Dartmouth Hitchcock Nursing Year in Review 2012

Dartmouth-Hitchcock Nursing
A Year In Review2012

Dear Nursing Colleagues:
This special edition of D-H Nursing serves as our 2012
Nursing Annual Report, published annually during National
Nurses Week. It is an opportunity to pause for a moment
and consider the great work of our colleagues and peers
over the past year. More specifically, it is an opportunity to
highlight and celebrate the revision of the Nursing Strategic
Plan and the exciting direction it sets for the future.
In 2008, the Nursing Practice Council participated in a
comprehensive review and development of a Nursing
Strategic Plan. Given the organizational changes of 2011
and 2012; however, the timing was perfect to review the
plan and determine where revisions would be helpful.
In February 2012, all members of house-wide shared
governance councils, all chairs of unit-based councils, and
nursing leaders were invited to a day-long retreat for the
purpose of identifying revised or new goals for our nursing
community and specific activities or issues to be addressed.
As it turns out, the timing of the Nursing Strategic Plan
revision aligned perfectly with the development of the
Strategic Plan for Dartmouth-Hitchcock.
Under the leadership of Dr. Jim Weinstein, CEO and
president, D-H has a clear focus and direction for the
future: improving the health of the population, providing
value-based care and moving to new reimbursement
models. Throughout 2012, the nursing community revised
and developed the Nursing Strategic Plan to flow from
and align with the D-H Strategic Plan. In the fall of 2012,
we were able to kick-off the revised Nursing Strategic Plan
in concert with our new shared governance year. The plan
provides focus and direction for the work ahead of us as
a professional nursing community and supports creating
a sustainable health system to improve the lives of the
people and communities we serve. It also incorporates our
nursing mission and two high-level goals: a healthy care
environment and a healthy work environment.
I am extremely proud of our Nursing Strategic Plan because
it reflects true collaboration between direct care nurses and
formal nursing leaders to set a direction for our nursing
community that reflects our needs going into the future. The
engagement of nurses throughout our unit-based and house-
wide councils has been tremendous and the commitment
to excellence expressed by all nurses is gratifying.
The following pages tell the story of this great work and of
the commitment of each of you to provide care that is of
the highest quality and safety and that creates true value over
time. I am grateful to the leadership of Cheryl Abbott, your
staff nurse executive chair, as she has been a driving force
behind the strategic plan development as well as a revision
to our Shared Governance structure. Beginning in April 2013,
Cheryl became a member of the newly revised D-H Board
of Governors, the first direct care nurse in the history of
our great organization to hold this position – certainly
something to celebrate during National Nurses Week. I am
confident she will represent you well in the same way. I
am confident that you will continue to provide skilled and
compassionate care to our patients and families every day.
My sincere thanks,
Linda
Linda J. von Reyn
Chief Nursing Officer

Dear Nursing Colleagues:
We came together in early 2012 for an enthusiastic and
thoughtful discussion of our Nursing Strategic Plan. Clear
themes of communication, coordination and collaboration
emerged from that conversation. In the setting of
our evolution toward One D-H, redesigning Shared
Governance is a significant achievement and a key strategy
for communication, collaboration and coordination across
our integrated health system.
We are dedicated to providing protected time and the
right structure for this important work, and dedicated
to appreciating the leadership and insight of nurses at
all levels, in all practice areas. Leveraging that nursing
leadership and insight will be essential to achieving our
organizational and professional goals as we have described
in the Nursing Strategic Plan.
With our new bylaws, we welcome the innovative
Ambulatory Clinical Council, representing six D-H campus
communities; and create the Coordinating Council,
a groundbreaking group that opens the door for our
colleagues throughout D-H to engage a diverse group
of nursing leaders in organizational work. We appreciate
the renewed focus and dedication of our Unit-Based
Councils, Quality Practice Council, Research Council
and Professional Development Council to achieving the
healthiest possible environment of care.
In reflection of our shared commitment to working together
in a culture of caring, for our patients, for the future of D-H
and for the future of nursing, I thank you for a very exciting
year and look forward to new challenges to come.
Cheryl L. Abbott, MSN(c), CNRN
Staff Nurse Executive Chair, D-H Shared Governance

Professional
Practice Model
Defining and Differentiating
Nursing Practice at
Dartmouth-Hitchcock
At Dartmouth-Hitchcock (D-H), “nurses
are very focused and have a lot of specialty
expertise,” says Paula Johnson, BSN, MPA,
DA, RN, a note of pride evident in her
voice. “But it’s sometimes difficult to get
at what are the foundational principles
that guide nursing practice across the
entire organization.” That “but” is what lies
behind a relatively new initiative within
D-H Nursing — the introduction of a
Professional Practice Model (PPM).
Johnson, the clinical program coordinator for
Magnet and Retention, is taking the lead on the
initiative. Its goal, she says, is that, “regardless of
which setting you walked into, every single nurse
could speak to how the Professional Practice Model
guide my practice and how does it come to life in my
care setting.”
A PPM “drives nursing practice in a particular
organization,” Johnson goes on, and “is made up of
multiple elements as defined by the nurses at that
organization.” The elements must be both meaningful
to nursing staff and “in alignment, of course, with the
organizational mission and vision and goals.”
PPMs, which are becoming increasingly common,
especially at Magnet hospitals such as D-H, contain
five common elements: a statement of values; a
Strategic Initiative: improve population health
declaration about professional relationships, both
internal (such as collegiality) and external (such
as participation in professional organizations); an
approach to professional development; a description
of the care delivery system; and a description of
leadership and governance structures.
A given institution “then does the work of
identifying what [each element] looks like for us as
an organization,” says Johnson. The goal is to capture
“what defines and differentiates nursing practice at
D-H as opposed to another organization.”
She believes the way is paved for the smooth
introduction of a PPM at Dartmouth-Hitchcock,
because “we have several of the elements of what
would normally be in a model in place already.”
For example, “in the values category, we have
a long-identified mission for nursing at D-H, about
20-years old now, to create an environment in which
patients and families can heal.” Another element
that’s essentially in place is an articulation of
Nursing’s leadership and governance structures — as
evidenced, Johnson says, by “Linda von Reyn, as our
chief nursing officer, driving and being responsible
for nursing throughout the organization.” In addition,
Johnson notes, “we have had shared governance in
place since the 1980s and have continuously evolved
it, to make sure that it keeps pace with changes in the
organization and with where we want Nursing to be
within the organization.”
Other existing programs or concepts that Johnson
sees as fitting well into the PPM approach include: D-H’s
vision to achieve the healthiest population possible, the
Live Well/Work Well employee wellness initiatives and the
4

increasing focus on providing Relationship-Based Care.
The work of putting flesh on the bones of a D-H
Professional Practice Model has just gotten under
way. However, says Johnson, “there are a lot of best
practices out there that I’m sure we’ll be drawing
from as we move forward.”
Already, for example, she knows that familiarizing
staff with the terminology and definitions specific to
PPMs will be essential. “This will provide a common
language for nurses,” she explains, “so that everybody,
regardless of where they’re practicing and what their
role is, can identify with the model.”
In addition, Johnson says, staff “will want to
Strategic Initiative: improve population health
understand why this is important — what does
it mean to me as a nurse practicing here. ... It’s
something that will have to involve every nurse
throughout the organization, as far as the dialogue
about what is meaningful, what are the elements we
think are important. What takes the time is [fostering]
real engagement across the organization.”
A Professional Practice Model is, in other words,
not a spectator sport. So Johnson may be serving as
its spokesperson right now, but “this is something
that we’re going to expect everybody to participate
in the development of over the coming year or two
years,” she concludes. ●
In the values category, we have a long-identified mission
for nursing at D-H, about 20 years old now, to create an
environment in which patients and families can heal.”
- Paula Johnson, BSN, MPA, DA, RN
Left to right: Janice Chapman, BSN, RN;
Paula Johnson, BSN, MPA, DA, RN;
Mildred Sattler, BSN, RN, CCRN

