecause of the high incidence of diabetes intheLatinopopulationallthepatientsare

screened accordingly ldquoMany patients arepleasantly surprised that all our staff speak Spanish There is a difference between translating and speaking directly to the patientrdquo notesJanet adding ldquoIlike to think that Puente has a familyatmosphere I tell everyone that not only is thepatient our concern itrsquos thewholefamily When a father is diagnosed with diabetes for example the whole familyis affected His wife is taught to make healthychangesintheirnutritionbecausethe children are also at risk for diabetes ldquoOnaverage twooutoffivepatientswe see have a diagnosis of diabetes Two morearepre-diabetichavinginsulinresis-tance with elevated blood sugars and other diabetic risk factors such as high choles-terol and obesity Of those who have good weightandlabresultstheyalmostalwayshave a family history of diabetes Addition-allywearediagnosingpatientsatanearlieragendashsomeintheir20sand30sndashwhilejusta few years ago most of those diagnosed with diabetes were much olderrdquo The clinics emphasize prevention and education And through a grant-fundedCareforthePoorprogramcalledElClubcommunity educators provide biculturalbilingual education in nutrition exerciseand diabetes management

ldquoTheir conditions arenrsquot cured but they canlearntocontrolthemrdquoexplainsJanetldquoI have seen patients with uncontrolled symptoms who make lifestyle changes and are now off their medications They learn this will be a battle for the rest of their lives We protect them and help as-sure a healthy future by keeping track of their health We check their blood sugars everysixmonthsorsoandiftheirnum-bershavecreptupwestartthembackonmedications I tell them what wersquore doing isnotfortodayitrsquosfor10yearsfromnowto prevent blindness kidney and heartdisease Wersquore not telling them what to doorscoldingthembutinsteadshowingthemwhatrsquos possible and providing lotsof positive reinforcement Itrsquos an amazing programandthereissuchaneedforitinthis communityrdquo

Care for the Poor through an RNrsquos Eyes

E-news a Wellness MuseFeelinGreat Today St Joseph HospitalrsquosmonthlyE-newsletterarrivedinmorethan100000inboxesthissummerThenewE-newsletterisagreattooltohelpStJosephHospital stay in touch with the community and build health awareness -- without the cost of printed materials and postage Along with viewing a variety of timely andinformativehealtharticlesreaderscanemail health-related questions to ldquoAsk an Expertrdquo to be addressed in coming monthsrsquo newsletters In the latest issue HowardHewlett DPM explains how to protectonersquos feet when beginning a running pro-gram A quiz to test readersrsquo knowledge of stroke information on reducing prostatecancer risk and an invitation to hip and knee lectures appear Ifyoursquodliketosubscribepleasevisithttpwwwsjoorgsubscribe

HEALTHIEST COMMUNITIES

Healthiest Communities via Disneyreg Half Marathon - St Joseph Hospital dispatched nearly 170 volunteers to provide first aid for the 13500 runners at Disneyrsquos Half-Marathon on September 6 There were four medical tents along the 13-mile route At the finish line these Main Medical Tent nurses served with James Pierog MD (back row center) Medical Director of the event

JanetHildebrandRNFNP(atright)wasborn in Ecuador and raised by working poor parents in South Central Los Angeles She still recalls how as a child she took the bus with her mom from South Central to West-wood to be seen by medical students at UCLAtranslatingforhermom Janetrsquosbackgroundledhertobecomeapublichealthnursevisitingmothersandnewborns within the indigent population of Orange County Five years later she became a nurse with PuenteA La Salud MobileCommunityClinicsaStJosephHospitalprogram providing medical dental andvision care for the medically underserved As a part-time nursing instructor at CSU Dominguez Hills she makes sure her students are well aware of the needs of the community as well as resources available to them She recently spoke to Foundation members and community leaders at a ldquoDollars forDiabetesrdquo Care for the Poorevent ldquoMy parents always stressed helpingthosewhohavelessrdquostatesJanetldquoServingmedically unfundedunderfunded people in our community is my way of giving back for what Irsquove been able to personally achieverdquo Twice a week Janet travels withthe medical van to community centers in theStJosephHospitalserviceareaSheprovides comprehensive care to her patients including well woman exams physicalexams counseling support and educationBecause of the high incidence of diabetes intheLatinopopulationallthepatientsare