Shared
Governance
Redesign
Exceptional Commitment
to Transformational
Leadership and Structural
Empowerment
“Shared Governance is not unique to
Dartmouth-Hitchcock,” points out
Cheryl Abbott, MSN(c), CNRN, the staff
nurse executive chair of D-H’s Shared
Governance structure. “But we make
a commitment to Shared Governance
that really stands out, even among our
Magnet peers.” Abbott, who is a certified
neurosciences registered nurse, was elected
by her peers from across the organization
to lead Shared Governance at D-H.
6
Cheryl Abbott, MSN(c), CNRN, right
Mary Jean Mueckenheim, RN, left
Strategic Initiative: integrated health system

8
What makes D-H Nursing Shared Governance
stand out, Abbott explains, “is the engagement of
nurses at all levels, from all practice areas in the
strategic planning process. That creates a forum
for feedback, new ideas and goals to emerge.” The
Shared Governance structure then adapts to support
the work. “My role, as staff nurse executive chair, is
dedicated to nurturing that structure.”
The latest evidence of this dedication was a
redesign of the Shared Governance structure to
expand participation and improve commuication and
coordination among clinical nursing staff leaders.
Abbott notes that Shared Governance has evolved
over at least three decades at D-H. Its structure
and terminology have changed over the years,
but there have been three constants: fostering
communication, advancing nursing practice and
improving patient care.
c o o rd i nat i n g c o u n c i l
● More funding from the central Shared Governance
budget for the UBCs to give their chairs “a little more
protected time,” explains Abbott, “to do the very
important work of both participating in a house-wide
forum, and then taking that work back to their unit for
local feedback and implementation.”
Un i t - B as e D C o u n c i l
UBC UBC UBC UBC
Professional
Development
Council
Research
Council
Quality
Practice
Council
Ambulatory
Clinical
Council
H o u s e - W i d e C o u n c i l S
Nursing
Senior
Leadership
$ $ $ $
● More alignment in the way the unit-based
councils (UBCs) function.
● Inclusion of the UBCs in the D-H Shared
Governance Bylaws.
● Reconfiguration of the house-wide councils.
There are now four such groups. Two have had a
consistent focus for some time: the Professional
Development Council and the Research Council.
And two are new additions: the Quality Practice
Council (a merging, to avoid duplication of effort,
of previously separate Quality and Practice
Councils) and the Ambulatory Clinical Council
(“one of our challenges,” notes Abbott, “has always
been coordinating with our colleagues in the
ambulatory-care clinics”.)
● The creation of a Coordinating Council, made
up of the chairs of all the unit-based councils,
the chairs of the four house-wide councils and
Nursing’s senior leadership. “The units were
feeling that they were not in as close touch as
they wanted to be with the house-wide councils,”
says Abbott, “and the Coordinating Council
functions as a two-way conduit for information.”
The recent redesign — the outcome of a retreat in February 2012 that brought together
over 100 nurses from across the organization — included the following changes:

The Coordinating Council, she notes, is proving
to be “a wonderful networking forum for unit-based
leaders to talk to each other about what they’re doing
on their units,” while at the same time serving as a
locus for “more strategic work, organizational work
— issues, policies and concerns that generalize across
the organization.” By contrast, she says, “the Quality
Practice Council is focused a little closer to the point
of care — deep diving into care-delivery, nursing
practice and nursing quality issues.”
An important goal of the changes, Abbott points
out, was “seeking to engage direct-care staff as
early and often in the policy-making process as we
possibly can.” Input from the front lines “is necessary
to get the best patient outcomes, to promote a
feeling of accountability [among staff] for their own
professional practice and growth, and to give those
people that want to develop professionally the
resources to do so.”
Grace St. Pierre, BSN, RN-BC, a staff nurse on the
2 West Inpatient Surgery Unit, represents a case in
point. “I’m a unit-based council chair,” she explains,
“and with the redesign, that has given me a seat
on the Coordinating Council and on the Quality
Practice Council.” When a matter comes up at the
Coordinating Council or at a house-wide council
level, part of the charge for people in positions like
hers, says St. Pierre, is to “bring that information back
to the units and make it real and applicable” at that
level. The UBC chairs have a further charge, she adds.
Another “part of their responsibility is to bring back
information from the house-wide councils to the
UBC.” From there, the UBC members “disseminate
the information with the rest of the floor, because we
all may not work together on the same day or see the
same people.”
While the structural changes are too new for
their long-term effect to be clear quite yet, “we think
there’s been an energizing effect,” says Abbott. She
believes the UBC chairs appreciate “the expanded
protected time for that work,” as well as “the
commitment to giving direct-care staff an opportunity
to both provide feedback and gain insight in the
policy-making stage.”
St. Pierre agrees. Already, she says, she is
observing “richer discussion on the unit level. I think
that there’s less misinformation out there,” she adds,
plus a feeling among frontline staff of being more
involved stakeholders.
“I’m really excited to see what the future holds for
Shared Governance at Dartmouth-Hitchcock,” she
concludes. ●
Grace St. Pierre, BSN, RN-BC, center
Julia Coffin, BSN, RN, right
9

The Value
Institute
Process Improvement at its Best
“Wax on, wax off”: No one who has seen
the movie Karate Kid is likely to forget
the way Mr. Miyagi teaches Daniel the
importance of process.
Nor is anyone trained at D-H’s Value
Institute likely to forget the importance
of process improvement. Take Buffy
Meliment, BSN, RN, who’s been at D-H
since 2001. “I’ve worked on a lot of issues
through the years,” she says. “Historically
it could be frustrating, because you have a
lot of opinions and a lot of conversation”
... but she felt it was not always clear
how to make actual improvement. This
could be because not everyone was
approaching the process in the same way.
The Value Institute, established in 2011,
“gives us a common language around the
improvement process and the tools to
work through the process in a systematic
way, so you actually see improvement
happen,” continues Meliment. “And not
only happen, but be sustained.”
11
Strategic Initiative: leaders in value
Buffy Meliment, BSN, RN

Her regular job is as a pediatric staffing resource
team nurse. She became acquainted with the Value
Institute thanks to two temporary roles — as a project
specialist supporting nursing quality improvement and
patient safety, and as a Master of Science student
at The Dartmouth Institute for Health Policy and
Clinical Practice.
The Value Institute follows the DMAIC — define,
measure, analyze, improve and control — model
of the Six Sigma process-improvement system. It
comprises four levels of training. “Whitebelt training is
a series of six online learning modules that employees
are expected to do when they’re hired,” Meliment
explains. Two-day Yellowbelt training is for staff who
serve on a project team. Five-day Greenbelt training
is for team leaders. “Blackbelts go through much
more extensive training,” Meliment concludes, “then
provide mentorship and coaching to Greenbelts or
Yellowbelts.”
Meliment earned her Yellowbelt in December
2011, then served on a team looking at pediatric
readmissions. In June 2012, she got her Greenbelt and
led a project aimed at reducing catheter-associated
urinary-tract infections (CAUTIs).
In the past, she says, “everybody would have an
opinion” about how to fix a given problem. Indeed,
“when we brought [the CAUTI team] together, there
were a lot of thoughts about why these infections
were happening.”
But “with the tools from the Value Institute, we’re
able to measure what actually happens.” In the case
of CAUTIs, “what we felt from working on the clinical
unit — anecdotal evidence — was very different from
what the data showed us.” The team thought what
needed fixing was adherence to best practices, such
as keeping catheters secured to the patient’s leg,
below the bladder and off the floor. But staff “felt we
were using catheters for appropriate reasons,” says
Meliment, “so that’s not what we needed to look at.”
In fact, “we found that catheters were secured,
they were below the bladder and they were rarely
on the floor. We were performing much better
than the nurses thought in that area. But catheters
were being used for indications that were not
12
appropriate,” though nurses “felt we were using them
appropriately.”
The improve and control steps followed close
behind. “We were able to achieve 100 percent
[compliance with usage guidelines] within two weeks,”
says Meliment. “I can’t say we’re at 100 percent every
week since then, but the nurses are continuing to use
the tool on a regular basis.”
“Other nurses have had the same experience,”
she adds. “As you use the tools and start to see
meetings that really move forward, there’s been great
buy-in.” Meliment believes the program’s hands-
on and coaching aspects are key. “This isn’t just a
class you sit in, where you learn some tools that you
In the past everybody would
have an opinion about how to
fix a given problem. Indeed,
when we brought [the CAUTI
team] together, there were a lot
of thoughts about why these
infections were happening.”

might use some day. You’re involved in a project
where you immediately start to use the tools.” And,
she says, “you’re not just left with ‘Here’s your five
days of training, go perform,’ but you have ongoing
mentorship.”
Karen Pushee, RN, MA, the nursing manager
of the Cardiovascular Critical Care Unit and the
Intermediate Cardiac Care Unit (ICCU), is another
fan of the Value Institute. She’s currently leading a
project on the ICCU patient discharge process from
the perspective of nurse practitioners. The hope is
“to get patients out earlier,” since ICCU beds are at a
premium.
This project hasn’t reached the improve stage
yet, but “we’ve begun to appreciate all that goes into
a discharge,” Pushee says. It’s a process with lots of
moving parts — such as ensuring that all tests get
done, that a skilled nursing bed is available if the
patient is going into rehab, or that a ride is available if
the patient is going home — and lots of opportunities
for glitches — such as a patient who’s ready to leave
by 11:30 am but a ride that can’t be there until 5:30 pm.
Pushee echoes Meliment on the program’s
mentorship aspect. Her coach has helped her
understand that “if you jump to easy fixes, you may
be missing some big pieces of the process that will be
an obstacle down the road.” Once you “appreciate the
process,” she says, “then you have faith in it.” ●
Once you appreciate the process,
then you have faith in it.” - Karen Pushee, MA, RN

AgeWISE
Program
Sharing Knowledge;
Professional Renewal
When her elderly patient's brother asked
how his sister was doing — and then
started to cry — Meghan Poperowitz, BSN,
RN, immediately “recalled Mike's story.”
Poperowitz, a staff nurse on 1 East, is a recent
graduate of D-H’s AgeWISE nurse residency program.
The story she remembered at that critical moment —
shared with AgeWISE participants by Mike Waters –
D-H's director of Treasury and Investments for the
Finance Department — was about when first his
mother and then his father were near death in health-
care facilities in Rockland County, New York.
“There were incredible nurses that were kind and
considerate,” Waters says, “but the nurse we’ll remember
forever is one who yelled at my dad and made an awful
situation 10 times worse.” The family had just agreed
that his mother should go on a ventilator, and this
nurse “actually scolded my father — said, ‘I can't believe
you're doing this. She has end-stage cancer. What's the
point?’ Something very harsh.” The family, “stung by the
comment,” had received no palliative-care counseling.
A couple of years later, Waters and his siblings had
just decided to put their dad on comfort measures only
(CMO), after nine months of decline following a massive
heart attack. “A nurse who didn't know us, didn’t know
my dad ... said to us that we were making a huge
mistake, that we would regret it for the rest of our lives —
something like ‘You should be ashamed of yourselves.’”
“We got great care in the sense of the technology,”
Waters says, “but we got so little guidance. ... None
of the nurses, none of the doctors, framed any of
the options for us. So what I’ve told the AgeWISE
group on behalf of patients and families like mine is
‘Talk to us.’” He also reminds them that “if, in just one
moment, you don’t treat the family with respect and
honesty, you can ruin all the good work you’ve done.”
It was these lessons that Poperowitz recalled when
her patient's brother approached her. She wrote about
the incident for an AgeWISE newsletter put out by
Massachusetts General Hospital, which established the
program and invited D-H to be one of 12 institutions
to pilot it. The brother, Poperowitz related, “asked
me again what I thought was happening. Although
we were always told to put the question back to
the person asking, I recalled Mike’s story, and I felt
obligated to share my observations and feelings. I told
him I thought she was dying. He grabbed my hand and
said ‘Thank you.’ He said he felt the same.” After the
patient was put on CMO, “the brother kept returning
to me, thanking me for being ‘honest.’”
Stories like this gladden the heart of Deanna
Orfanidis, MS, RN. As the administrative director for
critical care and surgical services, she is AgeWISE's
14
Strategic Initiative: Innovation