screened accordingly ldquoMany patients arepleasantly surprised that all our staff speak Spanish There is a difference between translating and speaking directly to the patientrdquo notesJanet adding ldquoIlike to think that Puente has a familyatmosphere I tell everyone that not only is thepatient our concern itrsquos thewholefamily When a father is diagnosed with diabetes for example the whole familyis affected His wife is taught to make healthychangesintheirnutritionbecausethe children are also at risk for diabetes ldquoOnaverage twooutoffivepatientswe see have a diagnosis of diabetes Two morearepre-diabetichavinginsulinresis-tance with elevated blood sugars and other diabetic risk factors such as high choles-terol and obesity Of those who have good weightandlabresultstheyalmostalwayshave a family history of diabetes Addition-allywearediagnosingpatientsatanearlieragendashsomeintheir20sand30sndashwhilejusta few years ago most of those diagnosed with diabetes were much olderrdquo The clinics emphasize prevention and education And through a grant-fundedCareforthePoorprogramcalledElClubcommunity educators provide biculturalbilingual education in nutrition exerciseand diabetes management

ldquoTheir conditions arenrsquot cured but they canlearntocontrolthemrdquoexplainsJanetldquoI have seen patients with uncontrolled symptoms who make lifestyle changes and are now off their medications They learn this will be a battle for the rest of their lives We protect them and help as-sure a healthy future by keeping track of their health We check their blood sugars everysixmonthsorsoandiftheirnum-bershavecreptupwestartthembackonmedications I tell them what wersquore doing isnotfortodayitrsquosfor10yearsfromnowto prevent blindness kidney and heartdisease Wersquore not telling them what to doorscoldingthembutinsteadshowingthemwhatrsquos possible and providing lotsof positive reinforcement Itrsquos an amazing programandthereissuchaneedforitinthis communityrdquo

Care for the Poor through an RNrsquos Eyes

E-news a Wellness MuseFeelinGreat Today St Joseph HospitalrsquosmonthlyE-newsletterarrivedinmorethan100000inboxesthissummerThenewE-newsletterisagreattooltohelpStJosephHospital stay in touch with the community and build health awareness -- without the cost of printed materials and postage Along with viewing a variety of timely andinformativehealtharticlesreaderscanemail health-related questions to ldquoAsk an Expertrdquo to be addressed in coming monthsrsquo newsletters In the latest issue HowardHewlett DPM explains how to protectonersquos feet when beginning a running pro-gram A quiz to test readersrsquo knowledge of stroke information on reducing prostatecancer risk and an invitation to hip and knee lectures appear Ifyoursquodliketosubscribepleasevisithttpwwwsjoorgsubscribe

wwwsjoorgnursing_excellence

StJosephHospitalrsquosnewDialysisCenterat2212E4thStinSantaAnasawitsfirstthreepatientsonAugust192009This9000square-foot facility serves patients Monday through Saturdayand can accommodate up to 180 patients each week The original Dialysis Center also continues to operate fromthe Sister Elizabeth Building on the hospital campus ldquoItrsquos a welcome change forusrdquostatesElaineGoRNNPldquoWetrulyhadnoroomtoexpand in our other facility Having this site gives our pa-tientsmoreflexibilityrdquo Patient Dr Dong ChenofIrvinelikestheflexibilityof having a renal dialysis center thatrsquos closer to his home in IrvineHe remarksldquoIliketheatmospherehereItrsquosnicebeingabletolookoutofallthewindowsandit has the same good staff and technologyrdquo The new Dialysis Center was designed to be inviting and comfortable It of-ferspatientsampleparking30dialysisstationsfeaturingwirelessInternetaccessremotecontrolledflat-screenTVsprovidingcableandpatienteducationprogramsandpatient-testedreclinersThissamefullyrenovatedfacilityhousesStJosephHeritageMedicalGroupphysiciansandtheirUrgentCareCenterCenterforHealthPromotionprogramsincludingclassesonDiabetesEducationandapharmacy ldquoAdialysissession takesseveralhours three timesaweekWithourpatientsspendingthatmuchtimeintheDialysisCenterwewantedtomakethemcompletelycomfortablerdquo states St Joseph Hospital Executive Director of Kidney ServicesAnthonyMessana HeaddsldquoConsideringour regionrsquoshighprevalenceofdiabeteshypertensionandobesityandthekidneyfailurethatoftenresultstheneedforexpanded dialysis care was greatrdquo