site director at D-H. “A lot of this work isn't
quantitative,” she explains, “it's more qualitative. But
our sense is absolutely it's having an impact,” thanks
to stories like Poperowitz’s.
AgeWISE is a six-month residency in geropalliative
nursing care and policy for direct-care nurses. They
spend two days a month in classes — and listening to
speakers like Waters — then apply what they’ve learned
on their units. It’s been such a success at D-H that
Orfanidis is “in discussion with Linda von Reyn, our nurse
executive, about developing a budget for AgeWISE to
continue it here” after the pilot funding ends. Much
of the credit for its success, she adds, goes to “Nancy
Scalise and Jeannette Hoag, who have done 80 percent
of the work. They were in the first cohort,” she notes.
“We've seen leadership grow out of that cohort.”
In fact, she adds, “that's one of the core concepts —
how do you spread [the learning] to your colleagues.”
For that reason, those chosen for AgeWISE include
both senior nurses, with 20 or more years of
experience, and junior nurses, with two to five years
of experience. “The more experienced nurses then
mentor the junior nurses,” Orfanidis explains.
Professional renewal is another core principle, she
says. “You're giving folks an opportunity to debrief
around this really tough work.”
Participants also undertake specific projects. “The
first cohort created a symbol — a daisy with a falling
petal,” says Orfanidis. “If that's posted outside a
patient’s room, it means comfort measures only.” So,
for example, “dietary doesn't come in, and you know
to keep the noise down.”
The current cohort “is working on what we call a
Get-To-Know-Me poster. Especially in the critical-care
setting, we often have patients who are unresponsive.
But who is that person? They’re a father, they’re a
mother, ... maybe they’re an engineer.”
Waters has been “really impressed” with the
participants. “They ask the right questions, honest
questions.” As he watched junior nurses interacting with
more experienced peers, he recalls thinking, “How great
for them that they’ve come to work at an organization
where they’re encouraged to be active in this process, to
improve their skills. I walked out feeling very hopeful.” ●
The brother asked me again what I thought was
happening. Although we were always told to put the
question back to the person asking, I recalled Mike’s story
and I felt obligated to share my observations and feelings.”
- Meghan Poperowitz, BSN, RN

The word “unique” is often misapplied
to things that are merely unusual or
innovative. But a program at Dartmouth-
Hitchcock (D-H) that goes by the acronym
of I-SURF-N is not just uncommon or
novel but actually unique — one of a kind.
The “SURF” part of the program’s name stands for
Summer Undergraduate Research Fellowship. The “I”
refers to its funding source — a $15.4-million federal
grant from the IDeA (Institutional Development
Award) Networks of Biomedical Excellence, or INBRE.
And the “N” salutes the fact that it's the only INBRE
grant in the nation to include a nursing component.
The 24 INBRE programs nationwide are intended
to foster collaboration among institutions with
significant federally funded research programs and
small undergraduate schools in the same state. D-H
and the University of New Hampshire (UNH) are the
lead institutions for the New Hampshire INBRE.
When the grant's principal investigator, a
professor at the Geisel School of Medicine, asked
if D-H was interested in having nurses involved in
the initiative, the response was an enthusiastic yes.
But, recalls Mary Jo Slattery, MS, RN, the clinical
program coordinator for nursing research at D-H
and I-SURF-N's program director, “I looked high and
low and couldn’t find anything to model it on. So we
developed it from scratch.”
I-SURF-N is now entering its third year.
Undergraduate nursing students from Saint Anselm
College, Colby-Sawyer College and UNH apply to
spend the summer between their junior and senior
years at D-H. They’re introduced to three different
nursing research roles: One of those roles is nurses
conducting nursing research,” says Slattery. Another
is nurses who coordinate clinical trials, often drug
trials at D-H’s Norris Cotton Cancer Center. “The
third role is translation of research at the bedside,”
concludes Slattery, “an advanced practice nurse
involved in either evidence-based practice or quality
improvement.”
During nine weeks of the 10-week I-SURF-N
program, students are paired with both a nurse
researcher and an advanced practice nurse and work
on two projects simultaneously with their mentors.
For the other week, says Slattery, “they go to the
Cancer Center and work one-on-one with a nurse
there who coordinates a clinical trials research
experience, so they're exposed to Phase 1, Phase 2,
and Phase 3 clinical trials.”
Numerous other experiences are woven
throughout the 10 weeks — from a weekly research
roundtable to seminars on quality improvement
methodologies. The students also attend Grand
Rounds, meetings of the Tumor Board and the
Committee for the Protection of Human Subjects,
learn how to conduct complex literature searches, and
complete the NIH's CITI (Collaborative Institutional
Training Initiative) module. In short, students come
away realizing that “nursing research covers a broad
span and quite a bit of depth,” says Slattery. “We try
to immerse them in a variety of experiences.”
The benefits of the program for the students
are obvious. But Slattery says the institution most
definitely benefits, as well. The program “brings
16
Strategic Initiative: Distinctive education and research
D-H Program Offers“Unique”
Experience for Nursing Students

nursing research more to the forefront” and “helps
create a cohort of staff nurses interested in nursing
research quality improvement.” In addition, “those
folks now think of themselves as mentors, where they
haven’t been formal educators before. I think that’s
very good for them professionally.” Not to mention
the fact that “any time you have students around, it
provides stimulation.”
Slattery has observed one other benefit — “a
point we never really thought about,” she says — and
that's been the program’s positive impact on nurse
recruitment. “That has been an unexpected benefit.
These are students from around the state, and you
might think they would tend to go back home. But in
the first cohort there were four students, and two of
them are now working here — one in our Intensive
Care Unit and one on the Neurology floor.” And even
though the 2012 I-SURF-Ns are still in school, one
has already been accepted into a new D-H graduate
perioperative training program. And two others
remain involved in the D-H research they worked on
last summer, as part of a senior honors thesis. Slattery
is hopeful that they too may end up at D-H.
“This is really exciting for us,” Slattery explains,
partly as a proactive response to the nursing shortage,
but also “because it’s a very select program. These
students are encouraged to apply by the chairs of
their nursing departments — they’re at the top of
their class.”
In fact, two of the 2012 I-SURF-Ns will be back
this summer working in kind of a student coordinator
role, says Slattery, helping this year's participants
appreciate nursing's role in “the bigger picture —the
bigger health-care picture.” ●
Strategic Initiative: Distinctive education and research
The program brings nursing research more to the forefront and helps create a cohort of staff nurses
interested in nursing research quality improvement. Those folks now think of themselves as mentors,
where they haven’t been formal educators before. I think that’s very good for them professionally.
Not to mention the fact that any time you have students around, it provides stimulation.”
- Mary Jo Slattery, MS, RN
Mary Jo Slattery, MS, RN, left; Bianca Fortier, BSN, RN, right

Engagement
Survey Results
A Focus on Professional
Development and
Communication
You can’t discuss a survey without discussing hard
numbers — response rates, midpoints, means and so
on. But at the same time, some surveys attempt to
quantify soft concepts, like engagement.
Such a challenge is one that Dartmouth-Hitchcock
(D-H) tackled for the first time last year, measuring
employee engagement — as opposed to measuring
employee satisfaction — in a survey conducted by
an outside firm. The instrument assesses whether
employees understand D-H’s goals, whether they’re
willing to put discretionary effort into their work, and
whether they have an emotional attachment to the
organization.
The survey, administered in April 2012, posed
questions in 16 categories. In some areas, such as
Performance Evaluation and Training Compliance,
D-H’s results were well above national benchmarks
for such surveys. But in others, there was room for
improvement. “When we looked at the results for
Nursing,” says Johanna Beliveau, BSN, MBA, RN,
“we highlighted opportunities in two specific areas
that we felt were priorities and were within the
span of influence of the Nursing leadership team
to address. Those two things were professional
development and communication.”
Beliveau, the administrative director for Inpatient
Maternal Child Health and Psychiatry, also serves as
“employee engagement champion” within Nursing.
She explains some of the steps that have been
undertaken as a result of the 2012 survey.
In the communication arena, for example, a key
change was the institution of a 10- to 15-minute
“huddle” on every unit at the beginning of each shift.
The agendas for the huddles are simple, bulleted
information points. The list may include clinical issues
(a recap of patient acuity levels, for example), but also
brief mention of policy changes or drug shortages or
nursing scholarships with deadlines approaching.
A weekly leadership huddle was also instituted,
as well as more regular rounding by the Nursing
leadership. The template for unit-based council
meetings is also being standardized.
Several actions were taken on the professional
development front too: improving in-house
education and training offerings; helping nurses
prepare for specialty certification exams; expanding
nurses’ access to outside professional development
Strategic Initiative: PEOPLe
18
Intensive Care Unit,
7 am change-of-shift huddle

opportunities, such as conference attendance; and
increasing their awareness of scholarships and grants,
to enable them to take more advantage of external
opportunities.
Beliveau sees it as a plus that D-H typically has
a good response rate on the survey, compared to
national benchmarks. “I think the response rate is
indicative of the fact that people feel it’s important to
share their perspectives — that [someone] is going to
take action with the information.”
“This is ongoing work,” she emphasizes. “We’ve
made some steps in putting actions into place, but
we’ll be interested to see how we’re doing on our next
survey,” which is scheduled for later this year. “The
goal is to keep a good pulse on our performance,”
Beliveau adds. “We know that there’s more to do, and
that feedback will help us continue to prioritize what’s
important to the staff and where our biggest gaps are.”
She finds one other aspect of the effort especially
heartening — and that is the attention given to
the findings not only within Nursing but also at
the institution’s highest levels. She sees “a real
commitment from senior leadership on action planning
related to the data and to our responses.” Even Dr.
James Weinstein, CEO and president of D-H, she says,
“routinely asks his senior officers for updates on what
has been happening within their divisions.”
At the same time, reports on this progress note
that employees themselves bear some responsibility
— to actively participate in huddles, to ask clarifying
questions, and to both offer and listen to feedback.
The effort is, in other words, a circular process. ●

Linen
Management
Cost Savings One
Bedspread at a Time
“A bedspread here, a bedspread there, and
pretty soon you’re talking real money.”
That adaptation of an adage about
government appropriations — “a billion
here, a billion there, and pretty soon
you’re talking real money” — aptly sums
up a new linen awareness project at
Dartmouth-Hitchcock (D-H). It was
piloted on 3 West in the fall of 2012 and
implemented on several other units
beginning in late December. Just a few
months later, as of mid-March, the project
had already led to $41,567 in savings. One
bedspread at a time.
The project was identified as a cost-saving
opportunity based on a comparison to
national benchmarks, explains Katrina
Geurkink, MS, manager of Operational
Excellence, Supply Chain Management.
D-H’s inpatient linen usage averaged 26.2
pounds per patient day, compared to a
national average of 16.6 pounds.
21
Morgan Merchand, BSN, RN
Strategic Initiative: finance

22 “From there, it has been very straightforward
in terms of just going in and sharing the data with
the nursing units,” she says. “They’ve immediately
identified some things they can change.”
Kate Bryant, BSN, RN, the chair of 3 West’s
Unit-Based Council (UBC), was an early convert.
“Being a surgical floor, we go through lots of linen,”
she explains. “We don’t think about how much
we use on a daily basis because of the fast-paced
environment.” But once her team saw the data on
linen use, Bryant says they brainstormed ideas and
quickly implemented them. The changes ranged from
reducing the amount of linen routinely brought into
patients’ rooms to making more informed choices
regarding which item to use in a given situation.
For example, says Geurkink, usage at D-H of
“what we call bath blankets,” a lightweight but very
warm blanket, “was lower than [usage of] bedspreads,
which appear to be heavier and warmer — but they’re
actually not. And,” she adds, “bedspreads cost quite a
bit more to launder than bath blankets.” So using bath
blankets instead of bedspreads when patients are
chilly both saves money and serves patients better.
Bryant offers another example, noting that 3
West has reduced the number of blankets, towels
and washcloths that are routinely brought into
patient rooms. This has not only saved money but
also lightened the load of the LNAs on the unit. In
addition, says Bryant, “by minimizing the amount of
linen in the rooms, we create a safer, more clutter-
free environment, reducing the risk of patient falls.”
Furthermore, she notes, if rooms are overstocked
when patients are discharged, unused excess linen
must be relaundered.
Another change piloted on 3 West was working
closely with Linen Services to reduce the standard
inventory of linen supplies kept on the unit.
“In any health-care setting, the next
biggest expense after labor is supply
chain,” explains Michael Durkin, MHA, RN,
who holds a new position that sits at the
intersection of supply chain management,
purchasing and clinical decision-making. His
title is clinical products and value analysis
coordinator, and his role involves evaluating
clinical products and equipment — their
cost and effect on patient outcomes,
certainly, but also quality (do gloves tear,
for example?), ease of use (does a device
require costly training?), waste stream
impact, ergonomic considerations, storage
requirements and so on.
He draws on a range of resources —
from the published literature, to teams
26.2 lb/day
16.6 lb/day
national
average
ValueAnalysis
average inpatient
linen usage
By minimizing the amount of linen in the rooms, we
create a safer, more clutter-free environment, reducing
the risk of patient falls.” - Kate Bryant, BSN, RN