Bob Virga RN checks on patient Dong Chen DDS in the new Dialysis Center

A Second Center for Dialysis

SJO Second in State for Inpatient SurgeriesThemost recent statistics from theOfficeofStatewidePlanningandDevelopmentshowthatin2008StJosephHospitalhadthesecondhighestinpatientsurgicalvolumeinthestateofCaliforniawith27110adultandpediatricproceduresThisisanincreaseof 12 percent since last year when the hospital ranked third in the state for surgical volumeOSHPDdataonpatientvolumewasalsocollectedforEmergency ServicesSJOvolumesagainrankedfirstinOrangeCountyandthirdinthestatewith101341visitsVolumeincreased51percentover2007

Deliveries SJOremainedsecondinOrangeCountywith5010deliveriesCV Bypass Surgery SJOrsquos339CVbypass surgeries foradultandpediatriccases

ranked second for volume in Orange CountyCardiac Catheterizations SJO became the volume leader inOrangeCountywith2978cardiaccatheterizations(adultandpediatric)

GROWTHIn Step with

Soudi Bogert RN BSNSJOrsquos new Magnet

Project Coordinator

InJulySoudiBogertRNBSNacceptedthe roleofSt JosephHospitalrsquosMagnetProjectCoordinatorTohelpensurecon-tinuityandsuccessStaceyFischerRNBSNOCN formerMagnetCoordinator(andnewNurseNavigatorfortheBreastProgram)will continue to help with thetransition as well as continue to be aMagnetambassador ldquoI was honored to be considered for thisrolerdquosaysSoudildquoIlovedtheMagnetjourney thefirst time - itwassoexcitingseeing all the departments get on board Itrsquos all about what we already do every day but donrsquot think about We are that exceptional facility and can be proud that we work hereMagnet isaveryprestigiousawardandthejourneytoMagnetshouldbefunrdquo Soudi came to St Joseph Hospital10 years ago For the past six years she has served as the Outcomes Coordinator for the Critical Care Department alongwith providing bedside nursing She is involved with the Code Blue and METCommittees and helpedwith the devel-opment and implementation of the Condi-tion H program that has been emulated by hospitals across the country Soudi originally planned to be a law-yerbutafterworkinginalawofficede-cided she wanted more interaction with people ldquoI want to go home every day knowing Irsquove made a difference for some-onerdquoshesaysldquoIfIhadittodooveragainI would still choose nursing - I absolutely support it as a career Plus some ofmybestfriendsarehereatworkrdquo

wwwsjoorgnursing_excellence

SACRED ENCOUNTERS amp PERFECT CARE

Marchlsquo09 NursingSummitMagnetKickOff Data Collection teams re-initiated

Aprillsquo09 DataCollectionTeamsconfirmedandmembersnotified

Maylsquo09 DataCollectionTeamsbegintomeet(throughJune2010)Identify Sources of Evidence required for 2 years

Julylsquo09 1-yearDataCollectiontimeframebegins Teams were developed representing the 5

model components 1 Transformational Leadership -

KathyPenzes 2StructuralEmpowerment-PatBrydges ampJohnSenteno 3ExemplaryProfessionalNursingPractice - Carmen Ferrell and Alex Wiggins 4NewKnowledgeInnovationsand Improvements-ReneeMazeroll

Augustlsquo09 InitiatedatacollectionforannualDemo-graphics(Due110)

Octoberlsquo09 Oct1-3MagnetConferenceLouisvilleKY 8 staff members will be attending the meeting 2 poster presentations were accepted bullReachingtheNetGenerationand Beyond The learnings of the worldrsquos firstnursingresearchblog(seebackpg) bullCrashCourseResuscitatingtheCodeBlueProcess

Novemberlsquo09 Initiatere-designationapplicationprocess

Decemberlsquo09 SelectConsultant We will be looking for a consultant at the

NationalMagnetConferencewhowill

assistuswithourMagnetRe-designation

Januarylsquo10 Submitre-designationapplication Submit annual demographics The demographic form is an excel spread-

sheet that must be submitted annually dur-ing the anniversary month of designation OuranniversarymonthisJanuary