23Geurkink identifies several keys to the
project’s success so far:
Data: She says personnel on the units have found
the facts on linen usage very persuasive.
Dialogue: This has been an essential element,
Geurkink believes. “We felt it was really important to
engage nurses early in the process — go talk to them
before we suggest any improvements and just say,
‘Hey, here’s what we’re seeing. How does this match
or not match what you’re seeing on your units, what
you’re living every day?’”
Teamwork: She ticks off a long list of departments
and people involved in the effort — the pilot and
early-adopter units (2, 3, and 4 West); the nurse
managers who supported the changes on these
units; the nursing staff and others who made the
changes and offered feedback; and personnel in
Supply Chain Management, including Project Leader
Michael Colburn, Linen Supervisor Laurie Smidutz,
and Supply Hospital Chain Support Services
Manager Michael Kenney.
“Even though we’ve just begun working with
some units and are well past the midpoint of FY
2013,” says Colburn, “I still expect to see a cost savings
of $100,000 this fiscal year.” The project’s eventual
savings target is $200,000 annually.
The linen project has even prompted 3 West “to
look at other personal care supplies we bring into
the rooms,” explains Bryant. Now, “we’re trying to
encourage staff to offer these items as needed,”
instead of, for example, automatically giving all
patients a toothbrush, since they may well have
brought one from home. This approach is both “cost-
effective and environmentally friendly,” she adds.
“As a unit,” Bryant concludes, “3 West realized the
impact that this project could have: by saving money,
we then have more resources to care for our patients.
These are little things that make a huge difference.” ●
Michael Durkin, MHA, RN
$41,567
Cost savings since
implementation
(Dec.-Mar.)
$100,000
Expected cost
savings this
fiscal year
$200,000
Projected
cost savings
annually
of subject matter experts, to vendor fairs,
to the group purchasing muscle of two
hospital networks that D-H belongs to.
Durkin says “cost-saving is important,
but my work is not judged just on price.”
Nor is he “in a position of saying yes or
no” about purchases. Instead, his role “is
about weighing all the pieces and helping
clinicians come to a decision.”
Most decisions involve input from both
physicians and nurses. “Between 70 and 80
percent of all the things that are purchased
around the patient experience are touched
by Nursing,” he says. “Nurses right now
are weighing in on the use of a negative
pressure wound therapy device, an enteral
feeding pump [and] advanced life support
monitors.” He also assesses products “as
simple as disinfecting wipes. We’re looking
to standardize on the wipe that has the most
broad spectrum kill, but the least impact for
the people who are using them.”
When his position was created by the
Office of Professional Nursing in June 2012,
Durkin thought it “sounded like an amazing
opportunity. I have a curious background,”
he says. “I have a master’s in health-care
administration, and prior to becoming a
nurse I worked in the business world.”
His work, Durkin adds, “has broad
implications across the hospital, but
Nursing made the decision to create
the position. That’s a credit to Nursing
leadership here.”
Linen awareness project savings

AACN
Certified Critical Care Nurse
Tracy Anderson, RN, CCRN
Chris Apel-Cram, RN, CCRN
Jeannette Hoag, RN, CCRN, RN-BC
Janice Narey, MSN, RN, CCRN
Millie Sattler, BSN, RN, CCRN, ENPC
Joan Schwertner, BSN, RN, CCRN
Jane Womack, BSN, RN, CCRN
Megan Zerega, BSN, RN, CCRN
American Association
of Neuroscience
Nursing
Certified Neuroscience Nurse
Wanda Handel, MSN, RN, CNRN
American Association
of periOperative
Registered Nurses
Certified Operating Room Nurse
Linda Alongi, BSN, RN, CNOR
Jana Beth Stevens, RN, CNOR
American Board of Peri-
Anesthesia Nursing
Certified Ambulatory Peri-
Anesthesia Nurse
Della Lynde, BSN, RN, CAPA
American College of
Surgeons
National Surgical Quality
Improvement Program Surgical
Clinical Reviewer Certification
Erin Boettcher, RN
American Nurses
Credentialing Center
Certified Adult Nurse Practitioner
Janette Stender, MSN, ANP-BC
Certified Family Nurse Practitioner
Remy Bacaicoa, MSN, FNP-BC
Certified Medical-Surgical Nurse
Marianne Diaz, BSN, RN-BC
Nina Funari, RN-BC
Grace St. Pierre, BSN, RN-BC
Certification in Gerontological
Nursing
Jeannette Hoag, RN, CCRN, RN-BC
Timothy Stockton, RN-BC
Certification in Pediatric Cardiology
Michelle Adams, BSN, RN-BC
Psychiatric and Mental Health
Nursing
Claire Ketteler, RN-BC
Certified Pediatric Nurse
Deborah Gardner, BSN, RN-BC
Association of Clinical
Documentation
Specialists
Certified Clinical Documentation
Specialist
Cindy Goewey, BSN, RN, CCDS
Association of
Vascular Access
Vascular Access Board Certified
Timothy Bray, BSN, RN, VA-BC
Mary Coutermarsh, BSN, RN, VA-BC
Patricia Gilbert, RN, VA-BC
Board of Certification
for Emergency Nursing
Certified Pediatric Emergency Nurse
Millie Sattler, BSN, RN, CCRN, ENPC
Case Management
Society of America
Certified Case Manager
Amelia Emerson, MS, RN, CCM
National Association
of Orthopedic Nurses
Certified Orthopedic Nurse
Susanna Gadsby, BSN, MBA, RN, ONC
National Certification
Corporation
Low Risk Neonatal Nursing
Tammy Murray, BSN, RNC-LRN
Neonatal Intensive Care Nursing
Rachelle Kleber, RNC-NIC
Caryn McCoy, MSN, RNC-NIC
Inpatient Obstetric Nursing
Kimberly Boulanger, MSN, RN-C
Certified in Electronic Fetal
Monitoring
Kathleen Brochu, BSN, RN, C-EFM
Oncology Nursing
Certification
Corporation
Oncology Certified Nurse
Julia Beaulieu, RN, OCN
Maureen Stannard, RN, OCN
Pam Wider, RN, OCN
Marie Miller, BSN, RN, OCN
Certified Breast Care Nurse
Sarah Whicker, RN, CBCN
PICC Excellence
Certified PICC Ultrasound
Inserter
Mary Coutermarsh, BSN, RN
Patricia Ward, RN
Society of Clinical
Research Associates
Certified Clinical Research Associate
Laurie Rizzo, RN, CCRP
Education Updates
Received Bachelor’s Degree
Roseanne Arnett, BSN, RN,
Operating Room
Kelly Brandis, BSN, RN, MHO
Erin Cartier, BSN, RN,
Occupational Medicine
Linda Coutermarsh, BSN, RN,
Neuro Special Care Unit
Julie Dellinger, BSN, RN, ICU
Todd Gardner, BSN, RN,
Vascular Access Services
C. Heidi Lacasse, BSN, RN, CNRN,
Neurosciences
Lisa Lamadriz, BS, RN, IBCLC,
Lactation Services
Jason Osborne, BSN, RN, ICU
Tracy Webster, BSN, RN, CCRN,
CEN, CFRN, DHART
Received Master’s Degree
Remy Bacaicoa, MSN, FNP-BC, ICU
Kimberly Boulanger, MSN, RN-C,
Birthing Pavilion
Janice Narey, MSN, RN, CCRN, ICU
Christopher O’Connell, MSN, RN,
CFRN, Trauma Program
Una Shworak, MSN, RN,
Care Management
Stephanie Stone, MS, RN,
Quality Assurance and Safety
Steve Thomas, MSN, RN, CCRN, ICU
Scholarships Awarded
Elsa Frank Hintze Magnet
Scholarship for Nursing Excellence
Ellen Parker, RN
The Levine Nursing Continuing
Education Award
Judith Long, RN
Carissa Thurston, RN
Gladys A. Godfrey Scholarship
Maria Melendy
Evidence-Based Nursing Practice
Award
Terri Farnum, RN
The Patient Safety Training
Center Innovation in Nursing
Education Scholarship
Catherine Rodriguez, MSN, RN
James W. Varnum Scholarship
Awards
Kimberly Allen, LPN, Family Medicine
Sydney Allen, RN, Perioperative
Services
Lisa Barrett, Laboratory Support
Services
Ashley Beaulieu, 4 West
Stephanie Berman, RN,
General Internal Medicine
Lise Bernardi, RN, Medical
Specialties
Michelle Buck, RN, Patient
Placement Services
Jorda Chapin, APRN, ED
Marylan Clark, RN, Medical Specialties
Katrina Colby, RN, Radiation
Oncology
Certifications
24