Februarylsquo10 BegintowriteOrganizationalOverview

Aprillsquo10 BegintowriteeachcomponentandSOE

Junelsquo10 1-yeardatacollectionperiodends

Julylsquo10 CompleteOrganizationalOverview

Augustlsquo10 InitiatedatacollectionforannualDemo-graphics(Due0111)

Septemberlsquo10 Revisionstowriting

Octoberlsquo10 Proofdocuments

Oct13-15lsquo10 MagnetConferencePhoenixAZ InviteCouncilchairsambassadors

Novemberlsquo10 Preparedocumentsforsubmission ConsultantMockSurvey

Decemberlsquo10 Plannursinggeneralstaffampmedicaleducation

Januarylsquo11 Submitre-designationdocumentation Demographic data Organizational Overview

Februarylsquo11 Initiatenursinggeneralstaffampmedicaleducation

Aprillsquo11 Sitevisit(April-June)

Junelsquo11 Celebratesuccess

In the coming months hundreds of hours will be spent by nurses throughout the hospital on data accrual educa-tion and other preparations for the St Joseph Hospital Magnet redesignation In its final form the redesignation documentation submitted to the ANCC will be close to 15 inches in height Many of you will remember the ldquoGood to Greatrdquo Magnet journey that culminated in our original designation in 2007 Now our ldquoHeart of Excellencerdquo journey will require the same intense involvement - and more Not only must we demonstrate all of the quality measures previously presented we must show what further progress and improvements have been made Our redesignation site visit in the spring of 2011 may seem like a long time away but with all that is required there is no time to waste

Magnet Re-Designation Timeline 2009-2011

Breast cancer patients at St JosephHospital undergoing tumor removal surgery now have access to one of the worldrsquos most advanced radiation therapy strategies Intraoperative Radiation Therapy(IORT)Thisimportantcancer-fightingapproachhasgainedworldwideacceptance and approval for use by the US Food and Drug Administration (FDA) It has been carefully studiedfound to be safe and significantlyreduces the radiation treatment time for selected types of cancers Advantages of delivering the radia-tion boost during tumor-removal surgery over external beam radiation treatments includebull The physician is able to clearly visu-

alize the tumor and exclude normal tissue and structures that could oth-erwise be damaged in the path of the radiation beam

bull The procedure reduces cancer recur-rence by destroying tumor cells that may be left behind after surgery

bull A higher dose of radiation is deliv-ered to the residual tumor therebydecreasing weeks of post-operative radiation treatments

bull The risk of treatment abandonment is reduced which sometimes hap-pens as cancer patients tire of multiple trips for radiation treatment

IORT has only been offered by a handful of hospitals nationwide due to the riskslogisticsandexpenseIthaspreviouslyinvolvedtheldquoheroicrdquotransportofa patient with a surgical opening from the operating room to a location capable ofaccommodatinganon-mobilelinearacceleratorwhichmustbehousedinaroom shielded with at least 100 tons of concrete This brings risks of moving a patientduringsurgeryincludingpotentialinfectionandadditionaltimeunderanesthesiaStJosephHospitalacquiredthecountyrsquosfirstmobileself-shieldeddevice to deliver IORT This device called aMobetronwas purchased through a generous grantfromtheGuentherFoundationRather thanan18000-poundstationary linearacceleratorthe2700-poundmobileunitcanbemovedoverthepatientandtheconcentrated radiation is delivered in one to two minutes BeforeofferingIORTStJosephHospitalradiationsurgicalandmedicaloncologists will work together to determine if the patient is a candidate for this curativetreatmentoptionMorethan20yearsofclinicalstudieshavedemon-stratedtheeffectivenessofIORTforcancerswhichareverydifficulttotreatbecause of their proximity to vital structures in the body IORT may be applied topatientspresentingwithheadandneckpancreaticsarcomarectalandpedi-atric tumors

On August 28 2009 St Joseph Hospital performed Orange Countyrsquos first Intraoperative Radiation Therapy (IORT) cases for three breast cancer patients Medical Director of Radiation Therapy Robert Ash MD Radiation Oncologist Afshin Forouzannia MD Medical Director of the Breast Program and Breast Surgeon Michele Carpenter MD FACS and Breast Surgeon Jay Harness MD FACS collaborated on the procedure along with these nurses Diana Quing RN Main OR Gizelle Gonzalez RN CVOR Gianina Bennett RN CVOR manager Susan Coto RN Main OR manager and Anita Grohmann RN CVOR

Intraoperative Radiation Therapy (IORT)A Boost in World Class Cancer Care

PERFECT CARE

Stand By for Flu SeasonEveryyearintheUnitedStates5to20per-centofthepopulationgetsthefluMorethan200000peoplearehospitalizedfrominflu-enzacomplicationsandabout36000peoplediefromflu-relatedcausesMostfluseasonsfluoutbreakshappenasearlyasOctoberandinfluenzaactivitypeaks in Januaryor laterThisyeardiffershoweverduetothenovelinfluenzaA(H1N1-swineflu)pandemicthatbegan this past spring and spread throughout the summer According to the PresidentrsquosCouncil of Advisors on Science and Tech-nology itrsquos possible that nearly two mil-lion Americans could be hospitalized in this yearrsquosfluseasonwithasmanyas300000being admitted to intensive care units Signsandsymptomsofnovel influenzaA(H1N1)virusinfectionaresimilartothoseofseasonalinfluenzaandspecificdiagnostictestingisrequiredtodistinguishnovelinflu-enzaA(H1N1)virusfromseasonalinfluenzavirusSpecificvaccinesagainstthenovelin-fluenzaA(H1N1)virusarebeingmanufac-turedandlicensedvaccineisexpectedtobeavailable in the US by mid-October 2009 The most effective strategy for prevent-ing influenza isannualvaccinationGroupsathighest riskfor infectionor influenza-re-lated complications are the initial targets for vaccinationTheyincludepregnantwomenpersons who live with or provide care for in-fantsagedlt6monthshealthcare and emer-gency medical services personnel childrenandyoungadultsaged6months--24yearsand persons aged 25--64 years who havemedical conditions that put them at higher riskforinfluenza-relatedcomplications Seasonal influenza vaccines are not ex-pected to provide protection against the H1N1 virus infection because this novel strain hem-agglutinin is substantially different from sea-sonalinfluenzaAsofmid-Septembernode-tails onwhen the influenza vaccinationwillbe shipped were available Experts estimate it may be available by mid-October To protect the health of our patients and employeesSt JosephHospital is strictlyen-forcing public health agency recommendations to prevent the spread of H1N1 The Orange County Health Care Agencyrsquos medical direc-torhasstatedthatStJosephHospitalrsquosman-agementoftheinfluenzapandemichasbeenbest practice for the county

Magnet Conference Showcasing ldquoReaching the Net Generation and Beyondrdquo Poster

1100 W Stewart Dr Orange CA 92868

Congratulations to Library Manager and Nursing Communications Team Member Julie Smith MLS AHIP and the 2009 Nursing Blog team whose poster on the worldrsquos first nursing research blog will be presented at this fallrsquos Magnet Conference In 2006 SJOrsquos Burlew MedicalLibrary investigated innovative ways in which the library might contribute to success in the initial Magnet journeyPreliminary research indicated therewereno evidence-based nursing research blogs Recognizingthissocialmediaopportunitythey developed the blog called Nursing Research Show Me the Evidence ThebloghasfurtheredStJosephHospitalrsquosreputation as a premiere hospital devoted to evidence-based nursing and nursing research and engendered a very strong

relationship between Nursing and theMedicalLibrary Social media constitutes a major technological trend andblogging has grown exponen-tiallysincetheprojectbeganAf-ter threeyears thebloghas re-ceived 86593 hits from aroundthe world It continues to grow in readership and depth of content The blog now averages 59 hits per day St Joseph Hospital nurses(and the public) have a one-stopsource for information on evi-dence-based medicine (EBM)Examples of blog content includebull Dr Dana Rutledgersquos regular

column in which she pres-ents an abstract of a nursing research article with her ex-pert commentary

bull RN Victoria Morrisonrsquos interviewswith staff nurses who are engaged in nursingresearchEBMprojects

bull LinkstokeyEBMresourcesbull Featured news articles on nursing

research To visit and subscribe to the blog go to

httpevidencebasednursingblogspotcom or ldquoNursing Excellencerdquoonwwwsjoorg

SJO Video in Magnet Film FestAfive-minutevideosubmittedbyandfea-turingStJosephHospitalwasacceptedfortheMagnetConferenceFilmFestViewitat www anccmagnetconferenceorg