Amanda Cote, LPN, Cheshire
Medical, D-H Keene
Michelle Cutler, RN, HSCU
Kathleen Czarnec, RN, Pediatrics
Susan DiStasio, APRN, 1 West
Steven Doyle, Inpatient Pharmacy
Jane Eaton, RN, ICCU
Linda Evans, LPN, Cardiology
Melissa Garland, RN, 4 West
Wanda Handel, RN, OPN
Tristin Henson, RN, 3 West
Christine Kelly-Terena, ICCU
Rachel Kendall, RN, OB-GYN
Misty-Anne Koloski, ICCU
Rebecca Lacasse, 3 West
Meredith LeBlanc, Psychiatry
Jodi Lee, RN, OR
Katrina Masure, RN, ICN
Jennifer Mesrobian,
D-H Manchester, NCCC
Nichole Moorhead, RN, OR
Randy McDonald, RN, CVCC
Katherine McGuire, LPN,
D-H Keene Family Medicine
Amy Parthum, RN, Patient
Placement Services
Susan Perron, Medical Specialties
Jedidiah Peterson, RN, ED
Beverly Poljacik, RN, ICU
Angela Price, RN, 2 West
Sara Roebuck, RN, Hematology
Oncology
Mildred Sattler, RN, ED
Erika Seitz, 3 West
Carly Sheehan, RN, Nashua
Women’s Health
Lauren St. Pierre, Manchester
Family Practice
Rachel Traendly, OR
Jennifer Walker, RN, OR
Jennifer Wasilauskas, RN, OR
Lisa Wesinger, RN, HSCU
Heather Worster, LPN,
D-H Manchester, NCCC
Kerry Wulpern, RN, ICCU
Other Awards
Areté Awards
Amy Arbour, RN, HSCU
Diane Beattie, RN, OR
Catherine Bourgon, RN, OSC
Kate Bryant, RN, 3 West
Barbara Condon, RN, ICCU
Terri Farnham, RN, ISCU
Susan Gordon, RN, Birthing Pavilion
Greg Jenkins, RN, Life Safety
Myra Kebalka, RN, NSCU
Christopher Killam, RN, PACU
Sarah King, RN, Same Day Surgery
Sharon Markowitz, RN, Care
Management
Perri Maxham, RN, ICU
Sterling Moffat, RN, ICN
Sundi Morgan, RN, Ortho Clinic
Susan Nyberg, RN, 2 West
Kristal Renaudette, RN,
Hematology-Oncology St. Johnsbury
Allison Rosmus, RN, CVCC
Valerie Rude, RN, 4 West
Kimberly Shannon, RN, 1 West
Laura Walker, RN, Pediatrics
Tracy Webster, RN, DHART
Katharine Weeks, RN, Pediatric Clinic
The Deborah Miller, ARNP,
CNM, MPH, Award for Advanced
Practice in Nursing
Margaret Bishop, APRN
The Barbara Agnew, RN, Magnet
Award for Mentorship
Wendy Piburn, RN
The Marianne Markwell,
RN, Commitment Award for
Neuroscience Nursing
Becky Campbell, RN
The Rolf Olsen Partnership
in Nursing Award
Stephen Burlew
The Donna Crowley Excellence
in Nursing Leadership Award
Karen Pushee, RN
New Knowledge, Innovations and
Improvements Award
Mark Alderson, RN
Sheila Johnson, RN
DAISY Awards
Neuro Special Care Unit
Janice Gregory, RN, Infectious
Disease
Renee Thompson, RN, Same Day
Surgery
Sara McMillan, RN, ISCU
Amelia Cormier, RN, 2 West
Chelsea Curran, RN, ICN
Laura Walker, RN, Pediatrics
Sarah Brannigan, RN, 4 West
Ansel Erickson-Zinter, RN, 3 West
Elizabeth McDaniels, RN, Psychiatry
Sharlene Jacques, LPN, Merrimack
Family Practice
Sandy Williamson, RN, Medical
Specialties
Cheryl Abbott, MSN (c), CNRN
received the 2012 Clint Jones New
Hampshire Nursing Award of the
New Hampshire Foundation for
Healthy Communities
Barbara Bradford, RN, COHN
received the Medique Award, provided
by participating state associations to
an outstanding Occupational Health
Nurse Member who has exhibited
leadership in participating in the
association and professional activities.
Julie Buelte, MSN, CNM, APRN
received the Giesel School of Medicine
Excellence in Teaching Award.
Lynne Chase, MPH, RN
received Dr. Pamela Fuller Founder’s
Scholarship through Sigma Theta Tau
for her research study, “The Role of
Nursing in Health Policy Development in
the Middle East: An Exploratory Study.”
Michael Durkin, MHA, RN
received a certificate in the
Fundamentals of Value-based Health
Care from The Dartmouth Institute.
Deborah Gardner, BSN, RN-BC
received the Travel Award 2012 from the
Association of Child Neurology Nurses.
Debra Hastings, PhD, RN-BC
was awarded the Honorable William
D. Paine II Award from the NH
Department of Justice, Office of
the Attorney General. Debra was
also inducted into the NH Coalition
against Domestic and Sexual Violence
Hall of Fame.
Carly Sheehan, RN
received a Reproductive
Endocrinology and Infertility Nurse
Certificate from the American Society
for Reproductive Medicine.
Steve Thomas, MSN, RN, CCRN
was selected to participate in the 2013
AONE Nurse Fellowship Program.
Grants Awarded
James N. Dionne-Odom, MSN, RN
received a 2013 AACN-Sigma Theta
Tau Critical Care Grant for his
proposal, “Generating a Theoretical
Model of the Psychological Processes
of Surrogate Decision Making at
Adult End of Life in the ICU Using
Cognitive Task Analysis.”
Professional Activities
Barbara Bradford, RN, COHN
Secretary, NH Association for
Occupational Health Nurses
Janice Chapman, RN
Member, Vermont Cardiac Network
Conference Committee
Elda Cordero-Goodman, MS, APRN
President, Bedford Lions Club and
Zone Chairperson
Joyce Dupont, RN
Notary Public, National Notary
Debra Hastings, PhD, RN-BC
Editorial Review Board: Duchscher,
J.E.B. From Surviving to Thriving:
Navigating the First Year of
Professional Nursing Practice.
Nursing the Future, Canada.
Sharon Houle, BSN, RN
Member, Division of Child Youth
and Family Advisory Committee
Lisa Lamadriz, BS, RN, IBCLC
Co-chair, NH Breastfeeding Task
Force
Certifications
25