GROWTH amp PERFECT CARE

2009 Blog Team from left Kathy Dureault RN MSN

Stacey Fischer RN BSN OCN Victoria Morrison RN

MSN FNP Dana Rutledge RN PhD Vivian Norman RN MSN CCRN and Julie Smith MLS AHIP Not shown Soudi

Bogert RN BSN and Theresa Ullrich RN MSN FNP

Fall 2009 EventsCelebration 2009 SaturdaySep-tember2620096pmattheHiltonAnaheimProceedsbenefittheHeartandVascularCenterandTheCenterforCancerPreventionandTreatmentCall 714-771-8211

Race for the Cure onSundaySeptember27inNewportBeachSJOisagainsupportingtheRaceforthe Cure by paying 12 the registra-tioncostforSJOemployeesContactShereeSimpsonstjoeorg

Evidence Based Approaches to Infec-tion Prevention and Management FridayOctober28am-430pmFreetoSJOemployeesCallClinicalEducationext17345

Walk to Remembera5KwalkonSaturdayOctober10atUCIJointhePerinatalComfortCareProgramteam as a walker or sponsor at wwwocwalktorememberorg

wwwsjoorgnursing_excellence

Magnet Conference Showcasing ldquoReaching the Net Generation and Beyondrdquo Poster

1100 W Stewart Dr Orange CA 92868

Congratulations to Library Manager and Nursing Communications Team Member Julie Smith MLS AHIP and the 2009 Nursing Blog team whose poster on the worldrsquos first nursing research blog will be presented at this fallrsquos Magnet Conference In 2006 SJOrsquos Burlew MedicalLibrary investigated innovative ways in which the library might contribute to success in the initial Magnet journeyPreliminary research indicated therewereno evidence-based nursing research blogs Recognizingthissocialmediaopportunitythey developed the blog called Nursing Research Show Me the Evidence ThebloghasfurtheredStJosephHospitalrsquosreputation as a premiere hospital devoted to evidence-based nursing and nursing research and engendered a very strong

relationship between Nursing and theMedicalLibrary Social media constitutes a major technological trend andblogging has grown exponen-tiallysincetheprojectbeganAf-ter threeyears thebloghas re-ceived 86593 hits from aroundthe world It continues to grow in readership and depth of content The blog now averages 59 hits per day St Joseph Hospital nurses(and the public) have a one-stopsource for information on evi-dence-based medicine (EBM)Examples of blog content includebull Dr Dana Rutledgersquos regular

column in which she pres-ents an abstract of a nursing research article with her ex-pert commentary

bull RN Victoria Morrisonrsquos interviewswith staff nurses who are engaged in nursingresearchEBMprojects

bull LinkstokeyEBMresourcesbull Featured news articles on nursing

research To visit and subscribe to the blog go to

httpevidencebasednursingblogspotcom or ldquoNursing Excellencerdquoonwwwsjoorg

SJO Video in Magnet Film FestAfive-minutevideosubmittedbyandfea-turingStJosephHospitalwasacceptedfortheMagnetConferenceFilmFestViewitat www anccmagnetconferenceorg

GROWTH amp PERFECT CARE

2009 Blog Team from left Kathy Dureault RN MSN

Stacey Fischer RN BSN OCN Victoria Morrison RN

MSN FNP Dana Rutledge RN PhD Vivian Norman RN MSN CCRN and Julie Smith MLS AHIP Not shown Soudi

Bogert RN BSN and Theresa Ullrich RN MSN FNP

Fall 2009 EventsCelebration 2009 SaturdaySep-tember2620096pmattheHiltonAnaheimProceedsbenefittheHeartandVascularCenterandTheCenterforCancerPreventionandTreatmentCall 714-771-8211

Race for the Cure onSundaySeptember27inNewportBeachSJOisagainsupportingtheRaceforthe Cure by paying 12 the registra-tioncostforSJOemployeesContactShereeSimpsonstjoeorg

Evidence Based Approaches to Infec-tion Prevention and Management FridayOctober28am-430pmFreetoSJOemployeesCallClinicalEducationext17345

Walk to Remembera5KwalkonSaturdayOctober10atUCIJointhePerinatalComfortCareProgramteam as a walker or sponsor at wwwocwalktorememberorg

wwwsjoorgnursing_excellence