Kyle Madigan, MSN, RN, CMTE,
CFRN, CCRN, CEN, CTRN
Chairperson, Examination
Construction Review Committee
Member at Large, Board of
Directors: Air Surface Transport
Nurses Association
Kim Maynard, BSN, RN
Treasurer, Local Chapter of the
Oncology Nursing Society
Elizabeth McGrath, MSN, AG-ACNP-
BC, AOCNP, ACHPN
President, NH/VT Chapter,
Oncology Nursing Society
Christopher O’Connell, MSN, RN,
CFRN
Battalion Executive Officer, 405th
Combat Support Hospital USAR
Colonel, USAR Nurse Corps
Kelly Smith, BSN, RN
Ambassador, Medtronics for Deep
Brain Stimulation (DBS)
Guest Speaker, Parkinson’s Disease
and ET support groups regarding
DBS
Grace St. Pierre, BSN, RN
Director at Large, Board of
Directors, New Hampshire Nurses
Association
Evie Stacy, MS, APRN
President Elect, NH Nurse
Practitioner Association
Co-chair, Education Committee,
NH Nurse Practitioner Association
Maureen Stannard, RN, OCN
Secretary, Susan G. Komen For a
Cure VT/NH Affiliate
Linda Thompson, BSN, RN, CNOR
Treasurer, AORN, NH Chapter
Patricia Tobin, LPN
Guest Speaker, NHTI Pinning
Ceremony for LPNs
Board of Directors, National
Federation of Practical Nurses
Membership Chair and President’s
Chair, National Federation of
Practical Nurses Association
Lynne Weihrauch, MSN, FNP
Member, NH HIV/AIDS Planning
Group
Colleen Whatley, MSN, CNS-BC,
RNC-OB
Coordinating Team Member, NH
Association of Women’s Health,
Obstetric and Neonatal Nurses
Publications
Didehbani, T., Martin, C.B.,
Szczepiorkowski, Z., Dunbar,
N., Klinker, K. (2012). Nurse’s
Perspective on Symptom
Management of Citrate
Toxicity during Extracorporeal
Photophoresis Procedures where
Acid Citrate Dextrose (ACD-A) is
used as anticoagulant. Journal of
Clinical Apheresis, 27(1), 50.
Dionne-Odom, J.N., Bakitas, M.B.
(2012). Why Surrogates Don’t Make
Decisions the Way We Think They
Ought To: Insights from Moral
Pyschology. Journal of Hospice and
Palliative Care, 14(2), 99-106.
George, H., Davis, S., Mitchell,
C., Moyer, N., Toner, C. (2012).
Abstraction of Core Measure Data:
Creating a Process for Interrater
Reliability. Journal of Nursing Care
Quality, 28(1), 68-75.
Kirkland, K., Homa, K., Lasky,
R. (2012). Impact of a hospital-
wide hand hygiene initiative on
healthcare-associated infections:
results of an interrupted time
series. BMJ Quality Safety, 21(12),
1019-1026.
Splaine, M., Brown, J., Melon, C.,
Lasky, R., Foster, T., Batalden, P.
(2012) Better System Performance:
Approaches to Improving Care
by Addressing Different Levels of
Systems. In Paul Batalden and Tina
Foster (Eds) Sustainably Improving
Health Care: Creatively linking
outcomes, system performance and
professional development. New
York, NY: Radcliffe Publishing.
Wood, M. (2012) Diabetes Mellitus.
In T. Buttaro, J. Trybulski, P. Bailey,
J. Sandberg-Cook (Eds) Primary
Care: A Collaborative Practice. St.
Louis, MO: Elsevier.
Presentations
Abbott, C. and Golightly, M.
Anti-depressants and the Neuro
Patient: Emerging Evidence for
Multi-facted Benefits.
Gadsby, S. Sports Concussion,
Implications for School Nurses.
Sports Safety. Nashua, NH
(October).
Gardner, D. Handle with Care.
Association of Child Neurology
Nurses. Huntington Beach, CA
(October).
Martin, C. Nurse’s Perspective on
Symptom Management of Citrate
Toxicity during Extracorporeal
Photopheresis Procedures where
Acid Citrate Dextrose (ACD-A) is
used as anticoagulant. American
Society for Apheresis Annual
Meeting. Atlanta, GA (April).
Martin, D. Shoulder Dystocia
Update: Minimizing risks to mothers,
babies, and providers. American
College of Nurse-Midwives Annual
Meeting. Long Beach, CA (June).
Maynard, K. Hemovigilance and
Transfusion Safety. Patient Blood
Management: Patient Care and
Outcome Strategies Workshop.
Boston, MA (October).
McGrath, E., Pace, C., Urquhart,
L. Dimensions of Survivorship: Are
We Prepared? 15th Annual Breast
Cancer Conference. Burlington, VT
(October).
Pelletier, A. Helpful Apps for
the Health Office. School Nurse
Symposium. Bedford, NH
(October).
Smith, S. Retained Surgical Items.
CNOR Review Course, AORN
Local Chapter. Lebanon, NH
(November).
Stacy, E. ADHD: Management
in Children and Adolescents.
Northeast Regional Nurse
Practitioner Conference.
Manchester, NH (May).
Thompson, L. Minimally Invasive
Surgery. CNOR Study Course,
AORN Local Chapter. Lebanon,
NH (November).
Tobin, P. Laughter for the Weary
LPN. National Federation of
LPN Association. Las Vegas: NV
(October).
Wood, M. The Hospitalized
Patient with Diabetes: Enhancing
Clinical Practice. Diabetes in the
21st Century: Raising the Bar.
Plattsburgh, NY (May).
Wood, M. Conventional and
Newfangled Diabetes Medications.
Diabetes Today Conference.
Whitefield, NH (November).
Poster Presentations
Doton, K.A. Improving Access to
Patient and Family Centered Spina
Bifida Care with a Multidisciplinary
Group Medical Appointment. The
Future is Now Second World
Congress on Spina Bifida Research
and Care. Las Vegas, NV (March).
Lloyd, D., Mecchella, J.,
Albert, D. Baseline Screening
Recommendations for Rheumatoid
Arthritis Patients Treated with
Disease Modifying Anti-rheumatic
Drugs: Does an Educational
Intervention Change Practice in
an Outpatient Clinic? American
College of Rheumatology.
Washington, DC (November).
McGrath, E., Pace, C. Barriers
and Facilitators to Implementing
Survivorship Care Plans. NNECOS
Annual Meeting and Palliative
Care Symposium. Rockport, ME
(October).
Prior, E., Wasilauskas, J. Chocolate
Treat Preferences Study: A
Deliciously Easy Approach to
Learning about Research. Fourth
Annual Nursing Research
and Evidence Based Practice
Symposium: Creating a Research
Environment. Burlington, VT
(November).
Certifications
26

Cover: Emily Brown, nurse extern, Colby-Swayer College, center; and Danielle Cantin, BSN, RN, right | Inside back cover: Nancy Lee Vadnais, RN
Editors: Victoria McCandless; Anne Clemens. Design: Erin Higgins. Writer: Dana Cook Grossman. Photography: Mark Washburn. Project Management: Katherine Beinder

Dartmouth Hitchcock Nursing Year in Review 2012

Dartmouth Hitchcock Nursing Year in Review 2012

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